Diabetes is associated with increased risk of cognitive decline and is highly prevalent among older adults with cognitive impairment. To inform care decisions for managing type 2 diabetes in older adults with cognitive impairment, this review outlines a person-centered approach to glycemic management that aligns with the 4Ms framework for age-friendly care. The proposed tools integrate patient-specific factors, such as dementia progression, treatment burden, medication side effects, and hypoglycemia risk, to support people with diabetes and cognitive impairment, their care partners, and their clinicians as they engage in shared decision-making to cocreate a pharmacologic treatment plan that aligns with the individual’s needs, goals, and capabilities.

Objectives: This study explores the feasibility and value of integrating structured patient input into the PICOS (Population, Intervention, Comparator, Outcome, Study design) scoping process for Joint Clinical Assessments under the EU Health Technology Assessment Regulation. Methods: A modified Delphi panel, led by a steering committee composed of two clinicians, one patient expert, and one policy expert, engaged 12 individuals representing patient organizations across 12 European Member States to reach consensus on PICOS elements for CAR-T therapy in pediatric spinal muscular atrophy. Results: The Delphi process effectively facilitated PICOS consolidation and consensus among the 12 patient experts representing diverse EU contexts. Through 3 iterative rounds integrating quantitative rankings and qualitative feedback, the panel achieved strong agreement on key outcomes, intervention delivery, and study design elements, with population eligibility and comparator selection showing heterogeneity. Patient engagement was central: participants emphasized inclusive eligibility criteria, shared decision-making, and the inclusion of caregiver perspectives. The integration of qualitative insights allowed nuanced interpretation of dissent, distinguishing between genuine disagreement and framing effects, thereby enhancing transparency and scientific validity. Importantly, the process revealed patient priorities for outcomes, treatment burden, and evidence trade-offs, informing both PICOS refinement and future health technology assessment (HTA) strategies. This structured, participatory approach demonstrates the feasibility and value of incorporating patient voices systematically into early-stage EU HTA, fostering robust, credible, and context-sensitive consensus on complex rare-disease interventions. Conclusions: The study demonstrates the potential of consensus-building methodologies to enhance transparency, reduce heterogeneity, and support patient-centered evidence generation and decision-making in HTA.

Choroidal neovascularization (CNV) represents a major cause of vision loss in various retinal diseases such as age-related macular degeneration (AMD). Current treatment involves frequent, often monthly, eye injections. The development of minimally invasive, long-term, painless, and effective ocular drug delivery systems is crucial for advancing the treatment of AMD. This study explores a novel method that integrates controllably bioresorbable silicon nanoneedles loaded with bevacizumab (Si NNs-Bev) on a tear-soluble subconjunctival patch for sustained, 1 year ocular drug delivery. The Si NNs-Bev embed into the sclera in a minimally invasive manner, undergoing controlled degradation over one year. This approach facilitates the sustained release of therapeutic agents, enhancing treatment efficacy and reducing treatment burden. Si NNs-Bev for the treatment of CNV are validated in a rabbit model of AMD. The SiNN-Bev patch achieved a sustained therapeutic effect on CNV regression, with a mean reduction of 82% by 4 months that is persistent for at least 1 year with minimal recurrence, which is consistent with the localized drug delivery mechanism facilitated by the transscleral microneedles. These preliminary findings underscore the potential of SiNNs as a platform technology for long-term, sustained ocular therapeutics.

Respiratory infections are one of the most common causes of morbidity and mortality among children. After the COVID-19 pandemic, the epidemiology of respiratory tract infections has changed and has been better traced by more frequent and less expensive molecular and antigenic tests. The main aim of this retrospective study was to evaluate the epidemiology of respiratory infections among children hospitalized in Perugia during the epidemic seasons of 2018-2019 and 2023-2024, comparing clinical severity, hospitalization length, diagnostic and therapeutic interventions. We retrospectively analysed hospital records of all patients admitted to our clinic from October 2018 to March 2019 and from October 2023 to March 2024. In the post-COVID-19 era, hospitalizations for respiratory infections increased proportionally to other hospitalization causes, remaining the most common ones. Length of hospital stay was shorter, with no difference based on age, C-Reactive Protein levels or symptoms at admission. A change of respiratory infection epidemiology after the COVID-19 pandemic has been witnessed also in our setting: Respiratory Syncytial Virus and Influenza played a central role, displaying earlier peaks and severe clinical pictures. Increased use of molecular testing allowed for prompt etiological diagnoses, likely contributing to shorter inpatient stays and fewer antibiotic prescriptions, thus reducing economic burden for each patient and promoting improved antibiotic stewardship. In our setting, respiratory infections still accounted for the majority of pediatric hospitalizations during the autumn/winter seasons. A comprehensive testing strategy for etiological diagnosis of respiratory infections in hospitalized patients seemed to be cost-effective by reducing hospital stay and antibiotic prescriptions. This study may inform healthcare policy by emphasizing the importance of etiological diagnosis and the economic burden of inappropriate treatments.

Premature loss of deciduous teeth is a prevalent concern in pediatric dentistry and can disrupt normal occlusal development, often increasing the need for complex orthodontic and prosthodontic interventions. This retrospective observational study assessed the association between early primary tooth loss, malocclusion patterns, and subsequent treatment requirements among children attending dental clinics in Riyadh, Saudi Arabia. Records of 467 patients aged 6–18 years were analyzed. Early loss of deciduous teeth was observed in 39% of patients, most commonly due to dental caries and frequently involving primary molars. Children with premature tooth loss exhibited significantly higher rates of crowding, midline deviation, crossbite, and altered overjet or overbite. These occlusal disturbances often necessitated space management using fixed or removable space maintainers, pediatric partial dentures, or functional appliances to preserve arch length and guide the eruption of permanent successors. Patients with early tooth loss demonstrated a greater need for orthodontic treatment, increased treatment complexity, and prolonged treatment duration. Multivariable analyses identified early deciduous tooth loss as an independent predictor of severe treatment complexity, while timely space maintenance and prosthodontic rehabilitation showed a mitigating effect. These findings emphasize the importance of preserving primary teeth and integrating preventive, orthodontic, and prosthodontic strategies to optimize occlusal development and reduce long-term treatment burden in children.

Therapies with robust visual outcomes and reduced patient and healthcare system treatment burden are needed amidst the rising incidence of neovascular age-related macular degeneration (nAMD). Aflibercept 8 mg is an additional treatment option with demonstrated potential for extended dosing intervals of up to 24 weeks. The objective of this publication is to introduce a clinical care pathway, developed by expert consensus of experienced UK clinicians, to support best practice with aflibercept 8 mg in nAMD. A structured, face-to-face roundtable meeting of 13 UK retina specialists was held on 8 October 2024, organised and funded by Bayer. The expert panel reached consensus following review of key clinical trial data and consideration of current NHS clinical practice to provide guidance on the use of intravitreal aflibercept 8 mg in nAMD. The panel provided recommendations for an aflibercept 8 mg treat-and-extend pathway for both treatment-naïve and previously treated patients with nAMD. Criteria were developed to guide dosing interval extension, reduction or maintenance based on visual acuity and optical coherence tomography imaging. More detailed guidance includes considerations for switching treatments to or from aflibercept 8 mg, monitoring, and discontinuing treatment. Aflibercept 8 mg may offer opportunities for longer treatment intervals and reduced patient and clinic burden compared with first-generation agents. The proposed treatment pathway is practical and accounts for variability in healthcare structures and capacity pressures, providing clinicians with flexibility in implementing these recommendations while addressing patient needs.

Diabetic foot ulcers (DFUs) are a serious complication of diabetes, associated with high risks of infection, amputation, and reduced quality of life. Silver nanoparticle dressings, known for their broad-spectrum antimicrobial and anti-inflammatory properties, offer a promising advanced treatment option. This prospective, randomized, single-blind controlled trial evaluated the efficacy of tetra silver tetroxide dressings compared to conventional dressings in managing DFUs, with limb salvage as the primary endpoint and wound healing parameters as secondary endpoints. Fifty-nine patients were randomly assigned to Group A (tetra silver tetroxide spray and gel, n = 30) or Group B (conventional dressings, n = 29). While no statistically significant difference in limb salvage rates was observed (Group A: 100% vs 86.21%; P = .052), the silver nanoparticle dressing demonstrated superior outcomes in all secondary endpoints: a higher rate of complete healing (100% vs 82.76%, P = .024), reduced mean healing time (9.77 vs 18.79 weeks, P < .001), lower incidence of post-treatment infection (0% vs 20.69%, P = .011), and fewer median dressing days (62.5 vs 122.5 days, P < .001). These findings indicate that tetra silver tetroxide nanoparticle dressings significantly accelerate wound healing, reduce infection, and lessen treatment burden, supporting their use as an effective DFU treatment option.

In individuals with cystic fibrosis (CF), lean mass and muscle strength are important predictors of clinical outcomes. This study evaluated associations among body composition, handgrip strength, muscle quality, physical activity, and health-related quality of life in CF. This observational, cross-sectional study included 27 adults with CF and 24 age-matched healthy controls. Body composition was assessed using dual-energy x-ray absorptiometry, physical activity by self-reported questionnaire, strength by handgrip dynamometry, and quality of life by the CF Quality of Life-Revised (CFQ-R) questionnaire. Muscle quality was defined as handgrip strength divided by appendicular lean mass. Analyses included t- tests and Pearson or Spearman correlations. Demographics, body composition, handgrip strength, and muscle quality were similar between those with CF and controls. Among those with CF, muscle quality was positively associated with total physical activity score (r = 0.49, P = 0.009). Handgrip strength was positively associated with lean mass (r = 0.86, P < 0.001) and bone mineral density (r = 0.64, P < 0.001). Regarding CFQ-R, lean mass was positively associated with body image and emotion (r = 0.41, P = 0.03), and body fat was associated with lower physical functioning (r = -0.63, P = 0.004), greater treatment burdens (r = -0.49, P = 0.01), and worse digestive health (r = -0.45, P = 0.02). As the CF population ages, these data support continued efforts to promote physical activity and improve body composition for enhanced quality of life while also highlighting the value of integrating accessible measures of muscle function and quality into routine clinical care.

As the global population ages, an increasing number of older adults progress to end-stage kidney disease (ESKD). In this population, frailty, multimorbidity, and functional decline often limit the survival benefit of dialysis, challenging the conventional approach to renal replacement therapy. To summarize current evidence comparing dialysis with conservative kidney management (CKM) in older adults with advanced chronic kidney disease (CKD), focusing on survival, quality of life, hospitalization, and prognostic tools. A narrative synthesis was conducted based on observational, cohort, and systematic review studies including adults aged ≥ 70years with stage 4-5 CKD. The literature search was performed exclusively in the PubMed database, which represents a methodological limitation of this review. Search terms included: end-stage renal disease, chronic kidney disease, kidney failure, dialysis, conservative management, frailty, geriatric patients, and elderly patients. Outcomes were grouped into four domains: survival, quality of life, healthcare utilization, and prognostic models. Across studies, dialysis prolonged survival mainly in younger and less comorbid patients, but this advantage diminished with increasing frailty and multimorbidity. CKM provided comparable or superior health-related quality of life (HRQoL) and was associated with fewer hospitalizations. Patients managed conservatively were more likely to die at home, reflecting closer alignment with end-of-life preferences. Prognosis was primarily determined by patient-level factors-age, frailty, and eGFR decline-rather than by treatment modality. CKM-specific prognostic models remain limited. In older adults with advanced CKD, survival gains from dialysis are modest and frequently offset by higher treatment burden. CKM offers a patient-centered alternative focused on quality of life, comfort, and goal-concordant care. The development of validated CKM-specific prognostic tools is essential to support individualized, evidence-informed decision-making.

Oral cancer is a significant global health concern, particularly in countries like India, where tobacco and betel nut use are prevalent. Despite advances in therapy, the prognosis remains poor, largely due to late-stage diagnosis. Early detection is key to improving survival rates and reducing the burden of treatment. In recent years, Artificial Intelligence (AI) has emerged as a revolutionary tool in medical diagnostics, with promising applications in oral oncology. This article aims to explore the role of AI in the early detection of oral cancer, its current applications, diagnostic accuracy, limitations, and the future direction of its integration into routine oral healthcare. An extensive review of the current literature was conducted, focusing on AI techniques such as machine learning (ML), deep learning (DL), and convolutional neural networks (CNNs), as well as their applications in analyzing intraoral images, radiographs, histopathology slides, and salivary biomarkers. Clinical trials, pilot studies, and technological assessments were reviewed to evaluate the performance of AI in detecting oral potentially malignant disorders (PMDs) and early-stage squamous cell carcinoma. AI-based tools have shown considerable promise in the accurate and non-invasive diagnosis of oral lesions. These systems offer enhanced sensitivity and specificity, reduce human error, and provide objective assessments, even in low-resource or remote settings. DL algorithms, particularly CNNs, have demonstrated excellent performance in image recognition tasks relevant to oral pathology. However, challenges such as data standardization, algorithmic bias, lack of clinical validation, and ethical concerns still hinder widespread adoption. AI has the potential to transform early detection strategies for oral cancer by supporting clinicians in making faster and more accurate diagnoses. With proper validation, integration into clinical workflows, and adherence to ethical guidelines, AI can serve as an invaluable adjunct in oral medicine, especially for mass screening and personalized diagnostics. Continued research, investment in digital infrastructure, and training of dental professionals are essential for realizing its full potential in the future of oral healthcare.

Curietherapy User eXperience pilot study (CurieUx): a feasibility study of a novel augmented reality educational tool during radiation oncology consultation for patients with breast cancer.

The increasing use of the immune checkpoint inhibitor nivolumab places a significant financial burden on healthcare systems, contributes to environmental concerns, and strains hospital capacities. The nivolumab average exposure and exposure variation of a fixed subcutaneous (SC) dosing regimen (1200 mg every 4 weeks) is significantly higher compared with 3-mg/kg every 2 weeks intravenous dosing. We aimed to develop alternative dosing regimens for SC nivolumab to reduce drug expenses and lower the treatment burden for patients while ensuring effective exposure. Population pharmacokinetic simulation was conducted using a population pharmacokinetic model developed by the license holder to explore alternative SC regimens. In this process, patients were divided into three weight groups: less than 60 kg, 60-90 kg, and more than 90 kg. Furthermore, two experimental progressive alternative dosing regimens were developed, one based on a minimum effective concentration-driven approach. The second progressive alternative regimen was based on using the 1200-mg SC formulation as an intravenous infusion. We developed an alternative bodyweight-based regimen consisting of SC 1200 mg every 7 weeks (<60 kg), 1200 mg every 6 weeks (60-90 kg), and 1200 mg every 5 weeks (>90 kg). This new alternative dosing regimen would save an average of €24,345 (35%) per patient per year compared with SC 1200 mg every 4 weeks. The results for the first experimental, progressive, extended-interval dosing regimen for patients with melanoma indicate that 95% of patients exceed a steady-state trough concentration of 2.5 mg/L when administered SC 1200 mg every 10 weeks. This dosing regimen would decrease the yearly cost from €68,870 to €27,548 (60% less) per patient per year. The second experimental progressive regimen using SC 1200 mg as an intravenous administration every 7 weeks leads to a potential saving of €29,516, which is a 43% decrease compared with the SC 1200-mg approved regimen. The developed dosing regimen with a bodyweight-dependent interval offers a cost-effective and patient-friendly method to optimize SC nivolumab use while ensuring adequate exposure, which can be directly implemented in clinical practice. Moreover, the two experimental progressive proposed regimens provide a rationale for a clinical non-inferiority study in which alternative dose regimens are compared to standard dosing according to the drug label.

ABSTRACTBackgroundIn the PROSELICA, a randomized controlled trial (RCT) comparing cabazitaxel 20 mg/m2 (C20) versus 25 mg/m2 (C25) in metastatic castration‐resistant prostate cancer (mCRPC), one‐variable‐at‐a‐time subgroup analysis suggested possible heterogeneity in treatment effect (HTE) of C25 versus C20 among study participants. Novel predictive HTE analysis approaches may provide an in‐depth understanding of such results.MethodsWe analyzed patient‐level data from 1200 patients with mCRPC who were randomized in the PROSELICA trial. Outcomes included overall survival (OS) and progression‐free survival (PFS). Using baseline characteristics, patients were stratified into quartiles based on either quantitative baseline risk of poor outcome (risk modeling) or predicted individualized treatment effect (ITE) using a causal survival forest algorithm (effect modeling). Treatment effects were measured as differences in restricted mean survival time (RMST).ResultsFor risk modeling, the OS effect of C25 increased with risk quartiles: −0.07 months (95% CI, −1.60 to 1.46) in the lowest risk quartile and 1.67 months (95% CI, 0.25 to 3.10) in the highest risk quartile. For effect modeling, the OS effect ranged from −0.17 months (95% CI, −3.01 to 2.68) in the lowest ITE quartile to 0.57 months (95% CI, −2.27 to 3.41) in the highest ITE quartile. Both approaches demonstrated greater C25 benefit in patients with extensive previous treatment and baseline disease burden. PFS effects remained consistent across all quartiles.ConclusionsThe OS effect of C25 versus C20 may vary based on baseline characteristics in post‐docetaxel mCRPC. Patients with extensive treatment history and disease burden may benefit more from C25.

BackgroundPanic disorder (PD) significantly impacts individuals’ daily lives and overall well-being. While cognitive behavioral therapy (CBT) is the gold standard for PD treatment, there is a growing interest in brief interventions to improve accessibility and reduce treatment burden. This study explored the feasibility and preliminary outcomes of a brief, four-session CBT intervention for PD, grounded in an intention-focused approach. The treatment emphasized modifying patients’ intentions underlying avoidance and safety behaviors during exposure tasks, aiming to enhance engagement and therapeutic effect.MethodsThis naturalistic effectiveness study involved 27 patients from the Norwegian Specialist Health Care clinic who were referred for PD treatment. Participants received the Bergen Repeated One-Session Treatment (BrOST), a brief, intention-focused cognitive behavioral intervention delivered in four individual sessions over a period of two to three weeks. Standardized self-report measures were administered to assess the severity of panic symptoms, general anxiety, depressive symptoms, and treatment satisfaction.ResultsThe treatment resulted in significant reductions in PD severity from pretreatment to one week posttreatment, with sustained improvements at three months. There were also notable reductions in symptoms of anxiety and depression. High levels of treatment satisfaction were reported by the patients. These findings suggest that the BrOST could be a promising alternative to traditional CBT protocols.ConclusionThis study indicated that the BrOST may be a promising brief CBT intervention for individuals with PD. Larger and more controlled studies are warranted.Trial registrationThe study was reviewed by the Regional Committee for Medical Research Ethics Northern Norway, REK North (REK Midt 2023/ 701114).

Background/Objectives: Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant vascular dysplasia characterized by recurrent epistaxis, anemia, and visceral arteriovenous malformations. Epistaxis is the most frequent and disabling manifestation, with limited effective pharmacological options. Propranolol, a non-selective beta-blocker with vasoconstrictive and antiangiogenic properties, has shown benefit in other vascular anomalies but remains scarcely studied in HHT. This study aimed to evaluate the effect of oral propranolol on nasal bleeding in patients with HHT. Methods: A retrospective observational study including 151 adults with HHT (44 treated with propranolol, 107 untreated) was conducted using data from an Institutional HHT Registry from a referral center. Baseline demographic and clinical variables were recorded. Outcomes at 6 months included changes in hemoglobin, adherence to nasal hygiene, use of bleeding-related therapies, and improvement in epistaxis frequency and intensity according to the Sadick-Bergler scale. Logistic regression models were adjusted for confounders and indication bias using inverse probability of treatment weighting (IPTW). Results: After IPTW adjustment, propranolol was significantly associated with reduced frequency of epistaxis (adjusted OR: 3.8; 95% CI: 1.3-11.2; p = 0.016), while no effect was observed on intensity. Hemoglobin levels increased modestly in both groups without a significant difference. Patients without propranolol showed greater antifibrinolytic use, whereas adherence to nasal care remained stable among treated patients. Conclusions: Oral propranolol reduced nasal bleeding frequency in HHT, even among patients with greater baseline severity. Given its accessibility, safety, and potential to lessen treatment burden, it may represent a valuable adjunct therapy. This study represents the largest cohort of HHT patients treated with propranolol reported to date. Randomized trials including standardized bleeding scores and patient-reported outcomes are warranted to confirm clinical and quality-of-life benefits.

Many patients, especially those with long-term conditions, face significant challenges in managing their health. Burden of treatment is the effort required for self-managing health. This burden is often intensified by social determinants of health, such as limited access to care and financial instability. Burden of treatment is understudied in socially and medically complex patients, particularly in the critical period of transitioning home after hospital discharge. To address this gap, this study analyzed data from telephone interviews with urban primary care patients who had been recently hospitalized and were identified by an algorithm as having complex medical and social needs, and received a nurse-led outreach call intervention to examine the following areas: (a) how patients with complex health and social needs experience burden of treatment following hospitalization; (b) the individual, interpersonal, and healthcare system factors that patients perceive as impacting burden of treatment; and (c) the impact of an outreach phone call on burden of treatment. The study team completed telephone interviews with 22 patients who received the outreach call intervention, using a semi-structured interview guide based on established treatment burden measurement tools. Interview data were analyzed using rapid qualitative data analysis techniques to identify key themes to answer the research questions. Findings indicated that most participants reported minimal treatment burden across key domains, such as understanding diagnoses, scheduling appointments, managing medications, and engaging in self-care. A minority experienced substantial difficulties, such as frustration with appointment scheduling and challenges with activities of daily living due to their conditions. Several factors were identified as influencing treatment burden, including health condition complexity, family support, and provider communication. Patients generally responded positively to the outreach calls, finding them reassuring and informative. Treatment burden is variable among medically and socially complex patients following hospitalization and is shaped by a number of individual, interpersonal, and healthcare system factors. Further research is needed to develop and evaluate interventions to build healthcare system capacity to serve this population, to minimize treatment burden.

Background: Numerous studies have explored the dysfunction experienced by patients and their families due to psychotic disorders such as schizophrenia. However, there is a paucity of research comparing schizophrenia with neurotic disorders like obsessive-compulsive disorder (OCD). Aim: To assess and compare disability, quality of life (QoL), and family burden in treatment naïve patients with schizophrenia and OCD. Materials and Methods: A comparative study including 50 treatment naïve patients with schizophrenia and 50 with OCD. Severity of symptoms was evaluated by Positive and Negative Syndrome Scale in schizophrenia and by Yale-Brown Obsessive Compulsive Scale in OCD. All subjects were assessed using Indian Disability Evaluation and Assessment Scale (IDEAS), 36-Item Short Form Health Survey Questionnaire (SF-36), Family Burden Interview Schedule (FBIS), and Global Assessment of Functioning (GAF) scale. Results: Regarding disability, a significant difference was observed in all domains and the global score of IDEAS, with higher scores in schizophrenia, except in the work domain. QoL also had significantly poor scores in both groups and within themselves; schizophrenia showed poorer QoL in all the domains. Regarding family burden, a significant difference was observed in all domains of FBIS, more in schizophrenia except in domain of disruption of routine family activities. Conclusion: Treatment naïve patients with schizophrenia and OCD have significant impairment in overall functioning, OCD being comparable to schizophrenia. This study shows the need of early identification and intervention to reduce disability and family burden and to improve QoL in these disorders.

Empowerment or responsibilisation: Articulation work in English primary care coordination from the perspectives of patients and clinicians.

ABSTRACTObjectivesCFTR modulators have revolutionized cystic fibrosis (CF) management by targeting the defective protein rather than its consequences. Their impact on quality of life (QoL) have been studied in numerous trials, but few data are available on QoL in patients receiving Elexacaftor‐Tezacaftor‐Ivacaftor (ETI), notably in children given its recent authorization for this age group. We aimed to assess the impact of ETI on children's QoL.MethodsThis prospective observational study included children with CF (6−17 years), assessing QoL using the CF Questionnaire Revised (CFQ‐R) before (baseline) and 3 months after (M3) starting ETI treatment for children and their caregivers.ResultsWe included 23 children (median [range]) age 10.2 [6−17.2] years, 13 (57%) with homozygous F508del genotype. The total QoL score at baseline ([mean (SD)] children: 74.07 [10.86]; caregivers: 73.21 [10.38]) reflected severe disease impact, particularly regarding treatment burden in the children's perspective (63.28 [21.04]) and digestive domains in the caregivers' perspective (digestive symptoms: 66.67 [17.37]; eating disorder: 67.54 [32.14]; weight: 61.40 [33.82]). At M3, there was a significant increase in reported QoL (p = 0.0001), particularly regarding physical domains. Emotional/social/school domains barely showed improvement. Although QoL mean scores were comparable between children and caregivers' groups, they were poorly correlated within the same family. Homozygous F508del genotype was associated with better QoL improvement at M3 compared to composite heterozygous genotypes (p < 0.001).ConclusionETI treatment has a significant impact on children's QoL, particularly in physical health domains. Other QoL domains that are not improved by ETI need to be addressed, in particular, psycho‐social components. Both children's and caregivers' perspectives must be considered for a holistic picture of children's QoL.

Enhanced quality in primary care for elders with diabetes and dementia: Protocol for a multisite randomized controlled trial.