605 Sleep problems are associated with behavioral problems and decreased quality of life in children with Fontan circulation

Abstract Introduction Children with congenital heart disease who undergo a Fontan procedure are at higher risk of behavior and attention problems as well as reduced quality of life compared to age-matched peers. While sleep problems are associated with behavior and attention problems in children without Fontan circulation, this relationship has never been examined in children with Fontan circulation. We hypothesized that sleep problems in this population may increase the risk of behavior problems and also reduce health related quality of life (HRQOL). Methods We analyzed data from the Pediatric Heart Network Fontan cross-sectional study to evaluate associations between a parent-reported diagnosis of a sleep problem with reported behavioral concerns and HRQOL as measured by the child health questionnaire (CHQ) in 558 children with Fontan circulation. Analysis was performed using logistic regression or Wilcoxon sum rank test, as appropriate, with Bonferroni correction for multiple comparisons. Results Parent-reported sleep problems were present in 10% of participants. Sleep problems were associated with a 4.6x higher risk of attention problems, 10.2x higher risk of anxiety problems, 3.9x higher risk of behavioral problems, 9.5x higher risk of depression, 5.0x higher risk of developmental delay, 6.9x higher risk of learning problems and 2.2x higher risk of speech problems (p=0.04 for speech problems, p<0.001 for all others). Parent report of a sleep problem was associated with decreased physical HRQOL (z-score -1.3 [interquartile range-2.2, -0.2] vs 0.0 [-0.8, 0.4], p<0.001) and psychosocial HRQOL (-0.9 [-1.9, 0.0] vs 0.0 [-0.8, 0.7], p<0.001) compared to children without a reported sleep problem. Report of a sleep problem was associated with significantly lower HRQOL across all subdomains of the CHQ (p<0.05 for all subdomains). Conclusion Children with Fontan circulation with sleep problems have an increased risk of behavioral and developmental problems as well as reduced HRQOL. Better understanding of sleep problems is needed in children with Fontan circulation, as sleep disorders may represent a reversible cause of behavioral problems and decreased HRQOL in this population. Support (if any) Funding to DC from the American Heart Association, University of Arizona Health Sciences Center, and NIH-NHLBI. Fontan study data obtained from the Pediatric Heart Network.

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Gastrointestinal dysfunctions as a risk factor for sleep disorders in children with idiopathic autism spectrum disorder: A retrospective cohort study

Autism ◽

10.1177/1362361316667061 ◽

2017 ◽

Vol 21 (8) ◽

pp. 1010-1020 ◽

Cited By ~ 11

Author(s):

Lena M McCue ◽

Louise H Flick ◽

Kimberly A Twyman ◽

Hong Xian

Keyword(s):

Quality Of Life ◽

Autism Spectrum Disorder ◽

Confidence Interval ◽

Sleep Disorders ◽

Sleep Disorder ◽

Behavioral Problems ◽

Sleep Problems ◽

Autism Spectrum ◽

Spectrum Disorder

Sleep disorders often co-occur with autism spectrum disorder. They further exacerbate autism spectrum disorder symptoms and interfere with children’s and parental quality of life. This study examines whether gastrointestinal dysfunctions increase the odds of having sleep disorders in 610 children with idiopathic autism spectrum disorder, aged 2–18 years, from the Autism Genetic Resource Exchange research program. The adjusted odds ratio for sleep disorder among those with gastrointestinal dysfunctions compared to those without was 1.74 (95% confidence interval: 1.22–2.48). In addition, the odds of having multiple sleep disorder symptoms among children with gastrointestinal dysfunctions, adjusted for age, gender, behavioral problems, bed wetting, current and past supplements, and current and past medications for autism spectrum disorder symptoms were 1.75 (95% confidence interval: 1.10–2.79) compared to children without gastrointestinal dysfunctions. Early detection and treatment of gastrointestinal dysfunctions in autism spectrum disorder may be means to reduce prevalence and severity of sleep problems and improve quality of life and developmental outcomes in this population.

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Behavioral Outcomes in Children With an Orofacial Cleft in a National Study in New Zealand

The Cleft Palate-Craniofacial Journal ◽

10.1177/1055665620972862 ◽

2020 ◽

pp. 105566562097286

Author(s):

John M. D. Thompson ◽

S. Louise Ayrey ◽

Rebecca F. Slykerman ◽

Peter R. Stone ◽

Peter V. Fowler

Keyword(s):

Quality Of Life ◽

New Zealand ◽

Peer Relationships ◽

Behavioral Problems ◽

Life Support ◽

National Study ◽

Orofacial Cleft ◽

Prosocial Skills ◽

Increased Risk

Objective: To determine whether children with an orofacial cleft have higher levels of behavioral problems than the general population and whether this differs by cleft phenotype. Design: A cohort of children with cleft lip and/or palate (CL/P) born in New Zealand from January 1, 2000. Setting: Cleft clinics in New Zealand participating in a larger outcomes study between 2014 and 2017. Participants: Children (N = 378) aged 5 to 12 years of age and their parents. Main Outcomes: The Strengths and Difficulties Questionnaire (SDQ) and Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales 4.0 and Family Impact Module 2.0. Results: Compared to standardized norms, children with a cleft had higher than expected (defined as 20%) levels of abnormal/borderline SDQ scores for conduct problems (27.4%, P = .0003) and peer relationship problems (31.6%, P < .0001) but lower than expected levels of problems with pro-social skills (6.3%, P < .0001). There were no significant differences by age-group and or cleft phenotype other than an increased risk of hyperactivity in children with CP compared to children with CL. Total difficulties SDQ scores had moderate correlations with the PedsQL. Conclusions: While over 90% of children with CL/P had normal prosocial skills, they may not be easily accepted by their peers which may result in behavioral problems. These concerns were moderately related to lower quality of life. Support for establishment and maintenance of peer relationships is important to address externalizing and peer difficulties in children with CL/P. Community knowledge and understanding of CL/P needs to continue to be promoted.

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Prevalence of depression, sleep-related disturbances, and anxiety and their effect on quality of life in patients with adenocarcinoma of the pancreas

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e15678 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e15678-e15678

Author(s):

D. Brown ◽

A. Boyd ◽

C. Henrickson ◽

J. Hampton ◽

F. Almani ◽

...

Keyword(s):

Quality Of Life ◽

Pancreatic Cancer ◽

Depressive Symptoms ◽

Sleep Problem ◽

Sleep Problems ◽

Prevalence Of Depression ◽

Adenocarcinoma Of The Pancreas ◽

Cancer Clinic

e15678 Purpose: To evaluate the prevalence of depression, sleep related disturbances and anxiety and their effect on quality of life in patients with recently diagnosed adenocarcinoma of the pancreas who present to a multidisciplinary pancreatic cancer clinic. Methods: Cross-sectional and longitudinal psychosocial distress was assessed utilizing Personal Health Questionnaire 9 (PHQ9) to screen for depression and monitor symptoms during the course of care, the Penn State Worry Questionnaire (PSWQ) for generalized anxiety, and the Sleep Problems Questionnaire 4 (SPQ4)/ University of Michigan Sleep Questionnaire to monitor sleep symptoms. Patients were evaluated at their intake consultation and at subsequent follow up visits. Results: 24 patients (pts; mean age 66 years, 48% females) consented to participate during the 6 month pilot study with longitudinal follow up for 13. The PHQ9 scores on presentation revealed mild to moderate depressive symptoms in 54% (13 pts) of pts and moderately severe depressive symptoms in only 8% (2 pts). A minority (2 pts, 8%) had PSWQ scores characteristic of an anxiety disorder, while 33% (8 pts) had moderate anxiety scores. Only 3 pts (12.5%) scores revealed a clear sleep problem; 10 pts, (41.67%) had no sleep problem and 10 pts had a potential sleep problem. Due to the limited follow up, a statistical difference in scores over time was not observed. Conclusions: Our results indicate that mild to moderate depressive symptoms, anxiety and potential sleep problems are common in patients referred to a multidisciplinary pancreatic cancer clinic. Moderately severe depressive symptoms, severe anxiety and clear sleep problems are not as prevalent as is generally believed. To better characterize the relationship of depression (and potential causes) with pancreatic cancer, additional prospective longitudinal studies are needed. No significant financial relationships to disclose.

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Association Between Sleep Disturbances With Neurodevelopmental Problems and Decreased Health‐Related Quality of Life in Children With Fontan Circulation

Journal of the American Heart Association ◽

10.1161/jaha.121.021749 ◽

2021 ◽

Author(s):

Kirstin Knobbe ◽

Meghana Partha ◽

Michael D. Seckeler ◽

Scott Klewer ◽

Chiu‐Hsieh Hsu ◽

...

Keyword(s):

Sleep Disturbance ◽

Sleep Disturbances ◽

Attention Problems ◽

Fontan Circulation ◽

Increased Risk ◽

Related Quality ◽

Health Related ◽

Anxiety Depression ◽

Neurodevelopmental Problems

Background Children with Fontan circulation are known to be at increased risk for neurodevelopmental problems and decreased health‐related quality of life (HRQOL), but many factors that may contribute to this risk are unknown. Sleep disturbances may be one previously unidentified factor that contributes to this risk. Methods and Results We analyzed data from the Pediatric Heart Network Fontan cross‐sectional study to evaluate associations between a parent or child report of sleep disturbance with reported neurodevelopmental concerns and HRQOL in 558 children with Fontan circulation. Parent‐reported sleep disturbance was present in 11% of participants and child‐reported sleep disturbance was present in 15%. Parent‐reported sleep disturbance was associated with a significantly higher risk of attention problems, anxiety, depression, behavioral problems, and developmental delay ( P <0.001 for all). Similarly, parent‐reported disturbance was associated with decreased HRQOL on both parent and child‐reported HRQOL ( P <0.001 for most domains). Child‐reported sleep disturbances were associated with increased odds of anxiety, depression, and attention problems as well as worse HRQOL. These associations were present even after adjustment for cardiac, demographic, and socioeconomic factors that may affect HRQOL and neurodevelopmental status. Conclusions Sleep disturbances in children with Fontan circulation are associated with an increased risk of neurodevelopmental problems as well as reduced HRQOL compared with those without sleep disturbance. Better understanding of sleep disturbances is needed in children with Fontan circulation, as sleep disturbances may represent a reversible cause of neurodevelopmental problems and decreased HRQOL in this population.

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Assessment of the Therapeutic Effect of Physiotherapy on Minimizing Imbalances of Geriatric Patients

Acta Balneologica ◽

10.36740/abal202002103 ◽

2020 ◽

Vol 62 (2) ◽

pp. 86-91

Author(s):

Justyna Pawlak ◽

Małgorzata Dudkiewicz ◽

Łukasz Kikowski

Keyword(s):

Quality Of Life ◽

Therapeutic Effect ◽

Body Mass ◽

Geriatric Patients ◽

The Elderly ◽

Risk Of Falling ◽

Increased Risk ◽

Climbing Stairs ◽

Tinetti Test

Introduction: The progressing aging process and comorbidities worsen the efficiency of the balance system in the elderly, which leads to a weakening of stability and, as a consequence, to falls and injuries. The first ones lead to: worsening of functioning, reduced mobility, an increased risk of disease and mortality, therefore systematic physical activity and shaping the balance using physiotherapy, which can prevent dangerous falls is very important. Aim: Assessment of the therapeutic effect of physiotherapy on minimizing imbalances in geriatric patients. M aterial and Methods: The study group consisted of 46 people, including 32 women (69.6%) and 14 men (30.4%); average age of respondents – 72.5 years. They were patients of the Department of Rehabilitation of Poddębice Health Center, Ltd. The researchers used a self-made questionnaire, body mass to height index (BMI) and the Tinetti Test. Results: Patients with an elevated BMI (89.1%), as well as those taking more than 4 medication (78.3%), have had more falls over the past year (respectively 91.4% and 81.4%). After the use of comprehensive therapy, none of the patients achieved a worse result than before the physiotherapy while 91.3% of the respondents had an increase in the number of points scored in the Tinetti Test. The percentage of patients at high risk of falling reduced from 67.4% to 37%. There was also a decrease in the fear of walking (in 58.7%), falling (in 57.7%) and climbing stairs (in 47.9%). According to 78.3% of respondents, physiotherapy positively affected their independence and quality of life. Conclusions: The use of comprehensive physiotherapy reduces the fear of walking, climbing stairs and falling, which can be a good predictor of prevention. Both polypragmasia and an elevated body mass index (BMI) increase the risk of falling. Comprehensive physiotherapy of geriatric patients helps to improve balance and gait stereotype. Physiotherapy for the elderly helps improve the quality of life, independence, minimize imbalances, and thus reduce the risk of falls. Balance exercises play an important role in preventing falls.

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Lung Function and Quality of Life in Workers with Chemical and Dust Exposure

Revista de Chimie ◽

10.37358/rc.18.2.6104 ◽

2018 ◽

Vol 69 (2) ◽

pp. 346-349 ◽

Cited By ~ 1

Author(s):

Marina Ruxandra Otelea ◽

Oana Cristina Arghir ◽

Corina Zugravu ◽

Eugenia Naghi ◽

Sabina Antoniu ◽

...

Keyword(s):

Quality Of Life ◽

Occupational Exposure ◽

Lung Function ◽

Lung Diseases ◽

Dust Exposure ◽

Chronic Lung Diseases ◽

Respiratory Exposure ◽

Increased Risk ◽

Occupational Settings

Regarding the widely distribution of respiratory exposure hazards in occupational settings, workers have an increased risk for chronic lung diseases. For assessing the quality of life and lung function in workers exposed to chemicals and dust, St George�s Respiratory Questionnaire (SGRQ) and spirometry were performed among 40 patients, admitted in Occupational Clinic Department of Colentina Hospital, Bucharest, Romania, during February, 2017. SGRQ showed different predictors for patients according to their occupational exposure and total symptoms score correlated better with decreased spirometric parameters in defining lung function deterioration. Quality of life is earlier affected than lung function deterioration and emphasises the need of more sensitive methods for an earlier identification and better evaluation of respiratory hazards in different workplaces.

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Self Management Menentukan Kualitas Hidup Pasien Diabetes Mellitus

Jurnal Endurance ◽

10.22216/jen.v4i2.4026 ◽

2019 ◽

Vol 4 (2) ◽

pp. 402

Author(s):

Iskim Luthfa ◽

Nurul Fadhilah

Keyword(s):

Quality Of Life ◽

Diabetes Mellitus ◽

Correlation Study ◽

Self Management ◽

Rank Test ◽

P Value ◽

Cross Sectional ◽

Spearman Rank ◽

Consecutive Sampling

People with diabetes mellitus are at risk of developing complications, so that it affects the quality of life. These complications can be minimized through self-care management. This study aims to determine the relationship between self management with the quality of life for people with diabetes mellitus. This research is a kind of quantitative research with correlation study. This research used cross sectional design. The sampling technique uses non probability with estimation consecutive sampling. The number of respondents in this research are 118 respondents. Instrument for measuring self management used diabetes self management questionnaire (DSMQ), and instruments to measure quality of life used quality of life WHOQOL-BREEF. The data obtained were processed statistically by using spearman rank test formula and p value of 0,000 There is a significant relationship of self management with the quality of life of people with diabetes mellitus. Penderita Diabetes mellitus beresiko mengalami komplikasi yang dapat mempengaruhi kualitas hidupnya. Komplikasi tersebut dapat diminimalkan melalui manajemen perawatan diri (self management). Penelitian ini bertujuan untuk menganalisis hubungan self management dengan kualitas hidup pasien diabetes melitus. Jenis penelitian ini adalah deskriptif korelasi dengan desain cross sectional. Teknik pengambilan sampel menggunakan non probability sampling dengan pendekatan consecutive sampling. Jumlah sampel sebanyak 118 responden. Instrumen penelitian untuk mengukur self management menggunakan diabetes self management questionnaire (DSMQ), dan instrumen untuk mengukur kualitas hidup menggunakan quality of life WHOQOL-BREEF. Analisis data menggunakan spearman rank dan didapatkan hasil nilai p value 0,000 dan r 0,394.Terdapat hubungan antara self management dengan kualitas hidup pasien diabetes mellitus dengan arah korelasi positif.

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Biopsychosocial Patterning of Multimorbidity and Its Consequences

The Oxford Handbook of Integrative Health Science ◽

10.1093/oxfordhb/9780190676384.013.14 ◽

2018 ◽

pp. 220-236

Author(s):

Elliot Friedman ◽

Beth LeBreton ◽

Lindsay Fuzzell ◽

Elizabeth Wehrpsann

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Functional Outcomes ◽

The United States ◽

Chronic Medical Conditions ◽

Quality Of Life Research ◽

Increased Risk ◽

Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

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Potential of Beetroot and Blackcurrant Compounds to Improve Metabolic Syndrome Risk Factors

Metabolites ◽

10.3390/metabo11060338 ◽

2021 ◽

Vol 11 (6) ◽

pp. 338

Author(s):

Cameron Haswell ◽

Ajmol Ali ◽

Rachel Page ◽

Roger Hurst ◽

Kay Rutherfurd-Markwick

Keyword(s):

Quality Of Life ◽

Diabetes Mellitus ◽

Risk Factors ◽

Metabolic Syndrome ◽

Metabolic Abnormalities ◽

Dietary Nitrate ◽

Increased Risk ◽

High Concentrations

Metabolic syndrome (MetS) is a group of metabolic abnormalities, which together lead to increased risk of coronary heart disease (CHD) and type 2 diabetes mellitus (T2DM), as well as reduced quality of life. Dietary nitrate, betalains and anthocyanins may improve risk factors for MetS and reduce the risk of development of CHD and T2DM. Beetroot is a rich source of dietary nitrate, and anthocyanins are present in high concentrations in blackcurrants. This narrative review considers the efficacy of beetroot and blackcurrant compounds as potential agents to improve MetS risk factors, which could lead to decreased risk of CHD and T2DM. Further research is needed to establish the mechanisms through which these outcomes may occur, and chronic supplementation studies in humans may corroborate promising findings from animal models and acute human trials.

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