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Purpose: Symptom management among patients diagnosed with advanced cancer is a high priority in clinical care that often involves the support of a family caregiver. However, limited studies have examined parallel patient and caregiver symptom burden and associations with their own and each other's quality of life (QOL). This study seeks to identify patient and caregiver symptom clusters and investigate associations between identified clusters and demographic, clinical, and psychosocial factors (cognitive appraisals and QOL)., Methods: This study was a secondary analysis of self-reported baseline survey data collected from a randomized clinical trial of 484 adult advanced cancer patients and their caregivers. Latent class analysis and factor analysis were used to identify symptom clusters. Bivariate statistics tested associations between symptom clusters and demographic, clinical, and psychosocial variables., Results: The most prevalent symptom for patients was energy loss/fatigue and for caregivers, mental distress. Low, moderate, and high symptom burden subgroups were identified at the patient, caregiver, and dyad level. Age, gender, race, income, chronic conditions, cancer type, and treatment type were associated with symptom burden subgroups. Higher symptom burden was associated with more negative appraisals of the cancer and caregiving experience, and poorer QOL (physical, social, emotional, functional, and overall QOL). Dyads whose caregivers had more chronic conditions were more likely to be in the high symptom burden subgroup., Conclusion: Patient and caregiver symptom burden influence their own and each other's QOL. These findings reinforce the need to approach symptom management from a dyadic perspective., (© 2024. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Purpose: Quality of Life (QoL) is associated with a bandwidth of lifestyle factors that can be subdivided into fixed and potentially modifiable ones. We know too little about the role of potentially modifiable factors in comparison to fixed ones. This study examines four aspects of QoL and its associations with 15 factors in a sample of elderly primary care patients with a high risk of dementia. The main objectives are (a) to determine the role of the factors in this particular group and (b) to assess the proportion of fixed and potentially modifiable factors., Method: A high-risk group of 1030 primary care patients aged between 60 and 77 years (52.1% females) were enrolled in "AgeWell.de," a cluster-randomized, controlled trial. This paper refers to the baseline data. The multi-component intervention targets to decrease the risk of dementia by optimization of associated lifestyle factors. 8 fixed and 7 modifiable factors potentially influencing QoL served as predictors in multiple linear regressions., Results: The highest proportion of explained variance was found in psychological health and age-specific QoL. In comparison to health-related QoL and physical health, the modifiable predictors played a major role (corr. R 2 : 0.35/0.33 vs. 0.18), suggesting that they hold a greater potential for improving QoL., Conclusion: Social engagement, body weight, instrumental activities of daily living, and self-efficacy beliefs appeared as lifestyle factors eligible to be addressed in an intervention program for improving QoL., Trial Registration: German Clinical Trials Register, reference number: DRKS00013555. Date of registration: 07.12.2017., (© 2024. The Author(s).)

Aims: To evaluate cognitive and behavioural factors related to pain and poor sleep quality in women diagnosed with fibromyalgia and to develop and test the effects of a web-based therapeutic education intervention on pain intensity, pain catastrophizing, chronic pain self-efficacy, sleep quality, dysfunctional beliefs and attitudes about sleep and quality of life and health status related to fibromyalgia., Design: The project will employ a sequential exploratory mixed methods research design., Methods: For the qualitative phase, a theoretical sample living in the community will be recruited to participate in personal, semi-structured interviews. For the quantitative phase, a sample of adult women with fibromyalgia will be recruited from secondary care centres and randomly allocated an intervention or a control group. The study protocol was approved in 2019., Discussion: Fibromyalgia is the most common central sensitivity syndrome and one of the principal worldwide causes of chronic widespread pain among the adult population. Poor sleep quality is a highly prevalent and troublesome symptom for people with fibromyalgia. Psychosocial and behavioural factors have been shown to relate intimately with the symptom experiences of people with fibromyalgia; pain catastrophizing and dysfunctional beliefs and attitudes about sleep can perpetuate those and other fibromyalgia symptoms., Conclusion: It is imperative to reflect people's actual symptom experiences to develop effective symptom management strategies. In the Internet era, this project's proposed web-based therapeutic education intervention could offer women with fibromyalgia a new avenue for treatment as part of standard fibromyalgia management programs in primary and secondary healthcare services., Impact: Pain and poor sleep quality are highly prevalent and troublesome symptoms for people with fibromyalgia. The web-based therapeutic education intervention proposed in this project could provide women with fibromyalgia a new avenue for treatment in primary and secondary healthcare services. Protocol registration: ClinicalTrials.gov Identifier: NCT03686410., (© 2020 John Wiley & Sons Ltd.)

Restless legs syndrome (RLS) is a sleep disorder that may exacerbate many of the symptoms and consequences of multiple sclerosis (MS), and may have further implications for health-related quality of life (HRQOL). The present study examined the relationships among RLS, symptoms and HRQOL in people with MS. Participants with MS (n = 275) completed the Cambridge-Hopkins Restless Legs Syndrome Questionnaire, the International Restless Legs Syndrome Study Group Scale, the Multiple Sclerosis Impact Scale, the Pittsburgh Sleep Quality Index, the Fatigue Severity Scale, the Hospital Anxiety and Depression Scale and the Patient Determined Disease Steps. There were 74 (26.9%) persons with MS who had RLS (MS + RLS). The MS + RLS group reported worse physical and psychological HRQOL (p = 0.020 and p = 0.017, respectively) and greater perceived fatigue (p = 0.006) and anxiety symptoms (p = 0.042) than the MS-only group. Within the MS + RLS group, RLS severity was associated with physical (r = 0.43) and psychological (r = 0.46) HRQOL, sleep quality (r = 0.38), perceived fatigue (r = 0.28), depression (r = 0.38) and anxiety (r = 0.28). The relationships between RLS severity and the domains of HRQOL were attenuated when accounting for fatigue, depression and/or anxiety. Worse RLS severity was associated with reduced HRQOL, which was accounted for by fatigue, depression and anxiety., (© 2019 European Sleep Research Society.)

Purpose: Individuals post-stroke might have high levels of post-stroke fatigue (PSF) which might affect their quality of life. This study aimed to investigate the prevalence of post-stroke fatigue in Jordan and to comprehensively identify its possible associated factors., Methods: A cross-sectional design was implemented through one-hour face-to-face assessment sessions. The modified fatigue impact scale, 12-item Short-Form Health Survey, Montreal Cognitive Assessment, Motor Assessment Log, Upper Extremity Fugl Meyer assessment, Nine Hole Peg Test, 10 Meter Walk Testing, active and passive goniometry, Hand-held dynamometry, and modified Ashworth scale were used as outcome measures. Prevalence of post-stroke fatigue and levels of quality of life were reported using descriptive analyses. Multiple variable linear regression analysis was used to identify PSF associated factors of post-stroke fatigue. P < 0.05 was considered significant for all statistical tests., Results: 153 individuals with stroke participated in the study. A total of 117 participants (69.9%, 95% CI = 62.0-77.1%) were fatigued. Fatigue was significantly predicted by mental component of quality of life (β -0.42 [95% CI -0.53--0.31]; p < 0.001), cognition (β -0.69 [95% CI -1.08--0.29], p = 0.001), weekly sport hours (β -0.94 [95% CI -1.73--0.14], p = 0.022), and shoulder abduction spasticity (β -1.81 [95% CI -3.38--0.24], p = 0.024. The model explained 51% of the variation in the fatigue (F = 29.006, p < 0.001)., Conclusion: Jordanian individuals with stroke have a high prevalence of fatigue. Mental related quality of life was significantly associated with PSF levels. Other factors significantly associated with PSF included cognition status, sport participation, and spasticity. Healthcare practitioners working in neurorehabilitation should take PSF and its significant correlates into consideration when treating individuals with stroke.

Background: Patient-generated index (PGI) is one of the individualized measures used to measure the quality of life (QOL) in people with different chronic conditions including multiple sclerosis (MS). However, the psychometric properties of the Arabic version of the PGI have not been fully established in Jordanian living with MS. Therefore, the objective of this study is to identify what matters to Jordanian living with MS and to contribute evidence toward the psychometric properties of the Arabic version of the PGI., Methods: A total of 75 participants with MS completed three QOL measures; PGI, the patient determined disease steps (PDDS), and EQ-5D. Generalized estimating equations were used to compare the total score of three QOL measures. Bland-Altman plot and Spearman's correlation coefficient were used to study the relationships and differences between the PGI and the other study measures (PDDS and EQ-5D)., Results: Only 66 (88%) of the participants were able to complete the PGI. Overall, 36 areas of QOL concern were nominated by the participants using the PGI with the top three areas were emotional function (47%), involuntary movement reaction functions (45.5%), and walking (44 %). The average global score of the PGI was lower (34 ± 22) than the global score of the EQ-5D (69 ± 23), and the PDDS (68 ± 24). PGI had a moderate correlation with EQ-5D and PPDS., Conclusion: The Arabic version of the PGI is a feasible, acceptable, and valid measure among Jordanians with MS. PGI also captures more important areas that contribute to QOL than EQ-5D and PDDS. PGI could improve the decision making and guide healthcare professionals to provide appropriate intervention programs to reduce the burdens from MS disease and improve QOL., (© 2021 John Wiley & Sons Ltd.)

Objective: To evaluate physical activity-related quality of life (PAQOL) in breast cancer survivors compared to healthy women., Methods: Physical activity level was measured as not active, somewhat active, active or very active. Intensity was reported as hours per week of light, moderate and vigorous activity. Physical activity-related quality of life was measured with the Vitality Plus Scale, a self-report instrument developed and validated to measure exercise-related health benefits., Results: Compared to healthy women (n = 23), breast cancer survivors (n = 23) were older (57.0 ± 2.3 vs. 49.0 ± 1.1 years; p < .01) and reported more light activity (4.1 ± 0.6 vs. 2.4 ± 0.5 hr/week; p < .05), but no differences in PAQOL. However, when grouped by physical activity level there were no differences in age, but inactive women (n = 30) had higher body mass index (29.3 ± 1.0 vs. 25.1 ± 1.1 kg/m 2 ; p < .05) and reported less moderate (1.3 ± 0.4 vs. 3.6 ± 0.8 hr/week; p < .05) and vigorous (0.2 ± 0.1 vs. 1.9 ± 0.5 hr/week; p < .01) activity than active women (n = 16). Furthermore, active women reported higher overall PAQOL, greater energy levels and quicker sleep onset than inactive women (p < .05)., Conclusions: In these women, moderate and vigorous physical activity and PAQOL were not influenced by breast cancer survivorship. Despite diagnosis, active women who engaged in greater amounts of moderate and vigorous activity reported better PAQOL than inactive women., (© 2019 John Wiley & Sons Ltd.)

Individuals with multiple sclerosis (MS) are more sedentary than the general population, increasing their propensity for reduced functional ability, mobility, and activities of daily living. Self-efficacy has been one of the most consistent determinants of physical activity across populations, including those with MS. However, no studies exist that have attempted to influence self-efficacy in MS patients, in an effort to improve physical activity participation. We conducted a three-month randomised, controlled trial (n=26), contrasting the effects of an efficacy-enhancement exercise condition and a control exercise condition on exercise adherence, well-being, and affective responses to exercise. Analyses indicated that individuals in the efficacy enhancement condition attended more exercise sessions, reported greater levels of well-being and exertion, and felt better following exercise than individuals in the standard care condition. Regardless of treatment condition, individuals with a stronger sense of exercise self-efficacy, who reported more enjoyment following the exercise sessions, demonstrated significantly greater adherence with the exercise program. We believe this to be the first empirical attempt to change physical activity behavior in persons with MS using a well-established theoretical framework to drive the intervention. Continued examination of self-efficacy as a determinant of behavior change in individuals with MS is needed. [ABSTRACT FROM AUTHOR]

Using meta-analytic procedures, this study examined the overall effect of exercise training interventions on quality of life (QOL) among individuals with multiple sclerosis (MS). We searched MEDLINE, PSYCHINFO and CURRENT CONTENTS PLUS for the period of 1960 to November 2006 using the key words exercise, physical activity and physical fitness in conjunction with QOL and MS. We further conducted a manual search of bibliographies of the retrieved papers as well as literature reviews and contacted study authors about additional studies. Twenty-five journal articles were located and reviewed, and only 13 provided enough data to compute effect sizes expressed as Cohen's d. One hundred and nine effect sizes were retrieved from the 13 studies with 484 MS participants and yielded a weighted mean effect size of g = 0.23 (95% CI = 0.15, 0.31). There were larger effects associated with MS-specific measures of QOL and fatigue as an index of QOL. The nature of the exercise stimulus further influenced the magnitude of the mean effect size. The cumulative evidence supports that exercise training is associated with a small improvement in QOL among individuals with MS. [ABSTRACT FROM AUTHOR]

Background: Fatigue and inactivity are linked to decreased health-related quality of life (HRQoL) in chronic conditions. A multidimensional approach to activity pacing may improve HRQoL by promoting physical activity (PA) and alleviating fatigue. Addressing fatigue across chronic conditions is crucial, especially when underlying causes are unknown. This study aimed to (1) examine associations between HRQoL, fatigue, pacing, risk of overactivity, PA, and self-regulation of PA in adults with chronic conditions and (2) examine if these associations differ across HRQoL domains: physical, social, emotional, and functional well-being. Methods: Sixty-six adults with chronic conditions were recruited from UK fatigue clinics and the community. HRQoL, pacing, risk of overactivity, PA, and self-regulation of PA were assessed with standardised questionnaires and Actigraph monitor. Associations were analysed with linear mixed models, correcting for confounders. Results: HRQoL was significantly associated with fatigue (B=-7.82), pacing (B=-0.23), and self-regulation of PA (B = 0.11). Interaction effects revealed fatigue's impact on HRQoL varied significantly in physical (β=-13.49), social (β=-6.81), and emotional (β=-4.10) domains. Pacing showed significant differences in physical (β=-0.49), social (β=-7.12), and emotional (β=-7.45) domains. Perceived overactivity differed in social domain (β=-6.27), while device-based PA differed in physical (β = 0.35) and social (β = 5.73). Conclusion: The negative association between fatigue and HRQoL underscores the importance of effective fatigue management. Higher pacing engagement and lower HRQoL may indicate higher fatigue. Positive associations between self-regulation and PA with HRQoL emphasise benefits of appropriate PA behaviours. The stronger impact of decreased fatigue, increased pacing, and PA on physical well-being suggests a multidimensional fatigue management approach. [ABSTRACT FROM AUTHOR]

Purpose: As people with long-standing disabling conditions age, the interplay between pre-existing conditions and new comorbidities can present unique challenges. Therefore, the current study explored relationships between resilience and health, health promotion, and quality of life among older adults living with multiple sclerosis (MS). Method: Adults recruited from National MS Society chapters completed a mailed survey about their health, health promotion, and well-being. Results: The 147 respondents (mean age = 72 years) reported an average of three additional comorbidities and had been diagnosed with MS for 35 years on average. Resilience scores were most highly correlated with depressive symptoms, spiritual growth, social support, incapacity status, and quality of life. Resilience scores significantly improved prediction of emotional health, after controlling for other functional and psychosocial variables. Conclusion: Nurses can help patients with chronic conditions, such as MS, develop strategies for regulating their emotional health to adapt to new health challenges. [Journal of Gerontological Nursing, 51(1), 15–23.] [ABSTRACT FROM AUTHOR]

Background/Objectives: Patients with COPD have altered self-esteem, and good self-esteem promotes personal, health, and social success. Improving self-esteem could be a method for encouraging the maintenance of physical activity. Only one study has evaluated the effects of pulmonary rehabilitation (PR) on self-esteem in moderate COPD patients. The objective was to assess the evolution of self-esteem in COPD patients of all stages of severity during PR. Methods: COPD patients undergoing PR were included in this prospective observational study. Patients were evaluated before and after the 4-week PR program. The objectives were to (1) assess the evolution of self-esteem using the Physical Self Inventory-6 questionnaire (PSI-6), (2) assess the evolution in each sub-score of PSI-6, (3) examine the correlations between the evolution of self-esteem and the evolution of parameters usually used during PR, and (4) determine an MID for self-esteem. Results: In total, 76 patients were included. We found that there was a significant increase in the total score in PSI-6 (9.29, p < 0.001), CI 95% [6.74; 11.83], and in the sub-scores of PSI-6. The evolution of the PSI-6 score was moderately correlated with changes in exercise capacity using STST1 (r = 0.352, p = 0.002) and quality of life (r = −0.361, p = 0.001) and weakly correlated to changes in dyspnea (r = −0.245, p = 0.03), anxiety (r = −0.248, p = 0.03), and depression (r = −0.290, p = 0.01). Using a distribution-based analysis, we found an MID between 5.2 and 5.6. Conclusions: We showed a significant increase in global score and in each sub-score of self-esteem using PSI-6 in COPD patients undergoing a PR program. We propose an MID of 5.6. [ABSTRACT FROM AUTHOR]

BACKGROUND: Fatigue is the most prevalent symptom among people with multiple sclerosis (PwMS). Although exercise effectively reduces fatigue, the relationship between daily physical activity and fatigue has only recently been demonstrated. OBJECTIVE: The aim of this study was to evaluate the prevalence of fatigue and to understand the relationship with several variables in French PwMS. METHODS: Data were collected from 191 PwMS using Modified Fatigue Impact Scale (MFIS) and Fatigue Severity Scale (FSS) for fatigue, and the Godin Leisure-Time Exercise Questionnaire (GLTEQ) for physical activity. RESULTS: 110 PwMS (57%), 35 PwMS (18%) and 46 PwMS (24%) were considered as fatigued, non-fatigued and in the grey zone, respectively. Greater physical activity was observed in non-fatigued PwMS (20.2±19.8) compared to fatigued PwMS (12.5±14.1). FSS and MFIS scores were associated with physical activity (r = –0.28 and r = –0.25, respectively, p < 0.05). Using multivariate analysis, disability, physical activity and being unemployed explained 21% of the variance of the MFIS. CONCLUSIONS: The present study confirms that physical activity and fatigue are associated. Disability and unemployment status should also to be consider when assessing fatigue. Activity-oriented health policies should be redesigned to improve fatigue among PwMS. [ABSTRACT FROM AUTHOR]

Objective: Psychological interventions are pivotal in enhancing the Quality of Life for breast cancer survivors, with a primary focus on addressing affective and cognitive challenges through group discussions among those diagnosed with the disease. While the influence of Body Image on overall well-being is well-documented, research on interventions specifically designed to address Body Image concerns in this demographic remains scarce. The present study aimed to fill this gap by evaluating the outcomes of a psychological intervention focused on fostering a positive Body Image among 25 breast cancer survivors. Method: Participants were divided into an experimental group, which received the intervention (n = 13), and a control group that did not receive any psychological support (n = 12). Results: Our findings highlight significant disparities in emotional regulation strategies, specifically cognitive reappraisal and expressive suppression, with the intervention group reporting enhanced emotional regulation. Contrary to initial hypotheses, the analysis unveiled statistically significant differences in both negative (social physique anxiety) and positive (functionality appreciation) body image dimensions, indicating elevated levels of social physique anxiety and reduced functionality appreciation among intervention participants. Conclusion: The total results may suggest that the intervention, while effective in enhancing emotional regulation, heightened awareness of body image issues, leading to increased social physique anxiety and diminished functionality appreciation. The paper further discusses practical implications arising from these insights. [ABSTRACT FROM AUTHOR]

High levels of sedentary behaviour are associated with poor health outcomes in people with multiple sclerosis (MS). Identifying modifiable correlates of sedentary behaviour for people with MS is essential to design effective intervention strategies to minimise sedentary time. This study aimed to quantify patterns and identify correlates of sedentary behaviour among adults with MS. Fatigue, self-efficacy, walking capability, the physical and psychological impact of MS, health-related quality of life, and participation and autonomy were assessed by questionnaire. Participants wore an activPAL monitor. Total (min/day), prolonged bouts (≥ 30 min) and breaks in sedentary time were calculated. Associations were examined using regression analysis adjusted for demographic and clinical confounders. Fifty-six adults with MS participated (mean ± SD age: 57.0 ± 9.25 years; 66% female). Self-efficacy for control over MS was associated with sedentary time (β = 0.16, 95% CI 0.01, 0.30). Self-efficacy in function maintenance (β = 0.02, 95% CI 0.00, 0.04), health-related quality of life (EuroQol-5D) (β = 31.60, 95% CI 7.25, 55.96), and the autonomy indoors subscale of the Impact on Participation and Autonomy Questionnaire (β = − 5.11, 95% CI − 9.74, − 0.485) were associated with breaks in sedentary time. Future studies should consider self-efficacy, health-related quality of life and participation and autonomy as potential components of interventions to reduce sedentary behaviour. [ABSTRACT FROM AUTHOR]

Ataxia is a significant and often debilitating symptom characterized by the impaired coordination of voluntary muscle movements. It frequently occurs in patients with multiple sclerosis (MS) and profoundly impacts their quality of life. This comprehensive review explores the multifaceted nature of ataxia, including its diverse etiologies such as central nervous system lesions, medication side effects, nutritional deficiencies, and hereditary conditions, as well as its association with various diseases. A detailed examination of ataxia's correlations with neuroanatomy revealed its complex relationship with cerebellar pathology. This emphasized the critical role of the cerebellum and its associated pathways in coordinating voluntary movements. The manifestation of ataxia in MS were examined, highlighting its prevalence, impact on disability and life quality, and the pathological underpinnings within cerebellar structures. Diagnostic approaches, including the International Cooperative Ataxia Rating Scale, Scale for the Assessment and Rating of Ataxia, and nine-hole peg test for assessing upper limb dexterity, were discussed. Furthermore, the treatment strategies were critically reviewed. Although long-term effective options are currently lacking, specific pharmacological agents and rehabilitation techniques have demonstrated some benefits. The review findings indicate that further studies are required to better understand ataxia's dynamics, treatment efficacy, and overall impact on patients with MS. Additionally, there is a pressing need for advancements in management and therapeutic approaches. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is one of the most common progressive neurological disorders affecting young adults. This study aimed to perform a metaanalysis on the effect of interferon beta (IFN-β) on the quality of life (QOL) of patients with MS. Methods: Using valid keywords and searching through databases like Medlib, ScienceDirect, PubMed, etc., 10 articles published between 1999 and 2020 were collected. The inclusion criteria were developed based on clinical guidelines, focusing on studies involving adults with MS treated with IFN-β, with outcomes measuring QOL. The exclusion criteria included studies not in English, those involving pediatric populations, or those lacking a control group. In the reviewed studies, 14 scales of QOL were measured at the beginning and the end of treatment with IFN-β. [ABSTRACT FROM AUTHOR]

Our study investigated whether changes in physical activity due to COVID-19 mediate the association between quarantine or hospitalization due to COVID-19 and COVID-19 life impact score. A total of 154 participants (0.23%) were quarantined or hospitalized due to COVID-19. There were mediating effects of changes in physical activity due to COVID-19 (β = −1.63, 95% confidence interval = −0.77 to −2.42). This study suggests that measures to minimize lifestyle changes during the pandemic are required to reduce negative consequences. [ABSTRACT FROM AUTHOR]

Background and Purpose. The number of older adults and the occurrence of concomitant health issues continue to grow. One of the most prevalent mental health issues in this population is depression. Physical exercise (PE) is widely acknowledged as a method to alleviate the associated health burdens of aging, including depression; however, there is no collated evidence regarding the effectiveness of specific types of exercise on a range of health outcomes. To address this, we conducted a systematic review to evaluate exercise benefits for this specific subgroup. Methods. An electronic search of five databases was used to retrieve controlled studies investigating health‐related outcomes associated with any type of PE, in adults over 65 years with depression. Where possible, data were analyzed in meta‐analyses or else reported narratively. Results and Discussion. Fifteen studies were included in the review. All 15 studies had data available for meta‐analysis, yet heterogeneity in exercise types and outcome measures limited synthesis. When data for all types of exercise were pooled together, significant improvements were found in depression (SMD = 0.52; CI = 0.07, 0.97; p = 0.02), physical health and function (SMD = 0.44, CI = 0.14, 0.74; p = 0.004), anxiety (SMD = 0.23; CI = 0.04, 0.42; p = 0.02), and self‐efficacy (SMD = 0.97; CI = 0.32, 1.61; p = 0.003). When data were pooled according to exercise type, positive effects were demonstrated for aerobic exercise on depression (SMD = 0.49; CI = −0.16, 0.8; p = 0.003), tai chi/qigong on depression (SMD = 0.89; CI = −0.14, 1.63; p = 0.02), and self‐efficacy (SMD = 6.70; CI = −0.90, 12.50; p = 0.02) and multicomponent exercise demonstrated positive effects on physical function (SMD = 0.49; CI = 0.12, 0.87; p = 0.009) and the physical health component of quality of life (SMD = 0.88; CI = 0.10, 1.65; p = 0.03). No health‐related benefits were revealed from the combined findings of the two studies investigating strengthening exercises. Conclusion. Lack of consistency regarding exercise types, dosage, and outcomes presents challenges in the evidence. In general, exercise is beneficial across a range of health‐related variables. Multicomponent, aerobic, and tai chi forms of exercise appear most likely to reap benefits in depressed older adults; however, the type of benefit is determined by the type of exercise and should be considered when recommending a regime. This trial is registered with CRD42020173465. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is a persistent inflammatory condition impacting the brain and spinal cord, affecting globally approximately 2.8 million individuals. Effective self-management plays a crucial role in the treatment of chronic diseases, including MS, significantly influencing health outcomes. A personal health record (PHR) is a promising tool to support self-management, potentially empowering patients and enhancing their engagement in treatment and health. Despite these promising aspects, challenges in implementation persist and PHRs are still a relatively new concept undergoing rapid development. Objective: This study aimed to assess the feasibility and usability of the PHR. Secondary objectives included evaluating implementation determinants, and exploring preliminary effects on quality of care for both patients and healthcare professionals (HCPs), self-management, self-efficacy for patients, job satisfaction, efficiency, and demand for HCPs, and preliminary effects on costs and health-related quality of life. Methods: This study had a mixed-methods design. Quantitative data of patients (n = 80) and HCPs (n = 12) were collected via self-reported questionnaires at baseline (T0), after one year (T1), and after two years (T2). One focus group interview was conducted at T2 with patients (n = 7), and another one with HCPs (n = 4), to get a more in-depth understanding of the feasibility and usability of the PHR via the Unified Theory of Acceptance and Use of Technology framework, and to further explore the secondary objectives in-depth. Results: Most patients never logged in during the first year and logged in a couple of times per year during the second year, averaging around 15 min per log-in session. The HCPs mainly logged in a couple of times per year over the two years with an average use of six minutes per session. Patient usability and satisfaction scores were below average and moderate, respectively: with SUS-scores of 59.9 (SD = 14.2, n = 33) at T1 and 59.0 (SD = 16.3, n = 37) at T2, and CSQ-8 scores of 21.4 (SD = 5.0, n = 34) at T1, and 22.1 (SD = 5.0, n = 39) at T2. HCPs had similar usability and satisfaction scores. Multiple facilitators and barriers were identified by both patients and HCPs, such as (in)sufficient knowledge of how to use the PHR, lack of staff capacity and ICT obstacles. No significant differences were found in the preliminary effects. Qualitative data showed, among others, that both patients and HCPs saw the benefit of the PHR in terms of performance expectancy, by gaining more insight into health and health data, but challenges remained regarding effort expectancy, such as log-in issues and experiencing difficulties with information retrieval. Conclusion: The feasibility and usability were considered moderate by patients and HCPs; however, potential regarding the performance of the PHR was observed. Implementation challenges, such as the complexity of usage, lowered the adoption of the PHR. The evolving nature of PHRs requires ongoing evaluation and adaptation to optimize their potential benefits. Utilizing a participatory design approach and a dedicated implementation team could help in achieving this optimization, ultimately enhancing their adoption. [ABSTRACT FROM AUTHOR]

Objectives. This study aimed to assess the impact of an 8-week tele-exercise program on the quality of life (QoL) and body composition among female older adults. Materials and methods. This study involved female participants aged 60 and older, using a quasi-experimental research design. The tele-exercise regimen comprised a multimodal approach, with sessions lasting 30 minutes, conducted three times a week over an 8-week period. The program included breathing exercises, cognitive training, balance exercises, strength training, stretching, aerobic dance and karaoke singing. The sessions were conducted via streaming studio facilities at the Computer Center of Ubon Ratchathani Rajabhat University (Thailand). The teleexercise equipment was represented by the following technical means: a 50-inch LED TV, OBS (Open Broadcaster Software) version 30.1.2 for live broadcasting and video recording, Google Meet for virtual interaction, wireless portable microphones, a desktop computer, and two 19-inch computer monitors. Pre- and post-intervention data were collected, including assessments of QoL using the Thai abbreviated version of the World Health Organization QoL questionnaire and body composition measurements (waist circumference and bioelectrical impedance analysis; BIA). Results. Statistically significant improvements were observed in both QoL and body composition following the teleexercise intervention. QoL scores demonstrated significant enhancements in overall QoL (p = 0.004), as well as in the social relationship (p = 0.002) and environmental (p = 0.001) domains. Regarding body composition, reductions in waist circumference and visceral adipose tissue were statistically significant (p < 0.05), while muscle mass and body fat mass showed trends toward improvement, though not statistically significant. Conclusions. The findings suggest that tele-exercise training holds promise for enhancing QoL and positively influencing body composition among female older adults. This underscores the potential of tele-exercise as a viable option for older adults, offering cost and time-saving benefits, particularly in situations where transportation may pose challenges. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) is accompanied by many health-related issues. This study aimed to evaluate the anthropometric indices, nutrient intakes and health-related characteristics of MS patients as well as their possible correlations. This cross-sectional study was performed on 283 MS patients in Shiraz, Iran, during 2018–2019. Body mass index (BMI) and body composition were measured for each participant. A food frequency questionnaire was used to determine the patients' nutrient intakes. The level of fatigue, disability and quality of life of the individuals were assessed by the modified fatigue impact scale (MFIS), the expanded disability status scale and the multiple sclerosis quality of life-54 questionnaires, respectively. The results revealed that 43.11% of the patients were overweight or obese, and their %body fat (%BF) was 35.65 ± 7.63. Besides, intakes of vitamins A, E, D, folic acid, calcium, zinc and magnesium were significantly lower than recommendations in both genders, and sodium intake was significantly higher than the tolerable upper intake level in females. A significant positive linear correlation was observed between MFIS and BMI (r = 0.12, P = 0.045). Significant positive correlations were also found between psychosocial subscale of MFIS and both of %BF (r = 0.12, P = 0.049) and visceral fat area (r = 0.14, P = 0.02). Unexpectedly, the patients' quality of life showed significant negative correlations with fat free mass and skeletal muscle mass. Being overweight, having a high %BF and poor nutrient intakes are common among MS patients. Improving the patients' lifestyle and dietary intake is recommended to reduce fatigue and increase their life quality. [ABSTRACT FROM AUTHOR]

Background: Accounting for more than 60% of cancer survivors, older (≥65 years) cancer survivors have a 2- to 5-fold risk of physical function impairment, compared to cancer-free peers. One strategy to improve physical function is dietary and resistance training interventions, which improve muscle strength and mass by stimulating muscle protein synthesis. The E-PROOF (E-intervention for Protein Intake and Resistance Training to Optimize Function) study will examine the feasibility, acceptability, and preliminary efficacy of a 12-week randomized controlled trial of an online, tailored nutritional and resistance training education and counseling intervention to improve physical function and associated health outcomes (muscle strength, health-related quality of life (HRQoL), self-efficacy, and weight management). Methods: In this study, 70 older cancer survivors will be randomized to one of two groups: experimental (receiving remote behavioral counseling and evidence-based education and resources), and control (general survivorship education). We will examine the intervention effects on physical function, muscle strength, HRQoL, self-efficacy, weight, and waist circumference during a 12-week period between the experimental and control groups. Three months following the end of the intervention, we will conduct a follow-up assessment to measure physical function, muscle strength, and HRQoL. Significance and impact: This study is the first synchronous, online protein-focused diet and resistance training intervention among older cancer survivors. This novel study advances science by promoting independent health behaviors among older cancer survivors to improve health outcomes, and provide foundational knowledge to further address this growing problem on a wider scale through online platforms. [ABSTRACT FROM AUTHOR]

Copyright of Fenerbahce University Journal of Health Sciences (FBU-JOSH) / Fenerbahçe Üniversitesi Sağlık Bilimleri Dergisi is the property of Fenerbahce University Journal of Health Sciences (FBU-JOSH) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Multiple studies have highlighted elevated rates of depression among individuals with Multiple Sclerosis (MS), with its associated symptoms posing a significant threat to overall well-being. Moreover, existing literature suggests a potential interconnection between depressive manifestations and the decline of physical functionalities in the context of MS. Objective: to examine the viability of the Eye Movement Desensitization Reprocessing (EMDR) therapy protocol for the treatment of depressive disorders (DeprEND) for alleviating depression in individuals with MS. Methods: We conducted a process–outcome study to examine the feasibilty and effectiveness DeprEND enrolling 13 individuals with MS and depressive symtpoms. Psychological and physical assessment pre-, post-intervention and 3-month follow-up were included. Pre- and post-magnetic resonance imaging (MRI) scans were conducted to analyze potential alterations in brain function. Results: The EMDR DeprEND treatment showed a high level of adherence and feasibility. Significant reductions in depressive symptoms were found at post-intervention and at 3 months follow-up. No significant differences were observed in terms of physical symptoms. A significant modulation observed in parietal and premotor areas when examining negative valence stimuli post-treatment was found. Conclusion: for The EMDR DeprEND protocol may represent a feasible and cost-effective treatment for reducing depressive symptoms in MS patients and improving their mental well-being. [ABSTRACT FROM AUTHOR]

Background: Ankle instability is a common injury, affecting the quality of life, self-reported function, ankle proprioception as well as static and dynamic balance. Purpose: to compare the efficacy of backward walking and Biodex balance training in chronic ankle instability patients. Methods: Sixty subjects participated in this study; their age ranged from 19 to 35 years. They were randomly allocated into three equal groups. Group A received a traditional physical therapy treatment in addition to backward walking training, Group B received a traditional physical therapy treatment in addition to Biodex balance training, and Group C received a traditional physical therapy treatment only (strength training, short foot exercises, heel raise exercises, and calf stretch). All groups received treatment protocols three times a week for 6 consecutive weeks. Outcome measures included the stability indices measured by the Biodex Balance System as well as ankle proprioception measured by a digital goniometer, and functional limitations by the Foot and Ankle Disability Index. Results: Post-treatment Within-Group findings revealed a statistically significant balance improvement by a decrease in the overall, anteroposterior, and medio lateral stability indices, a decrease in ankle proprioception error, as well as a significant increase in Foot and Ankle Disability Index outcomes of all 3 groups (p < 0.05). On the other hand, there were no statistically significant differences between groups A, and B related to stability indices, ankle proprioception, and Foot and Ankle Disability Index, while, there were statistically significant differences between groups A and B compared with group C. Conclusion: Backward walking training has a significant effect which appears to be similar to the Biodex balance training in improving balance, risk of fall, ankle proprioception, and decreasing functional limitations in patients with chronic ankle instability. [ABSTRACT FROM AUTHOR]

Introduction: Multiple sclerosis (MS) is generally diagnosed at an early age, making the acceptance of this chronic disease challenging. Research dedicated to young adults with MS (YawMS) is still limited. A biopsychosocial co-created intervention for YawMS integrating social, physical and psychological activities was developed (ESPRIMO intervention) in order to improve the quality of life (QoL) and well-being. This pre-post intervention assessment study examines the feasibility of the ESPRIMO intervention and its signal of efficacy. Methods: Inclusion criteria were: age 18-45 years, MS diagnosis, Expanded Disability Status Scale score < 3.5. After giving informed consent, YawMS completed a battery of questionnaires, which was repeated after the intervention. The battery included a bespoke feasibility scale, the COOP/WONCA charts, and the Short Form-12 Health Survey (SF-12). Results: Fifty-three YAwMS were enrolled and 43 (81.1%) completed the intervention. The majority of the sample positively rated the pleasantness, usefulness and feasibility of the intervention. A significant change in the COOP/WONCA "general QoL" chart (t = 3.65; p < 0.01) and SF-12 mental wellbeing component (t = -3.17; p < 0.01) was found. Discussion: ESPRIMO is an innovative intervention that is feasible; preliminary results show an improvement in QoL and mental wellbeing. Further studies are needed to test its efficacy and evaluate future implementation in health services. [ABSTRACT FROM AUTHOR]

Background: Reducing sedentary behavior is a promising intervention target for improving health for older adults; however, few interventions include African American communities. The purpose of this research was to extend the reach of an effective sedentary behavior intervention to African American elders. Methods: Two pilot studies assessed the feasibility (retention, adherence, and safety) and acceptability (participant and leader perspectives) of a 4-wk "Stand Up and Move More" (SUMM) intervention. Sedentary behavior (self-reported and monitor-derived), function (short physical performance battery), and quality of life (SF-36) were measured at baseline (wk0), postintervention (wk4), and follow up (wk12; study 1) to examine preliminary effectiveness of the intervention. Participants (N=26) attended SUMM or an attention-matched stress management intervention (study 2). The magnitude of treatment effects were determined using Hedge's g effect size calculations [small (g =0.20 to 0.49), moderate (g =0.50 to 0.79), large (g >0.80)]. Results: Retention and adherence rates ranged from 50%-100% and 80%-100%, respectively. There were no adverse events. Participants expressed high satisfaction, and the leader of the SUMM intervention indicated that the intervention content was beneficial. Hedges' g revealed negligible to small changes in sedentary behavior (g <0.50)>g=0.51-0.82) and quality of life (g =0.54-1.07) from wk0 to wk4 in study 1; and moderate to large improvements in function (g =0.51-0.88) from wk0 to wk4 in study 2. There was a moderate improvement in quality of life (SF-36 emotional role limitations g =0.54) in the SUMM group only. Conclusion: Given its feasibility, safety, and acceptability, SUMM may be a promising intervention to improve functioning and well-being among African American elders. [ABSTRACT FROM AUTHOR]

Although the association between self-regulation of fatigue and health-related quality of life (HRQoL) has been confirmed, the potential mechanism remains unclear. This study aimed to explore the role of health literacy, health behavior, and exercise frequency in the relationship among middle-aged and elderly patients with recurrent stroke. A cross-sectional survey was conducted. A total of 176 patients completed the survey, in which self-regulation of fatigue, HRQoL, health literacy and health behavior were measured by questionnaires. Based on Bootstrap analyses, a moderating sequential mediation model using PROCESS software was constructed with health literacy and health behavior as mediators and exercise frequency as the moderator. Of the participants, the mean age was 65.44 ± 12.43 years. Self-regulation of fatigue was found to affect HRQoL indirectly through two significant mediation pathways: (1) health literacy (β=-0.11, 95%CI = −0.20, −0.03), which accounted for 28.79% of the total effect, and (2) health literacy and health behavior (β=-0.02, 95%CI = −0.05, −0.00), which accounted for 4.80% of the total effect. Exercise frequency moderated the relationship between self-regulating fatigue and HRQoL. Specifically, the interaction term between self-regulating fatigue and exercise frequency significantly predicted HRQoL (β = 0. 25, t = 2.55, p < 0.05). These findings highlight the role of health literacy and health behavior as sequential mediators of the relationship between self-regulating fatigue and HRQoL. Moreover, exercise frequency moderated the relationship between self-regulating fatigue and HRQoL. Encouraging patients with recurrent stroke to increase exercise frequency appropriately might improve HRQoL for patients with poor health literacy and health behavior. [ABSTRACT FROM AUTHOR]

This paper examines differences in the life satisfaction (LS) of Spanish Lesbian, Gay, Bisexual and Transgender (LGBT) community as a function of sexual and gender identities, health and sociodemographic variables. A cross-sectional study was conducted (1,451 LGBT adults) and non-parametric analyses were performed. LG presented higher LS than bisexuals and non-cisgender participants had lower LS than cisgender. LS was lower among obese persons than overweight and normal range groups. Those participants who accomplished the WHO's physical activity recommendations reported higher LS than those who did not meet them. The oldest persons and those with higher incomes reported higher LS than other corresponding groups by age and SES. This group of sexual, gender, health and sociodemographic correlates of LS among LGBT people provides additional information that may be useful for social policies aimed at improving the quality of life of this community, especially in the economic and health crises due to COVID-19. [ABSTRACT FROM AUTHOR]

Background and Objectives: objective measures of disability and neurological impairmentare used to search for disease activity and monitor disease evolution in multiple sclerosis (MS). These are sometimes in disagreement with subjective quality-of-life measures. We aimed to establish the relations between the Multiple Sclerosis Quality of Life instrument (MSQOL-54) and objective measures of neurological impairment. Materials and Methods: 107 patients with MS were evaluated with the Single Digit Modalities Test (SDMT) for cognition, Nine Holes Peg Test (9HPT) for upper limb function, 25 Feet Walk Test (25FWT) for gait, and EDSS for global disability in a cohort study. Age and education level were recorded as sociodemographic factors. Results: the median EDSS was 3.5 (IQR 2.5); average SDMT score was 30.38 ± 13.54; and 9HPT speed was significantly higher for the dominant upper limb (0.3 ± 0.1 pegs/s versus 0.28 ± 0.11 pegs/s) (p = 0.016). The mental health composite score of the MSQOL-54 correlated with the SDMT, education level, and EDSS. Education level correlated with cognition and quality of life. The physical health composite score of the MSQOL-54 correlated with motor-function parameters and with SDMT. The motor-function parameters correlated well among themselves. A linear regression model found an important influence of SDMT and education level on the mental health composite score of the MSQOL-54. Although the linear regression model predicting the physical health composite score from physical disability parameters was statistically sound, none of the determinants had a significant individual influence. Conclusions: the subscores of the MSQOL-54 correlated well with the objective parameters. The strongest correlations were those with the cognitive function. Correlations with physical disability were less powerful, probably reflecting their indirect and more limited influence on quality of life compared to cognition and perception of disability. [ABSTRACT FROM AUTHOR]

BACKGROUND: To advance rehabilitation we need a comprehensive understanding of functioning and disability of people after stroke. OBJECTIVE: To present an overview of the methodology of the Life After Stroke In Northern Sweden Study, compare participants and non-participants regarding gender and age, and describe baseline sociodemographics, stroke characteristics and the participants' self-rated degree of recovery. METHODS: Data were collected through a study specific questionnaire, from the participants' medical records and with internationally established self-assessment tools focusing on sleep disturbances, depressive symptoms, fatigue, physical activity, and remaining physical and cognitive impairments, activity limitations, participation restrictions and life satisfaction. RESULTS: Of 301 potential participants, 160 comprise the final sample (response rate 53%; 86 men and 74 women, mean age 73 years±11, mean time since stroke onset 35 months±11; 18– 61). Most participants had an ischemic stroke (87%), were retired (84%), cohabitant (63%) and walked independently (71%). The mean self-rated degree of recovery was 75 (SD±24; 0– 100). CONCLUSIONS: These baseline data together with forthcoming studies will describe stroke-related impairments, activity limitations, participation restrictions and life satisfaction more than one year after stroke, and deepen our understanding of factors of importance for a healthy and successful life after stroke. [ABSTRACT FROM AUTHOR]

Supporting organ transplant recipients' quality of life after surgery continues to be of interest to health researchers and applied practitioners. However, literature and guidance on the factors linked to quality of life in transplant recipient athletes remains underreported. This study aimed to identify significant predictors of quality of life in an international sample of organ transplant recipient athletes (N = 99, Mage = 53 ± 14). Adopting a cross-sectional design, we collected the study data during the 2019 World Transplant Games which consisted of demographic items, health, and physical activity-related measures (i.e., task and ego orientation, fatigue severity, assessment of physical activity, physical activity enjoyment). Predictor variables were summarised into three categories: demographic factors, sport-related factors, and levels of fatigue with physical and mental quality of life functioning as the outcome variables. Hierarchical regression analyses exposed fatigue to exert a significant negative influence on both mental and physical quality of life perceptions explaining 49% and 64% of the variance in these variables respectively. Routine measurement and monitoring of transplant athletes' level of fatigue in sport settings are recommended due to the negative bearing on quality of life that may be a potential barrier to sport participation and enjoyment. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Sport & Health Research is the property of Journal of Sport & Health Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Erectile dysfunction and the associated quality of life are a pressing social and medical problem for millions of people. The basis of the work was the results of a survey of 298 men injured as a result of combat operations (shrapnel and bullet wounds) using the questionnaires of the International Index of Erectile Function-5 (IIEF-5) and the SF-36 Health Status Survey (SF-36) questionnaire to characterize the quality of life. The research group was divided into two: men aged 20-39 years (group 1) and men aged 40-53 years (group 2). The control group consisted of 48 clinically healthy men without complaints of sexual dysfunction or cardiac, neurological or endocrinological pathology. It is shown that men aged 20-39 years have a mild form of ED where the total score is 19.57 ± 0.44. Men of the 2nd group aged 40-53 years also have a mild form of ED, but the total score is much lower and is 17.74 ± 0.41. Patients of both age groups affected by hostilities suffer from both mental and physical health components. Indicators such as general health, role functioning due to physical condition, and pain intensity have probably lower values compared to the contol group. Lower indicators of role functioning due to physical condition indicate limitations in everyday life due to unsatisfactory physical condition. The decrease in the physical functioning index has statistically significant differences only in patients of the 2nd observed group. Thus, a mild form of erectile dysfunction is observed in men injured as a result of hostilities. No significant differences in the severity of erectile dysfunction were found between male war victims of two age groups. All IIEF-5 domains were significantly reduced in men affected by combat operations. It has been proven that the physical and mental components of health suffer in victims of hostilities. Against the background of a decrease in all indicators on the scales of the physical component of health, general health and role functioning caused by physical condition lag behind the most. In the psychological domain, the most pronounced changes are recorded in such components as mental health, vital activity and social functioning. Сorrelation analysis revealed the significant correlation between physical functioning and role functioning caused by emotional state (r = +0.64; P < 0.05). [ABSTRACT FROM AUTHOR]

Preventive healthcare behavior (PHB) refers to actions taken by consumers to avert possible incidences of lifestyle diseases. Over the years, diverse approaches have been used to comprehend the complex nature of PHB. This paper follows a three‐step process to examine work done in the PHB domain. At the outset, past literature was examined. This review included PHB models and frameworks, followed by a root‐cause analysis to identify factors that impacted PHB adoption. A systematic literature review (SLR) using a domain‐based hybrid review approach was the study's third and most crucial part. The SPAR‐4‐SLR (scientific procedures and rationales for systematic literature reviews) protocol was used to conduct the hybrid review, involving two separate review studies. In the first study, a bibliometric analysis was carried out, wherein a trend analysis was conducted on an initial pool of 1011 primary peer‐reviewed publications (1998–2023). The trend analysis was followed by a co‐citation network analysis of 39,608 secondary articles, which validated the importance of primary articles as indicated by the co‐citations in these secondary articles. Further, a purification process based on reliability, validity, and replicability criteria resulted in a final pool of 190 relevant articles. These articles were subjected to a thematic analysis. Next, a framework‐based review based on the theories, contexts, characteristics, and methods (TCCM) framework was conducted on the 190 articles. This step validated the primary study findings. Additionally, it examined and reported the underlying theories, context (country level), characteristics, and methods adopted by previous PHB studies. This analysis helps in indicating the future research agenda regarding PHB. Furthermore, the inferences drawn from the two studies were used to propose a conceptual framework for understanding consumers' PHB decisions based on the antecedents, decisions, and outcomes (ADO) framework. The framework posits that specific personal, demographic, cultural, social and socioeconomic factors are precursors to PHB adoption. This PHB adoption, in turn, has positive outcomes such as enhanced quality of life, consumer wellbeing, health promotion, health behavior change, and planning. The comprehensive review and proposed framework will significantly help advance knowledge about PHB. Apart from contributing to the academic literature, learnings from this study hold value for practitioners at the global level for designing actionable strategies for preventive healthcare products and services. [ABSTRACT FROM AUTHOR]

Interventions to preserve functional independence in older adults are critically needed to optimize ‘successful aging’ among the large and increasing population of older adults in the United States. For most aging adults, the management of chronic diseases is the most common and impactful risk factor for loss of functional independence. Chronic disease management inherently involves the learning and adaptation of new behaviors, such as adopting or modifying physical activity habits and managing weight. Despite the importance of chronic disease management in older adults, vanishingly few individuals optimally manage their health behavior in the service of chronic disease stabilization to preserve functional independence. Contemporary conceptual models of chronic disease management and health habit theory suggest that this lack of optimal management may result from an underappreciated distinction within the health behavior literature: the behavioral domains critical for initiation of new behaviors (Initiation Phase) are largely distinct from those that facilitate their maintenance (Maintenance Phase). Psychological factors, particularly experiential acceptance and trait levels of openness are critical to engagement with new health behaviors, willingness to make difficult lifestyle changes, and the ability to tolerate aversive affective responses in the process. Cognitive factors, particularly executive function, are critical to learning new skills, using them effectively across different areas of life and contextual demands, and updating of skills to facilitate behavioral maintenance. Emerging data therefore suggests that individuals with greater executive function are better able to sustain behavior changes, which in turn protects against cognitive decline. In addition, social and structural supports of behavior change serve a critical buffering role across phases of behavior change. The present review attempts to address these gaps by proposing a novel biobehavioral intervention framework that incorporates both individual-level and social support system-level variables for the purpose of treatment tailoring. Our intervention framework triangulates on the central importance of self-regulatory functioning, proposing that both cognitive and psychological mechanisms ultimately influence an individuals’ ability to engage in different aspects of self-management (individual level) in the service of maintaining independence. Importantly, the proposed linkages of cognitive and affective functioning align with emerging individual difference frameworks, suggesting that lower levels of cognitive and/or psychological flexibility represent an intermediate phenotype of risk. Individuals exhibiting selfregulatory lapses either due to the inability to regulate their emotional responses or due to the presence of executive functioning impairments are therefore the most likely to require assistance to preserve functional independence. In addition, these vulnerabilities will be more easily observable for individuals requiring greater complexity of self-management behavioral demands (e.g. complexity of medication regimen) and/or with lesser social support. Our proposed framework also intuits several distinct intervention pathways based on the profile of selfregulatory behaviors: we propose that individuals with intact affect regulation and impaired executive function will preferentially respond to ‘top-down’ training approaches (e.g., strategy and process work). Individuals with intact executive function and impaired affect regulation will respond to ‘bottom-up’ approaches (e.g., graded exposure). And individuals with impairments in both may require treatments targeting caregiving or structural supports, particularly in the context of elevated behavioral demands. [ABSTRACT FROM AUTHOR]

To investigate cognitive reserve as a possible moderator in the relationship between fatigue and depressive symptoms in persons with multiple sclerosis (PwMS). Fifty-three PwMS (37 female; mean age, 52.66; mean education, 14.81) completed comprehensive neuropsychological testing and psychosocial questionnaires assessing the perceived effects of fatigue (Fatigue Impact Scale) and depressive symptoms (Beck Depression Inventory-Fast Screen). Cognitive reserve (CR) was operationalized as Fixed CR and Malleable CR. Fixed CR was quantified as the standardized mean of years of education and a vocabulary-based estimate of premorbid intelligence. Malleable CR was quantified as the standardized mean of cognitive exertion, exercise, and socializing items from the Cognitive Health Questionnaire. Regressions on depressive symptoms examining fatigue, both conceptualizations of CR, and their interactions were explored. A Bonferroni correction was used; results were considered significant at an alpha level of p  < .01. The interactions between fatigue and both conceptualizations of CR were significant, p  = .005 (Fixed CR); p  = .004 (Malleable CR). Simple effects tests revealed that fatigue only predicted depressive symptoms in PwMS with low Fixed CR or low Malleable CR (p' s < .001), and not in those with high Fixed or high Malleable CR (p  > .01). Cognitive reserve moderated the relationship between fatigue and depressive symptoms in PwMS. Specifically, fatigue does not appear to influence depression in PwMS with high cognitive reserve. Having higher cognitive reserve (either Fixed or Malleable) may reduce the likelihood that fatigue will lead to depressive symptoms in MS. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to evaluate the relationship between the post-covid-19 pandemic quality of life (QoL), body composition and physical activity (PA), and to investigate the gender differences in this relationship among college students. The article presents the results of a study on the impact of physical activity and body composition on the quality of life after the COVID-19 pandemic, focusing on sports department students. The study aims to comprehensively understand this complex phenomenon and provide significant insights for the academic community and the broader society. Design/methodology/approach: The experimental study included a group of 54 women (age 22 ± 1.63) and 89 men (age 22 ± 1.85). The study included an examination of body composition and BMI and two questionnaires on physical activity level and quality of life. Body composition and BMI analysis was performed using a SECA mBCA 515 (seca GmbH & Co. KG, Hamburg, Germany) with eight electrodes. The same group also completed the International Physical Activity Questionnaire Short Version (IPAQ-SF) and the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). Findings: The primary findings of this study highlight notable gender disparities in Quality of Life (QoL), physical activity, and body composition among college students following a series of study interruptions and one year of remote learning due to Covid-19. The research revealed that young women exhibited relatively higher levels of physical activity during the pandemic, resulting in better performance on body composition tests compared to the men in the study. Despite the adverse conditions brought about by the pandemic, including the closure of sports facilities and gyms, the authors did not observe any negative changes in women's body composition after 12 months. Conversely, significant and observable changes were noted in men's body composition. Furthermore, the women in the study reported relatively higher QoL levels compared to men in various aspects, including the physical, psychological, social relations, and environmental domains, following the Covid-19 pandemic. The findings of this research may provide valuable insights into the long-term effects of the pandemic on young individuals. It may also offer recommendations for universities, policymakers on how to support and enhance the quality of life for students as they navigate the unique challenges of a post-pandemic society. Research limitations/implications: The main limitation of the included study is a relatively small research group. In future studies, it is also possible to refer to different culturally diverse groups. In this study, the research group was culturally homogeneous, which can also be considered as a research limitation. Originality/value: The enhanced quality of life observed in women is likely attributed to their higher level of physical activity, a conclusion supported by research on body composition. Conducting gender-specific analyses of quality of life data, including studies related to COVID-19 and other specific investigations into sex differences, is of utmost importance. Having insights into these gender disparities in quality of life would serve as a crucial resource for comprehending the effects of a health crisis on both individuals and communities. It would also aid in the development of effective and equitable policies, public health initiatives, and targeted strategies necessary for achieving sustainable development. Undoubtedly, further extensive research in this area is needed to address this issue thoroughly. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to co-produce and validate an accessible, evidence-based questionnaire measuring 'living well' with dementia that reflects the experience of people with mild-to-moderate dementia. Methods: Nine people with dementia formed a co-production group. An initial series of workshops generated the format of the questionnaire and a longlist of items. Preliminary testing with 53 IDEAL cohort participants yielded a shortlist of items. These were tested with 136 IDEAL cohort participants during a further round of data collection and assessed for reliability and validity. The co-production group contributed to decisions throughout and agreed the final version. Results: An initial list of 230 items was reduced to 41 for initial testing, 12 for full testing, and 10 for the final version. The 10-item version had good internal consistency and test-retest reliability, and a single factor structure. Analyses showed significant large positive correlations with scores on measures of quality of life, well-being, and satisfaction with life, and expected patterns of association including a significant large negative association with depression scores and no association with cognitive test scores. Conclusions: The co-produced My Life Questionnaire is an accessible and valid measure of 'living well' with dementia suitable for use in a range of contexts. [ABSTRACT FROM AUTHOR]

The disease burden of depression among older populations is high. Detecting changes in late-life depression is predicated on the seldom-examined assumption of longitudinal measurement invariance (MI). Therefore, we investigated longitudinal MI of the 8-item Center for Epidemiological Studies Depression Scale in core members repeatedly assessed in the English Longitudinal Study of Aging, a nine-wave representative study of the English population above 50 years of age (initial N = 11,391). Based on prior literature, we tested MI of a one-factor solution, a one-factor solution with correlated errors of reversely coded items, and a two-factor solution (depressed affect/somatic complaints). For all factor solutions, residual MI was confirmed across nine waves and gender. Sum score models (i.e., all factor loadings constrained to equity) had a good fit. Depression scores correlated with psychiatric diagnoses, ill health, lower life quality, and female gender. Associations slightly differed depending on the factor solutions, signifying their applicability across contexts. [ABSTRACT FROM AUTHOR]

People with multiple sclerosis (pwMS) are affected by a wide range of disabilities, including a decrease in bone mineral density (BMD) and a worsening of body composition (BC), which negatively impact their quality of life quality. This study aims to analyze the effects of nonpharmacological interventions—in particular, physical activity, nutritional approaches, and rehabilitation—on BC and BMD in pwMS. This systematic review and meta-analysis was performed following the updated version of the PRISMA guidelines. In July 2022, five databases (MEDLINE, Embase, The Cochrane Library, Google Scholar, Web of Science) and gray literature were screened. Relevant articles published between 1 January 1990 and 1 September 2022 in any language were included. Outcomes of interest were anthropometric, BC measures, and BMD. The RoB 2.0 tool was used to assess the risk of bias. After duplicates elimination, 1120 records were screened, and 36 studies were included. A total of 25 articles were focused on physical activity and rehabilitation, 10 on nutrition, and 1 on multimodal intervention. One-third of the studies were judged to be at high risk of bias. The meta-analysis showed a high degree of heterogeneity due to the high variability in disease severity and intervention duration, intensity, frequency, and type. In general, no intervention showed consistent positive effects on BC. However, the most promising interventions seemed to be high-intensity training and ketogenic diets. Only a few studies considered BMD, and the results are inconsistent. Nevertheless, more studies are needed in order to confirm these results. [ABSTRACT FROM AUTHOR]

The primary aim of the study was to investigate the relationship between physical activity, life satisfaction, and the mediating effects of socialphysique anxiety and self-esteem. Furthermore, this study assessed the measurement invariance of research models according to gender and age. A total of 334 participants (29.43 ± 8.17 years) completed the measures. Path analysis was utilized to appraise the research models. The research models exhibited excellent fit based on the data fit index values. The findings of the study showed a positive relationship between physical activity and both self-esteem and life satisfaction. In contrast, a negative relationship was observed between social-physique anxiety and physical activity. Social-physique anxiety was negatively related to selfesteem and life satisfaction. Furthermore, social-physique anxiety played a mediating role in the correlation between physical activity and life satisfaction. Additionally, self-esteem was a mediator in the relationship between social-physique anxiety and life satisfaction. Physical activity directly and indirectly positively impacted life satisfaction, mediated by social-physique anxiety and self-esteem. Eventually, the finding highlights physical activity's significance in mitigating social-physique anxiety and promoting self-esteem and life satisfaction. Hence, promoting physical activity can yield positive outcomes for both physical and psychological well-being, contributing to an overall improvement in quality of life. Encouraging regular physical activity can be incorporated into public health campaigns and wellness programs, as well as in individualized health plans. [ABSTRACT FROM AUTHOR]

Background: Health state utilities (HSU) are a health-related quality-of-life (HRQoL) input for cost-utility analyses used for resource allocation decisions, including medication reimbursement. New Zealand (NZ) guidelines recommend the EQ-5D instruments; however, the EQ-5D-5L may not sufficiently capture psychosocial health. We evaluated HRQoL among people with multiple sclerosis (MS) in NZ using the EQ-5D-5L and assessed the instrument's discriminatory sensitivity for a NZ MS cohort. Methods: Participants were recruited from the NZ MS Prevalence Study. Participants self-completed a 45-min online survey that included the EQ-5D-5L/EQ-VAS. Disability severity was classified using the Expanded Disability Status Scale (EDSS) to categorise participant disability as mild (EDSS: 0–3.5), moderate (EDSS: 4.0–6.0) and severe (EDSS: 6.5–9.5). Anxiety/depression were also measured using the Hospital Anxiety and Depression Score (HADS). In the absence of an EQ-5D-5L NZ tariff, HSUs were derived using an Australian tariff. We evaluated associations between HSUs and participant characteristics with linear regression models. Results: 254 participants entered the study. Mean age was 55.2 years, 79.5% were female. Mean (SD) EQ-5D-5L HSU was 0.58 (0.33). Mean (SD) HSUs for disability categories were: mild 0.80 ± 0.17, moderate 0.57 ± 0.21 and severe 0.14 ± 0.32. Twelve percent reported HSU = 1.0 (i.e., no problems in any domain). Participants who had never used a disease-modifying therapy reported a lower mean HSU. Multivariable modelling found that the HADS anxiety score was not associated with EQ-5D-5L. Conclusions: HRQoL for people with MS in NZ was lower than comparable countries, including Australia. We suggest a comparison with other generic tools that may have improved sensitivity to mental health. [ABSTRACT FROM AUTHOR]

Aim: To explore the effect of information‐motivation‐behavioural skills (IMB) model on psychological and emotional state of caesarean section (CS) women. Design: Control‐group patients got routine nursing during the preoperative, intraoperative and postoperative periods. Observation‐group patients received routine nursing combined with the IMB model that included specific informational, motivational and behavioural interventions. Methods: Pregnant women (n = 102) who underwent CS in Hangzhou Women's Hospital were randomly divided into Control and Observation‐groups (n = 51 each). Self‐rating anxiety scale (SAS), self‐rating depression scale (SDS) and general self‐efficacy scale (GSES) scores, complication rate, fatigue severity scale (FSS) and Edinburgh postpartum depression scale (EPDS) scores were compared. Result: Interventions lowered SAS and SDS scores, significantly lower in the Observation‐group (p < 0.05), and increased GSES scores, significantly higher in the Observation‐group (p < 0.05). Observation‐group had less complications (4.08% vs. 17.39% in the Control‐group; p < 0.05), and decreased FSS and EPDS scores (p < 0.05). [ABSTRACT FROM AUTHOR]

Women today want to work in the business world, and they prefer to be with their partners in social and business environments rather than be supporters. Dual-career couples are defined apart from traditional couple roles. Both members of the couple follow their own professional goals and are rewarded for them. This study focuses on the concept of dual-career couples. The concept's equal gender perspective is questioned in general. Even though the concept of dual-career couples is still popular, does experience support collaborative family structures? This question serves as the study's starting point. In the study, in which purposive sampling was used, 196 dual-career couples who work at a public university in Turkey were interviewed. A holistic method was used to assess the responses to multiple-choice, open-ended, and Likert-type questions. According to the results, when the attitudes of women in dual-career couples are taken into account, the concept of dual-career women is seen as a much fairer approach. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system, with symptoms that greatly affect quality of life (QoL). One of the most prevalent symptoms of MS is fatigue, also one of the main factors reducing QoL. Low levels of vitamin D (VD) are associated with worse QoL and with increased risk of developing more severe forms of the disease. Methods: In this cross-sectional study, we compared perceptions of quality of life and fatigue in 324 patients, subdivided into four groups, according to their treatment: high-dose VD therapy only, disease-modifying therapy (DMT) only, both treatments, and no treatments. All subjects completed the MSQOL-54 and the FSS questionnaires via an online survey. Results: High-dose VD treatment was associated with an increased perception of physical QoL (83.60 vs. 66.92, p < 0.001), mental QoL (75.52 vs. 59.80, p < 0.001), and fatigue (1.89 vs. 2.98, p < 0.001), compared to the DMT-only group. Treatment with DMT was associated with a worse perception of physical QoL compared to no treatment (70.58 vs. 76.53, p = 0.024). Conclusions: high-dose VD treatment is well-tolerated and associated with an increased perception of QoL in people with MS. [ABSTRACT FROM AUTHOR]

Parkinson's Disease (PD) is a chronic disease that can affect the physical, psychological, and social functioning of an individual. Minimal research has examined the relationship among positive psychological variables such as gratitude and self-efficacy and their relationship with health-related quality of life (HRQOL) in this population. Gender analyses have also been limited. The aim of this exploratory, cross-sectional study was to examine the relationship among gratitude, self-efficacy, and HRQOL by gender in individuals with Parkinson's Disease (PD). Participants included 102 individuals with PD (55 women; 42 men; 5 did not report gender) who completed questionnaires on gratitude (Gratitude Questionnaire-6), self-efficacy (General Self-Efficacy Scale), and HRQOL problems (Parkinson's Disease Questionnaire-39). Although there were no gender differences between gratitude, self-efficacy, or health-related quality of life problems, there were key gender differences in how those variables were related. Gratitude was associated with more HRQOL problems for women than men, whereas self-efficacy was associated with more HRQOL problems for men than women. In addition, self-efficacy emerged as a more important predictor of HRQOL problems for women and men than gratitude. This research could lead to targeted interventions by gender aimed at improving HRQOL in individuals with PD, particularly in building self-efficacy. [ABSTRACT FROM AUTHOR]

Adults with multiple sclerosis (MS) experience multiple symptoms and may benefit from complementary symptom support, such as mindfulness activities. An 8-week mindfulness-based art therapy (MBAT) intervention with adults with MS was conducted, with participants reporting improved symptoms from baseline to 3 months after the MBAT. [ABSTRACT FROM AUTHOR]