Postpartum quality of life and mental health in women with heart disease:Integrated clinical communication and treatment

BACKGROUND Postpartum quality of life(QoL)in women with heart disease has been neglected.AIM To improve clinical communication and treatment,we integrated medical data and subjective characteristics to study postpartum QoL concerns.METHODS The study assessed QoL 6 wk after birth using the 12-Item Short-Form Health Survey.The Edinburgh Postnatal Depression Scale,Cardiac Anxiety Questionnaire,European Heart Failure Self-Care Behavior Scale,and a self-designed questionnaire based on earlier research were also used to assess patient characteristics.Patient data were collected.Prediction models were created using multiple linear regression.RESULTS This retrospective study examined postpartum QoL in 105 cardiac patients.Postpartum QoL scores were lower(90.69±13.82)than those of women without heart disease,with physical component scores(41.09±9.91)lower than mental component scores(49.60±14.87).Postpartum depression(33.3%),moderate anxiety(37.14%),pregnancy concerns(57.14%),offspring heart problems(57.14%),and life expectancy worries(48.6%)were all prevalent.No previous cardiac surgery,multiparity,higher sadness and cardiac anxiety,and fear of unfavorable pregnancy outcomes were strongly related to lower QoL(R^(2)=0.525).CONCLUSION Postpartum QoL is linked to physical and mental health in women with heart disease.Our study emphasizes the need for healthcare workers to recognize the unique characteristics of these women while developing and implementing comprehensive management approaches during their maternity care.

Scarcity and Mental Health—Multiple Mediators of Sleep Quality and Life Satisfaction

Background:In the current social environment,scarcity,as a universally present objective state,profoundly impacts individuals’decision-making and health through the subjective feeling it induces,known as a“scarcity mindset.”Particularly,the feeling of scarcity related to money and sleep time is not only widespread but also directly linked to an individual’s mental health.Purpose:This study aims to delve into the relationship between the feeling of scarcity and mental health,with a specific focus on the relationship between the feeling of money scarcity or sleep time scarcity and mental health,as well as the role of sleep quality or life satisfaction in this relationship.Procedure:We determined the sampling quotas based on the population and economic development levels of each province in the“China Statistical Yearbook(2021)”(National Bureau of Statistics,2021).Participants were selected using the Probability Proportional to Size(PPS)sampling method.Data was collected by distributing online questionnaires to participants,and the relationships between the main variables were explored using structural equation modeling.Results:1.In China,the feeling of sleep time scarcity is stronger than the feeling of money scarcity among the public.2.The feeling of money scarcity is positively correlated with depression and anxiety,whereas the feeling of sleep time scarcity is only positively correlated with depression.3.The feeling of scarcity mainly leads to depression and self-denial through reducing life satisfaction,and it leads to anxiety through reducing sleep quality.Conclusion:The feeling of scarcity in money and sleep time is related to different dimensions of mental health.Therefore,reasonably planning financial allocation and ensuring an adequate amount of sleep can reduce the sense of scarcity,thereby improving mental health.Additionally,improving sleep quality and increasing life satisfaction can alleviate the adverse effects of scarcity on mental health.

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.

Implications of Dynamic Interactions between Meteorological Patterns and Surface Water Quality on Environmental Health—A Case Study of the Nairobi River

Urban areas face significant challenges in maintaining water quality amidst increasing urbanization and changing climatic patterns. This study investigates the complex interplay between meteorological variables and water quality parameters in Nairobi City, focusing on the impacts of rainfall and temperature on surface water quality. Data from multiple sources, including the Water Resources Authority, Nairobi Water and Sewerage Company, and the World Bank’s Climate Change Knowledge Portal, were analyzed to assess the relationships between meteorological variables (rainfall and temperature) and water quality parameters (such as electroconductivity, biochemical oxygen demand, chloride, and pH). The analysis reveals varying impacts of rainfall and temperature on different water quality parameters. While parameters like iron and pH show strong relationships with both rainfall and temperature, others such as ammonia and nitrate exhibit moderate relationships. Additionally, the study highlights the influence of runoff, urbanization, and industrial activities on water quality, emphasizing the need for holistic management approaches. Recommendations encompass the establishment of annual publications on Nairobi River water quality, online accessibility of water quality data, development of hydrological models, spatial analysis, and fostering cross-disciplinary research collaborations. Implementing these recommendations can enhance water quality management practices, mitigate risks, and safeguard environmental integrity in Nairobi City.

Atmospheric Pollutants in a Commercial Region of Fortaleza, Ceará, Brazil: Integration of Health, Environment and Economy in Urban Planning to Improve Air Quality

The accelerated growth of the vehicular fleet, the modernization of large urban centers, and the few adjustments to the road network in Fortaleza have intensified the problems of traffic and emissions of atmospheric pollutants, highlighting the necessity for strategic urban planning initiatives to address the escalating issues of traffic and pollution. With the objective of analyzing the indices of concentrations of atmospheric pollutants and estimating how these levels can affect human health, this work consists of a study of the analysis of air quality in the intense trade region of Fortaleza. For this, the analysis zone was divided into three perimeters (Major - Medium - Minor), where each perimeter was analyzed at 7 am, 12 noon and 5 pm. Concentrations of the type of O3, particulate matter (PM2.5 and PM10), CO2 and HCHO were collected. Our results demonstrate that most of the analyses are within the limits of current legislation;however, at certain times and perimeters, the analyses of CO2 and HCHO exceeded the established limits. In view of the above, we conclude that public policies to control air quality are necessary to reduce the damage to human health and the environment caused by pollutants.

Affordability, Accessibility, and Quality of Maternal Health Care Services and Level of Satisfaction of Mothers in Rural Areas in China

Objective:This study aimed to understand the affordability,accessibility,and quality of maternal and child health services for postpartum mothers,and their impact on satisfaction.Methods:The study utilized the Anderson model and revised the Maternal Pregnancy and Perinatal Health Service Questionnaire.A survey was conducted among 289 mothers aged 20–49 in Feicheng City.Results:Regarding accessibility,most respondents(133)reported that travel time to healthcare services exceeded 60 minutes,while 99 respondents indicated a travel time of 16–30 minutes.The issue of affordability was highlighted,with 86.85%of participants perceiving maternal healthcare services as costly,indicating a significant financial burden.More than 50%of respondents were satisfied with two specific dimensions(P<0.05)regarding the quality of maternal healthcare services.Conclusion:The study found that accessibility,affordability,and quality significantly affect mothers’satisfaction with maternal health services.Future research should focus on developing more suitable service pathways for rural mothers.

Construction of project quality health monitoring system based on life-cycle theory

In order to more effectively assess the health status of a project, the monitoring indices in a project＇s life cycle are divided into quality index, cost index, time index, satisfaction index, and sustainable development index. Based on the feature of qualitative and quantitative indices combining, the PCA-PR （principal component analysis and pattern recognition） model is constructed. The model first analyzes the principal components of the life-cycle indices system constructed above, and picks up those principal component indices that can reflect the health status of a project at any time. Then the pattern recognition model is used to study these principal components, which means that the real time health status of the project can be divided into five lamps from a green lamp to a red one and the health status lamp of the project can be recognized by using the PR model and those principal components. Finally, the process is shown with a real example and a conclusion consistent with the actual situation is drawn. So the validity of the index system and the PCA-PR model can be confirmed.

Integrated assessment of river health based on water quality, aquatic life and physical habitat

The health conditions of Liao River were assessed using 25 sampling sites in April 2005, with water quality index, biotic index and physical habitat quality index. Based on the method of cluster analysis （CA） for water quality indices, it revealed that heavily polluted sites of Liao River are located at estuary and mainstream. The aquatic species surveyed were attached algae and benthic invertebrates. The result showed that the diversity and biomass of attached algae and benthic index of biotic integrity （B-IBI） were degrading as the chemical and physical quality of water bodies deteriorating. Physiochemical parameters, BODs, CODcr, TN, TP, NH3-N, DO, petroleum hydrocarbon and conductivity, were statistically analyzed with principal component analysis and correlation analysis. The statistical results were incorporated into the integrated assessing water quality index, combining fecal coliform count, attached algae diversity, B-IBI and physical habitat quality score. A comprehensive integrated assessing system of fiver ecological health was established. Based on the systimetic assessment, the assessed sites are categorized into 9 ＂healthy＂ and ＂sub-healthy＂ sites and 8 ＂sub-sick＂ and ＂sick＂ sites.

Assessment of disease specific knowledge and health-relatedquality of life among United States military veterans withinflammatory bowel disease

AIM To evaluate the association between patientdisease knowledge of inflammatory bowel disease （IBD）and health related quality of life （HRQoL） and identifypatient and disease related predictors of patientknowledge of IBD.METHODS： We performed a cross-sectional study ofIBD patients with an established diagnosis of IBD longerthan 3 mo prior to enrollment. The Crohn＇s and colitisknowledge score （CCKNOW） and short inflammatorybowel disease questionnaire （SIBDQ） were selfadministeredto assess patient knowledge of IBDand HRQoL, respectively. Demographic and diseasecharacteristics were abstracted from the electronicmedical record. The correlation between CCKNOWand SIBDQ scores was assessed by a linear regressionmodel. Associations of patient knowledge and thevariables of interest were calculated using ANOVA.RESULTS： A total of 101 patients were recruited.Caucasian race, younger age at diagnosis, and having a college or post-graduate degree were significantlyassociated with higher CCKNOW scores. Patients withCD had higher CCKNOW scores compared to patientswith ulcerative colitis and inflammatory bowel diseasetype unclassified, P 〈 0.01. There was no significantcorrelation between overall CCKNOW and SIBDQ scores（r^2 = 0.34, P = 0.13）. The knowledge sub-domain ofdiet in CCKNOW was negatively correlated with HRQoL（r^2 = 0.69, P 〈 0.01）.CONCLUSION： IBD diagnosis at a younger age inaddition to Caucasian race and higher education weresignificantly associated with higher knowledge aboutIBD. However, patient knowledge of IBD was notcorrelated with HRQoL. Further studies are required tostudy the effect of patient knowledge of IBD on otherclinical outcomes.

Higher vitamin D serum concentration increases health related quality of life in patients with inflammatory bowel diseases

AIM: To investigate the effect of vitamin D (VD) concentrations and VD supplementation on health related quality of life in inflammatory bowel disease (IBD) patients.

Surface water quality and potential health risk assessments in Changsha-Zhuzhou-Xiangtan section of Xiangjiang River, China

The Changsha-Xiangtan-Zhuzhou City Group is a heavy industrial district and accepted as the serious pollution area in the Xiangjiang River basin.In this study,7 metals(Pb,Hg,Cd,As,Zn,Cu and Se)and the river water quality parameters including pH,dissolved oxygen(DO),Escherichia coli(E.coli),potassium permanganate index(CODMn),dichromate oxidizability(CODCr),five-day biochemical oxygen demand(BOD5),ammonia nitrogen(NH4+-N),total nitrogen(TN),total phosphorus(TP)and fluoride(F)in 18 sampling sites of the Changsha-Xiangtan-Zhuzhou section are monthly monitored in 2016,which is the year to step into the second stage of the“Xiangjiang River Heavy Metal Pollution Control Implementation Plan”.It is found that E.coli,TN and TP are the main pollutants in the Changsha-Zhuzhou-Xiangtan section,and the pollution of heavy metal is not serious but As with potential risk to local people especially children should be concerned.In addition,Xiangtan city is mainly featured with heavy metal pollution,while Zhuzhou and Changsha city are both featured with other pollutants from municipal domestic sewage.

The Monte Carlo-Based Uncertainty Health Risk Assessment Associated with Rural Drinking Water Quality

In this study, Triangular Fuzzy-number of the Fuzzy Set Theory was introduced to reform parameters of those previous health risk assessment (HRA) models, Monte Carlo simulation parameter was applied to lower the randomness and fuzziness of the HRA system, and the Monte Carlo-United States Environmental Protection Agency (MC-EPA) model was employed to evaluate the health risk associated with water quality (HRWQ), so as to solve the uncertainty HRA associated with rural drinking water quality. Results showed that the water in Mingshan was contaminated mainly by Cr(VI), nitrate, fluoride and Fe. The health risk primarily embodied in the carcinogenic risk (CR) caused by Cr(VI) that generally exceeds the limit while little non-carcinogenic toxic effected presents. However, non-carcinogenic risk (NCR) in some water resources was high, exceeding the limit “1”. The results revealed the health risk level of the water quality and the health risk degree caused by the pollutants, providing scientific support for the management of the HRWQ of the WR. It also indicated the significance of MC-EPA model’s 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.

Utilising digital health to improve medication-related quality of care for hypertensive patients:An integrative literature review

BACKGROUND Hypertension or high blood pressure is considered as a significant contributor and risk factor to many serious conditions,approximately 1.13 billion people have hypertension globally.However,the integrated technologies can upscale health provisions and improve the effectiveness of the healthcare system.WHO has recommended that the digital health interventions(DHIs)and the Health System Challenges should be used in tandem in addressing health.AIM To summarise the outcomes from a range of research which investigated the use of DHI to improve the medication-related quality of care(MRQOC)for hypertensive patients.METHODS An integrative literature review was undertaken in October 2019 using the Medline,Cumulative Index of Nursing and Allied Health Literature,and Scopus databases for publications in English with no date limit.RESULTS In total,18433 participants were included in this review from 28 studies meeting the eligibility criteria.There were 19 DHI identified within eight countries:Australia,Canada,India,South Korea,Lebanon,Pakistan,the United Kingdom,and the United States of America.The DHI were provided as community-based,clinical-based and home-based program through mobile phone,mobile health system,short message service,and telehealth,digital medicine,and online healthcare(web-based).The mean age of participants was 59 ranging from 42 to 81 years with an average mean systolic blood pressure of 143.3 mmHg at baseline,ranging from 129.0 mmHg to 159.0 mmHg.The proportion of male participants ranged from 13.9%to 92.0%.Eighteen interventions showed evidence of reduction in blood pressure and improvement of self-management in relation to medication adherence and blood pressure control.The reduction of systolic blood pressure ranged between 1.9 mmHg and 26.0 mmHg,with a mean of 10.8 mmHg.The digital health was found positively associated with the MRQOC for hypertensive patients such as improvement in medication adherence and medication management;better blood pressure control;maintaining followups appointment and self-management;increasing access to healthcare particularly among patients living in rural area;and reducing adverse events.However,some interventions found no significant effect on hypertensive care.The follow up duration varied between 2 mo and 18 mo with an average attrition rate of 10.1%,ranging from 0.0%to 17.4%.CONCLUSION Utilising digital health innovation for hypertensive care in different settings with tailored interventions positively impacted on MRQOC leading to an improvement of patient outcomes and their quality of life.Nevertheless,inconclusive findings were found in some interventions,and inconsistent outcomes between DHI were noted.A future research and evidence-based DHI for hypertension or chronic diseases should be developed through the evidenceto-decision framework and guidelines.

ArcGIS-Based Rural Drinking Water Quality Health Risk Assessment

Aiming at the unsafe of water quality which is the core problem in rural drinking water safety, the study col-lected 221 water samples of rural drinking water sources in Ya'an and detected the concentrations of the car-cinogen and the non-carcinogen. Based on the analysis of water environment characteristics and the identifi-cation of water environment health risk source of Sichuan Ya’an City, which includes seven counties and a district and is the typical region of the western margin of Sichuan Basin, this study calculated and analyzed the carcinogenic risk (R) and non-carcinogenic risk (hazard index, HI) by applying the health risk model recommended by the US National Research Council of National Academy of Science. Then, taking advan-tage of the geo-statistic spatial analysis function of ArcGIS, this study analyzed the assessment result data (R and HI), selected the proper interpolation approach and educed R and HI spatial distribution maps of the study area. R and HI of the single factor and integrate factors were evaluated and thus obtained the following conclusions: For one thing, the cancerous risk indexes of the vast majority of water sources (about 94%) is the level of 10-7 and it belong to the safety extension. The main carcinogen in the water sources are As, Cr6+ and Pb, their concentrations are in the ranges of 0.004-0.01, 0.005, 0.01mg/l respectively and such water source mainly distributed in Yucheng district and Mingshan county. For another, the non-cancerous hazard indexes of the vast majority of water sources (about 98%) is also less than the limit value 1 and will not harm the local residents. The health risk of non-carcinogen comes mainly from As and fluoride, their concentra-tions are in the ranges of 0.004-0.01 and 0.1-4.2mg/l respectively. The results of the integrate factors health risk assessment showed that the total cancerous risk were still at the level of 10-6, only 12 drinking water source investigation sites (5%) exceeded the drinking water management standard value of EPA (the limit value is 10-6);the total non-cancerous hazard indexes are still in the range of 10-2-10-1, and will not harm the local residents either, only 18 drinking water source investigation sites (8%) exceeded the drinking water management standard value of EPA(the limit value is 1).The densely populated areas such as Yucheng Dis-trict, Tianquan County, Yingjing County and Shimian County are where the four contaminating materials, i.e., As, Cr6+, Pb and fluoride should be monitored with emphasis. Study results disclosed the health risk control indexes of source water quality of the studied area and thus provided the scientific basis for the water quality control of water sources. This study had worked efficiently in practice. Compared with the same kind of methods which had been found, the paper had the outstanding results for the health risk assessment of the rural drinking water safety.

Particulate Matter-Based Air Quality Index Estimate for Abuja, Nigeria: Implications for Health

In recent years, urban air quality in developing countries such as Nigeria has continued to degenerate and this has constituted a major environmental risk to human health. It has been shown that an increase in ambient particulate matter (PM10) load of 10 μg/m3 reduces life expectancy by 0.64 years. Air Quality Index (AQI) as demonstrated in this study shows how relatively clean or polluted the boundary layer environment of any location can be. The study was designed to measure the level of suspended particulate matter (PM2.5 and PM10) for dry and wet seasons, compute the prevalent air quality index of selected locations in Abuja with possible health implications. Suspended particulate matter (PM2.5 and PM10) was assessed using handheld aerosol particulate sampler. The US Oak Ridge National AQI was adopted for the eleven (11) locations sampled and monitored. The study results showed that the air quality of the selected areas in Abuja were generally good and healthy. Dry season, assessments, showed 15 - 95 μg/m3 and 12 - 80 μg/m3 for PM2.5 and PM10, respectively. While in wet season, 09 - 75 μg/m3 and 07 - 65 μg/m3 were recorded for PM2.5 and PM10. However at Jebi Central Motor Park, there was light air contamination with AQI of 42 for dry season and 31 for wet season. Other locations had clean air with AQI ≤ 11. It is revealed that clean air exists generally during the wet season. Comparing study outcome to other cities in Nigeria, residents of Abuja are likely not to be affected with health hazards of particulate matter pollution. Nonetheless, the high range of PM2.5 and PM10 (fine and coarse particles) ratio evaluated i.e., 1.06 - 1.79 was higher than the WHO recommended standard of 0.5 - 0.8. This ratio remains a health concerns for sensitive inhabitants like pregnant women and their foetus as well as infants below age five whose respiratory airways are noted to have high surface areas and absorption capacity for fine particulate matter. Vegetation known to absorb suspended particulate matter should be planted across Abuja metropolitan areas and air quality monitoring stations installed at strategic locations for continuous monitoring and evaluations.

Advances in Research on the Effects of Calcium on Vegetable Quality and Human Health

Calcium is an important element that affects vegetable quality and human health.In this paper,the basic nutrition and functions of calcium,the effects of calcium deficiency on vegetable growth and human health,the effect of calcium supply on vegetable quality and the outlook for calcium-rich vegetables were overviewed,aiming at providing guidance for the cultivation of high-quality calcium-rich vegetables.

The Influence of Socio-Demographic, Health and Work-Related Factors on Health-Related Quality of Life among Iranian Industrial Workers

Health-related quality of life (HRQOL) has not been investigated among Iranian industrial workers. The present paper aimed to study the influence of the socio-demographic, health and work-related factors on HRQOL among Iranian industrial workers. In this cross-sectional study, participants were 280 workers of two factories. The Persian version of World Health Organization Quality of Life-Brief (WHOQOL-BREF) was used to assess the HRQOL. A questionnaire was developed to assess the socio-demographic, health and work-related factors. Results showed that the means (SD) of physical health, psychological health, social relationships, and environment domains of HRQOL were 13.2 (2.7), 13.3 (2.6), 14.2 (3.5) and 12.6 (2.5), respectively. A multiple linear regression showed that types of job, exercise activity, working schedule, sleep quality, smoking, and conflict between work and social life were significantly associated with physical health domain;whereas, working schedule, marital status, working demand, sleep quality, BMI, and conflict between work and individual life were significantly associated with psychological health domain. Working schedule, working demand, sleep quality, conflict between work and individual life, and having children over two years were significantly associated with social relationship domain;however, working demand, working schedule, smoking, sleep quality, working hour, job satisfaction, marital status and exercise activity were significantly associated with environment domain. Collectively, work-related factors including unhealthy working conditions, unsafe working environments, long working hours, irregular working schedules, and the lack of occupational training may negatively influence the HRQOL of workers. To improve workers’ HRQOL, intervention programs should focus on improving work environment, working schedule, occupational training and restricting working hours.

Factors that impact health-related quality of life in adults with celiac disease:A multicenter study

AIM: To evaluate the factors involved in the impairment of health-related quality of life (HRQOL) in patients with celiac disease.METHODS: A multicenter, cross-sectional prospective study was performed in patients with celiac disease who completed two HRQOL questionnaires: the gastrointestinal quality of life index (GIQLI) and the EuroQol-5D (EQ).RESULTS: Three hundred and forty patients (163 controlled with a gluten-free diet, and 177 newly diagnosed with a normal diet) were included. The GIQLI score was significantly better in patients on a gluten-free diet (GFD) than in non-treated patients on their usual diet, both in terms of the overall score (3.3 vs 2.7, respectively; P < 0.001), as well as on the individual questionnaire dimensions. Both the preference value of the EQ as the visual analogue scale were significantly better in treated than in non-treated patients (0.93 vs 0.72 P < 0.001 and 80 vs 70 P < 0.001, respectively). Variables significantly associated with a worse HRQOL score were female gender, failure to adhere to a GFD, and symptomatic status.CONCLUSION: In untreated celiac disease, the most important factors that influence patient perception of health are the presence of symptoms and a normal diet. HRQOL improves to levels similar to those described in the general population in celiac disease patients well controlled with a GFD.

The effects of an exercise program on health-related quality of life in postpartum mothers: A randomized controlled trial

Background and Objective: There is controversy on the psychological effects of postpartum exercise. The study aimed to evaluate the effectiveness of a postpartum exercise program on health-related quality of life and psychological well-being. Methods: We conducted a randomized controlled trial in Tokyo, Japan. The intervention groups participated in ball-exercise classes (weekly exercise of 90 minutes for four weeks) at three months postpartum. The exercise class included the following: 1) greeting and warm-up;2) aerobic exercise involving bouncing on an exercise ball 55 or 65 cm in diameter;3) rest and self-introduction;4) stretching and cooling down. The primary outcome measure was health-related Quality of Life (QOL) assessed using the MOS Short-Form 36-Item Health Survey (SF-36v2). The secondary outcome measures were Rosenberg Self-Esteem Scale (RSES) and Edinburgh Postnatal Depression Scale (EPDS) scores. The intervention group was compared to the control group at four months postpartum. Results: Of the 120 women screened, 110 women met the study criteria. Nine could not be included and the remaining 101 were allocated randomly into intervention and control groups (50 and 51 participants respectively). Analysis of covariance adjusting for baseline values indicated that the SF36 subscales of physical functioning (p = 0.018) and vitality (p = 0.016) significantly improved in the intervention group compared to the control group, although there were no significant differences between the groups in the SF36 Physical Component Summary (PCS) and Mental Component Summary (MCS) scores. The RSES increased in the intervention group (p = 0.020) compared to the control group. No significant group differences were observed in EPDS scores. Conclusions: The postpartum exercise class program provided to healthy postpartum women appears to have contributed to promoting health-related QOL and self-esteem.