Subjective Cognitive Concerns and Attitudes toward Genetic Testing Are Associated with Depressive Symptoms and Quality of Life after Genetic Testing for the Cerebral Cavernous Malformation Common Hispanic Mutation (CCM1)

Purpose: This study aimed to characterize mood and quality of life and to examine the associations of these areas with subjective cognitive concerns and attitudes toward genetic testing for the Common Hispanic Mutation, a gene that has been associated with increased risk for CCM1. Method: Fifty-four adults with previous genetic testing for the Common Hispanic Mutation completed a mail survey that included assessments of the above identified areas. Results: Self-reported depressive symptoms and quality of life did not differ between those with positive and negative genetic test results. The negative group expressed a more favorable attitude toward genetic testing (p p = 0.06). Using generalized linear regression, more subjective cognitive concerns were associated with poorer quality of life and more depressive symptoms (p p Conclusions: Subjective cognitive concerns and negative attitudes toward genetic testing may influence emotional well-being after genetic testing for the Common Hispanic Mutation. Additional research is needed that uses objective neuropsychological measures to understand the associations of subjective cognitive concerns, emotional well-being, and cognitive test performance in individuals with CCM1. There is also a need for research that focuses on protective factors and resiliency following genetic testing for CCM1 and the development of mental health interventions to preempt psychosocial difficulties.

Processus pour le développement d’une stratégie d’évaluation de la qualitéde vie en cancer avancépédiatrique Process for Developing a Quality of Life Assessment Strategy in Advanced Pediatric Cancer

In pediatric advanced cancer,i.e.,when cancer-targeted treatments are not effective,care provided to patients is of palliative nature.It aims at limiting symptoms and optimizing quality of life(QoL).To orient care,it is necessary to know and measure what is really important for young people.Unfortunately,tools are still scarce in this context.The aim of this paper is to describe the development process of a new QoL assessment method,the Advance QoL program.This is specifically designed for the clinical context of pediatric advanced cancer.Three previous studies carried out by our team identified seven important QoL domains for this population.We developed a tool named Advance QoL—parent/caregiver version.A current study aims to develop self-reported versions of the Advance QoL for children(8-12 years)and adolescents(13-18 years)with advanced cancer.In the very near future,the Advance QoL tool will be available in three versions(parents/caregivers,children,and adolescents)ready to be tested in validation studies.Regular assessment of the QoL of young people with cancer is a central process in defining targets for care and should be carried out throughout the trajectory,including when cancer is at an advanced stage,i.e.,when no standard treatment options are available.

Quality of life and psychological distress in end-stage renal disease patients undergoing hemodialysis and transplantation

BACKGROUND Among diverse profound impacts on patients’quality of life(QoL),end-stage renal disease(ESRD)frequently results in increased levels of depression,anxiety,and stress.Renal replacement therapies such as hemodialysis(HD)and transplantation(TX)are intended to enhance QoL,although their ability to alleviate psychological distress remains uncertain.This research posits the existence of a significant correlation between negative emotional states and QoL among ESRD patients,with varying effects observed in HD and TX patients.AIM To examine the relationship between QoL and negative emotional states(depression,anxiety,and stress)and predicted QoL in various end-stage renal replacement therapy patients with ESRD.METHODS This cross-sectional study included HD or TX patients in the Eastern Region of Saudi Arabia.The 36-item Short Form Survey and Depression Anxiety Stress Scale(DASS)was used for data collection,and correlation and regression analyses were performed.RESULTS The HD and TX transplantation groups showed statistically significant inverse relationships between QoL and DASS scores.HD patients with high anxiety levels and less education scored low on the physical component summary(PCS).In addition,the results of the mental component summary(MCS)were associated with reduced depression.Compared with older transplant patients,TX patients’PCS scores were lower,and depression,stress,and negative working conditions were highly correlated with MCS scores.CONCLUSION The findings of this study revealed notable connections between well-being and mental turmoil experienced by individuals undergoing HD and TX.The PCS of HD patients is affected by heightened levels of anxiety and lower educational attainment,while the MCS of transplant patients is influenced by advancing age and elevated stress levels.These insights will contribute to a more comprehensive understanding of patient support.

Malnutrition negatively impacts the quality of life of patients with cirrhosis: An observational study

AIMTo verify how malnutrition is related to health-related quality of life (HRQL) impairment in patients with cirrhosis. METHODSData was retrospectively abstracted from medical records and obtained by direct interview. We included patients with cirrhosis from any etiology, evaluated at the Liver Clinic from Gastroenterology Department in a tertiary healthcare center, from June 2014 to June 2016. Child-Pugh score, data about complications, and demographic, clinical and anthropometric characteristics of patients were obtained. Nutritional status was evaluated by the Subjective Global Assessment (SGA). HRQL was evaluated through the Chronic Liver Disease Questionnaire. Patients were requested to assess their global HRQL with the following code: 0 = impairment of HRQL, when it was compared with other healthy subjects; 1 = good HRQL, if it was similar to the quality of life of other healthy subjects. To compare the primary outcome between malnourished and well-nourished groups, the χ2 test, Fisher’s exact test or Student’s t-test were used, based on the variable type. Associations between predictor variables and deterioration of HRQL were determined by calculating the hazard ratio and 95% confidence interval using Cox proportional hazards regression. RESULTSA total of 127 patients with cirrhosis were included, and the mean age was 54.1 ± 12.3 years-old. According to Child-Pugh scoring, 25 (19.7%) were classified as A (compensated), 76 (59.8%) as B, and 26 (20.5%) as C (B/C = decompensated). According to SGA, 58 (45.7%) patients were classified as well-nourished. Sixty-nine patients identified HRQL as good, and 76 patients (59.8%) perceived impairment of their HRQL. Multivariate analysis to determine associations between predictor variables and self-perception of an impairment of HRQL found strong association with malnutrition (P P CONCLUSIONMalnutrition is a key factor related to impairment of HRQL in patients with cirrhosis.

Suicidal Ideation and Attempts during Middle Childhood: Associations with Subjective Quality of Life and Depression

Background: Confronted to the increasing suicide rate in children, clinicians have to better understand and predict suicide-related behaviours (SRBs) in children with and without depressive symptoms. Aims: To investigate associations among suicidal tendencies (thoughts and/or attempts), depression and children’s perceptions of subjective quality of life. Methods: This was a cross-sectional study of 157 children of 6 - 13-year-old. Results: Children who attempted or thought of suicide reported goodless subjective quality of life than nonsuicidal children did, and children who thought of or attempted suicide reported higher levels of depressive symptoms than nonsuicidal children. Limitations: A more rigorous approach to investigating suicidal ideation and depressive symptomatology as a diagnostic interview based on the DSM-IV-TR will be valuable to future progress in understanding children’s suicidality. Conclusions: Results may reflect the confirmation of depressive symptoms as risk factors for suicidality and underline the high importance of social and emotional life context among suicidal children. For this reason, more effective recognition and comprehension of the underlying affective and social conditions of children with suicidality have special importance to prevent future suicidal behaviour during adolescence.

Quality of Life and Chinese Medicine──The Development of Health Status Measures for Chinese Medicine

Quality of Life (QOL) is a multiphase conception, including physical, mental and social factors, and can overall reflect health status of the human. At present, QOL has become a relevant measure of efficacy of treatment in clinical trials. Its use is spreading, and its importance is growing as a valid indicator of whether or not a medical treatment is

Defecation disorders are crucial sequelae that impairs the quality of life of patients after conventional gastrectomy

BACKGROUND Defecation disorders are obscure sequelae that occurs after gastrectomy,and its implication on daily lives of patients have not been sufficiently investigated.AIM To examine the features of defecation disorders after gastrectomy and to explore its implication on daily lives of patients in a large cohort using the Postgast rectomy Syndrome Assessment Scale(PGSAS)-45.METHODS We conducted a nationwide multi-institutional study using PGSAS-45 to examine the prevalence of postgastrectomy syndrome and its impact on daily lives of patients after various types of gastrectomy.Data were obtained from 2368 eligible patients at 52 institutions in Japan.Of these,1777 patients who underwent total gastrectomy(TG;n=393)or distal gastrectomy(DG;n=1384)were examined.The severity of defecation disorder symptoms,such as diarrhea and constipation,and their correlation with other postgastrectomy symptoms were examined.The importance of defecation disorder symptoms on the living states and quality of life(QOL)of postgastrectomy patients,and those clinical factors that affect the severity of defecation disorder symptoms were evaluated using multiple regression analysis.RESULTS Among seven symptom subscales of PGSAS-45,the ranking of diarrhea was 4th in TG and 2nd in DG.The ranking of constipation was 5th in TG and 1st in DG.The symptoms that correlated well with diarrhea were dumping and indigestion in both TG and DG;while those with constipation were abdominal pain and mealrelated distress in TG,and were meal-related distress and indigestion in DG.Among five main outcome measures(MOMs)of living status domain,constipation significantly impaired four MOMs,while diarrhea had no effect in TG.Both diarrhea and constipation impaired most of five MOMs in DG.Among six MOMs of QOL domain,diarrhea impaired one MOM,whereas constipation impaired all six MOMs in TG.Both diarrhea and constipation equally impaired all MOMs in DG.Male sex,younger age,division of the celiac branch of vagus nerve,and TG,independently worsened diarrhea,while female sex worsened constipation.CONCLUSION Defecation disorder symptoms,particularly constipation,impair the living status and QOL of patients after gastrectomy;therefore,we should pay attention and adequately treat these relatively modest symptoms to improve postoperative QOL.

A systematic review: How to choose appropriate health-related quality of life (HRQOL) measures in routine general practice?

In more recent times, health-related quality of life (HRQOL) measurements have formed an important part of as- sessing the quality of routine care in general practice. For a measure to have clinical usefulness it must not only be valid, appro- priate, reliable, responsive, and capable of being interpreted, but it must also be simple, fast to complete, easy to score, and provide useful clinical data. The Two-step method of choosing appropriate measures is introduced. Then through comparison of generic instruments with disease-specific instruments, we can conclude that sometimes a combination of generic and disease-specific HRQOL measures may be more appropriate for monitoring changes in a patient’s health status due to an intervention.

Comparison of effects of six main gastrectomy procedures on patients’ quality of life assessed by Postgastrectomy Syndrome Assessment Scale-45

BACKGROUND The effects of various gastrectomy procedures on the patient’s quality of life(QOL)are not well understood.Thus,this nationwide multi-institutional crosssectional study using the Postgastrectomy Syndrome Assessment Scale-45(PGSAS-45),a well-established questionnaire designed to clarify the severity and characteristics of the postgastrectomy syndrome,was conducted.AIM To compare the effects of six main gastrectomy procedures on the postoperative QOL.METHODS Eligible questionnaires retrieved from 2368 patients who underwent either of six gastrectomy procedures[total gastrectomy with Roux-en-Y reconstruction(TGRY;n=393),proximal gastrectomy(PG;n=193),distal gastrectomy with Roux-en-Y reconstruction(DGRY;n=475),distal gastrectomy with Billroth-I reconstruction(DGBI;n=909),pylorus-preserving gastrectomy(PPG;n=313),and local resection of the stomach(LR;n=85)]were analyzed.Among the 19 main outcome measures of PGSAS-45,the severity and characteristics of postgastrectomy syndrome were compared for the aforementioned six gastrectomy procedures using analysis of means.RESULTS TGRY and PG significantly impaired the QOL of postoperative patients.Postoperative QOL was excellent in LR(cardia and pylorus were preserved with minimal resection).In procedures removing the distal stomach,diarrhea subscale(SS)and dumping SS were less frequent in PPG than in DGBI and DGRY.However,there was no difference in the postoperative QOL between DGBI and DGRY.The most noticeable adverse effects caused by gastrectomy were mealrelated distress SS,dissatisfaction at the meal,and weight loss,with significant differences among the surgical procedures.CONCLUSION Postoperative QOL greatly differed among six gastrectomy procedures.The severity and characteristics of postgastrectomy syndrome should be considered to select gastrectomy procedures,overcome surgical shortcomings,and enhance postoperative care.

Malnutrition and Quality of Life in Chinese Cancer Patients: a Clinical Study of 23,994 Subjects

Background Malnutrition is common in patients with cancer,and can negatively impact their quality of life(QoL)and even survival.However,there is currently no large data available on the prevalence of malnutrition in Chinese cancer patients.This study evaluated the prevalence of malnutrition and the QoL of Chinese patients with locoregional,recurrent or metastatic cancer.Methods We conducted a nationwide observational,multi-center,hospital-based cross-sectional study within the Chinese Society of Nutritional Oncology(CSNO)Network.All of the patients were diagnosed with one of the following 18 different types of malignant tumors:lung cancer,gastric cancer,liver cancer,colorectal cancer,breast cancer,esophageal cancer,cervical cancer,endometrial cancer,nasopharyngeal carcinoma,malignant lymphoma,leukemia,pancreatic cancer,ovarian cancer,prostate cancer,bladder cancer,brain cancer,biliary tract malignant tumors or gastrointestinal stromal tumors.These patients were enrolled from 72 hospitals located in different regions of China.The patients’nutritional status was evaluated based on the body mass index(BMI),loss of bodyweight,laboratory measurements and patient generated-subjective global assessment(PG-SGA)scores.The cancer patients’physical status and QoL were assessed by the Karnofsky Performance Status(KPS)questionnaire and the European Organization for Research and Treatment of Cancer(EORTC)QLQ-C30 questionnaire,respectively.Results From December 2013 to April 2016,23,994 patients hospitalized for cancer treatment(such as surgery,chemotherapy or radiotherapy)were enrolled in the study.The patients included 12,494(52.9%)males and 11,124(47.1%)females.The mean age was 55.8±13.7 years.The proportions of patients in cancer stagesⅠ,Ⅱ,Ⅲ,Ⅳand uncertain were 11.5%,20.3%,27.5%,30.2%and 10.5%,respectively.Among the 23,994 inpatients,the proportions of patients who were underweight(BMI<18.5 kg/m2),normal(18.5 kg/m2<BMI<24 kg/m2),overweight(24 kg/m2≤BMI<28 kg/m2)and obese(BMI≥28 kg/m2)were 9.3%,59.9%,26.1%and 4.7%,respectively.A total of 18.3%(4,101/22,424)of patients had lost 5%or more of their bodyweight within the past month and 19.6%(2,463/12,538)of patients had lost 10%or more of their bodyweight within the past 6 months.According to the PG-SGA scores,26.6%of the patients were severely malnourished(score≥9),31.3%were moderately malnourished(scores 4~8).A total of 22.2%of patients had a serum albumin level lower than 35g/L.Only 8.6%(2056/23,991)of the patients had severe KPS scores(≤60).The patients with these severe KPS scores were most frequently among those with cancers of the brain(19.7%),prostate(18.0%),pancreas(15.5%)and bladder(15.0%).Based on the QLQ-C30 score,11.6%of patients had a poor QoL.The PG-SGA score and global QoL were correlated(r=-0.593,P<0.001).Conclusion The prevalence of malnutrition in patients with cancer is relatively high,and is related to a poorer QoL.The present findings should be kept in mind when assessing cancer patients,because addressing the patient’s problems in nutritional status would be expected to improve both the clinical outcomes and QoL in cancer patients with malnutrition.

Evaluation of the Translation,Cross-cultural Adaptation and Properties of Measurement of the FACT-BMT Questionnaire

Various questionnaires have been described which evaluate the quality of life in patients undergoing cancer treatment,but most were originally developed in English and have not been adequately validated for other languages.To evaluate the process of translation and cross-cultural adaptation and the measurement properties of the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation(FACT-BMT)questionnaire,a systematic review was conducted with two independent evaluators.The search for articles was carried out in four databases:MEDLINE,EMBASE,CINAHL and SCIELO,using the terms“questionnaire”,“quality of life”,“oncology”,and“valid”and their descriptors according to MeSH and DeCs.The searches yielded 6,877 studies,of which only three performed the stages of translation,cross-cultural adaptation,and evaluation of the measurement properties of the FACT-BMT questionnaire.The instruments in Arabic,Chinese,Korean and Portuguese showed and presented good methodological quality,but none of the four studies followed all the validation criteria for the questionnaire.The adapted versions of the FACT-BMT have methodological weaknesses in their process of translation and cross-cultural adaptation and evaluation of measurement properties,therefore the questionnaires possibly being used inadequately in other languages.

Living Kidney Donation – Subjective Experiences of Donors before and Two Years after Donation

Little is known about long-term quality of life of kidney donors. We studied subjective experiences of donors before and two years after kidney donation using in-depth interviews of eleven subjects. Interviews were audiotaped, transcribed, and analyzed by qualitative content analysis (grounded theory). Resulting categories of this process were grouped in order to construct ideal types of subjective experiences after kidney donation. Of our donors, 64% were female, mean age was 40.4 years. Donors reported that they had had no medical problems after donation. Most displayed psychological problems, e. g. difficulties adjusting to the new situation, hypochondriacal complaints, and fear of rejection of the recipient’s kidney. Psychological complaints were particularly troublesome in case of complications of the recipient. All donors wished extended counselling after kidney donation. Identifying problems of kidney donors may be easier when doctors are trained in typical experiences. This may also guide the tailoring of individual psychological interventions.

Investigating the Effect of COVID-19 Infection on Professional Athletes’ Post-Infection with a Focus on Fatigue and Chronic Fatigue Syndrome

Introduction and Objectives: COVID-19 has been reported to cause long-term sequela including persistent fatigue and Chronic Fatigue Syndrome (CFS) in the general population. However, it remains to be seen if similar effects are observed in an athlete population. The aetiology and pathophysiology are poorly understood but is thought to be multi-factorial. Patient reported outcome measures are commonly used to improve patient-centred outcomes (PROMs). They are essential to assess patient quality of life post-COVID infection. This paper aims to assess the effect of COVID-19 on athletes’ long-term fatigue and CFS and identify the PROMs used to characterise this. Methodology: Articles were selected for extraction based on the eligibility criteria and PRISMA guidelines. The inclusion criteria required papers to assess competitive athletes over eighteen years of age who were clinically diagnosed with COVID-19. Articles were extracted to assess different variables including type of sport, type of athlete and ethnicity. Key terms were obtained using MeSH trees and utilised with Web of Science and NCBI Pubmed. Papers were graded by quality using the Hawker quality assessment tool. Results and Discussion: Forty articles (N = 40) were identified for full-text screening (N = 8). Eight were selected for extraction based on the eligibility criteria. Data was obtained on athlete characteristics, sport characteristics, properties of PROM measurement techniques and fatigue presentation. Male athletes were found to be 10% - 50% more likely than female athletes to suffer from persistent fatigue symptoms (N = 2). Persistent fatigue was present in 9% - 10% Athletes from mixed backgrounds and genders (N = 2). Initial fatigue was documented to be between 47% - 56% (N = 2). A heterogenous range of PROMs were utilised to assess symptoms including fatigue and excluded emotional or mental fatigue. Conclusion: COVID-19 is associated with signs of persisting fatigue and potentially CFS in athlete populations. More work needs to be done to develop standardised and validated PROMs specific to CFS.

External validation of the Moroccan Arabic version of the European Organization for Research and Treatment of Cancer colorectal(CR29)module:Monocentric study

BACKGROUND Quality of life(QoL)outcomes are a focal endpoint of cancer treatment strategies.AIM To externally validate the Moroccan Arabic version of the European Organization for Research and Treatment of Cancer(EORTC)QoL Questionnaire(QLQ)for colorectal cancer(CRC)patients(CR29).METHODS Both Moroccan Arabic modules of QLQ-CR29 and QLQ-C30 were administered to Moroccan CRC.Psychometric properties were retested by measuring Cronbach’s alpha coefficient for reliability and Intraclass correlation coefficient(ICC)to examine test-retest reproducibility.The multitrait-scaling analysis was performed to demonstrate the validity of the instrument and known-groups comparison was used to test the score’s ability to discriminate between different groups of patients.RESULTS In total,221 patients were included in our study and 34 patients completed the questionnaire twice.The Urinary Frequency scale and Stool Frequency scale had good internal consistency with alpha Cronbach coefficients of 0.79 and 0.83 respectively,while the same coefficients were moderately lower for the Blood and Mucus in Stool scale(0.61)and the Body Image scale(0.67).The ICCs ranged from 0.88 to 1 indicating good to excellent reproducibility.In multitrait scaling analyses,the criterion for item convergent and divergent validity was satisfactory.The known-group comparison showed statistically significant differences between patients according to age,gender,stoma status,tumor location,and radiotherapy.CONCLUSION The Moroccan Arabic version of the EORTC QLQ-CR29 is a valid and reliable tool that can be used safely for research and clinical purposes in Moroccan CRC patients.

Psychological burden of food allergy

One fifth of the population report adverse reactions to food. Reasons for these symptoms are heterogeneous, varying from food allergy, food intolerance, irritable bowel syndrome to somatoform or other mental disorders. Literature reveals a large discrepancy between truly diagnosed food allergy and reports of food allergy symptoms by care seekers. In most studies currently available the characterization of patient groups is incomplete, because they did not distinguish between immunologic reactions and other kinds of food reactions. In analysing these adverse reactions, a thorough physical and psychological diagnostic approach is important. In our qualitative review, we present those diagnostic measures that are evidenced-based as well as clinically useful, and discuss the various psychological dimensions of adverse reactions to food. It is important to acknowledge the complex interplay between body and mind： Adults and children suffering from food allergy show impaired quality of life and a higher level of stress and anxiety. Pavlovian conditioning of adverse reactions plays an important role in maintaining symptoms. The role of personality, mood, or anxiety in food reactions is debatable. Somatoform disorders ought to be identified early to avoid lengthy and fiustrating investigations. A future task will be to improve diagnostic algorithms, to describe psychological aspects in clearly characterised patient subgroups, and to develop strategies for an optimized management of the various types of adverse reactions to food.

Development and validation of a rapid psychosocial well-being screening tool in patients with metastatic breast cancer

Objective The aim of this study was to develop and validate a rapid psychosocial well-being screening tool for metastatic breast cancer patients(MBC-PsySoc-Well-being).Methods Applying a mixed method approach,the study was conducted in two phases.Phase 1,a focus group method was employed for item development,and three focus group sessions were conducted,with patients,caregivers,and medical professionals,respectively.Phase 2,validity and reliability testing were performed.Five experts reviewed items for content validity.Construct validity,criterion-related validity,internal consistency,and test-retest reliability were conducted among a sample of 53 patients with metastatic breast cancer.Results Six themes were qualitatively analyzed based on focus group participants’responses.Eight items were then developed based on these themes.The index of Item-Objective Congruence scored by the experts ranged from 0.6 to 1.0.An exploratory factor analysis yielded three factors:Being curious and active in information seeking,Enthusiasm to return to a normal life,and Adjusting to positive lifestyle.The total scores of MBC-PsySoc-Well-being and the European Organization for Research and Treatment of Cancer’s Quality of Life Core Questionnaire(EORTC QLQ-C30)were moderately correlated(r=0.404,P=0.003).Cronbach’sαcoefficient of the overall scale was 0.686.Pearson correlation coefficients of items between two tests within 14-day ranged from 0.410 to 0.673.Conclusion This study represents an initiative to develop a rapid psychosocial well-being screening tool for patients with metastatic breast cancer.The results from validity and reliability testing indicate that the scale is moderately suitable for application to patients with metastatic breast cancer.However,a larger scale study should be further administered to confirm the validity and reliability of the measurement.

Evaluation of patient reported outcome measures post urethroplasty:Piloting a“Trifecta”approach

BACKGROUND Buccal mucosal graft urethroplasty is the gold standard treatment for urethral stricture disease.Toowoomba has obtained a fellowship trained urethroplasty surgeon who has been performing urethroplasties for the last two years.Patient reported outcome measure(PROM)questionnaires allow for a detailed and standardized analysis of success and morbidity post urethroplasty and can be used as a reference point against which urethral surgeons can benchmark their performance.AIM To assess whether patient compliance rates improved with the use of an abridged PROM questionnaire.METHODS Our database of urethroplasty patients was searched to identify patients who had completed the original PROM.This is routinely requested to be completed at the 3-,6-and 12-mo mark.All patients are asked to complete the questionnaire and to bring it back to their next appointment.Our original PROM consists of the international prostate symptom score,the sexual health index measure and the Global Response Assessment.An abridged version of the questionnaire was derived focusing on urinary flow,sexual function and overall quality of life and consisted of three questions.RESULTS Sixty-six patients were included in our study.Fifty-four patients had been invited to complete the original PROM with an overall compliance rate of 30%.Compliance rates improved to 91%with the introduction of the modified PROM.No correlation between non-compliance and patient factors were found.There was also no significant difference in patient reported quality of life when comparing urinary flow and sexual function.CONCLUSION We recommend the use of PROMs pre-and post-operatively to accurately determine the level of patient satisfaction.We acknowledge the aversion of patients in completing PROMs due to the length of these questionnaires.We propose a simplistic version aimed at the“Trifecta”of urethroplasty comprising of three questions focusing each on urinary flow,sexual function and quality of life.Our modified PROM demonstrated markedly improved compliance rates and can be used as a screening tool to identify patients who might have had a poor outcome and who require a more in-depth assessment.

Identifying coronary artery bypass grafting patients at high risk for adverse long-term prognosis using serial health-related quality of life assessments

Background:Patients who undergo coronary artery bypass grafting(CABG)are known to be at a significant risk of experiencing long-term adverse events,emphasizing the importance of regular assessments.Evaluating health-related quality of life(HRQoL)serves as a direct method to gauge prognosis.Our objective is to ascertain the prognostic significance of consecutive HRQoL assessments using the Physical Component Summary(PCS)and Mental Component Summary(MCS)derived from the Short-Form 36(SF-36)health survey in CABG patients.Methods:The study population consisted of 433 patients who underwent isolated elective CABG at Fuwai Hospital between 2012 and 2013.SF-36 assessments were conducted during both the hospitalization period and follow-up.The primary endpoint of the study was all-cause mortality,while the secondary outcome was a composite measure including death,myocardial infarction,stroke,and repeat revascularization.We assessed the relationships between the PCS and MCS at baseline,as well as their changes during the first 6 months after the surgery(referred to asΔPCS andΔMCS,respectively),and the observed outcomes.Results:The patients were followed for an average of 6.28 years,during which 35 individuals(35/433,8.1%)died.After adjusting for clinical variables,it was observed that baseline MCS scores(hazard ratio[HR]for a 1-standard deviation[SD]decrease,1.57;95%confidence interval[CI],1.07-2.30)andΔMCS(HR for a 1-SD decrease,1.67;95%CI,1.09-2.56)were associated with all-cause mortality.However,baseline PCS scores andΔPCS did not exhibit a significant relationship with all-cause mortality.Notably,there was a dose-response relationship observed betweenΔMCS and the likelihood of all-cause mortality(HRs for the 2nd,3rd and 4th quartiles compared to the 1st quartile,0.33,0.45 and 0.11,respectively).Conclusions:Baseline MCS and changes in MCS were independent predictors for long-term mortality of CABG.Better mental health status and recovery indicated better prognosis.

Measuring quality of life:A system of indicators

In this day and age,improving quality of life(QOL)remains a necessary prerequisite for social progress and the central goal of state policy in many countries worldwide,regardless of their economic development.The aim of this work is to propose a system of indicators able to describe the QOL of the population to the fullest extent possible.The research methodology includes an analysis of modern approaches to explaining the QOL concept and describing its main measurement criteria,as well as a matrix comparison of the fundamental characteristics of well-being.These methods’application and the subsequently obtained results allow developing the model for the QOL measurement.The system of indicators proposed within this model implies the consideration of both objective and subjective indicators distributed into two blocks for convenience:the Accepted Living Standard(material and environmental indicators)and the Quality of Life Opportunities(individual,cultural,and social indicators).The QOL level is determined by the balance or imbalance between the mean values of these blocks.In such a manner,the study advocates that the modern QOL measurement should consider both objective well-being indicators,collected from the reports of the analysed country’s national statistics service,and subjective indicators characterising the citizens’perceptions of well-being at the individual level.