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The MOS 36-Item Short-Form Health Status Survey (SF-36), I: Conceptual framework and item selection

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  • John Ware Research Group
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... The Physical Function subscale from the 36-Item Short Form Survey (SF-36; Ware & Sherbourne, 1992) assessed perceived level of physical functioning. This subscale includes 10 items, each scored with a 3-point Likert scale. ...
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Background/Objectives The aim of this study was to examine the effectiveness of two video-based multicomponent programs (FIBROWALK) and the Multicomponent Physiotherapy Program (MPP) for patients with fibromyalgia (FM) compared to treatment-as-usual (TAU) only. We posit that FIBROWALK, due to inclusion of specific psychological ingredients (cognitive restructuring and mindfulness), can produce additional clinical benefits when compared to TAU or MPP alone. Methods A total of 330 patients with FM were recruited and randomly allocated (1:1:1) to TAU only, TAU+FIBROWALK, or TAU+MPP. FIBROWALK and MPP consisted of weekly videos on pain neuroscience education, therapeutic exercise and self-management patient education, but only the FIBROWALK intervention provided cognitive restructuring and mindfulness. Both programs were structurally equivalent. Between-group differences in functional impairment, pain, kinesiophobia, anxious-depressive symptoms and physical functioning were evaluated at post-treatment following Intention-To-Treat and complete-case approaches. Results Compared to TAU only, individuals in the FIBROWALK arm showed larger improvements in all clinical outcomes; similarly, participants in the MPP program also showed greater improvements in functional impairment, perceived pain, kinesiophobia, depressive symptoms compared to TAU only. The FIBROWALK intervention showed superior effects in improving pain, anxiety and depressive symptoms and physical functioning compared to MPP. Conclusions This RCT supports the short-term effectiveness of the video-based multicomponent programs FIBROWALK and MPP for FM and provides evidence that cognitive behavioural and mindfulness-based techniques can be clinically useful in the context of physiotherapeutic multicomponent treatment programs.
... Other questionnaires: The quantitative ADAM (qADAM) questionnaire [27] is a new tool in quantifying the severity of hypogonadism, sexual encounter profile (SEP), and Global Assessment Question for assessing sexual performance[1]. The total qADAM score ranges between 10 and 50, with 10 being the most symptomatic and 50 being the least symptomatic. ...
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Sexual dysfunction (SD) is a prevalent but very commonly ignored aspect in the treatment of liver diseases and cirrhosis. The etiology of SD is multifactorial and therefore treatment strategies are complex, especially in females. Phosphodi- esterase inhibitors are useful and effective in erectile dysfunction in males but in females, no single drug is available for SD, therefore multimodal treatment is required depending upon the cause. The foremost and fundamental requirement in both genders is to be stress-free and have adequate control of liver diseases. Improved quality of life is helpful in improving SD and vice versa is also true. Therefore, patients suffering from liver diseases should come forward and ask for treatment for SD, and physicians should actively enquire about SD while history taking and evaluating these patients. SD results in deterioration of quality of life, and both are modifiable and treatable aspects of liver diseases, which are never addressed actively, due to social taboos and fears of SD treatment in the presence of liver diseases. The diagnosis of SD does not require costly investigations, as the diagnosis can be established based on validated questionnaires available for both genders, therefore detailed targeted history taking using questionnaires is essential. Data are emerging in this area but is still at an early stage. More studies should be dedicated to SD in liver diseases.
... At the baseline donation visit after trial recruitment, a full blood count was performed which provided the levels of Hb used to define the proportion of low Hb deferrals who would require additional consultations and tests. Trial participants were asked to complete a baseline questionnaire online, which included the SF-36 (Short Form 36) questionnaire [16]. ...
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Background The INTERVAL trial showed shorter inter-donation intervals could safely increase the frequency of whole-blood donation. We extended the INTERVAL trial to consider the relative cost-effectiveness of reduced inter-donation intervals. Methods Our within-trial cost-effectiveness analysis (CEA) used data from 44,863 whole-blood donors randomly assigned to 12, 10 or 8 week (males), and 16, 14 or 12 week inter-donation intervals (females). The CEA analysed the number of whole-blood donations, deferrals including low- haemoglobin deferrals, and donors’ health-related quality of life (QoL) to report costs and cost-effectiveness over two years. Findings The mean number of blood donation visits over two years was higher for the reduced interval strategies, for males (7.76, 6.60 and 5.68 average donations in the 8-, 10- and 12- week arms) and for females (5.10, 4.60 and 4.01 donations in the 12-, 14- and 16- week arms). For males, the average rate of deferral for low haemoglobin per session attended, was 5.71% (8- week arm), 3.73% (10- week), and 2.55% (12- week), and for females the rates were: 7.92% (12-week), 6.63% (14- week), and 5.05% (16- week). Donors’ QoL was similar across strategies, although self-reported symptoms were increased with shorter donation intervals. The shorter interval strategies increased average cost, with incremental cost-effectiveness ratios of £9.51 (95% CI 9.33 to 9.69) per additional whole-blood donation for the 8- versus 12- week interval for males, and £10.17 (95% CI 9.80 to 10.54) for the 12- versus 16- week interval arm for females. Conclusions Over two years, reducing the minimum donation interval could provide additional units of whole-blood at a small additional cost, including for those donor subgroups whose blood type is in relatively high demand. However, the significance of self-reported symptoms needs to be investigated further before these policies are expanded.
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Objectives To assess the feasibility of a telerehabilitation system for chronic post-stroke subjects compared to a conventional treatment. Methods A feasibility cross-over analysis was conducted in ten chronic post-stroke subjects. Two randomized groups followed two eight-weeks treatments, one with the telerehabilitation system Muvity and the other following conventional therapy (in random order). Before and after each treatment, physical evaluations were performed assessing functional independence, the perceived level of pain, balance control and self-reported health status. After the study, the participants answered a short questionnaire to measure the usability of the system. Results Four out of six subjects demonstrated better performance in ADLs (equal or higher FIM scores) and five out of six reported lower pain (VAS score) after the treatment with Muvity when compared to the treatment without. There were no clear trends in terms of balance control (Berg scale) or self-reported health status (PCS score within SF-36). Conclusions The results suggest that the proposed telerehabilitation system aids users to overall maintain or improve their ability to perform ADLs without increasing pain, when compared to conventional therapy. Most subjects found the use of Muvity more motivating than the conventional rehabilitation treatment. This provides initial evidence that Muvity might be an appropriate complement for the telerehabilitation of patients with physical disabilities. However, the differences observed between both treatments were not statistically significant. A clinical study with a larger sample size will be necessary to obtain more robust results.
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Urticaria is an inflammatory skin disorder that affects up to 20% of the world population at some point during their life. It presents with wheals, angioedema or both due to activation and degranulation of skin mast cells and the release of histamine and other mediators. Most cases of urticaria are acute urticaria, which lasts ≤6 weeks and can be associated with infections or intake of drugs or foods. Chronic urticaria (CU) is either spontaneous or inducible, lasts >6 weeks and persists for >1 year in most patients. CU greatly affects patient quality of life, and is linked to psychiatric comorbidities and high healthcare costs. In contrast to chronic spontaneous urticaria (CSU), chronic inducible urticaria (CIndU) has definite and subtype-specific triggers that induce signs and symptoms. The pathogenesis of CSU consists of several interlinked events involving autoantibodies, complement and coagulation. The diagnosis of urticaria is clinical, but several tests can be performed to exclude differential diagnoses and identify underlying causes in CSU or triggers in CIndU. Current urticaria treatment aims at complete response, with a stepwise approach using second-generation H1 antihistamines, omalizumab and cyclosporine. Novel treatment approaches centre on targeting mediators, signalling pathways and receptors of mast cells and other immune cells. Further research should focus on defining disease endotypes and their biomarkers, identifying new treatment targets and developing improved therapies. Full text link: https://rdcu.be/cVCVy
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Background Brain injury in out-of-hospital cardiac arrest (OHCA) survivors affects health status and health-related quality of life (HRQoL). It is unknown how HRQoL evolves over time, and assessments at different time points may lead to different results. Methods In a NORCAST sub study, OHCA survivors eligible for health status (EQ-5D-3L) and HRQoL (SF-36) assessments were examinated six months and five years after OHCA. At five-year follow-up, survivors also retrospectively assessed their health status for each consecutive year following OHCA. The next of kin independently assessed health status and HRQoL of their respective OHCA survivors. Results Among 138 survivors alive after six months and 117 after five years, 80 (88% male) completed both follow-ups. Health status and HRQoL remained stable over time, except for increasing SF-36 mental summary score and decreasing physical functioning and physical component score. Anxiety and depression levels were generally low, although younger survivors stated more anxiety than older survivors. Retrospective assessment showed reduced health status for the first two years, which increased only from the third year. Explorative analyses revealed that younger age, longer time to return of spontaneous circulation (tROSC) and late awakening affected health status, particularly in the first two years post-arrest. Conclusions OHCA survivors showed stable health status and HRQoL with only minor differences between six months and five years. Younger survivors with long tROSC, late awakening, and more anxiety and depression symptoms at six months, had reduced health status the first two years with significant improvements towards the fourth year.
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Background Obesity is associated with component malpositioning and increased revision risk after total hip arthroplasty (THA). With anterior approaches (AA) becoming increasingly popular, the goal of this study was to assess whether clinical outcome post-AA-THA is affected by body mass index (BMI). Methods This multi-center, multi-surgeon, consecutive case-series used a prospective database of 1,784 AA-THAs (1,597 patients) through bikini (n=1,172) or standard (n=612) incisions. Mean age was 63 years (range, 20 to 94) and there were 57.5% women, who had a mean follow-up of 2.7 years (range, 2.0 to 4.1 years). Patients were classified into the following BMI-groups: normal (BMI <25.0; n=572); overweight (BMI: 25.0 to 29.9; n=739); obese (BMI: 30.0 to 34.9; n=330); and severely-obese (BMI ≥35.0; n=143)]. Outcomes evaluated included hip reconstruction (inclination/anteversion and leg-length), complications and revision rates), as well as patient-reported outcomes including Oxford Hip Scores (OHS). Results Mean post-operative leg-length difference was 2.0 mm (range, -17.5 to 39.0) with a mean cup inclination of 34.8° (range, 14.0 to 58.0°), and anteversion of 20.3° (range, 8.0 to 38.6°). Radiographic measurements were similar between BMI-groups (p=0.1 to 0.7). Complication and revision rates were 2.5 and 1.7%, respectively. The most common complications were fracture (0.7%), periprosthetic joint infection (PJI) (0.5%), and dislocation (0.5%). There was no difference in dislocation (p=0.885) or fracture rates (p=0.588) between BMI-groups. There was a higher rate of wound complications (1.8%; p=0.053) and PJIs (2.1%; p=0.029) among obese and severely obese patients. Wound complications were less common among obese patients with the ‘bikini’ incision (odds ratio 2.7). Pre-operative OHS was worse among the severely obese (p<0.001), which showed similar improvements (Change in OHS; p=0.144). Conclusion Anterior approach THA is a credible option for obese patients, with low dislocation or fracture risk, and excellent ability to reconstruct the hip, leading to comparable functional improvements among BMI-groups. Obese patients have a higher risk of PJIs. Bikini incision for AA-THA can help minimize the risk of wound-complications. How do you know this???data above→data clarified and highlighted in red
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Aims This study aims to measure any changes in the marital relationship during the first year after a diagnosis of prostate cancer, identify the demographic characteristics that influenced such changes, and measure changes related to health‐related quality of life (HRQoL). Background Knowledge is limited on the impact of a diagnosis of prostate cancer on the marital relationship and HRQoL of patients and their spouses. Design A 1‐year longitudinal study. Methods Data were collected from five Finnish hospitals between October 2013 and January 2017. Of the 350 recruited couples (N = 700), 179 patients and 166 spouses completed the Marital Questionnaire and the RAND 36‐Item Health Survey 1 year after diagnosis. Results No major changes were found in the marital relationship during the follow‐up period. The spouses reported statistically significant changes in their marital relationships, but the patients did not. Furthermore, changes in the marital relationship were not associated with the patients' HRQoL. Among spouses, emotional well‐being was associated with changes in the marital relationship. Conclusion The marital relationship was relevant in terms of the spouses' HRQoL during the first year after a diagnosis of prostate cancer. Nurses and other healthcare providers should assess counselling and support provided to spouses individually.
Rationing: the search for sunlight British Medical Jour· na1303: 1561·1562 Evaluation of phar-maceutical innovation: challenges and opportunnies arising from the reforms of the National Health Service in the United Kingdom
  • R Smith
Smith R. Rationing: the search for sunlight British Medical Jour· na1303: 1561·1562.1991 St Leger S. Rowsell K. Standing V. Haycox A. Evaluation of phar-maceutical innovation: challenges and opportunnies arising from the reforms of the National Health Service in the United Kingdom. PharmacoEconomics I: 306-311. 1992