Health-related quality of life and insulin resistance over a 10-year follow-up

The aim of the study was to investigate the association between insulin resistance (IR) and health-related quality of life (HRQoL) among citizens of Palanga in a 10-year follow-up. A randomized epidemiological study was performed with 835 subjects. The following data were examined using questionnaires: sociodemographic characteristics, behavioural factors, HRQoL and self-perceived health. Fasting blood samples were drawn from all participants, and biochemical tests were performed for glucose and insulin. IR was evaluated by the homeostasis model assessment of IR (HOMA-IR). In subjects with IR, after adjusting for various factors, logistic regression analysis showed that within 10 years, there was a significantly higher chance of deteriorating HRQoL in the areas of physical functioning (odds ratio [OR] = 1.15, p < 0.001), emotional role limitations (OR = 1.07, p = 0.034), social functioning (OR = 1.26, p = 0.004), pain (OR = 1.09, p = 0.005) and general health perception (OR = 1.07, p = 0.022). People with IR have a worse HRQoL, and as they age, they are significantly more likely to have a deterioration in their HRQoL than people without IR in the areas of physical functioning, emotional role limitations, social functioning, pain and general health perception.

Architectural Valorization: Lighting Design Solution for the Bell Tower of “San Pasquale a Chiaia” Church

Christian churches and their bell towers represent a big part of the historical architectural heritage in Italy, and they had a major role in the development of the urban and social fabric of the Italian cities. This study is focused on the design of a lighting renovation for the bell tower of “San Pasquale a Chiaia” (Napoli, south of Italy). The lighting refurbishment is designed with the aim of: (i) emphasizing the architecture of the bell tower façades and (ii) providing a figurative and emotional role to the whole building. Several lighting scenarios have been implemented in order to compare the different luminaire types and arrangements on the basis of the effectiveness in valorizing the architectural characteristics of the bell tower, as well as the energy performances of the different design solutions. Finally, the best case has been further implemented in order to take into account the different needs of the historical building as well as the enhancement of the surrounding urban spaces.

SP5.1.1 The harsh reality of a long waiting list for bariatric surgery, a prospective study regarding health-related quality of life (HRQoL) among morbid obese patients following bariatric surgery versus those on a waiting list, a two-year follow-up study

Aims The aims of this study were to assess the changes in HRQoL during the 2 years follow-up between patients who underwent surgery and those on a long waiting list . Methods Between January to December 2017, 70 surgical patients and 69 patients on the waiting list were interviewed at baseline, 12-month and 24-month follow-up. Quality of life was measured by the SF-12v2 and the Impact of Weight on Quality of Life-Lite (IWQoL) questionnaires. Socio-demographics, clinical, and surgical-related variables were collected. Results 139 patients were analyzed, with similar baseline characteristics. Analyzing the entire sample: the higher the BMI, the worse the scores in the IWQoL. Performing more qualified work improves several aspects of the SF-12v2. In contrast, patients with depression tended to score worse on all dimensions of both questionnaires, women scored worse on the Self-Esteem domain and men improved on the Mental Health one. At 12 and 24-month follow-up, statistically significant differences were found among all aspects of the questionnaires between both groups (P&lt;.001). Furthermore, scores were lower in all domains in the evolution of wait-listed patients, with statistically differences among Bodily Pain, Emotional Role, Mental Health, and Mental Component Summary domains (P&lt;.05) at 12 months, but differences were not found at 24 months. Conclusions The quality of life of patients undergoing bariatric surgery is normalized one year after surgery, while patients on the waiting list get worse. Knowing the benefits of bariatric surgery, working on programs with long waiting lists should move us to fight against an unfair and unacceptable situation.

Quality of Life and Self-care Activities in Diabetic Ulcer Patients, Grade 3: Gender Differences

Introduction: Diabetic foot ulcer (DFU) is a common complication of diabetes mellitus associated with increased morbidity and mortality and diminished quality of life (QoL). This study aimed to explore the effect of gender differences on QoL and adherence to self-care activities. Methods: In this cross-sectional study, we enrolled 135 male and 135 female patients with DFU. Data was collected using the Short Form Health Survey (SF-36) and a questionnaire that measured self-care activities (Diet, Exercise, Blood Examination, and Foot Check). Data analysis was performed using SPSS version 20. Results: In terms of QoL, male participants had moderate to high levels in the categories of energy/fatigue, emotional well-being, social functioning, and bodily pain, whereas they had low levels in physical functioning, physical role, and emotional role. Female patients had moderate QoL in the categories of energy/fatigue and social functioning, whereas they had low QoL in physical functioning, physical role, emotional role, emotional well-being, and bodily pain. Finally, regarding general health, male participants had moderate QoL and females had moderate to low QoL. Both males and females had low adherence to exercise and high in blood-examinations. For both genders, adherence to exercise had a statistically significant association with all sub-categories of QoL apart from those of role (physical and emotional). Conclusion: It is essential for health care professionals to provide gender-specific approaches in treatment of ulceration.

Correlations between initial human-beta-defensin-1 level and quality of life of patients during anti-tuberculosis therapy

Background. The quality of life of patients with tuberculosis is an important component of the treatment effectiveness. Objective. To find the correlations between initial human-beta-defensin-1 (HBD-1) level and quality of life of patients during anti-tuberculosis therapy. Materials and methods. 100 patients with pulmonary tuberculosis were included in the study. The patients were diagnosed, treated and monitored according to current state protocols and World Health Organization guidelines. Additionally, the level if HBD-1 was measured in blood plasma by ELISA at the treatment onset. The patients were interviewed using SF-25 scale at the treatment inset, after 30 days and after 60 days. The parameters of physical functioning, role-physical functioning, bodily pain, general health, vitality, social functioning, emotional-role functioning, and mental health were assessed. Results. We found correlations between the initial level of HBD-1 and quality of life parameters: physical functioning (-0.43), role-physical functioning (-0.34), bodily pain (-0.23), general health (-0.42), social functioning (-0.42), emotional-role functioning (-0.36); p<0.05. The obtained negative correlations indicate that a high initial level of HBD-1 is a predictor of lower quality of life during treatment. Conclusions. An increase in the level of HBD-1 at the treatment onset can be considered a predictor of a decrease in the quality of life during treatment in patients with pulmonary tuberculosis.

Study of the quality of life in kidney donors at a transplant center in Urmia, Iran

Introduction: Maintaining and enhancing the quality of life (QOL) of living kidney donors are an essential measure for expressing health outcomes and consequences. Objectives: This study aimed to investigate kidney donors’ QOL at the transplant center of the Imam Khomeini hospital, Urmia, Iran. Patients and Methods: This retrospective cohort study was conducted on 30 kidney donors between the years 1997-2014 at the Imam Khomeini Hospital, Urmia. To this end, a QOL questionnaire was completed and data analysis was performed with SPSS version 22. Results: In this study, 90% (27) of the donors were male. The mean age of the donors at the time of examination and the duration of nephrectomy was 38 ± 9.48 and 7.36 ± 4.62 years, respectively. Fifty percent of the donors had a leave of absence more than 4 weeks after nephrectomy. The mean score of physical function, physical role, emotional role, vitality, mental health, social functioning, bodily pain, and general health was 77.66±25.88, 69.16±35.16, 54.44±45.04, 61.33±17.06, 64.26±19.56, 66.25±22.54, 81.25±18.75, and 61.83±21.83, respectively. However, none of the variables had a significant statistical relationship with QOL (P<0.05). Conclusion: Donors’ QOL is lower in Iran than in other countries. It is suggested to conduct studies with a larger sample size and an appropriate control group.

Health-related Quality of Life and Insulin Resistance: a Longitudinal Study

The aim of the study was to investigate insulin resistance (IR) in association with health-related quality of life (HRQoL) among citizens of Palanga in a ten years follow-up. A randomized epidemiological study was performed out for 835 subjects. All study participants were evaluated according to for socio-demographic characteristics, behavioral factors, HRQoL and self-perceived health using questionnaires. Fasting blood samples were draw from all participants and biochemical tests were performed for the glucose, insulin. IR was evaluated by the homeostasis model assessment of IR (HOMA-IR). In subjects with IR, after adjusting with various factors, logistic regression analysis showed, that within 10 years, a significantly higher chance of deteriorating HRQoL in the areas of: physical functioning (odss ratio [OR] = 1.15, p < 0.001), emotional role limitations (OR = 1.07, p = 0.034), social functioning (OR = 1.26, p = 0.004), pain (OR = 1.09, p = 0.005) and general health perception (OR = 1.07, p = 0.022). People with IR have a worse HRQoL and as they age, they are significantly more likely to have a deterioration in their HRQoL compared to people without IR in the areas of physical functioning, emotional role limitations, social functioning, pain and general health perception.

Effects of COVID-19 Lockdown on Physical Activity and Health-Related Quality of Life in Older Adults Who Regularly Exercise

The aim of the study was to analyze the effect of social distancing on physical activity (PA) and Health-Related Quality of Life (HRQoL) in active Spanish older adults according to their physical functionality. The study included 58 older adults aged 76.24 ± 6.00 years who were enrolled in a supervised physical exercise program before the COVID-19 outbreak. Anthropometric, physical function, physical activity and HRQoL were measured at baseline (October 2019). After the two-month lockdown due to the COVID-19, questionnaires were collected again during de-escalation (May 2020). Participants were divided into high- (n = 29) and low-functionality (n = 29) groups. Total PA, walking and cleaning significantly decreased (p < 0.001) whilst exercising or dancing increased (p < 0.001). General health, social and emotional role functioning dimensions and overall mental component scores worsened (p < 0.01–p < 0.05). Low-functionality participants had significantly lower physical functioning scores at baseline (p < 0.01) and lower bodily pain scores at de-escalation (p < 0.01). Emotional role functioning dimension and overall mental component significantly decreased only in low-functionality participants (p < 0.05). Although PA levels decreased significantly, older adults continued being active regardless of their functionality. While mental HRQoL in participants with higher physical functionality remained unchanged, participants with lower functional capacity had a higher risk of mental health concerns. Therefore, attention should focus on strategies to mitigate the negative effects of distancing measures on older people’s mental health, especially in those with lower functionality.

Quality of life of caregivers of patients with gastrointestinal cancer: The influence of sex, age, and stage of the cancer patients

Purpose: The caregivers of cancer patients may experience changes in their routine and environment that affect their quality of life. The aim of the study was to identify the domains that compromise the quality of life of the caregivers of patients with gastrointestinal cancer (GIC). Methods: A descriptive, observational study with caregivers of patients diagnosed with GIC during chemotherapy therapy was done. The caregivers answered 2 questionnaires, SF-36 (Short Form Health Survey 36) and CBS (Caregiver Burden Scale). Results: 100 caregivers of 100 patients with GIC were included. The mean age of the patients was 62.2±13 years. Most of them had colorectal cancer (66%), ECOG 0-1 (87%) and stage II/III (81%) disease. Among caregivers, 81% had less than 60 years old and 76% were female. According to the SF-36, lower levels were observed in the emotional, physical aspects and vitality and the best average in functional capacity. Regarding the CBS instrument, the general strain domain and disappointment was the more affected. Stage or ECOG was not associated to the caregivers QOL or burden. High schooling level of the patients was associated with a better quality of life and less burden of the caregivers. Ageing caregivers had a worst QoL and an increased burden.Conclusion: Most of caregivers were women and youngers and had a worst quality of life in emotional role, physical aspects and vitality and an increased burden in general strain and disappointment.

It’s long-term, well it’s for life basically: Understanding and exploring the burden of immunoglobulin treatment in patients with primary immunodeficiency disorders

This paper describes the burden of receiving immunoglobulin (Ig) treatment from the perspective of patients diagnosed with a Primary Immunodeficiency (PID). Thirty semi-structured interviews with patients receiving intravenous (n=21) and subcutaneous immunoglobulin (n=9) therapy, either at home or in hospital were undertaken. Underpinned by a phenomenological theoretical framework, and using a qualitative, inductive thematic approach to prioritise patients’ concerns, we identified that Ig treatment requires considerable effort by the patient, particularly in relation to the amount of time, organization and planning that is needed. They also face numerous physical, social, relationship, emotional, role functioning, travelling, and financial challenges in their effort to undergo and maintain their infusions and care for their health. Some qualitative differences in treatment burden were noted between home and hospital settings which contributed to non-adherence to those regimes. Immunoglobulin treatment burden is complex and influenced by therapeutic mode and setting and the personal circumstances of the patient. As choice over treatment method appears to be mainly informed by lifestyle needs, PID patients may benefit from more information about these potential Ig lifestyle influences when selecting which form of treatment to take together with their health professional.