Comparing the reliability and validity of the SF-36 and SF-12 in measuring quality of life among adolescents in China: a large sample cross-sectional study

Sense of coherence and health in adolescents: a longitudinal cohort study

OBJECTIVE

Several studies indicate an association between adolescents' sense of coherence (SOC) and health. However, a few longitudinal studies have been conducted. The aim of the study was to analyze the association between SOC and health among adolescents during secondary education.

METHODS

Participants of longitudinal cohort study were followed by questionnaires at the age of 15 (N = 441), and 17 (N = 354). The data were analyzed using the methods of descriptive and inferential statistics. We used hierarchical regression to examine significant predictors of health.

RESULTS

Adolescents' SOC was stable during the analyzed two-year period (128.84 ± 22.17; 129.24 ± 23.06). A strong significant positive correlation was found between SOC and mental health (r = 0.635, p<.001; r = 0.670, p<.001). A significant difference was found between adolescents with a low SOC and those with a high SOC in physical functioning (p<.018), general health (p<.001), vitality (p<.001), social functioning (p<.001), emotional role functioning (p<.013) and mental health (p<.001). Boys had higher SOC and most of the health dimensions. Having a stronger SOC, being male, and living with both parents were predictors of better mental health.

CONCLUSIONS

Sense of coherence was a significant and stable factor associated with mental health. Thus, salutogenic interventions for improving the sense of coherence during adolescence should be explored.

Association Between Nutrition Literacy and Quality of Life in Adults With Chronic Diseases in Bengbu China

CONTEXT

Nutrition literacy (NL) reflects an individual's ability to make correct nutritional decisions, and nutrition is a factor influencing patients' quality of life (QOL).

OBJECTIVES

To assess the association between NL and QOL in adults with chronic diseases.

DESIGN

A cross-sectional survey was conducted among Chinese residents beginning in May 2023. Investigators, who were trained to follow standardized procedures, conducted individual, face-to-face interviews.

SETTING

Bengbu City, Anhui Province, China.

PARTICIPANTS

A total of 1607 Chinese residents aged 18 and over.

MAIN OUTCOME AND MEASURES

A 12-Item Short-Form Health Survey was used to assess QOL and the short-form NL measurement tool to measure the NL. Ordinal logistic regression models were used to investigate the association between NL and QOL.

RESULTS

Of the 1607 participants, compared to those in the first quartile of NL, individuals in the 4th quartile, characterized by higher NL, reported a significantly higher QOL, including physical component summary and mental component summary. For dimensions, nutrition knowledge, understanding, interactive, and critical skills were associated with QOL. Upon stratification, this association was evident exclusively in individuals with low monthly incomes, moderate to high physical activity levels, those living with others and 1 to 3 diseases. Additionally, there's synergistic association between NL and the number of diseases with QOL.

CONCLUSIONS

Our findings underscore that adequate NL is positively associated with better QOL in populations with chronic diseases, and the relationship varied by income, physical activity, living arrangements, and the number of diseases. Focusing on the NL of populations with chronic diseases might help provide a basis for dietary nutrition management and intervention to improve QOL in patients with chronic diseases.

COPSOQ III in China: Preliminary Validation of an International Instrument to Measure Psychosocial Work Factors

BACKGROUND

The Copenhagen Psychosocial Questionnaire (COPSOQ) is an international instrument designed for the assessment and improvement of psychosocial conditions in workplaces and for research purposes. After the International COPSOQ Network took over responsibility for the development of COPSOQ, a new version was published in 2019 (COPSOQ III). However, there is no widely recognized instrument for measuring psychosocial work factors, and insufficient research exists regarding the use of COPSOQ III within the Chinese setting. This study seeks to conduct a preliminary validation of the Chinese long version of COPSOQ III.

METHODS

A cross-sectional questionnaire survey was conducted with a large sample in a medical consortium in China. Item analysis, reliability, and validity were explored.

RESULTS

The data management platform showed that 1067 respondents who met the inclusion criteria completed the questionnaire, among which 1054 questionnaires were valid. The content validity results showed that the I-CVI and S-CVI/AVE of each item ranged from 42.86 to 100.00, and the S-CVI/AVE was 92.52, indicating that the Chinese long version of COPSOQ III had good content validity. An exploratory factor analysis (EFA) extracted seven factors, which explained 63.96% of the variation. The results of confirmatory factor analysis (CFA) indicated that the model was well fit (χ2/df = 4.50, CFI = 0.910, TLI = 0.897, IFI = 0.910, RMSEA = 0.058). The Cronbach alpha coefficient of the questionnaire was 0.92.

CONCLUSIONS

The Chinese long version of COPSOQ III is of good reliability and validity, like the original, and can be used to assess psychosocial work factors in China.

A new generation of patient-reported outcome measures with large language models

BACKGROUND

Patient-reported outcome measures (PROMs) are cornerstones of patient-centered clinical medicine and reflect patients' abilities, difficulties, perceptions and behaviors. The highly structured questionnaire format of PROMs currently limits their real-world validity and acceptability to patients, which becomes increasingly relevant with the high clinical interest in PROM data. In this short commentary, we aim to demonstrate the potential use of large language models (LLMs) in the context of PROM data collection and interpretation.

MAIN BODY

The popularization of LLMs enables the development of a new generation of PROMs generated and administered through digital technology that interact with patients and score their responses in real time based on artificial intelligence. LLM-PROMs will need to be developed with multi-stakeholder input and careful validation against established PROMs. LLM-PROMs could complement traditional PROMs particularly in real-world clinical applications.

CONCLUSION

LLM-PROMs could allow quantifying patient-relevant dimensions based on less structured contents and foster the use of patient-reported data in digital, clinical applications of PROMs.

Effectiveness of motivational interviewing on pain-related outcomes in patients with musculoskeletal pain: a systematic review and meta-analysis

PURPOSE

To determine the effectiveness of motivational interviewing (MI) in the treatment of adult patients with musculoskeletal (MSK) pain.

MATERIALS AND METHODS

A comprehensive search strategy without date or language restrictions was performed in five scientific databases. Manual searches and reference tracking were also carried out. Two reviewers independently performed title and abstract as well as full-text screening, data extraction, assessment of risk of bias, and evaluation of overall certainty with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Where possible, a meta-analysis was performed to identify effects across multiple studies.

RESULTS

Ten studies reported in 16 manuscripts met the previously defined eligibility criteria. Many outcomes could be extracted and analyzed. Nine of the ten studies were considered to have a high risk of bias according to the revised Cochrane RoB 2.0. The majority of comparisons were based on low to very low overall certainty of the evidence.

CONCLUSIONS

The existing literature did not allow a reliable statement about the effectiveness of MI on pain-related outcomes in people with MSK pain. Only tendencies towards a positive influence of MI were recognisable. However, this must be confirmed by high-quality randomized controlled trials in the future.IMPLICATIONS FOR REHABILITATIONMotivational interviewing appears to be an option for patients with chronic musculoskeletal pain which presumably has few to no adverse effects.Motivational interviewing could represent an opportunity, particularly for patients for whom other treatment strategies have been ineffective so far.Motivational interviewing can safely be combined with other forms of treatment such as an active exercise therapy.

Association of urinary tract endometriosis with physical and mental health: a cross-sectional study

BACKGROUND

Urinary tract endometriosis (UTE) is a special type of endometriosis affecting the urinary system, yet the physical and mental health of UTE patients remain unexplored.

METHODS

We enrolled 92 women with UTE and another 234 with deep infiltrating endometriosis from the First Affiliated Hospital of Sun Yat-sen University. Personal information was collected via paper questionnaires. Health-related quality of life, including physical and mental health, was measured by physical component summary scale (PCS) and mental component summary scale (MCS) of the 12-item Short Form Health Survey (SF-12). Multiple linear regression analysis was conducted to identify factors influencing physical and mental health.

RESULTS

Patients in the UTE group had a higher creatinine level and detection rate of urinary leukocyte, erythrocyte and protein. The PCS score was lower in the UTE group, while the MCS was similar between two groups. Multiple linear regression analysis shown that patients using painkillers had lower PCS scores, while those aware of urologic abnormalities before surgery or with a history of more than two miscarriages had lower MCS scores.

CONCLUSIONS

Our study explores the quality of life in UTE patients and identifies influencing factors. Individualized and targeted care should be added to clinical practice to prevent negative outcomes for UTE patients.

The Korean medicine for aging cohort (KoMAC) study: A protocol for a prospective, multicenter cohort study on healthy aging in the population entering old age in South Korea

BACKGROUND

South Korea is anticipated to enter a super-aged society by 2025, necessitating a focus on healthy aging. In Korean medicine (KM), aging and disease susceptibility are individual specific, emphasizing personalized treatments, and many Korean local governments have integrated KM services for elderly people into the public sector. However, there is a notable absence of research incorporating KM to treat older adults.

AIM

The proposed study aims to examine the comprehensive health profiles of individuals entering old age in rural and urban areas and explore the significant correlations between healthy aging and four key factors: biological, psychological, social, and KM-based phenotype factors. It will also establish a database and blood biobank, serving as a platform for future research to develop a traditional KM-based healthy aging model.

METHODS

A multiple randomized controlled trial design will be adopted in this prospective, multicenter cohort study for the clinical investigation of the markers associated with KM-based healthy aging. The aim is to recruit 1,000 participants who are entering old age from both urban and rural settings for this study, and recruitment began in August 2023 with follow-up surveys planned at one-year intervals. Comprehensive health profiles, including biological, psychological, social, and KM-based phenotype factors, will be developed through the creation of a database, a blood biobank, and multi-omics data.

RESULTS

In the baseline phase of this study, we will focus on identifying markers for KM-based phenotypes and examining how these phenotypes relate to aging and associated diseases. In the next phase, we will implement interventions tailored to KM-based phenotypes to verify the effects of KM on healthy aging. Ultimately, we intend to develop a KM-based integrated health management model, with further substudies aiming to explore factors related to healthy aging. This protocol was approved by the institutional review board of Wonkwang University Korean Medicine Hospital, Iksan, Republic of Korea (approval number: WKUIOMH-IRB-2023-05) on August 16, 2023 and Jangheung Integrative Medical Hospital (approval number: WKUJIM-202307-001) on August 21, 2023. Recruitment started on August 16, 2023.

CONCLUSION

The anticipated results of our study aim to establish personalized preventive and therapeutic interventions for individuals entering old age. Additionally, we seek to offer an KM-based integrated health management model that incorporates comprehensive diagnosis and an integrative medical treatment strategy for healthy aging.

TRIAL REGISTRATION

Clinical Research Information Service: KCT0008863 (registered on October 11, 2023, https://cris.nih.go.kr/cris/search/detailSearch.do/25718).

Assessing the quality of life among African medical and health science students using the WHOQOL-BREF tool

BACKGROUND

The quality of life (QoL) among health professional students is available in the literature, yet there is a paucity of information concerning QoL among African students. The study aimed to measure the QoL with the World Health Organization Quality of Life-BREF (WHOQOL-BREF) tool among African medical and health science students.

METHODS

A cross-sectional study was conducted involving 349 African medical and health science students from various disciplines at the International African University in May 2024. A purposive sampling method was used to recruit participants from five different faculties. Data were collected using the WHOQOL-BREF tool, and analyzed using descriptive statistics, chi-square test and multiple linear regression to determine the predictors of QoL among students.

RESULTS

The overall QoL among 349 African medical and health science students was moderate, with a mean score of 67.5% ± 10.8%. The highest mean scores were observed in the physical health domain (69.3% ± 12.0%), while the lowest scores were in the environmental domain (62.9% ± 12.0%). The multiple regression analysis using demographic data as predictors of QoL revealed that dentistry students were significant predictors of higher overall QoL scores compared to other student groups (β = 7.059, p < 0.05), as well as specific QoL domains including physical health (β = 6.328), psychological health (β = 8.415), social relationships (β = 7.823), and environment (β = 7.017). Furthermore, students from the fields of laboratory sciences and medicine significantly predicted higher scores in the physical health domain (β = 5.223) and the psychological health domain (β = 4.433), respectively. Age was also a significant predictor; students aged between 20 and 23 years showed a positive impact on social relationship domain of QoL (β = 10.296). However, second year (β = -11.146), third year (β = -13.629), and fourth-year students (β = -10.144) exhibited lower social relationship domain of QoL scores.

CONCLUSION

Students of medical and health sciences in Africa exhibited moderate quality of life (QoL). The findings indicate that dentistry students generally experience higher QoL across multiple domains, which contrasts with students from other disciplines, such as pharmacy and nursing. Age and academic year were also significant predictors of QoL, with younger students and those in their initial years of study reporting lower scores. These results align with existing literature and underscore the need for targeted interventions to support students, particularly those in high-stress disciplines or at earlier stages of their education.

Mobile-based in-home telerehabilitation compared with in-hospital face-to-face rehabilitation for elderly patients after total hip arthroplasty in China's level 1 trauma center: a noninferiority randomized controlled trial

Background

Telerehabilitation is gaining popularity in European and American countries, but whether it can be successfully implemented in China still lacks support from clinical studies.

Objective

This trial aimed to determine if a home-based telerehabilitation method is clinically noninferior to standard in-hospital face-to-face rehabilitation for elderly patients with total hip arthroplasty (THA) in China.

Methods

This multicenter randomized controlled trial was conducted from January 2021 to June 2022 at The First Rehabilitation Hospital in Shanghai, Shanghai Jiao Tong University affiliated Sixth People's Hospital and Shanghai Tongji University affiliated Tenth People's Hospital. Sixty-four patients were recruited for this two-arm, single-assessor blinded, randomized controlled trial. The participants were randomly assigned to the in-home telerehabilitation group (TELE group) and the in-hospital physical therapist in-person group (PT group). The intervention consisted of a 12-week home-based rehabilitation program with video instructions and remote coaching on a mobile APP (TELE group). The PT group received a standard in-hospital rehabilitation intervention assisted by a physical therapist for one month and outpatient clinic for the next two months. Patients were evaluated at baseline, 4 weeks, and 12 weeks postoperatively employing functional tests (Timed Up & Go test and Berg balance test) and self-reported questionnaires (Hip disability and Osteoarthritis Outcome Score (HOOS) and Short Form 12 (SF-12)).

Results

There was no significant difference between the two groups for the demographic and clinical characteristics. 61 participants were analyzed (PT group: n = 31, women: 48.4% of participants; TELE group: n = 30, 33.3% of participants) whose median age was 70 and 69 years, in PT group (IQR: 63-73) and TELE group (IQR: 66-72) respectively. At 12 weeks follow-up evaluation, the main differences between the two groups regarding the HOOS gains, adjusted for baseline values, were close to zero (P > 0.05). There was no significant difference in primary and secondary outcome measures between the two groups.

Conclusion

Our results showed the noninferiority of in-home telerehabilitation and advocated its application as a reliable alternative to in-hospital face-to-face rehabilitation for patients who underwent THA.

Clinical Trial Registration

https://www.chictr.org.cn/, Chinese Clinical Trial Registry (Number: ChiCTR1900025825).

Subtalar arthroereisis with metallic implant is a safe and effective treatment for pediatric patients with symptomatic flexible flatfeet. A 10-year clinical and radiographic follow-up

BACKGROUND

Subtalar arthroereisis (SA) is an increasingly applied minimally invasive approach for flexible flat foot (FFF) not responsive to conservative treatment. This study aimed at evaluating the long-term clinical and radiographic outcomes of SA in pediatric patients with symptomatic FFF.

METHODS

Thirty-seven patients (11.9 ± 1.6yy) underwent SA (74 feet), with outcomes assessed after a mean 10-year follow-up. Pain, quality of life, foot functionality, and alignment were evaluated using validated tools and radiographic parameters, calculated on weightbearing x-rays pre- and post-operatively.

RESULTS

Clinical outcomes reached excellent postoperative results (FFI: 9.1, AOFAS: 94.5) with a low 0.9 NRS pain (p < 0.01) and a 92 % satisfaction. All radiographic parameters improved significantly towards normal values: CP 17.5 ± 3.9, MA 4.3 ± 5.8, TCA 42.8 ± 6.2, TNCA 21.1 ± 8.5, TNU% 26.6 ± 8.4 (all p < 0.01).

CONCLUSIONS

SA with a metallic endosinotarsal device provided significant long-term clinical and radiographic improvements, with low complication rates and high patient satisfaction, supporting its efficacy as a treatment option for pediatric symptomatic FFF.

LEVEL OF EVIDENCE

IV.

Early decompressive surgery improves long-term prognosis in patients with intracerebral hemorrhage

BACKGROUND

Multiple studies have shown that early decompressive surgery in patients with intracerebral hemorrhage can effectively limit hematoma expansion, reduce perihematomal edema, and improve prognosis. However, these studies are limited by small sample sizes and short follow-up times.

OBJECTIVE

To analyze the effect of early decompressive surgery on the long-term prognosis of patients with cerebral hemorrhage and identify the influencing factors for poor prognosis.

METHODS

A retrospective analysis of 78 patients with cerebral hemorrhage admitted between January 2020 and December 2022 was conducted. Patients were divided into early and delayed surgery groups for comparison of outcomes such as mortality rate, modified Rankin Scale score, and Short Form-36 scores. Additionally, factors influencing long-term prognosis were analyzed through logistic regression based on significant differences observed between groups.

RESULTS

The early decompressive surgery group showed superior outcomes with lower mortality rates, modified Rankin Scale (mRS) scores, hematoma expansion rates, and perihematomal edema volumes compared to the delayed surgery group (P< 0.05). Additionally, age, preoperative Glasgow Coma Scale (GCS) score, preoperative hematoma volume, and a history of hypertension or diabetes were identified as independent prognostic factors for patients with cerebral hemorrhage, with odds ratios (ORs) greater than 1.

CONCLUSIONS

Early decompressive surgery can improve the long-term prognosis and quality of life of patients with cerebral hemorrhage, reduce mortality rates, and decrease hematoma expansion and perihematomal edema. Older patients, those with higher preoperative hematoma volume and GCS score, and those with coexisting hypertension and diabetes should be given special attention to decrease the occurrence of adverse prognosis.

Factors associated with functional health literacy and the quality of life of riverside residents served by the primary care network in the Brazilian amazon: a cross-sectional study

BACKGROUND

the riverside population lives in a vulnerable social situation, shaped by geographical, economic, social, and educational aspects that have repercussions on health literacy, the limitations of which can compromise Quality of Life. These specificities influence the actions of Primary Health Care, especially in the rural context. This study aimed to assess the factors associated with Functional Health Literacy and Quality of Life among riverside residents of the Brazilian Amazon who use Primary Health Care.

METHODS

a cross-sectional study with 312 users of a riverside Family Health Team, using the Health Literacy Test, classified as adequate, limited, and inadequate, and the Study Short Form 12 Health Survey questionnaire, analyzing the physical and mental components in isolation. A theoretical model was built to assess the associations between sociodemographic and environmental variables and the Functional Health Literacy and Quality of Life outcomes. The Functional Health Literacy outcome was considered as two dichotomous variables (inadequate versus adequate; limited versus adequate), while the Quality of Life outcomes were considered as counts, with a Poisson distribution. Thus, a structural equation model was used to adjust the proposed theoretical model.

RESULTS

there was a worsening in inadequate Functional Health Literacy, associated with females, aged over 40, elementary school education, living close to the health service, and using only a cell phone for communication. Factors that compromised physical Quality of Life: livelihood problems; inadequate literacy; age range 40-59; and having two children or more. And those that worsened mental Quality of Life: age over 40; having a family allowance; and being in control of their medication.

CONCLUSIONS

sociodemographic, environmental, and economic factors and adherence to medication by river communities have been shown to be associated with Health Literacy and Quality of Life. Knowing these implications is fundamental for health provision. These findings can support the formulation of strategies in health services to improve Health Literacy and Quality of Life.

Analysis of the application effect of the Clark comfortable nursing approach in hemodialysis patients with end stage renal failure

OBJECTIVE

This study observed the effects of the Clark comfortable nursing approach on self-care ability, self-burden, treatment adherence, quality of life, and complications in hemodialysis patients with end stage renal failure (ESRF).

METHODS

Eighty-two patients with ESRF receiving hemodialysis treatment were included and allocated into control and intervention groups. The control group received conventional nursing care, while the intervention group received the Clark comfortable nursing approach. The self-care ability, self-burden, treatment adherence, quality of life scores before and after the nursing intervention, and the occurrence of complications in both groups were compared.

RESULTS

After the intervention, the intervention group showed higher scores in each dimension and the total score of the Exercise of Self-Care Agency Scale compared to the control group. Both groups exhibited improvements in various scores and total scores; however, the intervention group had lower scores overall than the control group. Additionally, the intervention group had higher scores in diet, water intake, medication, and dialysis regimen. Additionally, both groups had significantly higher scores in all dimensions of the quality-of-life scale post-intervention, with the intervention group demonstrating markedly higher scores in all dimensions. The total incidence of complications in the intervention group was 9.76%, which was lower than the 29.27% observed in the control group.

CONCLUSION

The Clark comfortable nursing approach applied to hemodialysis patients with ESRF can enhance self-care ability, improve quality of life, increase treatment adherence, and reduce the incidence of hemodialysis-related complications. This model is worthy of clinical promotion.

Implementation of a teen sleep app in Canadian high schools: Preliminary evidence of acceptability, engagement, and capacity for supporting healthy sleep habits

High school students suffer from mental health challenges and poorer academic performance resulting from sleep disturbances. Unfortunately, approaches to this problem sometimes focus on increasing sleep duration by going to bed early; a strategy with limited success because teens experience a phase delay in bedtimes. There is a need for approaches that leverage behavioural sleep science and are accessible, scalable, and easily disseminated to students. DOZE (Delivering Online Zzz's with Empirical Support) is a self-management app that is grounded in sleep and circadian basic science. Although initial testing supports it as a feasible and acceptable app in a research context, it has not been tested as a strategy to use in schools. The present study tested DOZE in private high schools in Canada. Two-hundred and twenty-three students downloaded the app and completed daily sleep diaries over 4 weeks. Students reported a more regularised routine for bedtime, Mdiff = -0.43 h, p < 0.001, 95% CI [-0.65, -0.21], and rise time, Mdiff = -0.61 h, p < 0.001, 95% CI [-0.84, -0.38], in addition to a higher total sleep time, Mdiff = 0.18 h, p < 0.008, 95% CI [0.05, 0.31]. Students also rated DOZE to be highly acceptable. The evidence suggests that students find DOZE to be acceptable and engagement in this nonclinical population was reasonably high under minimal researcher supervision. This makes DOZE an attractive option and a step towards broad-based sleep health services. High powered replications with control groups are needed to increase empirical rigour.

Evaluating a New Short Self-Management Tool in Heart Failure Against the Traditional Flinders Program

Background/Objective: Heart failure (HF) is a complex syndrome, with multiple causes. Numerous pathophysiological pathways are activated. Comprehensive and guideline-derived care is complex. A multidisciplinary approach is required. The current guidelines report little evidence for chronic disease self-management (CDSM) programs for reducing readmission and major adverse cardiovascular events (MACE). CDSM programs can be complex and are not user-friendly in clinical settings, particularly for vulnerable patients. The aim of this study was to investigate whether a simplified one-page CDSM tool, the SCReening in Heart Failure (SCRinHF), is comparable to a comprehensive Flinders Program of Chronic Disease Management, specifically in triaging self-management capabilities and in predicting readmission and MACE. Methods:SELFMAN-HF is a prospective, observational study based on community cardiology. Eligible patients, consecutively recruited, had HF with left ventricular ejection fraction <40% and were placed on sodium-glucose co-transporter-2 inhibitors (SGLT2-i) within 3 months of recruitment. SGLT2-i is the newest of the four HF treatment pillars; self-management skills are assessed at this juncture. CDSM was assessed and scored independently via the long-form (LF) and short-form (SF) tools, and concordance between forms was estimated. The primary endpoint is the 80% concordance across the two CDSM scales for predicting hospital readmission and MACE. Results: Of the 117 patients, aged 66.8 years (±SD 13.5), 88 (75%) were male. The direct comparisons for SF versus LF patient scores are as follows: "good self-managers", 13 vs. 30 patients (11.1% vs. 25.6%); "average", 46 vs. 21 patients (39.3% vs. 17.9%), "borderline", 20 vs. 31 patients (17.1% vs. 26.5%), and "poor self-managers" (vulnerable), 38 vs. 35 patients (32.5% vs. 29.9%). These findings underscore the possibility of SF tools in picking up patients whose scores infer poor self-management capabilities. This concordance of the SF with the LF scores for patients who have poor self-management capabilities (38 vs. 35 patients p = 0.01), alongside readmission (31/38 vs. 31/35 p = 0.01) or readmission risk for poor self-managers versus good self-managers (31/38 vs. 5/13 p = 0.01), validates the simplification of the CDSM tools for the vulnerable population with HF. Similarly, when concurrent and predictive validity was tested on 52 patients, the results were 39 (75%) for poor self-managers and 14 (27%) for good self-managers in both groups, who demonstrated significant correlations between SF and LF scores. Conclusions: Simplifying self-management scoring with an SF tool to improve clinical translation is justifiable, particularly for vulnerable populations. Poor self-management capabilities and readmission risk for poor self-managers can be significantly predicted, and trends for good self-managers are observed. However, correlations of SF to LF scores across an HF cohort for self-management abilities and MACE are more complex. Translation to patients of all skill levels requires further research.

Adapted Counseling Care Model for Management of Female Sexual Dysfunction Among Women Living With and Without HIV

Background and Objective

Sexual health research among women living with human immunodeficiency virus (HIV) has focused mainly on sexual practices and risk behaviors, with little consideration for treating sexual dysfunction and improving sexual satisfaction. The aim of this pilot study was to assess the effectiveness of an adaptive counseling care model in the management of female sexual dysfunction (FSD) among women living with HIV and without HIV in northern Nigeria.

Methods

This was a prospective cohort study of 200 women with HIV and a matched comparison arm of 200 women without HIV. Sexual function was assessed using the Female Sexual Function Index (FSFI), with a score ≤ 26.55 indicating FSD. We counseled women with FSD using the Permission, Limited Information, Specific Suggestions, Intensive Therapy (PLISSIT) model and evaluated the effectiveness of the model by comparing mean differences in baseline and six weeks post-intervention FSFI scores.

Results

The overall prevalence of FSD was 96.8%, with no difference between HIV-positive and HIV-negative participants (p = 0.398). Based on the six domains of the FSFI, the most common reported dysfunctions were sexual pain (21.7%), sexual desire disorder (17.6%), orgasm disorder (17.6%), lubrication disorder (17.2%), sexual arousal (16.9%), and poor sexual satisfaction (9.0%). The overall mean FSFI score (±standard deviation, SD) for those with FSD, in both groups (n = 387) prior to the counseling intervention was 16.05±10.65 (HIV-positive: 18.58±8.46; HIV-negative: 13.98±10.85). At the end of the intervention, the overall mean FSFI score in both groups increased to 23.58±16.53 (HIV-positive: 21.37±11.24; HIV-negative: 16.72±13.81) (p < 0.05 in all cases).

Conclusion and Global Health Implications

FSD is very common among women in Northern Nigeria, irrespective of HIV status. An adapted counseling care model improved sexual function in both HIV-positive and HIV-negative women. The PLISSIT model can guide healthcare providers to initiate and navigate sexual health discussions with women in this setting.

Pain, quality of life, and integral management in a cohort of patients diagnosed with hypophosphatasia in Colombia

BACKGROUND

Hypophosphatasia (HPP; OMIM 241510, 241500, and 146300) is a progressive metabolic, genetic disease with wide clinical heterogeneity, ranging from perinatal lethality to mild or moderate localized symptoms. This study aims to analyze the perception of pain, quality of life, and access barriers to healthcare among patients diagnosed with hypophosphatasia in Colombia. In this document we present pain and quality of life results.

METHODS

This study is an observational cohort of 18 HPP patients registered in the Colombian Association of Patients with Lysosomal Storage Diseases and Other Orphan Diseases (ACOPEL) database. We conducted a descriptive analysis using data from three questionnaires (SF-36, Brief Pain Questionnaire (BPQ), and Hypophosphatasia Impact Patient Survey (HIPS); the latter was translated into Spanish and validated for this study.

RESULTS

The most affected features, according to the SF-36 questionnaire, were overall health, vitality, and pain, with a median score above 67%. Patients' perception of their health status (HIPS questionnaire) was favorable, with 38.9% of cases reporting excellent health. On average, results from the BPQ indicated mild to moderate intensity of current pain experienced by patients. Consistency was observed in the reports of either the absence of pain or the presence of mild to moderate intensity when analyzing the results of the three questionnaires.

CONCLUSIONS

Colombian patients with HPP experience mild to moderate impairment in quality of life and pain that interfere with their daily activities. However, there is wide variability in the results obtained.

Associations between tea-drinking habits and health-related quality of life in Chinese adults: a mediation analysis based on sleep quality

BACKGROUND

The aim of this study was to explore the association between tea-drinking habits and health-related quality of life (HRQoL) in Chinese adults and the mediating effect of sleep quality in this association.

METHODS

Data were derived from the 2020 Survey of Social Factors for Chronic Disease Prevention and Control among adults in Lishui District, Nanjing, Jiangsu Province, China. Tea-drinking habits were measured by participants' self-report. The HRQoL was measured using the 12-item Short Form Health Survey. Multiple linear regression modelling and mediating effects modelling were used for analyses.

RESULTS

Habitual tea drinking, frequent tea drinking (drinking tea 6-7 days per week), tea concentration and <10 g of tea per day were strongly associated with an increase in HRQoL among Chinese adults (all p<0.05). The association between tea-drinking habits and HRQoL among Chinese adults was more pronounced in the male population and in those ≥45 y of age (all p<0.05). Tea drinking habits may improve HRQoL in Chinese adults by enhancing sleep quality (all p<0.05).

CONCLUSIONS

Maintaining the habit of habitual tea drinking (6-7 days per week), in small amounts (<10 g tea per day) was conducive to improving HRQoL of Chinese adults by improving sleep quality.

The effect of hetrombopag combined with conventional treatment on immune function and quality of life in patients with severe aplastic anemia

This study aimed to investigate the effect of hetrombopag combined with conventional treatment on immune function in patients with severe aplastic anemia (SAA). Patients were categorized into the control group (n = 50, receiving conventional treatment only) and experimental group (n = 50, receiving hetrombopag combined with conventional treatment). Before treatment and at weeks 18, 24, and 52 after treatment, the two groups were compared in routine blood test indicators, natural killer (NK) cell activity, and peripheral blood inflammatory factor levels. The overall remission rate and incidence of adverse events were also compared between the two groups. Outpatient or telephone follow-up was performed before treatment and at weeks 18, 24, and 52 after treatment to observe patients' immune function, treatment outcome, quality of life, and adverse events. Hemoglobin (Hb), and platelet count (PLT) (P < 0.05), and a rise in NK cell activity (P < 0.05). Interleukin (IL-10) levels were significantly higher, while IL-6 levels were significantly lower in the experimental group compared to the control group (P < 0.05). After receiving the treatment, all scores of SF-36 domains in both groups were higher than before treatment, particularly with higher scores in the experimental group (P < 0.05). Hetrombopag combined with conventional treatment improved the immune function and hematopoiesis of patients with SAA.

Evaluating optimal rehabilitation strategies in ICU: study protocol for a multicentre cohort study to assess Physical Activity dosing, Muscle mass, and physICal outcomeS (IPAMICS study)

BACKGROUND

Many patients who get discharged from the intensive care unit experience physical dysfunction that persists even after discharge. Physical dysfunction is associated with skeletal muscle atrophy and accompanying intensive care unit-acquired weakness in the early stages of intensive care unit admission, and early diagnosis and prevention with early mobilization are crucial. However, the amount of physical activity required for early mobilization remains controversial in critically ill patients. This study aims to reveal the optimal mobilization quantification score dose associated with physical dysfunction after hospital discharge.

METHODS

This is a multicenter prospective cohort study planned in 22 facilities; all consecutive patients admitted to the participating facilities between June 2024 and May 2025 will be included. Adult patients on ventilator management for at least 2 days and who will consent to this study will be included. Patients' mobility level and duration will be documented by the mobilization quantification score during their intensive care unit stay, and physical dysfunction will be assessed using muscle mass changes from day one to seven with ultrasonography and the Short-Form 12 Health Survey at 3 months after hospital discharge. The primary outcome is physical dysfunction at 3 months.

RESULTS AND CONCLUSION

Mobilization quantification score dose and muscle mass evaluation with ultrasonography will enable the quantification of the early mobilization intervention. This study will lay the foundation for future randomised studies.

Transcutaneous Electrical Acupoint Stimulation for Elders with Amnestic Mild Cognitive Impairment: A Randomized Controlled Pilot and Feasibility Trial

BACKGROUND

Amnestic mild cognitive impairment (aMCI) is an important window of opportunity for early intervention and rehabilitation in dementia. The aim of this study was to investigate the feasibility and effect of delivering transcutaneous electrical acupuncture stimulation (TEAS) intervention to elders with aMCI.

METHODS

A total of 61 aMCI patients were randomly allocated into the intervention group (receiving a 12-week TEAS) and control group (receiving health education). The feasibility outcomes included recruitment rate, retention rate, adherence rate, and an exploration of patients' views and suggestions on the research. The effective outcomes included cognitive function, sleep quality, and life quality, which were measured by the Montreal cognitive assessment scale (MoCA), auditory verbal learning test-Huashan version (AVLT-H), Pittsburgh sleep quality index (PSQI), and quality of life short-term-12 (QoL SF-12).

RESULTS

The recruitment rate, retention rate, and adherence rate were 67.35%, 92.42%, and 85.29%, respectively. Most aspects of the research design and administration of the TEAS intervention were acceptable. The quantitative analysis suggests that compared with the control group, the scores of MoCA, AVLT-H, and SF-12 (mental component summary) were significantly better (p < 0.05); however, the differences were not statistically significant in PSQI and SF-12 (physical component summary) (p > 0.05).

CONCLUSIONS

The findings demonstrated that the study was feasible. TEAS awas possible for enhancing cognitive function and mental health in people with aMCI.

Association between meeting 24-hour movement behavior guidelines and quality of life in adolescents with idiopathic scoliosis

BACKGROUND

Meeting the 24-hour movement behavior (24-HMB) guideline helps enhance quality of life (QOL) of adolescents. This study aimed to assess the associations between the 24-HMB (physical activity, screen time, sleep) and QOL among adolescents with idiopathic scoliosis.

METHODS

A cross-sectional study was conducted between September 2021 and September 2023. 24-HMB, QOL and demographic variables were collected through a self-reported questionnaire. Linear regression models and stratified analyses were used to explore statistical associations between the 24-HMB and QOL.

RESULTS

A total of 1073 participants aged 10-18 years with a spinal Cobb angle between 10° and 40° were included. Overall, 20 participants (1.9%) met all three behavioral guidelines, and 272 participants (25.3%) met none. Compared to those who did not meet any of the guidelines, adolescents meeting both screen time and sleep duration (β = 4.10, 95% CI: 2.02-6.18, P < 0.001) and all 3 guidelines (β = 4.39, 95% CI: 0.27-8.51, P = 0.037) had higher QOL scores. Stratified analyses showed that the above associations were more pronounced in adolescents without back pain or with good self-image.

CONCLUSIONS

These findings highlight the importance of adopting and maintaining healthy behavioral habits in order to improve QOL among adolescents with idiopathic scoliosis, especially in those without back pain or with good self-image.

Effect of Shi-Style Steaming and Bathing Decoction in Patients with Knee Osteoarthritis: Study Protocol for a Randomized Placebo-Controlled Trial

Purpose

To prove more accurately that Chinese herbal bath therapy may be a safe, effective, simple alternative treatment modality for knee OA, we designed a randomized, double-blind, placebo-controlled trial to explore the effectiveness of SSBD for the relief of pain, daily activities, and quality of life in patients with knee OA.

Patients and Methods

A single-center, 52-week, randomized controlled trial of SSBD versus placebo is being performed. A total of 200 patients with symptomatic knee OA will be randomly allocated to the SSBD treatment or placebo intervention group for 4 weeks. The two groups of patients are allowed to steam and bathe their knees once every other day, using one packet of SSBD each time, for 30 minutes, 3 times a week, for a total of 4 weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale at 4 weeks is the primary outcome measure, and the secondary outcomes include WOMAC stiffness and function scores, the Lysholm knee scale score, quality of life, the Brief Pain Inventory score, the Patient's Global Impressions of Improvement Scale score and the Clinical Global Impressions of Severity scale score. The safety of the herbal medications will also be evaluated.

Conclusion

We will discuss whether SSBD has greater advantages in terms of efficacy, safety, and patient overall perception than does placebo control in middle-aged and elderly patients with knee OA. The findings may provide new and valuable information about the efficacy and safety of Chinese herbal bath therapy in the treatment of knee osteoarthritis.

Assessing how individuals conceptualize numeric pain ratings: validity and reliability of the Pain Schema Inventory (PSI-6) Short Form

Background

While numeric scales to represent pain intensity have been well validated, individuals use various conceptualizations when assigning a number to pain intensity, referred to as pain rating schema. The 18-item Pain Schema Inventory (PSI-18) quantifies pain rating schema by asking for numeric values for multiple mild, moderate or severe pain conditions. This study aimed to assess the validity and reliability of a shortened form of the PSI, using only 6 items (PSI-6).

Methods

A secondary analysis was performed on two existing datasets. The first (n = 641) involved a community-based population that completed the PSI-18. The second (n = 182) included participants with chronic pain who completed the PSI-6 twice, one week apart. We assessed face validity, convergent validity, offset biases, test-retest reliability, and internal consistency of the PSI-6 compared to the PSI-18.

Results

Both the PSI-18 and PSI-6 demonstrated excellent face validity. The PSI-6 demonstrated excellent convergent validity relative to the PSI-18, with correlations from r = 0.88 to 0.92. Bland-Altman plots revealed offset biases near zero (< 0.22 on 0-10 scale) across all categories of mild, moderate, severe and average pain. Internal consistency was excellent, with Cronbach's Alpha = 0.91 and 0.80, for PSI-18 and PSI-6 respectively. Test-retest reliability of the PSI-6 was high with correlations from r = 0.70-0.76.

Conclusion

The PSI-6 is a valid and reliable tool to assess pain rating schema with reduced subject burden, to better interpret individuals' pain ratings and adjust for inter-individual variability.

[Effectiveness of minimally invasive treatment of hallux valgus with small incision external articular osteotomy]

Objective

To compare the effectiveness of small incision external articular minimally invasive osteotomy and traditional Chevron osteotomy in the treatment of hallux valgus.

Methods

A retrospective analysis was conducted on the clinical data of 58 patients (58 feet) with hallux valgus who were admitted between April 2019 and June 2022 and met the selection criteria. Among them, 28 cases were treated with small incision external articular minimally invasive osteotomy (minimally invasive group), and 30 cases were treated with traditional Chevron osteotomy (traditional group). There was no significant difference in baseline data such as age, gender, disease duration, Mann classification, and preoperative inter metatarsal angle (IMA), hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), forefoot width, tibial sesamoid position (TSP) score, American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score, visual analogue scale (VAS) score, psychological score (SF-12 MCS score) and physiological score (SF-12 PCS score) of short-form 12 health survey scale, and range of motion (ROM) of metatarsophalangeal joint between the two groups ( P>0.05). The incision length, operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, weight-bearing walking time, fracture healing time, and incidence of complications were recorded and compared between the two groups; as well as the changes of imaging indexes at last follow-up, and the clinical function score and ROM of metatarsophalangeal joint before operation, at 6 weeks after operation, and at last follow-up.

Results

All patients were followed up 11-31 months, with an average of 22 months. The incision length and intraoperative blood loss in the minimally invasive group were significantly less than those in the traditional group ( P<0.05), and the intraoperative fluoroscopy frequency and operation time in the minimally invasive group were significantly more than those in the traditional group ( P<0.05); but no significant difference was found in weight-bearing walking time and fracture healing time between the two groups ( P>0.05). There was 1 case of skin injury in the minimally invasive group and 3 cases of poor incision healing in the traditional group; all patients had good healing at the osteotomy site, and no complication such as infection, nerve injury, or metatarsal head necrosis occurred. At last follow-up, the imaging indexes of the two groups significantly improved when compared with those before operation ( P<0.05). The changes of DMAA and TSP score in the minimally invasive group were significantly better than those in the traditional group ( P<0.05), and there was no significant difference in the changes of IMA, HVA, and forefoot width between the two groups ( P>0.05). The clinical scores and ROM of metatarsophalangeal joint significantly improved in the two groups at 6 weeks after operation and at last follow-up when compared with preoperative ones ( P<0.05), and the indicators in the minimally invasive group were significantly better than those in the traditional group ( P<0.05).

Conclusion

Compared with traditional Chevron osteotomy, small incision external articular minimally invasive osteotomy can effectively improve HVA, IMA, and forefoot width, correct foot deformities, and has less trauma. It can better correct the first metatarsal pronation deformity and restore the anatomical position of the sesamoid bone, resulting in better effectiveness.

Presurgical structural imaging and clinical outcome in combined bed nucleus of the stria terminalis-nucleus accumbens deep brain stimulation for treatment-resistant depression

Background

Structural imaging holds great potential for precise targeting and stimulation for deep brain stimulation (DBS). The anatomical information it provides may serve as potential biomarkers for predicting the efficacy of DBS in treatment-resistant depression (TRD).

Aims

The primary aim is to identify preoperative imaging biomarkers that correlate with the efficacy of DBS in patients with TRD.

Methods

Preoperative imaging parameters were estimated and correlated with the 6-month clinical outcome of patients with TRD receiving combined bed nucleus of the stria terminalis (BNST)-nucleus accumbens (NAc) DBS. White matter (WM) properties were extracted and compared between the response/non-response and remission/non-remission groups. Structural connectome was constructed and analysed using graph theory. Distances of the volume of activated tissue (VAT) to the main modulating tracts were also estimated to evaluate the correlations.

Results

Differences in fibre bundle properties of tracts, including superior thalamic radiation and reticulospinal tract, were observed between the remission and non-remission groups. Distance of the centre of the VAT to tracts connecting the ventral tegmental area and the anterior limb of internal capsule on the left side varied between the remission and non-remission groups (p=0.010, t=3.07). The normalised clustering coefficient (γ) and the small-world property (σ) in graph analysis correlated with the symptom improvement after the correction of age.

Conclusions

Presurgical structural alterations in WM tracts connecting the frontal area with subcortical regions, as well as the distance of the VAT to the modulating tracts, may influence the clinical outcome of BNST-NAc DBS. These findings provide potential imaging biomarkers for the DBS treatment for patients with TRD.

Mediating role of social support in dysphoria, despondency, and quality of life in patients undergoing maintenance hemodialysis

BACKGROUND

Dysphoria and despondency are prevalent psychological issues in patients undergoing Maintenance Hemodialysis (MHD) that significantly affect their quality of life (QOL). High levels of social support can significantly improve the physical and mental well-being of patients undergoing MHD. Currently, there is limited research on how social support mediates the relationship between dysphoria, despondency, and overall QOL in patients undergoing MHD. It is imperative to investigate this mediating effect to mitigate dysphoria and despondency in patients undergoing MHD, ultimately enhancing their overall QOL.

AIM

To investigate the mediating role of social support in relationships between dysphoria, despondency, and QOL among patients undergoing MHD.

METHODS

Participants comprised 289 patients undergoing MHD, who were selected using a random sampling approach. The Social Support Rating Scale, Self-Rating Anxiety Scale, Self-Rating Depression Scale, and QOL Scale were administered. Correlation analysis was performed to examine the associations between social support, dysphoria, despondency, and QOL in patients undergoing MHD. To assess the mediating impact of social support on dysphoria, despondency, and QOL in patients undergoing MHD, a bootstrap method was applied.

RESULTS

Significant correlations among social support, dysphoria, despondency, and quality in patients undergoing MHD were observed (all P < 0.01). Dysphoria and despondency negatively correlated with social support and QOL (P < 0.01). Dysphoria and despondency had negative predictive impacts on the QOL of patients undergoing MHD (P < 0.05). The direct effect of dysphoria on QOL was statistically significant (P < 0.05). Social support mediated the relationship between dysphoria and QOL, and this mediating effect was significant (P < 0.05). Similarly, the direct effect of despondency on QOL was significant (P < 0.05). Moreover, social support played a mediating role between despondency and QOL, with a significant mediating effect (P < 0.05).

CONCLUSION

These findings suggest that social support plays a significant mediating role in the relationship between dysphoria, despondency, and QOL in patients undergoing MHD.

The Added Value of Face-to-Face Supervision to a Therapeutic Exercise-Based App in the Management of Patients with Chronic Low Back Pain: A Randomized Clinical Trial

Low back pain (LBP) is a significant global health challenge due to its high prevalence, and chronicity and recurrence rates, with projections suggesting an increase in the next years due to population growth and aging. The chronic and recurrent nature of LBP, responsible for a significant percentage of years lived with disability, underscores the need for effective management strategies, including self-management strategies advocated by current guidelines, to empower patients and potentially improve healthcare efficiency and clinical outcomes. Therefore, the aim of this study was to analyze the added value of face-to-face visits in patients with chronic LBP undergoing a self-management program based on therapeutic exercises on pain intensity, disability, quality of life and treatment adherence and satisfaction. A randomized clinical trial was conducted, allocating 49 patients into a experimental group with a mobile health (mHealth) app usage and face-to-face sessions and 49 patients into an active control group without face-to-face sessions. Pain intensity, disability and quality of life were assessed at baseline, 4 weeks postintervention and 12 weeks postintervention. Patients' satisfaction and adherence were assessed at the end of the study. The multivariate general model revealed no statistically significant time × group interaction for any outcome (p > 0.0068) but mental quality of life (p = 0.006). Within-group differences revealed significant improvements for all the clinical indicators (all, p < 0.001). Patients allocated to the experimental group reported greater satisfaction and adherence (both, p < 0.001) compared to the control group. The use of mHealth apps such as Healthy Back® as part of digital health initiatives may serve as a beneficial approach to enhance the management of LBP.

Effectiveness and mechanism of action of rTMS combined with quadriceps strength training in individuals with knee osteoarthritis: study protocol for a randomized controlled trial

BACKGROUND

Quadriceps training is necessary in function and activity of daily living for patients with knee osteoarthritis (KOA). However, it did not reduce the rate of surgical treatment for end-stage KOA in the long term. This may be related to brain structure changes and maladaptive plasticity in KOA patients. Transcranial Magnetic Stimulation (TMS) could enhance the functional connectivity of brain regions and improves maladaptive plasticity. However, the synergistic effect of the combination of the two for treat KOA is still unclear. Therefore, the purpose of this study is to investigate whether the High-Frequency rTMS combined with quadriceps strength training can improve the pain and function in KOA more effectively than quadriceps training alone and explore the mechanism of action.

METHODS

This study is an assessor-blind, sham-controlled, randomized controlled trial involving 12 weeks of intervention and 6 months follow-up. 148 participants with KOA will receive usual care management and be randomized into four subgroups equally, including quadriceps strength training, high-frequency rTMS training, sham rTMS and quadriceps strength training, high-frequency rTMS and quadriceps strength training. The rehabilitation interventions will be carried out 5 days per week for a total of 12 weeks. All outcomes will be measured at baseline, 4 weeks, 8 weeks, and 12 weeks during the intervention and 1 month, 3 months and 6 months during the follow-up period. The effectiveness outcomes will be included visual analog scale, isokinetic knee muscle strength, Knee Injury and Osteoarthritis Outcome score and 36-Item Short-Form Health Survey score; The act mechanism outcomes will be included motor evoked potential, grey matter density, white matter, subcortical nuclei volumes, cortical thickness and functional connectivity by MRI. Two-way of variance with repeated measures will be used to test the group and time effect for outcome measures.

DISCUSSION

The study will be the first protocol to examine whether there are synergistic effects following high-frequency rTMS combined with quadriceps strength training for treat KOA and clarify the mechanism of action. High-frequency rTMS can be added into the training program for KOA patients if it is proven effective.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2300067617. Registered on Jan.13,2023.

Older Persons Participation in Hard Martial Arts: Opportunities to Improve Psychological Well-Being? A Scoping Review

This study aims to explore the potential psychological and cognitive advantages for older individuals engaged in hard martial arts (HMA), through a comprehensive scoping review of literature up to 2023. Specifically, it examines the extent of changes in cognition, mental state, and quality of life among elderly participants of HMA. Inclusion criteria were studies conducted on healthy persons who were over 50 years of age. Only papers published in the English language were included. The search was undertaken in electronic databases and sources of grey literature. Thirteen papers with a total of 514 participants met the inclusion criteria. Improved cognition and decreased levels of anxiety and depression were emerging themes. Together, these factors contributed to the quality of life of participants. HMA was found to benefit cognitive abilities and psychological well-being, increasing quality of life more than traditional exercise alone. Findings suggested duration of training influenced change more than frequency. The limited number of studies exploring the effects of HMA on mental wellness and cognitive ability in older adults underscores the need for further research. The findings of this review suggest cognitive and quality of life improvements and reduced depression and anxiety in individuals engaging in HMA. This review serves as a foundation for soundly designed future research.

Safety and Tolerability of Intra-Articular Injection of Adipose-Derived Mesenchymal Stem Cells GXCPC1 in 11 Subjects With Knee Osteoarthritis: A Nonrandomized Pilot Study Without a Control Arm

The current study aimed to determine the safety profile of intra-articular-injected allogeneic adipose-derived mesenchymal stem cells (ADSCs) GXCPC1 in subjects with knee osteoarthritis (OA) and its preliminary efficacy outcome. The 3 + 3 phase I study was designed with two dose-escalation cohorts: low dose (6.7 × 106 GXCPC1, N = 5) and high dose (4 × 107 GXCPC1, N = 6). The primary endpoint was safety, which was evaluated by recording adverse events throughout the trial; the secondary endpoints included total, pain, stiffness, and function subscales of the Western Ontario and McMaster Universities Arthritis Index (WOMAC), Visual Analogue Scale (VAS) for pain, and 12-Item Short Form (SF-12) health survey questionnaire. The GXCPC1 treatment was found to be safe after 1 year of follow-up with no treatment-related severe adverse events observed. When compared to baseline, subjects in both the low- and high-dose cohorts demonstrated improving trends in pain and knee function after receiving GXCPC1 treatment. Generally, the net change in pain (95% confidence interval (CI) = -7.773 to -2.561t at 12 weeks compared to baseline) and knee function (95% CI = -24.297 to -10.036t at 12 weeks compared to baseline) was better in subjects receiving high-dose GXCPC1. Although this study included a limited number of subjects without a placebo arm, it showed that the intra-articular injection of ADSCs was safe and well-tolerated in subjects with therapeutic alternatives to treat knee OA. However, a larger scale study with an appropriate control would be necessary for clinical efficacy in the following study.

Pelvic floor dysfunction after colorectal cancer treatment is related to physical and psychological health and body image: A cross-sectional study

PURPOSE

Pelvic floor dysfunction (PFD) often occurs in patients with colorectal cancer (CRC), which can affect their quality of life. However, the precise factors that related to PFD in CRC patients remain elusive. The main objective of this study was to identify the variables associated with PFD following CRC treatment and establish a foundation for the development of a tailored rehabilitation plan specific to this population.

METHODS

The classification of 149 patients with CRC was conducted according to the type of medical treatment they underwent. PFD was evaluated using the Urogenital Distress Inventory 6 (UDI-6) and Colorectal-Anal Distress Inventory 8 (CRADI-8) questionnaires. The study employed the Short form 36 health survey (SF-36) and Body Image Scale (BIS) to evaluate physical and psychological health as well as body image disorders. The connection between PFD and independent variables was determined through logistic regression analyses.

RESULTS

Of all patients, more than 50% reported experiencing dysfunction, with the highest proportion observed in the PRT (primary radiotherapy) group. The LRR/RR (robotic-assisted colorectal resection or laparoscopic colorectal resection) group revealed a significant association between high BMI (Body Mass Index) and alcohol consumption with PFD. Moreover, in the PRT group, PFD was correlated with poorer physical condition (OR = 0.94, 95% CI = [0.88-1.00]).

CONCLUSIONS

PFD is a commonly complained-about issue among patients with CRC. Early intervention targeted towards these factors may aid in the alleviation of associated distress and contribute towards the individualization of CRC rehabilitation programs, consequently improving the quality of life for patients.

Health empowerment and health-related quality of life in older individuals with disabilities and their spouse carers: A cross-sectional study

The stress of disability significantly impacts an individual's quality of life and that of a spouse. Health empowerment, based on the idea that individuals may be successful despite disability, may be meaningful to disabled persons and their spouse carers. This cross-sectional survey study aimed to explore the effect of health empowerment on the health-related quality of life (HRQOL) of older individuals with disabilities and their spouse carers on both a personal (actor effect) and interpersonal level (partner effect). A total of 1092 dyads of older individuals with disabilities and their spouse carers residing in communities were recruited from seven provinces in China. Two separate Actor-Partner Interdependence Model analyses were conducted to examine the impact of health empowerment on the two domains of HRQOL: the Physical Component Score (PCS) and the Mental Component Score (MCS). The results revealed that health empowerment had actor effects on the PCS and MCS of older individuals with disabilities, as well as on the PCS and MCS of their spouse carers. However, no significant partner effects of health empowerment on the PCS and MCS of either the individuals with disabilities or their spouse caregivers were observed. Empowering individuals with disabilities and their spouse carers may help them enhance their own HRQOL, both physically and mentally. However, more research is required to determine the interpersonal effect of health empowerment on the HRQOL.

Assessment of quality of life in patients with craniopharyngioma and identification of risk factors for compromised overall wellness

Objective

Quality of Life (QoL) has been a multifactorial concerning issue in oncology. We aimed to inspect the pre-operative QoL among patients with craniopharyngioma and to explore the potential correlations between parameters of QoL and clinical indices.

Subjects and methods

We enrolled a total of 109 patients with craniopharyngioma. We utilized Short Form 36 (SF-36), Symptom Check List-90, Generalized Anxiety Disorder Questionnaire scale (GAD7), Patient Health Questionnaire Depression (PHQ9) and Pittsburgh Sleep Quality Index to prospectively evaluated their QoL. Parameters of QoL along with clinical indices were compared among sub-groups divided according to Puget classification. Correlation analyses and regression analyses were performed to detect influential determinants to self-reported wellness.

Results

Patients presented impaired QoL compared with general population (p < 0.001), as assessed by SF-36. Correlation analyses indicated the detrimental influence resulting from central diabetes insipidus (CDI). Multivariate linear regression unveiled the adverse effect of CDI on Mental Component Summary (coefficient = -13.869, p= 0.007), GAD7 total score (coefficient = 2.072, p = 0.049) as well as PHQ9 total score (coefficient = 3.721, p = 0.001). Multivariate logistic regression verified CDI as a risk factor of developing depressive symptoms (OR = 6.160, p = 0.001).

Conclusion

QoL of patients with craniopharyngioma was remarkably compromised before operation. CDI exerted detrimental influences on patients' QoL and it might serve as a marker for early identification of patients at risk of depression.

Can Ultrasound-Guided Continuous Paravertebral Block Reduce the Incidence of Chronic Postsurgical Pain in Patients with Thoracoscopic Lung Cancer Surgery? A Randomized Controlled Trial

Background

Thoracoscopic lung cancer surgery is accompanied by severe pain. Both continuous paravertebral block (CPVB) and continuous wound infiltration (CWI) are widely used for perioperative analgesia in thoracoscopic surgery. However, the effects of these different methods on chronic postsurgical pain (CPSP) are still unknown. Patients and Methods. This prospective randomized controlled trial assessed the eligibility of 113 patients. Ninety-seven patients who met the inclusion criteria were randomly divided into a CPVB group and a CWI group, and 80 patients were analyzed in the final study. The primary outcome measures were the incidence and intensity of chronic postsurgical pain (CPSP) at 3, 6, and 9 months after surgery. The secondary outcome measures were the numerical rating scale (NRS) score of rest and activity at 12, 18, and 24 hours and on the 2nd, 3rd, and 7th days postoperatively; the Barthel Activities of Daily Living (ADL) score of activity levels on the 1st, 2nd, 3rd, and 7th days postoperatively; and the long-term quality of the life score at 3, 6, and 9 months postoperatively.

Results

The incidence of chronic postsurgical pain in the CWI group was significantly higher than that in the CPVB group at 3, 6, and 9 months after surgery (all P < 0.05). The intensity of chronic postsurgical pain was significantly decreased in the CPVB group at 3, 6, and 9 months after surgery (P < 0.05). NRS-R and NRS-A scores were significantly decreased in the CPVB group within the first week after thoracoscopic surgery (P < 0.001). ADL scores were increased in the CPVB group within 3 days postoperatively. However, there were no differences in the ADL score on the 7th postoperative day or the long-term quality of the life score at 3, 6, and 9 months postoperatively.

Conclusion

Continuous ultrasound-guided paravertebral block reduced the intensity of acute pain within 7 days postoperatively and reduced the incidence of chronic pain at 3, 6, and 9 months after surgery, but there was no significant advantage in long-term quality of life. This trial is registered with ChiCTR2000038505.

Instruments to assess post-intensive care syndrome assessment: a scoping review and modified Delphi method study

BACKGROUND

The assessment of post-intensive care syndrome (PICS) is challenging due to the numerous types of instruments. We herein attempted to identify and propose recommendations for instruments to assess PICS in intensive care unit (ICU) survivors.

METHODS

We conducted a scoping review to identify PICS follow-up studies at and after hospital discharge between 2014 and 2022. Assessment instruments used more than two times were included in the modified Delphi consensus process. A modified Delphi meeting was conducted three times by the PICS committee of the Japanese Society of Intensive Care Medicine, and each score was rated as not important (score: 1-3), important, but not critical (4-6), and critical (7-9). We included instruments with ≥ 70% of respondents rating critical and ≤ 15% of respondents rating not important.

RESULTS

In total, 6972 records were identified in this scoping review, and 754 studies were included in the analysis. After data extraction, 107 PICS assessment instruments were identified. The modified Delphi meeting reached 20 PICS assessment instrument recommendations: (1) in the physical domain: the 6-min walk test, MRC score, and grip strength, (2) in cognition: MoCA, MMSE, and SMQ, (3) in mental health: HADS, IES-R, and PHQ-9, (4) in the activities of daily living: the Barthel Index, IADL, and FIM, (5) in quality of life: SF-36, SF-12, EQ-5D-5L, 3L, and VAS (6), in sleep and pain: PSQI and Brief Pain Inventory, respectively, and (7) in the PICS-family domain: SF-36, HADS, and IES-R.

CONCLUSION

Based on a scoping review and the modified Delphi method, 20 PICS assessment instruments are recommended to assess physical, cognitive, mental health, activities of daily living, quality of life, sleep, and pain in ICU survivors and their families.

Mental Health and Contraceptive Knowledge in High Schoolers: Comparing Remote and In-Person Learning during COVID-19

Background and Objectives: In response to the COVID-19 pandemic's effects on education, this study delves into the behavioral, mental health, and sexual education characteristics of high school students during 2020-2021 and 2022-2023. Materials and Methods: We evaluated a variety of factors, including substance use, academic performance, sexual activities, mental health support, pandemic-related anxiety levels, and quality of life indicators using standardized instruments such as the SF-36, GAD-7, and WHOQOL-BREF. Furthermore, we addressed specific questions concerning contraception and sexual education during this period. Results: The questionnaires were filled in by 44 students in 2020-2021 and 41 students in 2022-2023. Significant findings included a noteworthy increase in COVID-19 vaccination rates, from 18.2% in 2020-2021 to 39.0% in 2022-2023 (p = 0.033), enhanced perceptions of mental health support during remote learning, from 7.1% to 20.0% (p = 0.044), and a rise in students partaking in reproductive health discussions from 10.7% to 25.0% (p = 0.046). Additionally, there was a marked decline in anxiety regarding the transition back to in-person learning (p = 0.048). Health surveys, such as the SF-36, signaled improvements in both physical and mental health over the years (p = 0.046 and p = 0.019, respectively), while the GAD-7 scores depicted a considerable reduction in anxiety symptoms (p = 0.038). The WHOQOL-BREF results also highlighted a significant uptick in students' mental well-being in 2022-2023 (p = 0.039). Conclusions: As the COVID-19 pandemic ended, high school students exhibited shifts in behavior, health, and education over four academic years, particularly in areas of contraceptive knowledge and mental health outcomes. The pronounced enhancements in vaccination rates, perceptions of mental health support, participation in health conversations, and overall mental wellness emphasize the adaptability and resilience of students in these tumultuous periods, and a general increase in contraceptive knowledge and quality of life during the end of the pandemic.

Early goal-directed mobilization in patients with acute type A aortic dissection: A randomized controlled trial

OBJECTIVE

To determine the safety and efficacy of early postoperative mobilization in patients who have undergone surgical repair of acute type A aortic dissection.

DESIGN

Randomized controlled trial.

SETTING

Heart Medical Center.

SUBJECTS

Seventy-seven patients with acute type A aortic dissection were assessed.

INTERVENTION

Patients were randomly allocated into: (1) the control group (usual care) (n  =  38) and (2) the intervention group (early goal-directed mobilization) (n  =  39).

MAIN MEASURES

The primary outcome was the patient's functional status. The secondary outcomes included vital signs, serious adverse events, muscle strength, intensive care unit-acquired weakness, grip strength, duration of mechanical ventilation, length of stay, readmission rate, and health-related quality of life after 3 months.

RESULTS

The vital signs of the patients were within the tolerable ranges during the entire intervention. No serious exercise-related adverse events were observed in the intervention group. The Barthel Index score (P  =  0.013), Medical Research Council score (P  =  0.001), grip strength (P  =  0.001), and health-related quality of life (P  =  0.001) were higher in the intervention group. Intensive care unit acquired weakness (P  =  0.019), duration of mechanical ventilation (P  =  0.002), intensive care unit stay (P  =  0.002), and total length of stay (P  =  0.010) were lower in the intervention group. Patients in the intervention group had a higher physical health-related quality of life (P  =  0.015) at 3 months post-surgery. There was no difference in readmission rates.

CONCLUSIONS

Delivery of early goal-directed mobilization in acute type A aortic dissection was safe and facilitated the recovery of daily living ability, shorter hospital stay, and improved quality of life after discharge.

Is Increasing Diet Diversity of Animal-Source Foods Related to Better Health-Related Quality of Life among Chinese Men and Women?

Diet plays a crucial role in regulating individuals' lifestyles and is closely related to health. The intake of animal-sourced foods (ASF) provides the human body with high-quality protein and various micronutrients. This study aimed to investigate whether the diversity of animal foods has a positive impact on the health-related quality of life (HRQoL) among residents. The data came from the Shaanxi baseline survey of the Northwest Chinese Regional Ethnic Cohort Study, which recruited more than 100 thousand participants aged 35 to 74 from five provinces between June 2018 and May 2019. A total of 39,997 participants in Shaanxi (mean age: 50 years; 64% women) were finally included in this current study. The animal source food diet diversity score (ASFDDS) was established based on the frequency of consuming pork, mutton, beef, poultry, seafood, eggs, pure milk, and yogurt. The physical component score (PCS) and mental component score (MCS), ranging from 0 to 100 on the 12-Item Short Form Survey (SF-12), were used to assess participants' HRQoL. Better PCS/MCS was defined as scores higher than the 90th percentile. The results showed that men had a higher intake of ASF and ASFDDS than women. After adjusting for potential confounders, compared with those who never or rarely consumed animal foods, the likelihood of having better PCS and MCS increased by 16% (OR = 1.16, 95%CI: 1.01-1.34) and 24% (OR = 1.24, 95%CI: 1.03-1.448), respectively, in men with an ASFDDS ≥ 2. In women, a 34% increase (OR = l.34, 95%CI: 116-l.54) likelihood for better PCS was observed for an ASFDDS ≥ 2, but no association was observed for MCS. Increasing each specific animal source's food intake was associated with better PCS after adjusting for all covariates. However, for MCS, positive associations were only observed in seafood consumption among men and eggs among women. Restricted cubic splines showed a substantial dose-response association between intake frequency of animal-source foods and PCS, both in men and women. The study suggests that a diverse intake of animal-sourced foods can potentially improve the HRQoL of Chinese adults.

Neuro-11: a new questionnaire for the assessment of somatic symptom disorder in general hospitals

Background

Somatic symptom disorder (SSD) commonly presents in general hospital settings, posing challenges for healthcare professionals lacking specialised psychiatric training. The Neuro-11 Neurosis Scale (Neuro-11) offers promise in screening and evaluating psychosomatic symptoms, comprising 11 concise items across three dimensions: somatic symptoms, negative emotions and adverse events. Prior research has validated the scale's reliability, validity and theoretical framework in somatoform disorders, indicating its potential as a valuable tool for SSD screening in general hospitals.

Aims

This study aimed to establish the reliability, validity and threshold of the Neuro-11 by comparing it with standard questionnaires commonly used in general hospitals for assessing SSD. Through this comparative analysis, we aimed to validate the effectiveness and precision of the Neuro-11, enhancing its utility in clinical settings.

Methods

Between November 2020 and December 2021, data were collected from 731 patients receiving outpatient and inpatient care at Shenzhen People's Hospital in China for various physical discomforts. The patients completed multiple questionnaires, including the Neuro-11, Short Form 36 Health Survey, Patient Health Questionnaire 15 items, Hamilton Anxiety Scale and Hamilton Depression Scale. Psychiatry-trained clinicians conducted structured interviews and clinical examinations to establish a gold standard diagnosis of SSD.

Results

The Neuro-11 demonstrated strong content reliability and structural consistency, correlating significantly with internationally recognised and widely used questionnaires. Despite its brevity, the Neuro-11 exhibited significant correlations with other questionnaires. A test-retest analysis yielded a correlation coefficient of 1.00, Spearman-Brown coefficient of 0.64 and Cronbach's α coefficient of 0.72, indicating robust content reliability and internal consistency. Confirmatory factor analysis confirmed the validity of the three-dimensional structure (p<0.001, comparative fit index=0.94, Tucker-Lewis index=0.92, root mean square error of approximation=0.06, standardised root mean square residual=0.04). The threshold of the Neuro-11 is set at 10 points based on the maximum Youden's index from the receiver operating characteristic curve analysis. In terms of diagnostic efficacy, the Neuro-11 has an area under the curve of 0.67.

Conclusions

(1) The Neuro-11 demonstrates robust associations with standard questionnaires, supporting its validity. It is applicable in general hospital settings, assessing somatic symptoms, negative emotions and adverse events. (2) The Neuro-11 exhibits strong content reliability and validity, accurately capturing the intended constructs. The three-dimensional structure demonstrates robust construct validity. (3) The threshold of the Neuro-11 is set at 10 points.

Review of the Most Cited Patient-Reported Outcome Measure (PROM) Studies Published in the Neurospine Surgical Literature

Patient-reported outcome measures (PROMs) are validated tools that are widely utilized in research and patient care. Their diversity, quality, and application remain matters of peak research interest. This article is a review of the PROMs that were utilized in high-impact publications in the neurospine surgical literature. The 50 most cited articles on the subject were selected and analysed. Most (42 articles) were published in spine journals and, in particular, in the journal Spine (Phila Pa 1976) (28 articles). A total of 34 PROMs were utilized, of which 24 were used only once in single studies. The four most common PROMs were Scoliosis Research Society-22 (SRS-22) (15 articles), Short Form-12 and Short Form-36 (SF-12 and SF-36) (11 articles), Ronald-Morris Disability Questionnaire (RMDQ) (nine articles), and Oswestry Disability Index (ODI) (five articles). Nineteen articles focused on validating translated versions of 11 PROMs to other languages. The languages that had the maximal number of tools translated to amongst the highly cited articles were Italian (six tools), Portuguese (four tools), German (three tools), and Japanese (three tools). The most common diagnoses and the PROMs used for them were back pain and cervical spine disorder (SF-12 and SF-36 (nine articles), RMDQ (eight articles), and ODI (five articles)), and idiopathic scoliosis (SRS-22) (14 articles)). The median (range) article citation number was 137 (78-675). The four most cited PROMs were SRS-22 (2,869), SF-12 and SF-36 (2,558), RMDQ (1,456), and ODI (852). Citation numbers were positively impacted by article age and participant number but not by tool type or clinical diagnosis. In conclusion, a wide range of PROMs was utilized in the 50 most cited publications in the neurospine surgical literature. The majority were disease-specific rather than generic and targeted particular spine pathology. Neurosurgical PROMs were under-represented amongst the most cited articles. Awareness of the PROMs used in high-impact studies may be helpful in tool selection in future research. PROMs are valuable in standardizing subjective outcomes. Their use in research and clinical settings in any validated language is highly encouraged.

Profile and quality of life of the adult population in good health according to the level of vitality: European NHWS cross sectional analysis

BACKGROUND

The World Health Organization's definition of health highlights the importance of mental and physical wellbeing and not only disease state. However, lack of awareness on the burden of impaired vitality and its impact on the quality of life of the general healthy population prevents healthcare providers from delivering appropriate solutions and advice. This study aims to better characterize this population in Europe and identify the profile and the health reported outcomes associated with impaired vitality.

METHODS

This retrospective observational study included National Health and Wellness Survey (NHWS) data collected in healthy participants aged 18-65 years from five European Union countries in 2018. Socio-demographic and lifestyle characteristics, comorbidities, attitudes towards healthcare systems, Patient Activation Measure, health-related quality of life outcomes (EQ-5D), and work productivity and activity impairment were analysed according to SF-12 vitality score subgroups (≥ 60, 50- < 60, 40- < 50, < 40).

RESULTS

A total of 24,295 participants were enrolled in the main analysis. Being a female, younger, having a lower income and being obese or having sleep and mental disorders was associated with an increased risk of impaired vitality. This was associated with a higher consumption of healthcare resources along with having a weak patient-physician relationship. Participants who were disengaged in the self-management of their health were 2.6 times more likely to have a low level of vitality. For participants in the lowest vitality group, odds of mobility problems increased by 3.4, impairment of usual activity by 5.8, increased of pain and discomfort by 5.6 and depression and anxiety by 10.3, compared with participants in the highest vitality group. Also, odds of presenteeism increased by 3.7, overall work impairment by 3.4 and daily activity losses by 7.1.

CONCLUSION

Evidence-based trends facilitate the identification of a healthy population with impaired vitality in real-world practice. This study highlights the actual burden of low vitality on daily life activities, particularly on mental health and reduced work productivity. Additionally, our results underline the importance of self-engagement in the management of vitality impairment and highlights the need to implement strategies to address this public health concern in the affected population (HCP-patient communication, supplements, meditation).

Evaluation and correlation analysis of ocular surface disorders and quality of life in autoimmune rheumatic diseases: a cross-sectional study

OBJECTIVE

This cross-sectional study aimed to reveal the association between ocular surface disorders and psychological, physiological situations among autoimmune rheumatic patients.

METHODS

Ninety autoimmune rheumatic patients (180 eyes) hospitalized in the Department of Rheumatology, The Second Xiangya Hospital, Central South University and 30 controls (60 eyes) were enrolled in the study. All participants were assessed for ocular surface disorders including dry eye disease (DED) by the Ocular Surface Disease Index (OSDI) for symptoms evaluation, and slim lamp examinations for tear break-up time (TBUT), meibomian gland secretion, symblepharon and corneal clarity, Schirmer I test, corneal fluorescein staining (CFS), lid-parallel conjunctival folds (LIPCOF). Systematic conditions were evaluated using the Short Form 36-Health Survey (SF-36) for health-related quality of life, Hospital Anxiety and Depression Scale (HADS) for anxiety and depression, Health Assessment Questionnaire-Disability Index (HAQ-DI) for difficulties in activities of daily living, and Pittsburgh Sleep Quality Index (PSQI) for sleep quality. Pearson and spearman's analysis were conducted to examine the relationship between systematic conditions and ocular surface conditions.

RESULTS

The analyses were controlled for age and sex. 52.22% of eyes (94 in 180) of autoimmune rheumatic patients and 21.67% of eyes (13 in 60) of controls were diagnosed with DED. The autoimmune rheumatic patients showed significant higher OSDI score, fewer basal tear secretion, more severe CFS and conjunctivochalasis than controls. There were no statistically significant differences in TBUT, meibomian gland secretion, symblepharon, and corneal clarity between the two groups. For systematic conditions, autoimmune rheumatic patients had significantly lower SF-36 scores, higher anxiety scores, and HAQ-DI scores than controls. No statistically significant differences were detected in depression scores and PSQI between the two groups. Among autoimmune rheumatic patients, OSDI scores were moderately correlated with quality of life, anxiety, depression and sleep quality.

CONCLUSION

Factors including quality of life, anxiety, depression, and sleep quality are associated with ocular surface conditions, especially DED symptoms. Management of systemic conditions and psychotherapy should also be considered as part of the treatment among autoimmune rheumatic patients.

Self-perceived care needs and quality of life in people with cognitive impairment during routine care at home: cross-sectional results of the interventional study

BACKGROUND

Cognitive impairment (CI) is one of the most common disabling symptoms in the elderly, and people with CI face a variety of unmet care needs. There is limited evidence on the relationship between unmet needs and quality of life (QoL) of people with CI. The aim of this study is to analyse the current situation of unmet needs and QoL among people with CI, and to explore the correlation between QoL and unmet needs.

METHODS

The analyses use baseline data of the intervention trial, which recruited 378 participants to complete the questionnaire including the Camberwell Assessment of Need for the Elderly (CANE), and the Medical Outcomes Study 36-item Short-Form (SF-36). The SF-36 was further gathered into physical component summary (PCS) and mental component summary (MCS). Multiple linear regression analysis was conducted to explore the correlations between unmet care needs and PCS and MCS of SF-36.

RESULTS

The mean score of each of the eight domains of SF-36 was significantly lower than the Chinese population norm. The incidence of unmet needs ranged from 0 to 65.1%. Multiple linear regression results showed that living in rural areas (Beta=-0.16, P < 0.001), having unmet physical needs (Beta=-0.35, P < 0.001), and unmet psychological needs (Beta=-0.24, P < 0.001) were associated with lower PCS scores, whereas duration of CI > 2 years (Beta=-0.21, P < 0.001), unmet environmental needs (Beta=-0.20, P < 0.001), and unmet psychological needs (Beta=-0.15, P < 0.001) were associated with lower MCS scores.

CONCLUSION

The main results support the important view that lower QoL scores are associated with unmet needs in people with CI, depending on the domain. Given that the more unmet needs can further worsen QoL, it is recommended that more strategies should be taken, especially for those with unmet care needs, so as to improve their QoL.

Patient reported outcome measure domains and tools used among adolescents and young adults with cancer: A scoping review

Adolescent and young adult (AYA) cancer patients and survivors are growing and face with distinct issues from paediatric and older cancer survivors. Hence it is important the issues they encounter are measured using appropriate Patient Reported Outcome Measures (PROMs). We searched PubMed, EMBASE, CINAHL, and PsycINFO for articles including: (1) AYAs (ages 15-39), (2) Malignant neoplasms, and (3) PROMs. This resulted in 3566 unique articles, 523 were included for full text review, of which 175 were included. These studies included 203 distinct tools to measure PROMs across 31 domains. Physical function was most frequently measured domain, followed by social, emotional and mental health. The most commonly used tools were the EORTC QLQ-C30, HADS and SF-36. PROMs used in AYA cancer patients is a complex topic, this comprehensive review serves as a useful reference for researchers, clinicians and health services who want to better understand, and improve, outcomes among their patients.

Surface electromyography (sEMG) biofeedback posture training improves the physical and mental health of early adolescents with mild scoliosis: A qualitative study

Introduction

Asymmetry in paraspinal muscle activities is observed in adolescent idiopathic scoliosis and may be of value for predicting curve progression. We have reported the effects of the surface electromyography biofeedback posture training program in improving the symmetry of paraspinal muscle activities and reducing the curve progression of early adolescents with mild scoliosis. This study further explored their subjective experience of the training program on posture correction and health-related quality of life.

Methods

Using purposive sampling, 13 early adolescents aged between 11 and 13 years with mild scoliosis participated in semi-structured in-depth interviews after completing 30 sessions of training. The data were recorded, transcribed, and coded using thematic analysis with NVivo 10. Significant statements and phrases were categorized into themes and subthemes.

Results

As assessed by X-ray, five early adolescents showed at least a 5° Cobb angle reduction in spinal curvature, while eight showed no significant curve progression (a Cobb angle change under 5°). Several subthemes related to the benefits of the training program on the health-related quality of life were generated, namely (a) posture correction, (b) improvement in body appearance, (c) restoration of muscle relaxation, (d) reduction in bodily pain and fatigue, (e) enhancement of self-confidence/self-image, and (f) improvement in social functioning.

Conclusions

Given its positive effects, the sEMG biofeedback posture training program has the potential to be an alternative early intervention for early adolescents with mild scoliosis. Further empirical studies need to be carried out to substantiate its effectiveness and evaluate the sustainability of its benefits over time.

Functional outcomes and health-related quality of life after reconstruction of segmental bone loss in femur and tibia using the induced membrane technique

INTRODUCTION

The induced membrane technique (IMT), frequently called Masquelet technique, is an operative, two-staged technique for treatment of segmental bone loss. Previous studies mainly focused on radiological outcome parameters and complication rates, while functional outcomes and health-related quality of life after the IMT were sparsely reported.

MATERIALS AND METHODS

Retrospective study containing of a chart review as well as a clinical and radiological follow-up examination of all patients treated with the IMT at a single institution. The clinical outcomes were evaluated using the Lower Extremity Functional Scale (LEFS), the Short-Form-36 (SF-36) and the visual analog scale (VAS) for pain. The radiographic evaluation contained of standard anteroposterior and lateral, as well as hip-knee-ankle (HKA) radiographs.

RESULTS

Seventeen patients were included in the study. All had suffered high-energy trauma and sustained additional injuries. Ten bone defects were localized in the femur and seven in the tibia. Ten patients underwent additional operative procedures after IMT stage 2, among them three patients who contracted a postoperative deep infection. The median LEFS was 59 (15-80), and the SF-36 physical component summary (PCS) and mental component summary (MCS) were 41.3 (24.0-56.1) and 56.3 (13.5-66.2), respectively. The median length of the bone defect was 9 (3-15) cm. In 11 patients, union was obtained directly after IMT stage 2. Bone resorption was observed in two patients. At follow-up, 16 of the 17 bone defects had healed. The median follow-up was 59 months (13-177).

CONCLUSION

Our results show a high occurrence of complications after IMT stage 2 in segmental bone defects of femur and tibia requiring additional operative procedures. However, fair functional outcomes as well as a good union rate were observed at follow-up.

Transcutaneous auricular vagus nerve stimulation in poststroke cognitive impairment: protocol for a randomised controlled trial

BACKGROUND

As one of the most common stroke sequelae, poststroke cognitive impairment significantly impacts 17.6%-83% of survivors, affecting their rehabilitation, daily living and quality of life. Improving cognitive abilities among patients in stroke recovery is therefore critical and urgent. Transcutaneous auricular vagus nerve stimulation (TAVNS) is a non-invasive, safe, cost-effective treatment with great potential for improving the cognitive function of poststroke patients. This clinical research will evaluate the effectiveness, and help elucidate the possible underlying mechanisms, of TAVNS for improving poststroke cognitive function.

METHODS AND ANALYSIS

A single-centre, parallel-group, allocation concealment, assessor-blinded randomised controlled clinical trial. We will allocate 88 recruited participants to the TAVNS or sham group for an intervention that will run for 8 weeks, 5 days per week with twice daily sessions lasting 30 min each. Blood tests will be performed and questionnaires issued at baseline and 8-week and 12 week follow-ups. Primary outcomes will be changes in cognitive function scores. Secondary outcomes will be changes in activities of daily living, quality of life and serum oxidative stress indicators.

ETHICS AND DISSEMINATION

The Ethics Committee of the First Affiliated Hospital of Hunan University of Chinese Medicine has approved the protocol (No. HN-LL-YJSLW-2022200). Findings will be published in peer-reviewed academic journals and presented at scientific conferences.

TRIAL REGISTRATION NUMBER

ChiCTR2200057808.

Efficacy of a smartphone-based care support programme in improving post-traumatic stress in families with childhood cancer: protocol of a randomised controlled trial

INTRODUCTION

Diagnosis and treatment represent distressing experiences for the families of children with cancer. Psychosocial challenges are faced by these families in China because of limited health services and resources for psychosocial oncology care. Effective interventions tailored to the knowledge level and cultural values of this population are needed. The goal of this study is to evaluate a smartphone-based care support (SBCS) programme for the families of children with cancer in China.

METHODS AND ANALYSIS

A parallel randomised controlled trial will be conducted to examine the efficacy of an evidence-based and culturally tailored SBCS programme for the families of children with cancer in China. A total of 180 families will be recruited. The intervention will consist of an introduction session and four main sessions and will be conducted sequentially on a single weekend day. Participating families will be included in the intervention group. The post-traumatic stress and quality of life of families will be evaluated at baseline, during the intervention, immediately after the intervention, and 2 and 6 months after the intervention.

ETHICS AND DISSEMINATION

Ethical approval for this protocol has been obtained from the Nursing and Behavioural Medicine Research Ethics Review Committee, Xiangya School of Nursing, Central South University (Protocol #: E2020125). The findings of the trial will be disseminated through conference presentations and publications in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

ChiCTR2000040510.

Influence of Screen Time during COVID-19 on Health-Related Quality of Life of Early Adolescents

This study investigated the influence of screen time during COVID-19 on the physical and mental domains of the health-related quality of life of early adolescents. A total of 860 early adolescents were recruited. The 36-Item Short Form Health Survey was used to measure their health-related quality of life. The early adolescents reported their average daily time spent using smartphones and computers and watching television over the previous week. The results show that most early adolescents, on average, spent less than 1 h to more than 4 h per day during COVID-19 using smartphones (n = 833, 96.9%) and computers (n = 783, 91.0%), and watching television (n = 804, 93.5%), respectively. Though early male and female adolescents spent a similar amount of time daily on average using smartphones, early male adolescents spent more time using computers and watching television than early female adolescents and reported a significantly lower mean score for three out of the eight scales in the physical and mental domains of health-related quality of life. While health-related quality of life of early female adolescents was negatively associated with time spent using smartphones only, early male adolescents were adversely affected by the time spent using smartphones and computers and watching television (p < 0.05). Therefore, early adolescents who spent more time using display devices during COVID-19 had significantly poorer outcomes in their health-related quality of life, and gender difference was found in the influence of screen time on health-related quality of life.