Bridging the gap:Unveiling the crisis of physical inactivity in inflammatory bowel diseases

In this editorial we comment on the article titled“Inflammatory bowel diseases patients suffer from significant low levels and barriers to physical activity:The BE-FIT-IBD study”published in a recent issue of the World Journal of Gastroen-terology 2023;29(41):5668-5682.Inflammatory bowel diseases(IBD)are emerging as a significant global health concern as their incidence continues to rise on a global scale,with detrimental impacts on quality of life.While many advances have been made regarding the management of the disease,physical inactivity in these patients represents an underexplored issue that may hold the key for further and better understanding the ramifications of IBD.Chronic pain,fatigue,and fear of exacerbating symptoms promotes physical inactivity among IBD patients,while the lack of clear guidelines on safe exercise regimens contributes to a norm of physical inactivity.Physical activity(PA)is accepted to have a positive effect on disease outcomes and quality of life,while inactivity exacerbates comorbidities like cardiovascular disease and mental health disorders.The“BE-FIT-IBD”study,focusing on PA levels and barriers in IBD patients of Southern Italy,revealed that a significant proportion(42.9%)were physically inactive.This lack of PA is attributed to barriers such as fear of flare-ups and misconceptions about exercise exacerbating the disease.The study also highlighted the need for better communication between healthcare providers and patients regarding the benefits of PA and safe incorporation into lifestyles.Moreover,physical inactivity may also contribute to disability in IBD patients,having a great impact on employment status.Of note is the fact that IBD also comes with an important psychological burden with relevant evidence suggesting that regular PA can improve mood,reduce anxiety,and enhance mental health.The“BE-FIT-IBD”study advocated for the integration of PA into IBD management,emphasizing the bidirectional link between PA and IBD.Regular exercise can influence the course of IBD,potentially reducing symptom severity and prolonging remission periods.As such,it is mandatory that healthcare providers actively educate patients,dispel misconceptions,and tailor exercise recommendations to improve the quality of life and reduce IBD-related complications.

Shifting the Paradigm:A Fresh Look at Physical Activity Frequency and Its Impact on Mental Health,Life Satisfaction,and Self-Rated Health in Adolescents

As adolescent mental health problems are becoming a more serious issue globally,this paper explores the relationship of physical activity in adolescents and its frequency on mental health as well as examines the mediating effects of life satisfaction and self-rated health in order to provide a reference for the promotion of mental health in adolescents.A sample of 3578 Chinese high school students completed questionnaires assessing their mental health,physical activity frequency,life satisfaction,and self-rated health.The mean SCL-90 value for adolescents was found to be 1.629%,and 24.73%of adolescents had varying degrees of mental health issue.Increased physical activity frequency is positively associated with improved mental health(p<0.001).Additionally,life satisfaction and self-rated health were found to play significant mediating roles in the relationship between physical activity frequency and mental health.Specifically,low-frequency physical activity had the most pronounced mediating effect on mental health through life satisfaction,while high-frequency physical activity exerted the most significant mediating effect on mental health through self-rated health.These findings underscore the importance of promoting physical activity among adolescents and highlight the distinct pathways through which physical activity frequency can influence mental health outcomes.Further research is needed to explore these relationships in diverse populations and settings,as well as to develop targeted intervention.

Impact of lifestyle interventions on pathogenesis of nonalcoholic fatty liver disease

This editorial builds on the article titled“Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease”by Zeng et al.We carried out a critical examination of nonalcoholic fatty liver disease(NAFLD)pathogenesis and how lifestyle interventions could facilitate disease resolution,particularly highlighting that non-alcoholic steatohepatitis(NASH)is a severe form of NAFLD.Our discussion details that weight loss is a pivotal factor in disease outcomes:A 3%-5%reduction is enough for resolution in 50%of non-obese individuals,while a 7%-10%reduction achieves similar benefits in obese individuals,as demonstrated by magnetic resonance spectroscopy.Additionally,the editorial underscores that such lifestyle changes are instrumental not only in resolving NAFLD but also in reversing hepatic steatosis and inflammation.These insights,derived from the research,emphasize the critical role of personalized lifestyle modifications in halting the progression of NAFLD to NASH and even reversing fibrosis,thus offering a template for effective patient management.

A Bibliometric Analysis of Global Research Trends of Exercise in Oncology During the Past Three Decades

Recently, studies have found that exercise can promote recovery in cancer patients. Based on bibliometric analysis, this paper discusses the trends and hot spots of exercise oncology research in the past 30 years. The Science Citation Index Expanded of the Web of Science Core Collection (WoSCC) was searched to obtain information on publications and records published between 1993 to 2023.VOSviewer and CiteSpace were used to conduct bibliometric and visual analyanalysis on the overall distribution of keywords and highly cited papers, and a total of 1775 articles were retrieved. Harvard University was the institution with the highest number of publications and Fearon ranked first in 2013 with a total of 605 citations.

Health-related quality of life and the ability to perform activities of daily living: a cross-sectional study on 1079 war veterans with ankle-foot disorders

Background:The ankle-foot injuries are among the war-related injuries that cause many serious secondary problems for a lifetime.This nationwide study aimed to assess health-related quality of life and the ability to perform activities of daily living in veterans with ankle-foot injuries due to the Iran-Iraq war.Methods:A total of 1079 veterans with ankle-foot injuries were enrolled in a cross-sectional study from 2014 to 2016.Demographic characteristics,including age,gender,marital status,disability percent,educational level,employment and additional injuries,were collected.The ability to perform daily activities was assessed using the Barthel activities of daily living(ADL)and Lawton instrumental activities of daily living(IADL)Indexes.Physical and mental health-related quality of life(HRQOL)data were measured via the SF-36 subscales.The data were compared with those of bilateral lower limb amputees(BLLAs)and of the general Iranian population.Statistical analyses,including Pearson’s correlation coefficient,one-sample t-test and analysis of variance(ANOVA),were performed using SPSS16.0.A multiple linear regression model was used to determine the contribution of independent variables to the Physical Component Summary(PCS)and Mental Component Summary(MCS).Results:The highest and lowest scores were observed for mental health(48.93±20.69)and bodily pain(28.16±21.74),respectively.The mean scores of veterans with ankle-foot injuries on the SF-36 were significantly lower on all eight measures than those of the general Iranian male population and of the bilateral lower limb amputees(P<0.001).The mean scores of ADLs and IADLs were 83.9±16.3 and 5.3±2.0,respectively.The higher dependency in ADLs(P<0.001)and IADLs(P<0.001),the higher disability rate(P<0.001)and additional injury(P<0.001)were significant determinants of the PCS.ADL(P<0.001)and IADL(P<0.001)limitations,additional injury(P<0.001),history of hospitalization in the year preceding the study(P=0.007)and employment(P=0.001)were reported as determinants of the MCS.Conclusion:The results strongly suggest that veterans with ankle-foot injuries suffer from critically poor healthrelated quality of life.The main predicting factors of HRQOL were the disability to perform ADLs/IADLs,suffering two or more injuries,a history of hospitalization in the year preceding the study and unemployment.

Physical activity, screen time and pediatric health-related quality of life in the Mississippi Delta

Background: The association of physical activity (PA) and screen time (ST) on health-related quality of life (HRQOL) among predominantly low-income children in the Mississippi Delta region has not been previously described. Methods: We performed a cross-sectional survey to assess health risks from a representative sample of the population ≥3 years old in the Delta Region of Arkansas, Louisiana, and Mississippi. Linear models were utilized to examine Pediatric Quality of Life Inventory (PedsQL) scores based on reported PA and ST. Results: Median age of the 371 participants was 9.8 years, 57% were African American, and 26% had annual household income ≤$14,999. Overall, 262 (75%) were categorized as physically active and 48% reported >2 hours ST per day. Children reporting exercising 5 - 7 days per week had significantly better PedsQL total score (84.3 vs 80.8;p 2 hours per day) did not significantly impact HRQOL. Conclusions: Findings suggest that PA among children living in the Mississippi Delta was related to higher HRQOL;however, the positive effects of PA on HRQOL may be less for minority and low-income children.

New Characteristics of Active Life Expectancy of the Elderly in China

Life expectancy of the elderly is a significant problem in China, and it changes not only the health care, but also the pension. This study used tracking data from the Chinese Urban and Rural Elderly Population Survey to calculate the age-specific Active Life Expectancy (ALE) of the Chinese elderly population aged 60 years and over. For analysis, this population was divided into different sub-populations according to gender, census register and region. The main conclusions of our study are as follows: 1) The quality of life for elderly males may be greater than that for elderly females;2) There were significant differences in Active Life Expectancy (ALE) and Inactive Life Expectancy (ILE) between urban and rural elderly;3) The differences in ALE between the eastern, central and western regions of China were not significant;and 4) The increased remaining life expectancy of the elderly was mainly attributed to the extended ALE in the lower age group and the expanded ILE in the higher age group. This study expands the knowledge of Chinese elderly’s life expectancy in different health status.

Decreased expression of hyperpolarisation-activated cyclic nucleotide-gated channel 3 in Hirschsprung's disease

AIM: To determine if hyperpolarisation-activated nucleotide-gated(HCN) channels exist in human colon, and to investigate the expression of HCN channels in Hirschsprung's disease.METHODS:We investigated HCN1,HCN2,HCN3 and HCN4 protein expression in pull-through specimens from patients with Hirschsprung’s disease(HSCR,n=10)using the proximal-most ganglionic segment and distalmost aganglionic segment,as well as in healthy control specimens obtained at the time of sigmoid colostomy closure in children who had undergone anorectoplasty for imperforate anus(n=10).Fluorescent immunohistochemistry was performed to assess protein distribution,which was then visualized using confocal microscopy.RESULTS:No HCN1 channel expression was observed in any of the tissues studied.Both HCN2 and HCN4proteins were found to be equally expressed in the aganglionic and ganglionic bowel in HSCR and controls.HCN3 channel expression was found to be markedly decreased in the aganglionic colon vs ganglionic colon and controls.HCN2-4 channels were seen to be expressed within neurons of the myenteric and submucosal plexus of the ganglionic bowel and normal controls,and also co-localised to interstitial cells of Cajal in all tissues studied.CONCLUSION:We demonstrate HCN channel expression in human colon for the first time.Reduced HCN3expression in aganglionic bowel suggests its potential role in HSCR pathophysiology.

The Relationship among Chronic Disease, Feeling-for-Their-Age, Sleep Quality, Health-Related Quality of Life and Activities of Daily Living of Community-Dwelling Persons over 55 Years of Age

Japan’s aging population rate is increasing and healthy life expectancy has decreases by 10 years shorter than average life expectancy. The aim of this study is to determine the relationship among chronic disease, sleep quality, health-related quality of life (HRQOL), and activities of daily living in people over 55 years old who live in the community. Subjects were 161 persons aged 57 to 90 years who were treated with chronic disease in the outpatient department of the A hospital. Exclusion criteria included patients with dementia, cancer and severe heart disease. The survey evaluation questionnaires included the Pittsburgh Sleep Quality Index (PSQI), HRQOL by Short-Form 8 Health Survey (SF-8), and activities of daily living. Variables associated with quality of sleep, HRQOL in univariate analysis with p < 0.05 were entered into multivariate analysis using logistic regression with a stepwise forward selection procedure to determine independent variables and their association with major causes. The logistic regression analysis was done using SPSS software and the post-hoc power of the study was estimated using G*power. The level of significance was set at p < 0.05. The risk factor of poor sleep quality was because of history of cancer [odds ratio (OR): 3.53, 95% confidence interval (CI): 1.06 - 11.77], and insomnia (OR: 3.25, 95% CI: 1.55 - 6.79). The risk factors of poor physical HRQOL were motor disease (OR: 2.62, 95% CI: 1.36 - 5.07), respiratory disease (OR: 3.24, 95% CI: 1.27 - 8.26) and having pain (OR: 11.71, 95% CI: 5.35 - 25.66). In addition, anemia was found to be a risk factor of poor mental HRQOL (OR: 4.87, 95% CI: 1.11 - 21.33). The feeling-for-their-body-age (OR: 0.30, 95% CI: 0.15-0.59) was as “younger than actual age” and advanced the risk factor of poor sleep quality. In addition, feeling-for-their-age (OR: 0.44, 95% CI: 0.21 - 0.92) resulted in reduced risk factor of poor physical HRQOL. The risk factor of poor sleep quality was due to a patient with history of cancer. The factor for good sleep quality and the good factor for physical HRQOL were indications of feeling younger than the actual age.

The Effect of Allergic Rhinitis on Quality of Life in Patients Suffering from the Disease: A Case Control Study

Background: Apart from nasal symptoms allergic rhinitis was associated with ocular or other symptoms affecting social and somatic activities or sleep. In the literature, only a few prospective studies regarding allergic rhinitis and holistic consideration of quality of life were reported. Methods: The aim of this case control study was to investigate prospectively the effect of allergic rhinitis on quality of life. 103 patients (50 males and 53 females) with mean age 30.8 &plusmn;13.4 years, range 18 - 55 years, diagnosed with the disease with skin prick testing, were evaluated regarding quality of life by using the General Health Questionnaire-28, the Athens Insomnia Scale (AIS) and the mini Rhinocon-junctivitis Quality of Life Questionnaire. 50 participants without history or al-lergic symptoms during the last 12 months formed the control group. Inde-pendent sample t-tests were conducted to assess significant differences between patients with allergic rhinitis and controls regarding all the examined parameters concerning quality of life. Data was analyzed using Windows statistical package of SPSS version 18.0 (SPSS Inc., Chicago, IL, USA). Statistical significance was set a priori at 0.05. Results: Dust mite, mixed grass and pollens were the most common allergens found in patients with allergic rhinitis. It was also observed that the examined patients showed statistically worse results concerning not only physical and social activities but also quality of sleep and nasal or other symptoms as compared to healthy controls (p 0.05). Conclusion: Allergic rhinitis negatively affected the quality of life especially the parameters that were related to psychosocial activities and sleep, which might have an impact on daily living.

Disability and Quality of Life among Elderly Persons with Self-Reported Hearing Impairment: Report from the Ibadan Study of Aging

Background: Despite a high prevalence of hearing impairment (HI) among the elderly, the effect on their quality of life (QOL) has not been well studied in this environment. Aim: To determine the prevalence of disability and profile of QOL among elderly persons (aged ≥65 years) with HI. Design of Study: Cross-sectional. Setting: Eight contiguousYoruba-speaking states in Nigeria. Methods: Face-to-face interviews of respondents selected using a multi-stage, stratified area probability sampling of households;HI was based on self report and observer confirmation and the QOL was measured with the World Health Organization brief version (WHOQOL-Bref). Results: The prevalence of disability in Activities of Daily Living (ADL) was 35.4% while it was 10.1% in Instrumental ADL. Prevalence increased significantly with increasing age (P = 0.05). Disability in ADL (P = 0.01), poor family interaction (P = 0.01), poor community involvement (P = 0.01) cognitive impairment (P = 0.05) and poor report of overall health (P = 0.05) were significantly more common among the elderly with HI than those without. No significant differences were found in regard to current depression or the likelihood of experiencing verbal, physical or emotional abuses. Logistic regression analyses adjusting for age, sex, chronic medical conditions and disability confirmed the salient effect of HI on the decrement in the physical domains (P = 0.05). Conclusion: HI is associated with high prevalence of disability and has adverse effect on the quality of life. This observation strengthens the need for hearing rehabilitation in the policy formulation on the care of the elderly in resource-poor settings.

Effects of physical activity by the teach-back educational method on the physical ability and quality of life in hemodialysis patients:a clinical trial

Objective:To determine the effect of physical activity by using the teach-back educational method on hemodialysis patients’quality of life(QOL)and physical ability.Methods:This is a single-blind clinical trial study involving a control group.A total of 90 patients who admitted to the dialysis centers of Beheshti and Besat hospitals in Hamadan were selected using a convenience sampling method and were randomly assigned to intervention(n=45)and control(n=45)groups.Data were collected using a demographic information checklist,a kidney disease QOL questionnaire,and a 6-minute-walk distance(6MWD)checklist.The patients’QOL questionnaire was completed,and the 6MWD was recorded before and at the end of the 2nd,4th,6th,8th,and 12th weeks of the intervention.In the intervention group,the patients were taught to perform physical activities with Pilates stretches in different resistances using the teach-back educational method during dialysis sessions for 12 weeks.Data were analyzed by using the independent t-test and chi-square test using SPSS-22 software.Results:Before the intervention,no differences were observed between the experimental and control groups in terms of demographic characteristics,QOL,and physical ability(P>0.05).The physical ability and QOL levels of patients exercising in the test group were higher than those in the control group after the intervention(P<0.05).Based on the results,the 2 groups significantly differed with regard to the scores of various dimensions of QOL and physical ability after the intervention(P<0.05).Conclusions:Physical activity by using the teach-back method can effectively increase physical ability and improve QOL of hemodialysis patients.Therefore,the recommendations and inclusion of exercise in the dialysis care plan can effectively promote patients’health.

The Impact of a Pet, in This Case a Dog, on Physical Activity, Independence, Social Contacts, Health and Quality of Life of Elderly People

In a rural area near Munich, 52 persons aged 65 years and older were interviewed in person about health and social life circumstances. Findings: Dog owners take significantly longer walks than people who do not own dogs, averaging more than 120 minutes daily (p < 0.0001). On average, people who do not own a dog walked 38 minutes, cat owners 17 minutes. 94% of the dog owners were active daily compared to 14% of those who do not own a dog. Dog owners go to the doctor on average 5.3 times per year, people who do not own a dog 7.8 times. There was no difference between the two groups in regard to the use of medication. 80% would not move to a residential home for the elderly because of the dog, and 87% would want to take the dog along. 50% of the dog owners and 41% of those who do not own a dog had on average more than 3 contacts with other people, 6% of the dog owners and 23% of those who do not own a dog had less than one contact per day. 19% of the dog owners and 36% of those who do not own a dog would describe themselves as reserved in dealings with people. 71% stated that the dog had been very useful to help them overcome the loss of a person close to them. The W-5 [Wellbeing Five score] for dog owners was an average value of 75%, for those who did not own a dog 71%. Depression was uniformly distributed in both groups. The BMIs in both groups were similar. There was no correlation to the length of the daily walk.

AB030.Usability of ArtontheBrain:A visual-arts based mobile health solution to promote quality of life in older adults with low vision due to age-related macular degeneration

Background:Taking part in productive and enjoyable recreational activities has been shown improve quality of life for people of all ages and capabilities.However,vision loss can have a significant impact on participation in important leisure activities.This is especially the case for the elderly,whose lowered mobility is further impacted by vision loss.Technology can offer solutions to bridging some barriers caused by these deficits by bringing leisure activities to the user in the form of mobile applications.As such,the purpose of the present study was to evaluate the accessibility and usability of the ArtOnTheBrain application,a visual art based mobile health solution to promote brain health and well-being,by older adults with low vision due to age-related macular degeneration(AMD).Methods:There were a total of 16 participants(age range,65-93 years,M=79,10 males).All had a diagnosis of AMD with visual acuities in the better eye between 20/60 and 20/200.Additionally,all participants had accessed rehabilitation services and most had experience using a computer at home.Using an Apple iPad Air(2013),they were asked to interact with the ArtOnTheBrain website’s Learn(e.g.,Listen to artwork description)and Play(e.g.,complete a word-search game)features with either the Safari or Google Chrome Internet apps.Using the Concurrent Think Aloud method,participants were asked to continuously comment on their activities and experiences with the app and verbalize their internal monologue while being audio and video recorded.These recordings were later transcribed verbatim and analysed using qualitative description and thematic analysis.Results:Participants’behaviours and verbal feedback were divided based on whether they presented as barriers or facilitators.Beginning with barriers,these were mostly related to the accessibility of the visual aspects of the applications interface(i.e.,contrast and font size),whereby participants requested additional control over the magnification options,both for text as well as images of the artwork.The main facilitator was the audio option built into the Learn tab,which allowed participants to listen to the artwork descriptions.Facilitators also included the aesthetics of the app,the perceived boost in confidence in interacting with technology,and the educational and leisure benefits.Conclusions:Older adults with low vision are faced with a decreased ability to engage in leisure activities.The development of technologies aimed at increasing the accessibility of leisure activities for these individuals is an important step in increasing their quality of life.As such,despite some of the accessibility challenges,the majority of participants viewed ArtontheBrain positively.Identifying the barriers and facilitators to its use is an important step in the development of this application in order to optimize its accessibility for older adults with low vision.Future work to be done with this application will be to evaluate the cognitive impact of ArtontheBrain on low vision users.

Lifestyle and dietary factors in the prevention of letha prostate cancer

The prevention of lethal prostate cancer is a critical public health challenge that would improve health and reduce suffering from this disease. In this review, we discuss the evidence surrounding specific lifestyle and dietary factors in the prevention of lethal prostate cancer. We present a summary of evidence for the following selected behavioral risk factors： obesity and weight change, physical activity, smoking, antioxidant intake, vitamin D and calcium, and coffee intake.

The impact of perceived social support, loneliness, and physical activity on quality of life in South Korean older adults

Purpose: The purpose of this study was to propose and test a conceptual model that explains the interrelationships among perceived social support, loneliness, physical activity(PA), and quality of life(QoL) among active older adults in South Korea.Methods: Data were collected from 332 individuals over the age of 65 using a systematic stratified convenience sampling method. Survey data were collected and analyzed using a structural equation model(SEM).Results: Perceived social support had a significantly positive effect on PA(b = 0.14, p < 0.01) and QoL(b = 0.28, p < 0.001) while decreasing loneliness(b = —0.55, p < 0.001). PA had a significant positive effect on QoL(b = 0.12, p < 0.01), and loneliness had a negative effect on QoL(b = —0.37, p < 0.001). Loneliness mediated the relationship between perceived social support and QoL.Conclusion: The SEM results of the current study support the proposed model that explained the interrelationships among perceived social support, loneliness, PA, and QoL among active older adults in South Korea. These findings suggest the importance of incorporating social support mechanisms for PA interventions in order to enhance QoL. The findings of this study can help create more effective health and physical education programs for the older generations in South Korea to enhance their QoL.

Impact of pain on health-related quality of life in patients with inflammatory bowel disease

AIM: To evaluate intensity, localization and cofactors of pain in Crohn’s disease and ulcerative colitis patients in connection with health-related quality of life (HRQOL) and disease activity. METHODS: We reviewed and analyzed the responses of 334 patients to a specifically designed questionnairebased on the short inflammatory bowel disease questionnaire (SIBDQ) and the German pain questionnaire. Pain intensity, HRQOL, Crohn’s disease activity index (CDAI) and colitis activity index (CAI) were correlated and verified on a visual analog scale (VAS). RESULTS: 87.9% of patients reported pain. Females and males reported comparable pain intensities and HRQOL. Surgery reduced pain in both genders (P = 0.023), whereas HRQOL only improved in females. Interestingly, patients on analgesics reported more pain (P = 0.003) and lower HRQOL (P = 0.039) than patients not on analgesics. A significant correlation was found in UC patients between pain intensity and HRQOL (P = 0.023) and CAI (P = 0.027), and in CD patients between HRQOL and CDAI (P = 0.0001), but not between pain intensity and CDAI (P = 0.35). No correlation was found between patients with low CDAI scores and pain intensity. CONCLUSION: Most IBD patients suffer from pain and have decreased HRQOL. Our study reinforces the need for effective individualized pain therapy in IBD patients.

Relationship between activities of daily living and depression among older adults and the quality of life of family caregivers

Objective： The purposes of this study were to explore the associations of activities of daily living （ADL） and depression among older adults with family caregivers1 quality of life and provide evidence for improving family caregivers＇ quality of life.Methods： Older adults （n=395） and their family caregivers （n=395） were selected as participants. The ADL scale and Geriatric Depression Scale were used to assess ADL and depression among older adults, and the 36-Item Short Form Health Questionnaire （SF-36） was used to assess family caregivers1 quality of life. Descriptive statistics and multiple linear regression were used to analyze the data.Resslts： The older adults’ ADL and depression scores were 21 ±7 and 11 ±6, respectively. Approximately 69.9% of older adults had declining or severely impaired ADL, and 47.1% had mild or moderate-to-severe depression. Family caregivers＂ mean quality of life score was 529±100. There was a negative correlation of older adults＇ ADL and depression with caregivers＇ quality of life. The correlation coefficient between ADL and the SF-36 mental component summary score was stronger than it was with the SF-36 physical component summary score.Conclusions： The ADL and depression of older adults influenced family caregivers＇ quality of life. Psychological health deserves closer attention, especially that of caregivers of disabled older adults.

Associations between meeting 24-hour movement guidelines and quality of life among children and adolescents with autism spectrum disorder

Background:The Canadian 24-hour movement behavior(24-HMB)guidelines suggest that a limited amount of screen time use,an adequate level of physical activity(PA),and sufficient sleep duration are beneficial for ensuring and optimizing the health and quality of life(QoL)of children and adolescents.However,this topic has yet to be examined for children and adolescents with autism spectrum disorder(ASD)specifically.The aim of this cross-sectional observational study was to examine the associations between meeting 24-HMB guidelines and several QoLrelated indicators among a national sample of American children and adolescents with ASD.Methods:Data were taken from the 2020 U.S.National Survey of Children’s Health dataset.Participants(n=956)aged 617 years and currently diagnosed with ASD were included.The exposure of interest was adherence to the 24-HMB guidelines.Outcomes were QoL indicators,including learning interest/curiosity,repeating grades,adaptive ability,victimization by bullying,and behavioral problems.Categorical variables were described with unweighted sample counts and weighted percentages.Age,sex,race,preterm birth status,medication,behavioral treatment,household poverty level,and the educational level of the primary caregivers were included as covariates.Odds ratio(OR)and 95%confidence interval(95%CI)were used to present the strength of association between adherence to 24-HMB guidelines and QoL-related indicators.Results:Overall,452 participants(45.34%)met 1 of the 3 recommendations,216(22.65%)met 2 recommendations,whereas only 39 participants(5.04%)met all 3 recommendations.Compared with meeting none of the recommendations,meeting both sleep duration and PA recommendations(OR=3.92,95%CI:1.639.48,p<0.001)or all 3 recommendations(OR=2.11,95%CI:1.034.35,p=0.04)was associated with higher odds of showing learning interest/curiosity.Meeting both screen time and PA recommendations(OR=0.15,95%CI:0.040.61,p<0.05)or both sleep duration and PA recommendations(OR=0.24,95%CI:0.070.87,p<0.05)was associated with lower odds of repeating any grades.With respect to adaptive ability,participants who met only the PA recommendation of the 24-HMB were less likely to have difficulties dressing or bathing(OR=0.11,95%CI:0.020.66,p<0.05)than those who did not.For participants who met all 3 recommendations(OR=0.38,95%CI:0.150.99,p=0.05),the odds of being victimized by bullying was lower.Participants who adhered to both sleep duration and PA recommendations were less likely to present with severe behavioral problems(OR=0.17,95%CI:0.040.71,p<0.05)than those who did not meet those guidelines.Conclusion:Significant associations were found between adhering to 24-HMB guidelines and selected QoL indicators.These findings highlight the importance of maintaining a healthy lifestyle as a key factor in promoting and preserving the QoL of children with ASD.

Health-Related Quality of Life of Children and Adolescents with Juvenile Idiopathic Arthritis in Western Saudi Arabia

Objectives: To evaluate the effect of Juvenile Idiopathic Rheumatoid Ar-thritis (JIA) on the health-related quality of life (HRQOL) in Saudi children. Methods: A cross-sectional study was conducted in a tertiary hospital in Jeddah, Saudi Arabia to evaluate the HRQOL of children aged ≤ 18 years who had JIA using the childhood health assessment questionnaire modified for Arab children (CHAQ-MAC). Such questionnaire investigates 34 activities of daily life (ADL) classified into 8 life domains. Children or their parents were invited for face-to-face interview, and a phone interview was done for patients who missed their appointments during the period between February and July 2017. A statistical model was used to calculate a total CHAQ.MAC score (range = 0 - 33;Cronbach’s alpha = 0.966);with higher values indicating poorer HRQOL. Results: Of a total of 44 children (male ratio = 0.63;mean ± SD age = 9.95 ± 5.44), Systemic-onset JIA was the most frequent type (27.3%), followed by polyarticular (15.9%) and oligoarticular (13.6%). Pain was reported among 43.2% (frequently in the knee, in 27.3%) whereas morning stiffness was reported in 20.5%. The mean CHAQ.MAC score = 2.89 (75th centile = 3.00). With respect of ADLs, up to 22.7% of the children complained of difficulty;and 31.8% reported a difficulty in at least one of the 34 investigated ADLs. With respect of the life domain, children reported difficulties for activities (27.3%), dressing & grooming and hygiene (13.6%), and eating (6.82%). According to the life domain, 4.5% to 13.6% of the children needed help to execute the related ADLs and up to 9.1% used aids or devices. Poor HRQOL was associated with articular pain (p = 0.003) and specific medication (p = 0.043). Con-clusion: Children with arthralgia and those on specific treatment are at higher risk of impaired QOL, which emphasizes the need for systematic screening for treatment adverse effects and joint pain and implementation of efficient management to improve HRQOL.