Influencia de la capacidad manipulativa en la calidad de vida y actividades de la vida diaria en la esclerosis múltiple / Influence of manipulative skills on quality of life and activities of daily living in multiple sclerosis

Introducción: Más de un 50% de los pacientes diagnosticados con esclerosis múltiple (EM) comunican problemas con la función manipulativa e impedimentos en su vida diaria a causa de esta alteración. Por ello, el objetivo del presente estudio es determinar la afectación que la fuerza de pinza, la fuerza de presa y la destreza manipulativa ejercen sobre la calidad de vida y la autonomía personal de las personas diagnosticadas de EM, y estudiar si existe diferencia de estos aspectos entre los distintos tipos de esta enfermedad. Sujetos y métodos: Se contó con una muestra total de 126 participantes, de los cuales 57 fueron controles, y 69, casos. A todos ellos se les evaluó con el Multiple Sclerosis Quality of Life-54, el Nine-Hole Peg Test, la dinamometría de pinza y de presa para la medición de la fuerza, y el índice de Barthel para la evaluación de las actividades básicas de la vida diaria. Resultados: Las personas con EM presentaron peores fuerza de pinza, fuerza de presa, destreza manipulativa, desempeño en actividades básicas de la vida diaria y calidad de vida (p < 0,001). La fuerza de presa es un factor condicionante en el desempeño de actividades básicas y calidad de vida en personas con EM. En cuanto al tipo de EM, el tipo remitente-recurrente presentó mejores valores (p < 0,001).Conclusiones: Los hallazgos de este estudio apuntan a que los pacientes diagnosticados con EM presentan una disminución en la fuerza de pinza, la fuerza de presa, la destreza manipulativa, la calidad de vida y la autonomía en las actividades de la vida diaria en comparación con la población sana.(AU)

Introduction: More than 50% of patients diagnosed with multiple sclerosis report problems with manipulative function and impairments in their daily lives due to this disorder. Therefore, the aim of the present study is to determine how pinch strength, prey strength and manipulative dexterity affect the quality of life and personal autonomy of people diagnosed with multiple sclerosis and to study whether there is a difference in these aspects between different types of multiple sclerosis.Subjects and methods: There was a total sample of 126 participants, of which 57 were controls and 69 cases. All of them were assessed with a Multiple Sclerosis Quality of Life-54 test, Nine-Hole Peg Test and Barthel Index.Results: People with multiple sclerosis have worse pinch strength, prey strenght, manipulative dexterity, performance in basic activities of daily living and quality of life (p < 0.001). Prey strength is a conditioning factor for performance and quality of life in people with multiple sclerosis. As for the type of multiple sclerosis, relapsing-remitting multiple sclerosis presented better values (p < 0.001).Conclusions: The findings of this study point to the fact that patients diagnosed with multiple sclerosis have a decrease in prey strength, pinch strength, manipulative dexterity, quality of life and autonomy in activities of daily living compared to the healthy population.(AU)

Predicting successful ageing among older adults seems possible even as far as two decades ahead.

BACKGROUND: Successful ageing is the term often used for depicting exceptional ageing and can be measured with multidimensional models including physical, psychological and social wellbeing. The aim of this study was to test multidimensional successful ageing models to investigate whether these models can predict successful ageing, and which individual subcomponents included in the models are most significantly associated with successful ageing. METHODS: Successful ageing was defined as the ability to live at home without daily care at the age of 84 years or over. Data on the participants' physical, psychological and social wellbeing were gathered at baseline and the follow-up period was 20 years. Four successful ageing models were constructed. Backward stepwise logistic regression analysis was used to identify the individual subcomponents of the models which best predicted successful ageing. RESULTS: All successful ageing models were able to predict ageing successfully after the 20-year follow-up period. After the backward stepwise logistic regression analysis, three individual subcomponents of four models remained statistically significant and were included in the new model: having no heart disease, having good self-rated health and feeling useful. As a model, using only these three subcomponents, the association with successful ageing was similar to using the full models. CONCLUSIONS: Multidimensional successful ageing models were able to predict successful ageing after a 20-year follow-up period. However, according to the backward stepwise logistic regression analysis, the three subcomponents (absence of heart disease, good self-rated health and feeling useful) significantly associated with successful ageing performed as well as the multidimensional successful ageing models in predicting ageing successfully.

Exploring potential EQ-5D bolt-on dimensions with a qualitative approach: an interview study in Hong Kong SAR, China.

PURPOSE: The introduction of bolt-on dimensions in EQ-5D instruments is growing common, but most bolt-on studies have targeted the diseased population and obtained bolt-on from other existing Health-related Quality of Life (HRQoL) instruments. As the qualitative approach offers important evidence to support the consistency and design of the potential bolt-on items, this paper studies the Hong Kong SAR community's perception of the current EQ-5D-5 L instrument and identifies potential bolt-on via a qualitative approach. METHODS: A representative sample mix was recruited based on the age group, gender, and education level composition of the Hong Kong SAR community by quota sampling. Semi-structured interviews were conducted and the interviews were transcribed and coded to identify emergent and recurrent themes. RESULTS: Thirty interviews were conducted and the majority of the interviewees considered the EQ-5D-5 L insufficiently comprehensive to illustrate their HRQoL. While some key HRQoL aspects included in the EQ-5D matched with the community's HRQoL perception, respondents showed concern about the potential overlap of the existing HRQoL dimension, the optimal number or attributes, and the appropriateness of the EQ-VAS. Among the potential bolt-on dimensions that emerged, 'Sleep', 'Interpersonal Relationship', and 'Satisfaction' were the key potential bolt-on dimensions identified and emphasized in the interviews. CONCLUSIONS: The qualitative findings of the study illustrate the possible gap between EQ-5D-5 L measurements and community HRQoL perception, while the findings support the development of EQ-5D bolt-on dimensions in the target community with content and face validity.

Health-related quality of life and subjective well-being among children aged 9-12 years in Shandong Province, China.

PURPOSE: To investigate the health-related quality of life (HRQoL) and subjective well-being (SWB) of children aged 9-12 years in eastern China, and examine concordance within child self-reported and parent proxy-assessed. METHODS: Data was collected from 9 to 12 years old children (including their parents) in Shandong Province in 2018. Participants self-completed a hard-copy questionnaire including Child Health Utility 9D (CHU9D), Pediatric Quality of Life Inventory (PedsQL)™ 4.0 Short Form 15 Generic Core Scales (hereafter the PedsQL™), Student's Life Satisfaction Scale (SLSS), as well as information on socio-demographic characteristics and self-report health status. Spearman's correlation coefficients and the difference between sub-groups were conducted to assess and compare the agreement on HRQoL and SWB instruments. Exploratory factor analysis (EFA) was used to ascertain the number of unique underlying latent factors that were associated with the items covered by the two generic HRQoL and the SWB instruments. The concordance of child self-reported and parent proxy-assessed was analyzed using weighted kappa coefficient and Bland-Altman plots. RESULTS: A total of 810 children and 810 parents were invited to participate in the survey. A valid sample of 799 (98.6%) children and 643 (79.4%) parents completed the questionnaire. The child self-reported mean scores were CHU9D = 0.87, PedsQL™ = 83.47, and SLSS = 30.90, respectively. The parent proxy-assessed mean scores were PedsQL™ = 68.61 and SLSS = 31.23, respectively. The child self-reported PedsQL™ was moderately correlated with the CHU9D (r = 0.52). There was a weak correlation between CHU9D and SLSS (r = 0.27). The EFA result found 3 factors whilst seven SLSS items grouped into a standalone factor (factor 3), and the nine dimensions of CHU9D shared two common factors with the PedsQL™ (factor 1 and factor 2). A low level of concordance was observed across all comparisons and in all domains (weighted kappa < 0.20) between parents and their children. Furthermore, a high level of discordance was observed between child self-reported and father proxy-assessed. CONCLUSIONS: CHU9D and PedsQL™ instruments have a higher agreement in measuring the HRQoL in children. CHU9D/PedsQL™ and SLSS instruments showed a low agreement and EFA result suggested that measuring SWB in children potentially may provide further information, which might be overlooked by using HRQoL instruments exclusively. Concordance of child self-reported and parent proxy-assessed was poor. Overall, mother-child concordance was higher than father-child concordance.

Methodological considerations in the study of perceived discrimination at work and its association with workers health and occupational outcomes: A scoping review. / Consideraciones metodológicas en el estudio de la discriminación laboral percibida y su asociación con la salud de los trabajadores y resultados ocupacionales: revisión panorámica.

Introduction: Perceived workplace discrimination is a complex phenomenon involving unfair treatment in the workplace based on personal characteristics such as age, ethnicity, gender, or disability. The objective of this study is to explore the association of perceived workplace discrimination with health and occupational outcomes. Methods: Following the PRISMA-ScR guidelines and the Joanna Briggs Institute methodology, a scoping review of articles published between 2000 and 2022 was conducted in databases such as Pubmed, Scopus, and PsyInfo. Inclusion criteria focused on studies exploring perceived workplace discrimination among workers, excluding those on patients, students, or the general population, and articles not written in English or Spanish. Results: Of the 9,871 articles identified, 102 met the criteria and were analyzed. Research showed a progressive increase in the study of perceived workplace discrimination, with a majority of studies in North America and Europe and a predominance of cross-sectional designs. Most studies did not clearly define the concept of perceived workplace discrimination nor report the psychometric characteristics of the measurement instruments. A significant association was found between perceived discrimination and negative outcomes in workers' mental and physical health, as well as a negative impact on job satisfaction and an increase in absenteeism. Additionally, sociodemographic characteristics such as race/ethnicity, gender, and age influenced the perception of discrimination. Conclusions: This review confirms that perceived workplace discrimination significantly impacts the health and job satisfaction of workers, with particular detriment in minorities and women. Despite an increase in research over the last two decades, there remains a lack of consistency in the definition and measurement of the phenomenon. Most studies have used cross-sectional designs, and there is a notable absence of research in the Latin American context.

Introducción: La discriminación laboral percibida es un fenómeno complejo que implica un trato injusto en el lugar de trabajo, basado en características personales como edad, etnia, género o discapacidad. El objetivo de este estudio es explorar cómo ha sido investigada la discriminación laboral percibida, en el contexto de investigaciones acerca de su asociación con salud y resultados ocupacionales. Métodos: Siguiendo la guía PRISMA-ScR y la metodología del Instituto Joanna Briggs, se realizó una revisión panorámica de artículos publicados entre los años 2000 y 2022 en bases de datos como PubMed, Scopus y PsycInfo. Los criterios de inclusión se centraron en estudios que exploraron la discriminación laboral percibida en trabajadores, excluyendo aquellos en pacientes, estudiantes o población general, y artículos no escritos en inglés o español. Resultados: De los 9871 artículos identificados, 102 cumplieron con los criterios y fueron analizados. La investigación mostró un aumento progresivo en el estudio de la discriminación laboral percibida, con una mayoría de estudios en América del Norte y Europa y un predominio de diseños transversales. La mayoría no definió claramente el concepto de discriminación laboral percibida ni reportó las características psicométricas de los instrumentos de medición. Se encontró una asociación significativa entre la discriminación percibida y resultados negativos en la salud mental y física de los trabajadores, así como un impacto negativo en la satisfacción laboral y un aumento en el ausentismo. Además, las características sociodemográficas como raza/etnia, género y edad influyeron en la percepción de discriminación. Conclusiones: Esta revisión confirma que la discriminación laboral percibida impacta considerablemente la salud y satisfacción laboral de los trabajadores, afectando más a minorías y mujeres. A pesar de un incremento en su investigación en las últimas dos décadas, persiste una carencia de consistencia en la definición y medición del fenómeno. La mayoría de los estudios han utilizado diseños transversales, y se observa una notable ausencia de investigaciones en el contexto latinoamericano.

There is a correlation between nutritional status, Self-Rated Health and Life Satisfaction? Evidence from 2018 Health Behaviour in School-aged Children cross sectional study in a sample of Italian adolescents living in Tuscany Region.

Background: Overweight has been associated with several social and phycological problems and is perceived as one of the major health care challenges to focus on in the future. The purpose of the study is to investigate the correlations among nutritional status, assessed by the Body Mass Index, the perception of one's own health status and Life Satisfaction, detected in Italian adolescents living in Tuscany Region, and to investigate the influence of gender on them. Methods: A statistically representative sample of 2760 Tuscan adolescents aged 11, 13 and 15 was involved in the 2018 Health Behaviours at School-aged Children survey. The participants were divided into three nutritional status class: underweight, normal weight and overweight (overweight + obese). Results: The results show that there is a statistically significant difference in all categories between boys and girls aged 13 and 15 years; in girls aged 11 and 13 years, the Life Satisfaction of the overweight group is statistically lower than that of normal and underweight groups; Self-Rated Health is statistically lower in all age groups for overweight individuals compared to normal weight children, except for 11-year-old females. Conclusions: Viewing the psychosocial problems related to overweight, more attention and care must be placed on adolescents to ensure their healthier development.

Medicare Advantage Health Risk Assessments Contribute Up To $12 Billion Per Year To Risk-Adjusted Payments.

With Medicare Advantage (MA) enrollment surpassing 50 percent of Medicare beneficiaries, accurate risk-adjusted plan payment rates are essential. However, artificially exaggerated coding intensity, where plans seek to enhance measured health risk through the addition or inflation of diagnoses, may threaten payment rate integrity. One factor that may play a role in escalating coding intensity is health risk assessments (HRAs)-typically in-home reviews of enrollees' health status-that enable plans to capture information about their enrollees. In this study, we evaluated the impact of HRAs on Hierarchical Condition Categories (HCC) risk scores, variation in this impact across contracts, and the aggregate payment impact of HRAs, using 2019 MA encounter data. We found that 44.4 percent of MA beneficiaries had at least one HRA. Among those with at least one HRA, HCC scores increased by 12.8 percent, on average, as a result of HRAs. More than one in five enrollees had at least one additional HRA-captured diagnosis, which raised their HCC score. Potential scenarios restricting the risk-score impact of HRAs correspond with $4.5-$12.3 billion in reduced Medicare spending in 2020. Addressing increased coding intensity due to HRAs will improve the value of Medicare spending and ensure appropriate payment in the MA program.

In HFpEF with obesity, semaglutide improved health status and weight loss at 52 wk, regardless of initial health status.

SOURCE CITATION: Kosiborod MN, Verma S, Borlaug BA, et al; STEP-HFpEF Trial Committees and Investigators. Effects of semaglutide on symptoms, function, and quality of life in patients with heart failure with preserved ejection fraction and obesity: a prespecified analysis of the STEP-HFpEF trial. Circulation. 2024;149:204-216. 37952180.

Five-Year Cumulative Cardiovascular Health and Clinical Events in Patients With Chronic Kidney Disease: The CRIC Study.

BACKGROUND: Higher cardiovascular health (CVH) score is associated with lower risks of cardiovascular disease (CVD) and mortality in the general population. However, it is unclear whether cumulative CVH is associated with CVD, end-stage kidney disease (ESKD), and death in patients with chronic kidney disease. METHODS AND RESULTS: Among individuals from the prospective CRIC (Chronic Renal Insufficiency Cohort) Study, we used the percentage of the maximum possible CVH score attained from baseline to the year 5 visit to calculate cumulative CVH score. Multivariable-adjusted Cox proportional hazards regression was used to investigate the associations of cumulative CVH with risks of adjudicated CVD (myocardial infarction, stroke, and heart failure), ESKD, and all-cause mortality. A total of 3939 participants (mean age, 57.7 years; 54.9% men) were included. The mean (SD) cumulative CVH score attained during 5 years was 55.5% (12.3%). Over a subsequent median 10.2-year follow-up, 597 participants developed CVD, 656 had ESKD, and 1324 died. A higher cumulative CVH score was significantly associated with lower risks of CVD, ESKD, and mortality, independent of the CVH score at year 5. Multivariable-adjusted hazard ratios and 95% CIs per 10% higher cumulative CVH score during 5 years were 0.81 (0.69-0.95) for CVD, 0.82 (0.70-0.97) for ESKD, and 0.80 (0.72-0.89) for mortality. CONCLUSIONS: Among patients with chronic kidney disease stages 2 to 4, a better CVH status maintained throughout 5 years is associated with lower risks of CVD, ESKD, and all-cause mortality. The findings support the need for interventions to maintain ideal CVH status for prevention of adverse outcomes in the population with chronic kidney disease.

Influence of physical exercise on negative emotions in college students: chain mediating role of sleep quality and self-rated health.

Background: Negative emotions in college students are a significant factor affecting mental health, with suicide behaviors caused by negative emotions showing an annual increasing trend. Existing studies suggest that physical exercise is essential to alleviate negative feelings, yet the intrinsic mechanisms by which it affects negative emotions have not been fully revealed. Objective: Negative emotions in college students represent a significant issue affecting mental health. This study investigates the relationship between physical exercise and negative emotions among college students, incorporating sleep quality and self-rated health (SRH) as mediators to analyze the pathway mechanism of how physical exercise affects students' negative emotions. Methods: A cross-sectional study design was utilized, employing online questionnaires for investigation. The scales included the Physical Activity Rating Scale-3 (PARS-3), the Depression Anxiety Stress Scales-21 (DASS-21), the Pittsburgh Sleep Quality Index (PSQI), and the 12-Item Short Form Health Survey (SF-12), resulting in the collection of 30,475 valid questionnaires, with a validity rate of 91%. Chain mediation tests and Bootstrap methods were applied for effect analysis. Results: The proportions of university students engaged in low, medium, and high levels of physical exercise were 77.6, 13.1, and 9.3%, respectively. The proportions of students experiencing "very severe" levels of stress, anxiety, and depression were 4.5, 10.9, and 3.6%, respectively. Physical exercise was significantly positively correlated with self-rated health (r = 0.194, p < 0.01), significantly negatively correlated with sleep quality (r = -0.035, p < 0.01), and significantly negatively correlated with stress, anxiety, and depression (r = -0.03, p < 0.01; r = -0.058, p < 0.01; r = -0.055, p < 0.01). Sleep quality was significantly negatively correlated with self-rated health (r = -0.242, p < 0.01). Mediation effect testing indicated that sleep quality and self-rated health partially mediated the relationship between physical exercise and negative emotions, with total effect, total direct effect, and total indirect effect values of -1.702, -0.426, and - 1.277, respectively. Conclusion: College students primarily engage in low-intensity physical activity. Sleep quality and self-rated health mediate the impact of physical exercise on students' negative emotions. A certain level of physical activity can directly affect students' emotional states and indirectly influence their negative emotions via sleep and self-rated health. Regular engagement in physical activities primarily positively impacts emotional states by enhancing mood stability and overall emotional resilience.

Geographical accessibility of medical resources, health status, and demand of integrated care for older people: a cross-sectional survey from Western China.

BACKGROUND: The World Health Organization (WHO) published the Integrated Care for Older People (ICOPE) framework to help healthcare providers cope with the population aging crisis. However, the relevant evidence on the demands of older people and the compensatory capacity of the environment is limited. This study reports for the first time the level of the ICOPE demand in Western China that includes the impact of geographic accessibility of medical resources (GAMR) on ICOPE demand and the potential mechanism of health status. METHODS: A cross-sectional questionnaire survey was conducted among 1200 adults aged 60 years and older selected through multi-stage stratified cluster sampling to obtain relevant data, including ICOPE demand, health status, and GAMR. Propensity score matching (PSM) was used to analyze the impact of GAMR on ICOPE demand among older people and those with different health statuses. RESULTS: Among the prospective research participants, 1043 were eligible for the study. The mean score of ICOPE demand among all participants was 3.68 (standard deviation [SD] = 0.78). After adjusting for covariates between high and low GAMR groups (1:1 match), ICOPE demand was significantly higher in the low GAMR group than in the high GAMR group (average treatment effect on the treated [ATT] = 0.270, p < 0.05). For both good and poor self-rated health status, the ICOPE demand of the low GAMR group was significantly higher than that in the high GAMR group (ATT = 0.345, p < 0.05; ATT = 0.190, p < 0.05). For chronic diseases, the ICOPE demand of older people with multimorbidity in the low GAMR group was significantly higher than that in the high GAMR group (ATT = 0.318, p < 0.01). CONCLUSIONS: The older population in Western China has a relatively high demand for ICOPE. Low GAMR is a key factor in ICOPE demand growth in this region. It accelerates demand release for both older people with multimorbidity and self-perceptions of health.

Quality of life of patients undergoing chemotherapy: a tertiary care hospitalbased study from Karachi.

The quality of life (QoL) of cancer patients is of paramount concern due to the enduring effects of chemotherapy on the physical, emotional, spiritual, and social aspects of life. This study aims to examine the factors influencing QoL among cancer patients. A cross-sectional analysis encompassing 200 chemotherapy patients aged 18 and above was conducted, using self-reported surveys and clinical records. The results indicate higher social wellbeing and lower physical well-being scores. Significantly, patients in joint families, with income above Rs25,000, limited pre-diagnosis check-ups, over four chemotherapy cycles, showed better QoL. Engaging diversions like art and internet usage alleviated worries. Conversely, comorbidities correlated with lower FACT-G scores. QoL is still compromised, even with the developments of advanced cancer treatments. Managing mental, emotional, social, and physical health is vital. Future research should focus on evidence-based policies, innovative strategies, psychiatric assessments, mindfulness interventions, and exploring the impact of social interactions on QoL, aiming to enhance the wellbeing of newly diagnosed cancer patients.

Widening Educational Inequalities in Physical Health Due to the Obesity Trend?-A Mediation Analysis Using the German Socio-Economic Panel Study.

Objectives: This study examined the contribution of obesity to the development of educational inequalities in physical health. Methods: We used data from the German Socio-Economic Panel for the period 2002-2020. Physical health was measured with the modified SF12-questionnaire. Logistic regression analyses were applied to estimate time trends. The Relative Index of Inequality (RII) and the Slope Index of Inequality (SII) were calculated to examine educational inequalities. The role of obesity as a mediator was analyzed using the Karlson-Holm-Breen (KHB) method. Results: Over time, educational inequalities in obesity as well as impaired physical health widened in men and women, particularly among those aged 30-49 years. For individuals with a low level of education at this age, the probability of impaired physical health increased significantly by 7.7%-points in women and 9.4%-points in men. Of this increase, 25.9% for women and 14.8% for men could be attributed to the increase in obesity. Conclusion: Our findings suggest that the steeper rise in obesity among individuals with a low level of education partly explains the observed widening in educational inequalities in physical health.

Depression and associated factors among older people in Vietnam: Findings from a National Aging Survey.

BACKGROUND: Depression is one of the most common mental health disorders among older people. Depressive symptoms are often overlooked and untreated in primary care settings. This study aims to assess the prevalence of depressive symptoms and associated factors among older people in Vietnam. METHOD: The study analyzed data from the Vietnam National Aging Survey (VNAS) conducted in 2022 with a nationally representative sample of 3,006 older people aged 60 and over in 12 provinces. The 15-item Geriatric Depression Scale (GDS-15) was used to assess depressive symptoms. Bivariate and multiple logistic regression analyses were used to explore the association between depressive symptoms and other related factors such as sociodemographic and economic characteristics, social support, health status, Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) limitations, chronic diseases, cigarette smoking status, alcoholic drinking, and domestic violence. RESULTS: The prevalence of depressive symptoms among older people was 20.2%. The associated factors that increase the odds of having depression among older people were female gender (OR = 2.21, 95% CI 1.34-3.62), living in rural areas (OR = 1.83, 95% CI 1.15-2.89), the poorest quintile (OR = 2.26, 95% CI 1.39-3.66), self-rated poor health (OR = 11.68, 95% CI 4.96-27.49), ADL limitations (OR = 2.12, 95% CI 1.51-2.99), IADL limitation (OR = 1.61 95% CI 1.16-2.25), and experiencing domestic violence in the last 12 months (OR = 6.66, 95% CI 4.00-11.05). CONCLUSION: Depression symptoms were prevalent among older people in Vietnam. Depression screening for older people should be included in primary care settings for early identification and treatment of depression.

Factors associated with the quality of life of living kidney donors in Korea: A cross-sectional study.

This study investigated the relationship between self-determination, physical health status, and Health related Quality of Life (=HRQoL) among living kidney donors. A descriptive survey was conducted between 2019 and 2020 and included 111 kidney donors. Data were collected using a self-report questionnaire on general and donation-related characteristics, self-determination, and HRQoL. The data also included medical records reflecting the physical health status at the time of the survey. Data were analyzed using a multiple regression model. Factors associated with HRQoL were perceived health recovery after donation (ß = 0.42, P < .001), up to 1 year since donation (ß = 0.33, P = .008), more than 1 up to 5 years since donation (ß = 0.52, P < .001), more than 5 up to 10 years since donation (ß = 0.53, P < .001), and competence of self-determination (ß = 0.23, P = .033). The explanatory power of these variables was 43.3%. HRQoL of living kidney donors can be affected by subjective and psychological factors. Therefore, health care providers should help living kidney donors have high self-determination during pre and post donation and concentrate on the subjective and psychological factors as well as objective health status.

Tumor necrosis factor-α is transferred to equine neonates via colostrum but is not associated with their health status.

We followed the hypothesis that equine neonates with reduced transfer of tumor necrosis factor-α (TNFα) are at increased risk of neonatal infection. We investigated TNFα concentrations in colostrum of healthy mares and blood of their neonates in a non-hospitalized population of Warmblood mares where delivery, neonatal adaptation and health was closely monitored by veterinarians. Concentration of TNFα and IgG was determined in colostrum respective milk and in neonatal blood collected immediately after delivery and 18 h thereafter in 97 foals that were assigned to groups failure of passive transfer (FPT; n = 31) and control (CON; n = 66) based on serum IgG concentration at 18 h of age. Foal health was assessed repeatedly during the first 24 h of life. Statistical analysis was done with p < 0.05 indicating significance. There were no significant differences between foal groups FPT and CON regarding age and parity of dams, gestation length (FPT 343 ± 10, CON 340 ± 8 days) and foal sex. Concentrations of TNFα in colostrum at birth and in foals at 18 h varied but did not differ between groups (colostrum FPT 6.1 ± 9.1, CON 9.9 ± 31.5 ng/ml; foal FPT 2.3 ± 5.9, CON 2.4 ± 5.3 ng/ml; n.s.). There was an increase in the mean serum TNFα concentration until 18 h in foals (n.s. between groups). Results of the present study confirm previous findings of TNFα transfer from the mare to the neonate via colostrum but do not suggest that transfer of TNFα via colostrum is important for protection of the neonate against infectious diseases.

Development of a disease-specific health utility score for chronic obstructive pulmonary disease from a discrete choice experiment patient preference study.

OBJECTIVES: While patient input to health technology assessment (HTA) has traditionally been of a qualitative nature, there is increasing interest to integrate quantitative evidence from patient preference studies into HTA decision making. Preference data can be used to generate disease-specific health utility data. We generated a health utility score for patients with chronic obstructive pulmonary disease (COPD) and consider its use within HTAs. METHODS: Based on qualitative research, six symptoms were identified as important to COPD patients: shortness of breath, exacerbations, chronic cough, mucus secretion, sleep disturbance, and urinary incontinence. We employed a discrete choice experiment (DCE) and the random parameter logistic regression technique to estimate utility scores for all COPD health states. The relationship between patients' COPD health utility scores, self-perceived COPD severity, and EQ-5D-3L utility scores was analyzed, with data stratified according to disease severity and comorbidity subgroups. RESULTS: The COPD health utility score had face validity, with utility scores negatively correlated with patients' self-perceived COPD severity. The correlation between the COPD health utility scores and EQ-5D-3L values was only moderate. While patient EQ-5D-3L scores were impacted by comorbidities, the COPD health utility score was less impacted by comorbid conditions. CONCLUSIONS: Our COPD utility measure, derived from a DCE, provides a patient-centered health utility score and is more sensitive to the COPD health of the individual and less sensitive to other comorbidities. This disease-specific instrument should be considered alongside generic health-related quality of life instruments when valuing new COPD therapies in submissions to licensing and reimbursement agencies.

Examining Demographic Factors, Psychosocial Wellbeing and Cardiovascular Health in Subjective Cognitive Decline in the Brain Health Registry Cohort.

BACKGROUND: Subjective cognitive decline (SCD) is defined as an individual's perception of sustained cognitive decline compared to their normal state while still performing within boundaries for normal functioning. Demographic, psychosocial and medical factors have been linked to age-related cognitive decline, and Alzheimer's dementia (AD). However, their relation to risk for SCD remains unclear. This study aims to identify demographic factors, psychosocial and cardiovascular health associated with SCD within the Brain Health Registry (BHR) online cohort. METHODS: Participants aged 55+ (N=27,596) in the BHR self-reported SCD measured using the Everyday Cognition Scale (ECog) and medical conditions, depressive symptoms, body mass index, quality of sleep, health, family history of AD, years of education, race, ethnicity and gender. Multivariable linear regression was used to examine whether SCD was associated with demographic, psychosocial, and medical conditions. RESULTS: We found that advanced age, depressive symptoms, poorer sleep quality and poorer quality of health were positively associated with more self-reported SCD in all models. No race or ethnicity differences were found in association with SCD. Males who reported alcohol and tobacco use or underweight BMI had higher ECog scores compared with females. CONCLUSION: In addition to well-established risk factors for cognitive decline, such as age, our study consistently and robustly identified a strong association between psychosocial factors and self-reported cognitive decline in an online cohort. These findings provide further evidence that psychosocial health plays a pivotal role in comprehending the risk of SCD and early-stage cognitive ageing. Our findings emphasise the significance of psychosocial factors within the broader context of cardiovascular and demographic risk factors.