Factors associated with quality of life and mood in adults with strabismus.

BACKGROUND/AIMS: To explore the factors associated with the mood and quality of life (QoL) of patients with strabismus due to undergo realignment surgery. METHODS: A cross-sectional study was undertaken with adult patients. Along with demographic, clinical and psychosocial process variables, the Hospital Anxiety and Depression Scale and AS-20 QoL measures were administered. Regression models were used to identify the factors associated with QoL and mood. RESULTS: Of the 220 participants, 11% were experiencing clinical levels of depression, and 24% clinical anxiety. This is in line with other forms of facial disfigurement but higher than other chronic diseases. Although mood and QoL were associated with age and diplopia, it was beliefs and cognitions which were more consistently associated with well-being. This included feelings of social anxiety and avoidance, a belief that strabismus has negative consequences, poor understanding of strabismus, social support, fear of negative evaluation and the perceived visibility of their condition. CONCLUSIONS: Psychosocial rather than clinical characteristics were identified as determinants of well-being in this population. It is important for clinicians planning surgery to be aware of these factors which could influence outcomes. Longitudinal studies need to be conducted to explore the direction of causality before interventions to improve well-being are developed and evaluated.

The impact of strabismus on quality of life in adults with and without diplopia: a systematic review.

Strabismus affects approximately 4% of the adult population and can cause substantial physical disturbance and changes to appearance. This article aims to examine the impact of strabismus in adults both with and without diplopia, focusing primarily on quality of life (QoL). We highlight the value of measuring QoL, assess the ways in which it can be measured, and the impact the disease, diplopia, and surgery have on the patient. QoL differs for strabismus patients based on their diplopia status. Patients with diplopia tend to have more concerns relating to functional QoL, whereas patients without diplopia have primarily psychosocial concerns. Two diplopia-specific questionnaires have been designed to assess QoL and the perceived severity of symptoms. Further research is needed to identify the variables which influence QoL so that appropriate support can be given to all patients with strabismus to improve their QoL.

Metabolic risk varies according to waist circumference measurement site in overweight boys and girls.

OBJECTIVES: To compare waist circumference (WC) values measured at 4 commonly recommended sites and examine the relationships between WC sites and markers of metabolic risk in a sample of overweight boys and girls referred for weight management. STUDY DESIGN: Overweight (mean body mass index percentile, 98.7; SD, 1.0) children and adolescents (n = 73; 41 girls, 32 boys; mean age, 12.5 years; SD, 2.6 years) had WC measured at 4 sites: iliac crest (WC1), narrowest waist (WC2), midpoint between the floating rib and iliac crest (WC3), and umbilicus (WC4). Height, weight, fasting insulin level, glucose level, cholesterol level, and systolic and diastolic blood pressure were also measured. RESULTS: Overall, WC1 (108.5 cm; SD, 16.3 cm) was greater than WC2 (97.4 cm; SD, 13.6 cm; P < .003), and WC2 was smaller than WC3 (104.3 cm; SD, 15.3 cm; P = .02) and WC4 (108.7 cm; SD, 16.2 cm; P < .0003). With logistic regression, WC2 and WC3 were revealed to be more consistently associated with metabolic syndrome by using 3 different definitions. CONCLUSION: In our sample, we observed differences in 4 commonly recommended WC measurement sites and found that all sites were not equivalently associated with metabolic risk. Our findings provide preliminary support suggesting that WC measured at the narrowest waist and midpoint between the floating rib and iliac crest may represent the measurement sites most closely associated with metabolic risk in overweight boys and girls.

Overweight children and adolescents referred for weight management: are they meeting lifestyle behaviour recommendations?

Adopting and maintaining healthy lifestyle behaviours can help overweight boys and girls manage their weight and reduce obesity-related health risks. However, we currently know very little about the lifestyle habits of overweight children and adolescents referred for weight management in Canada and whether or not they are meeting current lifestyle recommendations. The objectives of this study were (i) to determine the demographic characteristics and lifestyle behaviours of overweight children and adolescents referred for clinical weight management, and (ii) to examine sex (boys vs. girls) and (or) age (child vs. youth) differences with respect to the achievement of lifestyle behaviour recommendations. Overweight (age- and sex-specific body mass index > or = 85th percentile) children (n = 27 girls, n = 24 boys) and adolescents (n = 29 girls, n = 19 boys) were referred to and enrolled in weight-management programs at the Pediatric Centre for Weight and Health (PCWH) at the Stollery Children's Hospital (Edmonton, Alta.) from January 2006-September 2007. Information was collected at intake regarding demography, anthropometry, and lifestyle behaviours before participants started a formal weight-management program. Lifestyle behaviour recommendations for nutrition, physical activity, screen time, and sleep were used to determine whether participants were meeting established guidelines. Overall, participants presented with poor lifestyle behaviours. Although most consumed adequate servings of grain products (93.9%) and meat and alternatives (68.7%), few met the serving recommendations for milk and alternatives (31.3%) or vegetables and fruit (14.1%). Physical activity levels were low - 7.4% and 4.1% achieved the recommended time and steps per day goals, respectively. Approximately 1/4 (22.7%) met the screen time recommendation, whereas fewer than 1/2 (47.4%) achieved the nightly sleep duration goal. Sex and age-group comparisons revealed subtle, but potentially important, differences in lifestyle behaviours that have implications for pediatric weight management. This study highlights the sub-optimal lifestyle behaviours of overweight children and adolescents referred for weight management. Intervention studies are needed to determine whether overweight boys and girls who achieve the lifestyle behaviour targets included in this study are able to successfully manage their weight and (or) reduce obesity-related health risks.