Distressed personality is associated with late adverse effects in long-term survivors of Hodgkin lymphoma.

BACKGROUND AND PURPOSE: There are few studies of personality traits in long-term Hodgkin lymphoma survivors (HLSs) treated according to contemporary stage-and risk-adapted approaches. The Distressed Personality (DP) Scale covers negative affectivity and social inhibition. We examined differences in self-reported late adverse effects (LAEs) between HLSs with and without DP and other explanatory variables. MATERIAL AND METHODS: This cross-sectional questionnaire-based study included a population-based cohort of HLSs treated from 1997 to 2006, aged 8-49 years at diagnosis, and alive in 2016. Among 518 eligible HLSs, 303 responded (58%), and 294 completed the DP scale. DP was defined by scores above cut-off on both the negative affectivity and social inhibition subscales. LAEs studied were major depression, posttraumatic stress disorder, sleep problems, obesity, neuropathy, fatigue, memory problems, and general health. DP and 10 other explanatory variables were tested against LAEs as dependent variables in multivariable regression analyses. RESULTS: The mean age at survey was 45.9 years (standard deviation [SD] 4.6), mean follow-up time 16.7 years (SD 3.0), and 48% were females. Eighty-two HLSs had DP (28%, 95% confidence interval 23% - 33%). All LAEs except obesity were significantly more common/had higher mean score in HLSs with DP. In multivariable analyses, presence of DP was significantly associated with all LAEs except obesity. INTERPRETATION: The presence of DP is common among HLSs. The presence of DP was associated with most self-report LAEs examined. Including assessment of personality traits in the survivorship care plans of HLSs should be considered. Prospective studies assessing the influence of pretreatment DP on LAEs are warranted.

The burden and determinants of fatigue in incident and prevalent systemic sclerosis.

OBJECTIVES: To investigate the burden and clinical associations of fatigue in systemic sclerosis (SSc) as measured by FACIT-Fatigue scores. METHODS: Australian Scleroderma Cohort Study participants with ≥1 FACIT-Fatigue score were included. Participants were divided into those with incident SSc (≤5 years SSc duration at recruitment and FACIT-Fatigue score recorded within 5 years of disease onset) or prevalent SSc (first FACIT-Fatigue score recorded >5 years after SSc onset). Generalised estimating equations were used to model change in FACIT-Fatigue scores over time, expressed as an increasing (improving) or decreasing (worsening) score. RESULTS: Of 859 participants, 215 had incident SSc and 644 prevalent SSc. First-recorded FACIT-Fatigue scores were similar in those with incident (37 units, IQR 25-45.5) and prevalent SSc (36 units, IQR 23-44; p=0.17), as were lowest-ever recorded FACIT-Fatigue scores (incident 23 units; prevalent 22 units, p=0.75). In incident SSc, higher skin scores (regression coefficient (RC) -1.5 units, 95%CI -2.3 to -0.8), PAH (RC -8.2, 95%CI -16.5 to 0.1) and reduced left ventricular function (RC -10.6, 95%CI -18.3 to -2.8) were associated with more severe fatigue. In prevalent SSc, higher skin scores (RC -0.6, 95%CI -1.3 to 0), gastrointestinal symptoms (RC -6.6, 95%CI -9.0 to -4.2), hypoalbuminaemia (RC -2.8, 95%CI -5.0 to -0.7), BMI<18.5kg/m2 (RC -6.3, 95%CI -10.3 to -2.2), raised CRP (RC -3.1, 95%CI -4.7 to -1.5), and anaemia (RC -1.7, 95%CI -3.5 to 0.1) were associated with more severe fatigue. CONCLUSIONS: The burden of fatigue is substantial in both incident and prevalent SSc. Cardiopulmonary and gastrointestinal involvement are associated with worse fatigue.

Kinesiophobia, physical activity levels and barriers in breast cancer patients, survivors, and healthy controls: A case-control analysis.

OBJECTIVE: To investigate kinesiophobia, physical activity levels and barriers to physical activity in women with breast cancer and breast cancer survivors. METHODS: The case-control study was conducted at the Breast Clinic of Acibadem Maslak Hospital, and the Department of Physiotherapy and Rehabilitation at Acibadem Mehmet Ali Aydinlar University, Turkey, from October 2021 to July 2022, and comprised patients with breast cancer in group A, breast cancer survivors in group B and healthy controls in group C. The primary outcome measures were physical activity levels, barriers to physical activity and kinesiophobia levels, while the secondary outcome measures were levels of anxiety, depression, fatigue and quality of life. Data was collected using standard tools. Data was analysed using SPSS 22. RESULTS: Of the 212 women, 70(33%) were in group A with mean age 50.71±11.30 years, 70(33%) in group B with mean age 47.64±9.85 years, and 72(34%) in group C with mean age 47.03±7.48 years. Group C had better physical activity levels, fatigue and quality of life scores than the other groups, but it had worse perceptions of physical activity and more individual, psychosocial and environmental barriers to physical activity compared to the other groups (p<0.05). Group A had more barriers to exercise related to fear of overall body pain, poor balance, fear of falling and fear of feeling worse post-exercise compared to the other groups (p<0.05). Group B subjects were more afraid that lymphoedema might be exacerbated if they exercised (p<0.05). CONCLUSIONS: Women with breast cancer and breast cancer survivors had worse scores for physical activity levels, fatigue and quality of life compared to the healthy controls. All three groups had a variety of barriers to physical activity.

Pain and fatigue in adult patients with multiple osteochondromas: The Netherlands.

BACKGROUND: Multiple Osteochondromas (MO) is a rare genetic disorder characterised by the presence of numerous benign bone tumours, known as osteochondromas. Within the spectrum of debilitating symptoms associated with MO, pain is recognized as a major problem. Interestingly, our clinical observations suggest that fatigue is also a significant concern but has merely been touched upon in MO literature. This study aims to (1) assess the level of pain and fatigue in adult patients with MO; (2) compare fatigue in MO to healthy subjects and patients with Rheumatoid Arthritis (RA); (3) identify associated variables for pain and fatigue in patients with MO. METHODS: In this cross-sectional study, 353 adult MO patients completed a survey with validated questionnaires on pain, fatigue and psychosocial factors. Pain and fatigue were assessed with the Numeric Rating Scale (NRS), and fatigue was also measured with the Checklist Individual Strength (CIS). Fatigue (CIS) was compared with reference scores of healthy subjects and patients with RA, using a one-sample t-test. Multiple linear regression models for pain and fatigue were developed using a-priori selected independent variables based on a theoretical framework (ICF-model). RESULTS: Pain was reported by 87.8% (NRS = 3.19±2.6) and fatigue by 90.4% (NRS = 4.1±2.6) of patients with MO. Fatigue scores for MO (CIS = 84.1±15.3) were significantly higher (p<0.001) compared to reference scores of healthy subjects and patients with RA. The multivariable analysis for pain provided a final regression model with six variables (R2 = 0.445, p<0.001) of which fear avoidance beliefs and fatigue had the strongest association. For the fatigue models NRS (R2 = 0.455, p<0.001) and CIS (R2 = 0.233, p<0.001), the strongest associations were found with anxiety and depression respectively. CONCLUSIONS: Pain and fatigue are highly prevalent in patients with MO. Fatigue is significantly higher compared to healthy subjects and patients with RA. Several variables associated with pain and fatigue have been identified that could help improve multidisciplinary treatment plans.

Maritime accidents in the estuary of the River Seine from 2009-2019.

BACKGROUND: In confined waters, ships run a high risk of groundings, contact, sinkings and near misses. In such waters the maritime traffic is dense, the waterway is narrow, the depth is limited, and tides and currents are constantly changing. MATERIALS AND METHODS: From 2009-2019, 75 accidents were investigated in the estuary of the Seine. Weather conditions and perceived fatigue were studied. From May to June 2020, 114 seafarers, 34 pilots and 80 captains, responded to a questionnaire focusing on the use of Pilot Portable Units (PPU) and Electronic Chart Display Information Systems (ECDIS). RESULTS: The 75 accidents corresponded to an average of 6.8 ± 3.2 accidents per year. Groundings were the most frequent accidents (35%, n = 26) followed by contact accidents with the quayside (25%, n = 19), between ships or tugs while manoeuvring (8%, n = 6) or while sailing (1%, n = 1). There was no loss of vessels nor fatalities of crew members. In poor weather conditions, there were 76% more accidents than in normal conditions (4.4 ± 2.5 accidents/10,000 movements versus 2.5 ± 1.9 accidents/10,000 movements, p < 0.03). Almost all the accidents (96%) were related to human errors of judgment (81%), or negligence (53%), or both (39). Perceived fatigue was probably in cause in 6 accidents. Only 3 accidents were related to mechanical causes. Through the questionnaires, 69% of the pilots complained of difficulties in mastering the devices and software. They felt distracted by alarms which affected their attention while navigating. They requested training on a simulator. Concerning ship captains, 83% felt comfortable with ECDIS devices yet only 20% were able to configure the ECDIS correctly. CONCLUSIONS: In the Seine estuary, 75 accidents occurred within the 11 year-study. Risk factors were poor weather conditions and human error. PPU and ECDIS were considered as useful tools in the prevention of accidents. However, pilots and captains requested more thorough training in their use.

Work-related musculoskeletal disorders, fatigue and stress among gas station workers in China: a cross-sectional study.

INTRODUCTION: Work-related musculoskeletal disorders (WMSDs) are disorders of the musculoskeletal system that have the highest prevalence among workers worldwide. Workers in gas stations usually work in poor ergonomic working conditions, including prolonged standing and repetitive posturing. OBJECTIVE: The study aimed to investigate the prevalence of WMSDs and fatigue and to identify the predictors of WMSDs among gas station workers. DESIGN: The present study was a cross-sectional study. SETTING AND PARTICIPANTS: 2962 gas station workers from an oil and gas company in China, with ages ranging from 17 to 75 years old, 55.47% female. RESULTS: The prevalence of WMSDs within the 12 months prior to the study was 73.23%, with the highest prevalence in the neck, shoulders, ankles and feet. Furthermore, a correlation was observed between fatigue, stress and WMSDs. Fatigue and job role were the strongest predictors of WMSDs, with an OR range of 2.211-3.413. CONCLUSIONS: This research identified the detrimental impact of WMSDs and fatigue on gas station workers, indicating the critical need for interventions to reduce WMSDs and relieve fatigue.

Outcome clusters and their stability over 1 year in patients with SLE: self-reported and performance-based cognitive function, disease activity, mood and health-related quality of life.

OBJECTIVE: To determine if self-reported fatigue, anxiety, depression, cognitive difficulties, health-related quality of life, disease activity scores and neuropsychological battery (NB) cluster into distinct groups in patients with SLE based on symptom intensity and if they change at 1-year follow-up. METHODS: This is a retrospective analysis of consecutive consenting patients, followed at a single centre. Patients completed a comprehensive NB, the Beck Anxiety Inventory, Beck Depression Inventory, Fatigue Severity Scale, Short-Form Health Survey Physical Component Summary and Mental Component Summary scores and the Perceived Deficits Questionnaire. Disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index 2000. Ward's method was used for clustering and principal component analysis was used to visualise the number of clusters. Stability at 1 year was assessed with kappa statistic. RESULTS: Among 142 patients, three clusters were found: cluster 1 had mild symptom intensity, cluster 2 had moderate symptom intensity and cluster 3 had severe symptom intensity. At 1-year follow-up, 49% of patients remained in their baseline cluster. The mild cluster had the highest stability (77% of patients stayed in the same cluster), followed by the severe cluster (51%), and moderate cluster had the lowest stability (3%). A minority of patients from mild cluster moved to severe cluster (19%). In severe cluster, a larger number moved to moderate cluster (40%) and fewer to mild cluster (9%). CONCLUSION: Three distinct clusters of symptom intensity were documented in patients with SLE in association with cognitive function. There was a lower tendency for patients in the mild and severe clusters to move but not moderate cluster over the course of a year. This may demonstrate an opportunity for intervention to have moderate cluster patients move to mild cluster instead of moving to severe cluster. Further studies are necessary to assess factors that affect movement into moderate cluster.

Midlife stress-related exhaustion and dementia incidence: a longitudinal study over 50 years in women.

BACKGROUNDS: Cognitive problems are common symptoms among individuals with stress-related exhaustion. It is still unknown whether these individuals are at a higher risk of developing dementia later. This study aims to examine the relationship between midlife stress-related exhaustion and dementia incidence. METHODS: A population sample of 777 women (aged 38, 46, 50 and 54 years) without dementia at baseline was followed over 50 years, from 1968 to 2019. Stress-related exhaustion was based on information from the psychiatric examination in 1968/69. Information on dementia incidence between 1968 and 2019 was obtained from neuropsychiatric examinations, key-informant interviews, and hospital registry. Dementia was diagnosed according to the DSM-III-R criteria. A subgroup of non-demented women (n = 284) was examined for cognitive functions by the Gottfries-Bråne-Steen scale 24 years after baseline. RESULTS: Stress-related exhaustion in midlife was associated with higher risk for development of dementia before age 75 (Hazard ratio and 95% confidence interval: 2.95 and 1.35-6.44). The association remained after adjustment for age, major depression, and anxiety disorder. Mean age of dementia onset was younger for women with stress-related exhaustion than women without stress (mean ± SD, 76 ± 9 vs. 82 ± 8 . p = 0.009). Women with stress-related exhaustion in midlife still showed more cognitive impairments 24 years later compared with women without stress (Odds ratio and 95% confidence interval: 2.64 and 1.15-6.06). CONCLUSIONS: We found that women with stress-related exhaustion in midlife were at a higher risk to develop dementia at relatively younger age. These women showed persistently lower cognitive functions over years even without dementia. Present study results need to be interpreted with caution due to small sample size and should be confirmed in future studies with larger sample size. Our study findings may imply the importance of long-term follow-up regarding cognitive function among individuals with stress-related exhaustion.

Primary Dengue and Long-Term Health Status in Madeira Island, Portugal: A Retrospective Questionnaire-Based Study.

Dengue is among the most important mosquito-borne viral diseases worldwide. Although its acute manifestations are well known, little is known about the long-term impact of dengue on the population's health status. Madeira Island experienced a single outbreak of autochthonous dengue from September 2012 to March 2013. To extend our knowledge about the clinical impact of the outbreak on this naive population, we applied an online questionnaire to 168 adults diagnosed with dengue at the time to characterize retrospectively their symptoms during the infection and to identify long-term manifestations, possibly triggered by dengue. The most frequent symptoms during the clinical period, reported by more than three-quarters of our participants, were fever, myalgia, extreme tiredness, and headaches, whereas vomiting, pruritus, nausea, retro-orbital pain, and arthralgia occurred in 35% to 50% of participants. In the 8 years after dengue, 61.5% of participants reported at least one recurrent previously nonexistent symptom, the most frequent being headaches, abundant hair loss, extreme tiredness, arthralgia, and myalgia, experienced by 25% to 35% of participants. Nearly 20% of the participants with persistent symptoms reported the onset of chronic illness in the 4 years after dengue, most frequently ophthalmological and autoimmune diseases (5.6% each), versus only 2.2% of chronic disease onset in participants without persistent symptoms. Our results suggest that the occurrence of persistent symptoms after primary dengue might be more frequent than anticipated and may persist for several years, having an impact on the health status and well-being of a considerable proportion of the infected population.

Prevalence and factors associated with fatigue in patients with major depressive disorder or bipolar disorder.

AIMS: To study the prevalence of fatigue and factors associated with fatigue in patients with major depressive disorder (MDD) or bipolar disorder (BD). METHODS: Two hundred fifty-three outpatients with MDD or BD at the initial assessment were used to study the prevalence of fatigue and relationship between fatigue and other clinical correlates. The severity of fatigue was measured with Iowa Fatigue Scale (IFS), and depression and anxiety symptom-severity were measured with the QIDS-16-SR (the 16-item Quick Inventory of Depressive Symptomatology - Self-Report) and Zung-SAS (Zung Self-Rating Anxiety Scale). Correlation between IFS and QIDS-16-SR total scores, QIDS-16-SR item scores or Zung-SAS total scores, and independent factors associated with fatigue was assessed with simple or multiple linear regression analysis. RESULTS: Overall, 28.4 % of MDD and 29.8 % of BD patients did not have fatigue, but 41.2 % of MDD and 45.0 % of BD patients had fatigue, and 30.4 % of MDD and 25.2 % of BD patients had severe fatigue. Depression/anxiety severity was significantly correlated with fatigue. However, after controlling current psychiatric comorbidities, demographics, some social factors, and psychotropic use, only QIDS-16-SR scores were still significantly and positively correlated with IFS scores in both MDD and BD. Differential correlations between IFS scores and item scores of QIDS-16-SR in MDD and BD were observed. LIMITATION: Cross-sectional. CONCLUSIONS: In this outpatient sample, fatigue was highly prevalent in patients with MDD or BD. The independent association of depressive severity with the severity of fatigue highlights the importance of complete resolution of depressive symptoms in treating MDD and BD.

Gender inequalities of psychosomatic complaints at work vary by occupational groups of white- and blue-collar and level of skill: A cross sectional study.

BACKGROUND: Previous research has shown that women report more psychosomatic complaints at work than men. However, knowledge about gender inequalities in psychosomatic complaints within occupational groups and specific symptoms is lacking. This study aims to compare gender inequalities in psychosomatic complaints in the occupational groups of white-collar high-skilled, white-collar low-skilled, blue-collar high-skilled and blue-collar low-skilled workers. METHODS: The study implemented a cross sectional design using data from the nationwide German Employment Survey of the Working Population on Qualification and Working Conditions conducted in 2017/ 2018. Psychosomatic complaints were operationalised by the following symptoms: headache, insomnia, tiredness, irritability, dejection, physical fatigue, and emotional fatigue. N = 20012 working German-speaking respondents were sampled. After excluding persons with missing data on the study variables, the sample consisted of N = 16359 persons. RESULTS: Women reported significantly more psychosomatic complaints than men in the subgroups of white-collar high-skilled and white-collar low-skilled (ps < .05), inequalities in blue-collar high-skilled and blue-collar low-skilled only being numerical. Regarding specific symptoms, women reported more psychosomatic complaints then men in the subgroups of white-collar high-skilled workers, white-collar low-skilled workers, and blue-collar low-skilled workers. Headaches, physical fatigue, and emotional fatigue were the most common symptoms. The white-collar high-skilled subgroup had the highest number of symptoms with significant gender inequalities. These effects remained after controlling for age, working hours, parental status and marital status. CONCLUSIONS: Gender inequalities in psychosomatic complaints are ubiquitous but vary in their frequency by occupational subgroup and specific psychosomatic complaint. Women in white-collar high-skilled jobs in particular report to be burdened more often by many specific psychosomatic symptoms. Future studies should investigate the reasons for these occupational inequalities and develop interventions to reduce health inequalities in the workplace.

Trajectory patterns and predictors of cancer-related fatigue in postoperative lung cancer patients receiving chemotherapy.

PURPOSE: Cancer-related fatigue (CRF) is a chronic symptom that can affect the overall functioning of lung cancer patients throughout the course of the disease. However, there is limited research on the trajectory and predictors of CRF specifically in lung cancer patients. Furthermore, few studies have investigated the predictive role of positive psychological and social factors in relation to CRF. This study aimed to explore the trajectory of CRF and its predictors in postoperative chemotherapy patients with lung cancer. METHODS: A total of 202 lung cancer patients who underwent surgery and received adjuvant chemotherapy were recruited for this study. Baseline questionnaires were completed, covering sociodemographic information, disease details, CRF levels, personality traits, psychological resilience, and social support. CRF was assessed at three time points: first chemotherapy (T1), 3 months after chemotherapy (T2), and 6 months after chemotherapy (T3). Latent class growth modeling (LCGM) was used to identify distinct developmental trajectories of CRF. Logistic regression analysis was employed to examine predictors of CRF within different patient groups. RESULTS: The LCGM analysis revealed three distinct CRF trajectories: persistent high fatigue group (30.7%), rising fatigue group (30.7%), and no fatigue group (38.6%). Cancer stage (OR = 7.563, 95% CI = 2.468-23.182, P < 0.001), melancholic personality (OR = 6.901, 95% CI = 1.261-37.764, P = 0.026), and high psychological resilience (OR = 0.171, 95% CI = 0.041-0.706, P = 0.015) were associated with the CRF trajectory. On the other hand, sanguine personality (OR = 0.254, 95% CI = 0.071-0.916, P = 0.036) and high social support (OR = 0.168, 95% CI = 0.045-0.627, P = 0.008) were associated with the increasing fatigue trajectory. CONCLUSIONS: This study demonstrated that 60% of lung cancer patients experienced persistent fatigue throughout the assessment period. Moreover, it confirmed the heterogeneity of CRF trajectories among lung cancer patients. The severity of CRF was found to be higher in patients with advanced clinical stages, depressive personality traits, and lower psychological resilience.

Identifying pre-habilitation targets for the mitigation of long-term side effects of chemotherapy in patients with early breast cancer.

BACKGROUND: Pre-treatment characteristics of women with early breast cancer that are associated with persistent fatigue or suboptimal health-related quality of life (HRQOL) post-chemotherapy need to be identified as potential targets for pre-habilitation. PATIENTS AND METHODS: Ancillary analysis of previously collected data from patients with newly diagnosed Stage I-III breast cancer scheduled to receive chemotherapy. The objective was to identify baseline (pre-chemotherapy) variables associated with meaningful deteriorations in fatigue and other measures of HRQOL from pre-treatment to 6 months after chemotherapy completion. Percentages are reported along with unadjusted and adjusted relative risks. RESULTS: In a sample of 249 women post-chemotherapy, 32% reported worsening fatigue (FACIT-F), 35% worsening Physical Well-Being (PWB), 16% worsening Functional Well-Being (FWB), 8% worsening Emotional Well-Being (EWB), and 30% worsening Social Well-Being (SWB). In multivariable (MV) analysis, variables that were significant in univariate analysis - Black race, high BMI, and baseline poorer EWB - remained significant for worsening post-chemotherapy fatigue (FACIT-F). In MV analysis that included race, education, falls, and baseline EWB, Black race and a positive falls history remained significant for worsening PWB. In MV analysis inclusive of race, Short Physical Performance Battery (SPPB) and FWB, lower SPPB and FWB remained significant predictors of worsening FWB. In MV analysis that included baseline Mental Health Index-Anxiety, EWB and SWB, a higher SWB and lower EWB remained significant for worsening SWB. CONCLUSION: Pre-chemotherapy characteristics in women with early-stage breast cancer that are associated with increased fatigue and reduced HRQOL post-treatment could be used to identify patients who may benefit from pre-habilitation interventions.

Association between nutritional risk and fatigue in frailty conditions for older adult patients: a multicentre cross-sectional survey study.

BACKGROUND AND AIMS: Frailty is widespread in the elderly, while there is a bi-directional relationship between frailty and malnutrition. The objectives of this study were to investigate the prevalence and correlation of frailty and nutritional risk in older adult patients and to analyse the factors associated with fatigue which is one indicator of frailty. METHODS: This cross-sectional multicentre survey study was conducted in five hospitals in the same city from 01 January 2021 to 01 December 2021. We collected information on gender, age, diseases, medication and dietary status. Frailty status was diagnosed using the FRAIL scale, and Nutritional Risk Screening-2002 was used to screen the nutritional risk. Spearman rank correlation was used to analyse the correlation between frailty and nutritional risk. Univariate and multivariate logistic regression analyses were used to analyse the risk factors related to fatigue in all patients and inpatients. RESULTS: Among 2016 older adult patients, the prevalence of frailty was 15.1% (305/2016), the prevalence of nutritional risk was 16.2% (327/2016) and the overlap prevalence of frailty and nutritional risk was 7.3% (147/2016). Multivariate analysis showed that nutritional risk (OR 3.109, 95% CI 2.384 to 4.056, p<0.001) was an independent risk factor for fatigue in all patients; similar results were found for nutritional risk (OR 2.717, 95% CI 2.068 to 3.571, p<0.001) in hospitalised patients. CONCLUSIONS: Frailty and nutritional risk are prevalent among older adult patients, and nutritional risk is associated with the occurrence of fatigue in older adult patients and older adult inpatients. TRIAL REGISTRATION NUMBER: China Clinical Trial Registry (Registered No. ChiCTR-EPC-14005253).

Factors associated with perceived cognitive function in breast cancer patients treated with chemotherapy: A multicenter cross-sectional study.

PURPOSE: This study aimed to investigate the factors associated with perceived cognitive function among breast cancer patients treated with chemotherapy in China. METHODS: The study was a multicenter cross-sectional design. Data were collected from 10 public hospitals in China between April 2022 and February 2023. A total of 741 participants completed questionnaires assessing sociodemographic and medical characteristics, perceived cognitive function, sleep quality, fatigue, anxiety, and depression. Hierarchical multiple regression analysis was used to assess the determinants of cognitive function. RESULTS: The hierarchical multiple regression model accounted for 31.5% of variation in perceived cognitive function (sociodemographic 4.5%; medical 6.6%; exercise frequency 6.6%; sleep quality 2.1%; fatigue 2.8%; anxiety combined with depression 9.0%). Education level, chemotherapy type, number of chemotherapy cycles, and cyclophosphamide drug use were significant predisposing factors of perceived cognitive function (p < 0.001). Exercising ≥3 times/week (p < 0.001) was a significant factor positively influencing perceived cognitive function, meanwhile, anxiety (p < 0.001) and depression (p < 0 0.001) were negative factors. CONCLUSION: Our findings suggest that patients with low education levels, postoperative chemotherapy, cyclophosphamide treatment, and a greater number of chemotherapy cycles need more assessment. Sedentary patients, those who have never exercised, and those with anxiety or depression all showed greater cognitive decline. By identifying susceptible populations, encouraging regular exercise, and addressing anxiety and depression, healthcare professionals can contribute significantly to prevent patients' cognitive decline throughout chemotherapy.

Self-reported exhaustion and a 4-item physical frailty index to predict the incidence of major complications after onco-geriatric surgery.

BACKGROUND: The aim of this study was to analyze four pre-operative physical frailty indicators from a geriatric assessment (GA) independently and combined in a physical frailty index, in their ability to predict postoperative 30 d-complications. MATERIALS AND METHODS: In this secondary analysis of data from the published PERATECS study (ClinicalTrials.gov: NCT01278537), the predictive value of four physical frailty indicators from a defined GA battery was examined with univariable and multivariate logistic regression models in a sample of 493 onco-geriatric surgical patients. The primary endpoint was incidence of major (Clavien-Dindo ≥ grade 2 [CD ≥ 2]) complications within 30 postoperative days. Predictors of the first model included self-reported exhaustion (SRE), body mass index (BMI), Timed Up-and-Go (TUG) and handgrip strength (HGS) independently, and a second model combined these four items as a Physical Frailty Index (4i-PFI). Both regression models were adjusted for age, gender, American Society of Anesthesiologists (ASA) status, tumor sites, duration of surgery time and Mini Nutritional Assessment (MNA) score. RESULTS: A total of 233 patients (47 %) developed CD ≥ 2 complications. In addition to ASA score, length of surgery, and gynecological and upper gastrointestinal tumor sites, the first model showed that SRE (OR 1.866) predicted CD ≥ 2 complications, but not TUG, BMI and HGS. In the second model, the 4i-PFI predicted CD ≥ 2 complications (OR pre-frail = 1.808, frail = 3.787). CONCLUSIONS: Physical frailty indicators as SRE revealed a better ability to predict CD ≥ 2 complications than BMI, TUG and HGS. However, prediction of CD ≥ 2 complications was enhanced when these parameters were combined in a novel 4i-PFI.

Assessment of post-SARS-CoV-2 fatigue among physicians working in COVID-designated hospitals in Dhaka, Bangladesh.

BACKGROUND: Fatigue has been observed after the outbreaks of several infectious diseases around the world. To explore the fatigue level among physicians working in COVID-19-designated hospitals in Bangladesh, a matched case‒control study was conducted on post-SARS-CoV-2 fatigue. METHOD: In this study, 105 physicians diagnosed with COVID-19 who were declared cured at least 6 weeks before the interview date were recruited as cases, and the same number of age- and designation-matched healthy physicians were recruited as controls from the same hospital at a 1:1 ratio. Diagnosis of COVID-19 infection was confirmed by detection of SARS CoV-2 antigen by RT‒PCR from reference laboratories in Bangladesh or by HRCT chest. RESULT: Approximately two-thirds of the physicians were male (67.6% vs. 32.4%). More than 80% of them were younger than 40 years. The cases had a significantly greater number of comorbid conditions. The fatigue severity scale (FSS) score (mean) was much higher for cases (36.7 ± 5.3 vs. 19.3 ± 3.8) than for the control group, with a statistically significant difference. Similarly, approximately 67.7% of the previously COVID-19-positive physicians were in the highest FSS score tertile compared to the respondents in the control group, who had a mean score of <3. CONCLUSION: Physicians who had a previous history of COVID-19 infection had significantly higher total and mean FSS scores, signifying a more severe level of fatigue than physicians who had never been COVID-19 positive while working in the same hospital irrespective of their age and sex.

Prevalence of somatic symptoms among Ebola Virus Disease (EVD) survivors in Africa: a systematic review and meta-analysis.

BACKGROUND: Many Ebola virus disease (EVD) survivors have reported somatic and neuropsychological symptoms after discharge from the Ebola Treatment Unit (ETU). Since the 2014-2016 Ebola epidemic in West Africa, various studies have investigated and identified these symptoms. Evidence on somatic symptoms is widely available in the literature, however, there is no concise overview of the prevalence across different time intervals. METHODS: This meta-analysis was conducted following the (PRISMA) guidelines. A database search was conducted to identify original studies that reported the prevalence of symptoms. The primary outcome measure was the prevalence rate of several somatic symptoms. Results were pooled, and prevalence rates were assessed over time, to elucidate any particular trends. RESULTS: We included 23 studies (5,714 participants). The pooled prevalence was: arthralgia 50% (95% CI: 41%-59%); headache 44% (95% CI: 36%-52%); myalgia 32% (95% CI: 26%-38%); abdominal pain 27% (95% CI: 15%-39%); fatigue 25% (95% CI: 19%-31%); numbness of feet 16% (95% CI: 14%-18%); numbness of hands 12% (95% CI: 10%-14%) and hearing loss 9% (95% CI: 5%-12%). Prevalence across different time intervals revealed significant patterns. All the symptoms persisted for more than 2 years after discharge except for abdominal pain. CONCLUSION: The pooled prevalence rates of somatic symptoms are notably high. Arthralgia and headache are the most prevalent of the symptoms, with hearing loss and numbness in hands and feet being the least. We found that arthralgia, myalgia, and abdominal pain decreased over time. However, headache, fatigue, numbness of hands and feet, and hearing loss increased over time.

Cancer-related Fatigue and the Additive Effect of Treatment in the Context of Lymphoma: An Analysis of the Lymphoma Coalition's 2022 Global Patient Survey.

Cancer-related fatigue (CRF) continues to be a challenging phenomenon that is often under-reported and poorly understood. With etiologies in both disease and treatment manifesting as a symptom and a side effect respectively, CRF is highly incident and presents a significant clinical problem that impacts survivorship. We conducted a survey to ascertain the patient reported incidence of symptoms and side effects for people with lymphoma or chronic lymphocytic leukemia. We found that CRF was enhanced in those who received more intense therapies that coincided with more aggressive lymphoma subtypes. These data illuminate an unmet need among patients with lymphoma and provides an opportunity to further refine treatment regimens to reduce the burden of CRF in this vulnerable population. SIGNIFICANCE: CRF is a highly incident phenomenon in lymphoma that can be ascribed to a combination of causes. We have demonstrated substantial variability across various subtypes of lymphoma and have estimated that nearly half of the reported fatigue comes from treatment. Increased screening for and monitoring of fatigue will yield favorable health-related quality of life that will benefit health technology assessment activities and yield improved outcomes for patients.

Pandemic Fatigue and Preferences for COVID-19 Public Health and Social Measures in China: Nationwide Discrete Choice Experiment.

BACKGROUND: Information on the public's preferences for current public health and social measures (PHSMs) and people's mental health under PHSMs is insufficient. OBJECTIVE: This study aimed to quantify the public's preferences for varied PHSMs and measure the level of pandemic fatigue in the COVID-19 normalization stage in China. METHODS: A nationwide cross-sectional study with a discrete choice experiment and psychometric scales was conducted to assess public preferences for and attitudes toward PHSMs, using the quota sampling method. The COVID-19 Pandemic Fatigue Scale (CPFS) was used to screen fatigue levels among respondents. The multinomial logit model, latent class model, and Mann-Whitney test were used for statistical analysis. We also conducted subgroup analysis based on sex, age, monthly income, mental health status, and pandemic fatigue status. RESULTS: A total of 689 respondents across China completed the survey. The discrete choice experiment revealed that respondents attached the greatest importance to the risk of COVID-19 infection within 3 months (45.53%), followed by loss of income within 3 months (30.69%). Vulnerable populations (low-income populations and elderly people) were more sensitive to the risk of infection, while younger respondents were more sensitive to income loss and preferred nonsuspension of social places and transportation. Migrants and those with pandemic fatigue had less acceptance of the mandatory booster vaccination and suspension of transportation. Additionally, a higher pandemic fatigue level was observed in female respondents, younger respondents, migrants, and relatively lower-income respondents (CPFS correlation with age: r=-0.274, P<.001; correlation with monthly income: r=-0.25, P<.001). Mandatory booster COVID-19 vaccination was also not preferred by respondents with a higher level of pandemic fatigue, while universal COVID-19 booster vaccination was preferred by respondents with a lower level of pandemic fatigue. CONCLUSIONS: Pandemic fatigue is widely prevalent in respondents across China, and respondents desired the resumption of normal social life while being confronted with the fear of COVID-19 infection in the normalization stage of COVID-19 in China. During future pandemics, the mental burden and adherence of residents should be considered for the proper implementation of PHSMs.