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Strength-based approaches are increasingly common in neurodevelopmental research, but the positive characteristics that may be features of attention-deficit/hyperactivity disorder (ADHD) remain underexplored. The extent to which people with ADHD recognize and use their personal strengths, and whether these play a role in their life outcomes, is also unknown. Tackling these gaps in the literature, we conducted the first study of self-reported strengths, strengths knowledge, and strengths use in ADHD.
Methods
Adults with (n = 200) and without (n = 200) ADHD were recruited online and rated their endorsement of 25 putative ADHD-related strengths. Participants also completed self-report measures assessing strengths knowledge, strengths use, subjective wellbeing, quality of life, and mental health. Using both Frequentist and Bayesian methods, we compared the groups and explored the associations of strengths knowledge and use with outcomes across both groups.
Results
The ADHD group endorsed 10 strengths more strongly than the non-ADHD group, including hyperfocus, humor, and creativity, but reported similar endorsement for 14 of the strengths. Adults with and without ADHD did not differ on their strengths knowledge and use but, in both groups, increased strengths knowledge and, to some extent, greater strengths use were associated with better wellbeing, improved quality of life, and fewer mental health symptoms.
Conclusions
We conclude that, while adults with and without ADHD may have both similarities and differences in strengths, interventions that focus on enhancing people’s strength knowledge and promoting the everyday use of their personal strengths could have universal applications to improve wellbeing in adulthood.
Food refusal behaviors in preschool children can significantly impact their nutritional status and overall quality of life. This study investigated the relationship between food refusal behaviors, compliance with the Mediterranean Diet, and quality of life in preschool children. Conducted as a cross-sectional study, it included 400 children aged 4–6 and their parents. The Child Food Rejection Scale measured food refusal behaviors, KIDMED assessed compliance with the Mediterranean Diet, and the Kiddy-KINDL scale evaluated quality of life. The mean age of the children was 4.80±0.71 years. According to age-based Body Mass Index-Z scores, 71.0% were normal, 15.5% underweight, 9.0% slightly overweight, and 4.5% obese. Parents’ average age was 34.65±5.35 years; 96.8% were married, 88.8% had a nuclear family structure, 58.0% were university graduates, and 69.8% rated their income level as moderate. Girls had higher food refusal scores than boys(p<0.05). Children who frequently fell ill also scored higher in food refusal(p<0.05). Food refusal decreased with higher family income, larger family size, and older parental age(p<0.05). Parental nutrition education significantly reduced food refusal scores(p<0.05). Higher KIDMED scores were associated with lower food refusal(p<0.01), and children with low Kiddy-KINDL scores exhibited higher food refusal behaviors(p<0.01). A positive correlation was found between KIDMED and Kiddy-KINDL scores(p<0.01). No significant associations were detected between BMI Z scores and food rejection and its subscales. The findings suggest that compliance with the Mediterranean Diet reduces food refusal behaviors in preschool children and increases quality of life, while low quality of life is associated with increased food refusal behaviors.
Family caregivers (FCGs) may experience numerous psychosocial and practical challenges with interpersonal relationships, mental health, and finances both before and after their care recipient (CR) dies. The specific challenges affecting rural FCGs who often have limited access to palliative care services, transitional care, and other community resources are not well understood. The purpose of this paper is to quantify the challenges rural FCGs experienced immediately before the death of a CR and continuing into the bereavement period.
Methods
A secondary analysis of data from a randomized controlled trial was conducted. The 8-week intervention included video visits between a palliative care research nurse and FCGs caring for someone with a life-limiting illness. Data were from structured interviews during nurse visits with FCGs in the intervention arm whose CR died during the intervention period.
Results
Ninety (41.8%) of the 215 FCGs experienced the death of their CR. The majority of FCGs were female (58.9%), White (97.5%), spouses or partners (55.6%) and lived with the CR (66.7%). Most FCGs (84%) continued with intervention visits by the study nurse after the CR’s death. Visits resumed on average 7.2 days post-death. The majority of FCGs experienced challenges with grief/coping skills (56%) and interpersonal relationships/support systems (52%) both pre- and post-death of the CR. FCGs also experienced practical challenges with income/finance, housing, and communication with community resources both pre-and post-death.
Significance of results
Bereavement support should extend beyond a focus on grief to include practical challenges experienced by FCGs. Because challenges experienced in the bereavement period often begin before a CR’s death, there is benefit in continuity of FCG support provided by a known clinician from pre- to post-death. When given an option, many rural FCGs are open to bereavement support as early as a week after the death of a CR.
Benzodiazepines (BZ) are widely prescribed to patients with severe mental illnesses, yet their long-term impact on global health remains underinvestigated. While their symptomatic benefits are acknowledged, data on their associations with quality of life (QoL), metabolic comorbidities, and side effects are limited.
Methods
In this cross-sectional study, we analyzed clinical data from 1,248 patients with schizophrenia, bipolar disorder (BD), or major depressive disorder at a psychiatric center in Marseille, France. Associations between BZ use and key outcomes – including QoL (Short Form Health Survey [SF-36], EuroQol-5 Dimensions [EQ-5D], and Schizophrenia Quality of Life Questionnaire - 18 items [SQoL-18]), metabolic parameters, and treatment side effects (Udvalg for Kliniske Undersøgelser Side Effect Rating Scale [UKU scale]) – were examined using multivariate regression analyses.
Results
BZ use was significantly associated with lower QoL scores on physical and mental health domains of the SF-36 (p < 0.001), increased impairment across EQ-5D dimensions, and reduced subjective well-being (SQoL-18, p = 0.043). BZ users also presented higher rates of obesity, diabetes, and metabolic syndrome (all p < 0.05). Furthermore, BZ use was independently associated with a higher burden of side effects across UKU subscales, particularly in the psychiatric domain (emotional blunting, anxiety, and depressive symptoms; p = 0.003).
Conclusion
These findings suggest that BZ use in severe psychiatric disorders may be linked to a substantial multidimensional health burden, including reduced QoL, greater side effect profile, and increased metabolic risk. These results highlight the need for evaluation of long-term BZ use and the promotion of safer alternative treatments.
Constipation is a significant problem for people with intellectual disabilities, with a prevalence of 33–50%, causing at least five deaths annually in England. Individualised bowel care plans (IBCP) are recommended in England and Wales.
Aims
We evaluated the feasibility and impact of IBCPs for people with intellectual disabilities who are in in-patient psychiatric units, and the effect on clinical outcomes.
Method
People with intellectual disabilities who were at risk of constipation were recruited from four specialist in-patient psychiatric units in England and Wales. A constipation questionnaire was used to capture relevant data to devise IBCPs. Baseline, 3- and 6-monthly Health of the Nation Scales – Learning Disability (HoNOS-LD) were completed after the intervention. Descriptive statistics, Wilcoxon signed-rank, Mann-Whitney U, repeated-measures analyses of variance, with Bonferroni adjustment and Mauchly’s tests were conducted. Significance was taken at P < 0.05.
Results
Of 24 people with intellectual disabilities recruited from four units, all three data points were available for 18 patients. Constipation rates showed no statistically significant decline. The total HoNOS-LD score (18 items) did not decline. HoNOS-LD item 12 for physical functioning showed significant improvement for PwID with constipation compared with those without, between baseline and 6 months.
Conclusions
This quality improvement project suggests that a bigger study of IBCPs is feasible. Most outcomes examined via the HoNOS-LD, particularly those linked with mental illness, challenging behaviour and quality of life, did not show significant change, possibly because of the small sample size. However, people with intellectual disabilities and constipation showed positive changes in their physical functioning outcomes compared with those without constipation. Further in-depth evaluation of this intervention is needed.
To evaluate early postoperative complaints using the Palate postoperative Problems Score in patients undergoing modified barbed reposition pharyngoplasty with tonsillectomy and tonsillectomy alone.
Methods
The study included 40 patients who underwent modified barbed reposition pharyngoplasty with tonsillectomy and 18 patients who had tonsillectomy alone. Patients completed the Palate Postoperative Problems Score questionnaire at the first, third and sixth months post-operatively, and changes in their complaints were observed. Additional data included the Epworth Sleepiness Scale and sleep parameters (apnea-hypopnea Index, body mass index and oxygen saturation).
Results
In the modified barbed reposition pharyngoplasty group, Palate Postoperative Problems Scores decreased significantly from 8.85 (month 1) to 4.07 (month 6). The tonsillectomy group also showed significant improvement (from 5.28 to 2.61 by month 3).
Conclusion
The Palate Postoperative Problems Score questionnaire is an effective tool for assessing post-operative symptoms after palate surgery. Repeated use enables monitoring of patient recovery and the impact of tonsillectomy should be considered in Palate Postoperative Problems Score-based evaluations.
Efficacy of gastric inlet patch (GIP) ablation using argon plasma coagulation (APC) for patients presenting with persistent throat symptoms was evaluated.
Methods
Retrospective observational study from a single university hospital. Consecutive patients who had GIP ablation for persistent throat symptoms between 01/10/2018-31/10/2023 were reviewed and patients who met all of the set inclusion and exclusion criteria were included in this study for analysis.
Results
50% (n = 18/36) of patients responded to APC ablation (median follow-up 3 months) with their post-ablation GETS score decreasing by 30-100%. Long-term follow-up results could be obtained from 22 patients (n = 22/36) and 75% (n = 9/12) had their clinical effects maintained (median follow-up 4.5 years; range 2.7–5.8 years).
Conclusion
GIP ablation can be a very effective treatment for patients with persistent throat symptoms with its therapeutic effects long-lasting. Future studies should focus on evaluating the optimal patient selection process for GIP ablation for persistent throat symptoms.
Expressive writing interventions (EWIs) are associated with important psychological and physical outcomes in patients with cancer. However, EWIs have not been widely integrated into routine psychosocial care of cancer populations. A review of the current literature on EWIs’ impact on the cancer patient experience, including qualitative analyses of patient perspectives, will increase our understanding of barriers and facilitators to adoption in clinical settings.
Objectives
To bridge existing gaps in the literature by examining quantitative and qualitative studies on EWIs for patients with cancer. To present recent data examining the benefits of EWI’s for patients with cancer.To provide strategies for clinicians engaging in EWI’s for their patients.
Methods
Informed by the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines, we completed a scoping review of relevant quantitative and qualitative articles published from 2015 to 2025 to assess the impact of EWIs on health-related outcomes (e.g., physical symptoms and quality of life [QOL]) as well as approaches to improve their use in patients with cancer.
Results
Of the 28 studies with 3527 patients that we analyzed, 24 were quantitative and 4 were qualitative. Most studies were conducted in the USA (42.8%) or China (28.6%) and included patients with breast cancer (71.4%) or only included women (71.4%). Of the patients in the studies, 46.8% identified as White, 42.8% as Asian, 5.5% as Black, and 4.5% as Latino. Twenty-one of the quantitative studies found that EWIs were positively associated with cancer patients’ QOL and/or physical health outcomes. Of the 4 qualitative studies, themes of narrative reconstruction, cultural disclosure norms, and intervention delivery format emerged. The characteristics of EWI methods can be tailored to maximize therapeutic benefits through cultural adaptation, timing, and privacy.
Significance of results
Despite promising associations between EWIs and health-related outcomes in patients with cancer, EWIs for cancer populations are heterogeneous and randomized clinical trials are limited. Larger trials that establish the efficacy of EWIs in diverse cancer populations are warranted.
Despite consensus that quality of life (QoL) in later adulthood is multi-dimensional, scholars’ perceptions of the dimensions the construct comprises differ. Under the premise that models and measures of QoL should correspond with lay perspectives to have relevance to the targeted population, we investigated the constituents of QoL in later adulthood as perceived by middle-aged and older laypersons. We fielded a factorial design vignette experiment among 2,544 respondents aged 50+ participating in the Dutch Longitudinal Internet studies for the Social Sciences panel to assess how 11 dimensions identified from four established QoL instruments designed for older people (WHOQOL-OLD, CASP-19, OPQOL, ICECAP-O) influence QoL evaluations. The study extends prior work on lay perspectives on QoL by combining the internal validity of an experiment with the external validity of a true population sample. All dimensions considered significantly impacted the QoL ratings in the expected direction. Enjoyment and social participation had a significantly larger contribution than the other dimensions. Models stratified by age group showed a strong degree of similarity, suggesting a high level of consensus across age groups about the constituents of QoL in later adulthood. The study highlights the necessity of capturing a broad range of dimensions when conceptualizing QoL in later adulthood. Our finding that dimensions that were omitted in selected established instruments still contributed substantially to QoL evaluations arguably implies that these instruments may have suboptimal content validity. The insights gained from this study are important for developing and evaluating policies aimed at improving QoL for the ageing population.
As cancer incidence and survival rates rise, caregivers responsible for providing diverse support face increased burden and reduced quality of life (QoL). Although research on web-based interventions for this group is expanding, the impact of these interventions on caregiver burden and QoL remains unclear. This study aims to investigate the effects of web-based interventions on the caregiver burden and QoL of caregivers of patients with cancer.
Methods
Searches were conducted in PubMed, Web of Science, Cochrane Library, CINAHL, Embase, and PsycINFO from database inception to 10 June 2024. Two reviewers independently assessed each study and extracted data. The risk-of-bias in the studies was evaluated using Cochrane’s Risk-of-Bias tool for randomized controlled trials. The intervention effects were calculated using R package Meta version 4.0.3, utilizing standardized mean differences (SMD; Hedge’s ĝ) to calculate pooled effect sizes with 95% confidence intervals (CI). Publication bias assessment and sensitivity analysis were conducted to ensure the robustness of the results.
Results
We reviewed 13 randomized controlled trials; our analysis indicated a small effect size of web-based interventions on caregiver burden (SMD = −0.19, 95% CI: −0.36 to −0.01). However, sensitivity analysis concluded that the effect was very small or nearly absent. Additionally, there was no statistically significant effect on QoL (SMD = 0.15, 95% CI: −0.05 to 0.36).
Significance of results
Web-based interventions did not significantly reduce caregiver burden or improve caregivers’ QoL. To improve caregiver burden and QoL in the future, comprehensive and tailored web-based interventions for this population are needed.
In individuals with irritable bowel syndrome (IBS), eliminating dietary triggers can alleviate symptoms but may lead to nutrient deficiencies and overall health decline. Although various nutritional supplements show promising results in relieving IBS symptoms due to their potential to alter the microbiome, conclusive scientific evidence remains lacking. This exploratory study aims to assess the bifidogenic properties of four nutritional supplement interventions and their impact on IBS-symptoms, faecal microbiota composition, faecal short-chain fatty acid (SCFA) concentrations, stool pattern, and quality of life (QoL), compared to a placebo control. Seventy subjects with IBS, meeting the ROME IV criteria, participated in this randomised, double-blind, placebo-controlled parallel intervention study. Subjects were assigned to one of the four treatment groups, receiving either resistant starch, pea fibre, chondroitin sulfate, protein hydrolysate, or placebo daily for four weeks. Daily reports on stool pattern and gastrointestinal complaints were collected. Stool samples and questionnaires on dietary intake, symptom severity, QoL, and anxiety and depression were collected at baseline and after the 4-week intervention. The results show no significant increase in Bifidobacterium abundance or faecal SCFA levels after the 4-week intervention with any of the four nutritional supplement interventions. While some improvements in symptom severity and QoL were observed within-groups, these were not significantly different from changes observed with placebo. In conclusion, the tested nutritional supplements did not increase Bifidobacterium abundance in subjects with IBS within four weeks. Furthermore, we conclude that future studies should consider a run-in period and a larger sample size to study improvements in IBS symptoms.
Previous meta-analysis of the efficacy of mobile phone applications (mHealth apps) for depression has several limitations, including high risk of bias and heterogeneity in effect sizes across studies, and gaps in understanding of variability in treatment outcomes. We aimed to provide more reliable and clinically relevant findings by conducting a systematic literature search on PubMed, Embase and PsycInfo, focusing on newer studies with minimal risk of bias.
Results
Analysing 17 randomised controlled trials (n = 2821) published between 2020 and 2025, we found a pooled standardised mean difference (s.m.d.) of –0.46 (95% CI –0.64 to –0.28; P < 0.001) relative to the control groups, which indicates a significant reduction in depressive symptoms. Subgroup analyses confirmed efficacy in both adolescents (s.m.d. = –0.42) and adults (s.m.d. = –0.49). Despite evidence of publication bias, 70% of the studies had a low risk of bias, supporting the robustness and reliability of these findings.
Clinical implications
The results underscore the clinical relevance of mHealth apps as scalable and accessible tools for bridging gaps in mental healthcare. Their effectiveness across age groups highlights their potential for broad implementation, with future research needed to refine personalisation, engagement strategies and methodological rigour.
Public health emergencies make an impact on policing in many ways, create unique challenges for police departments and affect the quality of life of police officers. These impacts include response, enforcement, preparedness, and inter- and intra-organizational dynamics. While there is much research on policing the pandemic in the Global North, similar scholarship emanating from the Caribbean is limited. With this lacuna in mind, the views of 32 members of the Trinidad and Tobago Police Service were collected via semi-structured interviews at the back end of the COVID-19 pandemic and used to answer four research questions. The results indicate a host of impacts on policing, police leadership and police officer quality of life as a result of the COVID-19-facilitated pandemic. The current study adds to the limited scholarship on policing during the pandemic and offers guidance on policing practice to ensure police officer safety and preparation for future health pandemics.
Since the first device for mechanical emergency ventilation was introduced in 1907, there have been substantial changes with regard to technical advances on the one hand and indications and outcome targets on the other. The rationale for implementation of mechanical ventilation has gradually been amended. Initially, the primary goal was to merely safeguard survival in emergency cases; in recent years, the goal of long-term ventilation with primary outcome of survival has been gradually shifted to patient’s quality of life, especially where ventilation may last for months, years or even decades. For long-term ventilation, the impact on patient’s quality of life may be diverse and a fine-tuned discussion on pros and cons may be primarily driven by the question of securing quality of life under mechanical ventilation. In general, doctors and families underestimate the patients’ quality of life. In neurology in industrialized countries, ventilation is regarded a standard therapy for progressive neurodegenerative diseases, such as amyotrophic lateral sclerosis and spinal muscular atrophy, and neuromuscular diseases, for instance, Duchenne muscular dystrophy. This chapter reviews our current understanding of quality of life under long-term mechanical ventilation and discusses controversies.
The present study examines the quality of life (QoL) of transgender and gender-diverse individuals receiving versus not receiving gender-affirming hormone therapy (GAHT) in those assigned male at birth (AMAB) and assigned female at birth (AFAB). It also explores the relationship between QoL and concentrations of oestradiol and testosterone.
Methods:
This cross-sectional study used the WHOQOL-BREF questionnaire to assess QoL. Participants were categorised into four groups based on assigned sex at birth (AMAB or AFAB) and GAHT status, with non-GAHT participants serving as controls. MANOVA and t-tests were used to compare QoL between groups, and linear regression analyses examined associations between QoL and oestradiol/testosterone concentrations in AMAB and AFAB participants.
Results:
The study included 360 participants: 169 AMAB (143 receiving GAHT and 26 controls) and 191 AFAB (141 receiving GAHT and 50 controls). GAHT recipients had significantly higher QoL than controls in both AMAB (p < 0.01) and AFAB (p = 0.02) groups, particularly in the psychological health domain (D2). AFAB participants reported higher overall QoL than AMAB in both GAHT (p = 0.01) and control (p = 0.04) groups, with significance in the social relationship domain among GAHT participants. No significant relationship was found between oestradiol concentrations and QoL for participants AMAB. However, a significant relationship between testosterone concentrations and QoL was observed only in the social relationship domain (D3) for participant AFAB.
Conclusion:
This study highlights the benefits of GAHT for QoL and differences in QoL between individuals AMAB and AFAB.
Radiotherapy is a critical component of head and neck cancer (HNC) management that requires reliable patient immobilization. Using thermoplastic masks helps to ensure reproducible patient positioning during radiotherapy, thus reducing the risk of a geographical miss. However, the use of these masks can also induce anxiety and distress, which can negatively impact treatment adherence and quality of life outcomes.
Methods:
The research was a quantitative cross-sectional study that determined the prevalence and severity of thermoplastic mask-induced anxiety and assessed the scope of coping mechanisms used by HNC patients. Data were collected using a structured questionnaire from recruited participants and analysed with the Statistical Package for Social Sciences software, version 26·0. Relevant clinical and treatment-related data were retrieved from patients’ hospital-based medical records. Descriptive and inferential statistical analyses such as chi-square tests and likelihood ratios were conducted, with p-values < 0·05 considered statistically significant.
Results:
In all, there were 145 HNC patients with a male to female ratio of 1·9:1 and a median age of 52·8 years (IQR 20·7), ranging from 18 to 82 years. There was a high prevalence of thermoplastic mask-induced anxiety both during mask moulding (93·8%) and radiation therapy sessions (94·5%). Most participants (95·2%) adopted coping mechanisms including distraction (58%) and visualization techniques (46%).
Conclusions:
Even though there was a high level of awareness and utilization of coping mechanisms, the high prevalence of thermoplastic mask-induced anxiety highlights a critical aspect of HNC patient care that may be overlooked in resource-limited settings.