Total Score Of Quality Research Articles

A preliminary study of comprehensive behavioral intervention for tics in Chinese children with chronic tic disorder or Tourette syndrome.

To investigate the adaptability of Comprehensive Behavioral Intervention for Tics (CBIT) for a Chinese population, and evaluate the efficacy of combined CBIT and pharmacotherapy (CBIT + PT) compared to CBIT or pharmacotherapy (PT) alone for reducing tics and for improving the quality of life (QoL) in a sample of Chinese children with chronic tic disorders (CTD) and Tourette syndrome (TS). In this 10-week randomized controlled pilot trial, 37 outpatients aged between 6 and 16 years affected by TS and CTD were randomly assigned to receive CBIT (n = 22) or PT alone (n = 15). Considering the feasibility, the patients allocated to the CBIT treatment group could further choose whether to simultaneously take medicine voluntarily, resulting in a CBIT alone group (n = 12) and a CBIT + PT group (n = 10). At baseline, no significant difference was found between the three groups in the demographic and clinical characteristics (p > 0.05). All three groups showed a significant reduction in tic severity after treatment assessed by the Yale Global Tic Severity Scale (YGTSS) severity score [F (2,33) = 35.05, p < 0.001, η p 2 = 0.51], the score of the Clinical Global Impression scale for Improvement (CGI-I) [F (1,34) = 13.87, p = 0.001, η p 2 = 0.29], and YGTSS impairment score [F (2,33) = 31.71, p < 0.001, η p 2 = 0.48]. Significant interactions were found between the time-point and group in emotional functioning [F (2,29) = 4.39, p = 0.02, η p 2 = 0.23], psychosocial functioning [F (2,29) = 5.93, p = 0.007, η p 2 = 0.29], and total QoL score [F (1,34) = 3.72, p = 0.04, η p 2 = 0.20] of Pediatric Quality of Life Inventory (PedsQL 4.0) for children suggesting a significantly larger improvement in emotional functioning, psychosocial functioning, and total QoL score of the life quality in the CBIT group for children self-report. PedsQL for proxy report only showed a significant main effect of time-point in physical functioning [F (1,33) = 8.35, p = 0.01, η p 2 = 0.2], emotional functioning [F (1,33) = 10.75, p = 0.002, η p 2 = 0.25], psychosocial functioning [F (1,34) = 11.38, p = 0.002, η p 2 = 0.26], and total Qol score [F (1,34) = 13.21, p = 0.001, η p 2 = 0.29]. CBIT is probably effective in reducing tic severity in Chinese children with tic disorders. CBIT + PT may not be superior to CBIT alone in reducing tic severity and improving quality of life. CBIT alone showed advantages in improving quality of life over CBIT + PT and PT alone. CBIT might be an appropriate treatment option for patients with tic disorder in Chinese mainland.

Cross-sectional and longitudinal association of sleep and Alzheimer biomarkers in cognitively unimpaired adults.

Sleep abnormalities are prevalent in Alzheimer's disease, with sleep quality already impaired at its preclinical stage. Epidemiological and experimental data point to sleep abnormalities contributing to the risk of Alzheimer's disease. However, previous studies are limited by either a lack of Alzheimer's disease biomarkers, reduced sample size or cross-sectional design. Understanding if, when, and how poor sleep contributes to Alzheimer's disease progression is important so that therapies can be targeted to the right phase of the disease. Using the largest cohort to date, the European Prevention of Alzheimer's Dementia Longitudinal Cohort Study, we test the hypotheses that poor sleep is associated with core Alzheimer's disease CSF biomarkers cross-sectionally and predicts future increments of Alzheimer's disease pathology in people without identifiable symptoms of Alzheimer's disease at baseline. This study included 1168 adults aged over 50 years with CSF core Alzheimer's disease biomarkers (total tau, phosphorylated tau and amyloid-beta), cognitive performance, and sleep quality (Pittsburgh sleep quality index questionnaire) data. We used multivariate linear regressions to analyse associations between core Alzheimer's disease biomarkers and the following Pittsburgh sleep quality index measures: total score of sleep quality, binarized score (poor sleep categorized as Pittsburgh sleep quality index > 5), sleep latency, duration, efficiency and disturbance. On a subsample of 332 participants with CSF taken at baseline and after an average period of 1.5 years, we assessed the effect of baseline sleep quality on change in Alzheimer's disease biomarkers over time. Cross-sectional analyses revealed that poor sleep quality (Pittsburgh sleep quality index total > 5) was significantly associated with higher CSF t-tau; shorter sleep duration (<7 h) was associated with higher CSF p-tau and t-tau; and a higher degree of sleep disturbance (1-9 versus 0 and >9 versus 0) was associated with lower CSF amyloid-beta. Longitudinal analyses showed that greater sleep disturbances (1-9 versus 0 and >9 versus 0) were associated with a decrease in CSF Aβ42 over time. This study demonstrates that self-reported poor sleep quality is associated with greater Alzheimer's disease-related pathology in cognitively unimpaired individuals, with longitudinal results further strengthening the hypothesis that disrupted sleep may represent a risk factor for Alzheimer's disease. This highlights the need for future work to test the efficacy of preventive practices, designed to improve sleep at pre-symptomatic stages of disease, on reducing Alzheimer's disease pathology.

RF12 | PSUN118 Diet Quality and Energy Intake Mediate the Association of Food Insecurity with Adiposity

Abstract Food insecurity, the lack of consistent access to sufficient food for an active and healthy life, is associated with lower diet quality, higher BMI and adiposity, and poor metabolic health. Although lower diet quality is assumed to be responsible for the impact of food insecurity on adiposity, this hypothesis has not been previously investigated. To test the hypothesis that diet quality mediates the association of food insecurity with adiposity, we used data from the 2015-2016 National Health and Nutrition Examination Survey (NHANES, age ≥18 years, n=5821, weighted N=233,636,542). Anthropometrics included BMI, waist circumference and fat mass (measured by dual X-ray absorptiometry and expressed as percentage of total body weight). Food insecurity was assessed with the 10-item NHANES Food Security Survey Module and defined as ≥3 affirmative responses. Nutrition information was derived from 24h food recalls obtained on 2 separate occasions. Diet quality was estimated by the Healthy Eating Index-2015 (HEI), which includes a total score for overall diet quality, and sub-scores for several dietary components. Mediation analysis was conducted with the Baron and Kenny approach. A p-value &amp;lt;0.05 was considered statistically significant. The cohort included 52% women, 11% non-Hispanic Black and 15% Hispanic participants. Eighteen percent were food insecure. They reported a lower energy intake compared to food secure participants, although the difference was not significant after adjusting for demographics and income (difference [95% confidence interval] -84 [-207.36, 38.91] kcal/day, p=0.15). Total HEI and fruit scores were lower in food insecure individuals, suggesting lower diet quality (adjusted difference -1.70 [-3.09, -0.32], p=0.03; and -0.28 [-0.53, -0.02], p=0.04, respectively). Obesity was 22% more prevalent in food insecure individuals (p&amp;lt;0.01). Fat mass and waist circumference were also higher in individuals with food insecurity (adjusted difference 0.95 [0.19, 1.7] %, p=0.02; and 3.81 [1.3, 6.31] cm, p=0.01, respectively). Mediation analysis revealed that total energy intake mediated the effect of food insecurity on fat mass but not BMI or waist circumference, while total HEI partially mediated the effect of food insecurity on waist circumference but not BMI or percent fat mass. No mediation of total fruit score on BMI or adiposity was observed. In summary, our results confirm a greater prevalence of obesity and higher adiposity in food insecure individuals, despite a similar reported energy intake compared to food secure individuals. Energy intake and measures of diet quality appear to mediate some of the effect of food insecurity on overall and central adiposity, but not on BMI. This suggests that other factors, including the social determinants of health, may also play a role. Presentation: Saturday, June 11, 2022 1:18 p.m. - 1:23 p.m., Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.

SLEEP QUALITY AND AFFECTING FACTORS AMONG ELDERLY LIVING IN A NURSING HOME AT EAST NUSA TENGGARA INDONESIA

Sleep is one of the processes that greatly affects aging, It essential for mental, physical, and maintenance of physical health. Kupang East Nusa Tenggara, Indonesia, a research study in a nursing home of the elderly experience have a bad quality of sleep. This study aimed to analyze the sleep quality and the factors affecting, among old age living in a nursing home at East Nusa Tenggara Indonesia. The research design was cross-sectional with primary data on 103 elderly living in nursing homes. There was a relationship between age, gender, marital status, spouse, education background, have a chronic diseases, living arrangement, anxiety, and depression with sleep quality (p&lt;0.05). The correlation showed that there was a strong and positive patterned relationship (&lt;0.05) between the total anxiety score and the total sleep quality score (r=0.608) and the total depression score with the total sleep quality score (r=0.561) meaning that the higher of the elderly felt anxiety and depression worsened for the quality of sleep. Old age who lives alone are more susceptible to stress or depression resulting from unconvenient environment where they live. High levels of anxiety and depression in the elderly are associated with poorer sleep quality.

Artificial Intelligence in the Diagnosis of Hepatocellular Carcinoma: A Systematic Review.

Hepatocellular carcinoma ranks fifth amongst the most common malignancies and is the third most common cause of cancer-related death globally. Artificial Intelligence is a rapidly growing field of interest. Following the PRISMA reporting guidelines, we conducted a systematic review to retrieve articles reporting the application of AI in HCC detection and characterization. A total of 27 articles were included and analyzed with our composite score for the evaluation of the quality of the publications. The contingency table reported a statistically significant constant improvement over the years of the total quality score (p = 0.004). Different AI methods have been adopted in the included articles correlated with 19 articles studying CT (41.30%), 20 studying US (43.47%), and 7 studying MRI (15.21%). No article has discussed the use of artificial intelligence in PET and X-ray technology. Our systematic approach has shown that previous works in HCC detection and characterization have assessed the comparability of conventional interpretation with machine learning using US, CT, and MRI. The distribution of the imaging techniques in our analysis reflects the usefulness and evolution of medical imaging for the diagnosis of HCC. Moreover, our results highlight an imminent need for data sharing in collaborative data repositories to minimize unnecessary repetition and wastage of resources.

Comparison of psychological distress and quality of life in patients with advanced liver cancer before and after transformation therapy

To analyze the changes in psychological distress and quality of life of patients with advanced liver cancer after transformation therapy. This study was conducted among 60 patients with advanced liver cancer undergoing transformation therapy from July, 2019 to March, 2022. Before and after 2-10 cycles of treatment, the patients were assessed for psychological distress and quality of life using a psychological stress thermometer and the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep). The patients showed significantly lowered scores for psychological distress after transformation therapy (P < 0.01) with decreased psychological stress, emotional factors, tension, worry, sleep problems, memory decline and inattention, physical factors, pain, fatigue, eating problems and dyspepsia (P < 0.05). The total score of quality of life and the scores for physical status, social and family status, emotional status, functional status and hepatobiliary-specific items were all significantly lowered after the treatment (P < 0.05). In patients with advanced liver cancer, the psychological distress involves mainly the emotional factors and physical factors. Transformation therapy can significantly relieve psychological distress of the patients and improve their quality of life.

The Effectiveness of Brainwave Entrainment by Binaural Beats on the Sleep Quality

Background and Objective: Binaural beats are important because these methods are non-invasive intervention methods on sleep. The aim of this study was to investigate the effectiveness of brainwave entrainment via binaural beats on the improvement of sleep disorders.&#x0D; Materials and Methods: An experimental method with pre-test and post-test design was adopted to fulfill the purpose of the present study. The population of the study included all the people aged 20 to 40 years who referred to psychiatric clinics due to insomnia in Tehran, Iran, in 2019. Among this population, a sample size of 24 people was selected using convenience sampling and randomly divided into experimental and control groups (12 people in each group). The Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI) were used to collect the required data. An aural synchronizer was also used as an intervention in the experimental group. Analysis of covariance (ANCOVA) was used to analyze the hypotheses.&#x0D; Results: The mean age of the participants in the experimental and control groups was 29.5 and 33.0 years, respectively. The calculated effect size of this treatment was 0.46 for sleep quality and 0.43 for the insomnia. Further, the findings showed that synchronization through binaural beats had the greatest effect on the sleep latency component of PSQI.&#x0D; Conclusion: Synchronization of brain waves by binaural beats had a significant effect on improving the total score of sleep quality and insomnia.

A comparative study of intranasal steroids with intranasal antihistamines sprays v/s intranasal steroids sprays alone in management of allergic rhinitis

Allergic rhinitis is the most common form of rhinitis, worldwide, affecting close to 10% to 30% of the global population. Heredity and environmental exposures may contribute to a predisposition to allergies. Pharmacotherapy along with effective allergen avoidance measures forms the mainstay of management of Allergic Rhinitis. The evidence indicates that intranasal corticosteroids are more efficacious than are antihistamines in the control of Allergic Rhinitis symptoms. This "superiority" is principally related to their effect on nasal obstruction. The numbers of studies done to know the efficacy of combination sprays over steroidal sprays alone are very few and provide insufficient insight. The purpose of this study was to ascertain whether the combination nasal sprays should be prescribed as a standard medical management for allergic rhinitis or not, as to achieve better quality of life after treatment with maximum improvement in Total Nasal Symptom Score (TNSS). 100 subjects were taken up for this study, 50 in each group after fulfilling the inclusion and exclusion criteria. Subjects were allocated in two groups according to consultant’s preference. Subjects were evaluated for Total Nasal Symptom Score (TNSS) and score of Mini Rhino conjunctivitis Quality of Life Questionnaire (MiniRQLQ) before and after the treatment initiation The study was conducted in two groups based on drug given and both the groups were evaluated after 2 weeks and 4 weeks of medication on the basis of TNSS and MiniRQLQ score. Allergic Rhinitis was found to be more common in younger age group. Both the drugs were effective in reducing the Total nasal symptom scores (TNSS) and score of MiniRQLQ significantly (p&amp;#60;0.001). However, Combination Nasal Sprays (Intra-nasal corticosteroids with intranasal antihistamines) were found to be statistically superior when compared to only intranasal steroid sprays. Combination Nasal Sprays are highly efficacious and statistically better to steroid nasal sprays hence this study confirms the superiority of combination nasal sprays and recommends combination nasal sprays as first line of treatment for allergic rhinitis.

The impact of national music activities on improving long-term care for happiness of elderly people.

This paper aims to analyze the influence of national music activities on the long-term care for and happiness of elderly people in the current aging society. Under the popular square dance movement of the whole society, a questionnaire survey was conducted to investigate the differences in the silver-haired body self-esteem and the happiness of the silver-haired exercisers with different exercise methods. Forty first-time square dance participants were selected as experimental objects, and they were divided into an experimental group (ethnic music square dance) and a control group (ordinary music square dance), with 20 people in each group. The results showed that the effective recovery rate of the questionnaire was 95.10% (136/150). There were 47, 45, and 44 people in the square dance, other sports, and non-sport groups, respectively. The total scores of physical self-esteem, physical self-worth, physical quality, health worry, satisfaction and interest in life, control of emotion and behavior, and happiness of silver-haired people who participated in square dance activities were higher than those of other sports players (p < 0.05). The total scores of physical self-esteem, exercise ability, physical condition, and physical quality scores were significantly higher than those of non-sports people (p < 0.01), and each factor and total score on the happiness were higher than those of non-sports people (p < 0.05). The body weight, waist circumference, hip circumference, and thigh circumference of the experimental group after exercise were significantly different from those before exercise (p < 0.01), and the factors of the body self-esteem scale and well-being scale were higher than those before the experiment (p < 0.05). This shows that music has a positive effect on the long-term care for and happiness improvement of the silver-haired family, which can improve the physical and mental health of the silver-haired family and further improve the quality of life of the silver-haired family in their later years. This offers a theoretical basis for the development of the elderly folk music square dance movement in the future and provides a reference for the formulation of silver-haired patriarchal photos and happiness intervention programs.

Investigation of relationship between melatonin level and religious orientation, depression level and sleep quality of students in nursing and different department

Background. With insufficient information about the importance of melatonin in human physiology, this hormone is known to be associated with sleep, mood, reproduction, tumor development, and aging. Chronic sleep problems, stress, fatigue, irritability, confusion, tension, and depressive symptoms can be observed in melatonin deficiency. There is no such study in the literature and it is thought to shed light on the literature. The purpose of the study is to examine the relationship between melatonin level and religious orientation, depression level, and sleep quality of students in nursing and different department. Materials and methods. This cross-sectional study was conducted between April 2019 and April 2020. The target population of the study consisted of 1200 students who studying in 2nd grade to ensure harmony and homogeneity in stress, sleep, and melatonin parameters. The sample of the study consisted of 145 individuals who accepted to participate in the study among the 2nd-grade students. Descriptive Information Form, Religious Orientation Scale, Beck Depression Inventory, and Pittsburg Sleep Quality Index (PSQI) scale were used to collect research data. Results. According to the findings obtained from the study, it was determined that the melatonin level of the students was 0.79±0.52 pg/ml, the total score mean of the Sleep Quality Scale was 7.24±3.35, the Beck Depression Inventory was 16.40±10.84 and the Religious Orientation Scale was 47.41±6.05. It was determined that their sleep quality was “bad”; moderately depressed and religious orientation and the melatonin level was below normal. Conclusions. Since the sleep quality total score of the students was above 5, it was determined that their sleep quality was “bad”. It was found that the group was moderately depressed and had a moderate religious orientation. In the study where the standard was accepted as 0.90, it was found that the melatonin level was below normal. It is recommended that the study be conducted in larger groups.

A Pilot Study to Assess the Performance of Phase-Sensitive Breast Tomosynthesis.

Background A new modality, phase-sensitive breast tomosynthesis (PBT), may have similar diagnostic performance to conventional breast tomosynthesis but with a reduced radiation dose. Purpose To perform a pilot study of the performance of a novel PBT system compared with conventional digital breast tomosynthesis (DBT) in patients undergoing additional diagnostic imaging workup for breast lesions. Materials and Methods In a prospective study from June 2020 to March 2021, participants with suspicious breast lesions detected at screening DBT or MRI were recruited for additional PBT imaging before additional diagnostic workup or biopsy. In this pilot study, nine radiologists independently evaluated image quality and assessed the likelihood of lesion malignancy by retrospectively evaluating DBT and PBT images in two separate reading sessions. Image quality was rated subjectively using a Likert scale from 1 to 5. Areas under the receiver operating characteristic curve (AUCs) were used to compare the lesion classification (malignant vs benign) performance of the radiologists. Results Images in 50 patients (mean age, 56 years ± 12 [SD]; 49 women) with 52 evaluable lesions (28 malignant) were assessed. For image appearance and general feature visibility, DBT images had a higher total mean image quality score (3.8) than PBT images (2.9), with P < .002 for each comparison. For classification of lesions as benign or malignant, the AUCs were 0.74 for both PBT and DBT. PBT images were acquired at a 24% mean radiation dose reduction (mean, 1.78 mGy vs 2.34 mGy for DBT; P < .001). Conclusion The phase-sensitive breast tomosynthesis system had a 24% lower mean radiation dose compared with digital breast tomosynthesis, although with lower image quality. Diagnostic performance of the system remains to be determined in larger studies. © RSNA, 2022 Online supplemental material is available for this article. See also the editorial by Gao and Moy in this issue.

Effect of closed and permanent stoma on disease course, psychological well-being and working capacity in Swiss IBD cohort study patients.

Little is known about the impact of ostomy formation in inflammatory bowel disease patients on course of disease, psychological well-being, quality of life and working capacity. We analyzed patients over a follow-up of up to 16 years in the Swiss inflammatory bowel disease cohort study (SIBDCS) with prospective data collection. We compared Ulcerative colitis and Crohn's disease patients with and without ostomy as well as permanent and closed stoma formation before and after surgery, investigating disease activity, psychological wellbeing and working capacity in a case-control design. Of 3825 SIBDCS patients, 176 with ostomy were included in the study and matched with 176 patients without ostomy using propensity score, equaling 352 patients for the analysis. As expected, we observed a lower mean and maximal disease activity in patients after stoma surgery compared with control patients without stoma. Overall, psychological wellbeing in patients with stomas vs. controls as well as patients with permanent vs. closed stoma was similar in terms of disease-specific quality of life (total score of the Inflammatory Bowel Disease Quality of Life questionnaire), psychological distress (total score of the Hospital Anxiety and Depression Scale), and stress at work (effort-reward-imbalance ratio), with the exception of a higher Posttraumatic Diagnostic Scale total score in patient with vs. without stoma. Compared to IBD patients without stoma, the adverse impact on working capacity in overall stoma IBD patients appeared to be modest. However we observe a significantly higher reduction in working capacity in permanent vs. closed stoma in CD but not UC patients. As to be expected, IBD patients may benefit from closed and permanent stoma application. Stoma surgery appears to only modestly impact working capacity. Importantly, stoma surgery was not associated with adverse psychological outcomes, with comparable psychological well-being regardless of presence and type of stoma.

Reduction of the cardiac pulsation artifact and improvement of lesion conspicuity in flow-compensated diffusion images in the liver-A quantitative evaluation of postprocessing algorithms.

To enhance image quality of flow-compensated diffusion-weighted liver MRI data by increasing the lesion conspicuity and reducing the cardiac pulsation artifact using postprocessing algorithms. Diffusion-weighted image data of 40 patients with liver lesions had been acquired at 1.5T. These data were postprocessed with 5 different algorithms (weighted averaging, p-mean, percentile, outlier exclusion, and exception set). Four image properties of the postprocessed data were evaluated for optimizing the algorithm parameters. These properties were the lesion to tissue contrast-to-noise ratio (CNR), the reduction of the cardiac pulsation artifact, the data consistency, and the vessel darkness. They were combined into a total quality score ( set to 1 for the trace-weighted reference image), which was used to rate the image quality objectively. The weighted averaging algorithm performed best according to the total quality score ( ). The further ranking was outlier exclusion algorithm ( ), p-mean algorithm ( ), percentile algorithm ( ), and exception set algorithm ( ). All optimized algorithms except for the exception set algorithm corrected the pulsation artifact and increased the lesion CNR. Changes in were significant for all optimized algorithms except for the percentile algorithm. Liver ADC was significantly reduced (except for the exception set algorithm), particularly in the left lobe. Postprocessing algorithms should be used for flow-compensated liver DWI. The proposed weighted averaging algorithm seems to be suited best to increase the image quality of artifact-corrupted flow-compensated diffusion-weighted liver data.

Effect of Health Education via Mobile Application in Promoting Quality of Life Among Asthmatic Schoolchildren in Urban Malaysia During the COVID-19 Era: A Quasi-experimental Study.

Bronchial asthma among children is a common chronic disease that may impact quality of life. Health education is one of the strategies to improve knowledge and quality of life. This study aims to assess the effect of health education via a mobile application in promoting the quality of life among schoolchildren with asthma in urban Malaysia during the COVID-19 era. A quasi-experimental, pre- and post-intervention design was used in this study involving a total of 214 students, randomly assigned into two groups (an intervention group and a control group). The control group received face-to-face health education, whereas the experimental group received health education via a mobile application. The findings showed that the total score of quality of life improved from a mean total score at pre-intervention of 5.31 ± 1.27 to post-intervention of 5.66 ± 1.28 for the control group, compared with the experimental group with a mean total score of quality of life at pre-intervention of 5.01 ± 1.36 and post-intervention of 5.85 ± 1.29. A comparison between the experimental and control groups using an independent t test showed statistically significant differences in their mean quality of life scores. The effect of health education via a mobile application showed a statistically significant improvement in the mean quality of life score from pre- to post-intervention (F1,288 = 57.46, P < .01). As recommended, the use of mobile technology in health education improved the quality of life of schoolchildren with asthma as compared with the traditional methods of a face-to-face lecture and/or a handbook. Thus, educational modules using mobile applications do improve quality of life.

Associated Factors of Smartphone Addiction in the Students of the Faculty of Health Sciences

Aim: This study aimed to investigate associated factors of smartphone addiction in the students of a faculty of health sciences. Material and Methods: This is a cross-sectional study. A total of 839 health sciences students participated in our study. The data was collected by Personal Information Form, the Smartphone Addiction Scale-Short Form, the Pittsburg Sleep Quality Index, and the Piper Fatigue Scale. Results: As the smartphone addiction score increases by 0.59 units, the sleep quality total score increases by one unit. The smartphone addiction score decreases by 0.12 units when the fatigue score increases by one unit. It was determined that female students' smartphone addiction scale scores were higher than male students. Conclusion: The female students’ Smartphone Addiction Scale scores average were higher than males. In addition, fatigue and sleep problems were more significant in individuals with smartphone addiction. Appropriate Technology Use courses should be added to the curriculum to prevent telephone addiction.

Quality of life after totally laparoscopic versus laparoscopic-assisted total gastrectomy: a retrospective cohort study with propensity score matching

Objective: To evaluate the postoperative quality of life in patients after totally laparoscopic total gastrectomy (TLTG). Methods: A retrospective cohort study based on propensity score matching was performed. Clinical and follow-up data of patients who underwent laparoscopic radical gastrectomy at Union Hospital of Fujian Medical University from January 2014 to May 2015 were collected. Case indusion criteria: (1) primary gastric cancer confirmed by postoperative pathology; (2) receiving TLTG or laparoscopic-assisted total gastrectomy (LATG);(3) R0 resection; (4) completing follow-up for 12 months and complete follow-up data. Exclusion criteria: (1) gastric stump cancer; (2) concurrent tumor; (3) distal metastasis found during operation; (4) history of upper abdominal operation. According to surgical procedures, patients were divided into the LATG group (1076 cases) and the TLTG group (106 cases). To eliminate potential bias in baseline data between the two groups, the propensity score was calculated using a logistic regression model with the following covariates, including age, sex, body mass index, American Society of Anesthesiologists score, tumor location, tumor size, pathology type, and stage. The two groups were matched using a 1:2 propensity assessment ratio and a caliper width of 0.01 standard deviation was specified. The primary outcomes were the quality of life of the two groups at 3, 6 and 12 months after gastrectomy, including physical symptoms and social function. Higher function score indicated better function, and higher symptom score presented worse symptoms. Quality of life score = (100 - somatic symptom scale score + social function scale score) / 2. The secondary outcomes were postoperative nutritional recovery and food tolerance at 3, 6 and 12 months after gastrectomy. The categorical variables were expressed as n(%), and compared using the χ2 test or Fisher exact test. The continuous variables conforming to the normal distribution were represented by Mean ± SD and compared with the paired t-test. Repeated measurement of variance was used to compare nutrition-related indicators within the group among pre-operation, postoperative 1, 3, 6, 12 months. Results: After PSM, there were no significant differences in clinicopathological baseline data between the TLTG group (n=104) and the LATG group (n=208) (all P>0.05). The physical symptoms scores in the TLTG group before operation and 3, 6 and 12 months after operation were 8.6±5.8, 15.5±8.4, 10.1±5.9 and 6.1±2.4 respectively (F=43.493, P<0.001). In the LATG group, the above mentioned scores were 9.7±6.9, 23.7±10.4, 13.3±8.3 and 8.5±4.2 respectively (F=112.588, P<0.001). Compared with the LATG group, the symptom scores in the TLTG group were lower at 3 and 6 months after operation, and the differences were statistically significant (t=-3.653, P<0.001; t=-2.513, P=0.012). At 12 months after operation, although the physical symptom score in the TLTG group was also lower than that in LATG group, the difference was not statistically significant (t=-1.487, P=0.138). The social function scores in the TLTG group before operation and 3, 6 and 12 months after operation were 90.3±8.9, 77.5±14.3, 87.4±10.3 and 91.7±6.7 respectively (F=28.524, P<0.001). In the LATG group, the above mentioned scores were 92.5±6.3, 68.5±16.8, 79.8±14.7 and 84.7±11.1 respectively (F=57.975, P<0.001). Compared with the LATG group, the social function scores of patients in the LATG group were higher at 3, 6 and 12 months after operation (t=3.543, P<0.001; t=3.216, P=0.001; t=2.235, P=0.026). The total scores of quality of life at 3, 6 and 12 months after operation in the TLTG group were 81.0±15.6, 88.3±8.1 and 93.3±9.1 respectively, and the above mentioned scores in the LATG group were 72.4±13.6, 83.3±11.5 and 88.1±7.7 respectively, whose differences at corresponding time point were all significant between the two groups (all P<0.05). The change of total body mass[(-8.4±1.4)% vs. (-13.2±1.6)%, t=2.273, P=0.024], serum albumin[(-5.1±0.7)% vs. (-7.4±0.8)%,t=2.095, P=0.037], meal quantity [(-15.6±4.7)% vs. (-24.1±6.0)%, t=2.885, P=0.004] and meal times [(20.8±7.1)% vs. (30.6±11.5)%, t=3.043, P<0.001] in the TLTG group were significantly lower than those in the LATG group one year after operation (all P<0.05). At 3, 6 and 12 months after operation, the diet proportions of solid and soft food in the TLTG group were higher than those in the LATG group (all P<0.05). Conclusions: Compared with LATG, patients with gastric cancer undergoing TLTG have better health-related quality of life and faster recovery of nutrition.

Quality of information offered to women by drug sellers providing medical abortion in Nigeria: Evidence from providers and their clients.

BackgroundEvidence confirmed that the demand for medical abortion (MA) increased significantly during the COVID-19 outbreak in many developing countries including Nigeria. In an abortion-restrictive setting like Nigeria, local pharmacies, and proprietary patent medicine vendors (PPMVs) continue to play a major role in the provision of MA including misoprostol. There is the need to understand these providers' knowledge about the use of misoprostol for abortion and the quality of information they provide to their clients. This analysis is focused on assessing the quality of care provided by both drug seller types, from drug sellers' and women's perspectives.MethodologyThis study utilized primary data collected from drug sellers (pharmacists and PPMVs) and women across 6 Local Government Areas in Lagos State, Nigeria. The core sample included 126 drug sellers who had sold abortion-inducing drugs and 386 women who procured abortion-inducing drugs from the drug sellers during the time of the study. We calculate quality-of-care indices for the care women received from drug sellers, drawing on WHO guidelines for medication abortion provision. The index based on information from the sellers had two domains—technical competency and information provided to clients, while the index from the women's perspectives includes an additional domain, client experience.ResultsResults show that the majority of drug sellers in the sample, 56% (n = 70), were pharmacists. However, far more than half of women 60% (n = 233) had visited PPMVs. Overall, the total quality score amongst all drug sellers (mean 0.48, SD0.15) was higher than the total score calculated based on women's responses (mean 0.39, SD 0.21). Using our quality-of-care index, pharmacies and PPMVs seem to have similar technical competency (mean score of 0.23, SD 0.13 in both groups (range 0–1), whilst PPMV's performed better on the information provided to client domain (mean score of 0.79, SD 0.17 compared with pharmacies 0.69, SD 0.25). Based on women's reports, PPMVs scored better on both quality of care domains (technical competency and information provided to clients) compared with pharmacies.Program/Policy ImplicationIn resource-constrained settings such as Nigeria, particularly in the context of health emergencies like COVID-19, there is the need to continue to strengthen and engage PPMVs' capacity and skills in dispensing and administration of MA drugs as a harm reduction strategy. Also, there is the need to target frontline providers in pharmacies for training and skill upscale in MA provision.

Sleep quality, caregiver burden, and individual resilience among parents of children with epilepsy

PurposeParents caring for children with epilepsy have poor sleep quality and experience a certain level of caregiving burden. Individual resilience is a crucial psychological variable that contributes to health during extraordinary challenges. This study aimed to determine the relationships among individual resilience, caregiver burden, and sleep quality. MethodsThis was a descriptive cross-sectional study with a convenience sample, following the STROBE guidelines. One hundred and ninety-one parents of children with epilepsy were invited to participate in the study. Of these, 173 participants completed measures of sleep quality, caregiver burden, and individual resilience. Path analysis was performed to probe the indirect relationship between individual resilience and sleep quality via caregiver burden. ResultsCorrelation analysis revealed that individual resilience total scores were significantly and marginally negatively correlated with caregiver burden and sleep quality total scores (r = −0.215, P <.01; r = −0.250, P <.01). Moreover, there was a significant moderate positive correlation between the total caregiver burden scores and total sleep quality scores (r = 0.389, P <.001). The path model showed that individual resilience is indirectly associated with sleep quality via caregiver burden. ConclusionThe higher the level of individual resilience, the less the caregiver burden and the better the sleep quality for parents of children with epilepsy.

A Systematic Review and Meta-Analysis of Resistance Training on Quality of Life, Depression, Muscle Strength, and Functional Exercise Capacity in Older Adults Aged 60 Years or More.

Aging is generally associated with numerous metabolic and physical changes that augment susceptibility to several chronic conditions, disability, and diminished quality of life. The purpose of this meta-analysis was to investigate the efficacy of resistance training on quality of life, depression, muscle strength, and functional exercise capacity in older adults (≥60years). A systematic search was conducted in PubMed, MEDLINE, Cochrane, Google Scholar, and Scopus up to December 20, 2021. 21 studies (N = 1610) were included. Resistance training significantly improved physical functioning (standard mean differences (SMD), 0.31; p = 0.02), mental health (SMD, 0.44; p = 0.001), bodily pain (SMD, -0.52; p = 0.004), general health (SMD, 0.43; p = 0.002), social functioning (SMD, 0.25; p = 0.006), and mental component score (SMD, 0.51; p = 0.001) subscales. Moreover, depression (SMD, -1.13; p = 0.01), upper-limb muscle strength (mean difference (MD), 15.26kg; p = 0.002), lower-limb muscle strength (MD, 48.46kg; p = 0.02), and handgrip muscle strength (MD, 1.35kg; p = 0.003) significantly improved following resistance training. No benefits were found for vitality, physical component score, total score of quality of life, and the 6-min walk distance. Preliminary evidence reveals that resistance training can be effective for improving most domains of quality of life, upper- and lower-limb muscle strength, handgrip strength, and depression in aged people. More proof is hence needed to draw solid conclusions.

A STUDY OF QUALITY OF MARITAL LIFE AMONG SPOUSES OF PATIENTS DIAGNOSED WITH ALCOHOL DEPENDENCE SYNDROME

Alcohol dependence syndrome is a very common condition affecting the general population. Alcohol abuse can result in several diseases and can result in signicant phenomena like violence, road trafc accidents, and psychiatric disorders like anxiety, depression, and family disharmony. These problems are much more common in countries like India. In this single stage cross- sectional case control study, the degree of marital disharmony was grossly affected in spouses of patients with alcohol dependence in comparison to those who had spouses without alcohol dependence syndrome. Those in the study group scored higher mean scores in marital quality total score as well as 12 domain mean scores. Statistical analysis in study group showed a higher mean value (170.5) with a SD of 20.3 than the control group whose mean value was 73.4 with a SD of 10.0. Thus the study showed high degree of marital maladjustment in spouses of patients with alcohol dependence syndrome.