Changes In Health Status Research Articles

PO-02-194 CHANGES IN ANXIETY AND DEPRESSION IN ATRIAL FIBRILLATION PATIENTS AFTER RECEIVING MULTIDISCIPLINARY CARE AT AN ATRIAL FIBRILLATION CENTER OF EXCELLENCE

Anxiety and depression are known to occur in over one third of patients with atrial fibrillation (AF) and may negatively affect quality of life (QoL) and AF symptom severity. Though highly prevalent, the relationship between anxiety and depression with AF care remains poorly defined. The goal of an Atrial Fibrillation Center of Excellence (AFCoE) is to improve outcomes by delivering team-based multidisciplinary care to streamline risk factor modification while incorporating performance -measures and ongoing quality improvement to facilitate data-driven delivery of high-quality, guideline directed care. In the pilot phase of the AFCoE at the Inova Heart and Vascular Institute, an AF care coordinator and specialists from electrophysiology and sleep medicine were included based on patient need. To investigate changes in mental health status following multidisciplinary AF care received in an AFCoE in patients with AF. 138 patients were referred to the Inova AFCoE pilot between 10/2021 and 4/2022. Demographic and clinical comorbidities were ascertained. The frequency and severity of anxiety and depression were measured in a subset of participants (n=41) using the General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) tools administered at baseline and again between 3 to 6 months after their initial AFCoE visit. Baseline and follow-up summed GAD-7 and PHQ-9 scores were compared using the Wilcoxon test. Additional analyses were performed among patients with clinically significant baseline anxiety (GAD-7 score ≥5 points) or depression (PHQ-9 score ≥5 points). A total of 12/41 (29%) patients had clinically significant depression or anxiety (scores ≥5 points) at baseline. Among patients with clinically significant depression or anxiety at baseline, the median [interquartile range] summed score improved at follow-up from 13[11–15] to 6[1–9] points (p=0.005, score reduction 8[2–14] points). Nearly one third of patients referred to the Inova AFCoE pilot phase had clinically significant anxiety and/or depression at baseline. Multidisciplinary AF treatment without specific behavioral health intervention was associated with clinically significant improvements in anxiety and depression.

122 US senior horses: When are they considered “old” and how does that affect their management?

Depending on the age definition applied (e.g., chronologic, demographic, physiologic), a horse may be considered old at 15 years, 20 years, or even at an older age. The management of a horse is likely adjusted once it is considered old, however, details concerning these changes are currently sparse. Similarly, it is unclear at what age owners typically consider their horses to be old and why. To learn more about these and other topics related to older horses, a US-wide survey was conducted with owners of horses aged ≥ 15 years. The objectives of the present subsection of this survey were to 1) determine at what age horses were considered old by their owners, 2) identify the reasons for this decision, and 3) assess management changes made because the horse was considered old. The anonymous survey was distributed through social media and a press release and was online from Oct. 15th to Nov. 21st, 2020. 2717 of 2927 started surveys were eligible for analysis. Responses were received from all US states with southeastern states being most represented (38%; n = 2607). Data were analyzed descriptively with frequency counts expressed as percentages. Percentages amounted to maximally 100% for single-choice questions (s-c q.) but could exceed 100% for multiple-choice questions (m-c q.). All responses were discrete variables. At the time of the survey, about half (47.4%)of the participants considered their horse to be old (n = 2528 total responses to question; s-c q.). Most indicated to have first considered their horse old at an age of 20 (22.8%) or 25 years (14.1%) (n = 1181; s-c q.). Other ages were overall less commonly reported and hence grouped: < 15 years (1.0%), 15–19 years (24.0%), 21–24 years (22.4%), 26–30 years (13.9%), and > 30 years (1.9%). The top 3 reasons for considering their horses old were: 1) horse showed reduced ability to work/exercise (43.6%), 2) horse showed first signs of age-related disease/disorder (43.5%), 3) horse's hair turned gray/increase in gray hair (29.3%) (n = 1153; m-c q.). Ninety-one percent (90.6%) made changes to their horse's management once it was considered old (n = 1187; m-c q.). The top 3 changes were: 1) changed diet and/or supplements (65.9%), 2) exercised horse less intensely (31.3%), and 3) stopped riding/driving exercise (29.6%) (n = 1187; m-c q.). In conclusion, horses were often considered old at distinct ages (20 and 25 years), with changes in fitness level, health status, and physical characteristics (i.e., gray hair) reported as the main reasons. For almost all horses, management was adjusted once they were considered old, and changes mainly pertained to exercise regimen and diet.

Categorization of the health status and its transition of community-dwelling older adults during the coronavirus disease (COVID-19) epidemic

The purpose of this study was to categorize and clarify transitions in the health status of older adults living in the community during the coronavirus disease (coronavirus disease 2019: COVID-19) pandemic. The participants were older adults (≥65 years of age) who lived in Takasaki City, Gunma Prefecture. The survey items included basic information and subjective health perception (questionnaire for medical checkup of old-old). Latent class analyses were conducted for the first (baseline) and second surveys (6 months). The scores for each item were compared to identify the characteristics of each class at baseline and at 6 months. In addition, transitions in class affiliation from baseline to 6 months were summarized. A total of 434 of 1,953 participants (mean age: 79.1 years, 98 males and 336 females) completed the survey (22.2%). In both time periods, the responses were categorized into four classes: 1) good, 2) poor physical, oral and cognitive function, 3) poor social status and lifestyle, and 4) poor in all except social status and lifestyle. During 6 months of follow-up, a transition from the generally good class to the poor physical, oral and cognitive functions class was observed in many cases. The health status of the older adults living in the community was classified into four classes, and changes in health status occurred even within a short period of time during the COVID-19 pandemic.

Patient-Reported Outcomes in Myotonic Dystrophy Type 2: Correlations with Motor and Cognitive Endpoints (S7.007)

<h3>Objective:</h3> To characterize patient-reported outcomes (PROs) and evaluate relationships between PROs and clinical endpoints in patients with myotonic dystrophy type 2 (DM2). <h3>Background:</h3> Although muscle weakness is the key feature in DM2, two-thirds of patients report that impaired cognition is among the most disabling symptoms and affects their quality of life. PROs of physical and mental status are extremely limited in DM2 but could serve as measures for clinical trial development. <h3>Design/Methods:</h3> Ten individuals with DM2 and ten age and gender-matched controls were enrolled. All participants underwent brain MRIs and a comprehensive battery of cognitive and motor measures. Additionally, they completed PROs, including the 36-Item Short Form (SF-36), PRO Measurement Information System (PROMIS-10), Beck Depression and Anxiety Inventory (BDI and BAI), and Apathy Evaluation Scale (AES). Paired t-test and Spearman’s correlation were used to determine group differences and correlations between PROs and clinical endpoints. <h3>Results:</h3> Of 20 participants (60% female), mean age and education were similar between groups. Compared to controls, the DM2 group showed a significant difference in BAI, AES, and SF-36 physical functioning (PF) subscale (<i>p</i>=0.004–0.024) and impaired PROMIS-Global Physical (GPH) and Mental Health (GMH). We found a strong correlation between SF-36 (PF) and PROMIS-GPH with a 6-minute walk test and gait speed (<i>rho</i>=0.68–0.75, <i>p</i>=0.02–0.04). Moderate correlations were observed between 1) BDI and verbal fluency test; 2) BAI and processing speed; 3) AES and a test of executive function and cerebral white matter integrity. <h3>Conclusions:</h3> Our pilot study demonstrates that changes in mental and physical health status are of significance for DM2 patient’s quality of life. The relationships between PROs (BAI, BDI, and AES) and cognitive endpoints suggest brain involvement. PROs, as measured by SF-36 and PROMIS-10, are associated with motor endpoints. These results support the use of PROs as a tool to measure disease burden in DM2. <b>Disclosure:</b> Dr. Jain has nothing to disclose. Dr. Olszewski has nothing to disclose. Dr. Flashman has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Archives of Clinical Neuropsychology. The institution of Dr. Flashman has received research support from NIH/NINDS. The institution of Dr. Flashman has received research support from Michael J Fox Foundation. Mrs. Burgos-Aguilar has nothing to disclose. Dr. Duncan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BrainQ Technologies. Dr. Duncan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for University of Pittsburg Pepper Center. Dr. Duncan has stock in CareDirections. The institution of Dr. Duncan has received research support from PCORI. The institution of Dr. Duncan has received research support from NIA and NINDS. The institution of Dr. Duncan has received research support from AHRQ. Dr. Duncan has received intellectual property interests from a discovery or technology relating to health care. The institution of Dr. Nopoulos has received personal compensation in the range of $500-$4,999 for serving as a Consultant for norvartis. The institution of Dr. Puwanant has received research support from Muscular Dystrophy Association. The institution of Dr. Puwanant has received research support from NIH/NINDS. The institution of Dr. Puwanant has received research support from NIH/NINDS.

Treatment expectations in glaucoma: what matters most to patients?

Background/ObjectivesRecent clinical trials in glaucoma have used patient-reported outcome measures (PROMs) of health-related quality of life to evaluate interventions. However, existing PROMs may not be sufficiently sensitive to capture changes in health status. This study aims to determine what really matters to patients by directly exploring their treatment expectations and preferences.Subjects/MethodsWe conducted a qualitative study using one-to-one semi-structured interviews to elicit patients’ preferences. Participants were recruited from two NHS clinics serving urban, suburban and rural populations in the UK. To be relevant across glaucoma patients under NHS care, participants were sampled to include a full range of demographic profiles, disease severities and treatment histories. Interview transcripts were evaluated using thematic analysis until no new themes emerged (saturation). Saturation was established when 25 participants with ocular hypertension, mild, moderate and advanced glaucoma had been interviewed.ResultsThemes identified were: Patients’ experiences of living with glaucoma, patients’ experiences of having glaucoma treatment, most important outcomes to patients, and COVID-related concerns. Participants specifically expressed their most important concerns, which were (i) disease-related outcomes (intraocular pressure control, maintaining vision, and being independent); and (ii) treatment-related outcomes (treatment that does not change, drop-freedom, and one-time treatment). Both disease-related and treatment-related experiences were covered prominently in interviews with patients across the spectrum of glaucoma severity.ConclusionsOutcomes related both to the disease and its treatment are important to patients with different severities of glaucoma. To accurately evaluate quality of life in glaucoma, PROMs may need to assess both disease-related and treatment-related outcomes.

Impact of COVID-19 on Dental Care Utilization and Oral Health Conditions in the United States.

We aim to understand the impact of the COVID-19 on health care utilization and oral health conditions of patients at federally qualified health centers (FQHCs), where patients are disproportionately low income, publicly insured, or uninsured. Using deidentified electronic health records of patients at FQHCs in the United States from January 2019 through December 2020 (n = 431,509), variations in health care utilization since the COVID-19 outbreak were observed by procedure types and patient characteristics. Changes in dental utilization and oral health conditions were characterized using mixed-effect negative binomial and logistic regression models. Dental utilization decreased more drastically than medical utilization during shelter-in-place periods in 2020 and rebounded more slowly after the reopening. Greater demands for oral surgery and teledentistry and less demands for preventive services were observed in 2020. As compared to 2019, patients experienced more psychological stress-related dental conditions with odds ratios of 1.52 (95% confidence interval [CI], 1.31-1.76) for uninsured, 1.48 (95% CI, 1.07-2.02) for Medicaid enrollees, and 2.38 (95% CI, 1.68-3.40) for private insurance beneficiaries. As a result of COVID-19, patients received more invasive dental procedures due to delayed treatment and experienced a higher risk of psychological stress-related dental conditions. Continued support for statewide policies to expand access to oral health care and oral health promotion strategies for the vulnerable populations would be encouraged. Our study describes the impact of COVID-19 on dental care use and oral health conditions at Federally Qualified Health Centers, targeted to provide care for some of the most vulnerable populations in the United States. The results of this retrospective cohort study can be used by clinicians and policymakers on understanding the clinical needs of the vulnerable populations after the pandemic. It highlights the need for continued support to expand access to oral health care and oral health promotion to these populations.

Information Technology-Based Educational Video Model For Changes In Gingival Health Status In Adolescents

The health problem that is often experienced by adolescents is dental and oral hygiene, RISKESDAS data for 2018, 57.6% of Indonesian people have dental and oral health problems. Gingival problems are common in adolescents. Lack of dental and oral hygiene causes gingival inflammation. Plaque, bacteria, and calculus that accumulate on the tooth surface are the main causes of periodontal disease. Early detection that is carried out independently as well as providing solutions for prevention and treatment to patients is very necessary. Media that is currently developing among adolescents is technology-based media which is increasingly creative and can be a solution for preventing dental disease. Proving appropriate information technology-based educational videos and their effective application to changes in gingival health status in adolescents. The research method used is Research and Development (RnD) with Quasy Experiment pre-test post-test control group design. Educational video based on information technology is appropriate for changes in gingival health status with the results of expert validation of 83% and p-value 0.044 and its application is effective in increasing knowledge (p=0.000), attitude (p=0.002), skills (p=0.000), GI (p = 0.001). As well as indicated by the delta value of knowledge (2.14), attitude (1.29), skills (2.14), decreased GI score (0.44) compared to the control group. Educational videos have proven to be appropriate and effective in their application to changes in gingival health status in adolescents marked by a decrease in the gingival index score.

The Increasing Salience of Health in Social Forces Research

Global life expectancy at birth approximately doubled during the 100-year history of Social Forces (Heuveline 2022; Riley 2005). As the average length of life of the individuals and their experiences in the communities and institutions studied in the journal increased, health became more salient to social and economic life. The increasing prominence of health, embodied by an individual’s continuing physical, emotional, mental, and social ability to cope with his or her environment over the life course, is reflected in the trend of health-related articles in Social Forces. A handful of health-related articles appeared during the decades from 1920 to 1960, followed by a small but steady flow of publications from 1970 to 2000, after which there has been more growth and diversity in health-related publications in the twentieth-first-century issues of Social Forces. The trend in health research within Social Forces has been driven by three factors: (1) the substantive relevance of health status, behavior, and healthcare (i) within societal structures and institutional contexts, (ii) in relation to social behavior, and (iii) as influenced by social stratification processes; (2) increasing availability of high-quality health data; and (3) increased attention to measurement of health. While much of the early health research published in Social Forces focused on mental health and mental health systems, over time as new surveys delivered a greater range of health measures, research soon included diverse measures of general health status, health behavior, and physical health indicators and change in them over time.

An Evaluation of The Effect of Passive Smoking on Caries and Periodontal Index in Preschool Children

Objective: To observe the changes that passive smoking causes in early childhood caries and periodontal tissues in preschool children. Method: In our study, caries, periodontal, and plaque indexes were measured in preschool children aged 3-5 years and subjected to passive smoking. A 7-item questionnaire was administered to the parents. Results: Periodontal and plaque indexes of children whose parents were smokers were higher than those of the children of non-smoking parents. In the evaluation made according to the education level of the parents, it was seen that the mean plaque index of the children of the fathers who were secondary school graduates was higher than that of parents with university degree. It was determined that the plaque index of children who did not use fluoride toothpaste and did not consume milk daily were higher than that of the other children. It was determined that the caries indexes of children who consumed sweet snacks during day were significantly higher than those who did not. Conclusions: Passive smoking causes many changes in dental caries, periodontal health, and plaque status in preschool children. In order to protect the oral health of children in the risk group, preventive measures should be taken in the early period and routine dentist controls should be made. Key words: Secondhand smoke, dental caries, periodontal status, dental plaque index

STRESSORS IN LEPROSY WITH DISABILITY: A SYSTEMATIC REVIEW

Background: Psychological pressure on leprosy sufferers can be triggered by changes in individual health conditions that can cause stress. The stress experienced by leprosy sufferers can be reduced by identifying the causes of stress, to determine the right efforts to deal with psychological problems in leprosy sufferers.&#x0D; &#x0D; Objective: This systematic review aims to determine the stressors in leprosy patients with disabilities.&#x0D; &#x0D; Design: Database search includes Google Scholar, PubMed, and Researchgate from 18-21 November 2022 with the keywords Leprosy, disability, and stressor. The criteria for the selected articles are published in 2018-2022 with full text, in Indonesian and English. the Joanna Briggs Methodology model was used to analyze 15 selected articles to find the main themes in the preparation of the Qualitative Systematic Review.&#x0D; &#x0D; Result: the results of the analysis of the articles that have been carried out show that the cause of stress in leprosy sufferers, there are three main themes identified, namely self-stigma as a psychological aspect, disability as a physical aspect, and public stigma as a stressor in a social aspect.&#x0D; &#x0D; Conclusion: the findings show that the causes of stress in leprosy sufferers can come from psychological, physical, and social aspects that affect leprosy sufferers. this makes the three main themes that have been identified to help lepers to reduce stress.

Sensitivity to change of generic preference-based instruments (EQ-5D-3L, EQ-5D-5L, and HUI3) in the context of treatment for people with prescription-type opioid use disorder in Canada

PurposeUsing data from a randomized controlled trial for treatment of prescription-type opioid use disorder in Canada, this study examines sensitivity to change in three preference-based instruments [EQ-5D-3L, EQ-5D-5L, and the Health Utilities Index Mark 3 (HUI3)] and explores an oft-overlooked consideration when working with contemporaneous responses for similar questions—data quality.MethodsAnalyses focused on the relative abilities of three instruments to capture change in health status. Distributional methods were used to categorize individuals as ‘improved’ or ‘not improved’ for eight anchors (seven clinical, one generic). Sensitivity to change was assessed using area under the ROC (receiver operating characteristics) curve (AUC) analysis and comparisons of mean change scores for three time periods. A ‘strict’ data quality criteria, defined a priori, was applied. Analyses were replicated using ‘soft’ and ‘no’ criteria.ResultsData from 160 individuals were used in the analysis; 30% had at least one data quality violation at baseline. Despite mean index scores being significantly lower for the HUI3 compared with EQ-5D instruments at each time point, the magnitudes of change scores were similar. No instrument demonstrated superior sensitivity to change. While six of the 10 highest AUC estimates were for the HUI3, ‘moderate’ classifications of discriminative ability were identified in 12 (of 22) analyses for each EQ-5D instrument, compared with eight for the HUI3.ConclusionNegligible differences were observed between the EQ-5D-3L, EQ-5D-5L, and HUI3 regarding the ability to measure change. The prevalence of data quality violations—which differed by ethnicity—requires further investigation.

An Update of Epigenetic Drugs for the Treatment of Cancers and Brain Diseases: A Comprehensive Review.

Epigenetics has long been recognized as a significant field in biology and is defined as the investigation of any alteration in gene expression patterns that is not attributed to changes in the DNA sequences. Epigenetic marks, including histone modifications, non-coding RNAs, and DNA methylation, play crucial roles in gene regulation. Numerous studies in humans have been carried out on single-nucleotide resolution of DNA methylation, the CpG island, new histone modifications, and genome-wide nucleosome positioning. These studies indicate that epigenetic mutations and aberrant placement of these epigenetic marks play a critical role in causing the disease. Consequently, significant development has occurred in biomedical research in identifying epigenetic mechanisms, their interactions, and changes in health and disease conditions. The purpose of this review article is to provide comprehensive information about the different types of diseases caused by alterations in epigenetic factors such as DNA methylation and histone acetylation or methylation. Recent studies reported that epigenetics could influence the evolution of human cancer via aberrant methylation of gene promoter regions, which is associated with reduced gene function. Furthermore, DNA methyltransferases (DNMTs) in the DNA methylation process as well as histone acetyltransferases (HATs)/histone deacetylases (HDACs) and histone methyltransferases (HMTs)/demethylases (HDMs) in histone modifications play important roles both in the catalysis and inhibition of target gene transcription and in many other DNA processes such as repair, replication, and recombination. Dysfunction in these enzymes leads to epigenetic disorders and, as a result, various diseases such as cancers and brain diseases. Consequently, the knowledge of how to modify aberrant DNA methylation as well as aberrant histone acetylation or methylation via inhibitors by using epigenetic drugs can be a suitable therapeutic approach for a number of diseases. Using the synergistic effects of DNA methylation and histone modification inhibitors, it is hoped that many epigenetic defects will be treated in the future. Numerous studies have demonstrated a link between epigenetic marks and their effects on brain and cancer diseases. Designing appropriate drugs could provide novel strategies for the management of these diseases in the near future.

A Method for Satellite Component Health Assessment Based on Multiparametric Data Distribution Characteristics

This research presents a novel data-based multi-parameter health assessment method to meet the growing need for the in-orbit health assessment of satellite components. This method analyzed changes in component health status by calculating distribution deviations and variation similarities in real-time operational data. Firstly, a single-parameter health state description method based on data distribution characteristics was presented. Secondly, the main health characteristic parameters were selected by mechanistic analysis and expert experience. The CRITIC method and the entropy weighting method were fused to assign reasonable weights and establish a multi-parameter component health assessment model. Then, the feasibility of a component health assessment algorithm based on data distribution characteristics was verified using real telemetry data from satellites. Finally, to verify the rationality of the presented health assessment algorithm, the results were compared with the pre-processed original data using empirical mode decomposition. The experimental results show that the method can accurately describe the change trend of the health status of the components. It proves that the method can be effectively used for the real-time health condition assessment and monitoring of satellite components.

Abstract 38: PBMC donor selection affects engraftment rates and onset of graft versus host disease in humanized NCG mice for use in cancer studies

Abstract Preclinical studies examining tumor biology and immunity are limited by differences between the mouse and human immune systems. Humanized mouse models offer a unique tool to assess the anti-tumor response by recapitulating aspects of human tumor biology. Humanized mice are created by injecting either human CD34+ hematopoietic stem cells or peripheral blood mononuclear cells (PBMCs) into an immunodeficient mouse strain. Here we utilized a PBMC humanized NCG mouse model to investigate human T-cell mediated anti-tumor response (&amp;gt;95% CD3+ T-cells by day 21). The challenges encountered with this model include the onset of graft versus host disease (GvHD) and donor variability leading to donor specific engraftment rates. Consistency is required with humanized PBMC models to ensure their use as an appropriate research model. Therefore, we examined the relationship between donor selection and engraftment rates as well as the onset of GvHD. Inter-donor variability was assessed by collecting PBMCs from multiple healthy donors. Intra-donor consistency was assessed by collecting PBMCs from the same donors at subsequent collections and comparing to initial human immune cell profiling by flow cytometry. NCG mice were injected with 1 × 107 PBMCs from individual donors. Animals were weighed three times a week to monitor for changes in body weight and general health status. Peripheral blood was collected at day 9, 21 and 42 for flow cytometry screening of human immune cell engraftment (hCD45+, hCD3+, hCD4+ and hCD8+) at the initial collection. Human PBMCs isolated from additional collections from the same donors were also injected into NCG mice and flow cytometry was performed on the new cell lots at day 21. Donors were grouped into categories based on engraftment rates, which were donor dependent. Donor variability is an important aspect to consider when humanizing mice with human PBMCs. PBMC humanized models are important for the study of pre-clinical therapeutics, but donor engraftment rates must be considered when engrafting the mice to create a consistently humanized mouse. Citation Format: Steven Bronson, Jenny Rowe, Christoph Eberle, Stephen Festin. PBMC donor selection affects engraftment rates and onset of graft versus host disease in humanized NCG mice for use in cancer studies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 38.

INJURIES RISK ASSESSMENT FOR EMPLOYEES WITH DISABILITIES AT THE MANUAL TRANSFERRING OF LOADS

The employment of persons with permanent functional changes in health state is a difficult issue taking into account the fact that, in addition to objective risks caused by the presence of equipment, vehicles and other sources of potential hazards in the production environment, there are subjective risks related to psychophysiological features of a person. The vulnerability of persons with disabilities, compared to other workers, leads to discrimination in employment on the workplaces, because employers tend to consider them as a potential direct or indirect source of increasing the level of injuries or accidents in the company. The lack of qualified specialists in most Ukrainian enterprises capable to assess the risks and implement the principle of reasonable adaptation of equipment and technological processes to the special needs of persons with disabilities determines the need to develop risk assessment methods that will allow effective management decisions to be made to ensure safety at employees' workplaces. The article proposes a method that allows assessing the risks of manual transferring of loads and takes into account the limitations of the life activities of persons with disabilities who, according to the conclusions of the medical and social expert commission, can do this work. The risk assessment methodology was developed on the basis of the international standard EN 1005-2 Safety of machinery – Human physical performance and adapted taking into account the peculiarities of the national legal framework. At the calculation of the risk, it is suggested to use a coefficient that depends on the degree of severity of life restrictions in relation to loads on the musculoskeletal system, established by the medical and social expert commission. This allows making the effective preventive decisions. For example, obtaining the value of the RІІ risk index at the level of 1.42 at the lifting a load weighing 10 kg, which is characterized as an unacceptable risk, can be adjusted both by changing the organization of the workplace and by reducing the weight of the load by 4 kg. The use of the methodology allows specialists who are responsible for the safety to assess risks and use the labour potential of employees without harming their health and increasing the level of industrial injuries. Keywords: risk, worker with disability, trauma, manual transferring of loads.

Exploring Changes in Attitudes, Behaviors, and Self-Measured Health Data Through Lifestyle Modification Support by Community Pharmacists: Suito-Ogaki Selfcare (SOS) Trial.

Contributing to public health by supporting people's health is the social mission of community pharmacists. This multicenter, prospective case series study aimed to evaluate changes in people's behavior and health states through community pharmacists' self-care support for healthy lifestyles. The participants were recruited from voluntary adults aged ≥20 years who agreed to participate in the study, at community pharmacies in Gifu, Japan, between June and September 2021. Participants self-managed their lifestyles for six months while recording their health data, including blood pressure (BP), daily using devices (home BP monitor, body composition monitor, and activity meter) and a diet-recording app. They received lifestyle modification support at pharmacies at least once per month. Participants' subjective health status, attitudes, and behavioral changes were evaluated using self-report questionnaires. Due to the exploratory nature of this study, data were primarily analyzed descriptively. Fifty-four participants aged 20 to 77 (mean age: 49.6 years; female participant proportion: 55.6%) participated in this study. Their mean weekly BP shifted almost horizontally from baseline to week 24 (systolic BP: 118.8 to 121.5 mmHg; diastolic BP: 76.1 to 77.5 mmHg). At six months, 38.9% and 35.2% of the participants reported better overall health and mental health, respectively, than at baseline. Over 85% of the participants became more proactive in improving their lifestyles regarding salt intake, diet, weight loss, and exercise, although drinking and smoking habits were more challenging to change. All the participants reported that they intended to continue to improve their lifestyle. The participants' responses suggested that community pharmacists' support helped increase participants' health awareness and promote their health-enhancing behaviors. However, its impact on health parameters should be further examined in future studies. More vigorous, tailored self-care support may be worth considering in developing a more effective, community-fitted health/well-being support system in Japan.

Health changes during Covid-19: a nationwide study with dental students.

To assess the changes in stress levels, social behavior, dietary and parafunctional habits, oral hygiene, among other conditions perceived by dental students in Brazil during the Covid-19 pandemic and evaluated the correlations between stress level and other variables. An online questionnaire was developed and validated. Undergraduates enrolled in private and public dental schools were recruited by convenience sampling. Data were collected on the perceived changes regarding stress levels, financial and social characteristics, dietary habits, oral hygiene, health conditions, and parafunctional habits. Quantitative variables were expressed as absolute and relative frequencies. Wilcoxon test evaluated comparisons between perceived changes, and correlations between changes in stress levels and other variables were analyzed by Spearman correlation (α = 0.05). A total of 638 dental students, mean age of 22.95 ± 4.10 years, participated in the study. During the pandemic, the reported stress levels increased while household income decreased (p < 0.05). Late dinners and mindless eating increased in frequency, whereas oral hygiene decreased (p < 0.05). Most of the health conditions and parafunctional habits assessed changed (p < 0.05). Perceived stress levels showed poor negative correlations with household income (rS = -0.14), poor positive correlations with the pressure to contribute financially in the household (rS = 0.19), and poor positive correlations with food choice frequency (rS = 0.15) (p < 0.05). Dental students reported perceived changes in stress levels, dietary habits, oral hygiene, health conditions, parafunctional habits, and social behavior. Moreover, the results showed poor correlations, as students with higher stress levels tended to have the lowest household income, feel pressured to contribute financially in the household, and present a high meal intake frequency.

Establishing minimal detectable change thresholds for the international knee documentation committee and Kujala scores at one and two years after patellofemoral joint arthroplasty.

To define the minimal detectable change (MDC) for the international knee documentation committee (IKDC) and Kujala scores one and two years after patellofemoral joint arthroplasty (PFA). A distribution-based method (one-half the standard deviation of the mean difference between postoperative and preoperative outcome scores) was applied to establish MDC thresholds among 225 patients undergoing primary PFA at a single high-volume musculoskeletal-care center. Stability of change in MDC achievement was explored by quantifying the proportion of achievement at one- and two-year postoperative timepoints. Multivariable logistic regression analysis was performed to explore the association between sociodemographic and operative features on MDC achievement. MDC thresholds for the Kujala score were 10.3 (71.1% achievement) and 10.6 (70.4% achievement) at one- and two years, respectively. The MDC thresholds for the IKDC score were 11.2 (78.1% achievement) and 12.3 (69.0% achievement) at one- and two years, respectively. Predictors of achieving the MDC for the Kujala and IKDC scores at both time points were lower preoperative Kujala and IKDC scores, respectively. Preoperative thresholds of ≤ 24.1 and 7.6 for the Kujala and IKDC scores, respectively, were associated with a 90% MDC achievement probability. When preoperative thresholds approached 64.3 and 48.3 for the Kujala and IKDC, respectively, MDC achievement probability reduced to 50%. The MDC thresholds for the Kujala and IKDC scores two years after PFA were 10.6 and 12.3, respectively. Clinically significant health status changes were maintained overall, with a slight decrease in achievement rates between one and two years. MDC achievement was associated with disability at presentation, and several probability-based preoperative thresholds were defined. These findings may assist knee surgeons with patient selection and the decision to proceed with PFA by better understanding the patient-specific propensity for MDC achievement. IV, retrospective case series.

“Extrafine single inhaler triple therapy effect on health status, lung function and adherence in COPD patients: A Panhellenic prospective non-interventional study – The TRIBUNE study”

The extrafine single inhaler triple therapy (efSITT) containing beclometasone dipropionate/formoterol fumarate/glycopyrronium 87/5/9 μg has proved to be efficacious in patients with Chronic Obstructive Pulmonary Disease (COPD) in randomized control trials. TRIBUNE study aimed to assess the efSITT effectiveness on health status, lung function, adherence and rescue medication use in COPD patients in Greece in a real-world setting.This was a 24-week prospective, multicenter, observational study in 1,195 patients with moderate/severe COPD and history of at least one exacerbation during the previous year despite dual therapy. Health status (COPD Assessment Test/CAT), lung function parameters and rescue medication use were recorded at baseline, 3 (Visit 2/V2) and 6 months (Visit 3/V3) after treatment. Adherence (Test of Adherence to Inhalers/TAI) and self-reported overall impression of health condition change (Visual Analogue Scale/VAS) were recorded at V2 and V3.Mean CAT score decreased from 20.9 points at V1, to 15.1 at V2 and 13 at V3 (p < 0.001, all pair comparisons). 85.9% of patients achieved a CAT decrease of minimal clinically important difference (MCID) or more (≥2) at V3, compared to V1. Mean FEV1 increased from 1.4 ± 0.5 L on V1, to 1.6 ± 0.5 L on V3 (p < 0.001, N = 275). The percentage of patients with “good adherence” increased from 58.4% (V2) to 64.0% (V3). Rescue medication use and VAS also significantly improved.The efSITT achieves improved outcomes on health status, lung function and rescue medication use as well as satisfactory adherence and patient-reported improvement of health condition, in moderate/severe COPD patients previously treated with a dual combination in a Greek real-world setting.

Exercise-Induced Left Atrial Hypertension in Heart Failure With Preserved Ejection Fraction

BackgroundMany patients with heart failure and preserved ejection fraction have no overt volume overload and normal resting left atrial (LA) pressure. ObjectivesThis study sought to characterize patients with normal resting LA pressure (pulmonary capillary wedge pressure [PCWP] <15 mm Hg) but exercise-induced left atrial hypertension (EILAH). MethodsThe REDUCE LAP-HF II (A Study to Evaluate the Corvia Medical, Inc. IASD System II to Reduce Elevated Left Atrial Pressure in Patients With Heart Failure) trial randomized 626 patients with ejection fraction ≥40% and exercise PCWP ≥25 mm Hg to atrial shunt or sham procedure. The primary trial outcome, a hierarchical composite of death, heart failure hospitalization, intensification of diuretics, and change in health status was compared between patients with EILAH and those with heart failure and resting left atrial hypertension (RELAH). ResultsPatients with EILAH (29%) had similar symptom severity, but lower natriuretic peptide levels, higher 6-minute walk distance, less atrial fibrillation, lower left ventricular mass, smaller LA volumes, lower E/e′, and better LA strain. PCWP was lower at rest, but had a larger increase with exercise in EILAH. Neither group as a whole had a significant effect from shunt therapy vs sham. Patients with EILAH were more likely to have characteristics associated with atrial shunt responsiveness (peak exercise pulmonary vascular resistance <1.74 WU) and no pacemaker (63% vs 46%; P < 0.001). The win ratio for the primary outcome was 1.56 (P = 0.08) in patients with EILAH and 1.51 (P = 0.04) in those with RELAH when responder characteristics were present. ConclusionsPatients with EILAH had similar symptom severity but less advanced myocardial and pulmonary vascular disease. This important subgroup may be difficult to diagnose without invasive exercise hemodynamics, but it has characteristics associated with favorable response to atrial shunt therapy. (A Study to Evaluate the Corvia Medical, Inc. IASD System II to Reduce Elevated Left Atrial Pressure in Patients With Heart Failure [REDUCE LAP-HF TRIAL II]; NCT03088033)