654 PHARYNGEAL POUCH SURGERY IN OCTO- AND NONAGENARIANS IS SAFE AND EFFECTIVE: A MULTICENTER COMPARATIVE COHORT STUDY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
David Liu ◽  
Mohamed Afzal ◽  
Tim Bright ◽  
David Watson ◽  
Peter Devitt ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Revisional Surgery ◽  
Age Groups ◽  
Symptomatic Improvement ◽  
Advanced Age ◽  
Perioperative Outcomes ◽  
Pharyngeal Pouch ◽  
Comparative Cohort Study ◽  
Pouch Surgery

Abstract   Surgery is the only effective treatment strategy for a symptomatic pharyngeal pouch. However, octo- and nonagenarians are often denied referral to a surgeon because of perceived increased risks. Here, we examine the perioperative outcomes of pharyngeal pouch surgery in octo- and nonagenarians in comparison to patients under 80 years-of-age. Methods Analysis of a prospectively maintained database of 113 patients (≥80 years-of-age: 27, <80 years-of-age: 86) who underwent pharyngeal pouch surgery across seven hospitals from 1 January 2006 to 30 September 2020. Results Patients ≥80 years-of-age had comparable operative time, complication profile, intensive care admission, emergency reoperation, and revisional surgery as their younger counterparts. The severity of complications was not significantly different between the two age groups. No surgical mortality was recorded. Multivariate analysis demonstrated that diverticulectomy combined with cricopharyngeal myotomy independently predicted higher rates of complications (OR: 4.53, 95% CI: 1.43-14.33, p = 0.010), but also greater symptomatic improvement (OR: 4.36, 95% CI: 1.50-12.67, p = 0.007). Importantly, a greater proportion of octo- and nonagenarians experienced improved swallowing than patients <80 years-of-age (96.3% vs. 74.4%, p = 0.013). Advanced age was not predictive of complications on multivariate analysis. Conclusion In appropriately selected patients, pharyngeal pouch surgery can be safely offered to patients above 80 years-of-age resulting in significant improvement in their quality-of-life. These patients should not be denied surgery on the basis of advanced age alone.

Pharyngeal Pouch Surgery in Octo- and Nonagenarians is Safe and Effective: A Multicentre Comparative Cohort Study

2021 ◽  
Author(s):  
Mohamed Afzal ◽  
David S. Liu ◽  
Tim Bright ◽  
David I. Watson ◽  
Peter G. Devitt ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pharyngeal Pouch ◽  
Comparative Cohort Study ◽  
Pouch Surgery

Leukemia Support Groups: How Are They Doing?

1997 ◽  
Vol 4 (5) ◽  
pp. 407-412
Author(s):  
Donna Corwin Moss
Keyword(s):  
Quality Of Life ◽  
Support Groups ◽  
Age Groups ◽  
Cancer Treatments ◽  
Future Directions ◽  
Course Of Illness ◽  
New Concepts ◽  
Sources Of Support ◽  
Practical Impact

Background Support groups help their participants to cope with the emotional and practical impact of their illnesses. Methods The effectiveness of the Leukemia Society of America support groups in enhancing the quality of life for their participants is reviewed. The groundwork, purpose, and structure of such groups, as well as alternate sources of support, are presented. Evaluation and future directions for oncology groupwork are discussed. Results Support groups complement the therapies provided by clinical practitioners and scientists by addressing the additional needs of cancer patients over the course of illness and survival. Conclusions New concepts and methods that address the needs of specific age-groups and incorporate the newly generated data on cancer treatments will further enhance the benefits provided by support groups.

scholarly journals Children’s Understanding of Informed Assents in Research Studies

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 871
Author(s):  
Hortense Cotrim ◽  
Cristina Granja ◽  
Ana Sofia Carvalho ◽  
Carlos Cotrim ◽  
Rui Martins
Keyword(s):  
Health Care ◽  
Positive Relationship ◽  
Age Groups ◽  
High Capacity ◽  
Decision Making Process ◽  
Objective Understanding ◽  
Level Of Understanding ◽  
Age And Sex ◽  
Acceptance Of Health Care

The assent procedure reflects an effort to enable the minor to understand, to the degree they are capable of, what their participation in the decision making process would involve. Aims: To evaluate the minors’ ability to understand the information provided to them when obtaining assent and to evaluate the opinion of the parents regarding the importance of asking the child’s assent. Methods: The sample included a total of 52 minors aged between 10 and 17 years who underwent exercise echocardiogram. The Quality of Informed Consent is divided into two parts: Part A was used to measure objective understanding and part B to measure subjective understanding. Results: The results show that the minors have a high capacity to understand the information given to them when asking for assent. A positive relationship was found between the two parts of the questionnaire. No statistically significant relationship was found between age and sex and part A and part B or between both age groups (<14 years old and ≥14 years old) and the measure. In the case of the parents, 96.6% of parents consider assent as an advantage for the child’s acceptance of health care. The opinion of the parents is not related to the age, sex or level of schooling. Conclusion: Minors showed a substantial level of understanding regarding the information provided to them. The parents considered the implementation of assent fundamental to the child’s acceptance of health care.

scholarly journals Trends in prevalence of gestational diabetes mellitus in Zhejiang Province, China, 2016–2018

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Meng Wang ◽  
Ru-Ying Hu ◽  
Wei-Wei Gong ◽  
Jin Pan ◽  
Fang-Rong Fei ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Rural Areas ◽  
Urban Areas ◽  
Age Groups ◽  
Zhejiang Province ◽  
Advanced Age ◽  
Female Population ◽  
Annual Prevalence

Abstract Background Limited population-based studies have investigated the secular trend of prevalence of gestational diabetes mellitus (GDM) in mainland China. Therefore, this study aimed to estimate the prevalence of GDM and time trends in Chinese female population. Methods Based on Diabetes Surveillance System of Zhejiang Province, 97,063 diagnosed GDM cases aged 20–50 years were identified from January 1, 2016 to December 31, 2018. Annual prevalence, prevalence rate ratios (PRRs) and average annual percentage change with their 95% confidence intervals (CIs) were reported. Results The age-standardized overall prevalence of GDM was reported to be 7.30% (95% CI 7.27–7.33%); 9.13% (95% CI 9.07–9.19%) in urban areas and 6.24% (95% CI 6.21–6.27%) in rural areas. Compared with 20–24 years age group, women in advanced age groups (25–50 years) were at higher risk for GDM (PRRs ranged from 1.37 to 8.95 and the 95% CIs did not include the null). Compared with rural areas, the risk for GDM was higher in urban areas (PRR: 1.69, 95% CI 1.67–1.72). The standardized annual prevalence increased from 6.02% in 2016 to 7.94% in 2018, with an average annual increase of 5.48%, and grew more rapidly in rural than urban areas (11.28% vs. 0.00%). Conclusions This study suggested a significant increase in the prevalence of GDM among Chinese female population in Zhejiang province during 2016–2018, especially in women characterized by advanced age and rural areas.

scholarly journals Oral Health Related Quality of Life and Prosthetic Status among Institutionalized Elderly from the Bucharest Area: A Pilot Study

2021 ◽  
Vol 18 (12) ◽  
pp. 6663
Author(s):  
Laura Iosif ◽  
Cristina Teodora Preoteasa ◽  
Elena Preoteasa ◽  
Ana Ispas ◽  
Radu Ilinca ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Age Groups ◽  
Health Related Quality ◽  
Institutionalized Elderly ◽  
Related Quality ◽  
Health Related ◽  
Prosthetic Status ◽  
The Impact

The aim of the study was to assess the oral health related quality of life (OHRQoL) of elderly in care homes, one of Romania’s most vulnerable social categories, to correlate it to sociodemographic, oral health parameters, and prosthodontic status. Therefore, a cross-sectional study was performed on 58 geriatrics divided into 3 age groups, who were clinically examined and answered the oral health impact profile (OHIP-14) questionnaire. Very high rates of complete edentulism in the oldest-old subgroup (bimaxillary in 64.3%; mandibular in 64.3%; maxillary in 85.7%), and alarming frequencies in the other subgroups (middle-old and youngest-old), statistically significant differences between age groups being determined. The OHIP-14 mean score was 14.5. Although not statistically significant, females had higher OHIP-14 scores, also middle-old with single maxillary arch, single mandibular arch, and bimaxillary complete edentulism, whether they wore dentures or not, but especially those without dental prosthetic treatment in the maxilla. A worse OHRQoL was also observed in wearers of bimaxillary complete dentures, in correlation with periodontal disease-related edentulism, in those with tertiary education degree, and those who came from rural areas. There were no statistically significant correlations of OHRQoL with age, total number of edentulous spaces or edentulous spaces with no prosthetic treatment. In conclusion, despite poor oral health and prosthetic status of the institutionalized elderly around Bucharest, the impact on their wellbeing is comparatively moderate.

Food intake, physical activity and quality of life among children and youth

Work ◽  
2021 ◽  
pp. 1-10
Author(s):  
Emília Martins ◽  
Rosina Fernandes ◽  
Francisco Mendes ◽  
Cátia Magalhães ◽  
Patrícia Araújo
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Healthy Lifestyle ◽  
Eating Habits ◽  
Age Groups ◽  
Related Quality ◽  
Health Related ◽  
Life Habits ◽  
Definition Of

BACKGROUND: The health-related quality of life construct (QoL) implies a relationship with eating habits (EA) and physical activity (PA). Sociodemographic and anthropometric variables (gender, age and Body Mass Index - BMI) are highlighted in the definition of healthy lifestyle habits promotion strategies. OBJECTIVE: We aim to characterize and relate PA, EA and QoL in children/youth and explore gender, age and BMI influences. METHODS: It is a non-experimental study, with 337 children/youth, ages between 8 and 17 years (12.61±2.96), mostly from the rural inland of Portugal. In data collection we used a sociodemographic and anthropometric questionnaire, a weekly register table of EA and Kid-Kindl (QoL). Statistical analysis (p <  0.05) were performed in SPSS-IBM 25. RESULTS: Lower BMI was associated with better EA (p <  0.001), PA (p <  0.05) and self-esteem (p <  0.01) and worse scores on family subscale of QoL. Female showed higher fruit intake (p <  0.05). The older has shown better results. PA is positively correlated with QoL (p <  0.01) and EA (p <  0.05). CONCLUSIONS: It is important to explore other relevant social and family dimensions, to promote intervention programs with parents, school and community, as well as healthy practices policies. The intervention in these age groups is critical for a longer-term impact in improving healthy life habits.

scholarly journals ‘We tend to get pad happy’: a qualitative study of health practitioners’ perspectives on the quality of continence care for older people in hospital

2021 ◽  
Vol 10 (2) ◽  
pp. e001380
Author(s):  
John Percival ◽  
Katharine Abbott ◽  
Theresa Allain ◽  
Rachel Bradley ◽  
Fiona Cramp ◽  
...  
Keyword(s):  
Quality Care ◽  
Age Groups ◽  
Well Being ◽  
Residential Home ◽  
Care Planning ◽  
Open Communication ◽  
Predisposing Factor ◽  
Health Practitioners ◽  
Care Training

BackgroundBladder and bowel control difficulties affect 20% and 10% of the UK population, respectively, touch all age groups and are particularly prevalent in the older (65+ years) population. However, the quality of continence care is often poor, compromising patient health and well-being, increasing the risk of infection, and is a predisposing factor to nursing and residential home placement.ObjectiveTo identify factors that help or hinder good continence care for patients aged 65 years and over in hospital medical ward settings. Medical care, not surgical, was our exclusive focus.MethodsWe conducted 27 qualitative interviews with nursing, medical and allied health practitioners in three hospitals. We used a purposive sample and analysed data thematically, both manually and with the aid of NVivo software.ResultsInterviews revealed perspectives on practice promoting or inhibiting good quality continence care, as well as suggestions for improvements. Good continence care was said to be advanced through person-centred care, robust assessment and monitoring, and a proactive approach to encouraging patient independence. Barriers to quality care centred on lack of oversight, automatic use of incontinence products and staffing pressures. Suggested improvements centred on participatory care, open communication and care planning with a higher bladder and bowel health profile. In order to drive such improvements, hospital-based practitioners indicate a need and desire for regular continence care training.ConclusionsFindings help explain the persistence of barriers to providing good quality care for patients aged 65 years and over with incontinence. Resolute continence promotion, in hospitals and throughout the National Health Service, would reduce reliance on products and the accompanying risks of patient dependency and catheter-associated gram-negative bacteraemia. Robust assessment and care planning, open communication and regular continence care training would assist such promotion and also help mitigate resource limitations by developing safer, time-efficient continence care.

scholarly journals The Quality of Life and Satisfaction with Continuous Glucose Monitoring Therapy in Children under 7 Years of Age with T1D Using the rtCGM System Integrated with Insulin Pump—A Caregivers Point of View

Sensors ◽  
2021 ◽  
Vol 21 (11) ◽  
pp. 3683
Author(s):  
Ewa Rusak ◽  
Natalia Ogarek ◽  
Karolina Wolicka ◽  
Anna Mrówka ◽  
Sebastian Seget ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Insulin Pump ◽  
Age Groups ◽  
Glucose Monitoring ◽  
Point Of View ◽  
Therapy Assessment ◽  
Monitoring Therapy ◽  
Original Survey

Quality of life (QoL) is an important parameter that affects the choice of therapy. Assessment of QoL and satisfaction with therapy using the rtCGM in children with T1D aged < 7 years was conducted. The study group consisted of 38 children with T1D aged < 7 years (34% aged 2–4, 66% aged 5–7 years), HbA1c: 6.53 ± 0.63%, duration of diabetes: 2.6 ± 1.6 years, treated with an rtCGM-augmented insulin pump for 1.92 ± 1.15 years. Two anonymous surveys were conducted: a. PedsQL3.0 diabetes standardized questionnaire—QoL assessment among age groups: 2–4/5–7 years. b. An original survey assessing the CGM use satisfaction. The mean scores in PedsQL3.0: communication 75%, worries 30%, treatment 70%, and problems associated with diabetes 65%. The QoL scale is: 0–19% very low, 20–39% low, 40–59% moderate, 60–79% high, 80–100% very high. The most frequently reported concerns were long-term diabetes complications and prick pain. Satisfaction with CGM use was high (68% in group aged 5–7 and 92% 2–4 years). Twenty-seven (71%) caregivers confirmed the positive effect of CGM on sleep. During the use of rtCGM a high quality of life was reported, and the quality of sleep in their caregivers was increased.

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