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1.
Lifestyle (Medicine) and Healthy Aging.
Friedman, SM
Clinics in geriatric medicine. 2020;(4):645-653
Abstract
Healthy aging is a process that occurs over the life cycle. Health habits established early and practiced throughout life impact longevity, the ability to reach old age, and the health with which one experiences older adulthood. The new field of lifestyle medicine addresses root causes of disease by targeting nutrition, physical activity, well-being, stress management, substance use, connectedness, and sleep. As a result, lifestyle medicine can optimize the trajectory of aging, and promote targets that have been recognized in geriatric medicine as essential to well-being and quality of life, resulting in a compression of morbidity.
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2.
Quality of Life in Individuals with Diabetic Foot Syndrome.
Navarro-Flores, E, Cauli, O
Endocrine, metabolic & immune disorders drug targets. 2020;(9):1365-1372
Abstract
BACKGROUND AND OBJECTIVE Diabetic foot syndrome (DFS) is a common long-term complication of diabetes mellitus. DFS has recently been associated with adverse effects that could further impair the quality of life of diabetic patients, and increase the social and economic burden, morbidity, and premature mortality of the disease. The main physio-pathological basis of DFS is due to diabetesinduced neuropathy and angiopathy in the lower limbs and feet. Patients diagnosed with DFS must significantly modify their daily habits in order to cope with signs and symptoms of DFS and this can alter their quality of life. The objective of this review is to summarize the evidence regarding the economic, physical and social limitations which can affect the quality of life (QoL) in patients with DFS, the effects of ulcers and amputations on QoL outcomes. RESULTS Different aspects related to DFS such as physical alterations, psychological complaints and even disorders, socio-economic difficulties can affect the quality of life of these patients. However, the QoL related to low socio-economic factors gave mixed results and physical activity, education and type of footwear can influence the outcomes. There is a general gender-dependent higher prevalence of DFS in men, although it depends on the geographical area. DFS often co-occurs with other diabetes-induced complications (retinopathy, nephropathy and cardiovascular disorders) and comorbid obesity generally worsens it. CONCLUSION Accessibility to health services aimed at reducing inequalities and constant health education and promotion and care regarding psychological and socio-economic issues should be continuously undertaken for individuals with DFS in order to improve their QoL.
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3.
Nutrition and gastroenterological support in end of life care.
Schütte, K, Middelberg-Bisping, K, Schulz, C
Best practice & research. Clinical gastroenterology. 2020;:101692
Abstract
Malnutrition and the broad spectrum of cancer cachexia frequently occur in patients with malignant disease of all tumour stages and impact on survival and quality of life of patients. Structured screening for the risk of malnutrition with validated tools and nutritional assessment are the prerequisite for adequate nutritional support in cancer patients. In patients receiving tumour directed therapy, the patients diet should meet the requirements to give optimal support, while later on comfort feeding is part of symptom focused palliation. The basis of nutritional support in a malnourished patient is nutritional counselling, and nutritional support can be offered within a step-up approach meeting the patient's needs. A combination of nutritional support with interventions targeting metabolic changes and physical exercise is suggested to treat cancer cachexia.
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4.
Body composition changes in patients with head and neck cancer under active treatment: a scoping review.
Ferrão, B, Neves, PM, Santos, T, Capelas, ML, Mäkitie, A, Ravasco, P
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2020;(10):4613-4625
Abstract
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.
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5.
Sexual dysfunction after stroke-A biopsychosocial perspective.
Na, Y, Htwe, M, Rehman, CA, Palmer, T, Munshi, S
International journal of clinical practice. 2020;(7):e13496
Abstract
OBJECTIVES Poststroke sexual dysfunction (PSSD) is widespread and underrecognised, affecting over half of stroke patients with significant effects on a patients' quality of life. We reviewed the postulated factors contributing to PSSD and explore the underrecognition by presenting a questionnaire study as well as examining existing literature. METHODS A literature search between January 1980 and December 2019 in electronic databases such as EMBASE, MEDLINE and PubMed was conducted. The questionnaire study involved all adult stroke patients attending the outpatient clinic over a 6-month period, containing multiple choice and open questions relating to prevalence, impact and provision provided for patients with PSSD. FINDINGS Poststroke sexual dysfunction is unlikely attributed solely to the physical effects of stroke. We present a biopsychosocial model summarising the wide range of factors which can contribute to PSSD. Less than 10% of patients receive any advice despite 90% of patients hoping for advice relating to sexual dysfunction in stroke. INTERPRETATION AND IMPLICATIONS A multidisciplinary, proactive involvement in screening and managing PSSD is required to successfully manage a commonly forgotten complication of stroke. As part of the wider theme of managing lifestyle factors poststroke (eg, smoking, driving advice, dietary advice, alcohol), the 'sexual function aspect' of patients' lives must not be ignored.
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6.
A Review of Literature on Health-Related Quality of Life of Retinoblastoma Survivors.
Belson, PJ, Eastwood, JA, Brecht, ML, Hays, RD, Pike, NA
Journal of pediatric oncology nursing : official journal of the Association of Pediatric Oncology Nurses. 2020;(2):116-127
Abstract
Background: Retinoblastoma is a malignant tumor of the eye that typically presents in early childhood and occurs in approximately 1 in 20,000 births. While active treatment of the tumor is typically completed in childhood, survivors often suffer from long-term effects from treatment including visual impairment, facial deformities, and fear of recurrence or secondary cancer. However, little is known how these long-term effects affect their health-related quality of life (HRQOL). Purpose: To review the literature on HRQOL in retinoblastoma survivors. Method: We searched three electronic databases from January 2005 to December 2018 for original research articles reporting on HRQOL or individual domains such as function, cognition, and psychosocial outcomes in retinoblastoma survivors. Results: A total of 59 articles were reviewed and 15 were identified as eligible. Five of the studies reported worse HRQOL in retinoblastoma survivors than controls or general population norms. Parent-proxy ratings were worse than survivors' self-reports. Conclusion: Our findings confirm the need for further HRQOL research to assess the factors influencing long-term outcomes associated with treatment in adolescent and young adult retinoblastoma survivors. By identifying any potential deficits in specific domains of HRQOL, early interventions might be developed to improve HRQOL in retinoblastoma survivors.
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7.
Preserving Engagement, Nurturing Resilience.
Kusz, H, Ahmad, A
Clinics in geriatric medicine. 2020;(4):601-612
Abstract
Engagement and resilience constitute 2 psychological aspects of healthy aging that are commonly identified by many individuals as more important than health or longevity. Both of them play a crucial role in healthy aging. Social engagement enhances psychological well-being and improves physical and cognitive health outcomes. In times of adversity, resilience buffers the negative effects of stress and promotes return to baseline health and function. Strong resilience helps individuals become more engaged and active engagement promotes resilience. We discuss the role, health outcomes, and practical implications of these 2 major domains of healthy aging.
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8.
When I'm 64: A review of instrumental music-making and brain health in later life.
Jordan, C
Experimental gerontology. 2019;:17-23
Abstract
According to the World Health Organization, global average life expectancy increased by 5.5 years between 2000 and 2016. This is the greatest increase in life expectancy since the 1960s. Identifying lifestyle choices which can be implemented in later life to support brain health are imperative given the increasing prevalence of age-related neurodegenerative diseases, such as dementia. Music-making, specifically instrumental music-making, has been suggested to support cognition function and emotional wellbeing in later life. This review will distinguish instrumental music-making from other musical activities (i.e. singing or listening to music), specifically focusing on its influence on cognitive function in later life and its contribution to the emotional wellbeing and quality of life. This review will also explore the viability of instrumental music-making as an intervention to support brain health in later life.
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9.
Impact of Hepatic Encephalopathy in Cirrhosis on Quality-of-Life Issues.
Montagnese, S, Bajaj, JS
Drugs. 2019;(Suppl 1):11-16
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Abstract
Hepatic encephalopathy (HE) has a major impact on health-related quality of life (HRQOL) in patients, which has clinical and psychosocial consequences. HRQOL in cirrhosis has been measured by generic and liver-specific instruments, with most studies indicating a negative impact of HE. HRQOL abnormalities span daily functioning, sleep-wake cycle changes, and the ability to work. Of these, sleep-wake cycle changes have a major effect on HRQOL, which remains challenging to treat. The personal effect of HRQOL is modulated by the presence of HE, the etiology of cirrhosis, and cognitive reserve. Patients with higher cognitive reserve are able to tolerate HE and its impact on HRQOL better than those with a poor cognitive reserve. The impact of HRQOL impairment is felt by patients (higher mortality and poor daily functioning), as well as by caregivers and families. Caregivers of patients with HE bear a major financial and psychological burden, which may affect their personal health and longevity.
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10.
Health Characteristics Associated With Hot Flashes in Women With HIV During Menopause: An Integrative Review.
Rivard, C, Philpotts, LL, Flanagan, J, Looby, SE
The Journal of the Association of Nurses in AIDS Care : JANAC. 2019;(1):87-97
Abstract
Hot flashes (HFs) are a prominent symptom of menopause known to unfavorably influence mood, sleep, and quality of life. More women living with HIV are entering menopause and may experience a greater prevalence of HFs and more severe HFs compared with uninfected women. This integrative review evaluated existing evidence on potential health characteristics associated with HFs in women living with HIV during menopause. A search strategy was conducted within 6 databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guided the review, and the Johns Hopkins Nursing Evidence-Based Practice model was used to evaluate methodological quality and appraisal of the evidence. Five articles met the review eligibility criteria. Three content categories emerged from the key findings of the 5 articles: HIV-specific characteristics, mental health and cognitive characteristics, and quality of life and social characteristics. Implications for research and clinical care were identified.