Summary
Objective
To evaluate whether vagus nerve stimulation (VNS) as adjunct to best medical practice (VNS + BMP) is superior to BMP alone in improving long‐term health‐related quality of life ...(HRQoL).
Methods
PuLsE (Open Prospective Randomized Long‐term Effectiveness) was a prospective, randomized, parallel‐group, open‐label, and long‐term effectiveness study (conducted at 28 sites in Europe and Canada). Adults with pharmacoresistant focal seizures (n = 112) received VNS + BMP or BMP (1:1 ratio). Medications and VNS parameters could be adjusted as clinically indicated for optimal seizure control while minimizing adverse effects. Primary endpoint was mean change from baseline HRQoL (using Quality of Life in Epilepsy Inventory‐89 total score; QOLIE‐89). Secondary endpoints included changes in seizure frequency, responder rate (≥50% decrease in seizure frequency), Centre for Epidemiologic Studies Depression scale (CES‐D), Neurological Disorders Depression Inventory‐Epilepsy scale (NDDI‐E), Clinical Global Impression‐Improvement scale (CGI‐I), Adverse Event Profile (AEP), and antiepileptic drug (AED) load. The study was prematurely terminated due to recruitment difficulties prior to completing the planned enrollment of n = 362. Results for n = 96 who had baseline and at least one follow‐up QOLIE‐89 assessment (from months 3‐12) were included in this analysis. Mixed model repeated measures (MMRM) analysis of variance was performed on change from baseline for the primary and secondary endpoints.
Results
Significant between‐group differences in favor of VNS + BMP were observed regarding improvement in HRQoL, seizure frequency, and CGI‐I score (respective p‐values < 0.05, 0.03, and 0.01). More patients in the VNS + BMP group (43%) reported adverse events (AEs) versus BMP group (21%) (p = 0.01), a difference reflecting primarily mostly transient AEs related to VNS implantation or stimulation. No significant difference between treatment groups was observed for changes in CES‐D, NDDI‐E, AEP, and AED load.
Significance
VNS therapy as a treatment adjunct to BMP in patients with pharmacoresistant focal seizures was associated with a significant improvement in HRQoL compared with BMP alone.
A PowerPoint slide summarizing this article is available for download in the Supporting Information section here.
Objective: The purpose of this study was to quantify the effect of physical activity (in both descriptive and intervention studies) on health-related quality of life (HRQOL) in children and ...adolescents from both healthy and chronic illness populations. Method: A systematic review of PubMed, PsycINFO, and ProQuest identified 33 studies of physical activity and HRQOL in youth, including descriptive and prepost intervention designs. Results: In descriptive studies (N = 14), there was a small, positive association between physical activity and HRQOL based on child-reports (Hedges' g = .302, p < .001, 95% confidence interval, CI .178, .426) and a negligible association based on parent-proxy reports (Hedges' g = .115, p = .101, 95% CI −.023, .253). Intervention studies (N = 19) yielded a small, positive effect of physical activity intervention on HRQOL based on child-reports (Hedges' g = .279, p = .014, 95% CI .057, .500) and a medium, positive effect based on parent-proxy reports (Hedges' g = .522, p = .012, 95% CI .117, .928). Intervention effects were attenuated by removal of a single study. Hypothesized and exploratory moderators did not moderate the relationship between physical activity and HRQOL. Conclusions: Findings supported the primary hypothesis that physical activity was related to better HRQOL in youth, although the magnitude of these effects did not represent a minimal clinically important difference (MCID) in most studies. Future studies are needed to assess HRQOL in youth before and after exercise interventions to quantify the type, frequency, duration, and intensity of physical activity needed to change HRQOL.
Summary
Objective
To develop and validate a shortened version of the Quality of Life in Childhood Epilepsy Questionnaire (QOLCE). A secondary aim was to compare baseline risk factors predicting ...health‐related quality of life (HRQoL) in children newly diagnosed with epilepsy, as identified using the original and shortened version.
Methods
Data came from the Health‐Related Quality of Life in Children with Epilepsy Study (HERQULES, N = 373), a multicenter prospective cohort study. Principal component analysis reduced the number of items from the original QOLCE, and factor analysis was used to assess the factor structure of the shortened version. Convergent and divergent validity was assessed by correlating the Child Health Questionnaire (CHQ) with the shortened QOLCE. Multiple regression identified risk factors at diagnosis for HRQoL at 24 months.
Results
A four‐factor, higher‐order, 55‐item solution was obtained. A total of 21 items were removed. The final model represents functioning in four dimensions of HRQoL: Cognitive, Emotional, Social, and Physical. The shortened QOLCE demonstrated acceptable fit: Bentler's Comparative Fit Index = 0.944; Tucker‐Lewis Index = 0.942; root mean square approximation = 0.058 (90% CI: 0.056–0.061); weighted root mean square residuals (WRMR) = 1.582, and excellent internal consistency (α = 0.96, subscales α > 0.80). Factor loadings were good (first‐order: λ = 0.66–0.93; higher‐order λ = 0.66–0.85; p < 0.001 for all). The shortened QOLCE scores correlated strongly with similar subscales of the Child Health Questionnaire (ρ = 0.38–0.70) while correlating weakly with dissimilar subscales (ρ = 0.30–0.31). While controlling for HRQoL at diagnosis, predictors for better HRQoL at 24 months were the following: no cognitive problems reported (p = 0.001), better family functioning (p = 0.014), fewer family demands (p = 0.008), with an interaction between baseline HRQoL and cognitive problems (p = 0.011).
Significance
Results offer initial evidence regarding reliability and validity of the proposed 55‐item shortened version of the QOLCE (QOLCE‐55). The QOLCE‐55 produced results on risk factors consistent with those found using the original measure. Given the fewer items, QOLCE‐55 may be a viable option reducing respondent burden when assessing HRQoL in children with epilepsy.
Objective
The aim of this study was to determine the relationship between Oral Health Related Quality of Life (OHRQoL) and general health‐related quality of life (GHRQoL) in partially edentulous ...patients before and after implant placement.
Material and methods
After obtaining informed consent, using convenient sampling method, 102 participants (64 female and 38 male participants with an age range of 18–81 years) were included in the study. Participants were required to fill EuroQol‐5D (EQ‐5D) and the Oral Health Impact Profile‐14 (OHIP‐14) questionnaire before implant surgery and three months after prosthetic placement. Data were not normally distributed, so non‐parametric tests were used for data analysis.
Results
Data analysis was carried out on 93 participants. After implant treatment, Visual Analogue Scale (VAS) and EQ‐5D score significantly increased by 0.05 and 0.06 units, respectively (p < .001 and p = .004, respectively). Also, the total OHIP‐14 score significantly decreased from 15.89 to 6.18 after implant treatment (p < .001).
Conclusion
Results indicated an increase in general and oral health‐related quality of life after implant treatment. According to this study, there was a positive weak relationship between GHRQoL and OHRQoL before and after implant treatment.
Validation study of a wellbeing scale Yaaqeib, Saad; Lambert, Louise; Hadjisolomou, Stavros ...
PloS one,
05/2022, Letnik:
17, Številka:
5
Journal Article
Recenzirano
The Scale of Positive and Negative Experience (SPANE) is an emerging wellbeing scale to measure the frequency of positive and negative emotions. This study explores the psychometric properties of ...SPANE on a sample from the Arab Gulf region. The Arab Gulf region shares cultural elements with the broader Muslim and Arab world, but maintains distinct features that warrants validation studies for psychological instruments. There were 1393 participants from Saudi Arabia, Oman, Kuwait and other Arab Gulf countries. The factorial structure of SPANE was examined using a principal axis factor analysis, followed up with a confirmatory factor analysis. The convergent validity was examined by correlating SPANE with the Satisfaction with Life Scale (SWLS). The findings confirmed a two-factor structure of SPANE, and demonstrated adequate psychometric properties and convergent validity. In conclusion, this study indicates that SPANE shows sufficient validity for use as a measure of wellbeing in the Arab Gulf region.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background:
The symptoms that have the largest impact on health-related quality of life (HRQoL) in people with multiple sclerosis (MS) may vary by MS phenotype (relapsing-remitting MS (RRMS), ...secondary progressive MS (SPMS) and primary progressive MS (PPMS)). Knowing these symptoms assists in symptom management.
Objective:
To examine the associations between 13 common MS symptoms and HRQoL in the total sample and stratified by MS phenotype.
Method:
The study included 1985 participants. HRQoL was measured with two multi-attribute utility instruments: assessment of quality of life with eight dimensions (AQoL-8D) and European quality of life with five dimensions and five levels for each dimension (EQ-5D-5L). Multivariable linear regression was used to identify the symptoms that had the largest impact on the HRQoLs.
Results:
Feelings of depression, pain, fatigue, and feelings of anxiety were most strongly associated with AQoL-8D and EQ-5D-5L. Walking difficulties additionally contributed to reduced EQ-5D-5L. The strongest single predictors in the multivariable analyses were feelings of depression or pain for AQoL-8D and walking difficulties for EQ-5D-5L, irrespective of MS phenotype.
Conclusion:
The strongest single predictors for the AQoL-8D and EQ-5D-5L were feelings of depression, pain and walking difficulties, irrespective of MS phenotype. Reducing these symptoms may have the largest impact on improving HRQoL in all MS phenotypes of people with MS.
Endpoints of active periodontal therapy Loos, Bruno G.; Needleman, Ian
Journal of clinical periodontology,
July 2020, 2020-07-00, 20200701, Letnik:
47, Številka:
S22
Journal Article
Recenzirano
Odprti dostop
Aim
Position paper on endpoints of active periodontal therapy for designing treatment guidelines. The question was as follows: How are, for an individual patient, commonly applied periodontal probing ...measures—recorded after active periodontal therapy—related to (a) stability of clinical attachment level, (b) tooth survival, (c) need for re‐treatment or (d) oral health‐related quality of life.
Methods
A literature search was conducted in Ovid MEDLINE(R) and Epub Ahead of Print, In‐Process & Other Non‐Indexed Citations and Daily <1946 to 07 June 2019>.
Results
A total of 94 papers were retrieved. From the literature search, it was found that periodontitis patients with a low proportion of deep residual pockets after active periodontal therapy are more likely to have stability of clinical attachment level over a follow‐up time of ≥1 year. Other supporting literature confirms this finding and additionally reports, at the patient level, that probing pocket depths ≥6 mm and bleeding on probing scores ≥30% are risks for tooth loss. There is lack of evidence that periodontal probing measures after completion of active periodontal treatment are tangible to the patient.
Conclusions
Based on literature and biological plausibility, it is reasonable to state that periodontitis patients with a low proportion of residual periodontal pockets and little inflammation are more likely to have stability of clinical attachment levels and less tooth loss over time. Guidelines for periodontal therapy should take into consideration (a) long‐term tangible patient outcomes, (b) that shallow pockets (≤4 mm) without bleeding on probing in patients with <30% bleeding sites are the best guarantee for the patient for stability of his/her periodontal attachment, (c) patient heterogeneity and patient changes in immune response over time, and (d) that treatment strategies include lifestyle changes of the patient. Long‐term large population‐based and practice‐based studies on the efficacy of periodontal therapies including both clinical and patient‐reported outcomes (PROs) need to be initiated, which include the understanding that periodontitis is a complex disease with variation of inflammatory responses due to environment, (epi)genetics, lifestyle and ageing. Involving people living with periodontitis as co‐researchers in the design of these studies would also help to improve their relevance.
Purpose
To (1) Compare vision-related quality of life (VRQOL) in adolescent and young adult (AYA) unilateral versus bilateral retinoblastoma (RB) survivors using a vision-targeted measure and a ...generic health-related quality of life (HRQOL) measure and (2) Assess associations among VRQOL and generic HRQOL domains and overall QOL and estimate associations of the VRQOL and HRQOL domains with overall QOL.
Methods
The National Institute for Health (NIH) Toolbox® VRQOL instrument, PROMIS®-29 Profile v 2.1, and a single-item QOL measure were administered in a cross-sectional study of 101 RB survivors. Reliability for multi-item scales was estimated. Product-moment and Spearman rank correlation coefficients and stepwise ordinary least squares were used to measure associations of other variables with overall QOL.
Results
Significantly worse VRQOL was reported by bilateral than unilateral RB survivors. Cronbach’s alpha coefficients for all VRQOL scales ranged from 0.83 to 0.95. Medium to large correlations were found between all NIH Toolbox® VRQOL scales and the PROMIS®-29 measures. Depression and ability to participate in social roles and activities from the PROMIS®-29 Profile accounted for 38% of the variance in overall QOL with the psychosocial domain of the NIH Toolbox® VRQOL explaining 16% of the variance.
Conclusion
VRQOL is impaired in bilateral RB survivors. VRQOL is associated substantially with the PROMIS-29 generic HRQOL measure but has significant unique associations with overall QOL. The NIH Toolbox® VRQOL measure provides important information about the vision-related effects on daily life of AYA RB survivors.
Background
The goal of this study was to compare health‐related quality of life (HRQL) from diagnosis to 10 years postdiagnosis among breast cancer survivors (BCS) and women without cancer over the ...same period and to identify BCS subgroups exhibiting different HRQL trajectories.
Methods
Our analysis included 141 BCS and 2086 controls from the Study of Women's Health Across the Nation (SWAN), a multiracial/ethnic cohort study of mid‐life women assessed approximately annually from 1995 to 2015. Pink SWAN participants reported no cancer at SWAN enrollment and developed (cases) or did not develop (controls) incident breast cancer after enrollment. We assessed HRQL with SF‐36 Mental Component Summary and Physical Component Summary scores. We modeled each as a function of case/control status, years since diagnosis, years since diagnosis squared, and the interaction terms between case/control status and the 2 time variables in linear models. We characterized heterogeneity in postdiagnosis HRQL of cases using group‐based trajectories.
Results
BCS had significantly lower HRQL compared with controls at diagnosis and 1 year postdiagnosis. By 2 years, BCS and controls no longer differed significantly. Among BCS, 2 trajectory groups were identified for both scores. For the Mental Component Summary, 88.4% of BCS had consistently good and 11.6% had very low scores. For the Physical Component Summary, 73.9% had good scores, and 26.1% had consistently low scores. Prediagnosis perceived stress and current smoking were related to being in the low mental trajectory group, and a higher number of comorbidities was related to being in the low physical trajectory group.
Conclusion
Although the majority of BCS have HRQL similar to non‐cancer controls after 2 years, subgroups of BCS continue to have low HRQL. Prediagnosis stress, comorbidities, and smoking are vulnerability factors for long‐term, low HRQL in BCS.
A longitudinal cohort of middle‐aged women reveals that the majority of breast cancer survivors have health‐related quality of life (HRQL) similar to noncancer controls after 2 years. However, subgroups of survivors continue to have low HRQL. Stress, comorbidities, and smoking prior to diagnosis are vulnerability factors for long‐term, low HRQL in breast cancer survivors.
Previous studies have reported that primary cutaneous lymphomas profoundly influence patients' health-related quality of life (HRQoL). However, assessment of this psycho-social concept is not common ...in routine patient care unless required within clinical trials. The aim of this review is to provide a comprehensive overview of HRQoL measures and outcomes in cutaneous lym-phomas in order to inform clinicians. Advanced-stage cutaneous lymphomas were found to be associated with worse HRQoL than early-stage disease. Specifically, progression of the disease, age, sex, psychosocial issues, educational level and therapy were related to the extent of impairment of HRQoL. Treatment response was linked to improved HRQoL, but notably ameliorated HRQoL scores were also reported despite objective disease response. However, the variety of instruments applied to measure HRQoL in cutaneous lymphomas makes it difficult to compare data directly. In conclusion, speciality-specific HRQoL instruments were superior to generic ones, which probably failed to recognize small, but relevant, changes, demonstrating the need for a disease-specific tool.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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