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Most adolescents do not consume a high-quality diet, while self-reported mental health problems within this group are increasing. This study aimed to investigate the association between diet quality and health-related quality of life, and to explore the differences in diet quality and health-related quality of life between gender and parental education status. In this cross-sectional study, a detailed web-based recall method was implemented to determine dietary intake, which was analysed using the newly developed Swedish Healthy Eating Index for Adolescents 2015 (SHEIA15) and the Riksmaten Adolescents Diet Diversity Score (RADDS), to determine diet quality. The KIDSCREEN-10 questionnaire was used to measure health-related quality of life, and parental education was self-reported through questionnaires. Parental education was divided into two groups: ≤12 years or >12 years. The study included 1139 adolescents from grade 7 (13–14 years old), 51% were girls. The results showed that girls had higher scores for healthy eating and diet diversity but lower scores for health-related quality of life. A positive association was found between diet diversity and health-related quality of life (Adj R2 = 0.072, p = 0.001), between vegetable/fruit consumption and health-related quality of life (Adj R2 = 0.071, p = 0.002), and between healthy eating and diet diversity (Adj R2 = 0.214, p < 0.001). No association was found between healthy eating and health-related quality of life for all participants. The mean scores for healthy eating and diet diversity were significantly higher in the higher education parental group. In conclusion, higher diet diversity and increased fruit and vegetable consumption could be a strategy to improve health-related quality of life among adolescents. There is a need to promote better diet quality, especially in households of low parental education. In addition, there is a further need to investigate the potential benefits of improved diet quality on mental health and overall well-being.

Objectives: The transphenoidal bi-nostril endoscopic resection of pituitary adenomas is regarded as a minimally invasive treatment nowadays. However, sino-nasal outcome and health-related quality of life (HRQoL) might still be impaired after the adenomectomy, depending on patients’ prior medical history and health status. A systematic postoperative comparison is required to assess differences in perceived sino-nasal outcome and HRQoL. Methods: In this single-center observational study, we collected data from 81 patients, operated between August 2016 and August 2021, at a 3–6-month follow-up after adenomectomy. We employed the sino-nasal outcome test for neurosurgery (SNOT-NC) and the HRQoL inventory Short Form (SF)-36 to compare sino-nasal and HRQoL outcome in patients with or without allergies, previous nose surgeries, presence of pain, snoring, sleep apnea, usage of continuous positive airway pressure (cpap), and nose drop usage. Results: At the 3–6-month follow-up, patients with previous nasal surgery showed overall reduced subjective sino-nasal health, increased nasal and ear/head discomfort, increased visual impairment, and decreased psychological HRQoL (all p ≤ 0.026) after pituitary adenomectomy. Patients with pain before surgery showed a trend-level aggravated physical HRQoL (p = 0.084). Conclusion: Our data show that patients with previous nasal surgery have an increased risk of an aggravated sino-nasal and HRQoL outcome after pituitary adenomectomy. These patients should be thoroughly informed about potential consequences to induce realistic patient expectations. Moreover, the study shows that patients with moderately severe allergies, snoring, and sleep apnea (± cpap) usually do not have to expect a worsened sino-nasal health and HRQoL outcome.

Background The Quality of Life after Brain Injury (QOLIBRI) score was developed to assess disease-specific health-related quality of life (HRQoL) after traumatic brain injury (TBI). So far, validation studies on the QOLIBRI were only conducted in cohorts with traumatic brain injury. This study investigated the longer-term residuals in severely injured patients, focusing specifically on the possible impact of major TBI. Methods In a prospective questionnaire investigation, 199 survivors with an injury severity score (ISS) > 15 participated in one-year follow-up. Patients who had sustained major TBI (abbreviated injury scale, AIS head > 2) were compared with patients who had no or only mild TBI (AIS head ≤ 2). Univariate analysis (ANOVA, Cohen’s kappa, Pearson’s r) and stepwise linear regression analysis (B with 95% CI, R, R 2 ) were used. Results The total QOLIBRI revealed no differences in one-year outcomes between patients with versus without major TBI (75 and 76, resp.; p  = 0.68). With regard to the cognitive subscore, the group with major TBI demonstrated significantly more limitations than the one with no or mild TBI ( p  < 0.05). The AIS head correlated significantly with the cognitive dimension of the QOLIBRI ( r  = − 0.16; p  < 0.05), but not with the mental components of the SF-36 or the TOP. In multivariate analysis, the influence of the severity of head injury (AIS head) on total QOLIBRI was weaker than that of injured extremities (R 2  = 0.02; p  < 0.05 vs. R 2  = 0.04; p  = 0.001) and equal to the QOLIBRI cognitive subscore (R 2  = 0.03, p  < 0.01 each). Conclusions Given the unexpected result of similar mean QOLIBRI total score values and only minor differences in cognitive deficits following major trauma independently of whether patients sustained major brain injury or not, further studies should investigate whether the QOLIBRI actually has the discriminative capacity to detect specific residuals of major TBI. In effect, the score appears to indicate mental deficits following different types of severe trauma, which should be evaluated in more detail. Trial registration NCT02165137 ; retrospectively registered 11 June 2014.

Chronic wounds commonly decrease patients' quality of life. Understanding how chronic wounds impact a patient's health‐related quality of life (HRQoL) is important for healthcare service delivery and treatment management. This study explored HRQoL among patients suffering from chronic wounds and investigated associations with patients' socio‐demographics and wound characteristics. Two hundred and thirty‐three patients across six primary care clinics were assessed and responded to a survey that collected information on socio‐demographic, wound characteristics, and HRQoL using the EQ‐5D‐5L instrument. Data were analysed by descriptive statistics and generalised linear models. The mean age of patients was 61.2 (SD: 14.6) years; 68.2% were males; and 61.8% were of Chinese origin. Arterial ulcers had the greatest negative impact on HRQoL related to mobility, self‐care, pain/discomfort and anxiety/depression, and the lowest VAS mean score 62.31 (SD: 28.3; range: 0‐100) indicating the worst health. HRQoL related to mobility was significantly associated with age (β = 0.008, P < .001), non‐Chinese ethnicity (β = 0.25, P = .001), mixed ulcers (β = −0.41, P = .022), atypical hard‐to‐heal wounds (β = −0.38, P = .021), wounds with low (β = 0.24, P = .044) to moderate (β = 0.29, P = .018) exudate level, and a wound duration ≥6 months (β = 0.19, P = .033). The findings can be used to improve healthcare delivery for patients with chronic wound to optimise their HRQoL.

Surgical site infections (SSI) substantially increase costs for healthcare providers because of additional treatments and extended patient recovery. The objective of this study was to assess the cost and health‐related quality of life impact of SSI, from the perspective of a large teaching hospital in England. Data were available for 144 participants undergoing clean or clean‐contaminated vascular surgery. SSI development, length of hospital stay, readmission, and antibiotic use were recorded over a 30‐day period. Patient‐reported EQ‐5D scores were obtained at baseline, day 7 and day 30. Linear regressions were used to control for confounding variables. A mean SSI‐associated length of stay of 9.72 days resulted in an additional cost of £3776 per patient (including a mean antibiotic cost of £532). Adjusting for age, smoking status, and procedure type, SSI was associated with a 92% increase in length of stay (P < 0.001). The adjusted episode cost was £3040. SSI reduced patient utility between baseline and day 30 by 0.156 (P = 0.236). Readmission rates were higher with SSI (P = 0.017), and the rate to return to work within 90 days was lower. Therefore, strategies to reduce the risk of surgical site infection for high‐risk vascular patients should be investigated.

Data on the oral health of the elderly depict a worrying situation, with an elevated prevalence of caries and moderate periodontal disease, frequent edentulism, and numerous cases of dry mouth and oral cancer. There is wide evidence that periodontitis is a risk factor for certain systemic diseases, and impaired oral health has been associated with mastication and nutritional problems, especially among the elderly, with highly negative effects on their quality of life. In this nonsystematic review, the authors discuss the importance of evaluating the oral health of the geriatric population in a comprehensive manner, beyond simple clinical assessments.

To evaluate the association between socioeconomic, psychosocial, and lifestyle factors with Oral Health-Related Quality of Life (OHRQoL) in a sample of adolescent males from Colegio Técnico San Agustín de Cartago - Ciudad de los Niños (St. Augustine’s Technical High School), located in the Cartago Province of Costa Rica. Data for this study were obtained from a descriptive, cross-sectional study conducted in 2019. The sample consisted of 394 adolescent males aged between 12 and 22 years. OHRQoL was assessed using the validated Spanish version of the Oral Health Impact Profile (OHIP-49). The following variables were considered: age, parental education, having a remunerated job, Health-Related Quality of Life (measured via the SF-36 questionnaire), self-esteem (Rosenberg scale), perceived stress (PSS-14), depression (CES-D), physical activity, history of dropping out of school, flossing and tooth-brushing habits, eating snacks between meals, medication intake for illness, having received oral health care instructions, history of dental visits due to pain, frequency of dental visits, history of childhood tooth decay, and access to dental health care during childhood. Qualitative variables were analyzed using the Student's t-test, while Pearson correlation was used for quantitative variables. Multivariable analysis was performed using linear regression. Statistical significance was set at p<0.05 using STATA 14®. Enhanced general health-related quality of life (p<0.01) and early childhood dental attendance (p<0.01) were identified as factors associated with improved OHRQoL. Conversely, having had dental visits for pain (p<0.01), elevated depression symptomatology (p<0.01), and a history of childhood dental cavities (p<0.01) were all associated with worse OHRQoL. This study suggests a link between general and oral health. Experiences during childhood appear to set a standard for adolescence. Lastly, it is crucial to note the significant impact of mental health on the perception of oral health. Evaluar las asociaciones entre la calidad de vida relacionada con la salud general, factores socioeconómicos, psicosociales y de estilo de vida con la Calidad de Vida Relacionada con la Salud Oral (CVRSO) en una muestra de adolescentes varones del Colegio Técnico San Agustín de Cartago - Ciudad de los niños. Para analizar los determinantes de la CVRSO, se utilizaron los datos de un estudio epidemiológico descriptivo transversal de tipo observacional. La edad de los participantes osciló entre los 12 y 22 años y los datos fueron recolectados durante 2019. El indicador de salud utilizado fue la CVRSO, la cual se aproximó mediante el instrumento OHIP-49 (Oral Health Impact Profile). Las variables independientes utilizadas fueron la edad, el SF-36 (cuestionario de calidad de vida relacionada con la salud general), el PSS-14 (Escala de Estrés Percibido), CES-D (Escala de Depresión), la escala de Rosemberg (Escala de Autoestima), escolaridad de los padres, haber tenido un trabajo remunerado, realizar deporte, toma de medicamentos, haber desertado la escuela en algún momento, visitas al odontólogo regularmente, haber visitado al odontólogo por dolor, haber recibido instrucciones de higiene oral, haber tenido caries durante la infancia, acceso a servicios de salud oral durante la infancia, haber recibido tratamiento por dolor dental, uso del hilo dental, la frecuencia de cepillado y consumo de meriendas entre comidas. Para los análisis bivariados se utilizaron las pruebas estadísticas T de Student y la correlación de Pearson. Para los análisis multivariados, se utilizó una regresión lineal ajustando por todas las variables significativas en el análisis bivariado. El umbral de significancia estadística utilizado fue de un 5% (p<0.05). El programa de estadística utilizado fue STATA versión 14®. Una mejor la calidad de vida relacionada con la salud general (p<0,01) y haber visitado los servicios odontológicos durante la infancia (p<0,01) se identificaron como factores que influyen positivamente en la CVRSO. Por el contrario, se observó que haber visitado al dentista por dolor (p<0,01), haber reportado sintomatología de depresión (p<0,01) y antecedentes de caries dentales infantiles (p<0,01), contribuyeron a una peor CVRSO. Este estudio sugiere un vínculo intrínseco entre la salud general y bucal. Las experiencias de salud durante la niñez parecen establecer un estándar para la adolescencia. Por último, es fundamental señalar el impacto significativo de la salud mental en la percepción de la salud bucal.

Background and objectives Motor Neuron Diseases (MND) are rare diseases but have a high impact on affected individuals and society. This study aims to perform an economic evaluation of MND in Germany. Methods Primary patient-reported data were collected including individual impairment, the use of medical and non-medical resources, and self-rated Health-Related Quality of Life (HRQoL). Annual socio-economic costs per year as well as Quality-Adjusted Life Years (QALYs) were calculated. Results 404 patients with a diagnosis of Amyotrophic Lateral Sclerosis (ALS), Spinal Muscular Atrophy (SMA) or Hereditary Spastic Paraplegia (HSP) were enrolled. Total annual costs per patient were estimated at 83,060€ in ALS, 206,856€ in SMA and 27,074€ in HSP. The main cost drivers were informal care (all MND) and disease-modifying treatments (SMA). Self-reported HRQoL was best in patients with HSP (mean EuroQoL Five Dimension Five Level (EQ-5D-5L) index value 0.67) and lowest in SMA patients (mean EQ-5D-5L index value 0.39). QALYs for patients with ALS were estimated to be 1.89 QALYs, 23.08 for patients with HSP and 14.97 for patients with SMA, respectively. Cost-utilities were estimated as follows: 138,960€/QALY for ALS, 525,033€/QALY for SMA, and 49,573€/QALY for HSP. The main predictors of the high cost of illness and low HRQoL were disease progression and loss of individual autonomy. Conclusion As loss of individual autonomy was the main cost predictor, therapeutic and supportive measures to maintain this autonomy may contribute to reducing high personal burden and also long-term costs, e.g., care dependency and absenteeism from work.

Background/Objectives Government guidance promote benchmarking comparing quality of care including both clinical values and patient reported outcome measures in young persons with type 1 diabetes. The aim was to test if the Nordic DISABKIDS health‐related quality of life (HrQoL) modules were construct valid and measurement comparable within the three Nordic countries. Methods Data from three DISABKIDS validation studies in Sweden, Denmark, and Norway were compared using Rasch and the graphical log‐linear Rasch modeling. Monte Carlo methods were used to estimate reliability coefficient and target was defined as the point with the lowest SE of the mean. Self‐report data were available from 99 Danish (8‐18 years), 103 Norwegian (7‐19 years), and 131 Swedish (8‐18 years) young people. Results For the DISABKIDS higher scores on most subscales were noted in the Norwegian population. The Swedish sample had a significantly higher score on the “Diabetes treatment” subscale and scores closer to optimal target than the other countries. For each country, construct validity and sensitivity were acceptable when accounting for differential item function (DIF) and local dependency (LD). Less LD and DIF were found if only Denmark and Norway were included. The combined model was reliable; however, some differences were noted in the scale translations relating to the stem and response alternatives, which could explain the discrepancies. Conclusion The Nordic versions of the DISABKIDS questionnaires measures valid and reliable HrQoL both within and between countries when adjusted for DIF and LD. Adjusting the Likert scales to the same respond categories may improve comparability.

Esophageal adenocarcinoma (EAC) is characterized by 6 striking features: increasing incidence, male predominance, lack of preventive measures, opportunities for early detection, demanding surgical therapy and care, and poor prognosis. Reasons for its rapidly increasing incidence include the rising prevalence of gastroesophageal reflux and obesity, combined with the decreasing prevalence of Helicobacter pylori infection. The strong male predominance remains unexplained, but hormonal influence might play an important role. Future prevention might include the treatment of reflux or obesity or chemoprevention with nonsteroidal antiinflammatory drugs or statins, but no evidence-based preventive measures are currently available. Likely future developments include endoscopic screening of better defined high-risk groups for EAC. Individuals with Barrett esophagus might benefit from surveillance, at least those with dysplasia, but screening and surveillance strategies need careful evaluation to be feasible and cost-effective. The surgery for EAC is more extensive than virtually any other standard procedure, and postoperative survival, health-related quality of life, and nutrition need to be improved (eg, by improved treatment, better decision-making, and more individually tailored follow-up). Promising clinical developments include increased survival after preoperative chemoradiotherapy, the potentially reduced impact on health-related quality of life after minimally invasive surgery, and the new endoscopic therapies for dysplastic Barrett esophagus or early EAC. The overall survival rates are improving slightly, but poor prognosis remains a challenge. [PUBLICATION ABSTRACT]