Search Results (97)

Background and Aim: Type 2 diabetes (T2D) continues to pose a significant public health challenge worldwide. Among therapeutic options, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have proven effective in optimizing glycemic control and improving cardiometabolic profiles. Semaglutide, now available in an oral formulation, represents a modern strategy to improve patient adherence while supporting glucose and weight regulation. This study primarily investigated the effects of oral semaglutide on key metabolic indicators and secondary endpoints included cardiovascular risk markers (blood pressure and lipid profile) and patient-reported quality of life (QoL). Study Design and Methods: A longitudinal, prospective observational study was conducted involving patients with T2D across two Italian healthcare facilities. Participants were assessed at baseline (T0) and at three subsequent intervals—6 months (T1), 12 months (T2), and 18 months (T3)—following the initiation of oral semaglutide use. Key Findings: Out of 116 participants enrolled, 97 had complete and analyzable data. Across the 18-month follow-up, significant improvements were observed in glycemic parameters, with a notable reduction in HbA1c levels (T0 vs. T3, p = 0.0028; p ≤ 0.05, statistically significant). Self-reported outcomes showed enhanced quality of life, especially in treatment satisfaction and perceived flexibility (T0 vs. T3, p < 0.001). Conclusions: Daily administration of 14 mg oral semaglutide in individuals with T2D resulted in substantial benefits in glycemic regulation, weight reduction, cardiovascular risk management, and overall patient satisfaction. These findings reinforce its potential role as a sustainable and effective option in long-term diabetes care from both a clinical and public health perspective. Full article

Background/Objectives: Quality of life (QOL) is a multifaceted concept involving a variety of factors which define the overall well-being of individuals. Food security, which implies a resilient food system, is one factor that is central to the calculus of the QOL status of a community considering that food is a staple of life. Advancing food security as a strategy for attaining sustained improvement in community QOL hinges on recognizing that food security is embedded in a matrix of other factors that work with it to generate the QOL the community experiences. The lived experience of the community defines the community’s QOL value matrix and the relative position of food security in that value matrix. Our thesis is that the role of food security in the lived experience of low-income communities depends on the position food security is accorded relative to other factors in the QOL value matrix of the community. Methods: This study employed a multimethod approach to define the QOL value matrix of low-income Guilford County residents, identifying the relative position of the value components and demographic segments based on priority ranking. First, an in-depth interview was conducted and then a telephone survey (280 sample) was used for collecting data. The ISAC Analysis Procedure and Best–Worst Scaling methods were used to identify and rank components of the QOL value matrix in terms of their relative impact on QOL. Results: The analysis revealed that spiritual well-being is the most important contributor to QOL, with a weight of 0.23, followed by access to health services (0.21) and economic opportunities (0.16), while food security has a moderate impact with 0.07. Conclusions: These findings emphasize the need for targeted policy interventions that consider the specific needs of different demographic segments to effectively improve QOL and inform the design of resilient food systems that reflect the lived experiences of low-income communities. Food security policies must be integrated with broader quality of life interventions, particularly for unemployed, low-educated, and single individuals, to ensure that a resilient food system effectively reduces inequities and address community-specific vulnerabilities. Full article

This paper clarified the correlation among quality of life (QoL) indicators, exercise implementation level, and exercise habits in middle-aged and older adults under identical exercise intervention conditions. The survey items were anthropometric and physiologic measurements, physical strength measurements, and exercise habits. During the 3-month experimental period, a weekly “health exercise course” served as the primary intervention. For all participants, anthropometric and physiologic measurements, physical strength tests, questionnaire surveys, and other surveys were conducted before and after the experiment; then, the pre- and post-intervention effects were compared. After the exercise intervention, significant differences were observed among middle-aged and older adults in terms of various parameters, such as weight, fat rate, diastolic pressure, systolic pressure, sit-up, standing on one foot, lower limb extension force, activity of daily living (ADL), and subjective well-being (PGC). ADL and PGC changed significantly in the participants who engaged in exercise more than twice a week. However, the participants who engaged in exercise for less than twice a week showed no significant differences in any parameters except the life satisfaction (LSI) mean; the LSI increased in the “Less than twice a week” exercise group but decreased in the “More than twice a week” group. In terms of average walking time per session, the “More than 30 min” exercise group showed significant differences in ADL and PGC, whereas the “Less than 30 min” group showed significant differences only in the LSI. The influence of exercise on QoL indicators of middle-aged and older adults, under the same exercise intervention conditions, is related to their exercise habits. This study highlights the benefits of physical exercise in middle-aged and older adults, emphasizing the importance of regular and sustained exercise for this population. Furthermore, the study provides a scientific basis for improving QoL in middle-aged and older adults, thus, to some extent, addressing the concerns related to the growing population of older adults. Full article

Background: Chronic low back pain (CLBP) is the leading cause of disability both within the United States and globally. However, reliable diagnosis and treatment remains limited due to a lack of objective and image-based biomarkers. Modic changes (MCs) are visible vertebral endplate and bone marrow changes in signal intensity seen on MRI. MCs have emerged as promising correlates with degenerative disc disease and CLBP. Methods: This is a non-systematic literature review. Results: This review synthesizes current evidence on the classification, pathophysiology, and imaging of MCs, with a particular focus on their associations with patient-reported outcomes, including pain (Visual Analog Scale), functional status (Oswestry disability index and Roland-Morris Disability Questionnaire), and health-related quality of life (Short Form-36 and EuroQol 5-Dimension 5 Level). MC type 1 and 2 show significant correlations with symptom severity and predict positive response to basi-vertebral nerve (BVN) ablation, a minimally invasive intervention inhibiting the nerves’ ability to transmit pain signals. Conclusions: Across multiple trials, BVN ablation has shown significant sustained improvements in patient-reported outcomes among patients with MC, reinforcing their role as both a diagnostic and therapeutic biomarker. Full article

This study develops and tests an integrated structural equation model (SEM) linking Butler’s Tourism Area Life Cycle (TALC), residents’ quality of life (QoL), and community participation in sustainable tourism governance (STG) across three emerging island destinations in Aceh, Indonesia. Drawing on survey data from 1266 residents, we employ confirmatory factor analysis and covariance-based SEM to (1) assess the direct effects of TALC-derived dimensions on residents’ QoL; (2) examine the influence of residents’ QoL on governance participation; and (3) evaluate both direct and indirect pathways linking TALC to STG. Rather than distinct life cycle stages, we conceptualize and measure residents’ perceptions of destination maturity based on key TALC dimensions, such as infrastructure development, tourism intensity, and institutional coordination. Results indicate that higher perceived destination maturity is positively associated with residents’ QoL (β = 0.21, p < 0.001), and that residents’ QoL strongly predicts governance participation (β = 0.31, p < 0.001). TALC dimensions also directly affect STG (β = 0.23, p < 0.001), with residents’ QoL partially mediating this relationship and accounting for 22.4% of the total effect. Multigroup SEM reveals consistent effect patterns across Weh, Pulo Aceh, and Simeulue. These findings illustrate how TALC-informed perceptions of destination maturity relate to residents’ quality of life and governance participation, suggesting that perceived well-being may play an important role in shaping community engagement in small-island tourism contexts. Full article

Background/Objectives: Occupational therapy (OT) plays a crucial role in addressing functional limitations and promoting independence in Parkinson’s disease (PD) patients. OT interventions target motor skills, daily activities, and engagement in meaningful tasks. Telehealth, the remote delivery of healthcare services, has expanded access to rehabilitation, including OT for PD. While several studies have examined the benefits of online OT, a comprehensive assessment of its impact on functional outcomes and quality of life (QoL) is needed. This review aimed to evaluate the effects of online OT interventions on functional outcomes and QoL of patients with PD. Methods: This review employed a systematized approach, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, though it did not constitute a full systematic review or meta-analysis. A comprehensive search was conducted across PubMed, Web of Science, Scopus, and Embase databases between August 2023 and September 2024. The search targeted randomized controlled trials (RCTs) investigating telerehabilitation interventions in OT for individuals with PD. Studies were excluded if they were not published in English, did not employ an RCT design, or lacked a focus on telerehabilitation within the scope of occupational therapy for PD. Additionally, systematic reviews, meta-analyses, qualitative studies, and studies without measurable outcomes were excluded. Nine studies met the inclusion criteria, with four involving occupational therapists directly and five evaluating interventions within the scope of OT practice. Results: The primary outcomes of this review focused on mobility improvements in PD patients, assessed through gait metrics such as gait speed, stride length, and gait variability. Secondary outcomes evaluated the impact of telerehabilitation on QoL, using tools such as the Parkinson’s Disease Questionnaire (PDQ-39) and other disease-specific instruments. The findings demonstrated that online OT interventions significantly improved motor skills, cognitive function, and activities of daily living in PD patients. Furthermore, these interventions enhanced overall well-being and QoL. The remote format fostered sustained engagement and adherence to therapy, contributing to better long-term outcomes. Conclusions: Online OT interventions show promising potential for improving functional outcomes and QoL in PD patients. These findings underscore the potential of telehealth to expand access to OT services, thereby enhancing long-term rehabilitation outcomes for this population. Full article

Energy efficiency (EE) is an important driver of quality of life (QoL), which is an overarching goal of sustainable development (SD). The levels of these phenomena in the European Union (EU) vary. Previous analyses presented in the literature have focused mainly on a one-dimensional view of EE and QoL. The authors of this article, given the multidimensional nature of the phenomena under study, present both categories from a holistic perspective. The purpose of this study was to identify the level of QoL in the context of EE and to compare the results of the classification of EU countries in terms of the analyzed phenomena. The study was conducted using the ELECTRE Tri method, one of the advanced techniques of multi-criteria decision analysis (MCDA). The classification procedure used made it possible to assign countries to predefined decision-making categories on the basis of preference threshold values and dominance relations to reference profiles. The 27 EU member states were analyzed on the basis of empirical data from 2023, using a set of 20 indicators characterizing EE and QoL. Countries were assigned to one of five classes, differentiating the level of development in both analyzed areas. Optimistic and pessimistic approaches were used to assess the stability of the classifications. The analysis showed the presence of countries with consistent results (e.g., Poland and Germany), extreme countries (Ireland and the Netherlands—high QoL with low EE; Romania and Croatia—inversely), as well as non-unique cases (e.g., Malta, the Czech Republic/Czechia, and Finland). The spatial approach indicated regions requiring special support. The results of the study can be a useful tool to support the process of designing public policies aimed at integrating social, economic, energy, and environmental goals within SD. Full article

Objective: The objective of the current post hoc analysis is to evaluate whether the combination of acetaminophen, aspirin, and caffeine (AAC) is more effective than placebo in relieving the pain intensity for and improving the quality-of-life (QoL) of subjects with menstrual migraine (MM). Methods: This analysis evaluated the impact of AAC (n = 85) versus placebo (n = 100) in relieving the pain intensity for and improving the QoL of subjects with MM during baseline and at 0.5, 1, 2, 3, 4, and 6 h post treatment. Subjects reported their pain intensity using a 4-point scale and QoL using a 5-point scale. A lower score indicates reduced pain intensity and improved QoL. Results: A statistically significant difference between the AAC and placebo groups (p ≤ 0.001) was observed in pain relief after 1 h (40% vs. 14%), 2 h (56.5% vs. 24%), 3 h (63.5% vs. 31%), 4 h (65.9% vs. 34%), and 6 h (64.7% vs. 31%) post treatment. Similarly, a significantly higher proportion of subjects reported improved QoL at 1 h (48.2% vs. 28.0%; p ≤ 0.005), 2 h (61.2% vs. 40.0%; p ≤ 0.005), 3 h (68.2% vs. 44.0%; p ≤ 0.001), 4 h (67.9% vs. 39.0%; p ≤ 0.001), and 6 h (64.3% vs. 37.0%; p ≤ 0.001) post treatment. The mean pain intensity and QoL scores reduced, while the relative pain intensity and QoL (difference between the AAC and placebo groups) increased with time and was sustained for 6 h. Conclusions: The rapid onset and sustained effect of AAC make it a potential option for managing headaches and other symptoms, and to improve the QoL of subjects with MM. Full article

Background: Anterior disc displacement without reduction (ADDwoR) of the temporomandibular joint (TMJ) often leads to persistent pain and reduced quality of life (QoL). Conservative treatments frequently fail to provide adequate symptom relief. Objective: To assess the short-term (≥6 months) effectiveness of functional arthroplasty in reducing pain and improving QoL in patients with ADDwoR unresponsive to conservative therapies. Methods: A retrospective cohort study was conducted on 105 patients (median age 38 years, 80% female) treated at Santa Maria Hospital from January 2018 to December 2021. All patients had unilateral painful ADDwoR confirmed via MRI and underwent functional arthroplasty. Primary outcomes included pain reduction (VAS) and QoL improvements (QoL-TMJ questionnaire). Covariates such as age, gender, and baseline mood disturbances were analyzed for associations with surgical outcomes. Statistical analyses included the Wilcoxon rank test, Friedman’s ANOVA, and Spearman’s rank correlation. Results: Postoperative VAS scores significantly decreased (8.0 pre-op vs. 2.0 post-op, p < 0.001). QoL-TMJ scores improved significantly in pain (p < 0.001), activity (p < 0.05), mood (p < 0.001), and anxiety (p < 0.01), but no significant changes were observed in chewing and speaking functions. Improvements in QoL correlated strongly with pain reduction. Gender and age did not influence the outcomes, though females reported higher baseline mood disturbances. Conclusions: Functional arthroplasty effectively reduces pain and improves QoL in patients with ADDwoR, regardless of age or gender. However, limited improvement in chewing and speaking abilities highlights the need for targeted interventions. Future studies should assess the long-term outcomes to confirm the sustained benefits of this procedure. Full article

Background: Small intestinal bacterial overgrowth (SIBO) is a dysbiosis marked by an excessive proliferation of bacteria in the small intestine, resulting in abdominal symptoms that significantly affect patients’ quality of life. Objectives: This study aims to evaluate the impact of a comprehensive therapeutic approach in improving the quality of life of patients with SIBO. Methods: For this purpose, standardized questionnaires were used at baseline, 30 days and 90 days, including the IBS-QOL (Irritable Bowel Syndrome Quality of Life Questionnaire), the GSRS (Gastrointestinal Symptom Rating Scale), the EuroQOL-5D, and the Bristol Scale. Results: The results show that a comprehensive approach, combining pharmacological treatment, appropriate dietary intervention, and strategies aimed at improving gut microbiota and intestinal permeability, produces a sustained improvement in the quality of life of a significant proportion of patients who participated in the study. Furthermore, the results suggest that, although gas normalization is a relevant indicator, clinical improvement and quality of life depend considerably on patients’ subjective perception of their health. Conclusions: This finding underscores the importance of recognizing SIBO as a prevalent condition that requires accurate diagnoses and individualized treatments to improve patients’ well-being. Full article

Background and Objectives: Ravulizumab, a long-acting C5 complement inhibitor, was approved in the US and Europe in 2022 as an add-on therapy for the standard treatment of AChR-positive generalized MG (gMG). We share our real-world experience with adult patients receiving this therapy in Romania. Materials and Methods: Six AChR-positive gMG patients received ravulizumab through an Early Access Program (January 2023–October 2024). Patient outcomes were assessed at the therapy start and q8w using Quantitative MG (QMG), MG Activities of Daily Living (MG-ADL), and MG Quality of Life 15-item revised (MG-QoL15r) scales. Results: Age at disease onset ranged from 15 to 35 years. Four of the six patients were women. Two patients had gMG severity level of IIa, and four patients of IIb according to the Myasthenia Gravis Foundation of America (MGFA) classification. Five patients experienced rapid and sustained improvements in MG symptoms with MG-ADL score reductions ranged from −3 to −5 at 26 weeks post-ravulizumab start (except for those with a low baseline score: three and one). QMG score dropped in three patients (−2 to 12) during the treatment period, increased in two (+2 and +8), and remained stable in one (zero). Three patients showed sustained improvement in MG symptoms after ≥60 weeks. MG-QoL15r significantly dropped (−22 to −10) throughout the treatment period. One patient experienced ravulizumab-associated adverse events (vomiting, diarrhea, chills) that resolved within 24 h following symptomatic management, two to three episodes of myasthenic exacerbations during treatment, and discontinued it. Conclusions: All cases presented here had early-onset AChR antibody-positive, non-thymomatous MG. Despite differences in disease duration and underlying conditions, clinically meaningful and sustained improvements in gMG symptoms, and reduced corticosteroid doses were observed in all patients except one after adding ravulizumab to the treatment plan. Full article

Families caring for children with congenital cardiac malformations under conservative management frequently experience psychological distress, which can compromise their overall quality of life (QoL). Despite growing recognition of the psychosocial burdens these families face, few studies have quantitatively assessed their QoL and stress-related outcomes. We aimed to evaluate the QoL, perceived stress, and parental burnout in caregivers of pediatric patients with cardiac malformations under conservative treatment. Methods: We conducted an observational, cross-sectional study of 78 caregivers (median age of 36 years) whose children (median age was 6.0 months) received conservative management for congenital cardiac malformations. Data were collected at two time points (diagnosis of congenital disease approximately at the time of birth, and six months after diagnosis) using the 36-Item Short Form Health Survey (SF-36), the Perceived Stress Scale (PSS), and the Parental Burnout Assessment (PBA). Statistical analyses included paired t-tests, chi-square tests, and Pearson correlation analyses; p-values < 0.05 were considered statistically significant. Results: Mean SF-36 Physical Component Summary scores significantly increased from 59.7 ± 11.7 at baseline to 63.5 ± 12.1 at six months (p = 0.026). PSS scores decreased from 22.9 ± 6.2 to 20.4 ± 5.9 (p = 0.012), indicating reduced perceived stress. Parental Burnout Assessment total scores also declined from 44.9 ± 8.5 to 40.1 ± 8.0 (p = 0.003). Correlation analyses revealed moderate negative correlations between SF-36 domains and both PSS (r range: −0.40 to −0.58) and PBA (r range: −0.34 to −0.52). Conclusions: Our findings highlight the multifaceted challenges faced by caregivers of children with cardiac malformations under conservative treatment. Improvements in QoL, accompanied by decreased perceived stress and parental burnout over six months, underscore the potential value of both clinical monitoring and targeted psychosocial support. Future research should explore larger, multicenter cohorts and longer follow-up durations to clarify long-term trends. Implementing interventions aimed at alleviating stress and burnout in these families may be pivotal for sustaining well-being and enhancing patient outcome. Full article

Background and Aims: Home parenteral nutrition (HPN) is essential in the management of chronic intestinal failure (CIF) and malignant bowel obstruction (MBO), particularly in cases where enteral feeding is not feasible. This review examines the evidence from 34 studies to evaluate the impact of HPN on survival and quality of life (QoL) in patients with MBO, CIF, and advanced cancer, as well as to identify clinical predictors of survival and address psychosocial challenges. Methods: A comprehensive review was conducted of 34 studies, focusing on the use of HPN in patients with MBO, CIF, and advanced cancer. Data were analyzed for survival outcomes, QoL metrics, and predictors of survival, including performance status, albumin levels, and the continuation of chemotherapy. The psychosocial aspects of HPN therapy were also assessed, particularly its influence on patient’s daily lives and mental health. Results: Key predictors of improved survival included good performance status, higher albumin levels, and the ability to continue chemotherapy. While HPN extended survival in many cases, its impact on QoL varied significantly. Psychosocial challenges, including lifestyle disruption and mental health strain, were common among long-term HPN patients, underscoring the need for comprehensive patient support. Conclusions: HPN can be a life-sustaining therapy for patients with CIF, MBO, and advanced cancer, but its success depends on careful patient selection and management. Identifying predictors of survival helps optimize outcomes, while addressing psychosocial challenges is crucial to minimizing the negative impact on QoL. This review highlights the need for a balanced approach to maximize the benefits of HPN. Full article

This research investigates the role residents’ place attachment plays in developing their trust in the government in the city of Budapest. Rooted in different domains such as politics, environmental, and social psychology and aligned with the related SDGs (goals 3, 11 16, 17), an integrative model of residents’ place attachment, trust in the local government, QoL, social impacts, and pro-social engagement is proposed, which the authors argue are important mechanisms to be explored in determining support for sustainable tourism development to promote responsible consumption and production (SDG 12). We applied SEM on a sample of 350 residents. Findings suggest that place attachment significantly influences residents’ trust in the local government, which also has a positive influence on quality of life. Quality of life has a significant influence on perceived social impacts, which strongly leads to pro-social engagement; pro-social engagement underpins support for tourism development. This paper sets a future research agenda for sustainable tourism by indicating its possible antecedents. Sustainable tourism development has important implications for the achievement of other sustainability goals. The study aligns well with the United Nations Tourism’s vision of tourism as an important driver of positive change for responsible consumption and advancing other SDGs. Full article

Drawing on Social Support Theory, this research makes a new attempt to examine the moderating role of emotional support for students with disability in the link from mental health disorder to a sustained quality of life. Responses from 620 students with disabilities were analyzed with SEM analysis using Smart PLS. The results showed a direct negative impact of stress, depression, and anxiety on the QoL of disabled students. Additionally, the results confirmed a moderating role of emotional support in the link between stress, anxiety, and QoL among disabled students. This means that emotional support was able to mitigate the negative impact of both stress and anxiety on the QoL of disabled students. However, the results did not confirm the moderate role of depression in this relationship. This means that emotional support given to students with disabilities was not enough to mitigate the negative impact of depression on the sustained QoL of disabled students. It also means that there are other support structures and interventions needed to mitigate the negative impact of depression on the QoL among disabled students. Implications of the results are thus elaborated. Full article