Health-related quality of life among Ebola survivors in Sierra Leone: the role of socio-demographic, health-related and psycho-social factors

Background Evidence of how social factors affect the health-related quality of life (HRQoL) of Ebola virus disease (EVD) survivors is limited. Our study explores the association between socio-demographic, health-related and psycho-social (stigma) factors and EVD survivors' health-related quality of life (HRQoL) in Sierra Leone. Methods We conducted a nationwide cross-sectional study among 358 EVD survivors between January and August 2018. We used a multistage sampling method to recruit EVD survivors, and the RAND 36-Item Health Survey item was used to assess the HRQoL. Data were analysed using descriptive statistics and multiple linear regression. Results When comparing by each dimension in relation to their respective summary scores, role limitation physical [0.00 (50.00)] and role limitation emotional [0.00 (33.33)] were the most affected physical health and mental health domains among EVD survivors respectively. EVD survivors who were older (β = − 3.90, 95% CI − 6.47 to − 1.32, p = 0.003), had no formal education (β = − 2.80, 95% CI − 5.16 to − 0.43, p = 0.021), experienced a unit increase in the number of post-Ebola symptoms (β = − 1.08, 95% CI − 1.74 to − 0.43, p < 0.001) and experienced a unit increase in enacted stigma (β = − 2.61, 95% CI − 4.02 to − 1.20, p < 0.001) were more likely to report a decreased level of physical health. EVD survivors who experienced a unit increase in the time spent in the Ebola treatment centre (β = − 0.60, 95% CI − 0.103 to − 0.18, p = 0.006) and those who experienced a unit increase in enacted Stigma were more likely to report decreased levels of mental health (β = − 1.50, 95% CI − 2.67 to − 0.33, p = 0.012). Conclusion Sociodemographic, health-related, and psycho-social factors were significantly associated with decrease levels of HRQoL. Our findings improve our understanding of the factors that might influence the HRQoL and suggest the need for EVD survivors to be provided with a comprehensive healthcare package that caters for their physical and mental health needs.

Postoperative Assessment of the Quality of Life in Patients with Colorectal Endometriosis

Morbidity and mortality alone are not comprehensive measures of evaluating the benefits of surgical interventions in endometriosis patients, thus, subjective patient-reported instruments are required. The 36-tem Short Form Survey (SF-36) is a Health-Related Quality of Life (HRQoL) instrument that has not been validated yet for women with endometriosis. The aims of this study are to evaluate the validity and reliability of the SF-36 in patients with colorectal endometriosis and to compare the HRQoL before and after surgery, using different Quality of Life (QoL) instruments: the Gastrointestinal QoL Index (GIQLI) and Knowles–Eccersley–Scott Symptom Questionnaire (KESS). We conducted a retrospective study using prospectively recorded data in the North-West Inter-Regional Female Cohort for Patients with Endometriosis (CIRENDO) database. The assessment was performed on four hundred and eighty-eight patients before and 12 months after the surgery. Preoperative and postoperative item-internal consistency and Cronbach’s α proved evidence for good reliability showing that SF-36 is a useful instrument for endometriosis patients’ QoL. The domains of Role (limitation) physical, Bodily pain and Role (limitation) emotional showed the most remarkable improvements (difference before vs. one year after surgery) with p < 0.001. Our data show that SF-36 has validity and reliability and can be used in patients with endometriosis. Surgery improved the QoL and digestive function.

Quality of Life (QoL) Is Reduced in Those with Severe COVID-19 Disease, Post-Acute Sequelae of COVID-19, and Hospitalization in United States Adults from Northern Colorado

The longitudinal quality of life (QoL) of COVID-19 survivors, especially those with post-acute sequelae (PASC) is not well described. We evaluated QoL in our COVID-19 survivor cohort over 6 months using the RAND SF-36 survey. From July 2020–March 2021 we enrolled 110 adults from the United States with a positive SARS-CoV-2 nasopharyngeal polymerase chain reaction (PCR) into the Northern Colorado Coronavirus Biobank (NoCo-COBIO). Demographic data and symptom surveillance were collected from 62 adults. In total, 42% were hospitalized, and 58% were non-hospitalized. The Rand SF-36 consists of 36 questions and 8 scales, and questions are scored 0–100. A lower-scale score indicates a lower QoL. In conclusion, hospitalization, PASC, and disease severity were associated with significantly lower scores on the RAND SF-36 in Physical Functioning, Role Limitation due to Physical Health, Energy/Fatigue, Social Functioning, and General Health. Long-term monitoring of COVID-19 survivors is needed to fully understand the impact of the disease on QoL and could have implications for interventions to alleviate suffering during recovery.

HEALTH RELATED QUALITY OF LIFE AMONG PATIENTS WITH PULMONARY TUBERCULOSIS IN PUDUCHERRY.

Tuberculosis is a disease with social implications due to the stigma attached to it. It has been seen that apart from physical symptoms, TB patients face various problems that are social and economic in nature. Therefore,for a comprehensive assessment of patients' health status, it is essential to consider the overall impact of TB on health and patients' perception of well-being, besides routine clinical, radiological and bacteriological assessments.Continuous care for patient with tuberculosis focuses on teaching to prevent the spread of the disease to the others and to ensure an effective treatment to eradicate the disease. Tuberculosis is a disease with social implications due to the stigma attached to it. It has been seen that apart from physical symptoms, TB patients face various problems that are social and economic in nature. Therefore, for acomprehensive assessment of patients' health status, it is essential to consider the overall impact of TB on health and patients' perception of well-being, besides routine clinical, radiological and bacteriological assessments The aim of the study to assess the health related quality of life among patients with Pulmonary tuberculosis in selected Primary Health Centres under RNTCP, in Puducherry. The Objectives of the study as to assess the health related quality of life among patients with newly diagnosed Pulmonary tuberculosis. A descriptive cross sectional research design was adopted for the study. For the purpose of this study, a total of 126 subjects with newly diagnosed pulmonary tuberculosis were selected from the four primary health centres as Mettupalayam,Lawspet, Reddiarpalayam and Mudaliarpet under RNTCP (October 2016 to February 2018) by using cluster stage sampling technique. The investigator explained the purpose of the study to the subjects. Socio demographic prole was assessed and the Quality of Life (QoL) score of the subjects with pulmonary tuberculosis was measured and evaluated by using modied Health-Related Quality of Life (HRQoL) short form 36 item scale (Kruijshaar, et al., 2010) with the aim of highlighting the impact of the disease on the overall well-being of the patient as often neglected aspect of health. Health-related quality of life refers to the overall conditions of the quality of life of the individuals in eight domains 1. physical functioning, 2. role limitation / physical health, 3. role limitation / emotional health, 4. energy/ vitality 5. emotional well being / mental health, 6. social functioning, 7. body pain and 8. general health of an individual or a group measured in terms of feelings of satisfaction or dissatisfaction which is a subjective assessment of one's own well-being and perception of the degree of contentment with and capability to perform and control different facets of one's own life..The major ndings of the study as out of 126 subjects, the overall health related quality of life mean score in the experimental group was 13.05 ± 8.27 and in the control group it was 12.55±8.28. Results. The results of the current study highlighted a signicant impact on several domains of HRQoL of pulmonary TB patients. Conclusion. The results of the present study concluded that TB patients had poor HRQoLin spite of the new therapeutic strategies and free availability of medicines. The disease had a negative impact on HRQoLof TB patients across all domains

EFFECTS OF PHYSICAL ACTIVITY ON QUALITY OF LIFE AMONG FEMALE UNDERGRADUATE STUDENTS

Objective: to determine the effects of physical activity on quality of life among female undergraduate students. Material & Methods: A randomized clinical trial was conducted on n=52 female students, after taking approval from higher authorities of the Bilquis Postgraduate College for Women PAF Nur Khan Base Rawalpindi, The inactive female students >1monthbetween 18-25 years were included in the study. The participants were randomly divided into three groups, such as Light Physical Activity (LPA), Moderate Physical Activity (MPA) and Vigorous Physical activity (VPA) group. The short form (SF-36) was used to observe Quality of Life (QOL), among participant at baseline and after six weeks of intervention. The One Way ANOVA with Tukey HSD post hoc was applied on mean differences for comparison. The clinical significance eta squared (η2) was used. Results: The result showed that Role limitation (mental) was significantly improved in vigorous activity group than the light (MD=21.20, d=0.85, 95% CI=0.97 to 43.37) and moderate (MD=23.94, d=0.96 95% CI=4.05 to 43.83) activity group. While social function showed significant improvement in moderate activity group as compared to light (MD=15.30, d=1.01, 95% CI=3.83 to 26.76) activity and vigorous (MD=9.60, d=0.63, 95% CI=1.68 to 20.88) activity group. The pain also showed significant improvement in moderate activity as compared to light (MD=20.32, d=1.09, 95% CI=5.48 to 35.16) and vigorous (MD=21.97, d=1.18, 95% CI=9.67 to 34.26) activity group. Conclusion: PA significantly improved QOL of female undergraduate students. It was also found that VPA improves role limitation (emotional) while MPA improves social function and body pain.

Determinants of compliance to the facemask directive in Greece: A population study

Purpose Primary objective of this study was to identify potential difficulties and/or discomfort when using a facemask. Moreover, to explore the impact of spectacles, contact lenses and visual acuity on the compliance to the facemask directive. Methods This is a prospective study that was conducted at the Department of Ophthalmology, University Hospital of Alexandroupolis, Greece between June 2020 and August 2020. Greek speaking citizens with permanent residency in Greece above 18 years old were included. A custom questionnaire (DeMask-20) was constructed and validated, which pertained to the perceived difficulty and discomfort when using a facemask. It contained 20 items grouped in 8 subscales (driving, near vision, distance vision, ocular discomfort, role limitation, collaboration, dependency on others, emotional stress). Perceived difficulty and discomfort when using a facemask, compliance and correlations of compliance with DeMask-20 scores, demographics, spectacle and/or contact lens use, and visual acuity were evaluated. Results The number of factors was determined through factor analysis. Cronbach’s alpha ranged from 0.716 for the “Role limitation” subscale to 0.938 for “Ocular discomfort” subscale. 1,214 participants (402 men, 812 women, mean age 36.79±12.50 years) completed the DeMask-20 instrument. Mean DeMask-20 score of all study participants was 3.79±0.71. Significant differences in DeMask-20 score were detected in gender (p = 0.009), spectacle use (p = 0.034), contact lens use (p = 0.049), and binocular distance visual acuity (bDVA) (p = 0.001). Mean compliance of all participants was 4.05±0.96. Men, people <50 years and spectacle wearers showed significantly worse compliance (p<0.05). Moreover, professional workers and professional drivers demonstrated significantly better compliance (p = 0.008 and p = 0.047). Significant correlation was detected between compliance and DeMask-20 score (p<0.001, R2 = 0.471). Significant correlations were detected with driving, near vision, distance vision, collaboration, role limitation, emotional stress (p<0.05, R2: 0.386–0.493). Conclusions Factor analysis suggested that the DeMask-20 instrument demonstrates adequate validity, while Cronbach’s alpha indicated sufficient internal consistency of all subscales. This study provided the necessary methods that could evaluate compliance trends and the efficacy of healthcare interventions against COVID-19. Our outcomes suggest that young males who use spectacles should be targeted by Greek Healthcare authorities in order to improve compliance rates.

AI-Based Radiological Imaging for HCC: Current Status and Future of Ultrasound

Hepatocellular carcinoma (HCC) is a common cancer worldwide. Recent international guidelines request an identification of the stage and patient background/condition for an appropriate decision for the management direction. Radiomics is a technology based on the quantitative extraction of image characteristics from radiological imaging modalities. Artificial intelligence (AI) algorithms are the principal axis of the radiomics procedure and may provide various results from large data sets beyond conventional techniques. This review article focused on the application of the radiomics-related diagnosis of HCC using radiological imaging (computed tomography, magnetic resonance imaging, and ultrasound (B-mode, contrast-enhanced ultrasound, and elastography)), and discussed the current role, limitation and future of ultrasound. Although the evidence has shown the positive effect of AI-based ultrasound in the prediction of tumor characteristics and malignant potential, posttreatment response and prognosis, there are still a number of issues in the practical management of patients with HCC. It is highly expected that the wide range of applications of AI for ultrasound will support the further improvement of the diagnostic ability of HCC and provide a great benefit to the patients.

The Associations Between Blood Pressure and Quality of Life in Elderly Patients with Hypertension in China

Objective: To investigate the status of quality of life (QOL) and examine the changes in quality of life with increasing age in elderly patients with hypertension; to determine the associations between blood pressure and quality of life in hypertensive elderly at different age groups; to determine the relationships between ranges of blood pressure and quality of life. Method: This was a cross-sectional study design. The study recruited 752 elderly patients with hypertension from one general hospital, thirty urban community clinics and rural clinics in Suzhou from October 2016 to October 2017.The quality of life was assessed by The Short Form Health Survey (SF-36), which is categorized into two aggregate summaries, including physical component summary (PCS) and mental component summary (MCS). Furthermore, PCS included four dimensions, namely; physical functioning (PF), role limitation because of physical health (RP), bodily pain (BP) and general health perceptions (GH); MCS included another four dimensions, namely; vitality (VT), social functioning (SF), role limitation because of emotional health problems (RE) and mental health (MH). Result: The result showed that scores of physical component summary (PCS) gradually decreased and scores of mental component summary (MCS) was stable with increasing age. In PCS, the scores of the bodily pain and physical functioning dimensions and in MCS the social functioning dimension score dropped in participants with age ≥ 85 years. Following analysis, the results showed that diastolic blood pressure (DBP) was positively associated with PCS (r=0.112, P =0.003). We further analyzed the relationship between DBP and PCS (including 4 dimensions) of quality of life at different age groups. We found that DBP had a positive relationship with PSC (r=0.114, P =0.003) and the bodily pain dimension (r=0.205, P < 0.001) in the elderly with an age < 85 years, while there was no relationship between DBP and PCS in the elderly with an age ≥ 85 years. After adjusting for the effects of socio-demographic and clinical factors, there was no association between DBP and PCS (B=0.026, P= 0.633), while DBP still had a positive effect on the bodily pain dimension (B=0.234, P= 0.026). Conclusions: We found that DBP had a positive relationship with physical quality of life in the elderly with age < 85 years.Therefore, medical personnel should maintain the DBP within normal range but may allow higher level, when managing hypertensive elderly patients aged < 85 years, so as to relieve their pain, which can help improve their quality of life.

METAFICTION AND DROSTE EFFECT IN THE NOVEL “IF ON A WINTER’S NIGHT A TRAVELER” BY ITALO CALVINO

f on a winter's night a traveler is considered one of the greatest novels by Italian writer Italo Calvino. Published in 1979, this literary work, which belongs to the postmodernist narrative style in the form of a frame story, tells about a reader trying to read a book with the same title from beginning to end. Much of the story’s content was written in the second-person’s narration, implying that “you” (the Reader) are the protagonist of the novel. Embedded inside are ten short stories (the loose ends of different novels) read by the main character, which causes the book to constantly switch between settings, narrators, and styles. If on a Winter’s Night a Traveler is truly a perfect illustration for the literary style characterized by metafiction and postmodernism. The novel is a conscious textual play with various techniques employed such as authorial role limitation, reader involvement in the plot line, open structure, non-linearity, fragmentation, multiplicity, and intertextuality. By effectively using these devices, Calvino deconstructs the traditional novel form and creates a new structure which shows a parallel between the processes of writing and reading a text. Calvino acts as the supreme game-master taking control of both the characters and the real players, who have been pushed into this game-like novel. This article focuses on analyzing the charactericstics of metafiction, the Droste effect and deconstruction in Calvino’s novel If on a winter's night a traveler, thereby helping to grasp his playful language and his narrative techniques as well as to discover his metafictional discourse.

Quality of life and its affecting factors among patients with multiple sclerosis: a cross-sectional study in northwest Iran

Background: Multiple Sclerosis (MS) is one of the most important diseases due to its adverse clinical, social and economic consequences for affected people. Objectives: This study tried to assess the quality of life of the patients suffering from Multiple Sclerosis in East Azerbaijan. Methods: This cross-sectional study used the Multiple Sclerosis Quality of Life-54 (MSQOL-54) questionnaire for interviewing 300 randomly selected MS patients in East Azarbaijan province, Iran. The independent T-test, ANOVA and Tukey post hoc test were used to examine the relationship between demographic variables and quality of life, and all analyses were performed using SPSS19. Results: The quality of life score among the MS patients is 48.22. The "life satisfaction" is the best and "physical role limitation" is the worst quality of life aspect. There were significant relationships between marital status, education level, employment status, age of symptoms onset and years of illness with quality of life (P<0.05). Conclusion: The quality of life of the MS patients in East Azarbaijan province is lower than other parts of Iran and much lower than OECD countries.