Gelotophobia and High-Functioning Autism Spectrum Disorder

Germline CDH1 mutation carriers are at risk for early-onset diffuse gastric cancer (DGC) and female carriers have an additional risk of lobular breast cancer. The reported literature GC risk of 70% has led to the recommendation for germline mutation carriers to undergo prophylactic total gastrectomy (PTG). The objective of this research was to examine post-surgical clinical outcomes and to identify which of the domains/symptoms from the European Organisation for Research and Treatment of Cancer QOL Questionnaire (EORTC QLQ-C30) were determinants of overall quality of life (QOL) in individuals undergoing PTG. Participants were recruited through multiple sources. Postsurgical clinical outcomes were obtained from hospital records. Participants completed validated questionnaires measuring generic and condition specific QOL (PROMIS, EORTC and SF 36v.II) at a single point in time. The mean QOL in this cohort was 70.6 (SD = 25.6), which is better than reference values from the general populations in USA and Canada Role and social function plus the symptoms anxiety, pain, taste, dyspnea and diarrhea were significant predictor variables for QOL (p < 0.05). Although this study reveals good overall QOL for individuals after PTG, attention should be given to managing symptoms as part of long term care to further enhance QOL. The function/symptom scores were associated with worse overall health and global health status and thus may mark a real need for more attentive post-surgical care.

Introduction: Evaluating the quality of life for individuals living with hypertension is essential, as their experiences can differ markedly from those of healthier individuals. Aims: This study aimed to gain insights into the quality of life of patients with hypertension by examining factors including functional ability, physical health, pain levels, overall well-being, vitality, and social and emotional aspects. Methods: The Researcher used the 36-item Short Form (SF-36) to assess participants&#39; quality of life. This established questionnaire evaluates various aspects of health, including both mental and physical well-being. A six-month study conducted at a tertiary care facility in Bangladesh involved 300 participants. The study design described in your text is a descriptive cross-sectional study. This study design is used to collect data at a single point in time from a population, allowing researchers to assess the prevalence of characteristics, conditions, or health outcomes (e.g., quality of life in hypertensive patients) and to analyze associations among demographic, clinical, and psychosocial factors. Results: The findings revealed some concerning trends. The quality-of-life assessment reveals significant insights across various domains. High physical functioning (70) and social functioning (77) scores indicate robust physical and social health. However, low scores in mental health (25) and role limitations due to emotional problems (34) highlight critical areas for improvement. Furthermore, moderate scores in energy/fatigue (66) and pain (47) suggest ongoing challenges. Addressing these issues is essential for enhancing overall well-being and fostering a more balanced quality of life. Prioritizing mental health support and reducing role limitations can lead to substantial improvements in daily functioning and overall happiness. These findings highlight the urgent need for effective hypertension management and increased public awareness. It is essential to focus not only on physical health but also on supporting patients&#39; overall mental and emotional well-being. Conclusions: By addressing these aspects, we can significantly enhance the overall quality of life for individuals living with hypertension.

Children, adolescents, and adults who stutter widely experience anxiety and avoid social situations; hence stuttering negatively affects their quality of life (Yaruss &amp; Quesal, 2004). The study aims to investigate the relation between social anxiety, stigma perception, and quality of life among individuals who stutter and to examine if stigma perception mediates between social anxiety and quality of life. Participants of aged 11- 25 years (Mage =18.83, SD = 4.74, N = 117) were recruited using purposive and snowball sampling technique. Participants were screened based on dysfluency using DSM-5 (2013) stuttering criteria. Results revealed significant association between social anxiety, stigma perception, and quality of life. Mediation analysis also showed that stigma perception partially mediated the relation between social anxiety and quality of life in individuals who stutter. Furthermore, significant age differences were found in social anxiety and quality of life in individuals who stutter. The study concluded that stigma perception partially mediates the relationship between social anxiety and quality of life; therefore, social anxiety and perceived stigma need to be reduced to enhance stuttering individuals’ quality of life. Results highlight the importance of multidisciplinary approach in the management of stuttering.

Impact of Acupressure on Pain, Functional Status, and Quality of Life in Individuals With Knee Osteoarthritis.

Objective: To examine and predict the relationship among social appearance anxiety, emotional regulation and quality of life in individuals with premature canities. Methods: The correlational study was conducted from September 2019 to February 2020 in Lahore, Pakistan, after approval from the Riphah International University, Lahore, and comprised individuals of either gender aged 15-25 years with premature canities. Social Appearance Anxiety Scale, Emotional Regulation Questionnaire and the Quality of Life Scale were used to measure the study variables. Data was analysed using SPSS 21. Results: Of the 100 subjects, 50(50%) each were males and females. The overall mean age was 19.80±3.33 years. Individuals with premature canities had significant social appearance anxiety which was positively correlated with emotional suppression. As social appearance anxiety increased, the quality of life decreased (p&lt;0.05). Lower level of cognitive reappraisal and higher expressive suppression were linked with improved quality of life in individuals with premature canities (p&lt;0.05). Conclusion: Social appearance anxiety, emotional regulation along with age were together found to be the predictors of quality of life. Key Words: Social appearance anxiety, Emotional regulation, Quality of life, Premature canities.

To examine and predict the relationship among social appearance anxiety, emotional regulation and quality of life in individuals with premature canities. The correlational study was conducted from September 2019 to February 2020 in Lahore, Pakistan, after approval from the Riphah International University, Lahore, and comprised individuals of either gender aged 15-25 years with premature canities. Social Appearance Anxiety Scale, Emotional Regulation Questionnaire and the Quality of Life Scale were used to measure the study variables. Data was analysed using SPSS 21. Of the 100 subjects, 50(50%) each were males and females. The overall mean age was 19.80±3.33 years. Individuals with premature canities had significant social appearance anxiety which was positively correlated with emotional suppression. As social appearance anxiety increased, the quality of life decreased (p<0.05). Lower level of cognitive reappraisal and higher expressive suppression were linked with improved quality of life in individuals with premature canities (p<0.05). Social appearance anxiety, emotional regulation along with age were together found to be the predictors of quality of life.

This study explored an intensive 3-week training program and use of psychiatric service dogs for military-related posttraumatic stress disorder (PTSD) and associated symptoms. The sample included 2 separate cohorts of military veterans (n = 7 and n = 5) with prior diagnoses of PTSD. Participants completed self-report measures assessing PTSD, depression, perception of social support, anger, and overall quality of life 1 month prior to the training (baseline), at arrival to the training site, and 6-month follow-up. Results indicated that, for this sample, there was a statistically significant decrease in PTSD and depression symptoms from pre- to posttreatment, as well as 6-month follow-up. For most participants decreases were both clinically significant and reliable changes. Further, participants reported significant reductions in anger and improvement in perceived social support and quality of life. Limitations of the study include a lack of control group, a limitation of most naturalistic studies, as well as small sample size. Despite this, the findings indicate that utilizing psychiatric service dogs, coupled with an intensive trauma resilience training program for veterans with ongoing symptoms, is feasible as a complementary treatment for PTSD that could yield beneficial results in terms of symptom amelioration and improvement to overall quality of life. (PsycINFO Database Record

While positive contributions of religion and spirituality (R/S) to quality of life (QOL) are confirmed by a growing body of evidence, only limited research has involved people with intellectual disabilities and so far, no studies included prelingually deaf individuals with intellectual disabilities. This study explores the role of R/S in people with intellectual disabilities and deafness living in three therapeutic living communities specifically adapted to their needs. Forty-one individuals (mean age: 46.93years, 43.9% female) with prelingual deafness and mild to moderate intellectual disability participated in structured sign language interviews adapted to their cognitive-developmental level, regarding their QOL, individual spirituality and participation in spiritual practices in the community. Participants' QOL was assessed with an established short measure for QOL (EUROHIS-QOL) adapted to easy-to-understand sign language. With 21 participants, qualitative interviews were conducted. In addition, proxy ratings from caregivers were obtained. The participants' ratings of their individual spirituality (r = 0.334; p = 0.03) and spiritual practices-in-community (r = 0.514; p = 0.00) correlated positively with their self-reported QOL. Qualitative findings illustrate the importance of R/S and give insights into R/S concepts and practices. Personal spirituality and participating in spiritual practices are positively related to self-reported quality of life in deaf individuals with intellectual disability (ID). As a consequence, access to spiritual and religious services should be included in comprehensive programs and society at large.

Purpose: To determine if quality of life is reduced in individuals with patellofemoral osteoarthritis, whether it can be improved with treatment, and potential factors associated with quality of life in individuals with patellofemoral osteoarthritis.Materials and methods: Published articles were identified by using electronic and manual searches. Studies reporting quality of life in individuals with patellofemoral osteoarthritis relative to a comparator group (e.g., no osteoarthritis) and intervention studies reporting quality of life in patellofemoral osteoarthritis following treatment relative to baseline/control group were included.Results: Seventeen studies (seven cross-sectional, 10 intervention) were included in this systematic review. Relative to those without osteoarthritis, individuals with patellofemoral osteoarthritis had worse knee-related quality of life (five studies) and health-related quality of life (two studies). Non-surgical treatments appear to improve knee-related quality of life compared to pre-treatment (three studies) but not control (three studies). Surgical-treatments also improved knee-related quality of life compared to pre-treatment (five studies). Worse knee-related quality of life was associated with younger age, worse pain, symptoms, function in activities of daily living, and function in sport and recreation.Conclusions: Individuals with patellofemoral osteoarthritis had worse knee-related and health-related quality of life compared to those without knee osteoarthritis. Non-surgical and surgical interventions may be effective in improving knee-related quality of life in individuals with patellofemoral osteoarthritis, but the intervention results are based on limited studies, and further research is needed to determine optimal strategies.Implications for rehabilitationClinicians and researchers should consider knee-related and health-related quality of life when developing treatment strategies for patellofemoral osteoarthritis.Researchers investigating the effectiveness of a treatment should compare intervention to a control group.Addressing knee pain and functional limitations may aid in improving knee-related quality of life in individuals with patellofemoral osteoarthritis.

PurposeTo assess the effects of virtual reality using the NintendoTM Wii Fit on balance, gait, and quality of life in ambulatory individuals with incomplete spinal cord injury (iSCI).RelevanceThere is a need for continued research to support effective treatment techniques in individuals with iSCI to maximize each individual's potential functional performance.SubjectsFive males with a mean age of 58.6 years who had an iSCI and were greater than one-year post injury.MethodsAn interrupted time series design with three pre-tests over three weeks, a post-test within one week of the intervention, and a four-week follow up. Outcome measures: gait speed, timed up and go (TUG), forward functional reach test (FFRT) and lateral functional reach test (LFRT), RAND SF-36. Intervention consisted of one-hour sessions with varied games using the Nintendo Wii Fit twice per week for seven weeks. Survey data was also collected at post-test.ResultsThere were statistically significant changes found in gait speed and functional reach. The changes were also maintained at the four-week follow up post-test. Survey reports suggested improvements in balance, endurance, and mobility with daily tasks at home.ConclusionAll subjects who participated in training with the NintendoTM Wii Fit demonstrated statistically significant improvements in gait speed and functional reach after seven weeks of training. Given the potential positive impact that the NintendoTM Wii Fit has on functional reach and gait speed in patients with iSCI, physical therapists may want to incorporate these activities as part of a rehabilitation program.

&lt;p dir="ltr"&gt;&lt;b&gt;Background&lt;/b&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;As the population ages, the number of adults living with multimorbidity- defined as having two or more chronic conditions-is increasing. The current healthcare system often focuses on treating one disease at a time, can fail to meet these individuals ' needs with risk of on the one hand unmet care needs and on the other risk of more visits to more healthcare providers and medications than benefits the individual. To better serve older individuals with multimorbidity, the healthcare system, particularly primary care, needs to adapt and evolve. This involves adopting a more person-centred and holistic approach to care, considering the individual' wants and needs, all health conditions, and overall well-being, rather than treating each disease separately. By doing so, the healthcare system can provide coordinated, person-centred care that effectively meets the complex needs of these individuals.&lt;/p&gt;&lt;p dir="ltr"&gt;&lt;b&gt;Aim&lt;/b&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;The aim of this thesis was to develop and pilot a complex intervention to improve wellbeing and quality of life in individuals with multiple health conditions and common mental health problems in Swedish primary care.&lt;/p&gt;&lt;p dir="ltr"&gt;&lt;b&gt;Methods&lt;/b&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;This thesis involves four studies involving quantitative, qualitative and mixed methods methodologies. Study 1 is a systematic literature review and qualitative synthesis of collaborative care interventions for individuals with multimorbidity and common mental health problems in primary care and community settings and a map of intervention components. Study 2 is a total population-based cohort study investigating the association between having multimorbidity with an increasing number of chronic diseases and potentially inappropriate prescribing of benzodiazepines in the total adult population in Stockholm, Sweden in two cohorts, one before and one during COVID-19. Study 3 is a qualitative study exploring GP's experiences of managing individuals with multimorbidity and common mental health problems in primary care in Stockholm, Sweden using reflexive thematic analysis. From the findings of study 1 and 3 the intervention Health and Life in Balance was developed for improving patient capacity for older people with multimorbidity. The intervention includes the collaborative care components of relational continuity, a shared care plan, and teamwork identified in study 1. Moreover, it uses a person-centred approach to care, minimally disruptive medicine, to assess patient capacity and workload in individuals with multimorbidity. This approach was identified in the literature sharing similarities with the findings from study 3. Study 4 is a pragmatic convergent mixed methods non- randomised pilot study. The study aimed to assess the acceptance, feasibility and further need of development of Health and Life in Balance.&lt;/p&gt;&lt;p dir="ltr"&gt;&lt;b&gt;Results&lt;/b&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;In study 1, 12 Randomised controlled studies were included. Eleven studies with medium to high quality showed positive results in reducing depressive symptoms in individuals with multimorbidity involving depression and one chronic disease. The last study had medium to low quality and investigated the effect on anxiety and depressive symptoms. There was a lack of medium to high quality studies addressing collaborative care for individuals with multimorbidity and anxiety, and for individuals with more than two health conditions. The qualitative synthesis identified a map of shared content in the 11 studies of collaborative care models with medium to high quality. In study 2, an association between an increasing number of chronic conditions and potentially inappropriate prescribing of benzodiazepines was identified in both cohorts, before and during COVID-19. The logistic regression model was adjusted for age and socioeconomic status and stratified for sex. The association remained although decreased when adjusting for each of the clinical confounders: number of healthcare visits, polypharmacy, and having a psychiatric diagnosis. In study 3 two themes were generated: Unmet patient needs and fragmented care send patients and physicians off balance and Dancing with the patient individually and together with others leads to confident and satisfied patients and physicians. General practitioners found it hard to address common mental health problems in individuals with multimorbidity, limited by disease-specific guidelines and fragmentation. They highlighted that aspects of person-centred care, involving relational continuity, flexibility and teamwork, would help them better address these individuals. In study 4, Health and Life in Balance was acceptable and feasible regarding to have relational continuity to a district nurse addressing non-disease-specific issues for individuals in need of it. However, the intervention needs further development. The intervention needs to be targeted for individuals with the greatest care needs including aspects of frailty, deprived psychosocial situation and many healthcare providers. Further, it needs to be further developed to provide person-centred care in a busy primary care setting, including raising priority for individuals with multimorbidity involving non- disease-specific needs, addressing how to provide and implement a person- centred care, and addressing how to provide teamwork and cooperation with others.&lt;/p&gt;&lt;p dir="ltr"&gt;&lt;b&gt;Conclusions&lt;/b&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;This thesis identifies individuals with multiple health conditions to be at risk of potentially inappropriate prescribing of benzodiazepines and poorly addressed non-disease-specific issues in today's fragmented healthcare system and shows person-centred care as a potential solution to address these issues. Furthermore, it describes the development and piloting of Health and Life in Balance, a person-centred intervention aiming to address these risks. The findings from the pilot study identified the intervention to be acceptable and feasible when at-need individuals had relational continuity to a district nurse who could address non-disease-specific needs. Yet, the intervention needs further development to identify and target individuals with the greatest care needs, make these individuals a priority in primary care, and to ensure teamwork and delivery and implementation of person-centred care. The results from this thesis and included studies can inform policy makers and other stakeholders of the need of prioritising a shift from fragmented care to person- centred and holistic care for vulnerable individuals and a need of further intervention development to address these individuals' needs. Furthermore, the findings can be used in further intervention development. However, in future intervention development it is important to involve individuals with multimorbidity and other stakeholders in both the research group and in different phases of the intervention development.&lt;/p&gt;&lt;h3&gt;List of scientific papers&lt;/h3&gt;&lt;p dir="ltr"&gt;I. Specific content of collaborative care: a systematic review of collaborative care interventions for patients with multimorbidity involving depression and/or anxiety in primary care. &lt;b&gt;C Kappelin&lt;/b&gt;, A Carlsson, C Wachtler Fam Pract 2021 Sep 21;39(4):725-734. &lt;a href="https://doi.org/10.1093/fampra/cmab079" rel="noreferrer" target="_blank"&gt;https://doi.org/10.1093/fampra/cmab079&lt;/a&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;II. The association between number of chronic diseases and potentially inappropriate benzodiazepine prescribing: A total population-based cohort study in Region Stockholm, Sweden. &lt;b&gt;Caroline Kappelin&lt;/b&gt;, Caroline Wachtler, Gunnar Ljunggren, Axel Carlsson. [Submitted]&lt;/p&gt;&lt;p dir="ltr"&gt;III. Dancing with the patient: a qualitative study of general practitioners' experiences of managing patients with multimorbidity and common mental health problems. &lt;b&gt;Kappelin C,&lt;/b&gt; Sandlund C, Westman J, Wachtler C. BMC Prim Care. 2023 Apr 20;24:104. &lt;a href="https://doi.org/10.1186/s12875-023-02056-y" rel="noreferrer" target="_blank"&gt;https://doi.org/10.1186/s12875-023-02056-y&lt;/a&gt;&lt;/p&gt;&lt;p dir="ltr"&gt;IV. Health and Life in Balance an intervention to improve patient capacity for older people with multimorbidity: A pragmatic mixed methods non-randomised pilot study. &lt;b&gt;Caroline Kappelin&lt;/b&gt;, Klas Ytterbrink Nordenskiöld, Elisabeth Bos Sparén, Annica Lagerin, Caroline Wachtler. [Submitted]&lt;/p&gt;

Objectives:To assess the overall and domain-specific quality of life (QOL) in post-stroke patients using the stroke-specific quality of life (SS-QOL) scale and to identify variables that may affect the QOL after stroke.Methods:A prospective cross-sectional study, included 80 stroke patients, was conducted in the Neurology department at King Fahad Hospital of the University (KFHU), Khobar, Saudi Arabia, from December 2019 to February 2020. Stroke patients were interviewed using the Arabic version of the SS-QOL questionnaire and modified Rankin scale (mRS).Results:The overall quality of life in the surveyed participants was at the level of 3.72 points, which is above the average recognized in the middle of the scale that ranges from 1 to 5. The overall quality of life was not significantly correlated with sex, age, type of stroke, recurrence of stroke, and time since stroke (p>0.05). Hypertension and atrial fibrillation were the only comorbidities that were determined to be significantly associated with the overall quality of life at the level of (3.53), and (2.97) respectively (p<0.05). There was a statistically significant correlation between the mRS score and the overall quality of life (p<0.05).Conclusion:Performing a comprehensive assessment of the overall QOL in post-stroke patients will result in better health outcomes, particularly in terms of quality of functioning in psycho-social aspects.

Background:Epilepsy is one of the most common serious neurological disorders. The present study aimed to investigate the influence of occupational status on the quality of life of Chinese adult patients with epilepsy.Methods:This study surveyed 819 subjects clinically diagnosed with epilepsy for more than 1 year in 11 hospitals in Beijing; 586 were employed (71.55%). All subjects completed the case report form with inquiries on demographic data, social factors, and illness. The patients’ quality of life was assessed using the quality of life in patients with epilepsy-31 items (QOLIE-31) questionnaire.Results:The QOLIE-31 score in the employed group was significantly higher than that in the unemployed group. Furthermore, the scores in all the sections (overall quality of life, energy/fatigue, emotional well-being, seizure worry, cognition, social function, and medication effects) of the employed group were higher than those of the unemployed group. Both the employed and unemployed groups achieved the highest difference in social function. The QOLIE-31 score of students was higher than those of farmers and workers. Both the students and workers scored higher in the quality of life compared with the adult peasants living with epilepsy. The students and farmers showed significant differences in QOLIE-31 score, cognition, emotional well-being, overall quality of life, energy/fatigue, and social function. In contrast, no significant difference was noted in seizure worry and medication effects across the three different kinds of occupation.Conclusion:Occupational status might affect the quality of life of Chinese adult patients with epilepsy, and social function is the most important contributing factor.

Purpose: This study aimed to investigate the effects of diaphragmatic mobilization and diaphragmatic breathing exercises on pain and quality of life in individuals with shoulder pain. Methods: A total of 72 individuals with shoulder pain were included in the study. The individuals included in the study were randomly divided into 3 groups as Diaphragmatic Mobilization Group (DMG) (n=24), Diaphragmatic Breathing Group (DBG) (n=24), and control group (n=24). In addition to classical physiotherapy treatment, diaphragmatic mobilization to mobilization group and diaphragmatic breathing exercises to breathing group were applied by the physiotherapist 3 days a week for 8 weeks. On the other hand, only classical physiotherapy treatments were applied to the control group. Individuals were evaluated in terms of pain and quality of life. Pain levels assessed with the Visual Analogue Scale (VAS) and quality of life assessed with Short Form-36 (SF-36). Results: In our study, it was observed that the pain level was reduced and the quality of life was improved in all groups (p&amp;lt;0.05). When DMG and DBG were compared with the control group, there was found a significant difference among groups in terms of reducing pain and improving quality of life in favor of DMG and DBG (p&amp;lt;0.05). When DMG and DBG were compared, no statistically significant difference was found between the groups (p&amp;gt;0.05). Conclusion: The study results demonstrated that diaphragmatic mobilization and diaphragmatic breathing exercises are found to be effective in reducing pain and improving quality of life in individuals with shoulder pain.

Does Asthma Affect Women's Sexual Life and Marital Adjustment?