Short Form Health Survey Questionnaire Research Articles

Does baseline EEG activity differ in the transition to or from a chronic pain state? A longitudinal study.

Identifying EEG brain markers might yield better mechanistic insights into how chronic pain develops and could be treated. An existing longitudinal EEG study gave us the opportunity to determine whether the development of pain is accompanied by less alpha power-ie, a "relaxed" brain state-and vice versa. Five-minute resting EEG with the eyes open was measured 2 times in 95 subjects at T0 (baseline) and T1 (6months later). Based on the Short-Form Health Survey and Brief Pain Inventory questionnaire, subjects were divided into 4 groups: staying pain-free (n=44), developing chronic pain (n=8), becoming pain-free (n=15), and ongoing chronic pain (n=28). The EEG data of 14 electrodes were analyzed by multilevel regression. The group that developed chronic pain demonstrated less power in the lower-frequency bands over time during the resting state EEG, whereas the transition to a pain-free state had the opposite pattern. Thus, the a priori hypothesis was confirmed. Transitions in pain states are linked to a change in baseline EEG activity. Future research is needed to replicate these results in a larger study sample and in targeted clinical populations. Furthermore, these results might be beneficial in optimizing neurofeedback algorithms for the treatment of chronic pain.

P218 It is time to grow up: readiness is associated with better outcomes in a prospective study of pediatric transition patients with Inflammatory Bowel Disease

Abstract Background Approximately 25% of patients with inflammatory bowel disease (IBD) are diagnosed before age 20, making the transition from paediatric to adult healthcare challenging due to the high burden of these diseases at a critical time, such as adolescence. We aimed to assess patients’ readiness to transition from paediatric to adult IBD services and the impact on clinical outcomes. We further investigated adherence and quality of life at 12 months post- structured transition clinic Methods An observational, prospective study was conducted in a tertiary adult and paediatric IBD centre including adolescent aged≥17yo with a confirmed diagnosis of IBD before 16yo and in clinical remission who underwent “structured transition”. We collected demographics and clinical data 12 months before and after the transition visit. At the time of recruitment patients filled out the Transition Readiness Assessment Questionnaire (TRAQ) and they were defined ready based on a mean TRAQ value ≥ 3.0. The Morisky Medication Adherence Scale (MMAS) and the Short Form Health Survey (SF36) Questionnaire were completed baseline and 12 months after transition clinic. Receiving operating characteristics (ROC) curve was used to determine cut-off values of TRAQ for predicting medication adherence.We further investigated which demographic and clinical parameters could predict medication adherence. Results We enrolled 60 patients in clinical remission based on Crohn’s Disease Activity Index (CDAI) score of 115±124 for CD and pMayo 2,85±1,3 for UC, who had transitioned throughout transition clinic to adult care and completed 12 months follow-up [Table1]. Overall 42 patients (70%) were considered ready for transition, with a mean TRAQ score=3,2±0,5. The number of outpatient visits(1,86±0,75vs2,28±1,2;p<0,02) as well as the number of clinical relapses (0,38±0,4vs1,06±0,9;p<0,02) and hospitalizations (0,05±0,1vs0,33±0,33;p<0,05) at 12 months were significantly lower in ready than in not-ready patients. The quality of life did not differ pre-and 12 months post-transition clinic(p=0,09) and between ready and not-ready patients (p=0,71)[Table2]. Based on ROC curve a TRAQ cut-off≥3,46 could predict medication adherence with a sensibility of 55%,specificity 86% and an AUC=0,71(0,57-0,85;p=0,008)[Fig1]. At multivariate analysis, a high mean TRAQ value was associated with medication adherence at 12 months (OR:7,042CI:1,68-29,54,p=0.008) Conclusion Patients ready for transition were more likely to have fewer outpatient visits,disease flares and hospitalizations compared to not-ready patients. The quality of life did not differ pre- and post transition and between ready and not-ready patients.TRAQ score could be a reliable tool with high specificity to predict medication adherence

Quality of life in Werner syndrome and associated subjective foot/ankle symptoms: A cross-sectional survey.

The aims of this study were to assess the general quality of life and foot/ankle health-related quality of life among subjects with Werner syndrome (WS) and to determine subjective foot/ankle symptoms associated with quality of life. Using a questionnaire survey, patients were asked to provide information on age, sex and presence of subjective symptoms and complete both the 36-Item Short Form Health Survey (SF-36) questionnaire and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q). Statistical analyses were performed using Student's t-test, the Mann-Whitney U test, Fisher's exact test and Spearman's rank correlation. Data from 12 patients with an average age of 54 ± 8.6 years were analyzed. The mean SF-36 score for the domain of physical functioning was 21.2; for role-physical function, 32.6; for bodily pain, 38.5; for general health, 34.4; for vitality, 44.8; for social function, 38.5; for role-emotional function and for mental health, 46.7. The mean mental component summary was as high as the national standard, but it was low in men. The mean SAFE-Q scores were also low. Patients with ulcers had significantly more pain and low general health perception. As compared with the national standard, the role/social component score was not low, and there was a correlation in most domains of the SAFE-Q. In WS, the general health-related quality of life was low overall in the physical domain and low only in men for the mental domain, whereas it was low in the social domain when foot/ankle health-related quality of life was low. Geriatr Gerontol Int 2023; 23: 188-193.

Clinical characteristics and quality of life in patients with inflammatory bowel disease-associated anemia in Southeast China.

Clinical characteristics of inflammatory bowel disease (IBD) with anemia have not been fully elucidated. This study aimed to investigate the frequency of, risk factors for, and management of anemia in IBD patients and to evaluate the quality of life (QOL) in IBD patients with anemia. We included two patient cohorts. In cohort 1, clinical data from 697 IBD patients were retrospectively collected. In cohort 2, the Short Form-36 Health Survey (SF-36) and Fatigue Scale-14 (FS-14) questionnaires for IBD patients were completed to evaluate the QOL. Anemia was present in 35.6% of IBD patients [38.2% of Crohn's disease (CD) patients vs. 29.3% of ulcerative colitis (UC) patients, P = 0.025]. Elevated platelet (PLT) count (CD: OR, 1.004; 95% CI, 1.001-1.007; P = 0.007; UC: OR, 1.010; 95% CI, 1.004-1.016; P = 0.001), elevated erythrocyte sedimentation rate (ESR) (CD: OR, 1.024; 95% CI, 1.012-1.036; P < 0.001; UC: OR, 1.025; 95% CI, 1.001-1.051; P = 0.044), and lower albumin levels (CD: OR, 0.801; 95% CI, 0.749-0.857; P < 0.001; UC: OR, 0.789; 95% CI, 0.720-0.864; P < 0.001) were associated with anemia. Among the IBD patients with anemia, only 25.8% received treatment for anemia. IBD patients with anemia had significantly lower SF-36 scores (P = 0.011) and higher FS-14 scores (P = 0.026) than those without anemia. Anemia is common in IBD patients. Elevated PLT count and ESR are risk factors for anemia in IBD patients. Anemia may negatively impact IBD patients' QOL, but few anemia patients receive treatment for anemia.

Assessment of Behavioural Preparedness on Recovery Outcomes in Patients Undergoing Abdominal Surgeries

Introduction: Behavioural preparedness is the process of preparing patients for the psychological and emotional challenges that may be encountered during and after surgery. This can include providing education about the surgical procedure and postoperative recovery, as well as training in coping strategies and techniques to manage anxiety, fear, and other negative emotions. Prior sensitisation is a form of behavioural preparedness that involves providing patients with information about the potential outcomes of their surgery in advance, in order to help them better understand and prepare for potential challenges. It has been suggested that providing this type of education and training may reduce patient anxiety, increase co-operation with medical staff, and improve recovery, potentially leading to shorter hospital stays and reduced medication needs. Aim: To assess the effects of behavioural preparedness and prior sensitisation on psychological aspects, recovery outcomes, and user satisfaction in patients undergoing abdominal surgeries. Materials and Methods: The study will be undertaken on patients in the Inpatient Department (IPD) of Department of Surgery in a rural tertiary care hospital in central India, during a period spanning two months. All adult patients (aged 18-60) undergoing elective abdominal surgical procedures under anaesthesia in the IPD of surgery will be eligible. The patients will be randomly selected and interviewed preoperatively, dividing them into two groups those receiving the intervention and those receiving standard care with no intervention. The investigator will provide an oral presentation to the intervention group regarding their recovery outcomes and expectations. Subjects will be evaluated with a Visual Analog Scale (VAS) scale for pain, RAND Short Form health Survey (SF36) questionnaire for physical mobility, RAND Patient Satisfaction Questionnaire III (PSQ-18) instrument for user satisfaction, length of hospital stay and analgesic switchover time on a survey form and the Spielberger State-Trait Anxiety Inventory (STAI) forms Y1 and Y2 for comparison of preoperative and postoperative negative affects. Effects of the intervention on recovery outcomes will be compared via the Chi-square test, the Mann-Whitney U test for comparison of qualitative data between the two groups and the Student’s Unpaired t-test for comparison of quantitative data between the groups. Wilcoxon’s Signed Rank test and the Student’s paired t-test will be used for analysing qualitative and quantitative input between preoperative and postoperative states. Conclusion: The study seeks to determine if a significant difference occurs from providing patients withprior knowledge about their outcomes and establishing the benefits of psychological preparedness as a cost-effective method in improving outcomes and postoperative recovery

Quality of life assessment in patients with temporomandibular disorder with stabilization splints and home therapeutic exercises: a randomized clinical trial

Objective: The present study aimed to evaluate the quality of life in TMD patients with the use of Stabilization Splints (SSs) and Home Therapeutic Exercises (HTEs) guidance. Material and Methods: The study was a clinical, randomized, controlled, prospective, and interventional trial. The screening included dentate patients of both genders, diagnosed with TMD through the RDC/TMD questionnaire with no TMJ osteoarthritis and/or osteoarthrosis. To assess the quality of life, the Short-Form Health Survey (SF-36) questionnaire was applied to all patients (n=70), randomized into a test group with SS and a control group with HTE. The evaluations of both questionnaires were performed before and after the intervention of 12 weeks. Results: The comparisons between pre- and post-intervention intragroups were performed by the non-parametric Wilcoxon test with a 5% significance level. There was a frequency distribution of the responses to the 36 items of the SF-36 questionnaire and comparisons between times. In the test group, 49 patients received a SS and did HTEs. In the control group, 21 patients performed HTEs. In the statistical analysis, among the eight domains, three were identified with significant scores: pain, mental health, and vitality. Conclusion: It was found that there was an improvement in pain and quality of life after the treatment of TMD with a SS and HTE. KEYWORDS Clinical trial; Quality of life; Stabilization splint; Temporomandibular disorder; Therapeutic exercises.

Quality of Life and Metabolic Indicators of Patients with Type 2 Diabetes: A Cross-Sectional Study in Iran.

The World Health Organization (WHO) has considered type 2 diabetes mellitus (T2DM) a major global health challenge because of its high prevalence worldwide. T2DM can affect patients' personal, social, and economic statuses. On the other hand, due to the increasing prevalence of T2DM, Quality of Life (QOL) has received more attention in recent years. The present study was conducted to investigate the relationships between QOL and physical activity level, body mass index, fasting blood sugar, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride, total cholesterol, HbA1c, and systolic and diastolic blood pressure among Iranian patients with uncomplicated T2DM. This cross-sectional study was conducted on 135 participants selected through consecutive sampling. The study data were collected using International Physical Activity Questionnaire and Short-Form Health Survey Questionnaire. Then, the data were entered into the SPSS ver. 28 software, and Pearson's correlation was used to measure the correlation between the variables. Linear regression was also employed. The significance level was set at 0.05. The significant association was observed between gender (p = 0.007), HDL level (p = 0.02), and gender-adjusted physical activity (p = 0.002) with QOL. Due to the association between physical activity and HDL level with QOL in patients with uncomplicated T2DM, they should be given the necessary training to improve their physical activity and regulate HDL level. Also, empowering them in this matter improves their QOL.

Relationship Between Quality of Life and Level of Physical Activity and Family Well-Being

Study purpose. The objective of the study was to assess the relationship between quality of life and physical activity level and family well-being.&#x0D; Materials and Methods. The International Physical Activity Questionnaire (IPAQ) was used to assess parental physical activity. The quality of life was assessed with the Short Form (SF-36) Health Survey Questionnaire. The data obtained were processed using cluster and correlation analysis, and descriptive statistics. The study involved 106 young adults (married couples), who were parents of preschool and primary school-aged children.&#x0D; Results. An assessment of parental physical activity showed that 62.3% of the respondents had a low level of physical activity and 37.7% had a moderate level, whereas no individuals with a high level of physical activity were found. Families with children were divided into clusters with the k-means method according to the level of physical activity: Cluster 1 included families with a low level of physical activity; and Cluster 2 included the families with a moderate level of physical activity. The results of the study confirmed the relationship between the quality of life and the level of physical activity and family well-being. It was found that all the quality of life components of the study participants with a moderate level of physical activity are significantly higher (р&lt;0.05) than those of the participants with a low level of physical activity. Correlation analysis of family well-being and quality of life indicators revealed significant relationships (p&lt;0.05) between physical functioning, physical role functioning, vitality, and mental health.&#x0D; Conclusions. The direct statistically significant relationship between family well-being score and quality of life components of the respondents was demonstrated.

High-intensity laser therapy (class IV) and ibuprofen gel phonophoresis for treating knee osteoarthritis among people living in hilly terrain: a randomized, double blind, multi-centre trial protocol

INTRODUCTION: People living in hilly terrain with abnormal cyclic loading could lead to bone cartilage degeneration. High-intensity laser therapy (HILT) and Ibuprofen gel phonophoresis (IGP) have innumerable benefits for patients with knee osteoarthritis (KOA). However, it is still unclear which treatment is effective among them in rehabilitating patients with KOA. OBJECTIVE: To verify whether 8-week HILT is no worse than the IGP in treating patients with knee osteoarthritis living in hilly terrain. MATERIALS AND METHODS: A total of 108 individuals with KOA will be recruited by simple random sampling to participate in a randomized, double-blind, controlled study. Recruited individuals with KOA will be randomly divided into two groups, the HILT group (experimental group) and the IGP group (active control group). The treatment duration of HILT and IGP will be 8 minutes in one session/knee joint for each day for 3 days/week up to 8 weeks in addition to their conventional exercises for 30 minutes. The Western Ontario and McMaster Universities Osteoarthritis Index, Digitalized pain pressure algometer, and 36-Item Short-Form Health Survey questionnaire are the outcome measures that will be recorded at baseline, end of the 8-week post-intervention period. PERSPECTIVES: The results from this trial will contribute to evidence-based recommendations for the clinical implication of whether HILT is no worse than IGP, along with exercise intervention for treating individuals with KOA living in hilly terrain. Trial Registry: Clinical Trials Registry (NCT04320914)

Is group-based physical therapy superior to individual rehabilitation in elderly adults after total knee arthroplasty? A prospective observational study.

Knee osteoarthritis (OA) is the most prevalent joint disease and one of the leading causes of disability, poor physical activity levels (PAL), and quality of life (Qol) of elderly people worldwide. The purpose of this study was to evaluate the superiority of a novel group-based physical therapy (GBPT) intervention compared to a more traditional one-to-one individual physical therapy (IPT) among elderly Bulgarian subjects underwent total knee arthroplasty (TKA). One hundred and thirty elderly TKA recipients of both genders with mean age=72.69±0.44 were randomly assigned to GBPT or to one-to-one IPT. Elderly participants were assessed at baseline and at 3 and 6 months after both rehabilitation interventions, with the use of the following evaluation tools: Physical Activity Scale for the Elderly (PASE), Six-Minute Walk Test (6MWT), and Short Form Health Survey questionnaire (SF-36v2). At 6 months elderly TKA recipients who received GBPT achieved 7.36 points more in the PASE questionnaire when compared with the IPT group. Elderly participants of the GBPT group walked significantly longer distance during the 6MWT than TKA recipients attended IPT, respectively 421.56 m vs. 398.62 m, (p< 0.001). Furthermore, significantly greater improvement in health-related quality of life (HRQoL) was obtained from the elderly participants of the GBPT arm compared with the participants of the IPT arm, respectively 70, 7% vs. 60, 8% at 6 months follow up. We conclude that our results suggest the superiority of the GBPT in terms of PAL (PASE score, 6MWT) and HRQoL among elderly TKA recipients across the first 6 months.

Comparative assessment of the quality of life and the effectiveness of treatment in patients after early and delayed anterior cruciate ligament reconstruction

Background. In modern medical practice, a significant interest in the study of quality of life is manifested in the biopsychosocial approach, which indicates the concept of a holistic view of the course of the disease and the effectiveness of treatment.&#x0D; Aim. To give a comparative assessment of the quality of life and the effectiveness of treatment of patients after early and delayed reconstruction of an isolated injury of the anterior cruciate ligament.&#x0D; Material and methods. The results of a survey of 782 patients aged 1854 years according to the international standardized questionnaire of the quality of life (SF-36 Short Form-36 Health Survey Questionnaire) before and after arthroscopic reconstruction of an isolated injury of the anterior cruciate ligament using a free autograft from the tendons of the semitendinosus and tender muscles are presented. All patients were divided into two groups. The first group included 403 patients (232 males and 171 females), anterior cruciate ligament plasty was performed at an early stage, from the 1st to the 6th week after the injury. The second group included 379 patients (211 males and 168 females) who were operated on late, from the 7th week to 1 year after the injury. Statistical analysis was performed using the Statistica 12.0 program (Stat Soft, Inc.). The significance of differences between independent samples was determined using nonparametric tests: the MannWhitney U test and the Wilcoxon T test.&#x0D; Results. It was found that 1 year after the operation, in patients of the first group, the values of the treatment effectiveness indicator in terms of the total indicator of physical and mental components of health are significantly higher compared to the second group (p 0.0001, MannWhitney U-test). A high correlation between the indicators of treatment effectiveness according to the assessment scales of the physical component of health and the mental component of health in groups depending on the timing of the reconstruction of the anterior cruciate ligament was found. Thus, the Spearman's rank correlation coefficient in the first group between the indicators of treatment effectiveness in terms of the total indicator of the physical and mental components of health was r=0.79 (p=0.001), and in the second group r=0.71 (p=0.001).&#x0D; Conclusion. The long-term results of assessing the quality of life of patients indicate the predominant effectiveness of the treatment of patients operated on in the early stages after injury, compared with delayed surgery.

The Impact of Dorsal Root Ganglion Stimulation on Pain Levels and Functionality in Patients With Chronic Postsurgical Knee Pain

BackgroundChronic postsurgical pain is a considerable source of disabling neuropathic pain. Rates of knee replacement surgeries are increasing, and many patients report chronic postsurgical pain in their wake. When conventional therapies prove ineffective, neuromodulation options such as dorsal root ganglion stimulation (DRGS) may be used. However, little is known about the effect of DRGS on improvements in quantitative functional outcome parameters. Materials and MethodsIn a prospective observational study at two pain centers, patients with chronic postsurgical knee pain underwent implantation with a DRGS system after an interdisciplinary multimodal pain program. Ratings of pain, mood, quality of life, and function were captured at baseline and through 12 months of treatment. Quantitative measures (range of motion, walking distance, and pain medication usage) were also recorded. ResultsVisual analog scale ratings of pain decreased from 8.6 to 3.0 (p < 0.0001; N = 11), and other pain measures agreed. Quality of life on the 36-Item Short Form Health Survey questionnaire improved from 69.3 to 87.6 (p < 0.0001), whereas the improvement in depression ratings was nonsignificant. International Knee Documentation Committee questionnaire ratings of function improved from 27.7 to 51.7 (p < 0.0001), which aligned with other functional measures. On average, knee range of motion improved by 24.5°, and walking distance dramatically increased from 125 meters to 1481. Cessation of opioids, antidepressants, and/or anticonvulsants was achieved by 73% of participants. ConclusionsBoth subjective-based questionnaire and quantitative examination-based variables were in broad agreement on the value of DRGS in improving functionality and chronic postsurgical pain in the knee. Although this finding is limited by the small sample size, this intervention may have utility in the many cases in which pain becomes problematic after orthopedic knee surgery.

LONG-TERM QUALITY OF LIFE AND POSTTRAUMATIC STRESS FOLLOWING CARDIAC SURGERY: A 5-YEAR FOLLOW-UP STUDY.

<h3>Objective</h3> Heart surgery can have a significant negative effect on patients' quality of life (QoL) and may cause long-term posttraumatic stress reactions. We aimed to estimate the longitudinal change and predictors of health-related quality of life (HRQOL) and identify factors associated with posttraumatic stress (PTS) at 5-year follow-up after elective cardiac surgery. <h3>Methods</h3> Single-centre prospective study was conducted after Regional Bioethics Committee approval. Adult patients undergoing elective cardiac surgery at tertiary heart center were enrolled in the study. HRQOL was measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) questionnaire before and 5-years after cardiac surgery. PTS was assessed using the International Trauma Questionnaire. To estimate change in eight domains of HRQOL assessment between two measurement points (preoperativelly and 5 years after surgery) we performed statistical analysis using multivariate latent change modeling. <h3>Results</h3> A total of 286 patients were enrolled into the study. At 5-year follow-up 210 patients were contacted and included into final data analysis. Median age was 62.29 [19–84] years, and 70 % were male. 65 % of study participants underwent coronary artery bypass grafting (CABG). All study participants achieved statistically significant (p<0.001) improvement in Physical Functioning (PF) Mental Health (MH), Vitality (VT) and Social Functioning (SF) domains of HRQOL assessment. No significant shift was observed in General Health (GH) (p=0.067), Bodily Pain (BP) (p=0.248) and composite scores of Role Problems (RP (p=0.686)) and Emotional Problems (RE (p=0.169)) domains 5 years after surgery. Significant gender effects were found on mean levels of GH (βintercept=0.17, p=0.003), PF (βintercept=0.19, p<0.001), BP (βintercept=0.19, p<0.001), MH (βintercept=0.14, p=0.006), VT (βintercept=0.24, p<0.001) and SF (βintercept=0.11, p=0.019), indicating higher scores of these HRQOL domains before heart surgery in men, compared to women. There were no differences in the moderating effects of age, dyslipidemia, hypertension, reduced EF and higher EuroScore II. Patients undergoing valve and combined surgery reported a significant increase in GH, while this change was not observed in the CABG group. In total, 4 (1.9%) patients met the diagnostic criteria for cardiac surgery-related PTSD at 5-year follow-up. <h3>Conclusions</h3> There was an improvement in HRQOL five years after cardiac surgery. Lower rates of all SF-36 domains before surgery, valve and combined surgery were associated with more signifficant HRQOL improvement. Female gender was associated with lower scores in HRQOL before heart surgery, and poorer improvement of physical functioning in comparison to male patients. The incidence of PTSD was 1,9 % in a sample of cardiac patients at 5-year post cardiac surgery.

All-polyethylene tibia components have the same functional outcomes and survival, and are more cost-effective than metal-backed components in patients 70 years and older undergoing total knee arthroplasty

The tibial component of total knee arthroplasty can either be an all-polyethylene (AP) implant or a metal-backed (MB) implant. This study aims to compare the five-year functional outcomes of AP tibial components to MB components in patients aged over 70 years. Secondary aims are to compare quality of life, implant survivorship, and cost-effectiveness. A group of 130 patients who had received an AP tibial component were matched for demographic factors of age, BMI, American Society of Anesthesiologists (ASA) grade, sex, and preoperative Knee Society Score (KSS) to create a comparison group of 130 patients who received a MB tibial component. Functional outcome was assessed prospectively by KSS, quality of life by 12-Item Short-Form Health Survey questionnaire (SF-12), and range of motion (ROM), and implant survivorships were compared. The SF six-dimension (6D) was used to calculate the incremental cost effectiveness ratio (ICER) for AP compared to MB tibial components using quality-adjusted life year methodology. The AP group had a mean KSS-Knee of 83.4 (standard deviation (SD) 19.2) and the MB group a mean of 84.9 (SD 18.2; p = 0.631), while mean KSS-Function was 75.4 (SD 15.3) and 73.2 (SD 16.2 p = 0.472), respectively. The mental (44.3 vs 45.1; p = 0.464) and physical (44.8 vs 44.9; p = 0.893) dimensions of the SF-12 and ROM (97.9° vs 99.7°; p = 0.444) were not different between the groups. Implant survivorship at five years were 99.2% and 97.7% (p = 0.321). The AP group had a greater SF-6D gain of 0.145 compared to the MB group, with an associated cost saving of £406, which resulted in a negative ICER of -£406/0.145 = -£2,800. Therefore, the AP tibial component was dominant, being a more effective and less expensive intervention. There were no differences in functional outcomes or survivorship at five years between AP and MB tibial components in patients aged 70 years and older, however the AP component was shown to be more cost-effective. In the UK, only 1.4% of all total knee arthroplasties use an AP component; even a modest increase in usage nationally could lead to significant financial savings.Cite this article: Bone Jt Open2022;3(12):969-976.

Public policy Factors Associated with Effectiveness of Working Environment and Quality of Life among Military Policemen in Brazil

Brazil is a violent society and police officers play a fundamental role in this scenario. Police work is a stressful occupation, dealing with routine violence, police officers must have high standards of physical and mental health. The problem has a negative impact on the life quality of security officers, who play an important role in insecurity issues. Because without security, economic development is a futile dream. A cross-sectional design study investigated a random sample of 525 male military police officers, engaged in patrolling the streets of Salvador, Brazil. The accessible population was composed of all the 4700 military police officers from 32 battalions. The study included only males, engaged in visible patrolling in public spaces in the city, and excluded those who were on medical leave, engaged in administrative functions, or in specific situations not related to their core-activity. Health-related quality of life was evaluated through the 36-Item Short Form Health Survey Questionnaire (SF-36). Preliminary data collection required self-administered questionnaires for the target population. The expert applied the test re-test technique to choose the reliability of the exam study. To establish the relationship between the variables, Pearson correlation analysis was performed on the dependent and independent variables confidence interval. The study found that the Physical Component Summary was associated with poor work ability (P &lt; 0.001). The mean Physical Component Summary was 3.368 units lower among those with poor work.The study concludes that the military police officers investigated presented low health-related quality of life, associated with younger age, excessive alcohol consumption, and poor work ability. Therefore, improving police working environment through timely promotion will play an important role in improving the life quality of the Brazil’s military policemen. Keywords: Promotion procedure, Duty assignment, Deployment, Life quality, working conditions:

Peripheral Nerve Stimulation on the Brachial Plexus With Ultrasound-guided Percutaneous Technique: A Case Series

IntroductionThe aim of this case series was to assess the safety and effectiveness of peripheral nerve stimulation (PNS) of the brachial plexus performed using a low invasive percutaneous approach with ultrasound guide. Materials and MethodsPatients affected by neuropathic pain with a documented brachial plexus partial avulsion were included in this observational study. A totally implantable PNS system specifically designed for peripheral placement (Neurimpulse, Padua, Italy) was implanted and followed for 18 months, recording the level of pain (Numeric Rating Scale [NRS]), therapy satisfaction (Patient Global Impression of Improvement), quality of life (Short Form Health Survey questionnaire), and change in drug consumption and work status. Descriptive statistic (mean and SD) was used to compare pre- and postimplantation differences. ResultsA total of 18 patients were included in the observational study; 16 of them proceeded with the permanent implantation. System infection (N = 1) and lead migrations (N = 2) were recorded during a follow-up mean of 14.8 ± 5.4 months. The average NRS reduction at 18 months was 41%. Average quality-of-life physical and mental indexes increased by 14% and 32%, respectively. Drug intake was stopped in 22% and reduced in 56% of the patients. ConclusionsPNS systems of the brachial plexus implanted with percutaneous approach appear to be safe and effective in a follow-up period of 18 months. Longer and larger studies are needed to confirm and extend these outcomes.

Reliability and Validity of the Adapted Chinese Version of the Quality of Life Profile for Spine Deformities in Adolescents With Idiopathic Scoliosis.

Retrospective cohort study. To evaluate the cross-cultural adaptability and internal consistency of the Chinese version of the Quality-of-Life Profile for Spine Deformities (QLPSD) questionnaire in mainland China. The original QLPSD was translated from Spanish into Chinese with proper cross-cultural adaptation based on the American Academy of Orthopaedic Surgeons guidelines. A total of 129 AIS patients referring to our institution from February 2021 to January 2022 were enrolled in this study. The effects of ceiling and floor were evaluated and the reliability was verified by examining the internal consistency (the Cronbach's α coefficient). Interclass Correlation Coefficient (ICC) was used to test and retest reliability. The C-QLPSD dimensions were compared with the domains in Chinese version of 36-Item Short Form Health Survey (SF-36) and Scoliosis Research Society-22 (SRS-22) questionnaires using Pearson correlation coefficient to assess the concurrent validity. No significant floor and ceiling effects in C-QLPSD was observed. The total Cronbach's α was estimated at .914, ranging from .768 in back pain dimensions to .862 in psychosocial function dimensions. The C-QLPSD dimensions indicated satisfactory test-retest reliability with ICC range of .784-.870. Construct validity analysis revealed that C-QLPSD was well correlated with SRS-22 and SF-36. The values of total correlation coefficient were calculated at -.924 and -.871, respectively, which were both statistically significant (P < .05). The adapted Chinese version of QLPSD had good internal consistency and excellent test-retest reliability, which can be used to assess the outcome among Chinese-speaking patients with adolescent idiopathic scoliosis.

Differences in pain, disability, and psychological function in low back pain patients with and without anxiety

Objectives: Non-specific low back pain affects people of all ages and is a leading contributor to disease burden worldwide. Chronic low back pain (LBP) reduces working hours, increases comorbidities, and increases rehabilitation needs. The aim of this study was to evaluate whether there were differences in pain, dysfunction, and psychological factors between two groups. The supplementary demonstrated the relationship between these influencing factors and anxiety. Methods: A cross-sectional study was designed to analyze the differences in pain, disability, and psychological function in non-specific LBP patients with and without anxiety. In total, 60 subjects were divided into two groups based on self-rated anxiety scores: 30 patients with SAS score ≥50 were in the low back pain with anxiety group, and 30 for the LBP without anxiety group with SAS score <50. The pain intensity was assessed using the Visual Analog Scale; psychological function, using the Pain Anxiety Symptoms Scale, the Tampa Scale for Kinesiophobia, and the Fear Avoidance Beliefs Questionnaire; functional disability, using the Oswestry Disability Index and the Roland-Morris Disability Questionnaire; quality of life using 36-Item Short-Form Health Survey questionnaire; and the quality of sleep using Pittsburgh Sleep Quality Index, and the relationships between variables and anxiety scores were estimated using Spearman correlation analysis. Results: A total of 60 participants were enrolled after self-rated anxiety was assessed and the full investigation was finished. The analyses showed significant differences of pain intensity (p = 0.034, disability (ODI, p = 0.007; RMDQ, p = 0.012) and psychological function (TSK, p = 0.000; PASS, p = 0.009; FABQ, p = 0.000; SF-36, p = 0.000; and PSQI, p = 0.000) between the two groups. Spearman correlation analysis showed that the anxiety score had significant positive correlations with functional disability (ODI, p = 0.004 and 95% CI = 0.112-0.573; RMDQ, p = 0.003, 95% CI = 0.135-0.586) and psychological function (TSK, p = 0.001, 95% CI = 0.174-0.612), excellent positive correlation with quality of sleep (PASS, p = 0.025, 95% CI = 0.031-0.512), and strongly negative correlations with the quality of life (SF-36, p = 0.000, 95% CI = 0.761-0.433). Conclusion: We recognized that anxiety in low back pain patients was mainly due to interaction with the intensity of pain, disability level, and a mass of psychological function. The future research direction could be to alleviate the anxiety on the comprehensive efficacy of patients with low back pain.

The Quality of Life After Liver Transplantation-The First Experience from Serbia.

Background: Liver transplantation (LT) is the most effective treatment for patients with end-stage liver disease, which dramatically effects patient's quality of life (QoL). The aim of this study was to evaluate the impact of socio-demographic and clinical factors on different QoL domains of patients who underwent orthotopic LT. Methods: A cross-sectional study included a total of 43 patients who underwent a LT from 2013 to 2018. Socio-demographic and clinical data were recorded in each patient. The QoL was estimated using two validated questionnaires: 36-Item Short Form Health Survey (SF-36) and Chronic Liver Disease Questionnaire (CLDQ). Results: Male patients obtained significantly higher scores than women, in the domains of general health perception (83.2 ± 16.3 vs. 71.0 ± 18.4; t = 2.229, p = .031) and physical component summary (69.0 ± 7.2 vs. 62.0 ± 11.4; t = 2.451, p = .019). There were no significant differences in other domains of SF-36 and CLDQ. Etiology of the underlying liver disease and the presence of post-transplant complications showed no effect on score values of SF-36 and CDLQ domains (p < .05). Time from LT showed negative medium correlation with role limitations due to physical health problems (S = -0.417, p = .005), while no other significant correlations were noted in other items of SF-36 and CLDQ. Conclusions: Men had higher scores in the domain of general health perception and physical component summary following LT than women. With the increase in time from LT, patients experience a decrease in limitations due to physical health problems. The audit and improvement of QoL is an essential part of the individualized long-term health-care approach to LT patients.

The Relationship between Health-Related Fitness and Quality of Life in Nonalcoholic Fatty Liver Disease.

It is well known that patients with nonalcoholic fatty liver disease (NAFLD) suffer from impaired quality of life (QoL) and decreased health-related fitness. Studies on the relationship between them have been scarce. A cross-sectional survey was performed in 104 NAFLD patients. Liver fat content and fibrosis were assessed using transient elastography. Health-related fitness was measured by fitness test. VO2max was determined by YMCA submaximal cycle ergometer test. Body composition was tested by bioimpedance analysis. QoL was evaluated using the 36-item Short Form Health Survey Questionnaire (SF-36). Most patients had severe liver steatosis without significant fibrosis. Most of them exhibited poor health-related fitness. Multiple linear regression analyses demonstrated that body compositions (waist circumference, hip circumference, percent body fat, percent skeletal muscle, visceral fat area) dependently contributed to QoL (health transition, role limitation due to physical problem, general health, physical functioning and vitality). VO2max was positively related with physical functioning. For NAFLD patients, decreased health-related fitness was associated with impaired QoL both in the physical and mental dimension. Our results indicate that visceral fat together with muscle mass and VO2max could serve as individual exercise intervention targets to improve QoL.