A Novel Approach to Assess Balneotherapy Effects on Musculoskeletal Diseases-An Open Interventional Trial Combining Physiological Indicators, Biomarkers, and Patients' Health Perception.

The present study aimed to evaluate whether a 14-day period of balneotherapy influences the inflammatory status, health-related quality of life (QoL) and quality of sleep, underlying overall health state, and clinically relevant benefits of patients with musculoskeletal diseases (MD). The health-related QoL was evaluated using the following instruments: 5Q-5D-5L, EQ-VAS, EUROHIS-QOL, B-IPQ, and HAQ-DI. The quality of sleep was evaluated by a BaSIQS instrument. Circulating levels of IL-6 and C-reactive protein (CRP) were measured by ELISA and chemiluminescent microparticle immunoassay, respectively. The smartband, Xiaomi MI Band 4, was used for real-time sensing of physical activity and sleep quality. MD patients improved the health-related QoL measured by 5Q-5D-5L (p < 0.001), EQ-VAS (p < 0.001), EUROHIS-QOL (p = 0.017), B-IPQ (p < 0.001), and HAQ-DI (p = 0.019) after balneotherapy; the sleep quality was also improved (BaSIQS, p = 0.019). Serum concentrations of IL-6 were markedly decreased after the 14-day balneotherapy (p < 0.001). No statistically significant differences were observed regarding the physical activity and sleep quality data recorded by the smartband. Balneotherapy may be an effective alternative treatment in managing the health status of MD patients, with a decrease in inflammatory states, along with positive effects on pain reduction, patient's functionality, QoL, quality of sleep, and disability perception status.

Qualidade de vida em idosos não institucionalizados / Quality of life of non-institutionalized older people / Calidad de vida en ancianos no institucionalizados

Resumo Enquadramento: A perceção dos idosos acerca da sua qualidade de vida (QdV) é decorrente de uma multiplicidade de fatores, podendo ser avaliada através de escalas genéricas e/ou específicas. Objetivos: Avaliar a QdV de uma amostra de idosos não institucionalizados e analisar a sua relação com variáveis sociodemográficas e clínicas. Metodologia: Estudo descritivo-correlacional, transversal, de cariz quantitativo. Obteve-se uma amostra de 250 idosos. Aplicou-se um instrumento de recolha de dados que integrava duas escalas que avaliavam a QdV, uma genérica (EUROHIS-QOL-8) e outra específica para a população idosa (WHOQOL-OLD). Resultados: Ambas as escalas, numa classificação 0-100, revelaram, para o global, um índice médio de QdV acima do ponto médio (67,19 ±17,95 na EUROHIS-QOL-8 e 67,49±15,46 na WHOQOL-OLD). Revelaram ainda diferenças estatisticamente significativas da perceção da QdV com o sexo, escolaridade e estado civil. A WHOQOL-OLD não revelou a existência de diferenças estatisticamente significativas em função da variável "presença ou não de patologias", contrariamente à EUROHIS-QOL-8. Conclusão: A perceção da QdV dos idosos estava associada às variáveis: sexo, escolaridade e estado civil.

Abstract Background: Older people's perceived quality of life (QoL) is based on several factors and can be assessed through generic and/or specific scales. Objectives: To assess the QoL of a sample of non-institutionalized older people and analyze its association with sociodemographic and clinical variables. Methodology: A descriptive-correlational, cross-sectional, quantitative study was conducted with a sample of 250 older people. Data were collected using two scales for assessing QoL: one generic (EUROHIS-QOL-8) and another specific for older people (WHOQOL-OLD). Results: On a scale from 0 to 100, a mean QoL index above the midpoint was found for the total scales (67.19 +/- 17.95 in EUROHIS-QOL-8 and 67.49+/- 15.46 in WHOQOL-OLD). Statistically significant differences were found between perceived QoL and gender, education level, and marital status. Unlike the EUROHIS-QOL-8, no statistically significant differences were found in the WHOQOL-OLD for the variable "presence of a disease". Conclusion: Older people's perceived QoL was associated with the variables of gender, education level, and marital status.

Resumen Marco contextual: La percepción de los ancianos sobre su calidad de vida (QdV) es el resultado de una multiplicidad de factores y puede ser evaluada a través de escalas genéricas y/o específicas. Objetivos: Evaluar la QdV de una muestra de ancianos no institucionalizados y analizar su relación con variables sociodemográficas y clínicas. Metodología: Estudio descriptivo-correlacional, transversal y cuantitativo. Se obtuvo una muestra de 250 ancianos. Se aplicó un instrumento de recogida de datos que incluía dos escalas que evaluaban la calidad de vida, una genérica (EUROHIS-QOL-8) y otra específica para la población anciana (WHOQOL-OLD). Resultados: Ambas escalas, en una clasificación de 0 a 100, mostraron, para el total, un índice de QdV medio por encima del punto medio (67,19±17,95 en la EUROHIS-QOL-8 y 67,49±15,46 en la WHOQOL-OLD). También mostraron diferencias estadísticamente significativas en la percepción de la QdV según el sexo, la escolaridad y el estado civil. La WHOQOL-OLD no mostró la existencia de diferencias estadísticamente significativas en función de la variable "presencia o ausencia de patologías", al contrario que la EUROHIS-QOL-8. Conclusión: La percepción de la QdV de los ancianos se asoció con las siguientes variables: sexo, escolaridad y estado civil.

Real GDP growth rates and healthcare spending - comparison between the G7 and the EM7 countries.

BACKGROUND: Accelerated globalisation has substantially contributed to the rise of emerging markets worldwide. The G7 and Emerging Markets Seven (EM7) behaved in significantly different macroeconomic ways before, during, and after the 2008 Global Crisis. Average real GDP growth rates remained substantially higher among the EM7, while unemployment rates changed their patterns after the crisis. Since 2017, however, approximately one half of the worldwide economic growth is attributable to the EM7, and only a quarter to the G7. This paper aims to analyse the association between the health spending and real GDP growth in the G7 and the EM7 countries. RESULTS: In terms of GDP growth, the EM7 exhibited a higher degree of resilience during the 2008 crisis, compared to the G7. Unemployment in the G7 nations was rising significantly, compared to pre-recession levels, but, in the EM7, it remained traditionally high. In the G7, the austerity (measured as a percentage of GDP) significantly decreased the public health expenditure, even more so than in the EM7. Out-of-pocket health expenditure grew at a far more concerning pace in the EM7 compared to the G7 during the crisis, exposing the vulnerability of households living close to the poverty line. Regression analysis demonstrated that, in the G7, real GDP growth had a positive impact on out-of-pocket expenditure, measured as a percentage of current health expenditure, expressed as a percentage of GDP (CHE). In the EM7, it negatively affected CHE, CHE per capita, and out-of-pocket expenditure per capita. CONCLUSION: The EM7 countries demonstrated stronger endurance, withstanding the consequences of the crisis as compared to the G7 economies. Evidence of this was most visible in real growth and unemployment rates, before, during and after the crisis. It influenced health spending patterns in both groups, although they tended to diverge instead of converge in several important areas.

Underlying Differences in Health Spending Within the World Health Organisation Europe Region-Comparing EU15, EU Post-2004, CIS, EU Candidate, and CARINFONET Countries.

This study examined the differences in health spending within the World Health Organization (WHO) Europe region by comparing the EU15, the EU post-2004, CIS, EU Candidate and CARINFONET countries. The WHO European Region (53 countries) has been divided into the following sub-groups: EU15, EU post-2004, CIS, EU Candidate countries and CARINFONET countries. The study period, based on the availability of WHO Global Health expenditure data, was 1995 to 2014. EU15 countries have exhibited the strongest growth in total health spending both in nominal and purchasing power parity terms. The dynamics of CIS members' private sector expenditure growth as a percentage of GDP change has exceeded that of other groups. Private sector expenditure on health as a percentage of total government expenditure, has steadily the highest percentage point share among CARINFONET countries. Furthermore, private households' out-of-pocket payments on health as a percentage of total health expenditure, has been dominated by Central Asian republics for most of the period, although, for the period 2010 to 2014, the latter have tended to converge with those of CIS countries. Western EU15 nations have shown a serious growth of health expenditure far exceeding their pace of real economic growth in the long run. There is concerning growth of private health spending among the CIS and CARINFONET nations. It reflects growing citizen vulnerability in terms of questionable affordability of healthcare. Health care investment capability has grown most substantially in the Russian Federation, Turkey and Poland being the classical examples of emerging markets.