scholarly journals Using Biologics in Inflammatory Arthritis: Assessing the Risks and Benefits

2016 ◽  
Vol 8 ◽  
Author(s):  
Gina Rohekar MD FRCPC MSc
Keyword(s):  
Quality Of Life ◽  
Disease Activity ◽  
Inflammatory Arthritis ◽  
Joint Damage ◽  
Well Being ◽  
Risks And Benefits ◽  
Long Term Consequences ◽  
Tremendous Impact

Inflammatory arthritis, such as rheumatoid arthritis (RA), is not simply a disease that affects an individual with symptoms in the present. It also has tremendous impact on the patient’s future well-being. RA has been proposed to be an interrelated triad of disease activity, joint damage, and disability.1 In this triad, current disease activity (pain, swelling, and stiffness of joints) leads to disability and decreased quality of life. Furthermore, disease activity leads to joint damage, which also leads to disability.1 In the modern treatment of inflammatory arthritis, the goal is to not only treat the present symptoms (disease activity) but also, by doing so, to decrease damage and disability and improve quality of life. There is a movement to treat inflammatory arthritis aggressively and early, with the thought that there is a “window of opportunity” in which early intervention can prevent long-term consequences.

scholarly journals P181 Long-term improvement in axial spondyloarthritis clinical outcomes following 2-weeks of intensive education and rehabilitation: results from the Bath residential rehabilitation programme

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Rosie Barnett ◽  
Anita McGrogan ◽  
Matthew Young ◽  
Charlotte Cavill ◽  
Mandy Freeth ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Disease Activity ◽  
Axial Spondyloarthritis ◽  
Rehabilitation Programme ◽  
Spinal Mobility ◽  
The Impact

Abstract Background/Aims  Axial spondyloarthritis (axSpA) is a chronic rheumatic condition, characterised by inflammatory back pain - often associated with impaired function and mobility, sleep disturbance, fatigue, and reduced quality of life. Despite the vast advances in pharmacological treatments for axSpA over the last few decades, physical activity and rehabilitation remain vital for effective disease management. At the Royal National Hospital for Rheumatic Diseases in Bath (RNHRD), the 2-week inpatient axSpA rehabilitation programme has been integral to axSpA care since the 1970’s. Prior research has demonstrated significant short-term improvements in spinal mobility (BASMI), function (BASFI) and disease activity (BASDAI) following course attendance. However, the long-term outcomes are yet to be evaluated in this unique cohort. Methods  Since the early 1990’s, clinical measures of spinal mobility, function and disease activity have been routinely collected at the RNHRD at all clinical appointments through administration of the BASMI, BASFI and BASDAI, respectively. Dates of attending the axSpA course and standard clinical and treatment follow-up data were also collected. Multiple linear regression models were used to investigate the impact of course attendance on final reported BASMI, BASDAI and BASFI scores (final score=most recent). Length of follow-up was defined as time between first and last recorded BASMI. Results  Of the 203 patients within the Bath SPARC200 cohort, 77.8% (158/203) had attended at least one rehabilitation course throughout follow-up. 70.0% (140/203) of patients were male. The mean duration of follow-up was 13.5 years (range 0-35 years); 28.1% (57/203) of individuals with 20+ years of follow-up. Course attendance (yes versus no) significantly reduced final BASMI score by 0.84 (p = 0.001, 95%CI -1.31 to -0.37) and final BASDAI score by 0.74 (p = 0.018, 95%CI -1.34 to -0.13). Although course attendance reduced final BASFI by 0.45 (95%CI -1.17 to 0.28), this relationship did not reach significance (p = 0.225). Whilst minimally clinically important difference (MCID) is, to our knowledge, yet to be defined for BASMI, MCIDs were achieved long-term for both BASDAI and BASFI - defined by van der Heijde and colleagues in 2016 as 0.7 and 0.4 for BASDAI and BASFI, respectively. Conclusion  These results provide novel evidence to support the integral role of education, physical activity and rehabilitation in the management of axSpA. Future work should investigate additional outcomes of critical importance to patients and clinicians, such as fatigue, quality of life and work productivity. Furthermore, a greater understanding of the factors that confound these outcomes may provide insights into those patients who may most benefit from attending a 2-week rehabilitation course. In addition to facilitating identification of those patients who may require additional clinical support. Disclosure  R. Barnett: None. A. McGrogan: None. M. Young: None. C. Cavill: None. M. Freeth: None. R. Sengupta: Honoraria; Biogen, Celgene, AbbVie, Novartis, MSD. Grants/research support; Novartis, UCB.

Quality of life in long-term childhood cancer survivors and the relation of late effects and subjective well-being

2004 ◽  
Vol 13 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Sigrid Pemberger ◽  
Reinhold Jagsch ◽  
Eva Frey ◽  
Rosemarie Felder-Puig ◽  
Helmut Gadner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Late Effects ◽  
Well Being ◽  
Childhood Cancer Survivors ◽  
Subjective Well Being

The crystal arthropathies

2013 ◽  
Vol 6 (11) ◽  
pp. 681-687 ◽  
Author(s):  
Robert A Jones ◽  
Brian Quilty
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Inflammatory Arthritis ◽  
Term Treatment ◽  
Routine Practice ◽  
Treatment Goals ◽  
Crystal Arthropathies ◽  
Long Term Treatment

Unlike many other forms of inflammatory arthritis, the crystal arthropathies are routinely diagnosed and managed in primary care. Gout, in particular, is relatively commonplace and rates of other types of crystal-related arthritis are predicted to increase. These are, therefore, conditions that GPs and trainees will regularly encounter during routine practice. While the clinical features and pathophysiology of gout and pseudo-gout are well described, the long-term treatment goals and options of management are often less well understood, and opportunities to assess for associated co-morbidities can easily be missed. GPs can be central in optimising management by promptly and appropriately addressing acute symptoms, preventing recurrent attacks, minimising disability and work absences, reducing cardiovascular risk factors, improving general health and enhancing quality of life.

scholarly journals END-OF-LIFE CARE PREFERENCES AND WELL-BEING IN LONG-TERM CARE RESIDENTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S669-S669
Author(s):  
Kelly Shryock ◽  
Jacinta Dickens ◽  
Anisha Thomas ◽  
Suzanne Meeks
Keyword(s):  
Quality Of Life ◽  
Positive Affect ◽  
End Of Life ◽  
End Of Life Care ◽  
Long Term Care ◽  
Well Being ◽  
Life Care ◽  
Term Care

Abstract Research on end-of-life care in nursing homes comes largely from the viewpoint of staff or family members. We examined patient perspectives on end-of-life care, preferences for care, and quality of life in long-term care settings. We hypothesized that fulfillment of the Self Determination Theory (SDT) needs of autonomy, competence, and relatedness would be related to better well-being and that the degree to which end-of-life care preferences are seen as possible in the setting would be related to SDT need fulfillment and well-being. Preliminary data, collected from older individuals at the end of life (over 55, presence of significant chronic disease, in long term care setting) (n= 72), demonstrated that autonomy, competence, and relatedness measures were moderately and significantly correlated with well-being as measured by life satisfaction, higher positive affect, lower negative affect, and overall quality of life measures The degree to which residents believed that their end-of-life care preferences could be honored in the setting was also significantly correlated with autonomy, competence, relatedness, positive affect, and psychological quality of life. These results are consistent with SDT and suggest that if long term care settings can promote autonomy, connection, and competence in making end of life decisions, possibly by discovering and fulfilling preferences for end of life care, individuals who end their lives on those settings have potential for greater satisfaction and happiness. These results suggest that SDT is a useful framework for ongoing research on how to improve the end of life experiences of older adults in long term care.

scholarly journals Quality of life in patients with mild acute brain injury and their carers’ needs in Greece

2021 ◽  
Vol 9 (1) ◽  
pp. 39
Author(s):  
Evgenia Stasinopoulou ◽  
Margarita Giannakopoulou ◽  
Georgios Fildisis ◽  
Maria Kalafati ◽  
Chryssoula Leomonidou
Keyword(s):  
Quality Of Life ◽  
Brain Injury ◽  
Social Life ◽  
Well Being ◽  
Acute Brain Injury ◽  
Support Network ◽  
Family Needs ◽  
Rehabilitation Centers

Background: Investigating quality of life (QoL) is of crucial importance for the scientific community as it could function not only as an indicator of prognosis and post-traumatic clinical and psychological changes in patients who have suffered from acute brain injury (ABI), but also as an indicator of the effectiveness of their treatment and social rehabilitation. In addition, it can highlight changes in the carer’s health, social life and well-being. This study examined the QoL of patients following ABI and the needs of their carers.Material and methodology: This study was conducted in patients suffering from ABI, who were admitted to the General Hospital of Attica “KAT” and to the National Rehabilitation Center and on their carers. Data collection including demographics and Quality of Life After Brain Injury Questionnaire (QOLIBRI) and the Family Needs Questionnaire (FNQ) was performed during patients’ rehabilitation, while six months after release, a follow-up survey was conducted using the same questionnaires. Statistical analysis of data was performed using SPSS.Results: We analysed 50 patients with mild ABI (GCS ≥ of 13/15) during rehabilitation and six months after release and found that their QoL improves and is positively related to improvement of health status (i.e. in terms of thinking ability, QoL improves from r = 2.33, p < .01 to r = 3.37, p < .001). We also found that “Age” has the greatest impact on the patient’s progress for recovery and the general QoL after ABI (r = -0.423, p < .01). In addition, it was found that carers of patients with ABI are confronted with the burden of care, while they record both fulfilled and unmet needs regarding their individual needs (i.e. only for 30% of the sample the need for help in preparing them for the worst is met).Conclusions: Our study confirms previous findings that underline that ABI has a major impact on QoL of both patients and their carers providing them with long-term daily care. Although it has been found that over time there is an improvement in the QoL of patients with ABI, the absence of an official support network for carers from public health system, hospitals and rehabilitation centers may adversely affect the QoL of patients and their carers. Therefore, more structured, long-term family-wide monitoring and support is needed, focusing on identifying those at risk of social isolation and incomplete social networking.

Place-Making and Sustainable Community Development

2019 ◽  
pp. 253-272
Author(s):  
Rosario Adapon Turvey
Keyword(s):  
Quality Of Life ◽  
Community Development ◽  
Well Being ◽  
Theory And Practice ◽  
Place Making ◽  
Sustainable Community Development ◽  
Healthy Environment ◽  
Sustainable Community

This review chapter explores place-making in terms of how it is linked with sustainable community development (SCD). Place-making as it relates to sustainable community development has not been understood in the practice of sustainability, urban planning, and community development. Here, place-making is a process of planning, designing, managing, and programming spaces to create patterns and activities in cultural, social, economic, and ecological terms to achieve a better quality of life, a prosperous economy, and healthy environment. As informed by research, it can be an approach to sustainability thinking as a strategy for transforming cities and public spaces to promote well-being and prosperity in a local place, urban area, or neighborhood. In the long-term, the theory and practice of sustainable community development relative to place-making will evolve and eventually produce well-grounded meanings and conceptualizations as we engage in more research on sustainability and sustainable development.

scholarly journals Stability of Drinking Reductions and Long-term Functioning Among Patients with Alcohol Use Disorder

2020 ◽  
Author(s):  
Katie Witkiewitz ◽  
Henry R. Kranzler ◽  
Kevin A. Hallgren ◽  
Deborah S. Hasin ◽  
Arnie P. Aldridge ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Well Being ◽  
Total Sample ◽  
World Health ◽  
End Of Treatment

Abstract Background The World Health Organization (WHO) categorizes alcohol consumption according to grams consumed into low-, medium-, high-, and very-high-risk drinking levels (RDLs). Although abstinence has been considered the ideal outcome of alcohol treatment, reductions in WHO RDLs have been proposed as primary outcomes for alcohol use disorder (AUD) trials. Objective The current study examines the stability of WHO RDL reductions and the association between RDL reductions and long-term functioning for up to 3 years following treatment. Design and Participants Secondary data analysis of patients with AUD enrolled in the COMBINE Study and Project MATCH, two multi-site, randomized AUD clinical trials, who were followed for up to 3 years post-treatment (COMBINE: n = 694; MATCH: n = 806). Measures Alcohol use was measured via calendar-based methods. We estimated all models in the total sample and among participants who did not achieve abstinence during treatment. Key Results One-level RDL reductions were achieved by 84% of patients at the end of treatment, with 84.9% of those individuals maintaining that reduction at a 3-year follow-up. Two-level RDL reductions were achieved by 68% of patients at the end of treatment, with 77.7% of those individuals maintaining that reduction at a 3-year follow-up. One- and two-level RDL reductions at the end of treatment were associated with significantly better mental health, quality of life (including physical quality of life), and fewer drinking consequences 3 years after treatment (p < 0.05), as compared to no change or increased drinking. Conclusion AUD patients can maintain WHO RDL reductions for up to 3 years after treatment. Patients who had WHO RDL reductions functioned significantly better than those who did not reduce their drinking. These findings are consistent with prior reports suggesting that drinking reductions, short of abstinence, yield meaningful improvements in patient health, well-being, and functioning.

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