World Health Organization Quality Of Life-BREF Research Articles

Health-related quality of life and associated factors among type 2 diabetic adult patients in Debre Markos Referral Hospital, Northwest Ethiopia

Health-related quality of life (HRQOL) is a multifaceted concept that is strongly impacted by Type II diabetes in developing countries. The majority of studies indicate diabetes mellitus prevalence without looking at people's quality of life.This study was conducted using an Institution-based cross-sectional design in Debre Markos Referral Hospital from March 03 to March 31, 2020. We evaluated HRQOL using the WHO quality of life BREF and data were obtained through face-to-face interviews. We used a systematic random sampling technique to select study participants. Data were entered into Epi data version 3.1 and exported to STATA version 14.0. Candidates for multivariable analysis were variables with a P-value less than 0.25 in the bivariable analysis and P-value less than 0.05 were considered to declare a statistically significant association. The final model was tested for its goodness of fit using Hosmer and Lemeshow's statistics.The analysis included a total of 368 adult individuals with type II diabetes and 206 (56%) had a good HRQOL. Being male (AOR = 4.28, 95%CI:2.36, 7.78), having duration of disease of more than 59 months (AOR = 2.93, 95%CI:1.61, 5.34), doing a physical exercise (AOR = 2.33,95%CI:1.34, 4.05) and got counseling (AOR = 3.33; 95%CI:1.82, 5.94) were directly associated with good HRQOL whereas the presence of diabetic complications (AOR = 0.46, 95%CI:0.26, 0.80), comorbidity (AOR = 0.45; 95%CI:0.25, 0.84) and drinking alcohol (AOR = 0.27, 95%CI:0.16, 0.48) had an inverse relationship with good HRQOL.More than half of type 2 diabetic adult patients had a good HRQOL. Being male, drinking alcohol, getting counseling, doing physical exercise, absence of diabetic complications, and comorbidity and long duration of disease were predictors of good HRQOL. Therefore, avoiding drinking alcohol and promoting physical exercise and counseling should be encouraged.

A Survey Study of Hearing Aid Satisfaction, Quality of Life, and Tinnitus of Elderly Hearing Aid Users

Purpose: The purpose of this study is to investigate hearing aid satisfaction, quality of life, and tinnitus of elderly hearing aid users to help hearing aid rehabilitation of the elderly. Methods: A total of 50 elderly hearing aid users (average age 75.7 years) with or without tinnitus participated in this study. We implemented pure tone audiometry and tinnitogram and conducted four questionnaires including Satisfaction with Amplification in Daily Life (SADL), World Health Organization Quality of Life-BREF (WHOQOL-BREF), Visual Analogue Scale (VAS), and Tinnitus Handicap Inventory (THI).Results: Positive correlations were found between SADL and WHOQOL-BREF scores. The average total SADL scores and WHOQOL-BREF scores are 5 points and 3.4 points respectively. There were no significant differences in the average SADL and WHOQOL-BREF scores between the elderly with tinnitus and the elderly without tinnitus. About 90% of the elderly with tinnitus described high frequency tinnitus above 2,000 Hz. Eighty-eight percent of the respondents had an experience of tinnitus therapy and 67% of the elderly with tinnitus therapy experiences reported that tinnitus therapy was not helpful. Ninety-two percent of the respondents stated that wearing hearing aid was helpful to reduce their tinnitus. The emotional and catastrophic subscales of THI were correlated with VAS scores. Conclusion: Positive correlations were found between SADL and WHOQOL-BREF scores regardless of tinnitus presence. Tinnitus of elderly hearing users was not directly related to the quality of life and successful hearing aid intervention could be a key factor in improving the quality of life of the elderly.

Effect of a Self-care Training Program Based on Temperament Modification on the Quality of Life of Patients with Type 2 Diabetes

Objective: Considering the high prevalence of diabetes mellitus and its effect on the quality of life (QoL) of patients which can lead to low self-care and increased risk of disease complications, this study aims to assess the effect of a self-care training program based on temperament modification on the QoL of patients with type 2 diabetes (T2D). Methods: In this quasi-experimental study, 110 patients with T2D were selected by a convenience sampling method and were randomly divided into two groups of intervention and control using the random number table. After obtaining informed consent from them, they completed a demographic from and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire, and their temperament was diagnosed by a doctor expert in Iranian traditional medicine. The intervention group received four sessions of self-care training based on temperament modification each for 45 minutes. The control group received routine treatment without any intervention. Then, they completed the WHOQOL-BREF questionnaire again three months after the intervention. Data were analyzed in SPSS software, version 22 using chi-square test, paired t-test, and independent t-test. The significant level was set at 0.05. Results: Before the intervention, there was no significant difference in the quality of life score between the intervention (83.2±11.9) and control (85±9.4) groups (P= 0.194). After the intervention, the difference was significant between the intervention (87.7±11.3) and control (85.1±9.5) groups (P=0.044). There was no significant difference in the quality of life score in control group before and after the intervention (P=0.244). Conclusion: The self-care program training based on temperament modification can improve the quality of life of patients with T2D.

Relationship Between Length of Rehabilitation and Quality of Life for Psychoactive Substance Users in Yogyakarta

The background of this research is the use of psychoactive substances causes complex problems and becomes a threat to the state. Rehabilitation can reduce the risk of relapse of psychoactive substance abuse and the risk of crime, thereby improving quality of life. Understanding rehabilitation with quality of life has a positive impact on users of psychoactive substances. Therefore, it is essential to study the relationship between the length of rehabilitation and the quality of life of users of psychoactive substances. The purpose of this study was to determine the relationship between the size of rehabilitation and the quality of life for users of psychoactive substances. This research method is a non-experimental observational analytic study with a cross-sectional design. The subjects of the study were users of psychoactive substances who were undergoing the rehabilitation process at the Class IIA Narcotics Prison in Yogyakarta. Quality of life was measured by the World Health Organization Quality of Life BREF (WHOQOL-BREF) instrument. The significance level of the statistical test was stated at p<0.05. Data analysis used the Spearman Rank correlation test and multiple linear regression. The results of this study carried out for two months (March to April 2021) obtained a total of 77 subjects using psychoactive substances. The length of rehabilitation has a significant positive correlation with the quality of life, indicated by the value of p = 0.048 (p <0.05) and r = 0.220, which means that the longer the respondent undergoes rehabilitation, the better the quality of his life. This study concludes that there is a significant relationship between the length of repair and quality of life for users of psychoactive substances.

Quality of life in patients with schizophrenia

There is limited evidence from India on the effect schizophrenia has on the quality of life (QoL) of patients.Our study aimed to determine the quality of life of patients with schizophrenia and analyze its determinants. This was a cross-sectional study carried out at the psychiatric outpatient department of SLN Medical College and Hospital in Koraput among 100 adult patients diagnosed with schizophrenia.Data was collected by psychiatrists usingthe Positive and Negative Syndrome Scale (PANSS) tool along with the WHO QoL BREF versionHADS (Hamilton Anxietyand Depression Scale) and GAF (Global Assessment of Functioning) tools. Among the participants, the lowest scores for WHOQOL-BREF werereported in the psychological domain of health (mean=11.6; SD=2.3), followed by the social domain (mean=12.2; SD=3.3) and environmental domains (mean=13.8; SD=2.4). The highest score was seen in the physical health domain (mean=13.9; SD=2.6). In general, the QoL was better among females than males. We found a significant association between the socio-demographic characteristicssuch as social support and the quality of life in schizophrenia. Significantly higher scores wererecorded from respondents who had good financial and living conditions and this was seen in all domains of the quality of life.

Patients' knowledge and concerns about using the implantable cardioverter defibrillator for the primary prevention of sudden cardiac death and its correlates: A cross-sectional study.

Background and AimsSudden cardiac death (SCD) is one of the most common causes of mortality in heart failure (HF) patients with reduced ejection fraction. Patients have concerns about the disease and use the implantable cardioverter defibrillator (ICD) to reduce the effects of HF disease. The current study aims to evaluate the barriers and factors affecting the implantation of the ICD for primary prevention.MethodsOne hundred‐forty‐seven patients with HF were studied in public hospitals in southern Iran by using a cross‐sectional design from April 2018 to June 2019. Demographic, researcher‐made questionnaire, World Health Organization Quality of life‐BREF (WHOQOL‐BREF), general self‐efficacy questionnaires, and Multidimensional Scale of Perceived Social Support (MSPSS) were measured for investigating the barriers and impact factors in patent HF.ResultsMost participants were male (56.5%), married (88.4%), illiterate (54.1%), and unemployed (72.6%). 62.6% (n = 92) of the participants did not know about HF and ICD. The total score of patients' concerns about using ICD was 47.11 ± 11.26, which showed a moderate level. The scores of knowledge about HF and ICD had a significant positive poor correlation with self‐efficacy, perceived social support and QoL. Also, the score of concerns about the ICD had a significant negative poor correlation with perceived social support.ConclusionUnderstanding HF patients' issues and obstacles can help us prevent sudden death. Doctors' advice has a significant impact on patients' acceptance. Poor knowledge is the most important reason for nonparticipation. Intervention is necessary to inform patients to understand the advantages and disadvantages.

Relationship Between Husband's Support and Quality of Life Among Menopausal Women in Bandung City

Menopause is a period of permanent cessation of menstruation which can cause the production of the hormones estrogen, progesterone and testosterone to stop. Quality of life is influenced by several factors including age, education, work and husband’s support. The purpose of this study was to determine the relationship between husband’s support and the quality of life of postmenopausal women in RW 11, the target area of the Babakan Sari Public Health Center in Kiaracondong District. A cross sectional study design was used. The sample consisted of 42 women aged 45-59 years with the criteria of normal menopausal women with husbands, recruited using accidental sampling. The WHOQOL-BREF (WHO Quality of Life - BREF) instrument was used to collect data on the quality of life, and husband’s support was measured using the Azwar questionnaire. Analyses included univariate analysis using frequency distributions and bivariate analysis using Spearman’s rank. 76.2% of respondents received high support from their husbands and 29 respondents (69.0%) had a good quality of life. A significant relationship was found (p = 0.01, with a correlation coefficient of 0.409, indicating a moderate relationship). This study therefore showed that there was a relationship between husband’s support and the quality of life of menopausal women in Kiaracondong District. So, it is very important for postmenopausal women to have the support of their husbands to improve and maintain their quality of life.
 Keywords: husband’s support, quality of life, menopause

Relationship between Self-Perception of Aging and Quality of Life in the Different Stages of Reproductive Aging in Mexican Women.

Biological aging has an abrupt beginning in women, changing their body and perceptions, which are not accepted easily because the actual stereotypes are focused on youth and anti-aging. Our interest was to explore what the self-perception of aging (SPA) is in middle-aged women throughout the reproductive aging stages and their association with the quality of life. A cross-sectional study was conducted with 240 women (40–69 years) living in Mexico City, who were separated according to their reproductive aging stage. An electronic version of the Spanish version of the Self-rated Attitudes Towards Old Age (SATO) and the WHO Quality of Life-Bref (WHOQoL) was applied to these women and was sent by WhatsApp or email. Seventeen women of the total sample (7%) had a negative self-perception of aging. There is an association between SATO and WHOQoL (r = –0.273, p < 0.0001), but in the menopausal transition stage, the association is strong in the psychological subscale, and after menopause, early and late postmenopausal women show a better association in the social subscale. Negative SPA impacts the WHOQoL psychological dimension and not the total WHOQoL score. Our findings suggest an association between SPA and quality of life in different reproductive aging stages.

Factors affecting the uptake of national practice guidelines by physicians treating common CVDS in out-patient settings

Aim To study factors that influence the consistency of real prescriptions with applicable national guidelines for outpatient physicians in the management of patients with common cardiovascular diseases (CVDs).Material and methods This was a cross-sectional study based on 16 randomly selected municipal polyclinics, where internists filled in validated questionnaires, including the Maslach Burnout Inventory - Human Services Survey (MBI-HSS), Hospital Anxiety and Depression Scale (HADS), Visual Analogue Scale (VAS), WHO Quality of Life - BREF (WHOQOL-BREF), and the Personal Decision-Making Factors (PDF-25). Participating physicians provided outpatient case reports of sequentially arriving patients with a high risk of CVD or confirmed CVDs during 2-3 working days, corresponding to the questionnaire period of ±1 week. The consistency of the prescriptions recorded in these case reports with the Russian Society of Cardiology (RSC) Guidelines was assessed.Results This study included 108 physicians (mean age, 44.0±13.1 years, 87.0 % women) who provided case reports of 341 patients (mean age, 64.4±13.2 years, 59.5 % women) with most common diagnoses of arterial hypertension (92.1 %), ischemic heart disease (60.7 %), and chronic heart failure (32.8 %). According to results of multivariate regression analysis, the following factors increased the likelihood of the prescription inconsistency with the guidelines: the fact that the physician had the highest attestation category (OR 2.56; 95% CI 1.39-4.7; p&lt;0.002), attended professional events less than 2 times in 5 years (OR 2.23; 95% CI 1.18-4.22; p=0.013), had an additional, part-time job (OR 15.58; 95% CI 1.51-160.5; p=0.021), was prone to prescribe familiar trade names (OR 2.04, 95% CI 1.08-3.85; p = 0.028), perceived drug supply problems as an important factor influencing the decision making (OR 5.13, 95% CI 2.69-9.75; p&lt;0.001), and a total score on the emotional exhaustion scale (OR 1.03, 95 % CI 1.01-1.06; р=0.031). Also, this likelihood was increased by older age of the patient (OR 3.29; 95 % CI 1.65-6.55; р&lt;0.001) and excessive alcohol consumption by the patient (OR 1.79, 95 % CI 1.31-2.43; р&lt;0.001). The likelihood of non-compliance with the guidelines was reduced by a high assessment of own health status according to the WHOQOL-BREF questionnaire (OR 0.19; 95% CI 0.05-0.72; p = 0.014), a high assessment of own working conditions (OR 0.76; 95% CI 0.64-0.9; p=0.002), and postgraduate education within the last 5 years (OR 0.14; 95% CI 0.06-0.36; p&lt;0.001).Conclusion The study identified the factors that influence the likelihood of the consistency of prescriptions made by outpatient physicians for patients with CVD with applicable national clinical guidelines. Among these factors, the most important ones were access to educational events, additional, external part-time job, indicators of inertia of previous practice, problems with drug provision, satisfaction with own health status and working conditions, and emotional exhaustion (a component of professional burnout), older age of patients and their excessive alcohol consumption.

SELF-CARE AND QUALITY OF LIFE PEOPLE WITH TYPE 2 DIABETES DURING THE COVID-19: CROSS-SECTIONAL STUDY.

Background. Social distancing and emotional stress during the COVID-19 pandemic have affected the self-care management of type 2 diabetes mellitus patients. There was a shift in self-care management during the COVID-19 that will impact the quality of life of type 2 diabetes mellitus (T2DM) patients. This study aims to determine the relationship between self-care management and quality of life of T2DM patients in the community health center during the lockdown.Methods. This research was a quantitative study with a cross-sectional study approach. The sampling technique used a non-probability sampling with total sampling of 89 respondents. The instruments used in this study were WHO Quality of Life-BREF and Summary of Diabetes Self Care Activities.FindingsThe results showed a significant relationship between self-care management and the quality of life of people with type 2 diabetes (p = 0.000) with moderate strength and a positive direction.ConclusionsPeople with diabetes coped well with their disease management which was supported by family and health professionals. Sustainable health education and motivation for patients and families are important so that the patients always carry out self-care management to improve the quality of life of type 2 diabetes mellitus patients.

Characteristics and Patient Reported Outcome Measures in Lipedema Patients—Establishing a Baseline for Treatment Evaluation in a High-Volume Center

Lipedema patients suffer not only from visual stigma but also reduction in their quality of life through pain and performance loss in daily life. In clinical practice, it is still difficult to reliably diagnose the disease. This study aims to provide further insights into the characteristics of lipedema patients of all stages and provide a baseline prior to surgery for a surgical treatment evaluation by means of patient-reported outcome measures. Methods: Patients completed a lipedema-specific questionnaire containing 50 items, the World Health Organization Quality of Life BREF (WHOQOL-BREF) and the Patient Health Questionnaire 9 (PHQ-9). The data were analyzed using SPSS statistics 27. Patients who had already received liposuction were excluded. Results: Five hundred and eleven patients were included, of whom 337 completed the PHQ9 and 333 completed the WHOQOL-BREF questionnaires. The general characteristics of lipedema patients, especially the daily symptoms, are described. Previous observations, such as the frequent occurrence of hypothyroidism and the low rate of type 2 diabetes, were confirmed. Over 49% suffer from severe impairments in their jobs, whereby the disease shows a familial accumulation. The results of the WHOQOL-BREF and the PHQ-9 suggest a high level of mental stress. Discussion: As surgical intervention in lipedema patients is gaining traction, its effects should be well-documented. Therefore, a comprehensive baseline needs to be established prior to surgical treatment. The psychological components are just as important as the inclusion of daily impairments.

Balance Confidence and Balance Performance, But Not Fall History Are Associated With Quality of Life in Community-Dwelling Older Adults: A Cross Sectional Study.

Fear of falling (FoF) is highly prevalent in community-dwelling older adults and is associated with low health-related quality of life (QoL). Low QoL is associated with increased health care utilization and is a predictor of future falls, but few studies have examined the relationship between high-level balance and dynamic gait performance and QoL in community-dwelling older adults. The purpose of this cross-sectional study was to determine whether there is a relationship between FoF avoidance behaviors, balance confidence, performance on measures of high-level mobility, and QoL in community-dwelling older adults. The secondary purpose was to determine whether older adults who fall have a different QoL than older adults who have not fallen in the past year. Eighty-nine community-dwelling older adults (76.33 ± 6.84 years, 54 female, 34 fallers) completed the World Health Organization Quality of Life-BREF (WHOQOL-BREF), Activities-specific Balance Confidence Scale (ABC), Fear of Falling Avoidance Behavior Questionnaire (FFABQ), Functional Gait Assessment (FGA), and Community Balance and Mobility Scale (CB&M). Correlation and multiple regression analyses were calculated to determine the relationship between the outcome measures and domains on the WHOQOL-BREF. Significant correlations were observed between the WHOQOL-BREF physical health domain and the ABC, FFABQ, FGA, and CB&M (ρ= 0.524, -0.509, 0.348, and r = 0.423, respectively), the WHOQOL-BREF psychological domain and the ABC (ρ= 0.284) and FFABQ (ρ=-0.384), and the WHOQOL-BREF environment domain and the ABC (ρ= 0.343) and FFABQ (ρ=-0.406). No correlations were found between WHOQOL-BREF domain scores and a history of falls. Performance-based outcome measures that measure high-level mobility such as the CB&M and FGA, and patient-reported outcome measures for balance confidence and FoF avoidance behavior such as the ABC and FFABQ, are correlated with the physical health QoL domain on the WHOQOL-BREF. The ABC and FFABQ are correlated with psychological and environment QoL. Fall history was not correlated with QoL. Interventions to decrease FoF or improve high-level mobility may improve QoL in community-dwelling older adults.

Effect of Ear Acupuncture plus Dry Cupping on Activities and Quality of Life in the Adults with Chronic Back Pain: a Randomized Trial.

Chronic pain is a complex phenomenon that brings physical and emotional impairments negatively impacting people's quality of life. The adoption of interventions such as ear acupuncture and dry cupping can represent a treatment option for people with chronic back pain. To investigate the effects of ear acupuncture combined with dry cupping therapy on the interference of pain with the daily activities and quality of life of adults with chronic back pain. An open-label, randomized, parallel-group controlled clinical trial. One hundred and ninety-eight adults were randomized into control (CG - ear acupuncture) or experimental (EG - ear acupuncture combined with dry cupping) groups. Interventions were performed in five sessions, once a week, lasting five weeks. Evaluations were performed before the first session, after the last session, and seven days after the second evaluation, using the Brief Pain Inventory to assess the impact of pain on daily activities and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) to assess the quality of life. Between the initial and final sessions, there were significant changes in daily activities , activity, work, mood, relationships, sleep, and in the physical, psychological and social relationships domains for both the control and experimental groups. Improved perception of quality of life and satisfaction with health were observed for the participants in the experimental group. Ear acupuncture combined with dry cupping showed better results in terms of perception of quality of life and satisfaction with health when compared to ear acupuncture by itself.

Association between burnout and nurses’ quality of life in neonatal intensive care units: During the COVID-19 pandemic

BackgroundNeonatal intensive care unit (NICUs) nurses could suffer from job stress and burnout, which could cause increased turnover rates and decreased Quality of Life (QoL) among nurses. PurposeTo determine the association between burnout and nurses’ QoL in NICUs. Study designThis correlational study was performed in 2020 on 140 nurses working in NICUs. The Maslach burnout and WHO Quality of Life-BREF was used to collect data. ResultsThere is a positive association between personal accomplishment and all dimensions of QoL (r = 0.40 to 0.56) and a negative association between emotional exhaustion, depersonalization of burnout and all dimensions of QoL (r = −0.47 to −0.79). ConclusionIt is suggested that several interventions must be taken to prevent burnout and increased QoL in NICU nurses. The findings could provide scientific evidence for managers and encourage evidence-based decision-making to reduce burnout and improve the QoL of nurses especially during the Covid-19 pandemic.

Food tolerance, nutritional status and health-related quality of life of patients with morbid obesity after bariatric surgery.

Bariatric surgery has been proven to be the most effective weight loss treatment for patients with morbid obesity. However, the alteration in the anatomy of the gastrointestinal structure, food aversion, and non-compliance to recommended dietary advice after bariatric surgery may cause food intolerance, which may affect the nutritional status and health-related quality of life (HRQOL). This study aims to determine the effects of bariatric surgery on food tolerance, nutritional status, and HRQOL among patients with morbid obesity in Malaysia. This prospective observational study screened a total of 97 patients with morbid obesity. Data on socio-demographic characteristic, food tolerance, nutritional status and HRQOL were collected and assessed at baseline, one month and three months after bariatric surgery. Food tolerance was evaluated using a validated quality of alimentation questionnaire. The anthropometry measurements, including the body mass index (BMI) and percent excess weight loss (EWL), were evaluated, and the dietary intake was collected using a three-day food record. The HRQOL was assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. This study recruited 90 patients with morbid obesity who underwent bariatric surgery with a response rate of 100%. There were 62 females (68.9%) and 28 male (31.1%) patients, with 50% of the patient age less than 40. The EWL one month and three months after surgery was 14.1% and 31.6%, respectively. There was a significant decrease in the total food tolerance score from 26.4 (SD=0.8) at baseline to 17.7 (SD=4.7) one month after bariatric surgery, but a gradual rise in the score to 21.7 (SD=4.3) was observed three months after surgery. A similar pattern is seen in the dietary intake assessment where a significant reduction in the total energy from 1842kcal (SD=445) at baseline to 570kcal (SD=180) one month and an increase to 731kcal (SD=185) three months after bariatric surgery. The HRQOL of the study patients showed a statistically significantly increase in the domain of physical health (t=-7.253, p=<0.001), psychological (t=-7.692, p<0.001), social relationship (t=-5.767, p<0.001) and environment (t=-4.208, p<0.013) three months after bariatric surgery. The present study showed that bariatric surgery effectively reduces weight and improves overall HRQOL domains among patients with morbid obesity despite reduced food tolerance and energy intake after bariatric surgery. Future longitudinal studies or randomized controlled trial with a larger sample size is recommended to determine the cause and effect mechanism between food tolerance, weight loss, dietary intake, HRQOL and bariatric surgery in Malaysia.

Efficacy of Brahmi vati in generalised anxiety disorder – Randomized double blind comparative clinical trial

BackgroundGeneralized Anxiety Disorder (GAD) is the most common anxiety disorder. GAD has high comorbidities and it can affect social, professional and personal life. Ayurvedic medicine, Brahmi vati is explored for the possible role in management of GAD and is compared to Manasmitra vataka. AimTo evaluate the efficacy of B. vati on Generalized Anxiety Disorder. MethodsA randomized double blind controlled trial, with total 56 patients meeting the DSM V criteria of GAD between 20–60 years of age and either sex participated in the study. Participants were randomly divided into two groups, Brahmi group received capsule B. vati 500 mg and Manasmitra group received capsule M. vataka 500 mg thrice a day with water for 45 days. Assessments were conducted through various clinical parameters such as Hamilton Anxiety Rating Scale (HARS), GAD 7 scale (GAD 7), Beck Depression Inventory scale (BDI), Epworth sleepiness scale (ESS), Pittsburgh Sleep Quality Index (PSQI), WHO Quality of Life- BREF (WHOQOL-BREF), Clinical Global Improvement scale (CGI). Blood variables including Haemoglobin, Erythrocyte Sedimentation Rate (ESR), Liver Function Test (LFT) and serum creatinine were assessed before and after the study. Assessments during intervention were conducted on every 15th day. ResultsStudy results indicate that both B. vati and M. vataka were comparable and each produced significant improvement (p < 0.001) in HARS, GAD-7, BDI, ESS, PSQI, WHOQOL-BREF and CGI. Brahmi vati also produced significant decrease in systolic (p = 0.002) and diastolic (p < 0.001) blood pressure. Both groups showed good safety profile evaluated through the assessment of serum creatinine levels and LFT. ConclusionB. vati and M. vataka were effective, safe and comparable in the management of GAD. Warrants further studies.

Analgesic Effects of Repetitive Transcranial Magnetic Stimulation in Patients With Advanced Non-Small-Cell Lung Cancer: A Randomized, Sham-Controlled, Pilot Study.

ObjectiveCurrent pharmacological intervention for the cancer-related pain is still limited. The aim of this study was to explore whether repetitive transcranial magnetic stimulation (rTMS) could be an effective adjuvant therapy to reduce pain in patients with advanced non-small cell lung cancer (NSCLC).MethodsThis was a randomized, sham–controlled study. A total of 41 advanced NSCLC patients with uncontrolled pain (score≥4 on pain intensity assessed with an 11-point numeric rating scale) were randomized to receive active (10 Hz, 2000 stimuli) (n = 20) or sham rTMS (n = 20) for 3 weeks. Pain was the primary outcome and was assessed with the Numeric Rating Scale (NRS). Secondary outcomes were oral morphine equivalent (OME) daily dose, quality of life (WHO Quality of Life-BREF), and psychological distress (the Hospital Depression and Anxiety Scale). All outcomes were measured at baseline, 3 days, 1 week, 2 weeks, and 3 weeks.ResultsThe pain intensity in both groups decreased gradually from day 3 and decreased to the lowest at the week 3, with a decrease rate of 41.09% in the rTMS group and 23.23% in the sham group. The NRS score of the rTMS group was significantly lower than that of the sham group on the week 2 (p < 0.001, Cohen’s d =1.135) and week 3 (p=0.017, Cohen’s d = -0.822). The OME daily dose, physiology and psychology domains of WHOQOL-BREF scores, as well as the HAM-A and HAM-D scores all were significantly improved at week 3 in rTMS group.ConclusionAdvanced NSCL patients with cancer pain treated with rTMS showed better greater pain relief, lower dosage of opioid, and better mood states and quality of life. rTMS is expected to be a new effective adjuvant therapy for cancer pain in advanced NSCLC patients.

Breathing-Focused Yoga Intervention on Respiratory Decline in Chronically Pesticide-Exposed Farmers: A Randomized Controlled Trial.

BackgroundOccupational exposure to pesticides has been associated with lung and cognitive function exacerbations. In the present study, we tested the effectiveness of breathing focused yoga intervention on alleviation of adverse respiratory and cognitive effects associated with chronic pesticide exposure in farmers.MethodsWe undertook a parallel, two-armed randomized controlled trial with blinded outcome assessors on a chronically pesticide-exposed farming population. The study was conducted at district Panipat, State Haryana located in the Northern part of India from November 2019 to August 2020. A total of 634 farmers were screened, and 140 farmers were randomized to breathing-focused yoga intervention (BFY, n = 70) and waitlist control arms (n = 65). BFY was delivered weekly in 45-min group sessions over 12 weeks followed by home-based practice. The primary outcome was the change in spirometry-based markers of pulmonary function from baseline expressed as raw values, Global Lung Initiative (GLI) percent predicted (pp), and GLI z-scores after 24 weeks of intervention. Secondary variables were Trail making tests (TMT A and B), Digit symbol substitution (DSST), and WHO Quality of life-BREF (WHOQOL-Bref). Analysis was by intention-to-treat. Mediation analysis was done considering oxidative stress markers as potential mediators.ResultsAt the end of 6 months of intervention, the overall follow-up in the participants was 87.85% (n = 123); 90% (n = 63) in the control group, and 85.71% in the yoga group (n = 60). The mean age of the study cohort (n = 140) was 38.75 (SD = 7.50) years. Compared with the control group, at 24 weeks post-intervention, the BFY group had significantly improved status of the raw sand z scores markers of airway obstruction, after adjusting for confounders, FEV1, FVC, FEF25-75 [z score-adjusted mean differences (95% CI); 1.66 (1.10–2.21) 1.88 (1.21–2.55), and 6.85 (5.12–8.57), respectively. A fraction of FEF25-75 change (mediation percentage 23.95%) was explained by glutathione augmentation. There were also significant improvements in cognitive scores of DSST, TMT-A and TMT-B, and WHOQOL-Bref.ConclusionIn conclusion, regular practice of BFY could improve the exacerbations in the markers of airway obstruction in chronically pesticide-exposed farmers and cognitive variables. A significant mediating effect of glutathione augmentation was also observed concerning the effect of the intervention on FEF25-75. These findings provide an important piece of beneficial evidence of the breathing-based yoga intervention that needs validation across different farming ethnicities.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: CTRI/2019/11/021989.

Health and coping strategies of nursing home residents and their relatives during the COVID-19 pandemic: a mixed-methods study protocol

IntroductionThe COVID-19 pandemic hit older adults particularly hard, especially those living in nursing homes. The present study’s primary aim is to quantify the states of physical and mental health of...

Health complexity assessment in primary care: A validity and feasibility study of the INTERMED tool.

Health complexity includes biological, psychological, social, and health systems. Having complex health needs is associated with poorer clinical outcomes and higher healthcare costs. Care management for people with health complexity is increasingly recommended in primary health care (PHC). The INTERMED complexity assessment grid showed adequate psychometric properties in specialized settings. This study aimed to evaluate INTERMED's validity and feasibility to assess health complexity in an adult PHC population. The biopsychosocial health care needs of 230 consecutive adult patients from three Brazilian PHC services were assessed using the INTERMED interview. Participants with a total score >20 were classified as "complex". Quality of life was measured using the World Health Organization Quality of Life BREF (WHOQOL-BREF); symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS); social support using the Medical Outcomes Study-Social Support Survey (MOS-SSS); comorbidity levels using the Charlson Comorbidity Index (CCI). We developed two questionnaires to evaluate health services use, and patient perceived feasibility of INTERMED. 42 participants (18.3%) were classified as "complex". A moderate correlation was found between the total INTERMED score and the total scores of WHOQOL-BREF (rho = - 0.59) and HADS (rho = 0.56), and between the social domains of INTERMED and MOS-SSS (rho = -0.44). After adjustment, the use of PHC (β = 2.12, t = 2.10, p < 0.05), any other health care services (β = 3.05, t = 3.97, p < 0.01), and any medication (β = 3.64, t = 4.16, p < 0.01) were associated with higher INTERMED scores. The INTERMED internal consistency was good (ω = 0.83), and the median application time was 7 min. Patients reported satisfaction with the questions, answers, and application time. INTERMED displayed good psychometric values in a PHC population and proved promising for practical use in PHC.