Affect Health Status Research Articles

Analysis of factors affecting health status and abnormal lung function of workers exposed to welding fumes in Tianjin from 2020 to 2022

Objective: To investigate the health status and the influencing factors of abnormal lung function of welding fumes exposure workers in Tianjin from 2020 to 2022, and to provide theoretical basis for the protection and intervention of key occupational diseases. Methods: In October 2023, the relevant data of occupational health examination of welding fumes exposure workers in Tianjin from 2020 to 2022 (10831, 10758 and 21717 in 2020, 2021 and 2022, respectively) were collected from the China Disease Prevention and Control Information Platform. The electrocardiogram, chest radiograph and lung function abnormalities of workers in each year were analyzed, as well as the association between lung function abnormalities and gender, age, working age, region, etc. With gender, age and years of service as independent variables, logistic regression analysis was performed year by year on the influencing factors of abnormal lung function. Results: From 2020 to 2022, electrocardiogram, chest radiograph and lung function abnormality rates of workers exposed to welding fumes had statistical significances (χ(2)=301.79, 7.87, 1614.54, P<0.05), and the lung function abnormality rate showed a downward trend year by year (χ(2)(trend)=1516.19, P<0.001). The abnormal rates of lung function in male workers exposed to welding fumes were higher than those in female workers (χ(2)=61.65, 8.04, 15.22, P<0.05). With the increase of age, the abnormal rate of lung function showed an increasing trend (χ(2)(trend)=6.47, 10.81, 4.72, P<0.05). The abnormal rates of lung function in the four districts around the city in each year were 22.05% (318/1442), 8.91% (171/1919) and 6.48% (273/4212), respectively. Year by year logistic regression analysis showed that females were the protective factors for abnormal lung function (OR=0.369, 0.568, 0.546; 95%CI: 0.298-0.458, 0.367-0.879, 0.388-0.767; P<0.05) . Conclusion: Attention should be paid to the health status of welding fumes workers in Tianjin, focusing on the protection of middle-aged male workers, and effective prevention measures should be taken for key areas and industries such as the four districts around the city.

Qualitative interview study of patient-reported symptoms, impacts and treatment goals of patients with obstructive hypertrophic cardiomyopathy

ObjectiveHypertrophic cardiomyopathy (HCM), including obstructive HCM (oHCM), is the most common inherited cardiomyopathy causing lifestyle-limiting symptoms. Data are lacking about patients’ perspectives on the daily impact of their symptoms. This...

The Effect of Treatment Adherence on Health Status of Outpatients with Chronic Obstructive Pulmonary Disease

Adherence to COPD treatment plays a crucial role in patient health outcomes. Understanding the correlation between treatment adherence and health status is vital for clinicians to develop effective disease management strategies. This study aimed to examine treatment adherence and its impact on the health status of COPD patients, specifically focusing on the effects of adhering to inhaled medications and breathing exercises. A cross-sectional study involving 420 outpatients diagnosed with COPD was conducted. The study encompassed administering questionnaires, observing patient breathing exercises, and measuring ventilatory function. Results showed that only 36.9% of participants adhered to treatment, with 44.7% following inhaler protocols and 36.9% regularly engaging in breathing exercises. The patients who were non-adherent exhibited a 0.3-fold increase in disease severity compared to the adherent group (p = .002). These findings suggest that consistent adherence to treatment, including inhaled medications and breathing exercises, may positively affect health status by reducing disease severity and airway obstruction in COPD patients. To address this, we recommend that home care clinicians implement a post-discharge assessment and intervention program. This program should focus on educating patients about the importance of treatment adherence and promoting behaviors that reinforce adherence to prescribed therapies.

The Effect of Health Literacy on Health Status in Patients with Heart Failure: A Path Analysis.

Managing heart failure (HF) is challenging because of its complexity and high rates of hospitalization, morbidity, and mortality. Effective management requires coordination between patients' abilities and healthcare services; however, low health literacy among patients with heart failure can adversely affect their health status. Therefore, the understanding relationship between health literacy and health status would provide the evidence for developing future intervention. This analytical study explored multilevel factors influencing health literacy and health status in patients with heart failure (HF) who underwent health service delivery at outpatient clinics. The sample consisted of 453 patients with HF from 12 hospitals located in five regional areas (north, south, east, northeast, central, and Bangkok) in Thailand. A hypothetical model was used to test the association between comorbidity, social support, patient-centered care, health service delivery, health literacy, and health status. Path analysis was used to analyze the data. The results indicated that 40.8% of patients with HF exhibited low or inadequate levels of health literacy, yet perceived their health status as good, with an average of 25.2±19.8 points. Health service delivery by a cardiologist and nurse case manager directly influences health literacy. Comorbidity had a direct impact on health status, whereas social support, patient-centered care, and the aforementioned health service delivery indirectly affected health status through health literacy. Importantly, health literacy status directly influences health status. Comorbidity, social support, patient-centered care, and health service delivery were related with health literacy and high level of health literacy could influence the better health status. To increase the quality of health care services, health care providers should promote health literacy and integrate the concept of patient-centered care for HF patients at outpatient clinics. Recommendations include the training of nurses as case managers.

Scar Perception in School-aged Children After Major Surgery in Infancy

BackgroundThe long-term effects of childhood surgery scars on health status, quality of life (QoL), self-esteem, and body image remain uncertain. This study explores these effects in school-aged children. MethodsWe conducted a retrospective cohort study involving 454 children (58% boys; 8–17 years) who had undergone surgical correction of anatomical anomalies or neonatal ECMO. Data included patient-reported scar perception and scar-related embarrassment, along with psychological assessment via questionnaires. ResultsAbout 34% of children rated their scars as 'nice-looking', 49% as 'indifferent', and 12% as 'rather ugly'. Most children (91%) never experienced scar-related embarrassment, while frequent embarrassment was reported by 3%. Surgical scar correction was desired by 6% of the 8-year-olds and 19% of the 17-year-olds. Scar perception did not significantly affect health status or QoL. However, negative scar perception was associated with lower self-esteem in girls and a more negative body image in boys. Girls were more likely to report negative scar perception (OR: 1.54, 95%-CI: 1.06–2.24) and scar-related embarrassment (OR: 4.29, 95%-CI: 1.77–10.44). ConclusionChildren who underwent surgery in the neonatal period and subsequently grew up with scars resulting thereof, mostly perceive them either indifferently or positively, with minimal effect on health status and QoL. Nonetheless, some children, particularly girls, experienced negative perceptions of their scars, although scar-related embarrassment was rare. We recommend integrating scar assessment into routine follow-up at ages 12 and 17, and offering appropriate and timely guidance and support to children at risk for negative effects of scars. Level of EvidenceIII.

The Public Health Implications of the Global Financial Crisis

The Global Financial Crisis resulted in significant economic problems that subsequently led to a public health crisis worldwide. For example, the unemployed suffered from more severe physical and mental health problems than the employed due to the loss of employer-sponsored health insurances. The crisis further exacerbated racial health inequalities that subsequently worsened maternal and child health outcomes, which negatively affected health status of the future generations. This paper provides a comprehensive discussion of the influence that this crisis has had on physical and mental health, health inequalities, and the intergenerational health impact. To respond to the health implications, the government implemented the Affordable Care Act and the Continuation of Health Coverage (CORBA). In the future, policymakers need to increase social safety net programs, especially government health insurance, for vulnerable populations so that another global financial crisis will likely not have such a negative and profound impact on public health outcomes. The motivation of this paper is to emphasize that higher-quality and more comprehensive unemployment health insurance that covers a broader and more diverse set of populations should become available for the unemployed during economic downturns. This article concludes that policymakers need to design health policies in a way that prevents future financial crises from depriving low-income and unemployed people of their right to health care. Policies must become proactive in advocating for health equity and creating opportunities for people to access medical services in a timelier manner, especially during times of financial downturns.

Quercetin Alleviates Insulin Resistance and Repairs Intestinal Barrier in db/db Mice by Modulating Gut Microbiota.

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disease which seriously affects public health. Gut microbiota remains a dynamic balance state in healthy individuals, and its disorder may affect health status and even results in metabolic diseases. Quercetin, a natural flavonoid, has been shown to have biological activities that can be used in the prevention and treatment of metabolic diseases. This study aimed to explore the mechanism of quercetin in alleviating T2DM based on gut microbiota. db/db mice were adopted as the model for T2DM in this study. After 10 weeks of administration, quercetin could significantly decrease the levels of body weight, fasting blood glucose (FBG), serum insulin (INS), the homeostasis model assessment of insulin resistance (HOMA-IR), monocyte chemoattractant protein-1 (MCP-1), D-lactic acid (D-LA), and lipopolysaccharide (LPS) in db/db mice. 16S rRNA gene sequencing and untargeted metabolomics analysis were performed to compare the differences of gut microbiota and metabolites among the groups. The results demonstrated that quercetin decreased the abundance of Proteobacteria, Bacteroides, Escherichia-Shigella and Escherichia_coli. Moreover, metabolomics analysis showed that the levels of L-Dopa and S-Adenosyl-L-methionine (SAM) were significantly increased, but 3-Methoxytyramine (3-MET), L-Aspartic acid, L-Glutamic acid, and Androstenedione were significantly decreased under quercetin intervention. Taken together, quercetin could exert its hypoglycemic effect, alleviate insulin resistance, repair the intestinal barrier, remodel the intestinal microbiota, and alter the metabolites of db/db mice.

Impact Assessment of Covid19 pandemic on operational aspect of national tuberculosis elimination program in Bhavnagar district

PurposeIndia account more than one forth tuberculosis cases. Covid 19 affect health condition like tuberculosis. We aim to assess impact of covid 19 on National Tuberculosis Elimination Program. MethodIn depth interviews of district tuberculosis officer, private practitioner and tuberculosis patients (who registered in District Tuberculosis Centre during April 2020–September2020) were conducted in Bhavnagar district. Notification rate during covid 19 was obtained from District Tuberculosis Centre of Bhavnagar district. All interviews were audio-recorded after obtaining written informed consent, transcribed in English, and analyzed in the form of codes and categories. ResultHealth care providers perceived covid 19 lockdowns, fear among patients, difficult transportation, diversion of resources and reduced concerns towards tuberculosis were the reason for low notification during the COVID-19 pandemic. ConclusionCOVID-19 lockdown had detrimental effects on notification rate. During such testing time patients felt proper supervision by front line worker, no issued in direct benefit transfer for nutrition support and adequate supply of medicine. Telemedicine, awareness through social media, collaboration with other agencies, bidirectional screening implementation, coping of covid 19 fear among patients, separate tuberculosis facility were the expectation from higher authority if next wave of covid 19 will come. Future studies can evaluate the feasibility, impact, and cost-effectiveness of such interventions.

Discriminating factors of body composition characteristics for academic performance in nursing college students: a cross-sectional study

BackgroundPoor body composition may affect health status, and better body composition is often associated with better academic performance. Nursing students face heavy academic and practical pressures, and the relationship between body composition and academic performance in this group is not fully understood.MethodsThis cross-sectional observational study used de-identified student data from a university of technology in southern Taiwan to analyze the correlation between body composition characteristics and academic performance using regression models.ResultsA total of 275 nursing college students were divided into four groups according to academic performance. The group with the lowest academic performance had a lower percentage of body fat (P < 0.05) but a higher percentage of muscle mass (P < 0.05) than the other three groups. Academic performance was positively correlated with percentage of body fat (R = 0.16, P < 0.01) and body age (R = 0.41, P < 0.01), but was negatively correlated with percentage of muscle mass (R = − 0.16, P < 0.01). Percentage of body fat, visceral fat area, and body age were significant discriminators of academic performance (P < 0.05).ConclusionsThe relationship between academic performance and body composition among nursing college students is not straightforward. Contrary to our initial hypothesis, students with higher academic performance tended to have a higher percentage of body fat and a lower percentage of muscle mass. Percentage of body fat, visceral fat area, and body age were significant discriminators of academic performance, indicating that body composition should be considered an important factor in nursing education and practice.

Role of anti-Asian racism for subjective well-being among people of Asian origin in Germany.

People of Asian origin in Germany are affected by racial-ethnic discrimination, which became even more evident in the context of surging anti-Asian racism (AAR) during the COVID-19 pandemic. Experiences of discrimination can pose a threat to mental health. This study tested the role of discrimination experiences for subjective well-being in a sample of Asian origin people in Germany. A total of 671 participants (76.5% women) who self-identified as being of Asian origin participated in an online survey in December 2020. Participants completed several measures of racial-ethnic discrimination experiences, some of which were related to the pandemic (e.g., experienced microaggressions and perceived change in discrimination experiences during the pandemic), as well as indicators of subjective well-being (positive and negative affect, life satisfaction, and subjective health status). In structural equation models, discrimination experiences were associated with lower subjective well-being (b = -.36, SE = .16, p < .05). A follow-up analysis suggested that this relationship was evident for discrimination measures that had a reference to the pandemic as well as measures without this reference. The range of different discrimination experiences among people of Asian origin in Germany is characterized by discrimination in the context of the pandemic and also beyond, and these may have a significant negative impact on the mental health of those affected. The findings of this study have practical implications both for reducing anti-Asian stigmas in society and in the context of psychological counseling of affected individuals, which should target the maintenance or improvement of subjective well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Food as Medicine: Can nutrition be a prescription?

Diet and lifestyle behaviors can affect health status and the development of disease. The importance of nutrition in healthcare is especially relevant as one in five deaths globally can be connected to poor diet. Food can be an integral part of preventing, managing, and treating disease through personalized nutrition, medically tailored meals and groceries, produce prescription programs, and culinary medicine. This publication dives into how nutrients connect to disease and uses of Food as Medicine as an overview for general learners.

Upaya Pencegahan Resiko Stroke Pada Lansia Melalui Pendidikan Kesehatan Di Panti Werdha Surya Jemursari Surabaya

Strokes are experienced by many elderly people and affect health status, resulting in impaired mobility and paralysis. To reduce the incidence of stroke in the elderly, health education and regular blood pressure checks are provided. The aim of community services at the Jemursari Nursing Home is to prevent the risk of stroke that occurs in the elderly. The method of implementing community services at the Surya Nursing Home is through education about stroke. Next, the team measured blood pressure, uric acid and blood sugar on 56 of the 71 elderly people living at the Surya Nursing Home. Examination results from 56 elderly people, blood pressure: elderly people who had blood pressure &gt;140/90 were 19 female participants and 7 male participants. Abnormal uric acid: 41 female participants and 8 male participants. Abnormal blood sugar was found in 7 female participants and 1 male participant. The output of this community service activity is to publish in the form of scientific articles for community service members which can increase knowledge, insight into how to prevent and carry out regular checks on blood pressure and other tests related to stroke.

The Relationship Between Hemodialysis Frequency and Quality of Life in Chronic Kidney Disease

Background: Chronic renal failure is a condition that shows abnormalities in kidney structure or function and affects health conditions. Hemodialysis is the main therapy for chronic renal failure patients. Hemodialysis is performed with a frequency of 8-12 times per month for 3-4 hours per hemodialysis session. Patients who undergo hemodialysis will affect their quality of life. Purpose: The purpose of this study was to determine the relationship between hemodialysis frequency and quality of life in patients with chronic renal failure undergoing hemodialysis. Methods: The research design used correlational analysis with a Cross-Sectional approach. Non-probability sampling technique with consecutive sampling approach totaling 40 samples. The research instrument used the World Health Organization Quality of Life-Bref (WHOQol-BREF) questionnaire. Bivariate test using Fisher's Exact Test. Results: The results of the Fisher's Exact Test bivariate test obtained a value of p = 0.000 (p &lt;0.05). The conclusion of this study shows a correlation between the frequency of hemodialysis and quality of life in patients with chronic renal failure. Implication: Determining the frequency of hemodialysis needs to consider the results of urea and creatinine examinations both before and after hemodialysis as well as things that need to be considered and how to handle them. Through the application of appropriate management, it can improve the quality of life of patients with chronic renal failure.

Can ChatGPT provide appropriate meal plans for NCD patients?

ObjectivesDietary habits significantly affect health conditions and are closely related to the onset and progression of non-communicable diseases (NCDs). Consequently, a well-balanced diet plays an important role in lessening the effects of various disorders, including NCDs. Several artificial intelligence recommendation systems have been developed to propose healthy and nutritious diets. Most of these systems use expert knowledge and guidelines to provide tailored diets and encourage healthier eating habits. However, new advances in large language models such as ChatGPT, with their ability to produce human-like responses, have led individuals to search for advice in several tasks, including diet recommendations. This study aimed to determine the ability of ChatGPT models to generate appropriate personalized meal plans for patients with obesity, cardiovascular diseases, and type 2 diabetes. MethodsUsing a state-of-the-art knowledge-based recommendation system as a reference, we assessed the meal plans generated by two large language models in terms of energy intake, nutrient accuracy, and meal variability. ResultsExperimental results with different user profiles revealed the potential of ChatGPT models to provide personalized nutritional advice. ConclusionAdditional supervision and guidance by nutrition experts or knowledge-based systems are required to ensure meal appropriateness for users with NCDs.

Risk Factors for Abnormal Hemoglobin Levels in Online Motorcycle Taxi Drivers in the Tanjung Mas Industrial Area, Semarang City

Air pollution can affect health conditions, CO and Pb are one of the compositions of vehicle exhaust gases that are dangerous. Online motorcycle taxi drivers have a high risk of exposure to pollutants. This research aims to determine the risk factors that affect hemoglobin levels in online motorcycle taxi drivers in the Tanjung Emas Area of Semarang City. The method used observational analytics with a cross-sectional approach. The total population in this study was 55 respondents and the number of respondents was determined using total sampling. Based on the results of examining hemoglobin levels using a hematology analyzer, of 55 respondents, 47 respondents had normal hemoglobin levels and 8 respondents had abnormal hemoglobin levels. The results of the Chi square test on smoking status have a significant relationship (p=0.04) to the blood hemoglobin level of online motorcycle taxis in the Tanjung Emas Area of Semarang city while in the status of Education, length of work, and knowledge there is no significant relationship (0.05) to the hemoglobin level of online motorcycle taxi drivers in the Tanjung Emas Area of Semarang City. The conclusion of this study is that there is a significant relationship between smoking status and hemoglobin levels of online motorcycle taxi drivers in the Tanjung Emas Area of Semarang City and there is no significant relationship between education factors, length of work time, and knowledge of hemoglobin levels of online motorcycle taxis in the Tanjung Emas Area of Semarang City.

Could vitamin D concentration be a marker of a long hospital stay in older adults patients?

Vitamin D plays a pleiotropic role in the human body. Some studies have suggested that hypovitaminosis D may serve as a marker of comorbidity severity and length of hospital stay. Hospitalized older adults patients with a higher comorbidity burden tend to have lower vitamin D status, which negatively impacts the length of their hospital stay. Vitamin D deficiency has been identified as a significant risk factor for a prolonged hospital stay. This study aimed to investigate the link between vitamin D status and prolonged hospital stays, focusing on geriatric patients, and to assess the variation in hospitalization duration among geriatric patients with different vitamin D statuses. The study sample comprised of 422 patients aged over 60 years admitted to the geriatric department. Blood samples were collected in the morning on the day of admission. According to the diagnostic threshold defining serum 25(OH)D concentration approved for Central Europe, patients were divided into two groups (deficiency group and suboptimal group). Patients were divided into two groups based on hospitalization duration: the first, "shorter hospitalization," included stays up to 11 days, whereas the second, "longer hospitalization," encompassed stays of 12 days and above. In total, 242 Caucasian patients, primarily women (172 women and 70 men), were recruited in the study. Patients with vitamin D deficiency had extended hospital stays compared with those with vitamin D levels below 49.92 nmol/L: 10.0 (8.00-13.00) days vs. 9.00 (8.00-11.00) days, P = 0.044. Hospitalization length (in days) had a negative correlation with vitamin D blood status (nmol/L) (P = 0.0005; R = -0.2243). ROC analysis indicated that patients with vitamin D levels below 31.2 nmol/L had a 47% higher chance of extended hospitalization, whereas those with levels above 31.2 nmol/L had a 77% higher chance of avoiding it. A significant majority of patients with suboptimal 25(OH)D levels experienced shorter hospital stays (≤11 days) than those with vitamin D deficiency (64.6%), P = 0.045. The study findings indicate that lower serum levels of 25(OH)D in hospitalized patients within the geriatric department are linked to extended hospital stays. Vitamin D holds potential as a predictor of hospitalization duration in geriatric patients. Nonetheless, further research is imperative to account for additional factors affecting health status and hospitalization duration in older adults individuals.

The self-care behaviors and health literacy can play important preventive roles in older female osteoporosis

BackgroundOsteoporosis is a common complication of aging and menopause. Self-care and health literacy are among the factors affecting health status. The purpose of this research was to determine the preventive roles of self-care behaviors and health literacy in older women with osteoporosis.MethodsThis cross‑sectional analytical research was conducted on 250 postmenopausal women consisting of 125 osteoporotic and 125 healthy people aged 60–70. They were selected by purposive sampling in Tabriz Sina Hospital from September 2021 to December 2021. Data collection instruments were a demographic questionnaire, a Menopausal Self‑Care Questionnaire, and a European Health Literacy Survey Questionnaire. Data were analyzed using SPSS 23 software.ResultsThe mean (SD) total score of self-care in healthy women was 118.97 (19.92) and in women with osteoporosis was 84.7 (14.98) (p < 0.001). Also, healthy women all had sufficient health literacy (100%), but 52.8% of women with osteoporosis had insufficient health literacy. The odds of osteoporosis decreased significantly with the rise in the total score of self-care behaviors [Odds ratio 95% confidence interval (95% CI); p: 0.909 (0.880 to 0.939); p < 0.001] and its subdomains as well as with increasing health literacy level [OR (95% CI); p: 0.322 (0.266 to 0.383); p < 0.001]. There was a significant positive correlation between self-care behaviors and health literacy (r = 0.616, p < 0.001).ConclusionsSelf-care in aged women is particularly important in reducing the risk of osteoporosis, and empowering women in the field of health literacy is an important factor in improving self-care behaviors and ultimately the health of these people.

Deep brain stimulation of the subthalamic nucleus in Parkinson’s disease after 15 years: Clinical outcome and caregiver burden

Background and objectivesTo provide a detailed overview of motor and non-motor outcome of Parkinson disease (PD) patients with deep brain stimulation (DBS) of the Subthalamic nucleus (STN) 13–17 years after surgery. Little information on long-term follow-up (>10 years) after surgery is available yet, with a high percentage of loss to follow-up (FU). MethodsIn this observational cohort study data on motor, autonomic symptoms, cognitive outcome, mood, quality of life, activities of daily living, Unified Parkinson’s disease rating scale (UPDRS, version 1) scores and dopaminergic medication were collected average 15.1 years (± 1.5 standard deviation) after surgery. To limit the loss to FU, patients unable to visit the hospital have been evaluated at their place of residency (e.g. home or nursing home). Furthermore, caregiver burden was assessed. ResultsFifteen (35%) of the 43 included patients survived follow-up, of which 9 patients were assessed at their institution. UPDRS I (1.46 vs. 6.7, p < 0.005), UPDRS II (10.5 vs. 30.5, p < 0.01) and UPDRS III (47.7 vs. 18.3, p = 0.005) significantly worsened compared to baseline with medication. Axial symptoms and bradykinesia were most severely affected of the UPDRS III score. New autonomic symptoms were dominant. One third (n = 5) of caregivers reported significant burden. EQ-5D was 0.43 and 4 patients (27%) showed signs of moderate to severe depression. Six patients (40%) met criteria of dementia. ConclusionCognitive, axial, bradykinesia and autonomic symptoms are highly dominant after 15 years of follow-up, whereas tremor and rigidity show no significant worsening over time. This significantly affects health status, quality of life and caregiver burden.

Dapagliflozin and Physical and Social Activity Limitations in Heart Failure With Reduced Ejection Fraction

BackgroundHeart failure (HF) is associated with impaired physical function and poor quality of life and affects health status more profoundly than many other chronic diseases. ObjectivesThe authors examined the effects of dapagliflozin on specific physical and social limitations as reported by patients in the DAPA-HF (Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure) trial. MethodsThe effect of dapagliflozin on the change from baseline to 8 months in each of the individual physical and social activity limitation questions answered by patients completing the Kansas City Cardiomyopathy Questionnaire (KCCQ), and overall scores, were examined with mixed-effects models and responder analyses. ResultsIn total, 4,269 (90.0%) and 3,955 (83.4%) patients had complete data for both the physical and social activity limitation scores at baseline and 8 months, respectively. Compared with placebo, dapagliflozin significantly increased (improved) the mean KCCQ physical and social activity limitation scores at 8 months (placebo-corrected mean difference 1.94 [95% CI: 0.73-3.16] and 1.84 [95% CI: 0.43-3.25], respectively). Dapagliflozin also increased each of the individual components that comprise the physical and social activity limitations domains at 8 months, with the largest improvement seen in “hobbies or recreational activities” (placebo-corrected mean difference: 2.76 [95% CI: 1.06-4.46]) and “doing yardwork, housework, or carrying groceries” (placebo-corrected mean difference: 2.59 [95% CI: 0.76-4.42]). The proportion of patients with a 5-point improvement from baseline to 8 months in the KCCQ physical and social activity limitation scores was greater with dapagliflozin than with placebo (ORs: 1.23 [95% CI: 1.09-1.40] and 1.19 [95% CI: 1.05-1.35], respectively). ConclusionsIn patients with HFrEF, dapagliflozin, compared with placebo, improved physical and social activity limitations as measured by KCCQ. (Study to Evaluate the Effect of Dapagliflozin on the Incidence of Worsening Heart Failure or Cardiovascular Death in Patients with Chronic Heart Failure [DAPA-HF]; NCT03036124).

Association between Urban Socio-Environmental Characteristics Including Travel Behavior, and Health Performance

Understanding the urban environment and the health status of residents is necessary for appropriate administrative services and regional management. This study used indicator scores derived from the area statistics of cities in the Tokyo metropolitan area to identify factors that affect health status. Indices were classified into two groups: health-related and non-health-related. The index values of each group served as the observed variables and were statistically standardized. The relationship between the two groups was analyzed using canonical correlation analysis. The results indicate that social infrastructure and daily travel behavior affect the health status of residents, possibly by promoting physical activity. Furthermore, characteristics of the urban environment and travel behavior were strongly associated with the ratio of deaths due to lifestyle-related diseases.