[Quality of live of palliative outpatient care in Westphalia-Lippe focusing on contentedness of patients and their relatives - a multicenter cohort study]. / Qualität der ambulanten Palliativversorgung im Modell Westfalen-Lippe hinsichtlich der Zufriedenheit von Patienten und ihren Zugehörigen : Eine multizentrische Kohortenstudie.

BACKGROUND: In Westphalia-Lippe - unlike the rest of Germany - outpatient palliative care, as general and specialized palliative care (AAPV and SAPV), exists as part of an innovative care model. Ten years after its introduction, an evaluation is to be carried out, focusing on the treatment satisfaction of patients and their relatives as well as the extent to which the model has proved successful in urban versus rural care contexts. METHODS: In a multicenter cohort study, in 2019/20, from a total of 36 palliative care regions, 12 - 4 metropolitan, mixed and rural each - were randomly selected, with 20 palliative patients each. Using established instruments (MIDOS, HOPE), the patients were questioned about stressful symptoms and quality of life. Additionally, their relatives were asked about their satisfaction with the care provided. RESULTS: 227 patients were included. The care period was 82.3 days on average (median 47.5). Distressing symptoms were consistently well controlled with a slight tendency for symptoms to increase at the end of life (NRS < 4). There were no significant differences between urban and rural regions. The outpatient palliative care provided by doctors and nurses in Westphalia-Lippe was largely viewed positively by the relatives. CONCLUSIONS: In Westphalia-Lippe, patients in need of palliative care can be offered early and low- threshold structured outpatient palliative care, which is mainly provided by GPs and outpatient specialists. The role of the GP in primary medical care is being strengthened. In this interprofessional and interdisciplinary model, patient care is demand-oriented, that is, the intensity of care can switch between general (AAPV) and specialized care (SAPV) according to the disease progress. This model has proven itself in practice and provides good services benefits for palliative patients and their relatives.

[Patient-reported outcomes in chronic diseases under treatment with cannabis medicines : Analysis of the results of the Copeia survey]. / "Patient-reported outcomes" bei chronischen Erkrankungen unter Therapie mit Cannabisarzneimitteln : Analyse der Ergebnisse der Befragung von Copeia.

BACKGROUND: The survey of Copeia captured early 2022 patient-reported outcomes (PRO) in Germany under cannabis medicinal product (CAM) therapy, with particular attention to symptoms, symptom changes, indications, side effects, dosages, and cost bearers. GOAL: This study investigated the question of whether associations emerge from the results that could play a role in the indication and treatment monitoring of CAM in chronically ill patients. MATERIALS AND METHODS: A standardized questionnaire was administered online nationwide in dialogue form over a 15-week period to collect itemized symptoms and PRO. Recruitment was supported by pharmacies, prescribing physicians, and patient associations. Inclusion criteria included physician-prescribed CAM therapy. RESULTS AND DISCUSSION: Of 1582 participants, 1030 data sets (65%) could be completely analyzed. There was a heterogeneous patient population, whose common feature was disease chronicity. The frequency distribution of symptoms showed a homogeneous pattern for the respective indications, in which the most frequent six (pain 71%, sleep disturbance 64%, stress/tension 52%, inner restlessness 52%, depressive mood 44% and muscle tension 43%) seem to have a special significance. According to subjective assessment, quality of life improved significantly in 84% of all participating patients. CONCLUSION: A symptom matrix (SMX) composed of different symptoms seems to play a special role in CAM therapy to improve the quality of life of chronically ill patients, regardless of the underlying disease. The SMX could contribute to the identification of an indication and to targeted treatment monitoring.

When the Going Gets Challenging-Motivational Theories as a Driver for Workplace Health Promotion, Employees Well-Being and Quality of Life.

Being characterized by high numbers of physical and mental health issues, the veterinary sector faces some negative peculiarities compared to other professions. To evaluate and possibly improve employees' well-being and to reward according to individual motivation, managing staff and the profession in general must understand every individual's motivation. Defining the motivation of veterinary professionals in a multidisciplinary way can be the first step in increasing the well-being of employees. To assemble current theories of work motivation and adapt and extend them to serve the veterinary profession, basic knowledge of the classical general psychological motivational theories and work motivational theories is inevitable. The authors aimed to illustrate the different motivational theories' key aspects and historical evolution to provide veterinary personnel with broad knowledge. In addition, the availability of already existing literature should be evaluated. A scoping review was performed. Methodological, empirical, review, and theoretical articles were evaluated. Only a minority of the studies (1.3%) evaluated motivational theories in veterinary health care. This reflects that there is a need for research in this field. Still, it is illustrated that the veterinarian profession would benefit from the implementation of general psychological as well as motivational work theories.

Quality of life and depression in Wilson's disease: a large prospective cross-sectional study.

BACKGROUND: Wilson's disease (WD) is an autosomal recessive genetic disorder due to a mutation of the ATP7B gene, resulting in impaired hepatic copper excretion and accumulation in various tissues. Lifelong decoppering treatments are the keystone of the treatment. These treatments can prevent, stabilize, or reverse the symptoms making WD a chronic disease. Quality of life (QoL) is one of the best outcome measures of any therapeutic intervention in chronic diseases but has not been evaluated in large cohorts of WD patients. METHOD: To better evaluate the QoL in WD and the correlation with different clinical or demographic factors we have performed a prospective cross-sectional study. RESULTS: Two hundred fifty-seven patients (53.3% men, mean age of 39.3 years and median disease duration of 18.8 years) were included between 1st January 2021 and 31st December 2021. Hepatoneurological form of the disease and depression were significantly correlated with low QoL (p < 0.001 for both). However, the patients' quality of life was similar to that of the general population, and only 29 patients (11.3%) had moderate to severe depression. CONCLUSIONS: Neurological patients should be closely monitored to prevent and treat symptoms of depression that impact their quality of life.

Validation of the Slovakian Version of the "Post­acute (Long) COVID­19 Quality of Life Instrument" and Pilot Study.

Purpose: The aim of our study was to validate a Slovakian translation of the PAC­19QoL instrument among Slovakian patients with post COVID-19 syndrome. Patients and Methods: The PAC-19QoL instrument was translated into the Slovakian language and administrated to patients with post COVID-19 syndrome. Cronbach's alpha coefficient was used to analyse the internal consistency of the instrument. Construction validity was evaluated by using Pearson's correlation coefficient and Spearman's rank correlation. Scores of patients and controls were compared using Mann-Whitney U-test. Results: Forty-five asymptomatic and forty-one symptomatic participants were included. Forty-one patients with post COVID-19 syndrome completed the PAC-19QoL and EQ-5D-5L questionnaires. PAC-19QoL domain scores were significantly different between symptomatic and asymptomatic participants. All items achieved a Cronbach alpha greater than 0.7. There was a significant correlation between all domains on the test (p < 0.001), with the highest correlation of Total (r = 0.994) and Domain 1 (r = 0.991). Spearman's rank correlation analysis confirmed that the instrument items correlated with the objective PAC-19QoL examination findings. Conclusion: The Slovakian version of the instrument is valid, reliable and can be a suitable tool for research and daily clinical practice among patients with post COVID-19 syndrome.

Subjective Quality of Life of Women in the Perinatal Period: A Post Covid-19 Pandemic Exploration in North Macedonia.

Subjective quality of life could be considered one of the indicators of health behavior and wellbeing of women in the perinatal period. Accordingly, the aim of this paper was to examine how women in perinatal period perceive quality of life in various domains. Its relationship to age, number of pregnancies, course of pregnancies, and method of delivery and experience with Covid-19 pandemic was investigated, as well. Our sample consisted of 366 pregnant women in any period of pregnancy who came in for regular outpatient examinations and control, those who were hospitalized due to pathological pregnancy or due to the need for intensive care, as well as women in their postnatal period, one year after delivery, who were seeking professional advice from a gynecologist. The majority were aged 20 to 30 years (53.8%). The findings showed that assessed domains of subjective quality of life were related to a variety of experiences with the Covid-19 pandemic. The results are presented and discussed in detail. Implications and limitations are given, as well.

Adaptação e validação de Índice de Qualidade de Vida para gestantes brasileiras / Adaptation and validity of the Quality of Life Index for Brazilian pregnant women / Adaptation and validity of the Quality of Life Index for Brazilian pregnant women / Adaptación y validación del Índice de Calidad de Vida para mujeres embarazadas brasileñas

Resumo Objetivo Adaptar e validar o Índice de Qualidade de Vida de Ferrans & Powers para gestantes brasileiras. Métodos Estudo metodológico. A versão brasileira Índice de Qualidade de Vida de Ferrans & Powers para gestantes tem 36 itens e quatro domínios. A validação de conteúdo foi realizada por comitê de juízes. Na etapa de validação foi testada a consistência interna, a validade de constructo convergente e discriminante e a dimensionalidade. Nível de significância 5%. Resultados Cinco juízes participaram do comitê. O índice de validade de conteúdo foi de 0,94 e a maioria dos itens apresentou coeficiente de validade de conteúdo por item acima de 0,80. Participaram da etapa de validação 280 gestantes.O alfa de Cronbach foi de 0,94 para o escore total com variação de 0,78 a 0,89 entre os domínios A correlação de Pearson entre o Índice de Qualidade de Vida de Ferrans e o WHOQOL-Bref foi positiva e forte (0,79; p<0,001). A validade de constructo discriminante não revelou diferenças estatisticamente significante. A análise fatorial confirmatória revelou que o modelo de quatro domínios se ajusta ao modelo. Conclusão A versão adaptada do Índice de Qualidade de Vida de Ferrans mostrou-se confiável e válida para aplicação em gestantes, mostrando-se uma ferramenta promissora para profissionais de saúde e pesquisadores na identificação da Qualidade de vida de gestantes.

Resumen Objetivo Adaptar y validar el Índice de Calidad de Vida de Ferrans & Powers para mujeres embarazadas brasileñas. Métodos Estudio metodológico. La versión brasileña del Índice de Calidad de Vida de Ferrans & Powers para mujeres embarazadas tiene 36 ítems y cuatro dominios. La validación de contenido fue realizada por un comité de jueces. En la etapa de validación se probó la consistencia interna, la validez de constructo convergente y discriminante y la dimensionalidad. Nivel de significación del 5 %. Resultados Cinco jueces participaron del comité. El índice de validez de contenido fue de 0,94 y la mayoría de los ítems presentó un coeficiente de validez de contenido por ítem superior a 0,80. En la etapa de validación participaron 280 mujeres embarazadas. El alfa de Cronbach fue de 0,94 para el puntaje total con variación de 0,78 a 0,89 entre los dominios. La correlación de Pearson entre el Índice de Calidad de Vida de Ferrans y el WHOQOL-Bref fue positiva y fuerte (0,79; p<0,001). La validez del constructo discriminante no reveló diferencias estadísticamente significativas. El análisis factorial confirmatorio reveló que el modelo de cuatro dominios se ajusta al modelo. Conclusión La versión adaptada del Índice de Calidad de Vida de Ferrans demostró ser confiable y válida para su uso en mujeres embarazadas y demostró ser una herramienta promisora para profesionales de la salud y para investigadores en la identificación de calidad de vida de mujeres embarazadas.

Abstract Objective To adapt and validate the Ferrans and Powers Quality of Life Index for Brazilian pregnant women. Methods This is a methodological study. The Ferrans and Powers Quality of Life Index for pregnant women, Brazilian version, has 36 items and four domains. Content validity was performed by a committee of judges. In the validity stage, internal consistency, convergent and discriminant construct validity and dimensionality were tested. Significance level 5%. Results Five judges participated in a committee. The Content Validity Index was 0.94 and most items had a content validity coefficient per item above 0.80. A total of 280 pregnant women participated in the validity stage. Cronbach's alpha was 0.94 for the total score, ranging from 0.78 to 0.89 between the domains. Pearson's correlation between the Ferrans and Powers Quality of Life Index and the WHOQOL-Bref was positive and strong (0.79; p<0.001). Discriminant construct validity did not reveal statistically significant differences. Confirmatory factor analysis revealed that the four-domain model fits the model. Conclusion The Ferrans and Powers Quality of Life Index, adapted version, proved to be reliable and valid for use in pregnant women, proving to be a promising tool for health professionals and researchers to identify pregnant women's quality of life.

Predictors of health-related quality of life after cardiac surgery: a systematic review.

BACKGROUND: Health-related quality of life (HRQoL) is important in determining surgical success, particularly from the patients' perspective. AIMS: To identify predictors for HRQoL outcome after cardiac surgery in order to identify potentially modifiable factors where interventions to improve patient outcomes could be targeted. METHODS: Electronic databases (including MEDLINE, CINAHL, Embase) were searched between January 2001 and December 2020 for studies determining predictors of HRQoL (using a recognised and validated tool) in adult patients undergoing cardiac surgery. Data extraction and quality assessments were undertaken and data was summarised using descriptive statistics and narrative synthesis, as appropriate. RESULTS: Overall, 3924 papers were screened with 41 papers included in the review. Considerable methodological heterogeneity between studies was observed. Most were single-centre (75.6%) prospective observational studies (73.2%) conducted in patients undergoing coronary artery bypass graft (CABG) (n = 51.2%) using a version of the SF-36 (n = 63.4%). Overall, 103 independent predictors (62 pre-operative, five intra-operative and 36 post-operative) were identified, where 34 (33.0%) were reported in more than one study. Potential pre-operative modifiable predictors include alcohol use, BMI/weight, depression, pre-operative quality of life and smoking while in the post-operative period pain and strategies to reduce post-operative complications and intensive care and hospital length of stay are potential therapeutic targets. CONCLUSION: Despite a lack of consistency across studies, several potentially modifiable predictors were identified that could be targeted in interventions to improve patient or treatment outcomes. This may contribute to delivering more person-centred care involving shared decision-making to improve patient HRQoL after cardiac surgery.

Implementation of a mobile application for outpatient care after liver transplantation.

Background: In the face of the Covid-19 pandemic and the need for social distancing new therapeutic tools like mobile health applications might gain in importance for outpatient care. Objective of the present study was to assess if and to what extent the implementation of a free available transplant application in a cohort of liver transplant recipients was possible. Methods: Patients of the aftercare program at the Department of Transplant Surgery Graz in June 2016 were first asked to complete a survey concerning knowledge about mobile health and their management of everyday life. After using the application for 2 months a second survey evaluated whether the implementation of the application in the daily routine was achievable. Results: Among 135 patients, 124 (91.9%) agreed to participate. Seventy-one (57.3%) owned a mobile device with which they could use the application, 42 patients (33.8%) decided to try it out for 2 months. The majority stated that the application supported them for therapy management and surveillance of vital parameters. Successful implementation of the application has been reached in 57.1% of patients after 2 months testing period. Conclusion: The technical prerequisites are only partially met and should be improved. Older patients need extensive support and motivation.

Atividades de vida diária, sintomas depressivos e qualidade de vida de idosos / Actividades de la vida diaria, síntomas depresivos y calidad de vida de los adultos mayores / Elderly's activities of daily living, depressive symptoms and quality of life

Resumo Objetivo Correlacionar os sintomas depressivos com a capacidade de realização das atividades básicas de vida diária e a qualidade de vida em idosos residentes em instituições de longa permanência. Métodos Estudo transversal, com amostra constituída por 99 idosos, residentes nas dez instituições de longa permanência para idosos públicas da cidade de São Paulo. Na coleta de dados utilizou-se os instrumentos Whoquol Bref e Old, Inventário de Depressão de Beck e Índice de Katz. Os dados foram coletados no período de julho de 2016 a fevereiro de 2019 e o tratamento estatístico foi realizado utilizando o software Statistical Package for the Social Sciences® (SPSS - versão 24.0). Resultado Os idosos têm uma perceção positiva da sua qualidade de vida correlacionada com a independência para as atividades básicas de vida diária, com significância estatística para os domínios funcionamento sensorial (r = ,263), físico (r = ,200) e psicológico (r = ,214). E uma avaliação negativa em relação a sintomas depressivos nos domínios funcionamento sensorial (r = -,438), autonomia (r = -,310), atividade passada, presente e futura (r = -,384), participação social (r = -,368), morte e morrer (r = -,913), intimidade (r = -,351), físico (r = -,590), psicológico (r = -,539), relações sociais (r = -,382) e meio ambiente (r = -,533). Conclusão Os idosos independentes apresentaram melhores escores nos domínios funcionamento sensorial, físico e psicológico; já os com sintomas depressivos demostraram piores escores em todos os domínios da qualidade de vida.

Resumen Objetivo Correlacionar los síntomas depresivos con la capacidad de realización de las actividades básicas de la vida diaria y la calidad de vida en adultos mayores residentes en instituciones de larga permanencia. Métodos Estudio transversal, con una muestra formada por 99 adultos mayores, residentes en las diez instituciones públicas de larga permanencia para adultos mayores en la ciudad de São Paulo. Para la recopilación de datos se utilizaron los instrumentos Whoquol Bref y Old, Inventario de Depresión de Beck e Índice de Katz. El período de recopilación de datos ocurrió de julio de 2016 a febrero de 2019 y el tratamiento estadístico se realizó utilizando el software Statistical Package for the Social Sciences® (SPSS - versión 24.0). Resultados Los adultos mayores tienen una percepción positiva de su calidad de vida que se correlaciona con la independencia para las actividades básicas de vida diaria, con significación estadística para los dominios funcionamiento sensorial (r = ,263), físico (r = ,200) y psicológico (r = ,214). Es una evaluación negativa con relación a síntomas depresivos en los dominios funcionamiento sensorial (r = -,438), autonomía (r = -,310), actividad pasada, presente y futura (r = -,384), participación social (r = -,368), muerte y morir (r = -,913), intimidad (r = -,351), físico (r = -,590), psicológico (r = -,539), relaciones sociales (r = -,382) y medioambiente (r = -,533). Conclusión Los adultos mayores independientes presentaron mejor puntuación en los dominios funcionamiento sensorial, físico y psicológico; con los síntomas depresivos demostraron peor puntuación en todos los dominios de la calidad de vida.

Abstract Objective To correlate depressive symptoms with the ability to perform activities of daily living and the quality of life of elderly people living in Nursing Homes. Methods This is a cross-sectional study, with a sample consisting of 99 elderly people, living in ten public Nursing Homes in the city of São Paulo. Data collection used the instruments WHOQOL Bref and Old, Beck Depression Inventory and Katz Index. Data were collected from July 2016 to February 2019 and statistical treatment was performed using the Statistical Package for Social Sciences® (SPSS - version 24.0). Results The elderly have a positive perception of their quality of life correlated with independence for activities of daily living, with statistical significance for sensory functioning (r = .263), physical (r = .200) and psychological (r = .214) domains; and a negative assessment in relation to depressive symptoms in sensory functioning (r = -.438), autonomy (r = -.310), past, present, and future activities (r = -.384), social participation (r = - .368), death and dying (r = -.913), intimacy (r = -.351), physical (r = -.590), psychological (r = -.539), social relationships (r = -.382), and environment (r = -.533) domains. Conclusion Independent elderly had better scores in sensory functioning, physical and psychological domains. Those with depressive symptoms had worse scores in all quality of life domains.

Specific autonomy recovery programme in a comprehensive rehabilitation on functionality and respiratory parameters in oncological patients with dyspnoea. Study protocol.

BACKGROUND: Survival in cancer patients has increased exponentially in recent years, with multiple side effects caused by treatments. Cancer-related asthenia and dyspnea are among them, which represent a serious health problem, with considerable limitations and reduced quality of life. An implementation of the conventional clinical practice, developed through physical exercise, may be useful in controlling dyspnoea. This study aims to compare the effects of a comprehensive rehabilitation implementing a programme of multimodal physical exercise with a specific autonomy recovery programme, versus an isolated intervention using the physical exercise programme alone, on the functionality, physical performance and respiratory parameters in oncologycal patients with dyspnea. METHODS: This is a protocol por an experimental, prospective, randomized, parallel-controlled clinical trial, with two arms design of fixed assignment with an experimental and control groups. It will conduct in the Oncology Hospitalisation Unit at the University Hospital Complex of Salamanca, using consecutive sampling to select 50 participants with oncological dyspnoea who are hospitalised at the time of inclusion. After baseline assessment, participants will be randomised into the groups. Experimental group will complete Comprehensive Rehabilitation with the autonomy recovery and the multimodal exercise programmes, and in the control group, only the multimodal exercise programme will be carried out. The primary outcomes will be basic activities of daily living (Barthel Index) and degree of dyspnoea (MRC scale). Additionally, physical performance will be evaluated with the Short Physical Performance Battery (SPPB), as will the oxygen saturation in the blood using pulse oximetry, fear/avoidance of movement with the Tampa Scale of Kinesiophobia (TSK), and the quality of life of the oncology patient (ECOG performance scale). DISCUSSION: The results of this study may be translated to clinical practice, incorporating a specific autonomy recovery programme into comprehensive rehabilitation programmes of care for cancer patients with dyspnoea. Increase in the survival of patients with cancer includes multiple side effects as cancer-related asthenia and dyspnea, which represents a serious health problem. The current study addresses to improve the conventional clinical practice by proposing an integral, rehabilitative approach, to implement education and training for oncology patients with dyspnea to increase their quality of life. TRIAL REGISTRATION: ClinicalTrials.gov; ID: NCT04766593 . (February 23, 2021).

Calidad de vida en niños del Programa Cubano de Implantes Cocleares / Quality of life in children of the Cuban Cochlear Implant Program

RESUMEN Fundamento: los estudios publicados sobre los resultados del Programa Cubano de Implantes Cocleares hacen referencia a evaluaciones audiológicas y quirúrgicas, lo que carece de la dimensión que aportaría conocer, el impacto del programa en la calidad de vida de los niños implantados y familia. Objetivo: determinar el impacto del Programa Cubano de Implantes Cocleares en la calidad de vida de los niños implantados y su familia. Métodos: se realizó un estudio descriptivo, prospectivo, longitudinal (pre- y post-implante coclear) a partir de la aplicación del cuestionario de calidad de vida del proyecto internacional pediátrico Cochlear paediatric implanted recipient observational study y la prueba de categorías del rendimiento auditivo, mediante un análisis de varianza de medidas repetidas. Resultados: el estudio evidencia que los implantes cocleares impactan en la familia y la calidad de vida de los niños, con mejora significativa tan temprano como seis meses post-implante coclear y mayores beneficios al año de implantados, respaldado por los hallazgos en la prueba de categorías del rendimiento auditivo, mientras que las expectativas de los padres se ajustan según avanza la rehabilitación post-implante coclear. Conclusiones: los implantes cocleares impactan en la calidad de vida del niño y su familia en la medida que avanza el programa de rehabilitación post-implante, al ajustarse a las expectativas de los padres o tutores, los cuales reportan cambios positivos en el desarrollo de las actividades diarias del niño, efecto sostenido en el tiempo.

ABSTRACT Background: the studies published on the results of the Cuban Cochlear Implants Program refer to audiological and surgical evaluations, lacking the dimension that knowing about the impact of cochlear implants on the quality of life of children and their family. Objective: to determine the impact in the Cuban Cochlear Implants Program on the quality of life of children and their family. Methods: it was carried out a descriptive, prospective, longitudinal study (pre- and post-cochlear implant) from the application of a quality of life questionnaire of the international pediatric project cochlear pediatric implanted recipient observational study and the categories auditory performance test, being applied an analysis of variance of repeated measures. Results: the study shows that cochlear implants impact on the quality of life of children and family, and improves significantly as early as six months post-cochlear implant, with greater benefits one year after implantation, supported by the findings of the categories auditory performance test. While parental expectations are adjusted as post-cochlear implant rehabilitation progresses. Conclusions: cochlear implants impact on the quality of life of the child and family with the post-implant rehabilitation program progresses, adjusting the expectations of the parents or child's guardian, who report positive changes in the development of their daily activities, a sustained effect in the time.

The long-term effect of complex regional pain syndrome type 1 on disability and quality of life after foot injury.

PURPOSE: To study the long-term evolution of patients with lower-limb Complex Regional Pain Syndrome (CRPS), focusing on functional and proprioceptive aspects and quality of life. METHODS: In 20 patients suffering from chronic distal lower-limb CRPS diagnosed using Budapest criteria, we assessed joint position sense and strength of the knee muscles at the CRPS and unaffected leg, functional exercise capacity, pain, CRPS severity score, quality of life and kinesiophobia. Similar assessments were performed in 20 age-matched controls. RESULTS: The joint position performance (at 45°) was significantly lower for the CRPS leg as compared to controls. The knee extensor strength of the CRPS leg was significantly reduced as compared to the unaffected leg (-27%) and controls (-42%). CRPS patients showed significantly reduced performance at the 6 min-walk test as compared to their age group predicted value and controls. Patients suffering from CRPS for 3.8 years in average still exhibit high pain, severity and kinesiophobia scores. CONCLUSIONS: Long-term deficits in strength and proprioceptive impairments are observed at the knee joint of the CRPS leg. This persistent functional disability has significant repercussions on the quality of life. We highlight the importance of including strength and proprioceptive exercises in the therapeutic approaches for CPRS patients.IMPLICATIONS FOR REHABILITATIONThe long-term evolution of patients suffering from lower-limb Complex Regional Pain Syndrome is associated with persistent disability, pain and impacts the quality of life.Strength, proprioceptive, functional and subjective assessments are necessary to better identify deficits.Rehabilitation should focus on the overall deficit of the affected and contralateral limb.

A subjective sense of the quality of life in adolescents from the Swietokrzyskie Voivodship.

OBJECTIVES: The measurement of the health-related quality of life (HRQOL) is one of the most important methods for self-assessment of health, which makes it possible to identify irregularities in the physical, mental and social functioning. The aim of the research was to determine HRQOL using the Health Related Quality of Life Questionnaire for Children and Young People (the KIDSCREEN-52 questionnaire) - the instrument recommended by the World Health Organization - which makes it possible to distinguish groups of adolescents with a diversified subjective sense of the quality of life. MATERIAL AND METHODS: The study involved a group of 871 adolescents, 411 boys and 460 girls, aged 13-16 years, residing in the Swietokrzyskie Voivodship. The method of a diagnostic survey was used in the research. The KIDSCREEN-52 questionnaire, which is an instrument for examining the HRQOL of adolescents, was employed in the study. The k-means clustering method was applied, which made it possible to establish 3 groups of adolescents with a different subjective sense of the quality of life. RESULTS: Three groups of adolescents with a diversified subjective sense of the quality of life (high, average, low) were identified using the KIDSCREEN-52 questionnaire. The subjective quality of life in the majority of the respondents was high, in particular in those living in rural areas. The surveyed boys with a high subjective quality of life showed a significantly higher self-esteem, acceptance and peer support than the surveyed girls. CONCLUSIONS: The KIDSCREEN-52 questionnaire is an accurate and sensitive tool for assessing HRQOL. It allows identifying 3 groups of adolescents with a diversified subjective sense of the quality of life. It can form the basis for further diagnosis of the bio-psycho-social functioning of adolescents. Int J Occup Med Environ Health. 2021;34(3):415-25.

[Symptoms severity profile and expectations in hyperactive bladder patients - VHEXPECTA Study.] / Perfil de severidad sintomática y expectativas en pacientes con vejiga hiperactiva - Estudio VHEXPECTA.

OBJECTIVES: To Evaluate the severity of symptoms in OAB patients and their outcomes expectations, symptoms management and Health-Related Quality of Life (HRQoL). MATERIAL AND METHODS: Epidemiological, multicentre, non-interventional, cross-sectional study, conducted by 294 physicians in Spain in clinical practice. Female adult patients with OAB symptoms, newly diagnosed or during follow-up were included. B-SAQ, OABq-SF and an ad-hoc patient expectation questionnaire were completed. Association between expectations, symptom severity and prior treatments was analyzed using Chi- Square. The non-parametric Kruskal-Wallis test was used to analyze the relationship between the intensity of the urgency and the impact of OAB symptoms on HRQoL and between expectative and symptoms characteristics and HRQoL. RESULTS: 1.107 patients were included. Mean age was 58 years. 60.6% were newly diagnosed and urinary urgency was the most frequent symptom reported (93.3%). According the B-SAQ score 58.7% suffered moderatedor severe OAB. Expectations in patients without previous treatment about " their symptoms will be cured permanently" were higher than in patients previously treated (p<0.005). The percentage of patients who expected a positive response to treatment decreased while the OAB symptom severity increased (73.9% mild symptoms, 32.5% very severe symptoms; p<0.005). Moreover, patients with higher symptom discomfort were less agreement with all expectations ( p<0.005), and HRQL was higher in patients with higher expectations (p<0.005). CONCLUSIONS: The expectations of patients with OAB regarding their pathology and the expected outcomes of treatments are related to symptom severity and HRQL.

OBJETIVOS: Evaluar la gravedad sintomática en pacientes con Vejiga Hiperactiva (VH) y sus expectativas respecto a evolución, manejo y Calidad de Vida Relacionada con la Salud (CVRS).MATERIALES Y MÉTODOS: Estudio epidemiológico, transversal, multicéntrico, realizado en práctica clínica habitual por 294 investigadores españoles. Se incluyeron mujeres adultas con síntomas de VH, de nuevo diagnóstico o en visita de seguimiento. Las pacientes completaron cuestionarios CACV, OABq-SF y una encuesta ad-hoc de expectativas. La asociación entre expectativas y gravedad sintomática, y entre expectativas y experiencia previa de tratamiento, se analizó mediante Chi-Cuadrado. La relación entre gravedad de la urgenciae impacto de los síntomas sobre la CVRS, y entre expectativas y molestia sintomática y CVRS, se evaluó mediante la prueba no-paramétrica Kruskal-Wallis. RESULTADOS: Se incluyeron 1107 pacientes, con una edad media de 58,8 años. El 60,6% era de nuevo diagnóstico, y la urgencia fue el síntoma más frecuente (93,3%). Según CACV, 58,7% tenía sintomatología grave o muy grave. Las expectativas en las pacientes  sin tratamiento previo de que sus síntomas se curen para siempre eran mayores que en las pacientes tratadas previamente (p<0,05). El porcentaje de pacientes que esperaban una respuesta positiva al tratamiento disminuía al aumentar la gravedad de VH (73,9% con sintomatología leve, 32,5% con sintomatología muy grave; p<0,005). Igualmente, las pacientes con mayor molestia sintomática mostraban un menor acuerdo con todas las expectativas planteadas (p<0,005), y la  CVRS fue mayor en las pacientes con mejores expectativas (p<0,005). CONCLUSIONES: Las expectativas de las pacientes con VH respecto a su patología y al resultado de los tratamientos están relacionadas con la gravedad sintomática y la CVRS.

Easy measurement of health related quality of life in patients with cystic fibrosis by the COPD assessment test (CAT) - A pilot study.

BACKGROUND: Quality of life (QOL) is an important patient-related outcome (PRO) in patients with cystic fibrosis (CF). There are several QOL questionnaires like the "Cystic Fibrosis Questionnaire Revised" (CFQ-R) or the "St George's Respiratory Questionnaire" (SGRQ) that are well validated in CF. The aim of the study was to evaluate whether the easily applicable "COPD assessment test" (CAT) can be used in CF patients. METHODS: 42 CF patients were recruited within the PulmoHOM study, a prospective, observational cohort study. The CAT, the SGRQ and the CFQ-R were handed out to the patients. The spearman's rank correlation coefficient and the Cronbach's α coefficient were used for the statistical analysis. RESULTS: The internal consistencies of the CAT, SGRQ and the CFQ-R were high (Cronbach's α coefficients = 0.89, 0.91 and 0.83). There were significant correlations between the CAT and the total score of the SGRQ (r = 0.851, p < 0.01), between the CAT and many items of the CFQ-R (physical score of the CFQ-R and total score of the CAT: r = -0.872, p < 0.01) and between the SGRQ and the CFQ-R (physical score of the CFQ-R and total score of the SGRQ: r = -0.878, p < 0.01). CONCLUSION: The main finding was the high correlation between the CAT and the validated questionnaires in CF. The CAT is a PRO instrument that can be filled quickly and that correlates well with the CFQ-R. The CAT or similar tools might be applicable in the care of CF patients.

Serviço social e arte educação: cuidado na prevenção da asma / Social work and art education: attention on prevention of asthma / Trabajo social y arte educación: atención a la prevención del asma

Objetivo: Descrever sobre a experiência em arte educação do Serviço Social em equipe multiprofissional, no cuidado preventivo à asma, e as mudanças sentidas pelos participantes do "Coral Voices em Superação", mediante as (inter)experiências e vivências de cantar e conviver com a asma. Método: Pesquisa qualitativa, empírica, bibliográfica e fenomenológica. Com uso de diário de campo, entrevista semiestruturada e análise de conteúdo. Participaram 14 mulheres e um homem entre 23 e 75 anos, acompanhados no Centro de Referência em Asma. Resultado: Arte educação, por meio da música, é um recurso para o assistente social potencializar a autoestima de pessoas em tratamento de asma. Conclusão: O convívio de pessoas com asma, em uma atividade de arte educação, influencia na sua qualidade de vida

Objective: The purpose of this article is to describe the experience in art education of Social Work in a multiprofessional team, in the preventive care for asthma, and the changes felt by the participants of the "Choir Voices in Overcoming", through the (inter) experiences and experiences of singing and living with to asthma. Methods: Qualitative, empirical, bibliographical and phenomenological research. Using field diary, semi-structured interview and content analysis. A total of 14 women and a man between the ages of 23 and 75 participated in the Asthma Reference Center. Results: Art education, through music, is a resource for the social worker to enhance the self-esteem of people in asthma treatment. Conclusion: The conviviality of people with asthma, in an activity of art education, influences their quality of life

Objetivo: Describir sobre la experiencia en arte educación del Trabajo Social en equipo multiprofesional, en el cuidado preventivo del asma, y los cambios sentidos por los participantes del "Coral Voices en Superación", mediante las (inter) experiencias y vivencias de cantar y convivir con el asma. Métodos: Investigación cualitativa, empírica, bibliográfica y fenomenológica. Con uso de diario de campo, entrevista semiestructurada y análisis de contenido. Participaron 14 mujeres y un hombre entre 23 y 75 años, acompañados en el Centro de Referencia en Asma. Resultado: El arte de la educación, a través de la música, es un recurso para que el asistente social potencializar la autoestima de las personas en el tratamiento del asma. Conclusión: La convivencia de personas con asma, en una actividad de arte educación, influye en su calidad de vida

Enseñanza del Yoga como técnica para disminuir los niveles de estrés en estudiantes de pregrado de la facultad de Salud Pública / Teaching of Yoga as a technique to reduce stress levels in undergraduate students of the Faculty of Public Health

Cursar una carrera universitaria implica una serie de esfuerzos físicos y mentales para los estudiantes de este nivel educacional. Las actividades evaluativas parciales y semestrales hacen que los estudiantes estén sometidos a niveles de estrés que en muchas ocasiones sobrepasen las capacidades adaptivas de los individuos generando así manifestaciones clínicas que disminuyen su capacidad intelectual y por ende su aprovechamiento académico. De este concepto se deriva la importancia de minimizar los niveles de estrás en estudiantes universitarios para mantener el correcto equilibrio biopsicosocial. El yoga es una técnica de relajación milenaria que se ha utilizado con buenos resultados para minimizar niveles de estrés en distintos grupos poblacionales; su enseñanza e implementación en estudiantes universitarios constituye una alternativa viable que puede representar a corto plazo disminución del estrés y maximizar el rendimiento académico de los estudiantes(AU)

To pursue a university career involves a series of physical and mental efforts for students of this educational level. The partial and semester evaluation activities mean that students are subject to stress levels that in many cases exceed the adaptive capacities of individuals, thus generating clinical manifestations that diminish their intellectual capacity and therefore their academic performance. From this concept derives the importance of minimizing the levels of stress in university students to maintain the correct biopsychosocial balance. Yoga is a thousand-year-old relaxation technique that has been used with good results to minimize levels of stress in different population groups; Its teaching and implementation in university students is a viable alternative that can represent short-term stress reduction and maximize the academic performance of students(AU)

[Percutaneous treatment of chronic total coronary occlusion]. / Le traitement percutané des occlusions coronaires chroniques.

Although frequent, chronic total occlusion (CTO) has long been neglected by interventional cardiologists, considering that the risk of complications was too high compared to the expected benefits. The presence of a CTO has therefore been an essential decision-making factor for referral of patients with multivessel disease to surgical coronary revascularization, or for the choice of the optimization of medical treatment in patients with an isolated CTO. The recent years technical progress of and the development of specific tools for percutaneous treatment of CTO have allowed to gradually change the vision within the cardiology community as the benefits in terms of quality of life and of complete revascularization have been clearly demonstrated. In contrast, the benefit on survival and improvement of left ventricular systolic function, although highlighted in meta-analyses and in some registries, has yet to be demonstrated by prospective randomized studies. The different reasons for considering percutaneous revascularization of CTO are discussed in this article. We will also review how to select patients based on clinical and angiographic data.

Bien que fréquentes, les occlusions coronaires chroniques («chronic total occlusion¼, CTO) ont longtemps été négligées par les cardiologues interventionnels, considérant que le risque de complications lié à une tentative de revascularisation était trop élevé par rapport aux bénéfices escomptés. La présence d'une CTO a, dès lors, été un facteur décisionnel essentiel pour l'orientation des patients vers une chirurgie de revascularisation coronarienne en cas d'atteinte pluritronculaire, ou pour le choix de l'optimalisation du traitement médical chez les patients avec une CTO isolée. Les progrès techniques de ces dernières années et le développement d'un matériel spécifique pour le traitement percutané des CTO ont permis de progressivement modifier la vision au sein de la communauté des cardiologues interventionnels, d'autant que les bénéfices en ce qui concerne la qualité de vie et les possibilités de revascularisation complète ont été clairement démontrés. En revanche, les bénéfices sur la survie et l'amélioration de la fonction systolique ventriculaire gauche, bien que démontrés dans les méta-analyses et certains registres, doivent encore être confirmés par des études prospectives randomisées. Les différentes raisons d'envisager une revascularisation percutanée des CTO sont discutées dans cet article. Nous ferons également le point quant à la manière de sélectionner les patients sur base des données cliniques et angiographiques. Mots-clés : Occlusion coronaire chronique - Qualité de vie - Angioplastie coronaire percutanée.