Compare Health Status Research Articles

A Strategic Health Index for Maternal and Child Wellbeing in Uttar Pradesh using MCDM

Maternal and child health (MCH) is a critical indicator of overall societal well-being, particularly in developing countries. The study presents a comprehensive analysis to evaluate MCH in Uttar Pradesh (UP), a state facing significant public health challenges. Using National Family Health Survey (NFHS-5) data on MCH indicators, we developed a health index to systematically assess and compare health status across various districts. The multi-criteria decision-making (MCDM) technique, specifically Criteria Importance Through Inter-criteria Correlation (CRITIC) and TOPSIS (Technique for Order of Preference by Similarity to Ideal Solution) is used to determine the importance of closeness of various criteria affecting MCH care, such as antenatal care, institutional delivery, postnatal care, immunization coverage and nutritional status. The overall performance of each district in terms of MCH was measured to develop a composite index based on the MCDM approach. In contrast, the indicator weights were determined by the CRITIC method. Some districts showed better performance on specific indicators, while others lagged. The resulting index provides a nuanced understanding of the regional disparities within UP, highlighting areas of urgent need for healthcare interventions. The findings underscore the importance of targeted policies and programs to improve MCH outcomes, contributing to the broader goals of sustainable development and public health enhancement in the region.. KEYWORDS :Maternal and child health, CRITIC, TOPSIS, Index.

Impact of age on health status after TAVI or SAVR in low risk patients with severe aortic stenosis: results from the PARTNER 3 Trial

Abstract Background Transcatheter aortic valve implantation (TAVI) results in similar 5-year survival and quality of life compared with surgical aortic valve replacement (SAVR) in patients with severe aortic stenosis (AS) and low surgical risk. Whether participants’ age at the time of intervention influences the health status benefit of TAVI vs. SAVR is unknown. Purpose To assess the relationship between age and both the short- and long-term health status outcomes of TAVI vs. SAVR among patients enrolled in the PARTNER 3 trial. Methods We used data from the PARTNER 3 randomized trial to compare health status outcomes between TAVI and SAVR, stratified by age (<70, 70-74, 75-79, ≥80 years). Health status was assessed at baseline, 1 month, 6 months, 12 months and annually through 5 years using the Kansas City Cardiomyopathy Questionnaire (KCCQ). The primary endpoint was the KCCQ overall summary score (KCCQ-OS) over the 5-year follow-up period (range 0-100; higher=better). The key secondary endpoint was an excellent outcome, defined as a KCCQ-OS>75 at 5-year follow-up without a decline of >10 points from baseline. Results Between March 2016 and October 2017, 1000 low-risk patients with severe AS were randomized in a 1:1 fashion to transfemoral TAVR using the balloon-expandable Sapien 3 valve or surgery in the PARTNER 3 trial. Among patients who underwent TAVI or SAVR (and had baseline health status available; TAVI: 494, SAVR: 449), 228 (24%) were <70, 284 (30%) were 70-74, 287 (31%) were 75-79, and 144 (15%) were ≥80 years old. Baseline health status was similar between the TAVI and SAVR groups as well as across age strata. At 30-day follow-up, health status was substantially better with TAVI than SAVR with similar differences across age strata (mean difference 13-18 points; Figure 1). At all other timepoints, there were no significant differences between TAVI and SAVR in any age group. The proportion of TAVI patients with an excellent outcome at 5-year follow-up ranged from 86% in the youngest subgroup to 73% in the oldest subgroup, with no significant differences compared with SAVR. Conclusions Among patients with severe AS at low surgical risk, TAVI using the SAPIEN 3 balloon-expandable valve resulted in substantially better health status in the early post-procedure period compared with SAVR across all age strata. Beyond the early recovery period, intermediate- and longer-term health status outcomes were similar with TAVI and SAVR, with no evidence of heterogeneity by age. Although longer term follow-up is necessary (and ongoing), these 5-year outcomes suggest that over the age range included in the PARTNER 3 trial, age alone should not play a dominant role in determining treatment recommendations for patients with severe AS.Health status by treatment and age group

Quality of life of patients with permanent colostomy and low anterior resections (meta-analysis)

BACKGROUND: patients with rectal cancer after low anterior resections and with permanent colostomy inevitably face negative functional consequences of treatment. The question of anastomosis performing often remains unanswered. AIM: to compare the quality of life of patients with rectal cancer after low anterior resections and surgical treatment with a permanent colostomy.MATERIALS AND METHODS: literature search was performed in MEDLINE database according to PRISMA criteria using the keywords: “QoL”, “Quality of life”, “EORTC”, “low anterior resection” “rectal”, “stoma”, “ostomy” using suffixes [OR], [AND]. The meta-analysis included 9 retrospective studies with 2438 patients.RESULTS: no significant differences were found in global health status between the groups (p = 0.11). A significant difference with a worse score in ostomy patients is noted on the physical (p = 0.003), role (p = 0.002), emotional (p = 0.03) and social functioning (p = 0.004). In contrast, patients undergoing sphincter-preserving surgery have a higher incidence of constipation and diarrhea (p < 0.00001).CONCLUSION: patients with permanent stoma and after low anterior resections have comparable global health status. These patients have different profiles of disturbances in QoL patterns and functional consequences of surgery.

Characterization of the preweaned Holstein calf fecal microbiota prior to, during, and following resolution of uncomplicated gastrointestinal disease

Little is known about shifts in the fecal microbiome of dairy calves preceding and following the incidence of gastrointestinal disease. The objective of this cohort study was to describe the fecal microbiome of preweaned dairy calves before, during, and after gastrointestinal disease. A total of 111 Holstein dairy calves were enrolled on 2 dairies (D1 and D2) and followed until 5 weeks old. Health assessments were performed weekly and fecal samples were collected every other week. Of the 111 calves, 12 calves from D1 and 12 calves from D2 were retrospectively defined as healthy, and 7 calves from D1 and 11 calves from D2 were defined as diarrheic. Samples from these calves were sequenced targeting the 16S rRNA gene and compared based on health status within age groups and farms: healthy (0–1 week old) vs. pre-diarrheic (0–1 week old), healthy (2–3 weeks old) vs. diarrheic (2–3 weeks old), and healthy (4–5 weeks old) vs. post-diarrheic (4–5 weeks old) calves. Healthy and diarrheic samples clustered together based on age rather than health status on both farms. Based on linear discriminant analysis, a few species were identified to be differently enriched when comparing health status within age groups and farm. Among them, Bifidobacterium sp. was differently enriched in pre-diarrheic calves at D1 (0–1 week old) whereas healthy calves of the same age group and farm showed a higher abundance of Escherichia coli. Bifidobacterium sp. was identified as a biomarker of fecal samples from healthy calves (2–3 weeks old) on D1 when compared with diarrheic calves of the same age group and farm. Feces from diarrheic calves on D2 (2–3 weeks old) were characterized by taxa from Peptostreptococcus and Anaerovibrio genera whereas fecal samples of age-matched healthy calves were characterized by Collinsella aerofaciens and Bifidobacterium longum. After resolution of uncomplicated diarrhea (4–5 weeks old), Collinsella aerofaciens was more abundant in D2 calves whereas Bacteriodes uniformis was more abundant in D1 calves. Taken together, these findings suggest that the age of the preweaned calf is the major driver of changes to fecal microbiome composition and diversity even in the face of uncomplicated gastrointestinal disease.

The Health Status of the Population of Sellye District, a Disadvantaged Micro-Region, in the Light of Sociodemographic Factors- Literature Review

Tackling health inequalities is a global goal also set by the WHO and is in the common interest of all societies. Keeping in mind the extremely close correlation between socio-economic status and health outcomes is of particular importance in planning health promotion and making health policy decisions. The research aimed at assessing the health status of the population of Sellye district, one of the most disadvantaged micro-regions according to available statistics, to examine the relationship between socio-economic status and health conditions, and to compare health status internationally with populations living in other disadvantaged regions. Research questions: How does the impact of sociodemographic factors on health prevail? Through what mechanisms does race/ethnicity affect health? Our present study is a literature review, the first stage of a comprehensive investigation, in which we examine the Hungarian and international literature. Health status is largely determined by sociodemographic characteristics, it is also influenced by the wider social, economic, political, and cultural environment. Health must always be considered in the context of the environment. Ethnicity is strongly connected to social class, but it can still be important in terms of social cohesion and the resources available to the Roma

The Million Veteran Program 1990-1991 Gulf War Era Survey: An Evaluation of Veteran Response, Characteristics, and Representativeness of the Gulf War Era Veteran Population.

To address gaps in understanding the pathophysiology of Gulf War Illness (GWI), the VA Million Veteran Program (MVP) developed and implemented a survey to MVP enrollees who served in the U.S. military during the 1990-1991 Persian Gulf War (GW). Eligible Veterans were invited via mail to complete a survey assessing health conditions as well as GW-specific deployment characteristics and exposures. We evaluated the representativeness of this GW-era cohort relative to the broader population by comparing demographic, military, and health characteristics between respondents and non-respondents, as well as with all GW-era Veterans who have used Veterans Health Administration (VHA) services and the full population of U.S. GW-deployed Veterans. A total of 109,976 MVP GW-era Veterans were invited to participate and 45,270 (41%) returned a completed survey. Respondents were 84% male, 72% White, 8% Hispanic, with a mean age of 61.6 years (SD = 8.5). Respondents were more likely to be older, White, married, better educated, slightly healthier, and have higher socioeconomic status than non-respondents, but reported similar medical conditions and comparable health status. Although generally similar to all GW-era Veterans using VHA services and the full population of U.S. GW Veterans, respondents included higher proportions of women and military officers, and were slightly older. In conclusion, sample characteristics of the MVP GW-era cohort can be considered generally representative of the broader GW-era Veteran population. The sample represents the largest research cohort of GW-era Veterans established to date and provides a uniquely valuable resource for conducting in-depth studies to evaluate health conditions affecting 1990-1991 GW-era Veterans.

Identification of multimorbidity patterns in older adults receiving long-term care in Canada, Italy, Finland and New Zealand: results from the ICARE4OLD project

Background: Older adults receiving home care (HC) services and living in long-term care homes (LTC) experience high levels of multimorbidity. In this project - called iCARE4OLD, we aimed first to identify and compare subgroups of care dependent individuals sharing the same patterns of chronic diseases. For these subgroups, we will identify care paths and try to make integration of services and continuity of care possible. 
 Settings and participants: We studied 102,000 individuals 60+ years receiving HC services or living in LTC homes in Canada, Italy, Finland and New Zealand.
 Methods: This is a cross-sectional study including the baseline interRAI HC and LTCF assessments of older people in the period of 2014 until 2018. The project has received funding from the European Union’s Horizon 2020 research and innovation programme under Grant Agreement number 965341 and from the New Frontiers Research Fund, grant number NFRFG-2020-00500.
 Latent Class Analysis (LCA) was used to classify individuals according to their underlying diseases patterns starting from a list of 19 conditions. 
 Results: Mean age of the sample was 80 years (65% females). After assessing several fit parameters, a 5-class solution was chosen as the best model for both HC and LTC. The following 5 disease patterns were identified in all countries: (1) Alzheimer/dementia; (2) psychiatric diseases; (3) cardio-pulmonary diseases; (4) stroke/hemiplegia; (5) other dementias. The distribution of sociodemographic, clinical and functional characteristics varied across the different multimorbidity patterns, with the cardio-pulmonary disease and the stroke/hemiplegia patterns showing the highest complexity and impairment.
 Results: Our results show that, by using a common assessment tool, it is possible to identify homogeneous morbidity patterns in older patients receiving long-term care. These may be useful to compare health status in care-dependent individuals across different settings and countries, as well as to predict health trajectories and care needs. 
 Discussion: By applying this methodology to whole populations, care paths can be drawn for home care and residential care clients in a more evidence-based way. The goals would be to use these algorithms to design more integrated care plans for older persons, so that clients and their families are better served, and policy makers can finance the right services and offer targeted care.

Abstract 14724: Health Status and Long-Term Outcomes After Acute Myocardial Infarction in Patients Without Standard Modifiable Risk Factors

Background: Prior studies examining patients who experienced acute myocardial infarction (AMI) as their initial presentation of coronary disease have shown that those without Standard Modifiable Risk Factors (SMuRF; diabetes, dyslipidemia, hypertension, and smoking) had worse in-hospital but better long-term survival than those with SMuRFs. However, the health status outcomes, patients’ symptoms, function, and quality of life among those without SMuRF are unknown. Research questions: Are there differences in long-term health status and mortality between patients who survived hospitalization following AMI with and without SMuRFs? Methods: We analyzed data from two prospective registries, PREMIER and TRIUMPH, comprising patients hospitalized to 31 US hospitals with AMI between 2003-2008. We compared the clinical characteristics, 1-year health status (with the Seattle Angina Questionnaire [SAQ]), and 5-year all-cause mortality between patients with and without SMuRFs. Patients with prior coronary artery disease were excluded. We used hierarchical linear mixed models for health status outcomes and Cox-proportional hazard models for mortality, adjusted for clinical and sociodemographic characteristics, including baseline SAQ scores. Results: Among 4076 patients with AMI (mean age 58.4±12.4 years, 34% female, 22% Black), 569 (13.9%) presented without SMuRFs. Despite similar mean age, patients without SMuRFs were more likely to be male, Non-Hispanic White, have higher income and education, fewer depressive symptoms, and higher SAQ Summary Scores at baseline (83.5±13.2 vs. 79.6±16.5). At 1-year follow-up, patients without SMuRFs had higher SAQ Summary Scores (93.9±10.1 vs. 89.9±14.7), although the difference between groups was attenuated after adjustment (1.69 points, 95% CI 0.40-1.97). Furthermore, there were no significant differences in all-cause mortality over 5 years between groups (adjusted HR= 0.83, 95% CI: 0.59-1.16). Notably, besides sex or race category, a higher incomes and better depression status were negative independent predictors for health status and clinical outcomes. Conclusions: AMI survivors, both with and without SMuRFs, had comparable long-term health status and survival after rigorous adjustment.

Periodontal health in adequately controlled and inadequately controlled type 2 diabetes: A cross-sectional study.

Objective: To compare health status in term of clinical attachment loss and pocket depth adequately-controlled vs. inadequately-controlled type 2 diabetes. Study Design: Cross-Sectional study. Setting: Department of Periodontology, Khyber College of Dentistry, Peshawar. Period: 1st May 2021 to 30th January 2022. Material & Methods: A total of 142 participants with Type 2 diabetes mellitus (DM), aged between 35 and 65 years, and with a DM duration exceeding 3 years, along with a minimum of seven teeth per arch determined through clinical examination, were included. Participants with type 1 diabetes mellitus, smokers, pregnant women, those on medications inducing gingival enlargement, those who underwent periodontal therapy in the last six months, and patients undergoing orthodontic treatment were excluded. Pocket depth and clinical attachment loss at six points on each reference tooth (including upper and lower first molars, first premolars, and central incisors) were measured using a Michigan 'O' Probe featuring William markings on a periodontal pocket chart. The arithmetic mean value was then calculated. To compare the two groups (adequately controlled diabetics and inadequately controlled diabetics), the mean pocket depth and mean clinical attachment loss were analyzed separately using an independent samples t-test. Results: The mean duration of DM, age, periodontal pocket depth, clinical attachment were 6.42 ±2.76 years, 50.77 ±9.50 years, 4.03 ±0.74mm, and 4.74 ±0.74mm. The males were 80(56%) and females were 62(44%). The mean PPD was less in well controlled (3.45±0.36mm) than poorly controlled diabetes (4.76±0.36mm) statistically significantly (p<0.001). Similarly mean CAL was less in adequately controlled (4.16±0.36mm) than inadequately controlled diabetes (5.47±0.36mm) statistically significantly (p<0.001). Conclusion: Inadequately controlled diabetes mellitus is associated with adverse periodontal health status.

Health Status of US Patients With One or More Health Conditions: Using a Novel Electronic Patient-reported Outcome Measure Producing Single Metric Measures.

Most existing research studying health status impacted by morbidity has focused on a specific health condition, and most instruments used for measuring health status are neither patient-centered nor preference-based. This study aims to report on the health status of patients impacted by one or more health conditions, measured by a patient-centered and preference-based electronic patient-reported outcome measure. A cross-sectional study was conducted among patients with one or more health conditions in the United States. A novel generic, patient-centered, and preference-based electronic patient-reported outcome measure: Château Santé-Base, was used to measure health status. Individual health state was expressed as a single metric number (value). We compared these health-state values between sociodemographic subgroups, between separate conditions, between groups with or without comorbidity, and between different combinations of multimorbidity. The total sample comprised 3913 patients. Multimorbidity was present in 62% of the patients. The most prevalent health conditions were pain (50%), fatigue/sleep problems (40%), mental health problems (28%), respiratory diseases (22%), and diabetes (18%). The highest (best) and lowest health-state values were observed in patients with diabetes and mental health problems. Among combinations of multimorbidity, the lowest values were observed when mental health problems were involved, the second lowest values were observed when fatigue/sleep problems and respiratory diseases coexisted. This study compared health status across various single, and multiple (multimorbidity and comorbidity) health conditions directly, based on single metric health-state values. The insights are valuable in clinical practice and policy-making.

Влияние ограничения или отказа от табакокурения на адаптационные возможности организма в условиях антарктической зимовки

The research was conducted by a member of the 60th Russian Antarctic Expedition at the all-yearround Mirny Station. The purpose was to study the effect of changed patterns of tobacco smoking on the adaptive capabilities of polar station staff. Materials and methods. Adaptive capabilities were evaluated using the method of cardio-respiratory synchronism, assessing the index of regulatory and adaptive status (IRAS). It is based on recording the synchronization parameters of controlled high respiratory rate and heart rate. IRAS dynamics was compared in four subjects (three regular smokers and one non-smoker as a control) over the course of one year of wintering. The subjects had comparable anthropometric data, health status and working conditions at the station. They were exposed to a similar amount of adverse environmental factors due to their professional activities and lived according to the station’s standard schedule without any personalized changes in their day regimen. Smoking patterns were determined by independent decisions of each expedition member and by the size of personal stocks of tobacco products prepared for the wintering. Results. In polar expedition members faced with smoking cessation or inability to adequately meet this need, IRAS decrease, being a marker of human adaptive capabilities, allowed us to determine the relationship between pronounced changes in the dynamics of regular tobacco smoking and body’s adaptive capabilities. The authors assume that organizational arrangements (sufficient stocks of nicotine-containing products such as cigarettes and tobacco) at the station as well as educational activities (dissuading expedition members from abrupt non-supervised changes in their smoking patterns during Antarctic wintering and properly explaining the reasons why such actions are undesirable) may contribute to improving the health of expedition members and optimizing their living conditions at the polar station. Completing a smoking cessation programme with medical supervision in advance (while preparing for a polar expedition) as well as upon returning from the station (at the end of the adaptation period) can be recommended.

Health status and mental distress in people with cancer and comorbid conditions: The Australian National Health Survey analysis.

Data on the impact of specific comorbidities on health outcomes is limited. We compared health status and mental distress between individuals with and without cancer according to comorbidity type. A cross-sectional analysis using data from the Australian National Health Survey 2017-18 including all respondents aged ≥25 years with and without a history of cancer. The odds of poor health and mental distress were reported according to cancer status, and specific individual and cluster of comorbidities. There were 1982 individuals (52% female) with cancer and 12,635 (51% female) without cancer. Individuals with cancer were older, and more likely to have a comorbidity compared with those without cancer. They were more likely to report poor health than those without cancer for each specific comorbidity; except for skin conditions and infectious diseases; with the adjusted odds ratio (aOR) ranging from 1.34 (95% CI = 1.01-1.79) for digestive disorders to 2.93 (95% CI = 1.62-5.29) for blood conditions. The strongest association with poor health (aOR 2.79, 95% CI = 2.27-3.43) and mental distress (aOR 9.01, 95% CI = 7.25-11.20) was observed for those with a comorbid mental illness. Exploratory cluster analysis identified four distinct comorbidity clusters: low comorbidity, musculoskeletal, respiratory and cardiometabolic; cancer survivors in the cardiometabolic cluster had a higher odds of reporting poor health (aOR 3.50, 95% CI = 2.48-4.92) and mental distress (aOR 2.33, 95% CI = 1.53-3.55) than those with a low comorbidity. Comorbidities in cancer survivors were common and associated with inferior health status, although the magnitude of the effect varied by comorbidity type. Risk assessment and management of comorbidities should be an important priority for cancer care and research.

Systematic Review and Meta-analysis of the Role of Total Pancreatectomy as an Alternative to Pancreatoduodenectomy in Patients at High Risk for Postoperative Pancreatic Fistula: Is it a Justifiable Indication?

Examine the potential benefit of total pancreatectomy (TP) as an alternative to pancreatoduodenectomy (PD) in patients at high risk for postoperative pancreatic fistula (POPF). TP is mentioned as an alternative to PD in patients at high risk for POPF, but a systematic review is lacking. Systematic review and meta-analyses using Pubmed, Embase (Ovid), and Cochrane Library to identify studies published up to October 2022, comparing elective single-stage TP for any indication versus PD in patients at high risk for POPF. The primary endpoint was short-term mortality. Secondary endpoints were major morbidity (i.e., Clavien-Dindo grade ≥IIIa) on the short-term and quality of life. After screening 1212 unique records, five studies with 707 patients (334 TP and 373 high-risk PD) met the eligibility criteria, comprising one randomized controlled trial and four observational studies. The 90-day mortality after TP and PD did not differ (6.3% vs. 6.2%; RR=1.04 [95%CI 0.56-1.93]). Major morbidity rate was lower after TP compared to PD (26.7% vs. 38.3%; RR=0.65 [95%CI 0.48-0.89]), but no significance was seen in matched/randomized studies (29.0% vs. 36.9%; RR = 0.73 [95%CI 0.48-1.10]). Two studies investigated quality of life (EORTC QLQ-C30) at a median of 30-52 months, demonstrating comparable global health status after TP and PD (77% [±15] vs. 76% [±20]; P =0.857). This systematic review and meta-analysis found no reduction in short-term mortality and major morbidity after TP as compared to PD in patients at high risk for POPF. However, if TP is used as a bail-out procedure, the comparable long-term quality of life is reassuring.

Comparing health status after major trauma across different levels of trauma care.

Mortality due to trauma has reduced the past decades. Trauma network implementations have been an important contributor to this achievement. Besides mortality, patient reported outcome parameters should be included in evaluation of trauma care. While concentrating major trauma care, hospitals are designated with a certain level of trauma care following specific criteria. Comparing health status of major trauma patients after two years across different levels of trauma care in trauma networks. Multicentre observational study comprising a secondary longitudinal multilevel analysis on prospective cohorts from two neighbouring trauma regions in the Netherlands. patient aged ≥ 18 with an ISS > 15 surviving their injuries at least one year after trauma. Health status was measured one and two years after trauma by EQ-5D-5L, added with a sixth health dimension on cognition. Level I trauma centres were considered as reference in uni- and multivariate analysis. Respondents admitted to a level I trauma centre scored less favourable EQ-US and EQ-VAS in both years (0.81-0.81, 71-75) than respondents admitted to a level II (0.88-0.87, 78-85) or level III (0.89-0.88, 75-80) facility. Level II facilities scored significantly higher EQ-US and EQ-VAS in time for univariate analysis (β 0.095, 95% CI 0.038-0.153, p=0.001, and β 7.887, 95% CI 3.035-12.740, p=0.002), not in multivariate analysis (β 0.052, 95% CI -0.010-0.115, p=0.102, and β 3.714, 95% CI -1.893-9.321, p=0.193). Fewer limitations in mobility (OR 0.344, 95% CI 0.156-0.760), self-care (OR 0.219, 95% CI 0.077-0.618), and pain and discomfort (OR 0.421, 95% CI 0.214-0.831) remained significant for level II facilities in multivariate analysis, whereas significant differences with level III facilities disappeared. Major trauma patients admitted to level I trauma centres reported a less favourable general health status and more limitations compared to level II and III facilities scoring populations norms one to two years after trauma. Differences on general health status and limitations in specific health domains disappeared in adjusted analysis. Well-coordinated trauma networks offer homogeneous results for all major trauma patients when they are distributed in different centres according to their need of care.

Health-Related Quality of Life Impairment Among Patients with Severe Chronic Rhinosinusitis with Nasal Polyps in the SINUS-24 Trial.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a predominantly type 2 inflammatory disease with a high symptom burden. Data are lacking on the comparative health status of patients with CRSwNP. This analysis compared baseline physical and mental health-related quality of life (HRQoL) and overall health status of patients with severe CRSwNP enrolled in a Phase 3 clinical trial with general population norms and with other chronic diseases. In this post hoc cross-sectional analysis of baseline data from the SINUS-24 study (NCT02912468), HRQoL was measured using the 36-item Short Form (SF-36) questionnaire and general health status was measured using the EuroQol-5 Dimension visual analog scale (EQ-VAS). Analyses included the intention-to-treat (ITT) population and subgroups defined by prior sinonasal surgery, systemic corticosteroid use, and coexisting asthma or non-steroidal anti-inflammatory drug-exacerbated respiratory disease (NSAID-ERD). Scores were compared with published values for population norms (50for SF-36 physical component summary (PCS) and mental component summary (MCS), 70.4-83.3 for EQ-VAS) and for rheumatoid arthritis, type 2 diabetes, and asthma. In the ITT population (n=276), mean SF-36 physical component summary (PCS), SF-36 mental component summary (MCS), and EQ-VAS scores were below general population norms (46.4, 48.6, and 66.0, respectively). Mean SF-36 PCS and EQ-VAS scores were below population norms across all subgroups; mean SF-36 MCS scores were below the population norm in all subgroups except no prior surgery. SF-36 PCS and MCS scores from SINUS-24 were generally similar to other chronic diseases, except SF-36 PCS which was lower in rheumatoid arthritis. EQ-VAS scores in SINUS-24 were lower than in other chronic diseases. HRQoL scores weakly correlated with objective measures of disease severity. In patients with severe CRSwNP, including those with coexisting asthma/NSAID-ERD, HRQoL was worse than population norms and as burdensome as diseases such as type 2 diabetes, asthma, and rheumatoid arthritis.

Competing at age 55 and over. Reasons why older athletes participate in sport

ABSTRACT This study explores the reasons why older people participate in sports. A total of 463 senior athletes (M = 61.4, SD = 5.5) who are actively engaged in competitive sports disciplines participated in this study. The participants indicated their degree of agreement with reasons for practicing sport on a 4-point Likert scale with 20 items, developed on the basis of a literature review on motivation theories in sports. These items were analyzed psychometrically. The exploratory factorial analysis revealed five components: competitiveness, interpersonal, cognitive, physical and emotional reasons. The most frequently reported reasons for participation were to feel healthier, to improve mood, and to release tension and stress. Analyses of variance showed significant differences in reasons for participating in sport based on sex, age, comparative health status, type of sport and number of competitive events attended per year. These findings could contribute to the development of age-specific sports promotion interventions tailored to different groups of older people.

Comparative Health Status of Women of Childbearing Age in Urban and Non-urban Communities in Malaysia

Background Women’s health and access to healthcare can be affected by diverse factors such as affluence, cultural norms and availability of healthcare resources. In this study, we compared health status parameters among women of childbearing age from different ethnic groups living in urban and non-urban communities in Malaysia. Methods Women under the age of 45-years in urban and non-urban areas of Malaysia were invited to participate in this study. In total, 1500 women were approached, and of these 1435 agreed to participate and met our inclusion criteria. Information about personal healthcare, communication with healthcare practitioners, sources of health information, health concerns, weight management, as well as socio-demographic characteristics were obtained using a questionnaire which was adapted from the Women’s Health National Survey 2016 of Australia. Results Women of Indian descent made up a higher proportion of respondents in non-urban areas. Women in non-urban areas were less likely to have a higher-level education and belonged to households with a lower annual income. Non-urban respondents were also more likely to be married and to have more children. Women from non-urban locations were less likely to be overweight or exhibit sedentary behaviors. Women from non-urban sites were more interested in improving their health status, more likely to attend routine health checks, and less likely to use dietary supplements. Conclusion Women from non-urban areas exhibit healthier behaviours than their urban counterparts and have a lower prevalence of obesity. This is despite poorer access to healthcare provision in rural communities.

Disability and the achievement of Universal Health Coverage in the Maldives.

To assess access to general and disability-related health care among people with disabilities in the Maldives. This study uses data from a case-control study (n = 711) nested within a population-based, nationally representative survey to compare health status and access to general healthcare amongst people with and without disabilities. Cases and controls were matched by gender, location and age. Unmet need for disability-related healthcare is also assessed. Multivariate regression was used for comparisons between people with and without disabilities. People with disabilities had poorer levels of health compared to people without disabilities, including poorer self-rated health, increased likelihood of having a chronic condition and of having had a serious health event in the previous 12 months. Although most people with and without disabilities sought care when needed, people with disabilities were much more likely to report difficulties when routinely accessing healthcare services compared to people without disabilities. Additionally, 24% of people with disabilities reported an unmet need for disability-related healthcare, which was highest amongst people with hearing, communication and cognitive difficulties, as well as amongst older adults and people living in the lowest income per capita quartile. Median healthcare spending in the past month was modest for people with and without disabilities. However, people with disabilities appear to have high episodic healthcare costs, such as for disability-related healthcare and when experiencing a serious health event. This study found evidence that people with disabilities experience unmet needs for both disability-related and general healthcare. There is therefore evidence that people with disabilities in the Maldives are falling behind in core components relevant to UHC: availability of all services needed, and quality and affordability of healthcare.

Caregiving for older people living with chronic pain: analysis of the English longitudinal study of ageing and health survey for England.

Chronic pain is a disabling condition. Many people with chronic pain seek informal support for everyday activities of daily living (ADL). However, there remains uncertainty on the type of people with chronic pain who access this support, what types of support they need and who provides such support. The purpose of this analysis was to answer these uncertainties. Data from the Health Survey for England (HSE) and English Longitudinal Study of Ageing (ELSA) were accessed. People who reported chronic pain (moderate or above for minimum of 12months) were identified. From these cohorts, we determined if individuals self-reported receiving informal care. Data on caregiver profiles and caregiving activities were reported through descriptive statistics. Logistic regression analyses were performed to compare health status outcomes between people with pain who received and who did not receive informal care. 2178 people with chronic pain from the ELSA cohort and 571 from the HSE cohort were analysed. People who received care were frequently female, older aged with several medical morbidities including musculoskeletal diseases such as arthritis. People with chronic pain received informal care for several diverse tasks. Most frequently these related to instrumental activities of daily living (IADL) such as shopping and housework. They were most frequently provided by partners or their children. Although they reported greater disability and symptoms (p < 0.001), people who received care did not report differences in health status, loneliness or wellbeing (p = 0.27; p = 0.46). Whilst it may be possible to characterise people living in chronic pain who receive informal care, there is some uncertainty on the impact of informal caregiving on their health and wellbeing. Consideration should now be made on how best to support both care recipients and informal caregivers, to ensure their health and quality of life is promoted whilst living with chronic pain.

Comparing Health Status and Access to Preventive Healthcare in Persons with Severe Intellectual and Developmental Disabilities by Age

Comparing Health Status and Access to Preventive Healthcare in Persons with Severe Intellectual and Developmental Disabilities by Age