Biopsychosocial factors are associated with impaired sexual function in Mexican patients with rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic disease with worldwide representation that impacts every domain of a patient´s life, extending to sexual and reproductive domains. The study characterized sexual health (SH) and reproductive health (RH) in Mexican RA outpatients and identified factors associated with impaired sexual function (ISF). METHODS: From September 1, 2020-January 31, 2022, consecutive RA participants had semi-structured interviews focusing on their SH and RH biographies, and self-administered questionnaires were applied to assess patient-reported outcomes, including fatigue with the Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F). ISF was defined based on published cut-offs of the International Index of Erectile Function (IIEF) in males and the Female Sexual Function Index (FSFI) in females (≥1 sexual intercourse in the last four weeks was required for index scoring). Multivariable logistic regression analysis was used to identify the factors associated with ISF. RESULTS: There were 268 participants, and 246 (91.8%) were females. Participants had 13 years of disease duration. Among females, 151 (61.4%) had FSFI applied, and the satisfaction domain was impaired in 111 (73.5%). Among males (N = 22), 17 (77.3%) had IIEF applied, and erectile dysfunction was present in 5 (29.4%). Almost half of the participants denied using a family planning method, were in their 50s, and receiving teratogenic drugs; 89.7% of the participants had children. ISF was detected in 94 (62.3%) females and 3 (17.6%) males. Male sex (aOR: 0.07, 95%CI: 0.01-0.36, p = 0.001), FACIT-F score (aOR: 0.96, 95%CI: 0.92-1.00, p = 0.03), and cohabitation with the couple (aOR: 0.32, 95%CI: 0.11-0.96, p = 0.04) were associated with ISF. CONCLUSIONS: We observed a disproportionate burden of ISF among women with RA compared to male participants. Male sex, lesser fatigue, and cohabitation with the couple were protective against ISF. Regardless of the prevalent use of teratogenic medications, contraceptive use was suboptimal among the participants.

A Spanish version of the Three-Dimensional Work Fatigue Inventory (3D-WFI): factor structure, internal consistency, and criterion validity.

BACKGROUND: In the working population, there are risks of overload due to physical, mental, and emotional demands. No instrument is available in Spanish to measure these three types of work fatigue (WF) separately. This paper adapts the Three-Dimensional Work Fatigue Inventory (3D-WFI) (2015), which is of American origin and measures and differentiates these three different types of WF. It has adequate psychometric properties at its root, as do the subsequent German (2018), Lebanese (2022), and Chinese (2023) adaptations. METHODS: A total of 1100 workers (average age = 40 years) from economic sectors such as security and transportation of valuables, secondary and university educational institutions, and healthcare centers participated. They responded to the 3D-WFI, the Health-Related Quality of Life Index, and the Individual Strength Checklist for concurrent validity effects, together with items with sociodemographic and lifestyle variables. RESULTS: A confirmatory factor analysis with the total sample 3D-WFI supports its three-dimensionality; Cronbach's alpha and Omega values are adequate by dimensions: for physical work fatigue (α = 0.92, Ω = 0.92), for mental work fatigue (α = 0.94. Ω = 0.94), and emotional work fatigue (α = 0.95, Ω = 0.95). The 3D-WFI correlates significantly with the Checklist Individual Strength (0.743), and a pattern of significant relationships is found between WF and antecedent variables (e.g., being exposed to heat and noise, emotional labor, concentration, and workwear), as well as some consequences of WF (for example, mental health, absenteeism, work satisfaction, and sleep quality). CONCLUSIONS: We contribute here to the cross-cultural validity of the 3D-WFI, which can be used reliably and validly in the Chilean and probably Latin American working population. Some WF predictor variables are confirmed, as well as WF impacts on the absenteeism, health, and quality of life among workers.

Disentangling between-person and within-person associations of physical symptoms of depression with self-perceived health and life satisfaction: A longitudinal study in Chilean adults.

Depression is a major health problem in Chile. Evidence suggests that physical symptoms of depression (PSD) negatively impact self-perceived health and life satisfaction. The aim of this study was to determine the between-person and within-person associations of PSD with self-perceived health and life satisfaction in Chilean adults. The sample consisted of 1424 participants (64.54% female; Mage = 46.77, SD = 14.88) with data in five waves of the Social Longitudinal Study of Chile. Variables were measured through self-report questionnaires. Hypotheses were tested using multilevel analysis. At the within-person level, physical slowing, fatigue, and sleep problems were associated with poorer self-perceived health and lower life satisfaction. At the between-person level, physical slowing and fatigue were associated with poorer perceived health and lower life satisfaction. PSD are associated with self-perceived health and life satisfaction in Chilean adults longitudinally. The study highlights the importance of monitoring PSD changes in Chilean adults.

The effect of sleepiness in situation awareness: A scoping review.

BACKGROUND: Situational awareness is the acquisition of information from elements present in the work environment, the perception of the meaning of this information, and the prediction of future working conditions. Sleepiness and fatigue can influence an individual's ability to reach situation awareness, decision-making, and performance on a task. OBJECTIVE: This scoping review examines methods used to assess situational awareness, fatigue, sleepiness, and their interrelationships. METHODS: A systematic search of online databases was conducted to identify experimental, peer-reviewed articles published in English between 2017 and 2022. A total of 29 publications were selected for analysis. RESULTS: The selected studies originated from various countries, primarily in the northern hemisphere. Health and automotive engineering were the academic categories with the highest publications. The studies employed objective and subjective methods to assess situational awareness, fatigue, and sleepiness. CONCLUSIONS: Most studies reported a decline in situational awareness during fatigue and sleepiness conditions, although one study did not find this association. Future research should focus on employing objective methods to analyze cognitive factors, increasing sample sizes, and conducting testing in real-world situations.

Health variables and professional practice profile of ballroom dance teachers in Brazil / Variáveis de saúde e perfil da prática profissional de professores de dança de salão no Brasil

ABSTRACT The objective was to investigate fatigue, quality of life (QoL) and professional profile of ballroom dance teachers in Brazil compared by gender. A total of 272 professionals from the five regions of Brazil were evaluated using a self-administered questionnaire divided into professional profile, QoL and fatigue. It was observed that women showed better results compared to men in terms of education and BMI. The general QoL of both sexes showed regular scores, with higher values for the social relations domain and lower values for the physical domain. The data reflect the search for information on the profile of the ballroom dance teachers and health factors related to their professional practice profile, with possible distinctions between the sexes and highlight the importance of awareness for the maintenance of the health of dance professionals.

RESUMO O estudo teve como objetivo investigar a fadiga, a qualidade de vida (QV) e o perfil da prática profissional de professores de dança de salão no Brasil de acordo com o sexo. Foram avaliados 272 profissionais das cinco regiões do Brasil por meio de um questionário autoaplicável dividido em perfil profissional, QV e fadiga. Observou-se que as mulheres apresentaram melhores resultados em relação aos homens em termos de escolaridade e índice de massa corporal. A QV geral de ambos os sexos apresentou escores regulares, maiores valores de escores no domínio das relações sociais e menores valores no domínio físico. Os dados refletem a busca por informações sobre o perfil do professor de dança de salão e fatores de saúde relacionados ao seu perfil de atuação profissional, com possíveis distinções entre os sexos e destacam a importância da conscientização para a manutenção da saúde dos profissionais de dança.

Fatigue, sleep quality and mental health symptoms in Brazilian women during the COVID-19 pandemic: longitudinal study.

To assess the impact of the COVID-19 pandemic on the variables of sleep quality, fatigue, anxiety, and depression in healthy Brazilian women. Longitudinal observational study conducted through an online questionnaire with women in 2020 and 2021. The Pittsburgh Sleep Quality Index, the Fatigue Severity Scale and the Hospital Anxiety and Depression Scale were used. The data were analyzed descriptively and the comparison between the data obtained in the first and second evaluation was performed using the McNemar test. A logistic regression was applied to test the association between the variables that showed a significant difference. A total of 235 women responded to the questionnaires. There was a significant increase in fatigue between the two moments (p < 0.05). In the first assessment, depression (OR: 2.39; 95% CI: 1.14-4.99), anxiety (OR: 2.68; 95% CI: 1.37-5.22) and sleep quality (OR: 4.01; 95% CI: 1.71-9.67) were associated with fatigue. In the second assessment, depression (OR: 2.93; 95% CI: 1.19-7.18) and anxiety (OR: 2.69; 95% CI: 1.27-5.71) were associated with fatigue. There was an impact on biopsychosocial aspects during the COVID-19 pandemic, with worsening of fatigue symptoms within a 6-month interval. In addition, fatigue was associated with symptoms of depression and anxiety, and worse sleep quality in the first year of the pandemic, remaining associated with symptoms of depression and anxiety in the second year of the pandemic in the country.

Internet-Delivered Cognitive Behavioral Therapy and Psychoeducation Program for Patients with Gastrointestinal Stromal Tumors.

Gastrointestinal stromal tumors (GIST) account for 0.2-3% of all cancer diagnoses and are thus considered a rare type of cancer. Severe levels of fatigue occur in 33% of patients on imatinib, but besides treatment, fatigue is also associated with psychological distress. As far as we know, only one previous study has reported on the design of a psychoeducational intervention for caregivers and patients with GIST. The current study was conducted to compare the preliminary effectiveness of an Internet-delivered cognitive behavioral stress management intervention and psychoeducation program for anxiety, depression, fatigue, and quality of life in patients with gastrointestinal stromal tumors (GIST). This study had an experimental pre-test post-test design with a control group. Ninety-nine patients were randomly allocated to an Internet-delivered cognitive program (n = 50) or psychoeducation control group (n = 49). Participants completed the questionnaires at three time points (pre-test, post-test, and 3-month follow-up). Twenty-seven participants completed the intervention. A significant interaction effect between groups and time was found for general fatigue [F(2, 28) = 8.2, p < 0.001, ƞ2p = 0.25], reduced motivation [F(2, 28) = 3.5, p < 0.05, ƞ2p = 0.12], distress [F(2, 28) = 3.4, p < 0.05, ƞ2p = 0.12], and global health status [F(2, 28) = 3.8, p < 0.05, ƞ2p = 0.13]. Both intervention programs showed reductions in the dimensions of fatigue and improvements in distress and dimensions of quality of life. Additional research on a larger sample size is needed to confirm the effects obtained in this study.

Guided imagery relaxation in quality of life of patients undergoing hematopoietic stem cell transplantation: a quasi-experiment.

OBJECTIVE: The aim of this study was to evaluate the effects of the relaxation technique with guided imagery by means of virtual reality on health-related quality of life in patients undergoing hematopoietic stem cell transplantation. METHODS: A quasi-experiment conducted in a Bone Marrow Transplantation Service of a public hospital in southern Brazil. From October 2019 to October 2020, forty-two adult participants who underwent transplantation were included, 35 in the intervention group and seven in the control group. A guided imagery intervention, with audio guiding the relaxation associated with nature images in 360º, was performed during the hospitalization period. Data were collected on the first day of hospitalization, on the transplantation day, during the neutropenia stage, and at pre-hospital discharge. The Functional Assessment of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) and Functional Assessment of Cancer Therapy-Neutropenia (FACT-N) were used to assess health-related quality of life, fatigue and neutropenia. Data were analyzed using the Generalized Linear Mixed Model for the evolution of the health-related quality of life assessments over time, considering the groups and stages. Pearson's correlation coefficient was adopted for the correlation analyses. RESULTS: Allogeneic transplantation was predominant: 28 (80%) in the intervention group and 5 (71.43%) in the control group. There were improvements in the health-related quality of life scores, although not significant. A significant difference was found among the stages (p <0.050) and a significant positive correlation (p <0.000) among the variables on general quality of life, additional concerns, fatigue and neutropenia in all stages. CONCLUSION: Patients undergoing hematopoietic stem cell transplantation suffer changes in their quality of life. Interventions based on integrative practices emerge as an option to minimize them. 
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Revisiting the acute effects of resistance exercise on motor imagery ability.

Motor imagery (MI) shares psychological and physiological similarities with the physical practice of the same action. Yet, it remains unclear whether fatigue elicited by exercise impairs MI ability. Fourteen participants performed MI of a self-paced walking sequence of 22 m before and after a resistance exercise eliciting muscle fatigue from upper and lower limbs, selectively. We indexed MI ability using psychometric and behavioral methods. Electromyography of the quadriceps was also recorded during physical practice trials of the walking sequence. For both experimental conditions, we recorded improved temporal congruence between MI and physical practice of the walking sequence (9.89 %, 95 % CI [7.03, 12.75], p < 0.01). Vividness decreased immediately after the fatiguing exercise (6.35 %, 95 % CI [5.18, 7.51], p < 0.05), before rapidly returning to pre-fatigue values during recovery trials. The results challenge the hypothesis of an effect of acute fatigue elicited by a resistance exercise on MI ability, i.e. restricted to MI tasks focusing fatigued effectors. The beneficial effects of fatigue conditions on the psychometric and behavioral indexes of MI ability are discussed in the broader context of psychobiological fatigue models linking perceived exertion with the reallocation of attentional resources. The general perception of fatigue, rather than local muscle fatigue, appeared linked to the acute effects of resistance exercise on MI ability.

A influência da prática de atividade física no estado de humor de mulheres adultas / The influence of physical activity on the mood of adult women

O objetivo do presente estudo foi comparar os níveis de estado de humor de mulheres adultas praticantes de atividade física regular com os de mulheres adultas sedentárias. Participaram do estudo 57 mulheres (53,36 ± 10,68 anos de idade), divididas em dois grupos: ativas e sedentárias. Utilizou-se um questionário para caracterização da amostra e a Escala de Humor de Brunel (BRUMS). Os resultados do presente estudo demonstraram que as mulheres ativas apresentaram estado de humor positivo, além de apresentaram baixos escores para o estado de humor negativo, quando comparadas aos escores das mulheres sedentárias. Pode-se concluir que a atividade física pode influenciar positivamente o estado de humor.

The aim of this study was to compare mood levels of adult women engaged in regular physical activity with those of sedentary adult women. Fifty-seven women participated in the study (53.36 ± 10.68 years' old), divided into two groups: active and sedentary. A questionnaire was used to characterize the sample, and the Brunel Mood Scale (BRUMS) was also applied. The results demonstrated that active women had a positive mood state in addition to having low scores for negative mood state when compared to the scores of sedentary women. It can be concluded that physical activity can have a positive influence on mood state.

The Impact of Frailty on the Relationship between Life-Space Mobility and Quality of Life in Older Adults during the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic has led to abrupt restrictions of life-space mobility. The impact of shelter-in-place orders on older adults' health and well-being is still unclear. OBJECTIVE: To investigate the relationship between life-space mobility and quality of life (QoL) in older adults with and without frailty during the COVID-19 pandemic. DESIGN: Multicenter prospective cohort study based on structured telephone interviews. SETTING: Four geriatric outpatient clinics in the metropolitan area of Sao Paulo, Brazil. PARTICIPANTS: 557 community-dwelling adults aged 60 years and older. MEASUREMENTS: The Life-Space Assessment was used to measure community mobility before and during the COVID-19 pandemic, and a previously validated decrease of ≥ 5 points defined restricted life-space mobility. Frailty was assessed through the FRAIL (fatigue, resistance, ambulation, illnesses, and loss of weight) scale. The impact of shelter-in-place orders on QoL was evaluated with the question «How is the COVID-19 pandemic affecting your QoL?¼, to which participants could respond «not at all¼, «to some extent¼, or «to a great extent¼. We used ordinal logistic regressions to investigate the relationship between restricted life-space mobility and impact on QoL, adjusting our analyses for demographics, frailty, comorbidities, cognition, functionality, loneliness, depression, and anxiety. We explored whether frailty modified the association between life-space mobility and impact on QoL. RESULTS: Participants were on average 80±8 years old, 65% were women, and 33% were frail. The COVID-19 quarantine led to a restriction of community mobility in 79% of participants and affected the QoL for 77% of participants. We found that restricted life-space mobility was associated with impact on QoL in older adults during the pandemic, although frailty modified the magnitude of the association (P-value for interaction=0.03). Frail participants who experienced restricted life-space mobility had twice the odds of reporting an impact on QoL when compared with non-frail individuals, with respective adjusted odds ratios of 4.20 (95% CI=2.36-7.50) and 2.18 (95% CI=1.33-3.58). CONCLUSION: Older adults experienced substantial decreases in life-space mobility during the COVID-19 pandemic, and this unexpected change impacted their QoL. Providers should be particularly watchful for the consequences of abrupt life-space restrictions on frail individuals.

Effect of Mindfulness Training on Fatigue and Recovery in Elite Volleyball Athletes: A Randomized Controlled Follow-Up Study.

Volleyball is a team sport with high physical and perceptual-cognitive demand, hence, increasing the perception of physical and mental fatigue during a competition. To alleviate fatigue (physical and mental), mindfulness and music have been proposed. The aim of this study was to analyze the effect of mindfulness-based mental versus music training on mental fatigue, physical fatigue, and recovery in elite competitive female volleyball athletes using a randomized two-controlled study with follow-up. Participants were 30 elite female Brazilian volleyball athletes. Athletes were randomly assigned to the following groups: 1) mindfulness-based mental training group (MBMT); 2) music-based training group (MBT); or 3) control group (CG). Three variables were evaluated as follows: 1) recovery based on total quality recovery; 2) mental fatigue visual analog scale; and 3) physical fatigue visual analog scale. Regarding recovery, there was no difference between the MBMT, MBT, and CG groups (p > 0.05). A difference in mental fatigue was noted between MBT and CG at follow-up [F(2,26) = 5.71, p = 0.009; large]. Regarding physical fatigue, there was no difference between the MBMT, MBT, and CG groups (p > 0.05). The mindfulness intervention effectively attenuated the mental fatigue caused by competition in volleyball athletes. These results will assist coaches and staff in providing fatigue management and reinforce the applicability of mental training in sports.

Patient-centered outcomes in non-small-cell lung cancer: a real-world perspective.

Aims: To assess non-small-cell lung cancer (NSCLC) patient-centered outcomes in the real world. Methods: This is a prospective study of NSCLC patients treated at a private cancer care institution in Brazil between 2014 and 2019. Results: The report comprises 337 patients. Advanced stage was associated with higher symptom burden - fatigue (p = 0.03), pain (p < 0.001) and arm pain (p = 0.022) - and worse global, social and physical functioning (all p < 0.001). In the first 2 years, most factors evolved to either improvement or stability: cough (p = 0.02), pain (p = 0.002), global functioning (p < 0.001) and emotional functioning (p < 0.001). Staging (p < 0.001), fatigue (p = 0.001) and gender (p = 0.004) were independently associated with overall survival. Conclusions: Our results demonstrate the feasibility of conducting real-world prospective analysis of patient-centered outcomes.

Lay abstract This study looked at patient-centered outcomes in lung cancer in a real-world setting. Standardized quality-of-life questionnaires were used to actively measure patients' perception of their functional well-being and health in a clinical setting. Three hundred thirty-seven patients were enrolled in a private cancer center in Brazil between 2014 and 2019. We demonstrated that patients diagnosed at advanced stages presented with more symptoms and lower capacity to perform daily activities. However, symptoms and functioning tended to improve during treatment. Our results show that it is possible to put patients at the heart of cancer care and use their experience to guide clinical approach.

Effectiveness of hospital clowns for symptom management in paediatrics: systematic review of randomised and non-randomised controlled trials.

OBJECTIVE: To evaluate evidence from randomised controlled trials and non-randomised controlled trials on the effectiveness of hospital clowns for a range of symptom clusters in children and adolescents admitted to hospital with acute and chronic conditions. DESIGN: Systematic review of randomised and non-randomised controlled trials. DATA SOURCES: Medline, ISI of Knowledge, Cochrane Central Register of Controlled Trials, Science Direct, Scopus, American Psychological Association PsycINFO, Cumulative Index to Nursing and Allied Health Literature, and Latin American and Caribbean Health Sciences Literature. STUDY SELECTION: Randomised and non-randomised controlled trials were peer reviewed using the following eligibility criteria: children and adolescents who were admitted to hospital for acute conditions or chronic disorders, studies comparing use of hospital clowns with standard care, and studies evaluating the effect of hospital clowns on symptom management of inpatient children and adolescents as a primary outcome. DATA EXTRACTION AND SYNTHESIS: Two investigators independently screened studies, extracted data, and appraised the risk of bias. Methodological appraisal was assessed by two investigators independently using the Jadad scale, the revised Cochrane risk-of-bias tool for randomised controlled trials (RoB 2), and the risk of bias in non-randomised studies (ROBINS-I) tool for non-randomised controlled trials. RESULTS: 24 studies (n=1612) met the inclusion criteria for data extraction and analysis. Most studies were randomised controlled trials (n=13). Anxiety was the most frequently analysed symptom (n=13), followed by pain (n=9), psychological and emotional responses and perceived wellbeing (n=4), stress (n=4), cancer related fatigue (n=3), and crying (n=2). Five studies used biomarkers, mainly cortisol, to assess stress or fatigue outcome following hospital clowns. Most of the randomised controlled trials (n=11; 85%) were rated as showing some concerns, and two trials were rated with a high risk of bias. Most non-randomised controlled trials (n=6; 55%) were rated with a moderate risk of bias according to ROBINS-I tool. Studies showed that children and adolescents who were in the presence of hospital clowns, either with or without a parent present, reported significantly less anxiety during a range of medical procedures, as well as improved psychological adjustment (P<0.05). Three studies that evaluated chronic conditions showed favourable results for the intervention of hospital clowns with significant reduction in stress, fatigue, pain, and distress (P<0.05). CONCLUSIONS: These findings suggest that the presence of hospital clowns during medical procedures, induction of anaesthesia in the preoperative room, and as part of routine care for chronic conditions might be a beneficial strategy to manage some symptom clusters. Furthermore, hospital clowns might help improve psychological wellbeing in admitted children and adolescents with acute and chronic disorders, compared with those who received only standard care. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018107099.

Perceived fatigue in multiple sclerosis: The importance of highlighting its impact on quality of life, social network and cognition.

OBJECTIVES: To study the relationship between perceived fatigue and heath related quality of life (HRQoL), social support and cognition in an Argentinean population of patients with MS (PwMS). PATIENTS AND METHODS: 128 PwMS were studied, 75 women (58 %). Mean age: 40 ±â€¯10.49 years-old, education: 14 ±â€¯3.04, Expanded Disability Status Scale (EDSS): 2.43 ±â€¯1.87, evolution: 10.07 ±â€¯7.23 years. INSTRUMENTS: Fatigue Severity Scale (FSS); EDSS; Beck's Depression Inventory II (BDI-II); International Quality of Life questionnaire (MusiQoL); Medical Outcomes Study Social Support Survey (MOS); BICAMS Battery, 7/24 Spatial Recall Test, Paced Auditory Serial Task (PASAT-3), Word list generation task (WLG). RESULTS: Sixty-six patients (51.6 %) presented fatigue. Significant differences were found between fatigued and non-fatigued patients in EDSS and BDI II (p < 0.001). Fatigue was associated with age, EDSS and BDI II (p < 0.05). When analyzing differences in HRQoL between fatigued and non-fatigued patients statistically significant differences were found in MusiQol (p < 0.05). FSS proved to be an independent predictor of HRQoL (typified ß =-0.612 and -0.287, p < 0.05). Fatigued patients had fewer friends in their social support network (p = 0.031) and worse performance in PASAT. FSS was established as an independent predictor of PASAT (ß = -0.280, p = 0.009) CONCLUSION: Fatigue is one of the most common symptoms in Multiple Sclerosis (MS) and has a great impact on patients daily life. This study highlights the importance of studying fatigue and treating it properly, since otherwise, it contributes to the dysfunction of patients daily life with psychological and social consequences.

Age at diagnosis and health-related quality of life are associated with fatigue in systemic lupus erythematosus patients: Data from the Almenara Lupus Cohort.

OBJECTIVE: To define the factors associated with fatigue in Mestizo patients with Systemic Lupus Erythematosus (SLE). METHODS: This is a cross-sectional study of SLE patients from a single center cohort. Visits were performed every six months. For these analyses, the first visit between October 2017 and December 2018 was included. Demographic and clinical characteristics as well as treatment were recorded at every visit. Fatigue was ascertained with the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-FT), Health-Related Quality of Life (HRQoL) with the LupusQoL, disease activity with the Systemic Lupus Erythematosus Disease Activity Index -2 K (SLEDAI-2K), and damage with the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology damage index (SDI). Prednisone use was recorded as current daily dose. Immunosuppressive drugs and antimalarial use were recorded as current, past or never. Univariable and multivariable analyses were performed using linear regression models. For the multivariable analyses, model selection followed a backward elimination procedure. RESULTS: Two hundred and twenty-six patients were evaluated. The mean (SD) age at diagnosis was 35.6 (13.1) years, 211 (93.4%) were female; and disease duration was 11.0 (7.3) years. The mean SLEDAI and SDI were 2.4 (3.5) and 1.3 (1.5), respectively. The mean FACIT-FT was 33.1 (10.8). On the multivariable analysis, age at diagnosis and some domains of HRQoL (physical health, emotional health and fatigue) remained associated. CONCLUSIONS: Age at diagnosis is negatively associated with fatigue whereas HRQoL domains like physical health, emotional health and fatigue are positively associated with fatigue.

Patient perception of vitality and measured physical activity in patients receiving haemodialysis.

AIM: Fatigue in haemodialysis (HD) patients can be captured in quality of life questionnaires and by the dialysis recovery time (DRT) question. The associations between fatigue and measured physical activity has not been explored until the present. We tested our hypothesis that the patient perception of chronic and post dialysis fatigue would be associated with lower physical activity. METHODS: This study was a cross sectional evaluation of baseline data from HD patients recruited in the HDFIT trial. Vitality scores from the Kidney Disease Quality of Life (KDQOL-36) and the dialysis recovery time (DRT) question were used as indicators of chronic and post dialysis fatigue, respectively. Granular physical activity was measured by accelerometers as part of the study protocol. RESULTS: Among 176 patients, Vitality score was 63 ± 21 and the DRT was ≤30 minutes in 57% of patients. The mean number of steps was 5288 ± 3540 in 24 hours after HD and 953 ± 617 in the 2-hour post-HD period. The multivariable analysis confirmed Vitality scores were associated with physical activity in the 24-hour post-HD period. In contrast, DRT was not associated with physical activity captured by the accelerometer in the period immediately (2 hours) after the HD session. CONCLUSION: Chronic fatigue was negatively associated with step counts, while patient perception of post-dialysis fatigue was not associated with physical activity. These patterns indicate limitations in interpretation of DRT. Since physical activity is an important component of a healthy life, our results may partially explain the associations between fatigue and poor outcomes in HD patients.

Eating, Sleep, and Social Patterns as Independent Predictors of Clinical, Metabolic, and Biochemical Behaviors Among Elite Male Athletes: The EROS-PREDICTORS Study.

Objectives: Physiological hormonal adaptions in athletes and pathological changes that occur in overtraining syndrome among athletes are unclear. The Endocrine and Metabolic Responses on Overtraining Syndrome (EROS) study evaluated 117 markers and unveiled novel hormonal and metabolic beneficial adaptive processes in athletes. The objective of the present study was to uncover which modifiable factors predict the behaviors of clinical and biochemical parameters and to understand their mechanisms and outcomes using the parameters evaluated in the EROS study. Methods: We used multivariate linear regression with 39 participants to analyze five independent variables-the modifiable parameters (caloric, carbohydrate, and protein intake, and sleep quality and duration of concurrent cognitive activity) on 37 dependent variables-that were elected among the parameters evaluated in the EROS study. Results: Carbohydrate intake predicted quick hormonal responses to stress and improved explosive responses during exercise. Protein intake predicted improved body composition and metabolism and caloric intake, regardless of the proportion of macronutrients, predicted muscle recovery, and alertness in the morning. Sleep quality predicted improved mood and excessive concurrent cognitive effort in athletes under intense training predicted impaired metabolism and libido. Conclusions: The results support the premise that eating, sleep, and social patterns modulate metabolic and hormonal function, clinical behaviors, and performance status of male athletes, and should be monitored continuously and actively to avoid dysfunctions.

Quality of life in women treated with chemotherapy for breast cancer in Cali, Colombia / [Calidad de vida en mujeres con cáncer de mama sometidas a quimioterapia en Cali, Colombia].

Introduction: Breast cancer is a serious neoplasm that originates in mammary tissues whose treatment with chemotherapy seems to generate significant changes in the quality of life. Objective: To determine the risk factors associated with health-related quality of life in women with breast cancer under chemotherapy in Cali, Colombia. Materials and methods: We conducted an observational, cross-sectional study with analytical components in a sample of 80 female patients using the QLQ-C30 questionnaire for cancer, and the QLQ-BR23 for breast cancer, as well as sociodemographic and clinical information. We performed a logistic regression analysis to determine associated risk factors through adjusted OR and 95% CI; the quality of life was classified using the QLQ-BR23. Results: The most relevant symptoms were fatigue, insomnia, and hair loss. Physical functionality, feelings of pleasure, and sexual activity were reduced. The factors associated with low quality of life were mammary symptoms (adjusted OR= 5.5; 95% CI: 1.2-24.8; p = 0.038), systemic therapy side effects (adjusted OR = 7.3; IC95%: 2.6-22.1; p = 0.012), lower sexual pleasure (adjusted OR = 1.8; IC95%: 1.2-11.8; p = 0.027) and reduction of expectations about the future (adjusted OR = 4.2; IC95%: 1.1-17.8; p = 0.045). Conclusions: The quality of life in women with breast cancer and under chemotherapy was mainly affected by the side effects of the therapy; the most relevant signs and symptoms identified were hair loss, insomnia, and fatigue besides breast symptoms, lower physical functionality, and decreased sensation of sexual pleasure. We recommend intervention strategies aimed at improving the quality of life and the physical and emotional care of these patients.

Introducción. El cáncer de mama es una neoplasia grave que se origina en los tejidos mamarios y cuyo tratamiento demanda quimioterapia, con los consecuentes cambios en la calidad de vida. Objetivo. Determinar los factores de riesgo asociados con la calidad de vida relacionada con la salud en mujeres con cáncer de mama sometidas a quimioterapia en Cali, Colombia. Materiales y métodos. Se hizo un estudio observacional y transversal con componente analítico en una muestra de 80 mujeres, utilizando los cuestionarios QLQ-C30 para cáncer y QLQ-BR23 para cáncer de mama, así como información sociodemográfica y clínica. Se hizo un análisis de regresión logística para determinar los factores asociados con las razones de momios (odd ratios, OR) ajustadas y un intervalo de confianza (IC) de 95 %; la calidad de vida se clasificó mediante el cuestionario QLQ-BR23. Resultados. Los síntomas más relevantes fueron fatiga, insomnio y pérdida de cabello. Se redujeron la funcionalidad física, las sensaciones de placer y la actividad sexual. Los factores asociados con la baja calidad de vida fueron los síntomas mamarios (OR ajustada=5,5; IC95% 1,2-24,8; p=0,038), los efectos secundarios del tratamiento sistémico (OR ajustada=7,3; IC95% 2,6-22,1; p=0,012), un menor placer sexual (OR ajustada=1,8; IC95% 1,2-11,8; p=0,027) y la reducción de expectativas para el futuro (OR ajustada=4,2; IC95% 1,1-17,8; p=0,045). Conclusiones. En las mujeres con cáncer de mama sometidas a quimioterapia, la calidad de vida se vio afectada principalmente por los efectos secundarios del tratamiento, en tanto que los signos y los síntomas más relevantes fueron la pérdida del cabello, el insomnio y la fatiga, además de los síntomas mamarios, la menor funcionalidad física y la menor sensación de placer sexual. Se recomienda la implementación de estrategias de intervención destinadas a mejorar la calidad de vida, y el cuidado físico y emocional de las pacientes.