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Background: Head and neck cancer patients have the second highest malnutrition prevalence, when compared with other oncological patients. They experience significant weight loss before diagnosis, during and after treatment, and even during the first year of follow-up. However, the prognostic value of weight loss depends on body mass index, and this may be associated with low skeletal muscle mass, masking its loss. Thus, weight loss itself poorly predicts outcome in head and neck cancer patients when compared with depleted skeletal muscle mass, illustrating the inadequacy of body mass index as an accurate method to reflect nutritional status. A synthesis is needed of the body composition changes occurring in head and neck cancer patients during treatment, as well as of the methods to assess it., Objective: The aim of this scoping review is to examine and map the body composition changes in head and neck cancer patients under oncological treatment with curative intent. A further objective is to determine which methods are used to assess body composition in these patients., Inclusion Criteria: Types of participants: The current review considered head and neck cancer patients, aged 18 years or older., Concept: This scoping review considered all studies that focused on the body composition changes., Context: This scoping review considered the studies that evaluated the body composition changes in the context of treatment with curative intent. Surgical treatment approach was excluded to avoid excess heterogeneity in the data. Types of sources: This scoping review considered only published studies, with abstract available., Search Strategy: A three-step search strategy was undertaken. This review was limited to studies published in English, Spanish, and Portuguese during 2000-2019., Data Extraction: The data extracted included author(s)/year of publication, aims and purpose of the study, sample size, study design, type of treatment, measurement points and component(s) of body composition evaluated, body composition assessment methods, and main results/findings., Presentation of Results: Head and neck cancer patients suffer from serious loss of lean body mass, skeletal muscle, or free fat mass, after treatment compared with baseline. Further, nutritional deterioration is evident and occurs up to 8-12 months after treatment. Bioelectrical impedance analysis is one of the body composition assessment tools that has the great advantage for being available on a regular basis for assessment of body composition in head and neck cancer patients. However, it cannot be recommended for clinical decision making until further validation., Conclusion: Head and neck cancer patients experience a significant depletion of lean body mass, fat-free mass, and skeletal muscle, accompanied by body fat mass, while undergoing (chemo)radiotherapy. This can be demonstrated either by triceps skinfold thickness, bioelectrical impedance analysis, dual-energy x-ray absorptiometry, or computed tomography. This loss has a remarkable impact on their survival, on their quality of life, and on the risk for post-operative complications and may result in a reduced response to cancer treatment. Thus, body composition assessment should become an integral component of the care of head and neck cancer patients, beyond weight and body mass index, and should be carried out at different times throughout treatment.

The aim was to systematically review the relationship between muscular strength (MS) and depression symptoms (DS) among adults, and conduct a meta-analysis to determine the pooled odds ratio (OR) for the relationship between MS and DS. The strategies employed in this systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Studies published up to December 2019 were systematically identified by searching in the PubMed, Scopus, and Web of Science electronic databases. Inclusion criteria were: (1) cross-sectional, longitudinal and intervention studies; (2) outcomes included depression or DS; (3) participants were adults and older adults; and (4) the articles were published in English, French, Portuguese, or Spanish. A total of 21 studies were included in the review, totalling 87,508 adults aged ≥18 years, from 26 countries. The systematic review findings suggest that MS has a positive effect on reducing DS. Meta-analysis findings indicate that MS is inversely and significantly related to DS 0.85 (95% CI: 0.80, 0.89). Interventions aiming to improve MS have the potential to promote mental health and prevent depression. Thus, public health professionals could use MS assessment and improvement as a strategy to promote mental health and prevent depression.

The Health Behavior in School-aged Children is a cross-national study collecting data on social and health indicators on adolescents in 43 countries. The study provides comparable data on health behaviors and health outcomes through the use of a common protocol, which have been a back bone of the study sine its initiation in 1983. Recent years, researchers within the study have noticed a questionable comparability on the widely used item on self-rated health. One of the four response categories to the item "Would you say your health is….?" showed particular variation, as the response category "Fair" varied from 20 % in Latvia and Moldova to 3-4 % in Bulgaria and Macedonia. A qualitative mini-survey of the back-translations showed that the response category "Fair" had a negative slant in 25 countries, a positive slant in 10 countries and was considered neutral in 9 countries. This finding indicates that there are what may be called semantic issues affecting comparability in international studies, since the same original word (in an English original) is interpreted differently across countries and cultures. The paper test and discuss a few possible explanations to this, however, only leaving to future studies to hold a cautious approach to international comparisons if working with the self-rated health item with four response categories.

The purpose of this study was to evaluate health-related quality of life and other psychosocial characteristics, including eating self-regulation and body image, in a group of successful long-term weight loss maintainers. Women enrolled in the Portuguese Weight Control Registry (n = 107) were matched and compared to women at the end of a behavior weight loss treatment program (n = 107), and also with women in the community who were not trying to lose weight (n = 107). Successful maintainers displayed higher quality of life and a more positive profile in selected eating and exercise markers of self-regulation compared to similarly-weighed women not attempting weight loss, but not when compared to the 'weight loss treatment' group. However, results also suggest that concerns with body shape and size may persist after weight loss and that some aspects of well-being and eating self-regulation can be more successfully targeted in specific weight loss programs.

PurposeToday, male and female adult and pediatric cancer patients, individuals transitioning between gender identities, and other individuals facing health extending but fertility limiting treatments can look forward to a fertile future. This is, in part, due to the work of members associated with the Oncofertility Consortium.MethodsThe Oncofertility Consortium is an international, interdisciplinary initiative originally designed to explore the urgent unmet need associated with the reproductive future of cancer survivors. As the strategies for fertility management were invented, developed or applied, the individuals for who the program offered hope, similarly expanded. As a community of practice, Consortium participants share information in an open and rapid manner to addresses the complex health care and quality-of-life issues of cancer, transgender and other patients. To ensure that the organization remains contemporary to the needs of the community, the field designed a fully inclusive mechanism for strategic planning and here present the findings of this process.ResultsThis interprofessional network of medical specialists, scientists, and scholars in the law, medical ethics, religious studies and other disciplines associated with human interventions, explore the relationships between health, disease, survivorship, treatment, gender and reproductive longevity.ConclusionThe goals are to continually integrate the best science in the service of the needs of patients and build a community of care that is ready for the challenges of the field in the future.

Oral hygiene has been shown to reduce adverse events and promote the quality of life of patients with stroke. However, a stroke can result in the impairment of physical, sensory, and cognitive abilities, and comprise self-care. Although nurses recognize its benefits, there are areas for improvement in the implementation of the best evidence-based recommendations. The aim is to promote compliance with the best evidence-based recommendations on oral hygiene in patients with stroke. This project will follow the JBI Evidence Implementation approach. The JBI Practical Application of Clinical Evidence System (JBI PACES) and the Getting Research into Practice (GRiP) audit and feedback tool will be used. The implementation process will be divided into three phases: (i) establishing a project team and undertaking the baseline audit; (ii) providing feedback to the healthcare team, identifying barriers to the implementation of best practices, and co-designing and implementing strategies using GRIP, and (iii) undertaking a follow-up audit to assess the outcomes and plan for sustainability. So, the successful adoption of the best evidence-based recommendations on oral hygiene in patients with stroke will reduce the adverse events related to poor oral care and may improve patients' quality of care. This implementation project has great transferability potential to other contexts. [ABSTRACT FROM AUTHOR]

Purpose: Evidence about factors influencing quality of life after inguinal hernia surgery is scarce. This study aimed to assess patient's Quality of Life (QoL) after open inguinal hernia repair and to identify predictors of low QoL at 3 months after surgery, to guide practice and inform patients at high risk. Methods: Prospective multicentric cohort study including consecutive patients undergoing elective open inguinal hernia repair in Portuguese hospitals (October–December 2019). The primary outcome was Quality of Life at 3 months after surgery, using the EuraHS-QoL score (higher score correlates with lower QoL). Low QoL was defined as the higher EuraHS-QoL score tertile and multivariate logistic regression was used to identify predictors. Results: 893 patients were included from 33 hospitals. The majority were men [89.9% (800/891)], had unilateral hernias 88.7% (774/872) and the most common surgical technique was Lichtenstein's repair [52.9% (472/893)]. The median QoL score was 24 (IQR 10–40) before surgery and 2 (IQR 0–10) at 3 months after surgery, showing significant improvement (p < 0.001). After adjustment, low QoL at 3 months was associated with low preoperative QoL (OR 1.76, 95% CI 1.21–2.57, p = 0.003), non-absorbable mesh fixation (OR 1.64, 95% CI 1.12–2.41, p = 0.011), severe immediate postoperative pain (OR 2.90, 95% CI 1.66–5.11, p < 0.001) and minor postoperative complications (OR 2.23, 95% CI 1.30–3.84, p = 0.004). Conclusion: This study supports the use of the EuraHS-QoL score preoperatively to inform consent. Although significant improvement in QoL is expected after surgery, high scores before surgery are associated with low postoperative QoL. Caution should be taken with non-absorbable mesh fixation and immediate postoperative pain control should be optimised. [ABSTRACT FROM AUTHOR]

Background Research on living with a chronic disease (CD) in adolescence is increasing. However, studies on the relevance of psychosocial factors are still needed. The present review, focuses on the impact of living with a CD in adolescence on on quality of life (QoL), health-related quality of life (HRQoL) and psychosocial factors. Methods A literature review of articles identified through PubMed, PsycINFO and PsycARTICLES (these last two ones comprise the Ebsco Host platform) and original peer-reviewed research papers, published between 2010 and 2015, with no restrictions regarding the format/source of interventions, randomized controlled trials (RCTs) or types of comparisons were included. Results Eighteen papers met the inclusion criteria and contradictory results were found: the majority showed a significantly higher risk of impairment on QoL/HRQoL and psychosocial factors, whereas others reported a significantly lower risk of impairment (highlighting possible protective factors), or no significant differences. Heterogeneity in the assessment procedures and substantial difficulties in considering adolescence as a single and independent age group, were also noted. Conclusion The higher risk of impairment and the heterogeneity observed between cohorts, reinforce the need to work towards consensual procedures, which allow for more accurate comparisons among studies. Additionally, it conveys the challenge to find more effective interventions. Furthermore, it is highly suggested to routinely assess HRQoL/psychosocial factors within an individualized framework, to considerer adolescents as a single/independent group, to emphasize potential protective factors, and, to increase youth's participation in their own adaptation process and in health promotion in general. These are possible future directions that could enable multidisciplinary responses to improve HRQoL and psychosocial care in adolescents with a CD. [ABSTRACT FROM AUTHOR]

Living with a chronic disease (CD) in adolescence involves new multifaceted challenges. This study aims to conduct a psychosocial characterization of a group of adolescents with chronic diseases in a hospital setting and to compare such dimensions for the total group and for different diseases. A cross-sectional study included 135 adolescents with chronic diseases (51.9% boys; 48.1% girls), having an average age of 14±1.5 years (SD=1.5) and attending a paediatric outpatient department in a hospital setting. Statistically significant differences were found among the different chronic diseases for the variables self-regulation (adolescents with diabetes had significantly higher competencies) and multiple psychosomatic symptoms (adolescents with neurologic diseases reported significantly more complaints). Boys presented both better health-related quality of life and psychosomatic health when compared to girls. No statistically significant differences were observed for health-related quality of life, psychosomatic health, resilience, and social support. These findings bring important suggestions especially while planning interventions, which must take into account the promotion of a healthy psychosocial development, through an inclusive perspective (covering different chronic diseases), that take into consideration specific and gendered approaches. Such suggestions might help healthcare professionals to better plan interventions in order to increase their effectiveness. [ABSTRACT FROM AUTHOR]

Context: Mindfulness meditation has been shown to effectively mitigate the negative effects of stress among nursing professionals, but in countries like Brazil, these practices are relatively unexplored.Objective: To evaluate the effects of a Stress Reduction Program (SRP) including mindfulness and loving kindness meditation among nursing professionals working in a Brazilian hospital setting.Design: Pilot study with a mixed model using quantitative and qualitative methods was used to evaluate a group of participants. The quantitative data were analyzed at three different time points: pre-intervention, post-intervention, and follow-up. The qualitative data were analyzed at post-intervention.Setting: Hospital São Paulo (Brazil).Participants: Sample 13 nursing professionals, including nurses, technicians, and nursing assistants working in a hospital.Intervention: Participants underwent mindfulness and loving kindness meditation during a period of six weeks.Instruments: Perceived Stress Scale (PSS), Maslach Burnout Inventory (MBI), Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Satisfaction With Life Scale (SWLS), Self-Compassion Scale (SCS), WHOQOL-BREF quality of life assessment, and Work Stress Scale (WSS). Qualitative data were collected via a group interview following six weeks participation in the SRP.Results: The quantitative analyses revealed a significant reduction (P < .05) between pre-intervention and post-intervention scores for perceived stress, burnout, depression, and anxiety (trait). These variables showed no significant differences between post-intervention and follow-up scores. The WHOQOL-BREF revealed significant increase (P < .05) just in the physical and psychological domains at post-intervention scores, which remained at the follow-up. Qualitative results showed improvement in the reactivity to inner experience; a more attentive perception of internal and external experiences; greater attention and awareness of actions and attitudes at every moment; and a positive influence of the SRP in nursing activities. [ABSTRACT FROM AUTHOR]

In coastal areas, the tourism sector contributes to the local economy, generating income, employment, investments and tax revenues but the rapid urban expansion creates great pressure on local resources and infrastructures, with negative repercussions on the residents' quality of life, but also compromising the visitor's experience. These areas face problems such as the formation of meteorological effects known as heat islands, due to the soil sealing, and increased energy demand in the peak season. To evaluate the impact of urban growth spatial pattern and change, three strategic sustainable challenges—urban form, urban energy, and urban outdoor comfort—were selected. The progress towards sustainability was measured and analyzed in a tourist city in the Algarve region, Portugal, for the period 2007–2018, using geographic information. A set of 2D and 3D indicators was derived for the building and block scales. Then, a change assessment based on cluster analysis was performed, and three different trends of sustainable development were identified and mapped. Results allow detecting the urban growth patterns that lead to more sustainable urban areas. The study revealed that a high sustainable development was observed in 12% of the changed blocks in the study area. All indicators suggest that the growth pattern of the coastal area is in line with the studied sustainability dimensions. However, most of the blocks that changed between 2007 and 2018 (82%) followed a low sustainable development. These blocks had the lowest variation in the built volume and density, and consequently the lowest variations in the roof areas with good solar exposition. The urban development also privileged more detached and less compact buildings. This analysis will support the integration of 2D and 3D information into the planning process, assisting smart cities to comply with the sustainable development goals. [ABSTRACT FROM AUTHOR]