Bazedoxifene plus conjugated estrogens improve menopausal symptoms in postmenopausal women: a systematic review and meta-analysis.

Our aim is to evaluate the efficacy of bazedoxifene (BZA) plus conjugated estrogens (CE) on menopausal symptoms in postmenopausal women. A series of databases including PubMed, EMBASE, Medline, Web of science, China national knowledge internet and Wanfang database up to 31 October 2021 were searched, and randomized controlled trials (RCTs) of BZA/CE for menopausal symptoms were included. Seven RCTs involving 5431 patients were included in this study. Compared with placebo group, there were significantly reduce in daily number of hot flushes, daily number of moderate or severe hot flushes, the percentages of parabasal cells and the time to fall sleep when patients treated with BZA/CE. Besides, there were significant improvement in sleep disturbance and total MENQOL. However, no significant improvements in sleep adequacy were observed in the three groups. Furthermore, BZA 20 mg/CE 0.625 mg was more effective than BZA 20 mg/CE 0.45 mg in improving the menopausal symptoms. Therefore, both bazedoxifene 20 mg plus conjugated estrogens 0.45 mg and bazedoxifene 20 mg plus conjugated estrogens 0.625 mg could significantly improve the menopause-related symptoms and MENQOL in postmenopausal women, and the curative effects of BZA 20 mg/CE 0.625 mg were better than that of BZA 20 mg/CE 0.45 mg. These findings need to be further confirmed by more high-quality RCTs.

Quality of life and sexual function analysis in a group of Italian postmenopausal women after COVID-19 vaccination.

AIM: The aim of the study was to evaluate the impact of SARS-CoV-2 vaccination on quality of life, psychological aspect and sexual life in a group of Italian postmenopausal women during the COVID-19 pandemic. METHODS: The study was a prospective, observational analysis of postmenopausal women before and after the COVID-19 vaccination. The population previously answered different questionnaires, such as the Female Sexual Function Index (FSFI), the Female Sexual Distress Scale (FSDS), the 36-Item Short Form Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Twelve weeks after the end of the vaccine cycle, these women were invited to complete the same questionnaires by e-mail to evaluate if vaccination coverage could positively impact the quality of life of postmenopausal women. The Patient Impression of Global Improvement (PGI-I) after three months of treatment was also calculated. RESULTS: A total of 114 patients were reported. The median age was 60.96 (52-66) years. Mean sexual intercourses/month increased from 1.28 ± 1.23 to 4.21 ± 1.80 (p = 0.001). The FSFI increased (19.22 ± 3.31 vs 29.24 ± 4.21, p < 0.0001) and the FSDS decreased significantly (20.12 ± 5.23 vs 9.32 ± 5.55, p < 0.0001) 12 weeks after vaccination coverage. The SF-36 increased from 64.23 ± 11.76 to 82.21 ± 10.24 (p < .0001) and the HADS questionnaire improved significantly from 9.3 ± 2.73 to 5.1 ± 1.34 after the COVID-19 vaccine execution (p<.0001). CONCLUSIONS: The spread of COVID-19 vaccine coverage positively influenced sexual function, quality of life and psychological aspect in postmenopausal women.

Effect of support groups on caregiver's quality of life.

The objective of this study was to evaluate the effect that participating in support groups for caregivers has on the quality of life and psychotropic drug use of family caregivers of adults with limitations in activities of daily living. A controlled quasi-experimental longitudinal design was used with 134 caregivers (64 in the experimental group and 70 in the control group). The outcomes were health-related quality of life (EuroQol 5D3L test) and psychotropic drug use (no/yes). The analyses were performed using SPSS and R statistical software. An interaction was observed between the condition and the level of limitations in activities of daily living of the care receiver, having an effect on the caregiver's psychotropic drug use (p = 0.003), with this use being lower among caregivers who attend support groups when their relatives present fewer limitations in activities of daily living. Moreover, the quality of life was higher in the post-test in the experimental group (B = 8.66, p = 0.015). In conclusion, support groups could improve the caregiver's quality of life and decrease psychotropic drug use when the care receiver has low limitations in activities of daily living.

El objetivo de este estudio es evaluar el efecto que tiene la participación en grupos de apoyo para cuidadores en la calidad de vida y el consumo de fármacos psicotrópicos de cuidadores familiares de adultos con limitaciones en las actividades de la vida diaria. Se usó un diseño longitudinal cuasiexperimental controlado con 134 cuidadores (64 en el grupo experimental y 70 en el grupo de referencia). Los criterios de evaluación fueron la calidad de vida relacionada con la salud (test EuroQol 5D3L) y el consumo de fármacos psicotrópicos (sí / no). Los análisis se realizaron usando los programas estadísticos SPSS y R. Se observó una interacción entre la enfermedad y el nivel de limitaciones en las actividades de la vida diaria del receptor del cuidado y el efecto que tuvo en el consumo de fármacos psicotrópicos del cuidador (p=0.003). Este consumo fue menor entre los cuidadores que asisten a grupos de apoyo cuando sus familiares presentan menos limitaciones en las actividades de la vida diaria. Además, la calidad de vida fue mayor en el grupo experimental después del test (B=8.66, p=0.015). En resumen, los grupos de apoyo podrían mejorar la calidad de vida del cuidador y disminuir el consumo de fármacos psicotrópicos cuando el receptor del cuidado tiene pocas limitaciones en las actividades de la vida diaria.

Perceived Collective Efficacy and Parenting Competence: The Roles of Quality of Life and Hope.

Parents' perceptions of their parenting competence predict successful implementation of parenting tasks and contribute to their interest and involvement in parenting and to their children's development. Thus, identifying factors that contribute to parents' perceptions of parenting competence can help inform efforts to promote children's safety and well-being. The present study employs social disorganization theory to examine the relationship between collective efficacy and parents' sense of competence, measured along two dimensions: parental efficacy and parental satisfaction. It examines the direct association between the two constructs and whether the association is mediated by parent perceptions of their quality of life (QOL) and sense of hope. Data were collected from 198 parents residing in a neighborhood in southern Tel Aviv, Israel. The analyses indicated that high collective efficacy was directly associated with high parental efficacy, but not with high parental satisfaction. Using structural equation modeling, a mediation model was found whereby higher collective efficacy was associated with (a) higher QOL, which in turn was related to a greater sense of hope, which was linked with higher parental efficacy; and (b) higher QOL, which was directly associated with higher parental satisfaction. The findings provide further support to the idea that neighborhood characteristics play an important role in parents' ability to care for their children.

Las percepciones de los padres de su competencia en la crianza predicen la implementación satisfactoria de las tareas de crianza y contribuyen a su interés y participación en la crianza y al desarrollo de sus hijos. Por ende, los factores identificadores que contribuyen a las percepciones de los padres de su competencia en la crianza pueden ayudar a orientar las iniciativas para promover la seguridad y el bienestar de los niños. El presente estudio emplea la teoría de la desorganización social a fin de analizar la relación entre la eficacia colectiva y la percepción de competencia de los padres evaluadas en dos dimensiones: la eficacia parental y la satisfacción parental. Además, examina la asociación directa entre los dos constructos y si la asociación está mediada por las percepciones de los padres de su calidad de vida y su sensación de esperanza. Se recopilaron datos de 198 padres que viven en un barrio del sur de Tel Aviv, Israel. Los análisis indicaron que una eficacia colectiva alta estuvo directamente asociada con una eficacia parental alta, pero no con una satisfacción parental alta. Utilizando modelos de ecuaciones estructurales, se descubrió un modelo de mediación por el cual una eficacia colectiva más alta estuvo asociada con (a) una calidad de vida más alta, la cual a su vez estuvo relacionada con una mayor sensación de esperanza, que estuvo ligada con una eficacia parental más alta; y (b) una calidad de vida más alta, que estuvo directamente asociada con una satisfacción parental más alta. Los resultados ofrecen mayor respaldo de la idea de que las características de un barrio desempeñan un papel importante en la capacidad de los padres para preocuparse por sus hijos.

Stigma, Expressed Emotion, and Quality of Life in Caregivers of Individuals with Dementia.

Expressed emotion (EE) is a measure of a caregiver's critical and emotionally overinvolved (EOI; e.g., intrusive, self-sacrificing) attitudes and behaviors toward a person with a mental illness. Mounting evidence indicates that high levels of these critical and EOI attitudes and behaviors (collectively termed high EE) in family members are associated with a poorer course of illness for people with a range of disorders, including dementia (Nomura et al., 2005). However, less is known about factors that might trigger high EE and how high EE might impact dementia caregivers' own mental health. In this study we propose that caregivers who perceive stigma from their relative's illness may be more likely to be critical or intrusive (high EOI) toward their relative in an attempt to control symptomatic behaviors. We further hypothesized that high EE would partially mediate the link between stigma and quality of life (QoL) as there is some evidence that high EE is associated with poorer mental health in caregivers themselves (Safavi et al., 2015). In line with study hypotheses and using a sample of 106 dementia caregivers, we found that greater caregiver stigma was associated with both high EE (for criticism and EOI) and with poorer QoL. Mediational analyses further confirmed that high EE accounts for much of the association between stigma and poorer QoL. Study results suggest that addressing caregiver stigma in therapy could reduce levels of high EE and indirectly therefore improve caregiver QoL. Intervening directly to reduce high EE could also improve caregiver QoL.

Health utilities in Chinese patients with coronary heart disease and impaired glucose tolerance (ACE): A longitudinal analysis of a randomized, double-blind, placebo-controlled trial.

BACKGROUND: We estimate health-related quality of life and the impact of four cardiovascular events (myocardial infarction [MI], stroke, congestive heart failure, angina) and gastrointestinal events in 6522 Chinese patients with coronary heart disease (CHD) and impaired glucose tolerance (IGT) participating in the Acarbose Cardiovascular Evaluation (ACE) trial. METHODS: Health-related quality of life was captured using the EuroQol-5 Dimension-3 Level (EQ-5D-3L), with data collected at baseline and throughout the trial. Multilevel mixed-effects linear regression with random effects estimated health-related quality of life over time, capturing variation between hospital sites and individuals, and a fixed-effects linear model estimated the impact of cardiovascular and gastrointestinal events. RESULTS: Patients were followed for a median of 5 years (interquartile range 3.4-6.0). The average baseline EQ-5D score of 0.930 (SD 0.104) remained relatively unchanged over the trial period with no evidence of statistically significant differences in EQ-5D score between randomized treatment groups. The largest decrement in the year of an event was estimated for stroke (-0.107, P < .001), followed by heart failure (-0.039, P = .022), MI (-0.021, P = .047), angina (-0.012, P = .047), and gastrointestinal events (-0.005, P = .430). MI and stroke reduced health-related quality of life beyond the year in which the event occurred (-0.031, P = .006, and -0.067, P < .001, respectively). CONCLUSIONS: Acarbose treatment had no impact on health-related quality of life in ACE trial participants with CHD and IGT. Events such as MI, stroke, heart failure, and angina reduce health-related quality of life around the time they occurred, but only MI and stroke impacted on longer-term health-related quality of life.

Quality of life and post-traumatic stress disorder among adult females with cancer in Palestine: a cross-sectional study.

Background: Little research has been conducted on the quality of life (QoL), functional status, and traumatic symptoms related to the diagnosis and treatment of cancer in the Arab region, particularly in Palestine, where the psychological problems in patients with cancer are often neglected.Objective: The aim of the study was to assess QoL and post-traumatic stress disorder (PTSD) symptoms among adult female patients with cancer attending Beit-Jala Governmental Hospital in Bethlehem.Method: Participants were recruited from 4 April 2015 to the end of July 2015. The sample included 253 female patients with cancer attending Beit-Jala Governmental Hospital in Bethlehem. Data were collected using self-reported questionnaires, including a socio-demographic data sheet, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, and the post-traumatic stress disorder checklist for PTSD symptoms.Results: The current study showed poor global QoL (57.4%) and poor physical function (48.5%) for female patients with cancer. Insomnia, fatigue, and loss of appetite were the most troublesome symptoms that the participants complained about. The prevalence of PTSD symptoms was 3%. Regarding PTSD symptom severity, 2% reported severe symptoms, 23.3% reported moderate symptoms, and (68.8%) reported mild symptoms, based on a 1991 classification of PTSD symptom severity scores. Finally, Pearson's test revealed a strong, statistically significant, inverse relationship between QoL domains and PTSD.Conclusion: The study found that the overall QoL of female patients with cancer was low and strongly associated with PTSD symptoms, suggesting that early detection and treatment of these symptoms is critical.

Post-traumatic stress disorder is being increasingly diagnosed among patients with cancer, in addition to low quality of life.The literature reveals a lack of studies in Palestine assessing these problems in female patients with cancer.A cross-sectional study including 253 patients with cancer using three self-reported questionnaires was conducted.Job loss circumstances and coping strategies (but not socio-demographic and work variables) were associated with class membership.