[Family support upon immediate cystic fibrosis announcement]

Cystic fibrosis, a rare, hereditary and chronic disease, affects the psychic functioning of children and their families. Since it is incurable, constant adjustments are essential to make sense of the inevitable evolution of the disease. The psychologists support the families and the patients so that all live as well as possible with cystic fibrosis.

[Therapeutic relationship and care with the person with severe cognitive impairment]

The inevitable evolution of cognitive disorders in neurodegenerative diseases, such as Alzheimer's disease, raises questions about the modalities and objectives of care provided to people with these diseases. It justifies the acquisition of a holistic and humanistic perspective to maintain the person as a whole at the core of our priorities. Person-centered care meets this requirement by being rooted in a supportive relationship.

[Factors associated with the quality of life of patients with knee osteoarthritis]

INTRODUCTION

knee osteoarthritis, a common condition in Sub-Saharan Africa, affects the quality of life of patients.

OBJECTIVE

Identify the factors associated with impaired quality of life.

PATIENTS AND METHODS

Cross-sectional and analytical study, carried out in the Department of Rheumatology at the University Teaching Hospital of Brazzaville, in two steps. The first made it possible to collect data of patients diagnosed as having knee osteoarthritis according to the the ACR criteria of 1986 and followed up from January 1st, 2013 to December 31st, 2017. The second step consisted in measuring the quality of life of patients using a specific quality-of-life questionnaire for knee and hip osteoarthritis OAKHQOL, then identifying by bivariate analysis after analysis of variance (ANOVA), the factors associated with an impairment of the quality of life (P≤ 5%). It took place from May 02 to November 02, 2018 (6 months). One hundred and nineteen patients were investigated.

RESULTS

We included in this study 103 women and 16 men (sex ratio M / F of 1/6). The average age was 56.1 ± 9 years (range 27 to 77 years). The mean evolution time was 5.1 ± 3.6 years. The knee osteoarthritis moderately impaired the overall quality of life of patients. The most affected dimensions were physical activity and pain (51.3% and 42.9% of patients between 25 and 50 respectively). The evolution time and functional impact were potentially associated with all dimensions of quality of life. Age was associated with poorer quality of life in the physical activities (p = 0.012) and social activities (p = 0.001) dimensions, as was obesity, with the social activities dimension (p = 0.004).

CONCLUSION

The duration of evolution and the functional impact were associated with deterioration in the quality of life.

[Cystic fibrosis, what follow-up action for adults in 2019?]

Long considered as a paediatric pathology, cystic fibrosis concerns in France more adults than children since 2015. Considering this demographic shift, the way healthcare is organized requires constant adaptation, particularly in the care of adults where new needs are rapidly emerging.

[Chemotherapy in hospital at home care]

Beyond the recommendations of the French directorate general for healthcare provision encouraging hospitals to find alternatives to conventional hospitalisation for their patients, hospital at home care is appreciated by patients for the comfort it enables them to maintain in the continuation of their cancer treatment. It is also increasingly favoured by oncologists who can be assured of the continuity of their protocols by a nursing community with expertise in chemotherapy.

Validation of the Arabic version of the SF-36, generic questionnaire of quality of life related to health among the elderly in Lebanon

Background

Measuring health status of elderly is essential for the prediction of their health care needs. Health research usually considers objective outcome measure; however there is a need to increase self-reported measures of health.

Aims

The aim of this study was to assess the psychometric properties of the SF36 among a group of Lebanese elderly.

Methods

It was a cross-sectional observational study. A systematic sample of elderly people aged 60 years and more was selected from dispensary, private and governmental hospitals in Lebanon. Data were collected using face-to-face interview. The first part of the questionnaire consisted of sociodemographic characteristics. The second part consisted of the Arabic version of the SF-36. The third part consisted of Activity of Daily Living (ADL) scale, presence of health problems and number of medication consumed per day.

Results

A total of 250 elderly people were included. The mean age was 70.69±7.70 years. Cronbach alphas for all SF-36 scales exceeded 0.798. The intra-Class correlation coefficient varied between 0.675 (item 2) and 0.980 (items 14, 16 and 18) indicating good reliability. The quality of life (QoL) of women was poorer than men (p<0.001). It was significantly lesser when the number of health problems (p<0.001) and medications (p<0.001) increased, and the ADL score (p<0.05) decreased.

Conclusion

SF-36 is a valid and reliable instrument for measuring QoL among Lebanese elderly and could be used for monitoring the QoL of this population.

Sex differences in psychosocial and cardiometabolic health among patients completing cardiac rehabilitation

Current programs of cardiac rehabilitation (CR) typically provide a standardized approach to all patients. We examined whether CR would produce similar improvements in psychosocial and cardiometabolic health indicators in women compared with men. The records of patients who completed a 3-month outpatient CR program were examined. We compared health-related quality of life (i.e., Physical Component Summary (PCS) and Mental Component Summary (MCS) scores), anxiety, depression, and cardiometabolic health indicators between women and men completing CR. Of the 591 participants who completed CR, 155 (26.2%) were women and 436 (73.8%) were men. At baseline, women were older (64 ± 9 vs. 62 ± 9 years, p = 0.045), had lower PCS (39.5 ± 8.1 vs. 43.9 ± 7.8 points, p < 0.001), and MCS (46.6 ± 10.8 vs. 49.4 ± 9.8 points, p = 0.003) scores, experienced elevated levels of anxiety (6.4 ± 4.0 vs. 5.2 ± 4.0 points, p = 0.001) and depression (4.7 ± 3.5 vs. 3.6 ± 3.3 points, p = 0.001), and had higher low-density lipoprotein cholesterol (2.1 ± 0.9 vs. 1.7 ± 0.7 mmol/L, p < 0.001) and high-density lipoprotein cholesterol (1.4 ± 0.4 vs. 1.1 ± 0.3 mmol/L, p < 0.001) concentrations when compared with men. Following CR, women showed smaller improvements in percent body mass (+1.1% ± 10.1% vs. −2.1% ± 9.7%, p = 0.002) and PCS scores (3.0 ± 8.1 vs. 6.3 ± 7.5 points, p < 0.001) when compared with men. Considering poorer psychosocial health at baseline and smaller improvements in health-related quality of life in women when compared with men, more specific CR strategies addressing the particular needs of women are required to improve their health status and reduce the risk of secondary cardiac events.

La qualité de vie à la suite à d’une cystoprostatectomie totale chez les hommes: perception des patients tunisiens

Introduction

La cystoprostatectomie totale (CPT) entraîne souvent des changements dans la qualité de vie postopératoire et, par le fait même, des répercussions psychologiques, physiques, sociales et sexuelles difficiles à assumer. La présente étude vise à décrire la qualité de vie postopératoire d’hommes tunisiens âgés ayant subi une CPT à cause d’un cancer de la vessie.

Méthodologie

Il s’agit d’une étude descriptive quantitative, menée auprès de 40 hommes cystoprostatectomisés. Les instruments de mesure utilisés sont: le questionnaire Stoma-Qualité de vie (Stoma-QOL) de Prieto, Thorsen et Juul (2005) , traduit et validé en arabe, ainsi que la version arabe du questionnaire de l’index international de la fonction érectile (IIEF5), validée par Shamloul, Ghanem et Abou-Zeid (2004) .

Résultats

77,5 % des participants obtiennent un score de qualité de vie médiocre. Toutes les dimensions de la qualité de vie sont touchées, à savoir l’image corporelle, physique et psychologique, la vie familiale et sociale, et enfin, la sexualité. En outre, tous les participants ont souffert d’impuissance sexuelle grave après l’intervention.

Conclusion

Le counseling pré et postopératoire s’avère nécessaire pour faciliter la transition après l’opération et assurer aux hommes ayant subi une CPT à cause d’un cancer de la vessie une meilleure qualité de vie liée à la santé.

[The quality and quantity of life of the elderly person in oncology]

Combining quality and quantity of life is one of the challenges of geriatric oncology This requires early diagnosis and a full medical, psychological and social assessment of the patient. The aim of this assessment is to take a global approach to the patient's care management, to take into consideration his or her own opinion and to define a suitable treatment. Once the treatment has been established, the setting up of follow-up care for any comorbidities and symptoms, as well as the putting in place of help where needed, can help to improve quality of life.

[Philosophical approach to quality of life]

Concern for quality of life has arisen from today's radical changes to medical care and the new ways of approaching disease and the patient. It is rooted however in very old philosophical thought on the meaning of human existence and on that of a good life. It shows that the difficulty in establishing a precise definition of quality of life does not mean there is no compelling need for it to be taken into consideration by the caregiving teams or the patients themselves.

[Quality of life in palliative care]

Palliative care aims to improve the quality of life of patients with a serious or terminal progressive disease, through global and multidisciplinary care. The notion of quality of life is multidimensional and unique to each individual patient, making them key players in their own care. Taking into account the different dimensions of a patient's quality of life is necessary in order to propose a personalised and appropriate care plan.

[Palliative care in a paediatric intrahospital mobile team]

Paediatric palliative care has been set up after extensive discussion and observations regarding the need to provide different support to children with a serious and incurable disease as well as their families. The mobile palliative care team support children and their family in this specific process and train caregivers in the palliative approach.

The Impact of Cohousing on Older Adults' Quality of Life

The global population including Canada's is aging, which demands planning for housing that will support older adults' quality of life. This mixed-method study is the first Canadian study to examine the impact of cohousing on older adults' quality of life and involved 23 participants. The older adults rated their quality of life very high, especially in the environmental, physical, and psychological domains of the World Health Organization Quality of Life (WHOQOL_BREF) survey; quality of life in the social domain was rated low, which was surprising in light of the focus group data findings. Four themes of "belonging in a community", "life in the community", "changes associated with aging," and "aging in place" emerged from the qualitative data to explain factors that influence older adults' quality of life. This research provides foundational, strong evidence that seniors' cohousing is an innovative housing solution that can support older adults' quality of life.

[Therapeutic education, a necessity for people with haemophilia]

Haemophilia is a chronic, restrictive and anxiety-inducing disease. In order to maintain a satisfactory quality of life, people can benefit from a therapeutic education programme to equip them with the skills they need to take care of their health.

[Learning to live with haemophilia]

Highlighting the importance and quality of the support provided by the nursing team to her young son with moderate haemophilia, a mother expresses how this care is essential in terms of the family's quality of life, her son's happiness and in ensuring his autonomy as an adult.

Physical activity and its association with psychosocial health following bariatric surgery

Physical activity (PA) helps sustain weight loss and may also provide psychological benefits in patients undergoing bariatric surgery. Using a set of questionnaires, we demonstrated that bariatric patients with increased level of PA at 1-year follow-up had better psychosocial outcomes including depressive symptoms and mental health-related quality of life compared with those who had reduced or unchanged level of PA. Our findings indicate the benefit of incorporating PA in the postoperative care for bariatric patients. Novelty Postoperative behavioural change in terms of physical activity improves psychosocial health in patients undergoing bariatric surgery.

[Early rehabilitation in medical intensive care]

Patients' quality of life in intensive care lies at the heart of their treatment. An innovative form of organisation has been put in place in Montpellier to favour early rehabilitation and improve patients' care and their experience of their stay. Presentation.

[Palliative care in maternity units]

Over recent years, palliative care in maternity units has developed considerably. This is due to the evolution of legislation, medicine and requests from many parents, faced with a fatal prenatal diagnosis, to continue with the pregnancy and support their baby at birth. In parallel, the neonatal intensive care of extremely premature babies has improved significantly. Different situations can be concerned by the setting up of palliative care in maternity units. This specific support comprises significant challenges.

[Therapeutic education, a source of inspiration for students]

Therapeutic education contributes to improving the health of patients suffering from chronic diseases, their quality of life and that of their loved ones. It is complementary and inseparable from treatment and care, symptom relief and prevention of complications. Inspired by the modalities of this approach towards children suffering from cystic fibrosis, students from a nursing training institute in Ile-de-France share their work on this theme.

Trajectories of women's physical and psychosocial health following obstetric fistula repair in Uganda: a longitudinal study

OBJECTIVES

To explore trajectories of physical and psychosocial health, and their interrelationship, among women completing fistula repair in Uganda for 1 year post-surgery.

METHODS

We recruited a 60-woman longitudinal cohort at surgical hospitalisation from Mulago Hospital in Kampala Uganda (Dec 2014-June 2015) and followed them for 1 year. We collected survey data on physical and psychosocial health at surgery and at 3, 6, 9 and 12 months via mobile phone. Fistula characteristics were abstracted from medical records. All participants provided written informed consent. We present univariate analysis and linear regression results.

RESULTS

Across post-surgical follow-up, most women reported improvements in physical and psychosocial health, largely within the first 6 months. By 12 months, urinary incontinence had declined from 98% to 33% and general weakness from 33% to 17%, while excellent to good general health rose from 0% to 60%. Reintegration, self-esteem and quality of life all increased through 6 months and remained stable thereafter. Reported stigma reduced, yet some negative self-perception remained at 12 months (mean 17.8). Psychosocial health was significantly impacted by the report of physical symptoms; at 12 months, physical symptoms were associated with a 21.9 lower mean reintegration score (95% CI -30.1, -12.4).

CONCLUSIONS

Our longitudinal cohort experienced dramatic improvements in physical and psychosocial health after surgery. Continuing fistula-related symptoms and the substantial differences in psychosocial health by physical symptoms support additional intervention to support women's recovery or more targeted psychosocial support and reintegration services to ensure that those coping with physical or psychosocial challenges are appropriately supported.

[Epilepsy today]

Epilepsy is a common disease that can express itself in very different forms. The main treatment is medicinal. This debilitating disease has an impact on the patient's quality of life and its management must consider the psychosocial dimension.

Quality of life and associated factors in patients with chronic Chagas disease

OBJECTIVES

To evaluate the quality of life (QoL) of patients with Chagas disease (CD) and the association between QoL domains and several clinical, socioeconomic and lifestyle characteristics of this population.

METHODS

Cross-sectional observational study conducted from March 2014 to March 2017 including a total of 361 outpatients followed at Evandro Chagas National Institute of Infectious Disease, Brazil. QoL was assessed using the Portuguese shorter version of the original WHO Quality of Life questionnaire (WHOQOL-BREF). Information about clinical CD presentation, presence of comorbidities, functional class, previous benznidazole treatment, socioeconomic profile and lifestyle was also obtained.

RESULTS

Environment and physical domains presented the worst QoL scores, while the social relationship domain presented the highest score. Multivariate regression analysis demonstrated that variables independently associated with QoL were functional class, sex, clinical presentation of CD, sleep duration, schooling, physical activity level, smoking, income per capita and residents by domicile.

CONCLUSIONS

The low socioeconomic status and the physical limitations imposed by the disease presented an important impact on the QoL reduction among CD patients, especially on environment and physical domains. Strategies to improve QoL among CD patients should be tailored and consider many different variables to maximise improvements not only of patients' physical but also of their mental health.

[Another way to care for cancer]

Seeking to reinforce personalised support for cancer patients, a mobile palliative care team has developed an innovative care facility. The Approche intégrative oncologique (Aion) offers comprehensive and alternative medical care to support patients in an active dimension of the disease. Illustration of these principles with follow-up of a patient called Mr. M.

Enoch Senior's College for Korean Immigrant Seniors: Quality of Life Effects

ABSTRACTA community-based program is increasingly recognized as promoting health and active social participation in one's life, yet information is lacking about the use and impact of such programs among immigrant visible minority seniors. This mixed-method research evaluated the impact of a cultural community program for Korean immigrant seniors by examining participants' health-related quality of life (HR-QOL) benefits and overall well-being. In this study, 79 participants completed the SF-36v2 questionnaire twice to assess the impact of Canada Enoch Senior's College (CESC) program on their HR-QOL and well-being. Statistically significant improvement in physical and mental health domains was observed: bodily pain and role limitations due to emotional problems. Qualitative data from participants' interviews supported the survey findings with positive contributions in health and social arenas of seniors' lives. These results suggest that the CESC program contributes to quality of life and well-being of Korean senior participants and supports similar community-based cultural programs.

Birthing experience and quality of life after vacuum delivery and second-stage caesarean section: a prospective cohort study in Uganda

OBJECTIVE

To assess perceptions of women undergoing vacuum extraction or second-stage caesarean section (SSCS) in a tertiary referral hospital in sub-Saharan Africa.

METHODS

Prospective cohort study, with six-month follow-up, of women who gave birth to a term singleton in cephalic presentation by vacuum extraction (n = 289) or SSCS (n = 357) between 25 November 2014, to 8 July 2015, in Mulago Hospital, Uganda. Excluded were women who had failed vacuum extraction, severe birth complications and those whose babies had died. Outcome measures were birthing experience satisfaction, physical component summary (PCS) and mental component summary (MCS) of the SF-12 quality-of-life questionnaire, pain scores and dyspareunia.

RESULTS

One day after vacuum extraction, 63.7% (181/284) of women were feeling well vs. 48.1% (167/347) after SSCS (OR 1.89; 95%CI 1.37-2.61) and mean pain sores were 2.70 vs. 3.87 (P < 0.001). In both groups, >90% of women were satisfied with their birthing experience. At six weeks, in vacuum extraction vs. SSCS, mean pain sores were 0.40 vs. 0.89 (P < 0.001); mean PCS was 48.67 vs. 44.03 (P < 0.001); mean MCS was 52.80 vs. 51.23 (P = 0.203); 40% (70/175) vs. 28.3% (70/247) of women had resumed sexual intercourse (OR 1.69; 95%CI 1.12-2.54) and 21.4% (15/70) vs. 28.6% (20/70) had dyspareunia (OR 0.68; 95%CI 0.32-1.47). No differences were found at six months after birth.

CONCLUSION

One day and six weeks after birth, outcomes were better in women who had vacuum extraction. At six months, outcomes were similar. To promote quick recovery, vacuum extraction should be the first intervention considered in the second stage of labour.

Frailty, Health-Related Quality of Life, Cognition, Depression, Vitamin D and Health-Care Utilization in an Ambulatory Adult Population With Type 1 or Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Cross-Sectional Analysis

OBJECTIVES

Frailty can cause increased vulnerability to adverse health outcomes, such as falls, fractures, depression and reduced health-related quality of life (HRQoL). This cross-sectional study compared the differences in body composition, HRQoL, mental health and cognitive and vitamin D (vitD) status with health-care utilization by frail and nonfrail adults with diabetes mellitus (type 1 and type 2) and with chronic kidney disease (stages 1 through 5).

METHODS

We studied adults with type 1 and type 2 diabetes and chronic kidney disease stages 1 through 5 who were participating in a longitudinal follow-up study (41 to 83 years of age; n=41). Body composition (dual-energy x-ray absorptiometry); vitD status (serum 25[OH]D₃); frailty (Edmonton Frail Scale); depression (Major Depression Inventory); HRQoL (Short Form Health Survey-36); and cognitive status (Mini Mental State exam) were measured using validated tools. Participants who were on dialysis and had body weights >136 kg, and coinciding comorbidities known to influence vitD metabolism were excluded.

RESULTS

Frailty occurred in 17% of participants (n=7). Frail participants had lower lean body mass, lower HRQoL scores (individual and composite scores), more depression (p=<0.05) and higher numbers of health visits (total, inpatient and emergency) compared with nonfrail participants (p<0.05). No differences in health-care visit types or vitD status were noted between frail and nonfrail participants (p>0.05).

CONCLUSIONS

Frailty in an ambulatory population of adults with chronic kidney disease and diabetes is associated with low lean body mass, low HRQoL, greater depression and higher numbers of health-care visits.

[Peritoneal dialysis, a first-line treatment?]

The number of patients heading towards the terminal stage of their chronic kidney disease, for the first time or after the failure of a kidney transplant, is constantly growing, requiring the use of renal replacement therapy. Nowadays, peritoneal dialysis can be given as a first-line treatment for most patients, in the same way as haemodialysis. It allows patients to remain at home or in their care facility, with the help of a private practice nurse when needed. Complications can be quickly detected and resolved. In the event of failure, the switch to haemodialysis is usually possible.

[Physical activities adapted to homeless people]

Around ten homeless people were invited to take part in a programme of physical activities to improve their health status. Only motricity and walking pathways were followed assiduously for eight weeks. The assessment of the physical condition and quality of life showed an improvement in these areas, in particular for one of the participants. However, the lack of motivation and assiduity remains an obstacle to regular activity.

[An innovative teleconsultation project in liver transplantation]

The Tours and Bourges hospital teams have developed innovative collaborative practices in the monitoring of patients having received a liver transplant. Teleconsultation helps the patient resume their normal life by enabling them to avoid tiring and time-consuming appointments.

[Microscopic Colitis]

Microscopic colitis (MC) is still an underestimated cause of chronic, non-bloody watery diarrhea. It is typically manifested in elderly patients with a female predominance. The incidence of microscopic colitis has been increasing. The aetiology and pathophysiology remain unclear. Conditions associated with it include autoimmune diseases. There may be a genetic predisposition, as familial cases have been described. As implicated by the name microscopic colitis, the diagnosis is found by histological examination. There are mainly two subtypes, the lymphocytic colitis (LC) and the collagenous colitis (CC). Even if the condition's long-term course is benign, a chronic recurrent course of the symptoms is frequent. Due to the symptoms, there is an impairment of patient's health-related quality of life. A correct diagnosis and therapy is therefore mandatory. The aim of this paper is to create awareness for microscopic colitis.

[Psychological support for patients with a ventricular assist device]

In the case of end-stage heart failure, the medical-surgical team can suggest the use of an external circulatory assist device as a definitive therapy. Living with this assistance requires a certain amount of adaptation on the part of the patients and their family, but can significantly improve quality of life. Support groups give them the opportunity to talk about their new life and receive psychological support.

[Diabetes and connected objects, appropriation or rejection?]

There are numerous connected objects aimed at the 3.5 million people with diabetes in France. What do patients think of them and what use do they actually get out of them? Diabète LAB, the living lab of the French Federation of Diabetics, questions patients with diabetes about their experiences, their uses of the technical devices and health services, as well as their needs.

[Nursing role and TPE in patients with lymphoedema of the limbs]

Lymphoedema, primary and secondary after cancer treatment, is a chronic condition which has a significant impact on patients' quality of life. Therapeutic education plays an important role in the initial care and in the follow-up of these conditions.

[Alzheimer's disease and training for carers in a rural region]

Alzheimer's disease or related diseases constitute a major public health issue at the heart of the 2014-2019 plan for neurodegenerative diseases. Family carers, seeing to the day-to-day care of their loved ones, require support, particularly in rural regions. A study carried out of these carers sought to understand their perception of Alzheimer's disease, their role, and in what ways their training can help to reduce their physical and mental exhaustion in order to improve their quality of life.

Correlation of 6-min walk test with left ventricular function and quality of life in heart failure due to Chagas disease

OBJECTIVES

To evaluate the correlation of the total distance walked during the six-minute walk test (6MWT) with left ventricular function and quality of life in patients with Chagas Disease (ChD) complicated by heart failure.

METHODS

This is a cross-sectional study of adult patients with ChD and heart failure diagnosed based on Framingham criteria. 6MWT was performed following international guidelines. New York Heart Association functional class, brain natriuretic peptide (BNP) serum levels, echocardiographic parameters and quality of life (SF-36 and MLHFQ questionnaires) were determined and their correlation with the distance covered at the 6MWT was tested.

RESULTS

Forty adult patients (19 male; 60 ± 12 years old) with ChD and heart failure were included in this study. The mean left ventricular ejection fraction was 35 ± 12%. Only two patients (5%) ceased walking before 6 min had elapsed. There were no cardiac events during the test. The average distance covered was 337 ± 105 metres. The distance covered presented a negative correlation with BNP (r = -0.37; P = 0.02), MLHFQ quality-of-life score (r = -0.54; P = 0.002), pulmonary artery systolic pressure (r = -0.42; P = 0.02) and the degree of diastolic dysfunction (r = -0.36; P = 0.03) and mitral regurgitation (r = -0.53; P = 0.0006) and positive correlation with several domains of the SF-36 questionnaire.

CONCLUSIONS

The distance walked during the 6MWT correlates with BNP, quality of life and parameters of left ventricular diastolic function in ChD patients with heart failure. We propose this test to be adopted in endemic areas with limited resources to aid in the identification of patients who need referral for tertiary centres for further evaluation and treatment.

[Assessment of the use of music therapy with nursing home residents]

A study analysed, on the one hand, the efficacy of the use of music therapy with residents and, on the other, the feasibility of the implementation of such a technique in nursing homes and in follow-up and rehabilitation units. In this context, music therapy seems to be an effective alternative to traditional approaches.

[Caring for patients and their families in their home]

When a patient with glioblastoma and their families wish, a hospital at home scheme can be put in place, providing care and support for the patient in the palliative phase. The quality of life of the patient remains the priority and special attention is paid to the family.

[Not Available]

Hyperactivity disorder in children is the most commonly found syndrome in paedo-psychiatric clinics. Children's professionals need to have clinical data on the subject. The diagnostic process includes several components which allow care to be tailored to each child.

[Not Available]

Zusammenfassung. Zusammenfassung: Die Komplikationsrate nach Osteosynthese von proximalen Humerusfrakturen ist trotz neu entwickelten Implantaten hoch. Wir sind der Meinung, dass die hohe Individualität der Patienten auch einen möglichst individuellen Therapieansatz benötigt. Somit definierten wir einen evidenzbasierten Behandlungsalgorithmus, der die Patientenindividualität und das ganze Behandlungsspektrum beinhalten sollte. Wir suchten dabei nach einem optimalen Weg zwischen Risiko (Komplikationen) und Ertrag (Schulterfunktion). Vor allem die Lebensqualität sollte nach der Frakturbehandlung wieder möglichst gut sein. Die ersten Resultate unserer prospektiven Untersuchung sind vielversprechend. Die konservativen Wege im Algorithmus scheinen gut zu funktionieren, nur sehr selten musste davon abgewichen werden. Es zeigt sich jedoch, dass vor allem die Osteosynthesen noch immer komplikationsbelastet sind. Diesbezüglich gilt es, den Algorithmus und die chirurgische Technik in Zukunft noch zu verbessern.

Computer Intervention: Illness Self-Management/Quality of Life of Rural Women

The Women To Women project, a computer-based support and educational research intervention, was designed to help rural women better understand and manage their chronic illnesses. Its impact on psychosocial adaptation has been reported elsewhere. This article reports on the effect of a computer intervention on chronic illness self-management skills and quality of life. Using a parallel 2-group study design, the researchers randomized 309 middle-aged rural women with chronic conditions to either a computer-based intervention or a control group. They collected data on self-management of chronic illness and quality of life indicators at baseline and at the end of the intervention. Women in the intervention group reported significantly more self-efficacy in managing their chronic disease than those in the control group and the observed effect was of moderate size. Women in the intervention group also reported statistically significant gains in quality of life; effect sizes were small but consistent. Select chronic illness self-management skills and quality of life can be positively influenced by a well-designed computer intervention.

Effects of aerobic or resistance training or both on health-related quality of life in youth with obesity: the HEARTY Trial

This study examined the effects of aerobic and resistance training, and their combination on health-related quality of life (HRQoL) in adolescents with overweight or obesity. After a 4-week run-in period, 304 (91 males, 213 females) post-pubertal adolescents aged 14-18 years, were randomized to 4 groups for 22 weeks of: aerobic training (n = 75), resistance training (n = 78), combined aerobic and resistance training (n = 75), or nonexercising control (n = 76). All participants received dietary counseling with a daily energy deficit of 250 kcal. Indicators of HRQoL such as overall HRQoL, and physical and psychosocial (an aggregate of emotional, social, and school functioning) HRQoL at baseline and 6 months postintervention were measured by the Pediatric Quality of Life questionnaire. The trial began in March 2005 and was completed in June 2011. In the intention-to-treat analyses, all groups showed significant improvements at 6 months on all HRQoL indicators. The aerobic group showed greater improvements than controls on physical HRQoL (mean differences of 5.5; 95% CI; 1.4-9.6, p = 0.009). In participants with ≥70% adherence, combined training produced greater improvements than control on overall HRQoL (mean differences of 4.8, 95% CI; 0.7-9.0, p = 0.02), physical HRQoL (mean differences of 5.8; 95% CI: 0.6-10.7; p = 0.03), social HRQoL (mean differences of 7.6; 95% CI: 1.0-14.2; p = 0.02), and school-based HRQoL (mean differences of 7.6; 95% CI: 1.0-14.2; p = 0.02). These findings highlight the potential importance of including resistance exercise into traditional aerobic exercise programs to maximize HRQoL in adolescents with obesity.

[Cognitive disorders of head trauma patients]

The repercussions of cognitive disorders resulting from a traumatic brain injury are considerable in patients' daily life. Their quality of life and that of their families is significantly reduced; their reintegration into working life difficult. This chronic cognitive disability requires adapted treatment.

[Head trauma patients and their life course]

A traumatic brain injury constitutes a complex treatment situation. Nurses are on the frontline having to assume a difficult position between idealism and fatalism with regard to the care pathway and quality of life. Taking a long-term approach to the care and systemised feedback from the patients form simple and economical levers for improvement.

[Not Available]

Zusammenfassung. Die tumorassoziierte Fatigue ist ein häufig auftretendes und ernstzunehmendes Beschwerdebild mit belastenden körperlichen, psychischen und sozialen Auswirkungen, das im Verlauf einer Brustkrebserkrankung zu jedem Zeitpunkt auftreten kann. Das Erscheinungsbild der tumorassoziierten Fatigue ist in der klinischen Symptomatik wie auch in den pathophysiologischen Mechanismen sehr heterogen und komplex. Sowohl die Abklärung von Ursachen als auch die Behandlung erfordert ein differenziertes Vorgehen. Eine frühzeitige Therapie der tumorassoziierten Fatigue ist wichtig, um einer möglichen Chronifizierung entgegenzuwirken. Die Behandlung der Fatigue-Symptomatik erfolgt mittels medikamentöser und nicht-medikamentöser Therapieansätze. Während pharmakologische Interventionen mit Psychostimulanzien in der Behandlung der Fatigue-Symptomatik inkonsistente Resultate zeigen, können die Beschwerden der Fatigue-Symptomatik durch nicht-pharmakologische Interventionen, besonders körperliches Training, kognitiv-behaviorale Therapie, Psychoedukation, komplementärmedizinische Behandlungen (Akupunktur, Yoga, phytotherapeutische Verfahren mit Ginseng) deutlich gemindert werden.

Systematic review of the relationships between sleep duration and health indicators in school-aged children and youth

The objective of this systematic review was to examine the relationships between objectively and subjectively measured sleep duration and various health indicators in children and youth aged 5-17 years. Online databases were searched in January 2015 with no date or study design limits. Included studies were peer-reviewed and met the a priori-determined population (apparently healthy children and youth aged 5-17 years), intervention/exposure/comparator (various sleep durations), and outcome (adiposity, emotional regulation, cognition/academic achievement, quality of life/well-being, harms/injuries, and cardiometabolic biomarkers) criteria. Because of high levels of heterogeneity across studies, narrative syntheses were employed. A total of 141 articles (110 unique samples), including 592 215 unique participants from 40 different countries, met inclusion criteria. Overall, longer sleep duration was associated with lower adiposity indicators, better emotional regulation, better academic achievement, and better quality of life/well-being. The evidence was mixed and/or limited for the association between sleep duration and cognition, harms/injuries, and cardiometabolic biomarkers. The quality of evidence ranged from very low to high across study designs and health indicators. In conclusion, we confirmed previous investigations showing that shorter sleep duration is associated with adverse physical and mental health outcomes. However, the available evidence relies heavily on cross-sectional studies using self-reported sleep. To better inform contemporary sleep recommendations, there is a need for sleep restriction/extension interventions that examine the changes in different outcome measures against various amounts of objectively measured sleep to have a better sense of dose-response relationships.

Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth

Moderate-to-vigorous physical activity (MVPA) is essential for disease prevention and health promotion. Emerging evidence suggests other intensities of physical activity (PA), including light-intensity activity (LPA), may also be important, but there has been no rigorous evaluation of the evidence. The purpose of this systematic review was to examine the relationships between objectively measured PA (total and all intensities) and health indicators in school-aged children and youth. Online databases were searched for peer-reviewed studies that met the a priori inclusion criteria: population (apparently healthy, aged 5-17 years), intervention/exposure/comparator (volumes, durations, frequencies, intensities, and patterns of objectively measured PA), and outcome (body composition, cardiometabolic biomarkers, physical fitness, behavioural conduct/pro-social behaviour, cognition/academic achievement, quality of life/well-being, harms, bone health, motor skill development, psychological distress, self-esteem). Heterogeneity among studies precluded meta-analyses; narrative synthesis was conducted. A total of 162 studies were included (204 171 participants from 31 countries). Overall, total PA was favourably associated with physical, psychological/social, and cognitive health indicators. Relationships were more consistent and robust for higher (e.g., MVPA) versus lower (e.g., LPA) intensity PA. All patterns of activity (sporadic, bouts, continuous) provided benefit. LPA was favourably associated with cardiometabolic biomarkers; data were scarce for other outcomes. These findings continue to support the importance of at least 60 min/day of MVPA for disease prevention and health promotion in children and youth, but also highlight the potential benefits of LPA and total PA. All intensities of PA should be considered in future work aimed at better elucidating the health benefits of PA in children and youth.

[A city for the elderly: research into new technologies in Singapore]

A city-state located at the heart of South East Asia, Singapore is now facing an accelerated ageing of the population, resulting from a very good health care coverage and a very low birth rate. A team of researchers from the French National Centre for Scientific Research (CNRS) is exploring the use of new technologies to improve the quality of life of elderly people in towns and cities and anticipate their health risks.

[Assessment of the quality of life with regard to health following a cancer diagnosis]

The measurement of the quality of life in terms of health of people undergoing treatment for cancer is developing. This new indicator focusing on patients' personal experience is combined with standard criteria relating to their tumours. The data are also a factor in the prognosis of overall survival. A team of researchers at Besançon university hospital shares its experience.

[Specialised Alzheimer's teams at home]

Specialised Alzheimer's teams aim to optimise the autonomy and quality of life of patients and their carers in their home.

[Gambling in elderly patients]

Behavioural addictions concern behaviour which generate pleasure (shopping, gambling, sex, etc.). Pathological gambling is the most common behavioural addiction in elderly people. It can be severely harmful causing psychological, financial and family problems and increasing the risk of suicide. Gambling addiction is underestimated in the elderly. Psychological, social and family support is important whatever the age, with treatment aiming to improve the person's quality of life, help them regain control of their gambling or stop altogether.