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Pediatric Nephrology (Berlin, Germany) Jun 2024X-linked hypophosphatemia (XLH) is a rare inherited phosphate-wasting disorder associated with bone and dental complications. Health-related quality of life (HRQoL) is...
BACKGROUND
X-linked hypophosphatemia (XLH) is a rare inherited phosphate-wasting disorder associated with bone and dental complications. Health-related quality of life (HRQoL) is reduced in XLH patients on conventional treatment with phosphate supplements and active vitamin D, while information on patients treated with burosumab is rare.
METHODS
HRQoL was assessed in 63 pediatric XLH patients participating in a prospective, observational study and patient registry in Germany using the KIDSCREEN-52 survey instrument and standardized qualitative interviews.
RESULTS
The median age of the XLH patients was 13.2 years (interquartile range 10.6 - 14.6). At the time of the survey, 55 (87%) patients received burosumab and 8 (13%) conventional treatment. Forty-six patients (84%) currently being treated with burosumab previously received conventional treatment. Overall, HRQoL was average compared to German reference values (mean ± SD: self-report, 53.36 ± 6.47; caregivers' proxy, 51.33 ± 7.15) and even slightly above average in some dimensions, including physical, mental, and social well-being. In general, XLH patients rated their own HRQoL higher than their caregivers. In qualitative interviews, patients and caregivers reported that, compared with conventional therapy, treatment with burosumab reduced stress, bone pain, and fatigue, improved physical health, and increased social acceptance by peers and the school environment.
CONCLUSIONS
In this real-world study in pediatric XLH patients, HRQoL was average or even slightly above that of the general population, likely due to the fact that the vast majority of patients had their treatment modality switched from conventional treatment to burosumab resulting in improved physical health and well-being.
PubMed: 38914781
DOI: 10.1007/s00467-024-06427-0 -
Journal of Neurology, Neurosurgery, and... Jun 2024Cognitive symptoms are often reported by those with a history of COVID-19 infection. No comprehensive meta-analysis of neurocognitive outcomes related to COVID-19 exists...
BACKGROUND
Cognitive symptoms are often reported by those with a history of COVID-19 infection. No comprehensive meta-analysis of neurocognitive outcomes related to COVID-19 exists despite the influx of studies after the COVID-19 pandemic. This study meta-analysed observational research comparing cross-sectional neurocognitive outcomes in adults with COVID-19 (without severe medical/psychiatric comorbidity) to healthy controls (HCs) or norm-referenced data.
METHODS
Data were extracted from 54 studies published between January 2020 and June 2023. Hedges' g was used to index effect sizes, which were pooled using random-effects modelling. Moderating variables were investigated using meta-regression and subgroup analyses.
RESULTS
Omnibus meta-analysis of 696 effect sizes extracted across 54 studies (COVID-19 n=6676, HC/norm-reference n=12 986; average time since infection=~6 months) yielded a small but significant effect indicating patients with COVID-19 performed slightly worse than HCs on cognitive measures (g=-0.36; 95% CI=-0.45 to -0.28), with high heterogeneity (Q=242.30, p<0.001, τ=0.26). Significant within-domain effects was yielded by cognitive screener (g=-0.55; 95% CI=-0.75 to -0.36), processing speed (g=-0.44; 95% CI=-0.57 to -0.32), global cognition (g=-0.40; 95% CI=-0.71 to -0.09), simple/complex attention (g=-0.38; 95% CI=-0.46 to -0.29), learning/memory (g=-0.34; 95% CI=-0.46 to -0.22), language (g=-0.34; 95% CI=-0.45 to -0.24) and executive function (g=-0.32; 95% CI=-0.43 to -0.21); but not motor (g=-0.40; 95% CI=-0.89 to 0.10), visuospatial/construction (g=-0.09; 95% CI=-0.23 to 0.05) and orientation (g=-0.02; 95% CI=-0.17 to 0.14). COVID-19 samples with elevated depression, anxiety, fatigue and disease severity yielded larger effects.
CONCLUSION
Mild cognitive deficits are associated with COVID-19 infection, especially as detected by cognitive screeners and processing speed tasks. We failed to observe clinically meaningful cognitive impairments (as measured by standard neuropsychological instruments) in people with COVID-19 without severe medical or psychiatric comorbidities.
PubMed: 38914455
DOI: 10.1136/jnnp-2024-333950 -
The American Journal of Orthopsychiatry Jun 2024Teaching staff have been especially vulnerable to experiencing psychopathology and compassion fatigue during COVID-19, given the significant demands they have...
Teaching staff have been especially vulnerable to experiencing psychopathology and compassion fatigue during COVID-19, given the significant demands they have experienced. Yet, research on risk and resilience factors is scant. We assessed the psychological status of Israeli teaching staff during COVID-19, focusing on psychopathology (depression, anxiety, somatization), compassion fatigue (burnout, secondary traumatic stress), and compassion satisfaction. We also examined the role of transdiagnostic risk and resilience factors-mentalizing, self-compassion, self-criticism, social support, and specialized trauma training-in predicting psychological status and mitigating the link between COVID-19-related distress and psychological status. An online questionnaire was completed by 350 teaching staff. Analyses included outlining the distributions of psychological status outcomes and running a series of moderation models using hierarchical robust regression. While 48% of the participants exhibited moderated-to-high levels of anxiety and 28.27% had no somatization, only 13% exhibited moderate-to-severe levels of depression; 60% had moderate levels of burnout, 48% had moderate levels of secondary traumatic stress, and 52% had low levels of compassion satisfaction. COVID-19-related distress, self-criticism, prementalizing modes, low socioeconomic status, and being in an intimate relationship emerged as key risk factors positively associated with psychological status, while self-compassion, general mentalizing, interest and curiosity about mental states, and social support were negatively linked with these outcomes. Teacher's mentalizing about students' mental states and social support moderated the link between COVID-19-related distress and psychological status. The findings highlight the importance of risk and resilience factors for assessing and preventing teaching staff's psychopathology and compassion fatigue during COVID-19. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
PubMed: 38913754
DOI: 10.1037/ort0000763 -
Ergonomics Jun 2024Based on multimodal measurement methods of NASA task load index (NASA-TLX), task performance, surface electromyography (sEMG), heart rate (HR), and functional...
Based on multimodal measurement methods of NASA task load index (NASA-TLX), task performance, surface electromyography (sEMG), heart rate (HR), and functional near-infrared spectroscopy (fNIRS), this study conducted experimental measurements and analyses under 16 different load levels of physical fatigue and mental fatigue combination conditions. This study observed the interaction between physical fatigue and mental fatigue at different levels, and at the subjective level, the effect of physical fatigue on mental fatigue was greater than that of mental fatigue on physical fatigue. Secondly, the results of fNIRS analysis showed that the premotor cortex is affected by physical fatigue, and the dorsolateral prefrontal cortex is affected by mental fatigue. Finally, this study constructed a fatigue classification model with an accuracy of 95.3%, which takes multimodal physiological data as input and 16 fatigue states as output. The research results will provide a basis for fatigue analysis, evaluation, and improvement in complex working situations.
PubMed: 38912844
DOI: 10.1080/00140139.2024.2364667 -
International Journal of Occupational... Jun 2024This article aims to present the overview of the situation during the coronavirus disease 2019 (COVID-19) pandemic about issues concerning the prevalence of mental... (Review)
Review
This article aims to present the overview of the situation during the coronavirus disease 2019 (COVID-19) pandemic about issues concerning the prevalence of mental disorders such as depression, anxiety, rate of suicide attempts, and long COVID (LC) infections in the general population during COVID-19 pandemic. Analysis of the literature (in English, Polish and Spanish language) on topics related to COVID-19, mental disorders (suicide attempts, depression, anxiety) and LC infection published during the 4 years (2020-2023) was done using Pubmed and PubMed Central search engine. Keywords such as "COVID-19," "mental disorders," "long COVID infection," "depression," "anxiety," "suicide attempts" were used during the search. The conduct of this review/comment followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) protocol, which corresponds to a checklist of 27 items designed to facilitate the development and reporting of a robust protocol for systematic reviews or meta-analyses. Overall 35 studies were selected and analyzed in the review on topics: including among others LC (14 studies), suicide attempts (7 studies), mental disorders (depression, anxiety) (14 studies). The main issues raised in the articles were: higher risk of LC symptoms in women, fatigue and brain fog listed as frequently encountered patient's complaints together with anxiety, depression, loneliness, especially in younger age groups and in women. Issues regarding LC, mental disorders and suicide attempts requires further research as the results vary in different countries. Int J Occup Med Environ Health. 2024;37(3).
PubMed: 38912617
DOI: 10.13075/ijomeh.1896.02373 -
International Journal of Women's Health 2024Research demonstrates resistance training is not only safe but also beneficial for pregnant women. However, exercise recommendations for pregnant women still minimize... (Review)
Review
Research demonstrates resistance training is not only safe but also beneficial for pregnant women. However, exercise recommendations for pregnant women still minimize the importance of resistance exercise and provide minimal guidance. With a large increase in strength-focused sports among women, it is critical to re-evaluate the risk/benefit ratio of these exercises and ensure the latest recommendations reflect the latest clinical research. The purpose of this review is to highlight the safety and benefits of resistance training for both maternal and fetal health, particularly focusing on recent work. Relevant research involving resistance training during pregnancy was accessed and analyzed via a quasi-systematic search. Results demonstrate that appropriate prenatal resistance training can help alleviate some of the common symptoms of pregnancy, such as fatigue, back pain, and poor mental health. Resistance exercise can assist with glucose control in gestational diabetes mellitus, as well as decrease the risk of infant macrosomia and childhood metabolic dysfunction associated with uncontrolled gestational diabetes. Resistance training can also increase the likelihood of a vaginal delivery, which is beneficial for both mother and baby. Concerning fetal health, resistance training increases uterine blood flow, decreases the risk of neonatal macrosomia, and improves cognitive function and metabolic health in childhood. As with all forms of exercise, pregnant women should avoid resistance exercises that involve the supine position for extended bouts of time, trauma (or risk of trauma) to the abdomen, ballistic movements, movements that rely heavily on balance, and conditions that prohibit appropriate temperature control. With these considerations in mind, resistance training's benefits far surpass the lack of risk to the fetus. Resistance training is a safe and effective way to improve and maintain physical fitness during pregnancy and represents no risk to fetal health and development. Thus, healthcare providers should recommend resistance training for pregnant women.
PubMed: 38912201
DOI: 10.2147/IJWH.S462591 -
Journal of Neurotrauma Jun 2024U.S. Service members and Veterans (SM/V) experience elevated rates of traumatic brain injury (TBI), chronic pain, and other non-pain symptoms. However, the role of...
U.S. Service members and Veterans (SM/V) experience elevated rates of traumatic brain injury (TBI), chronic pain, and other non-pain symptoms. However, the role of non-pain factors on pain interference levels remains unclear among SM/Vs, particularly those with a history of TBI. The primary objective of this study was to identify factors that differentiate high/low pain interference given equivalent pain intensity among U.S. SM/V participating in the ongoing LIMBIC-CENC national multicenter prospective longitudinal observational study. An explainable machine learning was used to identify key predictors of pain interference conditioned on equivalent pain intensity. The final sample consisted of N=1,577 SM/V who were predominantly male (87%), and 83.6% had a history of mild TBI(s), while 16.4% were TBI negative controls. The sample was categorized according to pain interference level (Low: 19.9%, Moderate: 52.5%, and High: 27.6%). Both pain intensity scores and pain interference scores increased with number of mild TBIs (p<0.001), and there was evidence of a dose response between number of injuries and pain scores. Machine learning models identified fatigue and anxiety as the most important predictors of pain interference, while emotional control was protective. Partial dependence plots identified marginal effects of fatigue and anxiety were associated with pain interference (p<0.001), but the marginal effect of mild TBI was not significant in models considering all variables (p>0.05). Non-pain factors are associated with functional limitations and disability experience among SM/V with mild TBI history. The functional effects of pain may be mediated through multiple other factors. Pain is a multidimensional experience that may benefit most from holistic treatment approaches that target comorbidities and build supports that promote recovery.
PubMed: 38907690
DOI: 10.1089/neu.2024.0126 -
PLOS Global Public Health 2024Compassion fatigue is a significant concern globally, particularly in Sub-Saharan Africa, where the COVID-19 pandemic exacerbated existing challenges, placing...
Compassion fatigue is a significant concern globally, particularly in Sub-Saharan Africa, where the COVID-19 pandemic exacerbated existing challenges, placing unprecedented strain on healthcare professionals. This study systematically estimated the prevalence of compassion fatigue among healthcare professionals before and during COVID-19 in Sub-Saharan Africa. A systematic review was conducted using keywords in PubMed, ScienceDirect, Google Scholar, and grey literature, covering all literature published between 2012 and December 30, 2023. The search team independently conducted study selection, quality assessments, data extractions, and analysis of all included studies. The systematic review, reported following PRISMA guidelines, included 11 studies. The results show that the pooled overall prevalence of compassion fatigue in Sub-Saharan Africa was 70% (95% CI: 57-82, I2 = 88.37%). The highest prevalence was found in Eastern Africa at 74% (95% CI: 55-93, I2 = 94.40%), compared to 64% in Southern Africa (95% CI: 49-79, I2 = 59.01%). Nurses reported the highest rates of compassion fatigue at 80% (95% CI: 57-100, I2 = 34.77%), followed by general healthcare professionals at 59% (95% CI: 22-97, I2 = 94.11%) and nursing students at 50% (95% CI: 35-64, I2 = 0.00%). Before COVID-19, the overall prevalence of compassion fatigue was 66% (95% CI: 41-91, I2 = 27%). During COVID-19, this increased to 74% (95% CI: 63-85, I2 = 88.73%). Our results indicate that nearly 3 in 4 healthcare professionals in Sub-Saharan Africa experience compassion fatigue, and this prevalence increased due to the pandemic. The high prevalence underscores the importance of addressing and mitigating compassion fatigue to support the mental health and emotional well-being of healthcare professionals dedicated to helping others in challenging circumstances. Systematic registration: PROSPERO. REG No: CRD42023449462.
PubMed: 38905176
DOI: 10.1371/journal.pgph.0003388 -
Alternative Therapies in Health and... Jun 2024To explore the clinical efficacy of modified Yiwei Shengyang Decoction combined with FOLFOX4 chemotherapy regimen in patients with advanced gastric cancer.
OBJECTIVE
To explore the clinical efficacy of modified Yiwei Shengyang Decoction combined with FOLFOX4 chemotherapy regimen in patients with advanced gastric cancer.
METHODS
Ninety patients with advanced gastric cancer, admitted to Cangzhou Central Hospital from January 2021 to December 2022, were randomized 1:1 into control and study groups. The control group received FOLFOX4 chemotherapy alone, while the study group received additional modified Yiwei Shengyang Decoction. Chinese medicine (TCM) symptom scores (TCM symptoms refer to the signs and manifestations of imbalances or disharmony within the body according to the principles of Traditional Chinese Medicine. These symptoms are assessed and diagnosed based on a holistic understanding of the individual's physical, mental, and emotional state. TCM symptoms may include various indicators such as pulse characteristics, tongue appearance, body temperature, complexion, energy levels, sleep patterns, appetite, digestion, pain, and specific subjective experiences reported by the patient, such as fatigue, anxiety, or insomnia), gastric cancer biomarkers such as serum CEA and CA199 levels, immune function, clinical efficacy, and side effects were compared.
RESULTS
Before treatment, both groups had similar TCM symptom scores. Post-treatment, the study group showed significantly greater reductions in appetite, epigastric pain, nausea, vomiting, and diarrhea scores compared to the control group (P < .001). After treatment, CEA and CA199 levels decreased significantly in both groups, with the study group exhibiting significantly lower levels than the control group (P = .001, .001). Post-treatment, CD3+ and CD4+ levels were higher in the study group, while CD8+ levels were lower than in the control group (P < .001). Treatment efficiency was significantly higher in the study group (62.33%) than in the control group (37.78%) (P = .02).
CONCLUSION
Modified Yiwei Shengyang Decoction combined with FOLFOX4 chemotherapy regimen is a promising option for patients with gastric cancer. It significantly improves immune indicators and appetite, reduces adverse symptoms including epigastric pain, nausea, vomiting, and diarrhea, and substantially enhances quality of life. Moreover, traditional Chinese medicine treatment is safe and merits promotion in clinics.
PubMed: 38904637
DOI: No ID Found -
European Journal of Physical and... Jun 2024Individuals with persistent impairments due to Coronavirus disease 2019 (COVID-19) can receive pulmonary rehabilitation in Germany. To date, there is no evidence of the...
BACKGROUND
Individuals with persistent impairments due to Coronavirus disease 2019 (COVID-19) can receive pulmonary rehabilitation in Germany. To date, there is no evidence of the medium- or long-term effects of pulmonary rehabilitation on Long COVID.
AIM
This study examined changes in health and occupational outcomes over time and described the therapeutic content of pulmonary rehabilitation and aftercare. This analysis also compared two rehabilitation groups after COVID-19 who had different levels of access to rehabilitation.
DESIGN
Longitudinal observational study with multicenter and prospective data collection.
SETTING
Pulmonary rehabilitation in four different rehabilitation facilities in Germany.
POPULATION
Individuals with a mild course of disease and long-lasting impairments (inpatient rehabilitation, IR) and patients with a severe course after hospitalization (follow-up rehabilitation, FuR). Participants had to be between 18 and 65 years of age.
METHODS
Written questionnaires were administered at the beginning and end of rehabilitation, as well as six and twelve months after rehabilitation. Health-related quality of life (HrQoL), fatigue, participation restrictions, COVID-19 symptoms, mental and physical health were assessed, as well as occupational outcomes and questions about rehabilitation and aftercare.
RESULTS
IR patients were predominantly female (68.0%) and 52 years of age on average, while 66.1% of Long COVID rehabilitees in FuR were male and three years older. Over the course of rehabilitation, most COVID-19 symptoms decreased with statistical significance. The subjective health scales showed improvements with medium to large effect sizes (ES) over time in IR (P<0.01; ES between 0.55 (cognitive fatigue) and 1.40 (physical fatigue)) and small to large effects in FuR (P<0.01; ES between 0.45 (anxiety) and 1.32 (physical fatigue)). One year after rehabilitation, most effects remained at a moderate level. After twelve months, an increase in neurocognitive symptoms was observed in FuR patients. More than 80% of employed people returned to work one year after rehabilitation, although FuR patients returned to work a median of four weeks later (P<0.01).
CONCLUSIONS
The comparative analysis showed that rehabilitees in different forms of rehabilitation attended rehabilitation with different impairments and rehabilitation goals, which are partly considered in treatment and aftercare.
CLINICAL REHABILITATION IMPACT
To provide needs-based rehabilitation to different rehabilitation groups with Long COVID, knowledge of their health histories and preferences is necessary.
PubMed: 38903009
DOI: 10.23736/S1973-9087.24.08207-8