Changes in acute and late toxicity and patient-reported health-related quality of life following radiotherapy in women with breast cancer:A 1-year longitudinal study

Objective:The objective of this study was to investigate the frequency of acute and late toxicities,as well as changes in the quality of life(QOL)for breast cancer patients following radiotherapy(RT).Materials and Methods:A total of 108 breast cancer women were recruited for this prospective study.Data were collected at various intervals;prior to,and 1,3,6 months,and 1 year after radiation therapy.The primary outcomes were toxicity radiation therapy oncology group/European Organization for Research and Treatment of Cancer(EORTC)criteria.Our secondary outcome was QOL,measured using EORTC QLQ-C30 and Edmonton Symptom Assessment Scale.We employed Friedman’s two-way analysis to evaluate the changes in QOL over the course of 1 year.Results:The early toxicities that are most commonly experienced include pharyngeal,skin,and mucous membrane toxicity.Late toxicities frequently involve skin and submucosal toxicity.To measure patient functionality,all functional subscale scores except for the patient’s emotional state increased over time compared to pre-RT.Symptoms of the patients,which were included in the QOL symptom scale,decreased during the follow-up period,except for fatigue;however,changes in pain,insomnia,and loss of appetite did not significantly change.We identified the analogous symptom profiles in Edmonton.Although patients’overall health scores declined in the 1st and 3rd months after radiotherapy(RT),they rebounded at 6 and 12 months.Conclusion:For breast cancer patients,RT did not adversely affect functional capacity or exacerbate symptoms,but persistent fatigue did increase during the observation period.Health-care professionals ought to devise strategies to assist patients with skin toxicity and fatigue.

Public satisfaction with the quality of First Health Facility Services in Indonesia: Does sociodemographic matter?

Objective:To investigate individual characteristics related to satisfaction with the quality of First Health Facility Services(FHFS)in Indonesia.Methods:This cross-sectional study analyzes national representation data.Meanwhile,the study involved 9846 representative respondents in 2019.Respondent’s satisfaction with FHFS based on the five dimensions of service quality(SERVQUAL)is a dependent variable.Independent variables consist of sex,marital status,age,education,employment,insurance ownership,and economics.The study used multivariate logistic regression to explain the relationship between individual characteristics and FSHS quality.Results:77.3%Respondents were satisfied with FHFS,with the highest order of satisfaction dimensions being assurance(59.4%),empathy(57.3%),reliability(53.6%),responsiveness(52.7%),and then tangibility(49.1%).Multivariate logistic analysis showed that divorce was 1.48 more likely than never-married to be satisfied(95%CI 1.17-1.87).Employees were 0.77 less likely than the unemployed to get satisfied(95%CI 0.70-0.86).Respondents with higher education was 0.82 less likely than those with primary education to be satisfied(95%CI 0.67-0.99).Meanwhile,respondents who had government-run insurance were 1.61 more likely than uninsured to be satisfied(95%CI 1.42-1.80).Moreover,the rich were 0.82 less likely than the poor to get satisfied(95%CI 0.73-0.92).Conclusions:Community satisfaction with FHFS is generally high,though some areas could be improved.Demographic factors are still strongly related to satisfaction ratings.The government can assess the quality of services in accordance with standards and disseminate information about service standards for primary facilities to all levels of society,ensuring that service satisfaction is rated as good by all groups.

Effects of strengthening prospective nursing practice on sleep quality,anxiety,and depression of awake patients in intensive care unit

BACKGROUND The intensive care unit(ICU)is a specialized hospital department.Awake patients in the ICU frequently encounter adverse psychological states,such as anxiety and fear,often accompanied by poor sleep quality.This situation has garnered significant attention within the medical community.AIM To investigate the impact of prospective nursing intervention strategies on the sleep quality and negative emotional state of conscious ICU patients.METHODS One hundred and twenty ICU awake patients admitted to our hospital were selected and randomly divided into control(n=60)and observation(n=60)groups.Patients in the control group were cared for using the conventional nursing model,while patients in the observation group were cared for using the prospective nursing model.Sleep improvement was assessed using the International Standardized Sleep Efficiency Formula and Pittsburgh Sleep Quality Index(PSQI).The PSQI,Generalized Anxiety Disorder 7-item(GAD-7)scale,Self-Depression Scale(SDS),and satisfaction before and after treatment were used to assess the negative emotional states of patients under the two care models.RESULTS Patient satisfaction in the observation group was significantly higher than in the control group.The GAD-7 and SDS scores in the observation group were significantly lower than those in the control group,and the total effective rate of sleep improvement in the observation group was significantly higher than in the control group.After treatment,the PSQI scores of the two groups significantly decreased(P<0.05).The decrease in the observation group was more significan than that in the control group,and the difference between the two groups was statistically significant.CONCLUSION Prospective nursing interventions can improve sleep quality and psychological levels and significantly affect conscious patients in the ICU,which is worthy of clinical application.

Hepatitis C virus eradication with directly acting antivirals improves health-related quality of life and psychological symptoms

BACKGROUND Alterations in health-related quality of life(HRQoL)and neuropsychological disorders were described in the hepatitis C virus(HCV)patients.Although several studies investigated the modifications of HRQoL after HCV eradication,no data exists on the modifications of neuropsychological symptoms.AIM To investigate the effect of directly acting antivirals(DAAs)treatment on HRQoL and neuropsychological symptoms.METHODS Thirty nine patients with HCV infection underwent a neuropsychological assessment,including Zung-Self Depression-Rating-Scale,Spielberg State-Trait Anxiety Inventory Y1-Y2 and the Toronto-Alexithymia Scale-20 items before and after DAAs treatment.HRQoL was detected by Short-Form-36(SF-36).RESULTS All HRQoL domains,but role limitation physical and bodily pain,significantly improved after treatment.Interestingly,after DAAs treatment,all domains of HRQoL returned similar to those of controls.Each neuropsychological test significantly improved after HCV eradication.A significant correlation was observed among each psychological test and the summary components of SF-36.At multiple linear regression analysis including each psychological test as possible covariates,Zung-Self Depression Rating Scale(Zung-SDS)score was independently and significantly related to summary components of the SF-36 in the basal state and the difference between Zung-SDS score before and after treatment was the only variable significantly and independently related to the modification of HRQoL induced by the treatment.CONCLUSION Neuropsychological symptoms strongly influenced HRQoL in HCV patients and there was a significant improvement of neuropsychological tests and HRQoL after DAAs treatment.

A Review of Systemic Lupus Erythematosus (SLE): Symptoms, Risk Factors, Treatment, and Health Related Quality of Life Issues

In this paper, we present a thorough review of one of the most life-threatening autoimmune diseases, Systemic lupus erythematosus (lupus). Symptoms, risk factors, including genetic and epidemiological factors are discussed. Treatment, life expectancies, and Health Related Quality of Life of patients with SLE will be discussed as well. Special attention will be given to Lupus Nephritis.

Health related quality of life after surgery for colonic diverticular disease

Diverticular disease(DD) of the colon is very common in developed countries and is ranked the fifth most important gastrointestinal disease worldwide.The management of acute diverticulitis without perforation and peritonitis is still debated.Health related quality of life(HRQL),subjectively perceived by patients,is becoming a major issue in the evaluation of any therapeutic intervention,mainly in patients with chronic disease.To date only a few published studies can be found on Medline examining HRQL in patients with DD.The aim of this study was to review the impact of surgery for DD on HRQL.All Medline articles regarding HRQL after surgery for colonic DD,particularly those comparing different surgical approaches,were reviewed.DD has a negative impact on HRQL with lower scores in bowel function and systemic symptoms.Both surgery-related complications and disease activity have a significant impact on patients' HRQL.While no signif icant differences in HRQL between different operations for DD in non-randomized studies were revealed,the only prospective double-blind randomized study that compared laparoscopic and open colectomy found that patients undergoing laparoscopic colectomy had signif icantly reduced major postoperative complication rates and subsequently had better HRQL scores.Formal assessment of HRQL could be a good instrument in the selection of appropriate patients for elective surgery as well as in the assessment of surgical outcome.

Maternal and Child Health Care Quality Assessment: An Improved Approach Using K-Means Clustering

High maternal and child deaths in developing countries are frequently linked to poor health services provided to pregnant women and children. To improve the quality of maternal, neonatal and child health (MNCH) services, the government and other stakeholders in MNCH emphasize the importance of quality assessment. However, effective quality assessment approaches are mostly lacking in most developing countries, particularly in Tanzania. This study, therefore, aimed at developing a quality assessment approach that can effectively assess and report on the quality of MNCH services. Due to the need for a good quality assessment approach that suits a resource-constrained environment, machine learning-based approach was proposed and developed. K-means algorithm was used to develop a clustering model that groups MNCH data and performs cluster summarization to discover the knowledge portrayed in each group on the quality of MNCH services. Results confirmed the clustering model’s ability to assign the data points into appropriate clusters;cluster analysis with the collaboration of MNCH experts successfully discovered insights on the quality of services portrayed by each group.

Health Related Quality of Life in Adult with Type 2 Diabetes Mellitus

Introduction: The health related quality of life (HRQoL) has an important role in adults suffering from diabetes. Objective: To assess the health related quality of life in adult with type 2 diabetes mellitus. Materials and methods: A cross-sectional study was conducted to assess diabetic patient’s HRQoL on 119 purposively selected type-2 DM patients (aged ≥ 18 years and duration of diabetes ≥ 1 year). Data were collected by face-to-face interview and by medical record review through a Bangle version of SF-36 semi-structured questionnaire and a checklist. Place and period of study: The study was conducted at outpatient department in Gopalganj 50 bedded diabetic hospital from 1st January, 2018 to 31st December 2018. Results: The mean age of the respondents was 52.34 (SD ± 10.19) years. Age group shows a significant difference associated with all domains of quality of life except role emotion (>0.05), gender shows the significant in social and pain domain (0.05) respectively co-morbidity shows the significant difference with all domains expect pain (>0.05). Physical functioning, emotional, pain and general health of the quality of life show the significant difference associated with use of insulin (Conclusion: The overall QoL of type-2 DM patients was poor and had lower score of health related quality of life.

The Impact of Total Quality Management on Health Services Improvement, Sana’a Hospitals, Yemen (2017-2020)

Background: Total quality management (TQM) plays a major role in quality health services improvement. The aims of the study are to identify the concepts of total quality management in health institutions to know the nature of the relationship between the application of TQM and improving the quality of health services in Sana’a Governorate. Method: This applied research is a descriptive cross-sectional study in which the TQM of 13 affiliated Sana’a Governorate hospitals during “2017-2020”, were evaluated based on self-administered questionnaires. Data were collected by questionnaires including demographical variables, TQM dimensions variables. Data were analyzed by using SPSS version 16. Results: A total of 281 users 98.6% had responded. The employee’s responses for sixth study dimensions were the top manager’s commitment (TMC) 80.46%, customers focusing CF 81.55%, continuous improvement (CI) 82.32%, training (T) 71.51%, and strategic planning of the quality (SPQ) 74.76%, health services quality improvement (HSQI) 74.25%. There is a strong relationship between TQM and HSQI. There is no relationship between demographic factors gender, profession, years of experience, except age with TMC, T, HSQI, qualification with the TMC, CI, T, HSQI and job with all study variables. Conclusion: The application of TQM at hospitals in quality of health services improvement has several challenges, lacking staff experience and lacking leadership support, weakness of the training, customers focusing, continuous improvement, and strategic planning of the quality. Therefore, benefiting from the experiences of leading hospitals in implementing total quality management programs by sending some cadres to these hospitals for training and gaining experience or by hosting experienced cadres to conduct training courses is recommended.

Progress in Research of Oral Health in Patients with Type 2 Diabetes Quality of Life Impact

Multiple studies have demonstrated that oral health quality of life(OHQOL)in patients with type 2 diabetes(T2DM)is affected by multiple factors.Therefore,during this study the related factors of OHQOL for T2DM was reviewed,and analyzed them from the aspects of socio-demographic factors,T2DM related factors and oral health related factors.This was to provide basis for nursing workers to develop personalized nursing measures.

Health-Related Quality of Life in HIV-positive Women on Long-Term Antiretroviral Therapy—A Study from Bangalore, South India

Introduction: Lifelong Anti-Retroviral Therapy (ART) promotes good quality of life and health among HIV-positive men and women. However, simplified newer and effective ART has not increased retention in care, or long-term ART adherence, especially among women. There are many factors that impede long-term adherence in women. This includes among other things female gender, depression, greater than once-daily dosing, longer time since HIV diagnosis, and patient beliefs. This study measures the quality of life in women whose ART durations range from one to fifteen years, using the standardized WHO Quality of Life questionnaire. Material and Methods: One hundred and fourteen women were divided into three groups based on ART duration. Group 1 had 37 women on ART for less than five years, Group 2 had 48 women on ART from 5 to 10 years and Group 3 had 29 women on ART for more than ten years. They were administered the WHO Quality of Life (QOL) questionnaire, which assesses QOL in six domains. QOL was considered poor in scores between 4 - 9.9, medium in scores of 10 - 14.9 and good in scores of 15 - 20. Results: Scores in all 3 groups were more than 85% in five domains and around 74.5% in the psychological domain. Domain mean scores were Physical 18 (CI 17.63 - 18.37), Psychological 14.9 (CI 14.55 - 15.25), Independence 18.6 (CI 18.33 - 18.87), Social relationships 17.5 (CI 17.07 - 17.93), Environmental 17.6 (CI 17.25 - 17.95), Spiritual, Religious, Personal beliefs, 17.4 (CI 16.93 - 17.87). Scores for women on long-term ART (Group 3) are not different from the other 2 groups and the p-values were not statistically significant. Conclusion: Women on long-term ART fare extremely well compared to other groups with more than 93% showing good QOL and none showing poor Quality of Health in spite of being on ART for a longer period of time than the other two groups. Despite a multitude of impeding factors, women who continue ART faithfully and consistently enjoy a good quality of health and life. Adequate preparation and a supportive health system are essential for ensuring long-term adherence, but the attitude and commitment of women are also critical.

Temperament and character as predictor of health related quality of life after metacarpophalangeal joint arthroplasty ——Personality and MCP joint arthroplasty outcome

Purpose: To evaluate personality characteris- tics’ impact upon outcome after silicone-based MP arthroplasty in RA patients. Methods: 40 RA patients who had undergone operations on their MP joints were investigated in a one-year fol- low-up. Objective measurement to assess grip strength and active range of motion—Paper- pencil-tests to assess pain during activity and at rest performance, QoL, and personality. Results: Significant improvement was observed in func- tion and pain related scores except for the pain related VAS and in several QoL facets and do- mains. Patients who experienced improvement reported higher scores on the activities of daily living facet of the WHO QoL questionnaire. Those with lower pain showed more independ- ence. The variance of the QoL domain scores, other than social and physical domains, could substantially and meaningfully be explained by variance of objective measures combined with personality scores. Conclusions: Most RA pa- tients’ QoL can be improved by MP arthroplasty despite remaining substantial level of pain. NS and HA seem to play an important role in the adaptation process during the long term, chronic illness;whereas SD represents a tool of coping with the burden of pain and disability. Personal- ity characteristics are highly predictive for QoL suggesting their important mediating role be- tween experienced pain and disability and HR QoL.

A Study on Oral Health-Related Quality of Life and Its Influencing Factors in Elderly Diabetic Patients

Objective:To investigate the oral health related quality of life in elderly diabetic patients and analyze its influencing factors.Methods:Convenience sampling was used to select 190 elderly patients with diabetes under the Department of Endocrinology and Department of Integrated Traditional Chinese and Western Medicine in the Affiliated Hospital of Hebei University as the research subjects.The Chinese version of the Oral Health Influence Scale(OHIP-14)was used to conduct a questionnaire survey,and univariate analysis and multiple stepwise regression analysis were used to analyze the influencing factors of oral health related quality of life in elderly diabetic patients.Results:The elderly diabetic patients'oral health related quality of life score was 34.48±3.23,which is in the middle-lower range.The findings of multivariate stepwise regression analysis revealed that the course of disease,regular visits to the dentist,sleep quality,oral health knowledge,and oral health attitude together explained 58.9%of the total variance in elderly diabetic patients in terms of their oral health related quality of life(p<0.05).Conclusion:The oral health related quality of life of elderly diabetic patients is generally low,and is affected by the duration of diabetes,sleep quality,and oral health knowledge,attitude,and behavior(regular visits to the dentist).Improving patientsJ attention to oral health problems by improving sleep as well as their own oral health knowledge,attitude,and behavior is an effective way to enhance oral health related quality of life.

China to Create an Access System for the Reproductive Health Industry Based on Quality Accreditation

Zhang Weiqing, director of the National Population and Family Planning Commission (NPFPC), disclosed at the inaugural meeting of the China Reproductive Health Industry Association (CRIA), held on March 26, 2007, that China will create an inspection system, a quality accreditation system, and an industry access system for better population structure and family planning.……

New Screening Approach for Ocular Diseases

Objective: Present a new screening approach for ocular diseases. Method: Transversal, retrospective, single center study that analyzed medical records of patients from a social project on the prevention of blindness and amblyopia, which aimed at: 1) Detect the main ocular disorders such as amblyopia, primary angle-closure suspect (PACS);glaucoma suspect (GS);predisposing retinal detachment lesions (PRDL);age-related macular degeneration (AMD), and diabetic retinopathy (DR);2) Perform cataract diagnosis;3) Provide guidance and treatment for allergic conjunctivitis. 4) Prescribe glasses for children until 14 years of age. Participants were examined by a single specialist, holder of a post-doctoral degree in ophthalmology, with 36 years of experience and a sub-specialization in retina and vitreous. All data were analyzed in 2022. Results: The examiner diagnosed 42 cases of PACS, 21 of GS, 8 of PRDL, 14 of AMD, 3 of DR, 40 of cataract and 31 cases of allergic conjunctivitis. Thirty-three participants younger than 14 were prescribed glasses. Other pathologies included retinal detachment, papilledema, corneal ulcer, suspected conjunctival squamous cell carcinoma, retinal vasculitis, strabismus, uveitis, bilateral papilla paleness and lacrimal duct obstruction. Out of the 297 cases examined, 168 participants presented some type of alteration that could compromise their vision. Conclusion: The examiner’s experience and knowledge were decisive factors for the quick diagnosis, advice, screening and/or treatment of several ocular diseases. The social project results reveal that the primary care and/or the screening performed by a specialist are likely to reduce blindness cases.

Associations between Continuing Symptoms and Quality of Life in Post-COVID-19 Patients (2023)

COVID-19 is a multisystem disease that can cause various symptoms which last even after the acute stage and negatively impact the quality of life of patients. It is of utmost importance to comprehensively evaluate how COVID-19 affects not only patients’ physical and mental health, but also their family and social life. This knowledge plays a significant role in the creation of effective ways to assist those suffering from long COVID to address health-related quality of life issues in a timely manner.

A Systematic Review of Patient-Reported Outcome Measurement for Psoriasis in Chinese Population

Objective To review the development of patient-reported outcome measurement(PROM)for patients with psoriasis in China,and to analyze the main results and methodology.Methods The systematic review method of COSMIN(consensus-based standards for the selection of health measurement instruments)was adopted,and the domestic and foreign databases were searched to find the patient-reported outcome scales based on Chinese psoriasis patients.Then,the included studies were evaluated by using COSMIN risk of bias checklist.Results and Conclusion A total of 3 studies were included,involving 3 scales.We found that the quality evaluation of the development process of the 3 scales was not high,and there were large methodological loopholes in the whole cycle of scale development and verification.The included studies have many problems such as low extrapolation,poor quality,and lack of validation,which can provide more insights for the quality control requirements of the whole cycle of scale development in the future.

Value of quality of life analysis in liver cancer: A clinician's perspective

Health related quality of life(HRQOL) is increasingly recognized as an important clinical parameter and research endpoint in patients with hepatocellular carcinoma(HCC). HRQOL in HCC patients is multifaceted and affected by medical factor which encompasses HCC and its complications, oncological and palliative treatment for HCC, underlying liver disease, as well as the psychological, social or spiritual reaction to the disease. Many patients presented late with advanced disease and limited survival, plagued with multiple symptoms, rendering QOL a very important aspect in their general well being. Various instruments have been developed and validated to measure and report HRQOL in HCC patients, these included general HRQOL instruments, e.g., Short form(SF)-36, SF-12, Euro Qo L-5D, World Health Organization Quality of Life Assessment 100(WHOQOL-100), World Health Organization Quality of Life Assessment abbreviated version; general cancer HRQOL instruments, e.g., the European Organisation for Research and Treatment of Cancer(EORTC) QLQ-C30, Functional Assessment of Cancer Therapy(FACT)-General, Spitzer Quality of Life Index; and liver-cancer specific HRQOL instruments, e.g., EORTC QLQ-HCC18, FACT-Hepatobiliary(FACT-Hep), FACT-Hep Symptom Index, Trial Outcome Index. Important utilization of HRQOL in HCC patients included description of symptomatology and HRQOL of patients, treatment endpoint in clinical trial, prognostication of survival, benchmarking of palliative care service and health care valuation. In this review, difficulties regarding the use of HRQOL data in research and clinical practice, including choosing a suitable instrument, problems of missing data, data interpretation, analysis and presentation are examined. Potential solutions are also discussed.

Novel metabolic and physiological functions of branched chain amino acids: a review

It is widely known that branched chain amino acids（BCAA） are not only elementary components for building muscle tissue but also participate in increasing protein synthesis in animals and humans. BCAA（isoleucine, leucine and valine） regulate many key signaling pathways, the most classic of which is the activation of the m TOR signaling pathway. This signaling pathway connects many diverse physiological and metabolic roles. Recent years have witnessed many striking developments in determining the novel functions of BCAA including：（1） Insufficient or excessive levels of BCAA in the diet enhances lipolysis.（2） BCAA, especially isoleucine, play a major role in enhancing glucose consumption and utilization by up-regulating intestinal and muscular glucose transporters.（3）Supplementation of leucine in the diet enhances meat quality in finishing pigs.（4） BCAA are beneficial for mammary health, milk quality and embryo growth.（5） BCAA enhance intestinal development, intestinal amino acid transportation and mucin production.（6） BCAA participate in up-regulating innate and adaptive immune responses.In addition, abnormally elevated BCAA levels in the blood（decreased BCAA catabolism） are a good biomarker for the early detection of obesity, diabetes and other metabolic diseases. This review will provide some insights into these novel metabolic and physiological functions of BCAA.