Search results for “Quality of life

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46 articles

Primary Healthcare Services and Health-Related Quality of Life of Older Persons with Non-Communicable Diseases: A Narrative Literature Review

Sep 2024 DOI 10.14302/issn.2693-1176.ijgh-24-5233
Fiona AtimCorresponding author

In response to the rising burden of non-communicable disease (NDC), the World Health Organization (WHO) developed tools to enable early detection and management of NCDs in Primary Healthcare centers (PHC). Globally, the prevalence of NCDs remains alarmingly high with 41 million deaths annually. Of these, 17 million people die before the age of 70, and 86% of these premature deaths occur in low-and middle-income countries. This narrative review aimed to assess the effect of PHC services on health-related quality of life (HRQoL) of older persons with NCDs, to critically analyze the potential of the existing literature in informing improvements in PHC services. We searched various databases (PubMed, Springer, Scopus, and ScienceDirect) for relevant literature. Peer-reviewed articles on the influence of PHC services on HRQoL among older persons with NCDs written and published in English between January 2013 and May 2024 were considered. The review indicates that effective PHC services are linked to good HRQoL. However, PHC services are sub-optimal and poor in low- and middle-income countries, hence more health interventions are essential to improve PHC services to enhance HRQoL of older persons.

Health-Related Quality of Life Perception Among Older Persons with Non-Communicable Diseases in Primary Healthcare Facilities: A Qualitative Inquiry

Sep 2024 DOI 10.14302/issn.2693-1176.ijgh-24-5215
Fiona AtimCorresponding author

Background The understanding of older persons with non-communicable diseases (NCDs) regarding health well-being is paramount and can translate to increased self-efficiency, independence, and enhanced well-being. However, little is known about older persons' understanding of the concept of health-related quality of life (HRQoL) in Uganda. The study explored perceptions and unveiled understanding of older persons with NCDs on HRQoL in central Uganda. Methods This exploratory qualitative study design involved 23 participants recruited from selected Primary healthcare facilities in Central Uganda. Thematic analysis using an inductive approach generated themes that informed the study's qualitative findings. Results The study highlighted the physical domain as a key component of HRQoL, encompassing holistic well-being, lifestyle modification, and financial stability. To promote well-being and support a healthy aging journey, it is essential to adopt a person-centered approach that aligns with the perceptions of older adults on HRQoL.

Investigation of Physical and Mental Fatigue, Perceived Social Support and Quality of Life in Greek Social Workers: The Role of Demographic and Occupational Characteristics

Feb 2024 DOI 10.14302/issn.2641-4538.jphi-24-4928
Theofilou ParaskeviCorresponding author

The present study focuses on the investigation of fatigue, social support and quality of life that characterizes social workers. Furthermore, the study aims to highlight the effect of demographic and occupational characteristics on the above factors. A total of 400 social workers with an average age of 39.05 years took part in the research. Most were women, single, residents of cities of more than 100,000, and health care workers. Participants were asked to answer online questionnaires (FAS for fatigue, MSPSS for social support and GHQ-28 for quality of life). From the analysis of the data, it was found that the level of fatigue of the social workers is at low levels. At the same time, the level of occurrence of negative symptoms is also low, with physical symptoms appearing more often than the rest. Participants receive a high level of support from their environment, and more so from the "significant other" in their life. Finally, it was found that the fatigue, social support and quality of life of social workers is affected by the age of the social workers, the total years of service, gender, marital status, place of residence, employer and position of responsibility.

Orthorexia Nervosa and Quality of Life in an Austrian Sample of Young Adults – An Exploratory Study

Aug 2023 DOI 10.14302/issn.2379-7835.ijn-23-4701
Steiner-Hofbauer VerenaCorresponding author

Young adulthood is a sensitive phase that comes with many developmental tasks. Successful mastery of these challenges is crucial not only for long-term physical and mental health. A positive relationship with one's own body and associated healthy dietary and behavioral patterns are essential building blocks for healthy adolescence and adult life. But being overly concerned with healthy food may lead to decreased quality of life and negative (mental) health outcomes. This study was conducted via a cross-sectional online questionnaire including the Düsseldorfer Orthorexieskala(DOS), the WHO Quality of Life BREF and questions about life style and nutritional habits. We investigated the prevalence of ON and its relationship with different aspects of quality of life and lifestyle factors (sport and nu trtional habits) in a sample of young adults in Austria. No significant difference in the DOS-scores of male and female participants were found and no significant difference between students and non-students. High DOS-scores significantly impair all three domains of QoL. We did not find a significant relationship between high DOS-scores and taking nutritional supplements or being vegan, vegetarian or omnivore. Participants with high DOS-scores spent significantly more hours per week with sport/exercising.

Human Health Research Open Access

Assessment of Oral Health-Related Quality of Life Among a Sample of Yemeni Population

Mar 2023 DOI 10.14302/issn.2576-9383.jhhr-22-4178
Abdulwahab Al-Shamahy HassanCorresponding author

The study aimed to assess the oral health condition and its impact on the quality of life (QoL) among a sample of Yemeni population. The study including 256 individuals who responded to the Oral Health Impacts Profile (OHIP) through completing a face-to-face survey of the OHIP-14 Arabic version. The data were collected by one dentist trained in the terms of oral health-related quality of life (OHRQoL). The study revealed that the impact of OHRQoL among the study sample was found with a weighted OHIP-14 score of 1.1 (±0.9). Physical pain (3.7±2.3), followed by physical disability (2.4±2.2), and psychological disability (2.1±2.3) were the highest scoring. A significantly higher effect (p < 0.05) was found for the adults (18-44 years old) compared to those elderly individuals (> 64 years). The OHRQoL was better in male than in female and in employees than in both pensioners and un-employees. Females had a significantly higher effect when compared to males in the OHRQoL (p < 0.05). The unemployed subjects were significantly higher than those pensioners and employees in the OHRQoL (p < 0.05). The OHRQoL was also better in subjects with higher income and education than those participants with low. However, there were no significant differences for OHRQoL with respect to the educational level and monthly income of participants (p > 0.05). Conclusion, the quality of life is greatly affected by the oral health conditions of the elderly. This impact of oral health on quality of life has an association with individual and contextual variables.

Self Determination and Quality of Life: a Comparison of the Measurement Scales for Students with Intellectual Disabilities

Feb 2019 DOI 10.14302/issn.2643-6655.jcap-18-2570
Emanuela ZappellaCorresponding author Department of Human and Social Sciences, University of Bergamo, Italy

Self-determination is a key concept to promote greater self-awareness in the subjects with disability, to build appropriate educational or professional projects and to evaluate the already active programs. Using PRISMA checklist, I selected articles from different databases (CINAHL, Medline, Psych INFO, Cochrane Library, ERIC, Scholar. The 9 evaluation measures identified are analyzed with respect to: choice of the points of view to be collected, domains, items and data collection methods. The results show that while some scales focus on autonomy, empowerment, self-realisation and self-regulation and others focus on knowledge, skills and abilities, attitudes and beliefs. Two instruments added also: opportunities and support. With respect to the choice of the points of view to be collected: in some cases the student’s opinion is collected but in other cases their point of view is integrated or replaced with that of teachers and parents. Only one tool is designed for all children and starts from the belief that self-determination is important for all people, including those with a disability. A third element of the analysis is the possibility of answering the questions posed by the various evaluation tools. A typical form is Likert scale while in other cases open questions are used. The analysis highlights two critical issues. The variety of definitions of self-determination is inevitably reflected in the choice of domains and items and therefore self-determination is only partially investigated. Secondly the opinion and people with disabilities are sometimes completed or replaced by that of third persons as parents and teachers. Starting from the analysis of existing instruments. the article closes with a reflection on the possibility of constructing a scale that considers all the aspects of self-determination offered in the literature (at the individual and environmental level) and collects the opinion of all the subjects involved in self-determination projects. This synthesis represents a first step in the construction of a possible universal scale starting from the analysis of the literature. A comparison would then be necessary with the students with intellectual disabilities, the family members and the other actors involved to understand which domains are really meaningful to them and to build indicators that correspond to the elements that are important to them. In this way we would have a tool capable of combining the point of view of literature with that of the people directly involved.

Biopsychosocial Path Model of Self-Management and Quality of Life in Patients with type 2 Diabetes

May 2017 DOI 10.14302/issn.2374-9431.jbd-17-1465
Bazzazian SaeidehCorresponding author Department of Psychology, Faculty of Human Sciences, Abhar Branch, IslamicAzad University, Abhar, Iran

Objectives: The present study investigated biopsychosocial predictors (HbA1c, self-efficacy, and social support) of self-management and health-related quality of life among patients with type 2 diabetes. Methods: 160 adults referred to the Iranian Diabetes Society participated in this study. Participants completed General Self-Efficacy Scale, Perceived Social Support, Diabetic Self-care Behaviors scale, and D-39 (diabetics’ quality of life). Results: Data were analyzed with SPSS-19 and Lisrel 8.8, utilizing statistical path analysis. Results revealed significant positive correlations between self-efficacy and social support subscales, self-care and health-related quality of life. Also, HbA1c had not correlation with HRQOL. The final path model fitted well and showed that direct self-care paths with (β = 0.24) and indirect social support with (β = 0.32) had the most effects on health-related quality of life. Conclusions: The results confirmed the theoretical model and scientific evidence for providing psychological solution to promote quality of life in patients with type 2 Diabetes.

Ophthalmic Science Open Access

Influence of Visual Impairment on The Quality of Life: A Survey of Patients Reporting at The Low Vision Centre of the Eastern Regional Hospital Of Ghana

Jul 2016 DOI 10.14302/issn.2470-0436.jos-16-940
Ofeibea Amedo AngelaCorresponding author Department of Optometry and Visual Science, Kwame Nkrumah University of Science and Technology, Private Mail Bag, Kumasi, Ghana

Our aim was to evaluate the influence of visual impairment on the quality of life of patients reporting at the low vision centre of the Eastern Regional Hospital in Koforidua. The World Health Organization Quality Of Life (WHOQOL-Bref) which assesses quality of life in four main domains was administered to two hundred and ninety four (294) patients who visited the low vision centre of the Eastern Regional Hospital, for various eye services. Additional information on patient demographics and their visual acuities were obtained. The mean quality of life scores were determined for the visually and non-visually impaired. 86(29.3%) of the participants were visually impaired (presenting vision worse than 6/18). A significant difference in mean age was realized between subjects who were visually impaired (53.7 ± 18.4) (mean ± SD) and subjects who were not visually impaired (34.3 ± 13.1) (p = 0.001). The visually impaired participants had a lower quality of life scores in all four domains of quality of life naming, environmental, physical, social and psychological with 7.5% unadjusted reduction in overall quality of life. Visual impairment is associated with significant reduction in different quality of life domains for this population. Quality of life is poorer with increasing severity of visual impairment.

Efficacy and Safety of Pulsed Magnetic Therapy in Sleep related Disorders: A Remote, Randomized, Double-Blind, Placebo-Controlled Trial

Mar 2026 DOI 10.14302/issn.2574-4518.jsdr-26-6010
Marmann PeterCorresponding author

Background/Aim Sleep disturbances are common and are associated with impaired daytime functioning, reduced quality of life, and increased health risks. Non-pharmacological neuromodulatory interventions have gained interest as alternatives to hypnotic medication. Pulsed electromagnetic field (PEMF) therapy has been proposed as a non-invasive approach to improve sleep quality and recovery, but evidence from large, well-controlled trials remains limited. The objective of this study was to evaluate the efficacy and safety of pulsed magnetic field therapy (PMT) on sleep quality, sleep-related symptoms, daytime functioning, and well-being in adults with heterogeneous sleep complaints.  Materials and Methods In this remote, randomized, double-blind, placebo-controlled trial, 217 adults reporting non-restorative sleep, difficulties initiating sleep, or frequent nocturnal awakenings were assigned to active PMT using a PEMF device (Night Harmony Female/Male protocol) or a sham application for three weeks. Primary outcomes were changes in the Pittsburgh Sleep Quality Index (PSQI) global score and self-rated sleep satisfaction, restfulness, and sleep initiation difficulties. Secondary outcomes included sleep diary measures, daytime functioning, well-being (WHO-5), symptom burden (MYMOP), and daytime sleepiness (Epworth Sleepiness Scale). Analyses followed the intention-to-treat principle using ANCOVA with baseline values of the respective parameter as covariate.  Results Both groups showed significant improvements over time in global sleep quality and most secondary outcomes (p < 0.001). Between-group differences in PSQI global score were not significant (p = 0.314). However, active PMT resulted in significantly greater improvements in subjective sleep satisfaction (p = 0.02) and restfulness (p = 0.02), particularly among participants with moderate to severe baseline sleep disturbances (p < 0.001 for both). Sleep continuity measures improved similarly in both groups. No serious adverse events were reported.  Conclusions PMT produced modest but significant improvements in subjective restorative aspects of sleep beyond placebo effects and was well tolerated. Further studies using objective sleep measures and longer follow-up are warranted.

The Effectiveness of Cognitive-Analytic Therapy in Women Diagnosed with Breast Cancer and Post-Traumatic Stress Disorder

Jan 2026 DOI 10.14302/issn.2574-612X.ijpr-25-5920
Aikaterini ΚoutroukiCorresponding author

The present study examines the effectiveness of Cognitive-Analytic Therapy (CAT) in women diagnosed with breast cancer and Post-Traumatic Stress Disorder (PTSD) on reducing PTSD symptomatology and improving their mental health state (depression, self-esteem, post- traumatic growth, quality of life, therapeutic alliance). Additionally, the investigation includes the determination of the demographic, socio-economic and medical factors’ impact on mental health indicators in women with breast cancer and PTSD. The sample was 188 women with breast cancer and PTSD at the Chemotherapy Unit of ‘Agios Andreas’ General Hospital in Patras. The questionnaire data were analyzed using descriptive and inferential statistical analysis in order to determine any statistically significant correlations between the experimental and the control group and between psychological scales and the demographic and socio-economic factors. The findings confirm the effectiveness of CAT in women with breast cancer and PTSD in reducing PTSD and depressive symptoms, improving self-esteem and quality of life, achieving greater post-traumatic growth, and fostering a better therapeutic relationship with the therapist. The demographic, socio-economic and medical factors examined affected dissimilarly each psychological scale, as statistically significant associations were found with some scales but not with others.

Psychosocial Interventions in Bipolar Disorder

Dec 2025 DOI 10.14302/issn.2574-612X.ijpr-25-5849
Yılmaz GülsümCorresponding author

Bipolar disorder is a chronic condition marked by episodes of mania and depression, significant functional impairment, and challenges with treatment adherence. Current guidelines highlight the importance of both medication and psychosocial approaches in treatment. This review explores the primary psychosocial interventions for bipolar disorder. Psychoeducation helps recognize early symptoms, improves medication compliance, and prevents relapses. It is simple to implement and cost-effective. Family-Focused Therapy (FFT) enhances family communication, reduces emotional expression, and lowers the frequency of depressive episodes. Interpersonal and Social Rhythm Therapy (IPSRT) supports maintaining social stability by addressing disturbances in biological rhythms. Cognitive Behavioral Therapy (CBT) decreases depressive symptoms and boosts treatment adherence by restructuring automatic thoughts. Additionally, cognitive and functional rehabilitation programs improve attention, memory, and executive functioning. Peer support groups and digital e-health tools, though supportive, have limited evidence of effectiveness. In summary, multicomponent psychosocial interventions serve as a valuable addition to medication, helping to prevent relapses, improve functioning, and enhance quality of life in individuals with bipolar disorder.

Prevalence of Burnout, Secondary Traumatic Stress, Anxiety, and Depression Among Maternal and Neonatal Healthcare Staff in Two Tertiary Hospitals in Zambia

Nov 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5745
Poole JolyonCorresponding author

Background Healthcare worker stress, anxiety, burnout, and trauma have been widely documented across global healthcare systems. Staff in maternal and neonatal units frequently encounter emotionally distressing events and work under high pressure with limited resources. In Zambia, despite some gains in reducing maternal and neonatal mortality, fatality rates remain above national targets, exposing staff to repeated occupational trauma. Objective(s) This study aimed to assess the psychological well-being of staff in maternal and neonatal intensive care units, identify specific needs and stressors, and develop practical recommendations to improve resilience and support staff mental health. Methods A mixed-methods cross-sectional study was conducted at Ndola Teaching Hospital (NTH) and Arthur Davison Children's Hospital (ADCH), two major tertiary hospitals in Zambia. Data were collected over four days in February 2025. The study included 87 (out of 161) healthcare professionals, including nurses, midwives, and doctors. The Goldberg Anxiety and Depression Scale (GADS) and the Professional Quality of Life Scale Version 5 (ProQOL 5) were used to collect quantitative data, which were analysed using descriptive statistics and 95% confidence intervals (CI). Open-ended survey questions provided qualitative data, which were analysed using thematic analysis. Ethical approval was granted by the hospital ethics committee. Results High rates of clinical symptoms were observed. The overall prevalence of symptoms in the past 30 days was: anxiety (62%), depression (68%), burnout (50%), and secondary traumatic stress (46%). Junior doctors demonstrated the highest rates of depression (83%) and burnout (67%). The obstetrics and gynaecology and labour wards had the highest rates of secondary traumatic stress symptoms. Key qualitative themes identified were professional stressors, team and leadership issues, and the emotional burden of the work. Conclusion This study highlights an urgent need for both psychological and organizational support for maternal and neonatal healthcare staff in Zambia. The findings indicate that burnout and secondary traumatic stress are highly prevalent, particularly among junior doctors and those in high-risk wards. Targeted interventions at both systemic and individual levels are necessary to protect the well-being of healthcare workers and improve patient outcomes.

ADHD And Care Open Access

Effectiveness of Mindful Routine in Attention Deficit Hyperactive Disorder (ADHD) Children

May 2024 DOI 10.14302/issn.3066-8042.jac-24-4991
Samantaray SoumyashreeCorresponding author

Attention deficit hyperactive disorder is characterised by set of neurological based symptoms in children which falls into broadly two categories; inattention and hyperactive impulsive behaviour. It adversely affect child in various areas like social skill, communication, routine of daily life, academic performance and many.It not only affects the child but also other family members. ADHD often creates unproductive pattern, spouse conflict and poor quality of life. Because of executive function issue, ADHD child face difficulty in establishing and maintaining routines from morning to night which increase demands on parents. As a result parents becomes more exhausted ,emotionally triggered and breakdown.This study shows establishing consistent mindfulness routine make daily life simpler and easier for both the parent and children with ADHD.

The Potential Usefulness of Peripheral Somatosensory Stimulation in Improving Sleep Quality in Patients with Insomnia

Feb 2024 DOI 10.14302/issn.2574-4518.jsdr-24-4949
Nussbaum LACorresponding author

Background Insomnia and other sleep disorders represent a major cause of disability and impaired productivity. We evaluated the impact of peripheral somatosensory stimulation (PSS) on sleep quality in 12 patients with varying degrees of insomnia. Methods Twelve adult patients underwent daily PSS therapy for a 4-week period and were evaluated using the Insomnia Severity Index at baseline (prior to initiation of therapy) and then at the conclusion of the treatments. All data were obtained through a self-reported 7-question survey evaluating overall severity of insomnia symptoms and the impact of sleep patterns on satisfaction with sleep, daily functioning, and overall quality of life. Changes from baseline insomnia scores were analyzed using cumulative link mixed models (CLMMs). Results Seven men and five women completed one month of PSS therapy. Mean age was 55.1 (range 29 to 80 years). No adverse events were described by the patients. The average total change from baseline score was -10.3 points (baseline: 16.5 vs. week 4: 6.2). Patients had statistically significant improvements for every individual survey question by week 4. The median composite score was improved from baseline, with an overall median score of 2 (IQR: 1.25 – 2.75, min-max: 1-4) at baseline compared to 0.5 (IQR: 0 – 0.25, min-max: 0-2) by week 4 (MD = -1 95% CI: , p < 0.001), signaling typically moderate insomnia at baseline vs. typically minimal to no symptoms by week 4. The predicted probability of obtaining the best outcome (score=0) was 9% at baseline vs. 53% by week 4. The overall cumulative odds ratio was 11.9 (p < 0.001), suggesting that on average, the odds of moving from one score to a lower (improved) score at week 4 compared to the baseline are approximately 12 times higher than moving to a neutral or worse score. Conclusions PSS stimulation appeared to have a significantly favorable effect on sleep quality in this group of patients. Symptoms related to ability to fall asleep, remain asleep, and overall quality of sleep were all improved with PSS therapy. We suggest that further investigation into the potential usefulness of PSS therapy in patients with sleep disorders is warranted.

The Role of Non-Pharmacological Interventions for Disrupted Sleep in the Moderate-Severe Dementia Population: A Systematic Review

Feb 2024 DOI 10.14302/issn.2998-4211.jalr-23-4813
del Carmen Teruel Hernández EstherCorresponding author

This study systematically reviews the literature on non-pharmacological interventions for disrupted sleep-in people meeting established criteria for moderate-severe dementia, and to analyze the methodological quality of the included studies. The PubMed, PEDro, Cochrane, Virtual Health Library, APA PsycInfo databases were searched using a systematic literature review approach to identify various types of non-pharmacological treatments that improve disrupted sleep-in subjects with moderate-severe dementia. In accordance with the inclusion criteria, eight studies were systematically reviewed and analyzed according to the type of non-pharmacological treatment carried out. This systematic review showed that 50% of the studies used bright light therapy, 12.5% ​​the use of manual therapy, and 37.5% sleep hygiene or walking or a combination of these interventions. Based on the results of the present study, although there is some evidence to support these strategies, it is not significantly supported and highlights variation in the way the interventions were delivered. Disrupted sleep is highly prevalent in people with dementia and have a negative impact on the quality of life of the sufferer and the caregiver. Non-pharmacological approaches to its treatment are increasingly popular as an alternative to drugs, whose efficacy and side effects have raised concerns among the population. Currently, there is a need to carry out more future research to establish its effectiveness and to be able to provide clear guidelines at the time of clinical practice.

Effect of Ultra-Processed Foods Consumption on Sleep Disturbances Among Brazilian Adults’ Population: A Propensity Score Matching Approach

Dec 2023 DOI 10.14302/issn.2574-4518.jsdr-23-4775
Zanga RosendoCorresponding author

Background Diet, exercise and sleep are three pillars of a healthy life. These lifestyle factors influence one another in complex and dynamic ways. Consistent evidence exists about the bidirectional relationship between sleep patterns and food intake. Objectives We aim to assess the effect of the ultra-processed food(UPF) consumption on sleep disturbances in a sample of the Brazilian adults. Method We analyzed 77,298 persons aged 18 and older from the Brazilian National Health Survey (2019). A Propensity Score Matching (PSM) approach was used to address confounding bias and balance the matched exposed and control groups. The population average treatment effect (PATE) and the population average treatment effect on the treated (PATT) were estimated. Also, the Absolute Risk Increase and the Relative Risk Increase were computed. Results The findings revealed that Brazilian adults who consumed UPF experienced small but statistically significant sleep disturbances compared to non-UPF users. Furthermore, salty UPF showed small but significant worsening of sleep compared to sweet UPF users. Conclusion The consumption of UPF is associated with sleep disturbances in Brazilian adults. The consumption of salty UPF had a more significant effect on sleep disorders than sweet UPF in the overall population. However, among individuals who already consumed sweet or salty UPF, these foods had a more significant effect on sleep disorders. To gain a deeper understanding of the complex relationship between UPF consumption, sleep disorders, and their impact on health and quality of life, further research is needed, including precise measurements and consideration of personality traits using prospective designs.

Human Health Research Open Access

Estimation of Glycemic Index of Liver Nutritional Supplement and its Importance in Liver Nutrition

Sep 2023 DOI 10.14302/issn.2576-9383.jhhr-23-4713
Bhoite RachanaCorresponding author

A global increase in incidence of chronic liver disease (CLD) indicated the necessity of dietary and lifestyle modification. Low glycemic index (GI) diet was reported to have a significant role in controlling diabetes caused by liver dysfunction. The International Standards Organisation (ISO) has standardized the determination of GI of a food in healthy individuals. This study aimed to estimate GI value of a high protein, energy dense liver nutritional supplement. This cross-over randomized controlled study randomly allotted 15 participants to consume either reference food 27.5 gm glucose (glucose monohydrate) or 77 gm nutritional supplement (equivalent to 25 gm of available carbohydrates); switching to another arm was done after 3 days wash-out period. After overnight fast, blood samples were collected at 15, 30, 45 and 60 minutes post-consumption of s upplement or reference food. The GI was calculated from the incremental area under the blood glucose response elicited by the nutritional supplement as a percentage of the response after consumption of 27.5 gm of glucose (glucose monohydrate) by the same participant using a standard formula. Mean GI of the nutritional supplementwas estimated as 11.4 ± 2.4.With the consumption of this nutritional supplement, the blood glucose levels were reduced at all postprandial time points, compared to the reference food. The liver nutritional supplement tested has a low GI, and comparatively slower and more sustained blood glucose response. Therefore, it can be used in patients with CLD to prevent CLD-associated metabolic complications and improve health outcomes and quality of life.

Human Health Research Open Access

A Note from the Field “Potlatch” Advancing a Health Survey: The Pen is Truly Mighty

Dec 2022 DOI 10.14302/issn.2576-9383.jhhr-22-4397
J Johnson RalphCorresponding author Research PA-C/Research Coordinator, University of Texas MD Anderson Cancer Center

Despite vast improvements in chemo-therapeutic interventions extensively extending the life span of patients with chronic and terminal diseases, there also is the unhappy extension of side- effects and adverse events. Thus, Health-Related Quality of Life (HR-QoL) becomes equally as important as length of life. Accurately, reliably, validly, and representatively measuring the on-going pulse beat of HR-QoL means ensuring optimal responses and response rates, which in turn means fostering and maximizing Survey Participants’ continued rapport, enlistment, engagement, and participation regarding HR-QoL research survey studies. This is generally true regarding all human subjects’ research. HR-QoL survey work at a nationally renowned Cancer Center recently identified an example of Potlatch or gift-giving (i.e., gifting), and its surrounding nuances, that were calculated and appear to evoke enhanced reciprocal engagement in a HR-QoL survey. This work involves continuous, iterative marketing study. The intent of this field note is to describe the methodological phenomenon that may have epistemological and theoretical relevance for ubiquitously advancing the interest of health survey research. Specifically, the contention will be that considered, and tactically deployed Potlatch can serve as a mechanism for facilitating and enhancing health survey research as well as enhancing stronger social engagement in research and treatment for patients undergoing medical care for long-term, chronic illness. First, it can rejuvenate and refocus Survey Participants’ involvement. Second, it can serve as an entrée and springboard to further forge a social connection in the interest of research. Lessons Learned and implications are reported.

Two Implant Mandibular Overdentures: Clinical and Laboratory Procedures

Nov 2021 DOI 10.14302/issn.2473-1005.jdoi-21-3988
Muhamad Abu-HusseinCorresponding author Practice limited to Children's Dentistry, Aesthetics Dental Clinic, Athens, Greece

Edentulism is considered a poor health outcome and may compromise quality of life. Implant-supported overdentures provide a good opportunity for dentists to improve the quality of life and oral health. Atrophic mandible poses a significant challenge to successful oral rehabilitation with dental implants. The aim of this case report is to demonstrate the concept of immediate functional loading in the mandible using unsplinted implants to support a locator attachment supported overdenture.

Virtual Reality in the Care of People with Dementia: A Single-Case Research Study

Dec 2020
K. Gusdal AnnelieCorresponding author School of Health, Care, and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden

More than 90% of people with dementia develop behavioral and psychological symptoms of dementia. First-line care strategies in dementia care should consider a combination of pharmacological and non-pharmacological interventions. The present single-case research study aimed to evaluate the use of virtual reality in the context of behavioral and psychological symptoms of dementia, quality of life, and medication use among people with dementia. Ten persons with dementia used virtual reality for a mean of twice per week for eight weeks. In each virtual reality session, lasting for a maximum of 30 minutes, the persons with dementia chose one to three short films from 11 different films: a hen run, a farm with animals, two cafés, an old-fashioned grocery shop, a local river, a square in the local city, a museum, a castle, a fishing boat and an Austrian mountain scenery. Quantitative and qualitative data were collected pre-, during, and post-intervention. No major differences in the quantitative data in terms of behavioral and psychological symptoms of dementia, quality of life, or medication use were observed. However, the qualitative data showed that the use of virtual reality provided the persons with dementia with short-term enjoyment, heightened energy and alertness, and an experience of reminiscence. The use of virtual reality may therefore serve as a complementary tool to the existing non-pharmacological management techniques of people with dementia in nursing homes.

Daily Grape Juice Consumption Promotes Weight Loss, Improved Stability and Reduced the DNA Damage in the Elderly

Jul 2020 DOI 10.14302/issn.2379-7835.ijn-20-3448
Dani CarolineCorresponding author Laboratório de Bioquímica, Centro Universitário Metodista – IPA, Porto Alegre/ RS, Brazil.

The aim of this study was to determine the influence of chronic supplementation with grape juice (400ml), in modulating the anthropometric and biochemical parameters. Thirty-nine seniors participated and were evaluated at baseline after 30 days. The chronic consumption of grape juice reduced weight, BMI and waist circumference. Indeed, the consumption modulated biochemical parameters, decreased the total cholesterol levels, Low-density lipoprotein (LDL) cholesterol, Urea and GGT. In addition, the intake of juice improved the performance in the TUG test, and caused more stability in the elderly. The levels of protein oxidation declined and the antioxidant potential significantly increased as well as SOD and the ratio SOD / CAT. In contrast, levels reduced sulfhydryl groups to consumption. In nuclear changes there are  a decrease in the frequency of MN and picnosis. In conclusion, grape juice could be an excellent option to improve quality of life in elderly.

Invivo Impact of Malaria and HIV Co-Infection on CD4 Cell Count of Infected Patients of Niger Delta Extraction

May 2020 DOI 10.14302/issn.2328-0182.japst-20-3347
Obioma AzuonwuCorresponding author Department of Medical Laboratory Science, Medical Bacteriology / Virology / Parasitology Unit, Rivers State University, Nkpolu – Oroworukwo, Port Harcourt, Rivers State, Nigeria.

The study evaluated the impact of co-infection of malaria parasitaemia, and HIV positive indices on the CD4 cell count of 120 HIV infected subjects, who were already diagnosed and visiting Braithwaite Memorial Specialist Hospital Port Harcourt for routine Medical check-up. Also, a control group of 40 HIV negative were included as part of the study control group. The subjects were between the age ranges of ≤10–79 years respectively. A double check laboratory assay was conducted to detect the presence of antibody to HIV as confirmed using immunocomb 11 and Determine for HIV status. A thick Blood film stained with field stain (A and B) was used to detect the presence of malaria parasite in the subject’s blood. Furthermore, CD4 cell count was assayed using Partec cyflow counter (Partec, Germany). Excel and Graphpad statistical software were used for analysis of the data generated. The result among the HIV positive subjects and control subjects revealed that the highest positive for malaria infection was observed among ≤10 years age group as 2 (100%) and 11 (84.61%) respectively. In the HIV positive subjects, the distribution of malaria infection among sex revealed a high rate in male 42(77.78%) than in female 44 (66.67%). Similarly, the control recorded a high rate of malaria infection in male 11 (57.89%) than in female 7 (33.33%). However, 86 (71.67%) had malaria and HIV co-infection while 34 (65%) had only HIV mono infection. The positive HIV subjects who had CD4 cells count below 200 cells/mm3 were 15%, above 200-499cells/mm3 were 58.3% while 500 cells/mm3 and above had normal CD4 cells counts for 26%. Nonetheless, for the control subjects, no CD4 cells count of below 200cells/ mm was observed, 2.5% fell within the moderate category while 75% had normal CD4 cells count. Statistical analysis using ANOVA and t-test showed that there is significant difference between CD4 of seropositive and seronegative subjects infected with or without malaria (p=0.00). In addition, a t-test further demonstrated Comparison of Mean CD4 Cell Count among HIV and Malaria Infected and Non-Infected Subjects. MP/HIV Co-Infection and Mono Infection with No Infection showed strong mean difference (p=0.00) in the various CD4 counts while HIV Mono-Infection and others only had a non significant (p=0.44) mean difference between HIV Mono-Infection and No HIV or Malaria Infection. A robust and effective malaria and HIV control management programme should be strongly underpinned; so as to improve the quality of life of patients and HIV patients should be encouraged to live a healthy life style, through the provision of antiretroviral drugs and regular health education engagement, even as the provision of antimalarial treated net would be helpful to the subjects.

Relationship Between Body Composition and Nutritional Status in Brazilian Nonagenarians

Apr 2019 DOI 10.14302/issn.2379-7835.ijn-19-2645
José Gonçalves Bós ÂngeloCorresponding author Professor of School of Medicine at Pontifical Catholic University of Rio Grande do Sul. Porto Alegre, Brazil

Introduction Brazil has undergone considerable changes in age distribution, particularly in nonagenarians. Allied to this reality, there is a series of nutritional disorders in this population segment. An important factor related to quality of life and healthy aging is good nutrition throughout life. Objective To observe the possible relationship between nutritional status and body composition in nonagenarians. Methodology This is a descriptive, cross-sectional and analytical study, with participants aged 90 years or older, evaluated using the Mini Nutritional Assessment (MNA), anthropometric parameters, and Bioimpedance. Results The sample consisted of 72 nonagenarians, averaging in age 93.7 years, most female (72%), white (82%) and widowed (64%), 19.4% were in nutritional risk, based on the MNA criteria. All anthropometric parameters presented lower averages among nonagenarians in nutritional risk. Regarding the bioimpedance parameters, in general the risk-free nonagenarians presented higher averages of weight, maximum ideal weight, minimum ideal weight, BMI, lean-mass, fat-mass, percentage of fat-mass and minimum percentage of fat-mass. Conclusions Most nonagenarians were in good nutritional status. Both anthropometric and bioimpedance parameters were effective to discriminate between normal and at nutritional risk nonagenarians. We also concluded that nutritional risk assessment in nonagenarians patients requires a joint analysis of the several existing methods for the nutritional evaluation, in order to obtain global diagnosis and accurate analysis of the nutritional status of the nonagenarians.

Respiratory Diseases Open Access

Diaphragmatic Pacing as an Alternative to Mechanical Ventilation: Early Experience from a Developing Country

Mar 2019 DOI 10.14302/issn.2642-9241.jrd-19-2689
A. S. Sardenberg RodrigoCorresponding author Chief of Thoracic Surgery, Hospital Paulistano, Americas Serviços Médicos São Paulo, Brazil

Background The aim of this study is to evaluate the outcomes of patients submitted to diaphragmatic pacing, and the impact on quality of life of patients who chronically depend on mechanical ventilation, as well as the effectiveness of phrenic stimulation to eliminate the need for mechanical ventilation. Methods From 2010- 2014, 10 patients completely dependent on mechanical ventilation were operated upon, with the implantation of phrenic pacing device. The diagnoses were quadriplegia and congenital central hypoventilation syndrome (CCHS). All patients underwent bilateral approach to the phrenic nerves, by video-assisted thoracic surgery or mini-thoracotomy. Results All patientsstarted pacing 30-40 days post-operatively. The mean age of patients was 12.1 years (2-27 years range) with a median of ten years. Six patients (54.5%) were as old as ten years, and three (27.2%) were older than 20 years. Younger patients had CCHS and older ones were quadriplegic. All patients with CCHS (n = 4) were nine years old or younger while only two quadriplegic patients were in this age group. Conclusions Diaphragmatic pacing can provide improvement in the quality of life of patients who depend on mechanical ventilation, allowing freedom to conduct daily activities, lower respiratory infections, and tracheostomy decannulation.

Family Medicine Open Access

The Temporal World in Caregivers of Cancer Survivors: Intertextual Analysis of their Experiences about the Perception of Time Compared with Excerpts from the Book "Einstein's Dreams

Jan 2019 DOI 10.14302/issn.2640-690X.jfm-19-2604
Vargas RafaelCorresponding author Facultad de Medicina, Universidad Antonio Nariño, Bogotá, Colombia.

Purpose: The perception of time and its measurements depend on subjective constructs that vary according to changes in health. The evidence has shown that cancer diagnosis induces new relationships with time in patients and caregivers. The purpose of this study was to propose a multifaceted view about time perception referred by caregivers of cancer survivors. Methods: This study used a qualitative phenomenological methodology including semi-structured interviews with caregivers of cancer survivors. Transcripts of the interviews were analyzed using an approach for intertextual analysis, taking as reference the book "Einstein's dreams". Results: The analysis of transcripts shows changes caregivers’ time perception. Participants were grouped into three essential moments related to each stage of the disease. The variations found in the perception of time in caregivers can be explained by common physiological and behavioral responses associated with the diagnosis of a chronic disease (i.e. stress, anxiety, fear, unhappiness, and sadness), which can be modified in the course of the disease. Conclusions: We propose that a holistic approach to patient and caregiver care should include management of time perception, thus establishing interventions that facilitate a change in the experience of time perception into a more pleasant experience after a cancer diagnosis. The above may result in increased quality of patient care and possibly increased quality of life of caregivers.

First Year University Students Self-Reported Health Outcomes Over an Academic Semester

Nov 2018 DOI 10.14302/issn.2474-9273.jbtm-18-2348
Doyle-Baker P.K.Corresponding author Faculty of Kinesiology, University of Calgary, Calgary, AB, T2N 1N4.

The transition to university can be a stressful time in a student’s life. Recent evidence demonstrates declining mental and physical health in college and university students compared to the general public. A prospective cohort study investigating mental and physical wellness over the course of a semester in a sample of first-year undergraduate students (N=74; 65%F) from nine faculties was completed at a large university in Canada. Sixty-eight (92%) students with a mean (SD, ±) age 18.2 ± 1.1 yrs., weight 67.9 ± 15.5 kg, height, 168.5 ± 11.6 cm and waist circumference 81.3 ± 9.8 cm completed the SF-36V2 quality of life questionnaire at the beginning and end of the semester in Fall 2014. A decrease in vitality (p=0.003), social functioning (p=0.004), emotional state (p=0.014), and mental health (p=0.019) outcomes as measured by the SF-36v2 occurred during the semester. In addition, aggregate mental health significantly declined from the beginning to the end of the semester (p <0.001), while physical health did not change (p=0.242). The importance of promoting and increasing awareness of campus wide mental health strategies should be considered a priority for first year undergrad students. Particularly, because students in their first year may take longer than one semester to adjust to the increased work load and although difficult to speculate it is possible that both mental and physical health would decline over the next (second) semester. Future research should aim for longer study duration.

Physiology of Distinct Modes of Muscular Contraction

Oct 2018 DOI 10.14302/issn.2578-8590.ipj-18-2441
Habibzadeh NasimCorresponding author PhD in Sport Science, Department of Sport Science, Teesside University, UK

Physiological changes in musculature allow widespread movements in human body. Correspondingly, varying in muscle prototypes characterise direct different training paradigms in therapeutics practice or can governs athletic performances. Mode of muscle contraction type are isometric, concentric or eccentric. Great examples of concentric exercise are walking- up-hill, stair ascent and lifting a dumbbell in bicep curl or pushing a bar up. Examples of eccentric muscle actions are walking - down-hill, satire decent and, isokinetic arm and leg extensions. During isometric muscle contraction the length of muscle does not change while muscle exert force .This type of movement can be seen while a person performs a maximal voluntary contractions (MVCs).Eccentric exercises increasing the concentric and isometric contraction as well. Performing the eccentric muscle contraction in daily life enhance quality of life and lifespan due to increasing muscle strength with low cost of energy consuming and thus it can apply in variety of domains. A simple walking task such as downhill - walking (i.e. 30 min) can provide the aforementioned conditions.

Assistive Technology and Cognitive-Behavioral Programs for Promoting Adaptive Skills of Persons with Alzheimer Disease: A Selective Review

Sep 2018 DOI 10.14302/issn.2470-5020.jnrt-18-2321
Stasolla FabrizioCorresponding author University "Giustino Fortunato" of Benevento, Italy.

Background: Person with Alzheimer Disease may present cognitive, social, communication, physical, and orientation impairments. Furthermore, individuals with Alzheimer Disease may exhibit challenging behavior, isolation, and passivity. Objectives: To emphasize the role of Assistive Technology-based interventions and Cognitive-Behavioral Programs to improve the independence, and the quality of life of patients with Alzheimer Disease. To assess the effects on teaching adaptive responding, and decreasing challenging behaviors. Method: A selective literature review was carried out considering Alzheimer, Assistive Technology, Cognitive-Behavioral Programs, Adaptive Responding, Challenging Behaviors, and Quality of life as keywords. Twenty-six studies were reviewed. Results: Empirical data demonstrated the effectiveness, and the suitability of the selected interventions, although few failures occurred. The participants involved significantly increased their adaptive responding during the intervention phases, and maintained their performance over the time. Conclusion: Assistive Technology-based rehabilitative programs and Cognitive-Behavioral Interventions may be helpful for promoting the independence and the quality of life of individuals with Alzheimer Disease.

Assessment of Biofield Energy Healing Based Vitamin D3 Effects on Bone Health Parameters Using Human Osteoblast Cell Line (MG-63)

Aug 2018 DOI 10.14302/issn.2379-7835.ijn-18-2301
Jana SnehasisCorresponding author Trivedi Science Research Laboratory Pvt. Ltd.,Bhopal, India

Poor bone health is the primary health issue, which leads to significant health problems, stress and worsening the patients' quality of life. The potential of The Trivedi Effect®- Biofield Energy Healing on vitamin D3 as a test item (TI) and DMEM on MG-63 cells was investigated. The test items were treated with The Trivedi Effect® by Mahendra Kumar Trivedi and divided as Biofield Energy Treated (BT) and untreated (UT) test items. An increase in ALP activity, collagen levels, and bone mineralization was considered as the biomarker for bone health. MTT data showed that the test samples observed nontoxic in the tested concentrations. The level of ALP was significantly increased by 832.9% and 209.4% in the UT-DMEM+BT-TI and BT-DMEM+UT-TI groups, respectively at 10 µg/mL, while 222.9% increase in the BT-DMEM+BT-TI at 1 µg/mL compared to the untreated group. Collagen was significantly increased by 487.7% and 544.5% in the BT-DMEM+UT-TI and BT-DMEM+BT-TI groups, respectively at 100 µg/mL, while 116.2% at 1 µg/mL in UT-DMEM+BT-TI compared to the untreated group. Moreover, the percent of bone mineralization was significantly increased in the UT-DMEM+BT-TI and BT-DMEM+UT-TI groups by 344.9% and 149.7%, respectively at 50 µg/mL, while 183.6% in the BT-DMEM+BT-TI group at 100 µg/mL compared to the untreated group. Thus, the role of Biofield Energy Treated vitamin D3 and DMEM in order to control osteoblast function and its direct effects on bone mineralization can be used to improve bone disorders.

Evaluation of Co-morbidities among Different Chronic Obstructive Pulmonary Disease Phenotypes

Aug 2018
Sh. Badawy M.Corresponding author Chest Department, Qena Faculty of medicine, South Valley University, Egypt

Background: Co-morbidities are associated with increasing risk of mortality, hospitalizations and costs of treatment in Chronic Obstructive Pulmonary Disease patients. Identification of Co- morbidities related to COPD phenotypes may guide individualized therapies and achieve better prognosis. Methods: A prospective study of one hundred ten patients of confirmed COPD diagnosis were carried out and divided into five different phenotypes with related co-morbidities. History taking, clinical examination, Chest X-ray, Computed chest Tomography, laboratory investigations, arterial blood gas, Echocardiography and Electrocardiography were done for all patients. St. George’s Respiratory Questionnaire, COPD assessment test (CAT score) and BODEx (BMI, FEV1, dyspnea and exacerbations) were used for assessment of disease impact on quality of life, severity, and exacerbation respectively. Results: Emphysema group were 31% among all cases with mean age 61.8±9.1, frequent exacerbator group and Chronic bronchitis phenotype were 18% with mean age 64.4±11.3, and 48.8±9 respectively. COPD with bronchiectasis group were 19% with mean age 60.3±6 and Asthma COPD Overlap Syndrome (ACOS) were 12% with mean age 62.8±15.8. There was significant difference as regards age between different group of phenotypes P- value <0.001. There was significance difference in BODEx index and in (CAT) score among different COPD phenotypes P-value 0.020, 0.001 respectively. There was significant difference in all items of SGRQ among different COPD phenotypes P–value 0.001. Diabetes was commonly presented in 50 % ACOS cases, Ischemic heart disease was present more in Emphysema 22.9%, Osteoporosis was more in COPD with bronchiectasis 28.6%, Cor-pulmonale was more present in frequent excerbator 65%, and Anemia more common in COPD with bronchiectasis 23.8%. Depression was more common in frequent excerbator phenotype (45.0 %). Gastro-esophageal reflux was the most common co-morbidities (58 %) then cor-pulmonale 41.8%, systemic hypertension 40 % and pulmonary hypertension 28%. Conclusion: The presence of significant co-morbidities is important modifying risk factors for severity in COPD. They contribute to the overall severity in individual patients, have a major impact on quality of life, and major causes of hospitalization. Co-morbidities can be associated with any clinical phenotype.

The Role and Effect of the Comprehensive Music Therapy in Project Sleep: A Multi-Disciplinary Quality Improvement Project.

Mar 2018 DOI 10.14302/issn.2574-4518.jsdr-17-1785
W Chang-LitCorresponding author Mount Sinai Beth Israel

Sleep is vital for the maintenance of physical health and mental wellbeing. Sleep also plays a cardinal role in the process of healing. It is estimated that 50 to 70 million Americans suffer chronically from sleep disturbances and insufficiency, which not only hinders daily functioning but also adversely affects health, quality of life and longevity.1 Deficient sleep is associated with an increased risk of developing chronic diseases such as hypertension, diabetes, obesity, heart disease, stroke, depression, frequent mental distress, as well as increased mortality, and reduced quality of life and productivity.1,2Aging, medical conditions, pain, and mental illness further aggravate sleep disturbances such as insomnia, sleep fragmentation and daytime sleepiness.3, 4, 5, 6, 7, 8 The a common treatment for sleep disturbances and insomnia is pharmacological therapy. Benzodiazepines may have negative long-term side effects including residual daytime sedation and tolerance development. Withdrawal difficulties may increase dependency. In  the older patient  there are  safety issues related to daytime sedation including increase risk of falls.  With the importance of sleep in hospital recovery and the side effects of sleep medication becoming more widely recognized, there has been an impetus to s use nonpharmacological alternatives , such as music.. This pilot study builds on the potential impact of music’s effectivity by introducing music therapy as a safe, cost effective and culturally sensitive intervention.

Family Medicine Open Access

Post Mastectomy Pain is No Longer Nightmare

Feb 2018 DOI 10.14302/issn.2640-690X.jfm-17-1900
Ali M. Elzohry AlaaCorresponding author Department of Anesthesia, ICU and Pain Relief, South Egypt Cancer Institute, Assiut University.

Background PMPS nowadays is common due to advances in both; diagnosis and treatment of cancer breast. Choosing proper treatments can improve the patients’ quality of life. Cancer breast is common and quite important disease and female in our family must be aware of it. Improvement of the diagnosis and treatment PMPS lead to increased patient’s satisfaction and decrease fear of cancer breast. Objective Discuss different methods for management of PMPS with less side effects, adequate analgesia, improvement of quality of life, and better patient satisfaction in the future. Methods Treatment approaches include both pharmacological interventions and non-pharmacological strategies. However, current treatments of the PMPS are near-optimal and prevention much better than treatment. Conclusion Continuous perioperative thoracic epidural Fentanyl–bupivacaine infusion was much better in pain relief, less sedating effect and shorter duration of hospital and ICU stay than continuous perioperative entanyl intravenous infusion in patients undergoing major upper gastrointestinal cancer surgery.

Metabolic Correction Therapy as Adjuvant Treatment for Breast Cancer Patients: A Case Report

Jan 2018
J Gonzalez MichaelCorresponding author University of Puerto Rico, Medical Sciences Campus, School of Public Health, San Juan, Puerto Rico

Breast cancer is the most common cancer in women worldwide. In the United States, is the second leading cause of cancer deaths in women. In Puerto Rico between 2008 and 2012, breast cancer was the most diagnosed type of cancer and the leading cause of cancer deaths among women. This is a case of 54 years old female diagnosed with stage IV right breast carcinoma. The patient complaints were weakness and a right breast ulcer. She started a metabolic correction therapy, which consisted of high intravenous vitamin C infusions, a nutritional supplementation plan, and Paleolithic diet. During treatment, both Glycohemoglobin and Carcinoembryonic Antigen levels decreased significantly, the right breast ulcer decreased in size, and the patient’s quality of life improved. Over the years, vitamin C studies have demonstrated a cytotoxic action against malignant cells. Based on the results from this case, we advocate continue studying possible adjuvant treatments for cancer patients, involving IV infusions of vitamin C and metabolic correction plans.

Drivers and Barriers to Medication Adherence in Patients with Chronic Myeloid Leukaemia: A Qualitative Study

Nov 2017 DOI 10.14302/issn.2372-6601.jhor-17-1761
Lee Mortensen GitteCorresponding author AnthroConsult, Fynsgade 24, 8000 Aarhus C, Denmark

With the introduction of tyrosine kinase inhibitors (TKI), patients with chronic myeloid leukemia (CML) have obtained survival rates close to normal. It may appear paradoxical, then, that medication adherence is suboptimal in some health care settings. As the first of its kind, this study aimed to explore drivers and barriers to TKI treatment adherence in Danish CML patients. A literature study informed the design of qualitative interviews with 20 patients, individually and in focus groups, focusing on their disease perceptions of CML, their health-related quality of life (QoL) and medication adherence. The study showed that many participants had previously switched treatment due to lacking efficacy or intolerance but most felt their current disease burden was tolerable. Anxiety might, however, resurface if treatment stopped working or with the occurrence of infections or side effects, creating a state of ‘fragile peace’. To these patients, their role functioning – as professionals, spouses, parents and grandparents – was crucial to uphold a positive self-image and meaningful life. Whether treatment enabled or hindered this was thus decisive to their QoL and medication adherence. Our participants expressed high adherence rates with only one having intentionally non-adhered due to side effects and poor QoL. Most participants felt well-informed about CML and treatment and privileged to receive specialised personal care from the public health care system acting to motivate their medication adherence. As a novel finding, this study indicates that the prospect of treatment-free remission may positively affect ‘adherence’ suggest this should be explored in future studies.

Fetal Surgery Open Access

The Evolution of Fetal Surgery

Aug 2017 DOI 10.14302/issn.2997-2086.jfs-17-1663
Knezevich MichelleCorresponding author Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.

Fetal surgery is the newest surgical specialty with a compelling history. The development of fetal surgery began in primates and lambs and, in its most basic form, was first performed in humans in 1965. Since its introduction, the field has expanded and changed dramatically. Several of these changes have involved the ethical aspect of fetal surgery. This field conflicts with the Hippocratic oath mantra of “first do no harm” as one of the patients, the mother, receives no benefit from these procedures. The ethical dilemma resulted in stringent inclusion and exclusion criteria for fetal operations. Initially, fetal surgery was only indicated for life-threatening conditions of the fetus but is now offered in some disease processes to improve quality of life for the child. As the field has matured, it has grown to encompass numerous different types of fetal interventions. Similar to other areas of surgery, the trend has been to migrate from more invasive to less invasive procedures. Currently, some of these therapies are performed entirely percutaneously. Theoretically, this trend would improve outcomes for both the mother and fetus. While this has generally proven true, there are some important exceptions to this rule. Finally, as the field continues to evolve, much research is being performed looking at possible new types of fetal interventions. Some of these procedures, such as fetal stem cell therapy and fetal gene therapy, could change the face of modern medicine.

A Checklist Instrument: Sensory Cues within Assisted Living Facilities

Apr 2017 DOI 10.14302/issn.2474-3585.jpmc-16-1213
Wood-Nartker JeanneaneCorresponding author Department of Human Environmental Studies, Central Michigan University

As people age, environments supporting changing needs can potentially impact their quality of life. The purpose of this exploratory study was to develop and assess the validity of a checklist instrument used to evaluate senior-supportive environmental risk factors within assisted living facilities (ALFs). Aging often leads to a decrease in the ability of a person to interpret sensory cues within his or her environment. This checklist instrument examined the relationship between sensory cue frequency and the influence on fall incidence within ALFs to maximize safety and quality of life. Observers visited 140 ALFs, utilizing the checklist instrument to document the presence or non-presence of 110 sensory cues. Contrary to the original hypothesis, a positive correlation was found between sensory cues and reported falls in each space. As the number of cues increased, the number of falls also increased. Additionally, the frequency of sensory cues within each room increased as facility size increased. Lastly, data revealed that more sensory cues were present in ALFs designed or renovated by design professionals. Although the results were contrary to expectations, the checklist instrument demonstrated face and predictive validity as a future research tool.

Depression and Dementia

Dec 2016 DOI 10.14302/issn.2476-1710.jdt-16-1260
Volicer LadislavCorresponding author School of Aging Studies, University of South Florida, Tampa, FL, USA

Relationship between dementia is very complex and individual. There are some pathogenetic processes that may be common to both conditions: neurotransmitter deficits, vascular changes and beta amyloid deposits. Presence of depression in persons with dementia have serious consequences on progression of dementia, quality of life and behavioral symptoms of dementia. Therefore, it is important to treat effectively even minor depressive symptoms.

Prevalence of Impulse Control Disorders among Adult Filipino Patients with Idiopathic Parkinson’s Disease seen at Jose R. Reyes Memorial Medical Center

Oct 2016 DOI 10.14302/issn.2470-5020.jnrt-16-1240
Kristoper P. de Guzman JanCorresponding author Department of Neurology, Jose R. Reyes Memorial Medical Center

Background: Impulse Control Disorders (ICDs) are characterized as pathologicalbehavioral patterns of excess impulsivity which may result as part of the non-motor complications of Parkinson’s disease (PD). These significantly affect the patient’s overall quality of life and have impact on their care givers, as well. Currently, the prevalence of ICDs among adult Filipino patients with Parkinson’s disease is unknown and less reported. Objectives: The study is intended to determine the prevalence of ICDs and its severityamong adult Filipino patients with idiopathic Parkinson’s disease seen at Jose R. Reyes Memorial Medical Center. Specifically, this study will identify risk factors and the clinical correlates to these patients. Methods: Adult Filipino patients diagnosed withidiopathic Parkinson’s diseasewhowere seen at the outpatient department from March 2015 – September 2015 are screened for the study. The Modified Hoehn and Yahr staging was utilized to determine the stage of PD. With approval from the author, the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease-Rating Scale (QUIP-RS) was used for detecting the presence of ICDs and corresponding severity. Results: We were able to examine 66 patients (31 males and 35 females) withidiopathic Parkinson disease. Majority of the patients manifested with Tremor Dominant (50%) subtype, followed by Early Disease Onset (34.8%), and Non-Tremor Dominant (15.2%). Sixteen (16) out of 66 patients (24.2%) have ICD symptoms with the following incidence rates: hobbyism/ punding 56.25%, compulsive eating 50%, hypersexuality 18.75%, compulsive shopping 18.75, Dopamine dysregulation syndrome 18.75%, and gambling 12.5%. Overall average QUIP-RS score is 5.42. There is significant association of PD duration with occurrence of ICD symptoms; the longer the PD duration, the higher risk of having ICD symptoms (x2 20.41; p = 0.026). Patients with higher mean modified Hoehn and Yahr stage (2.66±0.94), t 2.735, df 64, p 0.008, have much higher incidence of ICD symptoms. Conclusion: Filipino patients with idiopathic Parkinson disease who are majority onlevodopa + carbidopa therapy may develop impluse control disorders (ICDs). Other contributory factors in development of ICDs include longer duration of PD and higher mean Modified Hoehn and Yahr stage.

Compassion Fatigue and Adopted Coping Strategies of Mental Health Service Providers Working in A Regional Psychiatric Hospital in Nigeria

Sep 2016 DOI 10.14302/issn.2474-9273.jbtm-16-1195
Joyce OmoaregbaCorresponding author Consultant Psychiatrist at Federal Neuropsychiatric Hospital Uselu, PMB 1108, Benin City, Nigeria.

Background: Mental health service providers sometimes suffer burden resulting from their care of mentally ill individuals, and this burden could be modulated by the coping mechanisms they adopt. Objective: This study aimed to investigate the relationships between gender, coping strategy and compassion fatigue of mental health service providers in a mental health facility in Nigeria Method: This was a cross-sectional study which recruited 234 mental health service providers working in a mental health facility in Nigeria, and they completed questionnaires (the Coping Strategy Inventory modified by Addison, Campbell-Jenkins & Sarpong and the Compassion Fatigue subscale of the Professional Quality of Life developed by Stamms. Results: Majority of the mental health service providers surveyed were at risk of compassion fatigue (75.2%), gender did not significantly impact on compassion fatigue (t =-0.111; p>0.05), and coping strategies jointly predicted compassion fatigue (F = 11.927; p<0.05; r=0.417). However, when analyzed separately, only the subgroup of emotional focused engagement coping and emotional focused disengagement coping strategies independently predicted compassion fatigue, (β =0.246, t= 3.3.511, p<0.05) and (β =0.226, t= 3.698, p<0.05) respectively. Conclusion: Mental health service providers have high risk of compassion fatigue and the emotional based coping strategies are associated with this. Measures are suggested to mitigate compassion fatigue among this professionals, to reduce the effect on them and their patients.

Correlates of Mental Health in Survivors of Colorectal Cancer: The Influence of Individual, Family, and Community Level Factors

Aug 2016 DOI 10.14302/issn.2474-9273.jbtm-16-1105
J. Siembida ElizabethCorresponding author Department of Human Development and Family Studies, University of Connecticut, USA

An often neglected factor in the examination of the mental quality of life of survivors of colorectal cancer is the role of family and community level resources and support. The aim of this study was to develop a deeper understanding of the influence of family and community level resources over and above previously examined mental health variables. A survey-based pilot study was conducted with 101 colorectal cancer survivors. Four multiple linear regression models were developed to examine the associations between demographic, health-related, individual psychosocial, family and community level factors, and specific dimensions of mental quality of life (measured using the mental health subscales of the SF-12). In addition to examining all of the correlates of mental quality of life, the unique role of family and community level factors over and above previously examined factors was examined. Analyses found that family and community level factors, as a whole, explained a significant portion of the variance in role emotional health, mental health, and social functioning over and above demographic, health-related, and individual psychosocial factors. Family cohesion was a significant, unique predictor of role limitations due to mental health, and family and community social support was a significant, unique predictor of role limitations due to mental health and overall mental health. These results suggest the potential importance of considering family and community level resources when conducting research and designing interventions to improve mental quality of life in colorectal cancer survivors.

Psychosocial Factors and Comorbidity Associated with Recovery in Bipolar Disorder

Feb 2016 DOI 10.14302/issn.2476-1710.jdt-15-762
Rapport DanielCorresponding author Department of Psychiatry, The University of Toledo.

Bipolar disorder (BD) is a chronic psychiatric illness impacting patient functioning and quality of life. Medication produces improvement in many patients and remission in some, but there is minimal understanding about why some patients improve and others do not. Our goal was to identify demographic, psychosocial and comorbid variables associated with outcomes in BD. Charts of 121 outpatients treated with medication and supportive psychotherapy were reviewed. Forty four percent attained euthymia for 12 months while 56% did not. Poorer outcome was associated with economic stress, missed appointments, life stress, and presence of pain (p < 0.05). Those employed were more likely to improve (p < 0.02). Patients with BP-II reported more frequent life stressors, headache and use of alcohol (p <0.05) and were less likely to achieve euthymia than BP-I. Gender, education, and co-morbid medical illness did not affect results. Our findings suggest that poorer outcome is related to psychosocial factors. Increased attention to these variables may increase providers’ ability to manage challenging patients with BD.

Review of Useful Theories for Working with People Who are Living with HIV and AIDS

Feb 2016 DOI 10.14302/issn.2324-7339.jcrhap-15-828
E.E Enwereji,Corresponding author College of Medicine, Abia State University, Uturu, Nigeria

Introduction Working with people who are HIV positive is a herculean task and relevant theories to assist them medically, psychologically, economically, socially and otherwise are necessary. People who are living positively with HIV and AIDS are usually ridiculed, discriminated against, rejected and isolated. Using theories to work with them will help to cushion the negative impacts of HIV and AIDS, especially stigma which has been identified as a major barrier to health care and quality of life in illness management. The fundamental human rights of people living positively with HIV and AIDS should be protected since majority of such rights are usually trampled upon. The review aimed at discussing the potential benefits of using theories to assist people living positively with HIV and AIDS to cope with their various and varying situations in life. Materials and Method: Information for this study was collected by extensive review of recent literature on theories for assisting people living positively with HIV and AIDS. The paper reviews theories that influence long-term behaviour change among people living positively with HIV and AIDS. It assesses the need for using these theories to improve HIV and AIDS intervention in developing countries including Nigeria. In this study, eleven behaviour theories were reviewed. Result It was noted that some of the theories promoted adherence as well as helped to explain the benefits of adherence to HIV and AIDS medication. Also a good number of the theories assisted researchers in designing effective intervention strategies. Conclusion: Further research is needed to determine the effective theories that will increase adherence to long-term treatment regimens of HIV and AIDS. Such theories can be used to alleviate the potential burnout of Caregivers and people living positively with HIV and AIDS who travel long distances for diagnostic procedures and work long hours without adequate remuneration, support and supervision.

Food Intake Pattern of Obese Older Patients with Successful Weight Loss and Weight Maintenance on the Basis of Food Energy Density

Jun 2015 DOI 10.14302/issn.2379-7835.ijn-14-479
Erdmann JohannesCorresponding author Department of Nutritional Medicine, University of Applied Sciences Weihenstephan-Triesdorf, Weidenbach, Germany

Objective: Detailed reports in changes of eating habits especially in elderly subjects with successful weight loss and maintenance are virtually unknown. In this paper we have analyzed the eating habits of 104 obese patients (BMI 37.8±0.3 kg/m2, age range 65 and 84 years) who lost 11.5±0.3kg over an average follow-up period of 37.5±0.5 months. Design: Patients recorded food intake over a period of 12 days before and 12 days after changes of eating habits. Dietary counseling was based on food energy density (ED) with the aim to maintain food quantity as much as possible for adequate satiety in conjunction with a reduction of energy intake. Individual eating habits should be preserved as much as possible. Results: Average daily energy intake of solid food was reduced by 267kcal, food intake by 114g and ED by 0.10 kcal/g, respectively. Liquid calories were reduced by 79 kcal/d. Lower daily energy intake was the result of a reduction of medium and high ED food items compensated for by a greater intake of low ED food items. Changes of macronutrients comprised substantially lower carbohydrate and fat intake with minimal reduction of protein. From 28 different food groups 9 were reduced significantly (bread, butter, marmalade, cheese, meat products, fast food, fruit and chocolate) while 3 were increased (eggs, curds, ham). The relative contributions of the various food groups to daily energy intake remained fairly similar indicating that individual preferences were largely maintained. Conclusion: The data demonstrates that in elderly subjects with severe obesity an individual change of eating habits can lead to successful long-term weight loss with improvement of carbohydrate metabolism. This will contribute to increased mobility and to improved quality of life. This method which is based on the energy density of food items is a simple measure to reduce energy intake while ensuring long-term adherence.

Oxidative Telomere Attrition, Nutritional Antioxidants and Biological Aging

Jan 2015 DOI 10.14302/issn.2379-7835.ijn-14-606
Michael J. GladeCorresponding author

Telomeres are strings of DNA that are not themselves genes but that extend every chromosome beyond its last gene. Terminal telomeres are sacrificed during every mitotic event in human cells (“telomere attrition”), preserving the functional genome despite the “end replication problem.” However, the “telomeric theory of biological aging” suggests that when an individual cell has reproduced itself a sufficient number of times (the “Hayflick limit”), some the its telomeres have become critically shortened (“telomeric crisis”) and cannot completely “cap off” a chromosome, and any further attempts to replicate such a chromosome would produce damaged DNA and a dysfunctional cell (“cellular aging”). As cells enter telomeric crisis, they usually initiate intracellular signaling cascades that arrest DNA replication and mitotic activity, converting biologically active cells into inactive cells (“cellular senescence”). The progressive accumulation of senescent cells impairs the healthy functioning of tissues and produces “biological aging.” Oxidative stress damages telomeres and accelerates telomere attrition and biological aging. Premature biological aging is associated with degenerative diseases and diminished quality of life. Reducing the level of systemic oxidative stress can ease the oxidative drive toward cellular senescence and premature biological aging. Increased intakes of antioxidant-rich foods and specific antioxidant nutrients (such as fruits and vegetables, α -lipoic acid, astaxanthin, eicosapentaenoic acid, docosahexaenoic acid, trans-resveratrol, N-acetylcysteine, methylsulfonylmethane, lutein, vitamin C, vitamin D, vitamin E, and γ-tocotrienol) may decrease cellular and systemic oxidative stress and decelerate biological aging.

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