Methods to assess ambivalence towards food and diet: a scoping review.

BACKGROUND: Ambivalence towards food and diet, which favours behavioural inertia, might be a barrier to adopting healthier eating behaviours. Measuring it can help researchers to better understand its relationship with behaviour change and design interventions aimed at resolving it. In this scoping review, we map and describe methods and tools employed in studies to assess, measure or classify the ambivalence of participants towards food- and diet-related attitude objects. METHODS: In accordance with Joanna Briggs Institute guidance for conducting scoping reviews, we retrieved peer-reviewed studies from MEDLINE, CINAHL, PsycINFO, Web of Science, FSTA and Food Science Source and preprints from PsyArXiv and MedRxiv. Two independent reviewers screened the articles. We considered for inclusion peer-reviewed studies and preprints that assessed the ambivalence of participants of any age, sex or sociodemographic group towards food and diet. RESULTS: We included 45 studies published between 1992 and 2022, which included participants from 17 countries. Eighteen methods were employed across the included studies to assess different types of ambivalence (felt, potential or cognitive-affective), the most frequent of which were the Griffin Index, the Subjective Ambivalence Questionnaire, the MouseTracker Paradigm and the Orientation to Chocolate Questionnaire. CONCLUSION: This scoping review identified several methods and tools to assess different types of ambivalence towards food- and diet-related objects, providing an array of options for future studies.

Impact of a Theory-Based Intervention to Promote Medication Adherence in Patients With a History of Myocardial Infarction.

BACKGROUND: Patient discontinuation of cardioprotective medications after a cardiac ischemic event commonly occurs early after hospital discharge. Theory-based interventions could be effective in promoting better patient self-regulation of health-related behaviors and positive intentions to adhere to the recommended medical regimen. OBJECTIVE: The aim of this study was to evaluate the potential efficacy and feasibility of a theory-based intervention to promote adherence to cardioprotective medications. METHODS: In this mixed-methods quasi-experimental study with 3 time points, we recruited 45 participants with a positive intention to adhere and a history of myocardial infarction. They were recruited in primary care units in Brazil. Data collection occurred in 2 waves (Tb and T60). The intervention consisted of developing action and coping plans, delivered in a 30-minute face-to-face session, with face-to-face reinforcement at a 30-day interval. Quantitative data were submitted to descriptive, Wilcoxon, and McNemar analyses; qualitative data were submitted to content analysis. RESULTS: An increase in the proportion of patients adhering to medications at the end of follow-up was found (T60 - Tb, +60.0%; P < .001). In addition, a significant reduction was found for blood pressure (T60 - Tb, -8.6 mm Hg; P < .001), heart rate (T60 - Tb, -6.6 bpm; P < .001), and low-density lipoprotein (T60 - Tb, -6.2 mg/dL; P < .05). Qualitative results revealed that the intervention was feasible, with an attrition rate of zero. The intervention was found to be easy to apply to patients' daily lives, and there was adequate time for implementation. CONCLUSIONS: Our data confirm the potential efficacy of a theory-based intervention on the promotion of adherence to cardioprotective medications and on the related clinical end points, as well as its feasibility in the clinical context (Universal Trial Number: U1111-1189-9967).

Validation of the Brazilian Version of Functional Assessment of Cancer Therapy-Prostate-FACT-P (Version 4) in Prostate Cancer Patients.

The purpose of this study is to validate the Brazilian version of Functional Assessment of Cancer Therapy-Prostate FACT-P (version 4) in nonmetastatic prostate cancer (PC) patients. Patients with histopathological diagnosis of PC were submitted to health-related quality of life (HRQOL) questionnaires - SF-36 (Medical Outcomes Study 36 - Item Short-Form Health Survey) and FACT-P (version 4). After 7 to 15 days, FACT-P (version 4) was reapplied in the sample's percentage that participated the first evaluation. Cronbach alpha coefficient was used to determine internal consistency and intraclass correlation coefficient (ICC) certified stability. Correlations between FACT-P (version 4) and SF-36 tested convergent validity. Regarding known groups validity, the hypothesis tested was that FACT-P (version 4) is capable of discriminating HRQOL in patients with different PC risk classifications. A total of 112 patients with nonmetastatic PC were evaluated. Cronbach alpha coefficients (0.64-0.88) and ICC (0.75-0.93) obtained satisfactory results of reliability. Verified correlations (r 0.3-0.72) between FACT-P (version 4) and SF-36 suggest convergent validity. In the studied sample, FACT-P (version 4) was unable to discriminate HRQOL in nonmetastatic patients. The Brazilian version of FACT-P questionnaire (version 4) showed evidences of reliability and validity on evaluating HRQOL in Brazilian men with nonmetastatic PC.

Systematic review and meta-analysis of the efficacy of Unna boot in the treatment of venous leg ulcers.

This systematic review determined the effectiveness of the Unna boot in the treatment of venous leg ulcers (VLUs) by assessing the quality of the available evidence. A systematic search of studies published between August 2019 and February 2020 was conducted using the PubMed, PubMed/PMC, BVS/BIREME, CINAHL, Web of Science, MEDLINE, Embase, Cochrane, ProQuest, BDTD, CAPES Thesis and Dissertation, OPEN THESIS, Centre for Reviews and Dissemination and SciELO databases. Studies were eligible if they reported primary studies, controlled clinical trials, quasi-experimental studies or observational studies (cross-sectional studies or cohort studies). We identified 302 articles. After screening and critical appraisal, eight articles were included in this review, while six articles were included in the meta-analysis. Four studies were included in the outcome of complete ulcer healing rate with a weighted estimate of the odds ratio of 0.43 (95% CI = 0.188-1.01). No evidence of the presence of considerable heterogeneity was observed (p = 0.35, I2 = 32%). Two studies were assigned to the outcome time to complete ulcer healing (days) with a weighted estimated mean difference of 41.3 days (95% CI = 21.62-61.04). Evidence of the presence of considerable heterogeneity was observed (p = 0.01, I2 = 85%). The results showed a moderate degree of evidence that there is no difference in the healing rates of VLUs with the use of the Unna boot. For the time to complete ulcer healing, the low number of studies and low classification impaired the reporting at any level of evidence.

Influence of number of ingredients, use of supplement and vegetarian or vegan preparation on the composition of homemade diets for dogs and cats.

BACKGROUND: Homemade diets are a worldwide trend, and many recipes are currently available on websites but may not be considered balanced. This study aimed to evaluate if the number of ingredients, supplement, or vegetarian/vegan-only ingredients included in a recipe influence the nutrient content of homemade diets for dogs and cats. Chemical analyses were performed on 75 diets for dogs and 25 for cats prepared according to websites' recipes, and minerals were analyzed by inductively coupled plasma optical emission spectrometry (ICP-OES). RESULTS: Canine diets that met fat requirements had more ingredients than those below recommendations. None of the cat diets met iron requirements, and feline diets that met requirements of manganese had fewer ingredients and those that supplied requirements of protein and sodium had more ingredients than the diets below recommendations (p < 0.05). Non-supplemented canine and feline diets had calcium and calcium:phosphorus ratio below recommendations (p < 0.05). Non-supplemented feline diets had lower sodium and iron, and zinc levels were below recommendation in diets for both species. Diets with animal products for dogs had higher levels of protein and zinc, although zinc was deficient in both groups, and there were higher amounts of crude fiber, magnesium, and manganese in vegetarian/vegan diets (p < 0.05). Diets with animal products for cats had higher levels of protein (p = 0.003), but there was a higher amount of crude fiber (p = 0.014) in vegetarian/vegan diets. CONCLUSION: The number of ingredients and vegetarian/vegan preparation did not guarantee nutritional adequacy of diets, and the presence of supplement did not ensure a balanced diet.

Trends in access to female cancer screening in Brazil, 2007-16.

BACKGROUND: This study aims to analyse changes in the prevalence of cervical cancer (CCa) and breast cancer (BCa) screening among women in the Brazilian capitals and Federal District in the last decade (2007-16). METHODS: Data from the surveillance system of risk and protective factors for chronic diseases through telephone interviews (n = 267 949) were used. Adequate screening consisted of, at least, one Pap test triennially, for women aged between 25 and 64 years, and mammography exam biannually, for women aged between 50 and 69 years. The prevalence of adequate screening was investigated for each type of cancer isolated and combined (women aged between 50 and 64 years). The prevalence of adequate screening was estimated for the total population and according to socioeconomic variables. Linear regression models were used. RESULTS: The prevalence of adequate screening test for CCa remained stable, around 82%, while the screening test for BCa increased from 71 to 78% between 2007 and 2016. Higher increases were observed among women with low schooling and from less developed regions. The percentage of adequate screening (considering both types), for women aged between 25 and 69 years, remained stable, close to 78%. CONCLUSIONS: Screening for BCa increased significantly. Smaller coverage rates are verified among women with low schooling and from less developed regions.

Structural Evidence for Pnictogen-Centered Lewis Acidity in Cationic Platinum-Stibine Complexes Featuring Pendent Amino or Ammonium Groups.

As part of our continuing interest in the chemistry of cationic antimony Lewis acids as ligands for late transition metals, we have now investigated the synthesis of platinum complexes featuring a triarylstibine ligand substituted by an o-[(dimethylamino)methyl]phenyl group referred to as ArN. More specifically, we describe the synthesis of the amino stibine ligand Ph2SbArN (L) and its platinum dichloride complex [LPtCl]Cl which exists as a chloride salt and which shows weak coordination of the amino group to the antimony center. We also report the conversion of [LPtCl]Cl into a tricationic complex [LHPt(SMe2)]3+ which has been isolated as a tris-triflate salt after reaction of [LPtCl]Cl with SMe2, HOTf and AgOTf. Finally, we show that [LHPt(SMe2)][OTf]3 acts as a catalyst for the cyclization of 2-allyl-2-(2-propynyl)malonate.

Neutering in dogs and cats: current scientific evidence and importance of adequate nutritional management.

Neutering or spaying is a commonly recommended veterinary procedure. However, veterinarians are often confronted with conflicting findings and differences in concepts regarding practice and proper nutritional management after the procedure. The objective of the present review was to bring to light the most recent literature, summarise it and discuss the findings focusing on the risks and benefits of neutering in dogs and cats, and to determine the appropriate nutritional management for these animals.

[High-risk clusters and temporal trends in congenital syphilis infection in Brazil]. / Aglomerados de alto risco e tendência temporal da sífilis congênita no Brasil.

OBJECTIVE: To determine the occurrence of high-risk clusters for congenital syphilis (CS) in Brazil and describe the temporal trends in the CS infection in the country, comparing children whose mothers received vs. those whose mothers did not receive prenatal care. METHOD: This ecological study used data from the National Disease Notification System (Sistema de Informação de Agravos de Notificação, SINAN) and the Live Birth Information System (Sistema de Informações sobre Nascidos Vivos, SINASC). For cluster analysis, the Kulldorff scan statistic was applied to the population at risk. Statistical significance was determined by the log-likelihood ratio based on Poisson discrete distribution. To analyze the temporal trends of disease detection rates, Prais-Winsten regression was used. The analysis was performed with SatScan 9.4 and Stata 14.0 software. RESULTS: Clusters with detection rates of 41.3, 44.4 and 188.1 CS cases/10 000 live births were identified in 2001, 2009 and 2017 respectively. In 2001, the rates were 8 times higher in the clusters than in the remaining country; in 2009, the rates were 3.3 times higher; and in 2017, 2.5 times higher. An increasing trend in CS infection was detected in all regions and federation units. The rates were 8.53 times higher in the children of mothers without prenatal care (243.3 cases/1 000 live births vs. 28.3 cases/1 000 live births in the children of mothers with prenatal care). CONCLUSIONS: The identification of municipality clusters at high risk for CS and of increasing trends in CS infection across the country, even in the presence of prenatal care, suggests the need for improvement of public health actions to fight this disease.

Psychosocial determinants of adherence to oral antidiabetic medication among people with type 2 diabetes.

AIMS AND OBJECTIVES: The aim of this study was to identify the psychosocial determinants of adherence to oral antidiabetic medication, according to the Theory of Planned Behaviour (TPB). BACKGROUND: Appropriate adherence to oral antidiabetic medication contributes to long-term glycaemic control. However, glycaemic control is often poor in people with type 2 diabetes, mainly due to the poor adherence to oral antidiabetic agents. DESIGN: Prospective study with 2 waves of data collection, based on STROBE checklist was conducted. One hundred and fifty-seven adults with type 2 diabetes, in chronic use of oral antidiabetic agents, composed the sample. At baseline, self-reported measures of medication adherence (proportion and global evaluation of adherence) and of metabolic control (glycated haemoglobin) of diabetes were obtained. METHODS: The TPB main constructs (attitude, subjective norm and perceived control) and related beliefs were measured. Adherence and metabolic control measurements were obtained in a two-month follow-up (n = 157). RESULTS: Attitude and subjective norm, together, explained 30% of the variability in intention; their underlying belief-based measures (behavioural and normative beliefs) explained 28% of the variability in intention. In addition, intention predicted behaviour at follow-up. However, when added to the prediction model, past behaviour was the only explanatory factor of adherence behaviour. CONCLUSION: Adherence behaviour to oral antidiabetic medication was predicted by intention, which, in turn, was determined by attitude and subjective norm. In order to promote adherence to oral antidiabetic agents, health professionals should include motivational strategies as well as strategies targeted to attitude and subjective norm when designing interventions. RELEVANCE TO CLINICAL PRACTICE: The nonadherence to antidiabetic medication contributes to lack of control of diabetes and ensuing complications. The comprehension of the factors explaining the variability in medication adherence can inform the design of theory-based interventions aimed at promoting this behaviour.

Vitamin D metabolism in dogs and cats and its relation to diseases not associated with bone metabolism.

Due to the presence of receptors in the cells of numerous body tissues, vitamin D is associated with several physiological functions that go beyond calcium and phosphorus homoeostasis and control of bone metabolism in the body. In humans, several studies have associated lower vitamin D concentrations with numerous diseases, such as cancer, heart disease, autoimmune diseases and infectious diseases, and also with an increase in the total mortality rate of the population. Recently, this nutrient started to gain importance in veterinary medicine, and several articles have shown a correlation between low vitamin D status and diseases unrelated to bone metabolism. The present review aims to highlight the recent publications that investigated this relationship, bringing the evidence that exists so far in dogs and cats.

Measurement properties and factor analysis of the Diabetic Foot Ulcer Scale-short form (DFS-SF).

The purpose of this paper is to provide measurement properties evaluation and factor analysis of the Brazilian version of the diabetic foot ulcer scale-short form (DFS-SF). This methodological study evaluated the measurement properties of the DFS-SF by ceiling and floor effect reliability, responsiveness, and structural construct validity. The study included 290 people with diabetic foot under regular follow-up in a specialised outpatient clinic in inland São Paulo. Reliability was assessed by internal consistency using Cronbach's alpha and composite reliability. Ceiling and floor effects were assessed by the percentage of participants who scored the 15% worst (floor) and 15% best (ceiling) possible scale results. Validity was tested by correlating the instrument values with the domains of the Brazilian version of the Short Form Health Survey (SF-36). Responsiveness (n = 34) was accessed through the wound area obtained by photography and evaluated by the Image J Features program and the DFS-SF score at two moments, with a 4-week interval between them. The instrument had good evidence of reliability, shown by adequate internal consistency (Cronbach's alpha in domains >0.70) and compound reliability (0.84 > CC > 0.92); and of convergent validity, by significant positive correlations of moderate to strong magnitude with SF-36. Structural construct validity was examined by applying the DFS-SF confirmatory factor analysis, which indicated that the Brazilian version of the instrument is properly fitted to the original dimensional structure. The ceiling and floor effect analysis showed no ceiling or floor effects. Responsiveness was observed in the wound area, but not in the DFS-SF scores in the times. The Brazilian version of the DFS-SF presented evidence of validity and reliability, suggesting that this instrument is a valid tool for assessing the quality of life of people with diabetic foot in the Brazilian population.

Highly Active Ruthenium CNC Pincer Photocatalysts for Visible-Light-Driven Carbon Dioxide Reduction.

Five ruthenium catalysts described herein facilitate self-sensitized carbon dioxide reduction to form carbon monoxide with a ruthenium catalytic center. These catalysts include four new and one previously reported CNC pincer complexes featuring a pyridinol derived N-donor and N-heterocyclic carbene (NHC) C-donors derived from imidazole or benzimidazole. The complexes have been characterized fully by spectroscopic and analytic methods, including X-ray crystallography. Introduction of a 2,2'-bipyridine (bipy) coligand and phenyl groups on the NHC ligand was necessary for rapid catalysis. [(CNC)Ru(bipy)(CH3CN)](OTf)2 is among the most active and durable photocatalysts in the literature for CO2 reduction without an external photosensitizer. The role of the structure of this complex in catalysis is discussed, including the importance of the pincer's phenyl wingtips, the bipyridyl ligand, and a weakly coordinating monodentate ligand.

A High-Voltage Molecular-Engineered Organic Sensitizer-Iron Redox Shuttle Pair: 1.4†V DSSC and 3.3†V SSM-DSSC Devices.

The development of high voltage solar cells is an attractive way to use sunlight for solar-to-fuel devices, multijunction solar-to-electric systems, and to power limited-area consumer electronics. By designing a low-oxidation-potential organic dye (RR9)/redox shuttle (Fe(bpy)33+/2+ ) pair for dye-sensitized solar-cell (DSSC) devices, the highest single device photovoltage (1.42 V) has been realized for a DSSC not relying on doped TiO2 . Additionally, Fe(bpy)33+/2+ offers a robust, readily tunable ligand platform for redox potential tuning. RR9 can be regenerated with a low driving force (190 mV), and by utilizing the RR9/Fe(bpy)33+/2+ redox shuttle pair in a subcell for a sequential series multijunction (SSM)-DSSC system, one of the highest known three subcell photovoltage was attained for any solar-cell technology (3.34 V, >1.0 V per subcell).

Reliability and validity of the Treatment Satisfaction Questionnaire for Medication among Portuguese-speaking Brazilian patients with hypertension.

AIMS AND OBJECTIVES: This study examined the reliability and validity of the Brazilian Portuguese version of the Treatment Satisfaction Questionnaire for Medication (version 1.4) among patients with hypertension. Understanding the patient experience with treatment satisfaction will contribute to improved medication adherence and control of hypertension. BACKGROUND: Hypertension is a serious problem in Brazil that is associated with chronic illness controlled, in part, by consistent adherence to medications. Patient satisfaction with medication treatment is associated with adherence to medication. The Treatment Satisfaction Questionnaire for Medication (version 1.4) is a promising instrument for measuring medication; however, to date there has been no report of the reliability and validity of the instrument with Portuguese-speaking adults with hypertension in Brazil. DESIGN: Cross-sectional descriptive exploratory study. METHODS: A convenience sample of 300 patients with hypertension in an outpatient setting in the southeast region of São Paulo state in Brazil completed the Treatment Satisfaction Questionnaire for Medication (version 1.4). The instrument, comprised of four subscales, was evaluated for reliability using correlation analyses and internal consistency. Confirmatory factor analysis was used to determine factorial validity. RESULTS: Correlational analyses, internal consistency (Cronbach's alpha) and hierarchical confirmatory factor analysis demonstrate adequate support for the four-factor dimensionality, reliability and factorial validity of the Treatment Satisfaction Questionnaire for Medication (version 1.4). CONCLUSIONS: This study provides modest evidence for internal consistency and factorial validity of the Treatment Satisfaction Questionnaire for Medication (version 1.4) in Portuguese-speaking adult Brazilians with hypertension. Future testing should focus on extending reliability testing, discriminant validity and potential translation and literacy issues in this population. RELEVANCE TO CLINICAL PRACTICE: Within known limitations, clinicians will find the Treatment Satisfaction Questionnaire for Medication (version 1.4) useful for identifying adult Portuguese-speaking Brazilian patients at risk of poor adherence and tailoring adherence interventions to promote hypertension control.

Calorimetric and Light Scattering Investigations of the Transition from Spherical to Wormlike Micelles of C14TAB Triggered by Salicylate.

Although wormlike micelles (WLM) were first described more than 30 years ago, many aspects of their formation process are still unclear. Herein, a systematic experimental investigation of the process for wormlike micelle (WLM) formation in mixtures of tetradecyltrimethylammonium bromide (C14TAB) and salicylate (2-hydroxybenzoate) was carried out. This system was used as a model to investigate the conditions for the formation of the giant aggregate. For comparison, the other two isomers of salicylate (3- and 4-hydroxybenzoate) were also investigated, once in these cases wormlike micelles are not formed. The studies were based on calorimetric titration, static light scattering, and rheological measurements. Enthalpy changes upon titration of C14TAB into 2-hydroxybenzoate solutions revealed a highly cooperative and exothermic process that was associated with micelle growth. The size of the aggregates, obtained by static light scattering measurements, confirms the shape transition. In addition, the correlation of these two sets of results with measurements of micelle charge surface indicates that this transition occurs around the point of charge neutralization.

A randomized controlled trial of the effectiveness of planning strategies in the adherence to medication for coronary artery disease.

AIM: To examine the effect of action and coping planning strategies in the adherence to medication among outpatients with coronary artery disease. BACKGROUND: Action and coping planning strategies are based on implementation intention, which requires self-regulation by the individual, to prioritize intentionally planned responses over learned or habitual ones, from daily routines to stressful situations. DESIGN: Randomized controlled trial. METHODS: Participants (n = 115) were randomized into intervention (use of action and coping planning strategies, n = 59) or control (usual care, n = 56) groups. The study was conducted between June 2010-May 2011 in two in-person visits: baseline and 2-month follow-up. Participants in the intervention group received telephone reinforcement between baseline and 2-month follow-up. Adherence to medication for cardioprotection and symptoms relief was evaluated by proportion of adherence, global measure of adherence evaluation and Morisky Self-Reported Measure of Medication Adherence Scale at both baseline and 2-month follow-up. FINDINGS: When using the measure of global measure of adherence, participants in the intervention group reported adherence to therapy more often than controls (odds ratio = 5.3), but no statistically significant change was observed in the other two outcome measures. CONCLUSION: This study has shown that individuals who use action and coping planning report higher adherence to drug treatment, when measured by the global adherence evaluation. Further studies with longer follow-ups are needed to assess if the effect of planning strategies has long-term duration.

Allelopathic effects of cyanotoxins on the physiological responses of Chlorella vulgaris.

Contributing to the assessment of potential physiological changes in microalgae subjected to different concentrations and types of cyanotoxins, this study investigated the inhibitory effects of cyanotoxins on the growth, density, biomass, and ecotoxicity of Chlorella vulgaris. Chlorella vulgaris was exposed to crude extracts of cyanobacteria producing microcystin-LR (MC-LR), saxitoxin (SXT), anatoxin-a (ATX-A), and cylindrospermopsin (CYN) with initial concentrations of 5.0, 2.05, 0.61, and 1.42 µg.L-1, respectively. The experiments were conducted under controlled conditions, and monitoring of growth and cell inhibition occurred at 24h, 48h, 72h, and 96h. Chlorophyll-a content and ecotoxicity assessment were conducted with samples collected after 96h of exposure to cyanotoxins. The growth assays of Chlorella vulgaris, with results expressed in terms of average growth rates (doublings/day), indicated the following order for cyanotoxins: SXT (2.03) > CYN (1.66) > MC-LR (1.56) > ATX-A (0.18). This assay revealed the prominent inhibitory potential of ATX-A on Chlorella vulgaris growth compared to the other toxins evaluated. Regarding the inhibition of the photosynthetic process, expressed in terms of the percentage inhibition of Chlorophyll-a, the following order for cyanotoxins was obtained: ATX-A (82%) > MC-LR (76%) > STX (46%) > CYN (16%). These results also indicated that among the cyanotoxins, ATX-A was the most detrimental to the photosynthetic process. However, contrary to the observations in the growth study, SXT proved to be more harmful than CYN in terms of Chlorophyll-a inhibition. Finally, the results of the toxicity assay revealed that only ATX-A and MC-LR exerted a chronic influence on Chlorella vulgaris under the investigated conditions.

[Measure of disease impact: instrument construct validity in patients with coronary artery disease]. / Medida do impacto da doença: validade de constructo de instrumento entre coronariopatas.

This study estimated the known groups construct validity for the Instrument to Measure the Impact of Coronary Disease on Patient's Everyday Life (IDCV) related to signs and symptoms, ventricular systolic function, left ventricular ejection fraction (LVEF) and health-related quality of life (HRQoL) in 153 outpatients with coronary artery disease. Data was obtained through application of IDCV and Brazilian versions of the instruments The Medical Study 36-item Short Form Health Survey - SF-36 and the MacNew Heart Disease Health-related Quality of Life Questionnaire . Mann-Whitney test was used to verify the ability of IDCV in discriminating impact of signs and symptoms, LVEF and ventricular systolic dysfunction. Also, the Kruskal-Wallis test was used to verify the discrimination power of the IDCV in relation to HRQoL. It was observed that the IDCV discriminated the impact between variables scored in HRQOL quartiles (≤Q1, Q1-Q3, ≥Q3). The study findings contribute for improvement of IDCV in measurement of disease impact in coronary artery disease patients.