Social Functioning Subscales Research Articles

Cross-cultural adaptation and validation of the reliability of the Thai version of the Hip disability and Osteoarthritis Outcome Score (HOOS)

HOOS was developed as an extension of the Western Ontario and McMaster Universities' Osteoarthritis Index questionnaire for measuring symptoms and functional limitations related to the hip(s) of patients with osteoarthritis. To determine the validity and reliability of the Thai version of the Hip disability and Osteoarthritis Outcome Score (HOOS) vis-à-vis hip osteoarthritis, the original HOOS was translated into a Thai version of HOOS, according to international recommendations. Patients with hip osteoarthritis (n=57; 25 males) were asked to complete the Thai version of HOOS twice: once then again after a 3-week interval. The test-retest reliability was analyzed using the intraclass correlation coefficient (ICC). Internal consistencies were analyzed using Cronbach's alpha, while the construct validity was tested by comparing the Thai HOOS with the Thai modified SF-36 and calculating the Spearman's rank correlation coefficients. The Thai HOOS produced good reliability (i.e., the ICC was greater than 0.9 in all five subscales). All of the Cronbach's alpha showed that the Thai HOOS had high internal consistency (Cronbach's alpha greater than 0.8), especially for the pain and ADL subscales (0.89 and 0.90, respectively). The Spearman's rank correlation for all five subscales of the Thai HOOS had moderate correlation with the Bodily Pain subscale of the Thai SF-36. The pain subscale of the Thai HOOS had a high correlation with the Vitality and Social Function subscales of the Thai SF-36 (r=0.55 and 0.54)-with which the symptom subscale had a moderate correlation. The Thai version of HOOS had excellent internal consistency, excellent test-retest reliability, and good construct validity. It can be used as a reliable tool for assessing quality of life for patients with hip osteoarthritis in Thailand.

Efficacy and safety of long-term cabergoline treatment of antipsychotic-induced hyperprolactinemia (naturalistic study)

IntroductionAntipsychotic-induced hyperpolactinemia (AIH) is associated with disturbing clinical symptoms, such as sexual dysfunctions, menstrual disorders and galactorrhea. Long-term studies of dopamine agonists in AIH are scarce.ObjectivesTo assess efficacy and safety of cabergoline use in psychiatric patients with AIH, including impact on sexual function and quality of life(QoL).MethodsIt was an open-labeled non-randomized naturalistic prospective comparison of cabergoline vs nо treatment in 84 chronic psychiatric patients (F/M = 77/7) with AIH. Cabergoline treatment was started in 44 patients, the сontrol group included 40 patients who rejected the treatment with cabergoline. For assessment of QoL, sexual dysfunction and other hyperprolactinemia symptoms, UKU side effects rating scale (UKU) and SF-36 were used.ResultsThe main and control groups were comparable on all main clinical and psychiatric characteristics. The effective cabergoline dose was 0,25-3 (median-0,5) mg weekly; total cabergoline exposure–534 patient-weeks. Normal prolactin levels were achieved after 4-44 (median-14) weeks in 95% of patients. At 3 months after cabergoline discontinuation, prolactin remained normal in 71%, and AIH recurred in 29% of patients. Prolactin normalization was associated with significant reduction of menstrual disorders, galactorrhea, improvement of UKU scores on sexual desire, orgastic dysfunction, total UKU score and SF-36 scores on subscales of social functioning (P = 0,006), role-emotional (P = 0,042), and mental health (P = 0,049). The rate of psychosis exacerbation in control group was higher than in the treatment group (37,5% vs 0%; P < 0,001).ConclusionsCabergoline is effective and safe in majority of AIH patients. Long-term cabergoline treatment is not associated with psychosis exacerbation. Beyond reversal of typical AIH symptoms, treatment with cabergolin improves sexual function and QoL.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Are physical activity, sedentary behaviors and sleep duration associated with body mass index-for-age and health-related quality of life among high school boys and girls?

BackgroundPrevious studies reported lower health-related quality of life (HRQOL) scores in overweight and obese adolescents compared to their normal weight counterparts; however, few studies investigated the association between obesity-related behaviors including physical activity and sedentary behaviors and HRQOL in adolescents. This study aimed at investigating the relationship between physical activity, sedentary behaviors, sleep duration and body mass index-for-age (BMI-for-age) and HRQOL among high school Tehranian students.MethodsA total of 465 high school students (48.8 % girls) were recruited from three different socio-economic zones in Tehran. The BMI-for-age was determined and physical activity and HRQOL were assessed using validated questionnaires including Quantification de l’Activite Physique en Altitude Chez les Enfants (QAPACE) and Pediatric Quality of Life Inventory (PedsQL) respectively.ResultsOver one third of students (38.5 %) were either overweight or obese. The means of all self- and parent-reported HRQOL scores were significantly lower in girls, compared to boys, except for the parent-reported social functioning subscale. Mean hours of daily sleeping were significantly higher in girls, compared to boys (8.16 ± 1.27 vs. 7.73 ± 1.22 respectively; p < 0.05). Both girls and boys spent more time on sedentary activities than engaging in sport activities. During school and vacation periods, boys had significantly higher daily energy expenditure (DEE) compared to girls (p < 0.05). Only DEE during school period had a significant inverse correlation with BMI-for-age in boys but not girls (r = −0.14, p < 0.05). In addition, self-reported HRQOL scores were significantly associated with weekly hours adolescents spent on videogames/internet, listening to music and reading, watching TV, sports as well as DEE through sex-specific patterns. However according to parents’ perspective only weekly hours spent on listening to music and readings and sport activities were significantly associated with their children HRQOL scores.ConclusionIn summary, time spent on physical and sedentary activities were not associated with BMI-for-age, although both of these were associated with the HRQOL of high school students. The potential role of sedentary activities and physical activity should be considered in future interventions aimed at improving HRQOL in adolescents.

Which questionnaires should we use to evaluate quality of life in patients with chronic graft-vs-host disease?

AimTo investigate the ability of two standard quality of life (QOL) questionnaires – The Short Form (36-item) Health Survey (SF-36) and The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ C30) to evaluate QOL in patients with chronic graft-vs-host disease (cGVHD) graded according to National Institutes of Health (NIH) consensus criteria.MethodsIn this cross-sectional study, QOL was assessed in patients who underwent allogeneic stem cell transplantation (allo-SCT) at the University Hospital Centre Zagreb and were alive and in complete remission for more than one year after allo-SCT.ResultsThe study included 58 patients, 38 patients with cGVHD and 20 controls, patients without cGVHD. Patients with cGVHD scored according to the NIH criteria had significantly lower scores of global health status and lower QOL on all SF-36 subscales and most of QLQ C30 functional subscales (P < 0.050 for all comparisons). Furthermore, patients with active cGVHD had significantly lower QOL scores than patients with inactive cGVHD, and this difference was most evident in physical functioning subscale of SF-36 (P = 0.0007) and social functioning subscale of QLQ C30 (P = 0.009).ConclusioncGVHD scored according to the NIH criteria is correlated with patient-reported QOL, particularly in the physical domains as detected by SF-36. QLQ C30 questionnaire adds more information on social functioning and should be used as a valuable tool in the evaluation of social domains in cGVHD patients.

Speech and Language Difficulties Along with Other Child and Family Factors Associated with Health Related Quality of Life of Australian Children

Speech and/or language difficulties (SaLD) can potentially compromise a child’s health-related quality-of-life (HRQoL). Very few studies have examined associations between SaLD, other child and family factors and HRQoL and none have been undertaken in Australia. We explore these associations using data from a nationally representative Australian sample of 4–5 year old children, extracted from the Longitudinal Study of Australian Children (LSAC) (n = 4386). The Disability-Stress-Coping Model informed variable selection. Three domains of HRQoL were examined, and assessed on physical, emotional and social functioning subscales of the Pediatric Quality of Life Inventory (PedsQL). SaLD measures included parent concern about speech/language (Parents’ Evaluation of Developmental Status) and receptive vocabulary ability (adapted Peabody Picture Vocabulary Test-III). Multiple regression analyses revealed that various child and family factors representing all constructs from the Disability-Stress-Coping Model were significantly associated with HRQoL. Specifically, HRQoL was positively associated with parental warmth and child’s general health and negatively associated with parent speech/language concerns and maternal depression across all domains. Parents with concerns about their pre-school child’s speech and language rate the quality of their child’s health more poorly across physical, emotional and social domains. Associations between parent speech/language concerns and HRQoL were notable for being apparent in a (non-clinical) population sample and for persisting independent of factors such as maternal depression, parenting style and the child’s general health.

Calidad de vida relacionada con la salud en pacientes con ataxias espinocerebelosas

IntroductionThe progressive deterioration of patients with spinocerebellar ataxia (SCA) has a major impact on their health-related quality of life (HRQOL). This study evaluates HRQOL in a sample of patients diagnosed with SCA and aims to estimate the predictive ability of a set of sociodemographic variables for the different dimensions of the General Health Questionnaire. MethodsA total of 80 patients diagnosed with SCA were assessed using a sociodemographic questionnaire and the SF-36 General Health Questionnaire. The sociodemographic variables studied were sex, age, presence of a carer, employment status, and time elapsed from diagnosis of the disease. ResultsThe 8 subscales of the SF-36 show positive and significant correlations to one another. Mean scores obtained on each SF-36 subscale differ between women and men, although this difference is significant only on the general health subscale, with men scoring higher than women. We found significant age differences on the vitality and social function subscales, with higher scores among younger patients (< 34 years). The variable ‘presence of a carer’ accounts for most of the total variance of the questionnaire. ConclusionsThe SF-36 is a valid and useful instrument for evaluating HRQOL in patients diagnosed with SCA. Presence of a carer seems to be a determinant of self-perceived quality of life in these patients.

Creation of a head and neck Keloid quality of life questionnaire.

Create a head-and-neck keloid quality of life (QOL) questionnaire. Demonstrate the reliability of the keloid-specific QOL scale according to test-retest and internal consistency standards. Prospective cohort study. Patients presenting to a keloid clinic in a tertiary referral institution between April 2012 and February 2013 were enrolled on their first visit. They were administered a questionnaire assessing demographics and a 21-item Likert keloid-specific survey assessing symptomatology, self-esteem, social functioning, and therapeutic motivation during their first three visits. Reliability of the keloid questionnaire was assessed for internal consistency (Cronbach's alpha) and test-retest correlations. Patients were treated with Kenalog steroid injections at each visit. The 126-point total score from the questionnaire was then compared to each subscale (physical symptoms, self-esteem, social function, and medical motivation) using a Pearson coefficient. The keloid QOL questionnaire showed a Cronbach's alpha of 0.87 for the overall questionnaire and ranged from 0.66 to 0.86 for individual questions. The test-retest Pearson's R was 0.70 between visits 1 and 2 and 0.77 between visits 2 and 3. The Pearson correlation between symptoms, self-esteem, social functioning, and medical motivation subscales and the overall scale were 0.77, 0.73, 0.72, and 0.57, respectively. This head and neck keloid-specific QOL questionnaire proved to be a reproducible method of reliably assessing QOL burden on patients with head and neck keloids. N/A.

Quality of Life and Psychological Screening in Children with Type 1 Diabetes and their Mothers.

This study aimed to assess the levels of depression in children with type 1 diabetes mellitus (T1DM) and evaluate the quality of life as well as levels of depression and anxiety of their mothers.30 children with T1DM (mean age: 12.9±2.9 years) and their mothers (mean age: 40.0±7.5 years) were included in the study. Control group consisted of 30 healthy children (mean age: 12.7±2.7 years) and their mothers (mean age: 39.8±7.2 years). The presence and severity of depressive symptoms in the children were evaluated using the Children's Depression Inventory (CDI). The short form 36-health survey (SF-36), the Beck Depression Inventory (BDI), and Spielberg's State-Trait Anxiety Inventory (STAI) were administered to all mothers.The children with T1DM had higher scores of depression compared to healthy children in the control group. The mothers of children with T1DM had significantly lower scores on all subscales of SF-36 except the bodily pain subscale. We observed a significant difference between groups in their BDI scores; the mean BDI score was higher in mothers of children with T1DM (p=0.004). There was a significant difference in STAI scores between groups. CDI scores positively correlated with the ages of and HgA1C levels in the children with T1DM. There was a positive correlation between CDI scores of children with T1DM and BDI scores of their mothers. In addition, CDI sores negatively correlated with the scores of vitality and social functioning subscales of SF-36.Our findings suggest screening for mental health issues and quality of life in diabetic children and their mothers.

Validity and Reliability of the Quality of Life in Epilepsy Inventory (QOLIE-31) for Turkey.

The purpose of this study was to evaluate reliability and validity of the 31-item Quality of Life in Epilepsy Inventory (QOLIE-31) in Turkish epileptic patients. This study was performed methodologically. To standardize the inventory, using a standard "forward-backward" translation and cultural adaptation procedure the English version of the QOLIE-31 was translated to Turkish. Language equivalence of the scale was provided. The opinions of experts were considered regarding the content validity of the scale. Reliability of the scale was determined with the test-retest reliability, item-total correlation and internal consistency analysis. For the construct validity, QOLIE-31 was compared with Nottingham Health Profile (NHP) scale and pre validity was determined. One hundred and forty-eight epileptic patients (62 females, 86 males), with a mean age of 32.5 (SD: 10.71) years were enrolled in the study. Content Validity Index of instrument was .85. Alpha reliability was .91. Item-total correlations were between .46 and .74 (p=.001). The mean score for the quality of life of epileptic patients was found to be moderate level (56.4; SD: 17.3). The mean score of Seizure Worry subscale was the lowest (48.9, SD: 29.82), while social function subscale (60.1, SD: 20.12) was found to be highest. As expected, correlations between QOLIE-31 and NHP subscales were fairly strong, particularly between those subscales with close or interdependent content. Thus, Emotional Well-Being correlated with NHP Emotional Reactions, Social Isolation and Pain; Social Function with NHP Social Isolation and Physical Mobility; Seizure Worry with NHP Social Isolation and Emotional Reactions; and Cognitive Function with NHP Energy, Emotional Reactions and Pain. The Turkish version of the QOLIE-31 questionnaire has good structural characteristics, is a reliable and valid instrument and can be used for measuring the effect of epilepsy on the quality of life.

Correlation Between Life Events and Quality of Life in Patients with Medication-Overuse Headache.

The present study aimed to determine (a) the correlation between type and number of stressful life events and quality of life in patients with medication-overuse headache (MOH) and (b) whether stressful life events could be attributed to medication overuse and the conversion of headache to a chronic type. The present study included 114 patients aged between 15 and 65 years who met the criteria for headache classification of International Headache Society (IHS). The patients were divided into three groups according to the revised 2004 IHS classification; MOH (n=64), chronic migraine (n=25) and episodic migraine (n=25). Detailed data on clinical and sociodemographic characteristics were recorded. Neurological and physical examinations were performed for differential diagnosis. The patients underwent structured clinical interviews for DSM-IV Inventory (SCID-I), Beck Anxiety Inventory, Beck Depression Inventory, Short Form-36 (SF-36) and Life Events List. Scores of these inventories were statistically compared. Comparing MOH group with episodic migraine group via SF-36, statistically significant decreases were observed in the subscales of physical role limitation (p=.024), pain (p=.0001), general health (p=.043) and social functioning (p=.004). There was a statistically significant correlation between the number of life events and the time the disease became chronic in the patient group with non-MOH chronic migraine (p=.027). Moreover, a statistically significant correlation was observed between stressful family life events and the body pain subscale of quality of life scale (p=.038). The present study demonstrates that stressful life events impair quality of life in patients with MOH. It was also found that number of stressful life events could be attributed to the conversion of headache to a chronic type.

Health related quality of life and self esteem of substance users in Bangladesh

This study explored health related quality of life (HRQoL) of substance users (SUs) in Bangladesh in comparison with healthy control groups (CGs). Additionally, role of self esteem and sex on HRQoL was investigated. A trained assistant counselling psychologist measured HRQoL and self‐esteem of 120 SUs and 120 CGs using SF‐36 questionnaire and Rosenberg Self Esteem scale, respectively. SUs were mostly male (79.2%) from middle socioeconomic class (94%). SUs scored poorer in all domains of SF‐36 than the CGs. The magnitude of the effect size was largest for the role physical (effect size = –0.79), general mental health (effect size = –0.76) and social functioning (effect size = –0.73) subscale. Overall mental health was lower than physical health (effect size = –0.897). Males in both groups were better in four sub‐scales while females reported less role limitation due to physical and emotional problems. Self esteem moderated HRQoL of both group with slightly higher magnitude for SUs. HRQoL of SU of Bangladesh was lower than the study population.&#x0D; Dhaka Univ. J. Biol. Sci. 24(2): 199-207, 2015 (July)

Short-form mindfulness-based stress reduction reduces anxiety and improves health-related quality of life in an inner-city population.

Mindfulness-based stress reduction is a mindfulness-based intervention that is an effective treatment modality for many conditions including stress, anxiety, and depression. Using data from 23 patients who completed a short-form mindfulness-based stress reduction course at a federally qualified health center, a quasi-experimental design was used to assess the impact of participation on self-reported anxiety, stress, mindfulness, and quality of life. Mindfulness and stress showed improvements from pre- to posttests, but neither difference achieved statistical significance. Participants showed statistically significant decreases in anxiety (7-item Generalized Anxiety Disorder scale score: 7.8-4.4; P = .005) and improvements in health-related quality of life including the 36-item Medical Outcomes Study Short Form Health Survey Mental Component Summary (+9.1; P = .001), Physical Functioning (+6.6; P = .039), Vitality (+16.1; P = .001), Social Functioning (+16.9; P = .003), Role Physical (+16.8; P = .016), and Mental Health (+15.6; P < .001) subscales. These findings suggest that an abbreviated mindfulness-based stress reduction course can serve to reduce anxiety and improve quality of life in an underserved population.

Physical activity, walking, and quality of life in women with depressive symptoms.

Physical activity (PA) has a positive association with health-related quality of life (HRQL) in the general population. The association between PA and HRQL in those with poor mental health is less clear. To examine the concurrent and prospective dose-response relationships between total PA (TPA) and walking only with HRQL in women aged 50-55 years with depressive symptoms in 2001. Participants were 1,904 women born in 1946-1951 who completed mailed surveys for the Australian Longitudinal Study on Women's Health in 2001, 2004, 2007, and 2010, and reported depressive symptoms in 2001. At each time point, they reported their weekly minutes of walking, moderate PA, and vigorous PA. A summary TPA score was created that accounted for differences in energy expenditure among the three PA types. Mixed models were used to examine associations between TPA and HRQL (short form-36 [SF-36] component and subscale scores) and between walking and HRQL, for women who reported walking as their only PA. Analyses were conducted in 2013-2014. Concurrently, higher levels of TPA and walking were associated with better HRQL (p<0.05). The strongest associations were found for physical functioning, vitality, and social functioning subscales. In prospective models, associations were attenuated, yet compared with women doing no TPA or walking, women doing "sufficient" TPA or walking had significantly better HRQL over time for most SF-36 scales. This study extends previous work by demonstrating trends between both TPA and walking and HRQL in women reporting depressive symptoms.

The prosthesis evaluation questionnaire: reliability and cross-validation of the Turkish version.

[Purpose] Currently, there are a limited number of amputee-specific instruments for measuring prosthesis-related quality of life with good psychometric properties in Turkey. This study translated the Prosthetic Evaluation Questionnaire to Turkish and analyzed as well as discussed its construct validity and internal consistency. [Subjects and Methods] The Prosthetic Evaluation Questionnaire was adapted for use in Turkish by forward/backward translation. The final Turkish version of this questionnaire was administered to 90 unilateral amputee patients. Second evaluation was possible in 83 participants within a median 28 day time period. [Results] Point estimates for the intraclass correlation coefficient ranged from 0.69 to 0.89 for all 9 Prosthetic Evaluation Questionnaire scales, indicating good correlation. Overall Cronbach’s alpha coefficients ranged from 0.64 to 0.92, except for the perceived response subscale of 0.39. The ambulation subscale was correlated with the physical functioning subscales of Short Form-36 (SF-36) (r=0.48). The social burden subscale score of the Prosthetic Evaluation Questionnaire was correlated with social functioning subscales of SF-36 (r= 0.63). [Conclusion] The Turkish version of the Prosthetic Evaluation Questionnaire is a valid and reliable tool for implementation in the Turkish unilateral amputee population.

Impact of Resistance Training on Quality of Life and Ischemia Modified Albumin Levels in Men with Cardiovascular Risk Factors

Purpose: There are limited data concerning the effects of Resistance Training (RT) on the components of Quality of Life (QOL) and Ischemia Modified Albumin (IMA) serum levels, even though QOL is an important characteristic related to the treatment success involving non communicable diseases. Studies regarding IMA and physical activity have focused only in the acute effects of exercise. Thereby, the purpose of this study is to investigate the effects of a moderate intensity RT on Health-related Quality of Life (HRQoL) and IMA levels in men with cardiovascular risk factors. Methods: Nineteen sedentary men (59 ± 8.63 years old) with metabolic syndrome (MS) com- ponents underwent a RT with sessions three times a week, comprising 12 exercises, during 12 weeks. The Short-Form 36 was administered to evaluate the domains of physical and mental components of HRQOL pre and post-intervention. Body composition and serum biochemical parameters were analyzed. Results: Volunteers had total body fat content and total muscle mass unchanged along the in- tervention. With regard to serum analysis, triglycerides and IMA levels remained unchanged with RT, while increased HDL levels (p < 0.001) and reduced ratio between total and HDL cholesterol (p = 0.006) were observed. Moreover, improvements in the HRQOL subscales of role-physical (p = 0.048), general health (p < 0.001), vitality (p < 0.001), social functioning (p = 0.044) and mental health (p = 0.006) were verified after the RT. Conclusions: It was concluded that a moderate RT is useful in providing benefits on quality of life in men with cardiovascular risk factors, despite the maintenance of IMA levels.

A Pooled Analysis Evaluating the Efficacy and Tolerability of Tapentadol Extended Release for Chronic, Painful Diabetic Peripheral Neuropathy

Background and ObjectiveData from two similarly designed studies of tapentadol extended release (ER) for managing neuropathic pain associated with diabetic peripheral neuropathy (DPN; NCT00455520, NCT01041859) in adults were pooled for this analysis, allowing a detailed evaluation of efficacy in patient subgroups and secondary endpoints.MethodsIn each study, patients were titrated to their optimal dose of open-label tapentadol ER [100–250 mg twice daily (bid)] over 3 weeks. Patients with ≥1-point improvement in average pain intensity [11-point numerical rating scale (NRS)] were randomized (1:1) to receive placebo or tapentadol ER during a 12-week, double-blind maintenance period.ResultsMean (standard deviation [SD]) changes in pain intensity from baseline to week 12 of maintenance in the placebo (n = 343) and tapentadol ER (n = 360) groups, respectively, were 1.28 (2.41) and 0.08 (1.87) [least squares mean difference (LSMD): −1.14 (95 % confidence interval [CI]: −1.435, −0.838); P < 0.001, in favour of tapentadol ER]. Significant between-group differences were also observed in changes from the start of the double-blind treatment period to the double-blind endpoint for the Short Form-36 physical functioning, role-physical, bodily pain, social functioning and role-emotional subscale and physical component summary scores, and the EuroQol 5-Dimension health status index (all P < 0.05, in favour of tapentadol ER). No clinically relevant differences were observed in the efficacy of tapentadol ER across patient subgroups divided by age, sex, race, opioid experience and pain intensity. Incidences of treatment-emergent adverse events were 56.0 % (192/343) with placebo and 74.7 % (269/360) with tapentadol ER during maintenance.ConclusionResults of this pooled analysis indicate that tapentadol ER was effective for managing DPN-related pain, and provided consistent analgesic efficacy across different patient subgroups.

The Association Between Knee Pain, Symptoms, Function and Quality af Life After Anterior Cruciate Ligament Reconstruction at Short-Term Follow-Up

Objectives:To investigate the associations between pain, symptoms, function and knee-related quality of life (QOL) after ACL reconstruction at short-term follow-upMethods:Twenty patients who had undergone ACL reconstruction were included in the study. Knee Injury and Osteoarthritis Outcome Score-Turkish (KOOS-T) was used to evaluate knee pain, other symptoms (symptoms), activities of daily living and sport and recreation (Sport/Rec). Quality of life was assessed with Short Form (SF)-36. Lysholm knee scoring scale was used for clinical evaluation.Results:The mean age of patients was 28. 2 ± 5.5 and the mean time passed after surgery was 38.22 ± 24.7 weeks. A significant correlation (p<0, 05) was found between KOOS-T pain, activities of daily living subscales and all SF-36 subscale scores and both physical component and mental component summary scores. KOOS symptoms and Sports/Rec subscales were correlated with physical and social functioning subscale scores and mental component summary scores of SF-36. Symptoms subscale was also correlated with vitality subscale of SF-36. There was no correlation between SF-36 scores and age and time passed after surgery. Lysholm score was also correlated with most of the subscales of SF-36 but especially with physical component summary score.Conclusion:The QOL of patients who had undergone ACL reconstruction was significantly correlated with pain and activities of daily living. The mental health subscales of SF-36 also correlated with pain, symptoms, ADL and Sports/Rec suggesting that apart from the physical impairment, mental health is also an important clinical issue in patients who had undergone ACL reconstruction.

Long-term outcome of Guillain-Barré syndrome in children.

The objective of this study is to determine the long-term outcome and consequences of Guillain-Barré syndrome (GBS) in children. This is an observational cross-sectional cohort study of children diagnosed with GBS (0-18 years old) at the Sophia Children's Hospital in Rotterdam from 1987 to 2009. All patients were invited for a structured interview, questionnaires, and full neurologic exam to record their current clinical condition focused on complaints and symptoms, neurological deficits, disabilities, behavior, and quality of life. Thirty-seven patients participated, 23 were now adults, with a median age of 20 years (range 4-39 years) and a median follow-up time of 11 years (range 1-22 years). Residual complaints were reported by 24 (65%) patients, including paresthesias (38%), unsteadiness of gait in the dark (37%), painful hands or feet (24%), and severe fatigue (22%). Four patients had severe neurological deficits, including facial diplegia and limb weakness. Two patients had had a recurrence of GBS. In 10 patients (26%), GBS had a negative impact on their school career. Questionnaires identified a wide range of behavioral problems. Quality of life was below normal on the subscale vitality, and above normal on the subscales social functioning and positive emotions in the adult group. Most children show good recovery of neurological deficits after GBS, but many have persisting long-term residual complaints and symptoms that may lead to psychosocial problems interfering with participation in daily life.

Validación de la versión española del inventario de asertividad Gambrill y Richey en población con diagnóstico de esquizofrenia.

Objective: To validate the Spanish version of the questionnaire Gambrill and Richey Assertiveness for people with schizophrenia. Method: he sample comprised a total of 125 people with schizophrenia on treatment in one of the psychosocial rehabilitation centers participating in the study. The instruments used to assess convergent and discriminant validity are the Communication Skills Questionnaire(CSQ); the Social Functioning Scale(SFS); the Life Skills Profile(LSP); the Clinical Global Impression Scale(CGI) and the Global Functioning Scale (GAF). Results: Internal consistency of the instrument shows a Cronbach alpha of .935 in the full scale . The intraclass correlation coefficients to assess the instrument's internal consistency ranged between .21 and .78. The instrument shows a convergent validity with CSQ scale and the subscales of communication and social isolation (p &lt; .001-.05). With the rest of social functioning subscales shows divergent validity. With the CGI shows divergent validity with the probability of response, and convergent validity between the subscales of CGI and the degree of distress subscale of the instrument (p &lt; .012-.042). Conclusions: The instrument shows good psychometric characteristics and appears useful for assessing social skills in a sample of people with schizophrenia.

Change in quality of life after brief behavioral therapy for insomnia in concurrent depression: analysis of the effects of a randomized controlled trial.

The efficacy of cognitive behavioral therapy for insomnia (CBT-I) has been suggested for insomnia concomitant with depression, but its impact on quality of life (QoL) has not been adequately evaluated. The study aimed to determine which aspects of QoL could be affected by CBT-I and how any changes in QoL were mediated by changes in insomnia and depression. We conducted a 4-week randomized controlled trial with 4-week follow-up in outpatient clinics in Japan. Thirty-seven patients with DSM-IV diagnosis of major depressive disorder concomitant with chronic insomnia were randomly assigned to the treatment-as-usual (TAU) alone arm or the TAU with brief behavioral therapy for insomnia (TAU plus psychotherapy) arm using modified CBT-I consisting of 4 weekly individual sessions. We evaluated QoL using norm-based scoring of the Short Form-36 at baseline and at 8 weeks. We also examined associations between QoL subscales and remission in insomnia or depression while controlling for baseline scores of the entire sample. We tested group effects while controlling for baseline scores. TAU plus psychotherapy resulted in significantly better scores on physical functioning (p = 0.006), social functioning (p = 0.002), and mental health (p = 0.041) subscales than TAU alone at 8 weeks. Patients with either remitted insomnia or depression showed higher QoL scores than non-remitted patients; scores approximated those within the normal range. For patients with insomnia in depression, adding CBT-I to TAU can produce substantive benefits in some aspects of QoL. ClinicalTrials.gov Identifier: NCT00610259, http://www.clinicaltrials.gov/.