Health Domains Research Articles

Predictive Blood Biomarkers of Targeted Intervention for Chronic Mental Health Symptoms following Traumatic Brain Injury.

The purpose of this study was to assess the performance of predictive blood biomarkers for responsiveness to targeted treatments for chronic psychological issues years after traumatic brain injury (TBI). Targeted Evaluation Action and Monitoring of TBI was a prospective 6-month interventional trial of participants with chronic TBI sequelae (n = 95). Plasma biomarkers were analyzed pre-intervention: glial fibrillary acidic protein (GFAP), tau, hyperphosphorylated tau Thr231 (p-Tau), von Willebrand factor (vWF), brain lipid-binding protein (BLBP), ubiquitin C-terminal hydrolase-L1 (UCH-L1), vascular endothelial growth factor-a (VEGFa), and claudin-5 (CLDN5). Clinical outcomes included the Post-Traumatic Stress Disorder (PTSD)Checklist for DSM-5 (PCL-5) and Brief Symptom Inventory-18 (BSI-18). Regression models were built for change in PCL5/BSI-18. Biomarkers and covariates were included. Two models were built to identify responders (improved beyond the minimum clinically important difference). The model to predict change in PCL5 (R2=0.64; p < 0.001) included vWF (p = 0.032), BLBP (p = 0.001), tau (p = 0.002), VEGFa (p = 0.015), female sex (p = 0.06), and military status (p = 0.014). The model to predict change in BSI-18 (R2=0.42; p = 0.003) included vWF (p = 0.042), VEGFa (p = 0.09), BLBP (p = 0.01), CLDN5 (p < 0.001), female sex (p = 0.012), and military status (p = 0.004) as predictors. The model to differentiate participants who improved for PCL5 (R2=0.68; p < 0.001; AUC = 0.93) included vWF (p = 0.02), VEGFa (p = 0.008), and BLBP (p = 0.006). The model to differentiate participants who improved for BSI-18 (R2=0.25; p = 0.04; AUC = 0.75) included UCH-L1 (p = 0.03), GFAP (p = 0.06), and vWF (p = 0.03). Combinations of pre-intervention blood biomarkers were able to differentiate responders from nonresponders in both post-traumatic stress and overall psychological health domains.

Large language models and synthetic health data: progress and prospects.

Given substantial obstacles surrounding health data acquisition, high-quality synthetic health data are needed to meet a growing demand for the application of advanced analytics for clinical discovery, prediction, and operational excellence. We highlight how recent advances in large language models (LLMs) present new opportunities for progress, as well as new risks, in synthetic health data generation (SHDG). We synthesized systematic scoping reviews in the SHDG domain, recent LLM methods for SHDG, and papers investigating the capabilities and limits of LLMs. We summarize the current landscape of generative machine learning models (eg, Generative Adversarial Networks) for SHDG, describe remaining challenges and limitations, and identify how recent LLM approaches can potentially help mitigate them. Six research directions are outlined for further investigation of LLMs for SHDG: evaluation metrics, LLM adoption, data efficiency, generalization, health equity, and regulatory challenges. LLMs have already demonstrated both high potential and risks in the health domain, and it is important to study their advantages and disadvantages for SHDG.

Evaluation of akathisia in patients receiving selective serotonin reuptake inhibitors/serotonin and noradrenaline reuptake inhibitors.

Akathisia is an underestimated but disturbing extrapyramidal side effect of antidepressants, which could reduce treatment compliance in mood disorders. This study aimed to investigate the frequency and risk factors in patients treated with selective serotonin reuptake inhibitors/serotonin and noradrenaline reuptake inhibitors (SSRI/SNRI). In addition, we assessed the impact of akathisia on the quality of life (QoL). Patients were aged between 18 and 75 years, receiving an SSRI/SNRI for 4-8 weeks, and were diagnosed with anxiety, depression, or obsessive-compulsive disorder. The Barnes Akathisia Rating Scale was used to assess the severity of the akathisia. QoL was evaluated using the Short Form 36 (SF-36) questionnaire. Akathisia was observed in 25% (50/198) of patients. Smokers and younger patients were more frequent among patients with akathisia. Physical functioning, physical role, vitality, and mental health domains of the SF-36 were reduced in the presence of akathisia. In conclusion, our results suggest that akathisia is not a rare side effect of SSRI/SNRI in patients with mood disorders, especially in smokers and younger patients. In addition, akathisia may reduce treatment compliance owing to a reduction in QoL. Further investigations are needed to confirm the risk factors, frequency, and consequences of treatment compliance for SSRI/SNRI-induced akathisia in patients with mood disorders.

Health-related quality of life and utility of maternity health states amongst post-partum Australians.

This study aimed to measure patient-reported health-related quality of life amongst post-partum women in Queensland, Australia. Patient-reported health-related quality of life data was prospectively collected from 134 post-partum women using the EQ-5D-5L at weekly intervals during the first six weeks following birth. Data across the five health domains of the EQ-5D-5L was converted to a single health utility value to represent overall health status. Linear mixed modelling and regression analysis were used to examine changes in utility over the first six weeks post-birth and determine associations between utility and clinical and demographic characteristics of post-partum women. Gestation at birth and weeks post-partum were significantly associated with utility values when considered in a multivariate linear mixed model. Mean utility values increased by 0.01 for every week increase in gestation at birth, and utility values were 0.70 at one week post-partum and increased to 0.85 at six weeks post-partum, with the largest increase occurring between one- and two-weeks post-birth. When controlling for variables that were found to predict utility values across the first six weeks post-partum, no single state of health predicted utility values at one-week post-partum. Maternity services can use our data and methods to establish norms for their own service, and researchers and maternity services can partner to conduct cost-effectiveness analysis using our more relevant utility values than what is currently available. Time since birth and gestational age of the woman's baby should be considered when selecting post-partum health state utility values for maternity services cost-effectiveness analyses.

7119 Klinefelter Syndrome in a Tertiary Referral Clinic: A Case Series and Clinical Audit

Abstract Disclosure: J. Luo: None. S. Sarlos: None. R. Giri: None. I. Sim: None. R.I. McLachlan: None. C.A. Allan: None. R. Upreti: None. Background: Klinefelter syndrome, the most common chromosomal disorder in men, remains underdiagnosed in many of those affected. Klinefelter syndrome is associated with hypogonadism and infertility, as well as an increased risk for venous thromboembolism (VTE), cardiometabolic disease, osteoporosis and gynaecomastia in adults. We studied the clinical features and disease associations in a tertiary referral cohort, and audited the care provided. Methods: Following ethics approval, adult patients with Klinefelter syndrome attending a Clinical Andrology Service in a tertiary Australian institution since 1 January 2011 were recruited. A database was established and demographics, aspects of initial diagnosis, ongoing treatments and comorbidities were documented. We audited our care using the European Academy of Andrology 2021 Guidelines for Klinefelter Syndrome. Results: Of 94 patients eligible, 57 patients consented to participation. The median age of diagnosis was 28 years, with the most common karyotype being 47,XXY (74%), followed by mosaic (20%) and higher degree polysomy (6%). Infertility (44%) and hypogonadism (33%) were the most common reasons for diagnosis. Most patients (88%) were treated with testosterone. Five men (11%) had genetic children with seven (18%) having previously attempted surgical sperm extraction. VTE occurred in seven patients (12%), with five on long-term anticoagulation following VTE diagnosis. Cardiovascular risk factor prevalence assessed at a median age of 42 years included increased BMI (72%), hypertension (25%), dyslipidaemia (70%), tobacco use (26%), impaired fasting glucose (11%) and type 2 diabetes (22%), though only one patient had a previous cardiovascular event. Osteopenia and osteoporosis were present in 28% and 4% of patients respectively, though only two patients had minimal trauma fractures. The audit of longitudinal care showed that gynaecomastia status was underreported (42%) in our clinic, whilst assessment and management of other health domains were mostly in keeping with the current recommendations. Conclusions: Klinefelter syndrome diagnosis continues to be delayed until adulthood in many men, with presentations most commonly involving infertility and/or hypogonadism. Our tertiary cohort demonstrates low rates of fertility treatment and success, which is likely multifactorial. There is a high burden of VTE, cardiovascular risk factors and reduced bone density despite testosterone treatment. Low rates of cardiovascular events and fracture may be reflective of a younger cohort as well as more aggressive risk factor management in a sub-specialist service. Gynaecomastia identification, documentation and management are areas for potential improvement. Increased awareness of Klinefelter syndrome and research into its associated risks are essential for standardising care and improving long-term outcomes. Presentation: 6/1/2024

7119 Klinefelter Syndrome in a Tertiary Referral Clinic: A Case Series and Clinical Audit

Abstract Disclosure: J. Luo: None. S. Sarlos: None. R. Giri: None. I. Sim: None. R.I. McLachlan: None. C.A. Allan: None. R. Upreti: None. Background: Klinefelter syndrome, the most common chromosomal disorder in men, remains underdiagnosed in many of those affected. Klinefelter syndrome is associated with hypogonadism and infertility, as well as an increased risk for venous thromboembolism (VTE), cardiometabolic disease, osteoporosis and gynaecomastia in adults. We studied the clinical features and disease associations in a tertiary referral cohort, and audited the care provided. Methods: Following ethics approval, adult patients with Klinefelter syndrome attending a Clinical Andrology Service in a tertiary Australian institution since 1 January 2011 were recruited. A database was established and demographics, aspects of initial diagnosis, ongoing treatments and comorbidities were documented. We audited our care using the European Academy of Andrology 2021 Guidelines for Klinefelter Syndrome. Results: Of 94 patients eligible, 57 patients consented to participation. The median age of diagnosis was 28 years, with the most common karyotype being 47,XXY (74%), followed by mosaic (20%) and higher degree polysomy (6%). Infertility (44%) and hypogonadism (33%) were the most common reasons for diagnosis. Most patients (88%) were treated with testosterone. Five men (11%) had genetic children with seven (18%) having previously attempted surgical sperm extraction. VTE occurred in seven patients (12%), with five on long-term anticoagulation following VTE diagnosis. Cardiovascular risk factor prevalence assessed at a median age of 42 years included increased BMI (72%), hypertension (25%), dyslipidaemia (70%), tobacco use (26%), impaired fasting glucose (11%) and type 2 diabetes (22%), though only one patient had a previous cardiovascular event. Osteopenia and osteoporosis were present in 28% and 4% of patients respectively, though only two patients had minimal trauma fractures. The audit of longitudinal care showed that gynaecomastia status was underreported (42%) in our clinic, whilst assessment and management of other health domains were mostly in keeping with the current recommendations. Conclusions: Klinefelter syndrome diagnosis continues to be delayed until adulthood in many men, with presentations most commonly involving infertility and/or hypogonadism. Our tertiary cohort demonstrates low rates of fertility treatment and success, which is likely multifactorial. There is a high burden of VTE, cardiovascular risk factors and reduced bone density despite testosterone treatment. Low rates of cardiovascular events and fracture may be reflective of a younger cohort as well as more aggressive risk factor management in a sub-specialist service. Gynaecomastia identification, documentation and management are areas for potential improvement. Increased awareness of Klinefelter syndrome and research into its associated risks are essential for standardising care and improving long-term outcomes. Presentation: 6/1/2024

Blood flow modulation to improve motor and neurophysiological outcomes in individuals with stroke: a scoping review.

Ischemic Conditioning (IC) is a procedure involving brief periods of occlusion followed by reperfusion in stationary limbs. Blood Flow Restriction with Exercise (BFR-E) is a technique comprising blood flow restriction during aerobic or resistance exercise. Both IC and BFR-E are Blood Flow Modulation (BFM) strategies that have shown promise across various health domains and are clinically relevant for stroke rehabilitation. Despite their potential benefits, our knowledge on the application and efficacy of either intervention in stroke is limited. This scoping review aims to synthesize the existing literature on the impact of IC and BFR-E on motor and neurophysiological outcomes in individuals post-stroke. Evidence from five studies displayed enhancements in paretic leg strength, gait speed, and paretic leg fatiguability after IC. Additionally, BFR-E led to improvements in clinical performance, gait parameters, and serum lactate levels. While trends toward motor function improvement were observed post-intervention, statistically significant differences were limited. Neurophysiological changes showed inconclusive results. Our review suggests that IC and BFR-E are promising clinical approaches in stroke, however high-quality studies focusing on neurophysiological mechanisms are required to establish the efficacy and underlying mechanisms of both in stroke. Recommendations regarding future directions and clinical utility are provided.

Association of psychosocial factors with sleep quality among aging adults in India: Moderating role of functional limitations and negative feelings

ABSTRACT Sleep is one of the vital factors in physiological and psychological health and well-being. Good quality of sleep is essential for healthy aging and functioning. However, there is a lack of understanding of the role of psychosocial factors in sleep quality among aging adults in India. Further, with an increasing proportion of aging population in India, it becomes critical to understand the determinants of sleep quality among aging adults. The present study also explored the moderating role of negative feelings and functional limitations between psychosocial factors and sleep quality. The study used secondary data from the Longitudinal Ageing Study in India (LASI) wave –1 (2017–2018). A sample of 16,152 middle-aged and older adults was included in the study. Descriptive statistics, multiple regression, and moderation analysis were conducted to get an insight into the impacts of the predictors on individuals’ sleep quality. The results of the study suggest lower everyday discrimination (β = -.065, 99% CI [-.083, -.048]), good life satisfaction (β = -.009, 95% CI [-.017, -.002]), lower negative feelings (β = .1, 99% CI [.091, .109]), and functional limitations (β = .22, 99% CI [.197, .244]) was associated with good sleep quality. Furthermore, negative feelings and functional limitations acted as moderators in unadjusted models, while only functional limitations acted as moderators between life satisfaction and sleep quality, spirituality, and sleep quality in the fully adjusted model. This study implies the need for various measures to improve the sleep quality of aging adults by focusing on physical, psychological, and social domains of health and well-being.

Over fifteen years of chloroquine withdrawal in Nigeria: a qualitative investigation into the execution of this policy by healthcare providers and amongst patients in a rural community.

Background Chloroquine (CQ) was once an important drug used in malaria treatment especially due to its affordability, ease of use and high anti-malarial efficacy. However, it was withdrawn from clinical practice in Nigeria in 2005 following a widespread of resistance cases reported in the public health domain. This study aims to ascertain the level of compliance with the policy on CQ withdrawal among patients, Patent and proprietary medicine vendors (PPMVs), Pharmacists and Physicians. Method A cross-sectional survey involving both online and offline data collection was carried out. A total of 582 participants were recruited and consisted of patients (N = 300), PMVs (N = 94), Physicians (N = 94), and Pharmacists (N = 94). Patients spanned across health services at primary health centers and hospitals in the Anaocha community. Result Our findings show that the patients were equally aware of what CQ is used for (χ² = 7.071, p = 0.215). However, significant disparities were observed in the knowledge, attitude, and perception of CQ resistance and its continual use among health professionals and PPMVs (χ² = 160.54 and 158.54, p = 0.000). Additionally, despite the chloroquine withdrawal policy in Nigeria, there was evident non-compliance among majorly PPMVs and other healthcare professionals. A few of patients continued to utilize CQ for malaria treatment and PPMVs were mostly likely to prescribe and stock CQ. Conclusion The study revealed that chloroquine use in Nigeria is still sustained notwithstanding the switch in the antimalarial drug policy from chloroquine to ACTs in 2005. Feasible implementation strategy through awareness program and campaign especially in the primary health centers across Nigeria and through associations such as Nigeria Association of Patent and Proprietary Medicine Dealers (NAPPMED), Pharmaceutical Society of Nigeria (PSN) and Nigeria Medical Association (NMA) is recommended.

Restorative benefits of soundscapes for individuals with psychological disorders

Mental health is a significant focus in the global public health domain today. Soundscapes have been identified as having positive environmental restorative benefits, yet the discussion on the mechanisms through which soundscapes contribute to the recovery from psychological disorders remains insufficiently explored. To guide the creation of restorative soundscapes in psychotherapy settings, this article adopted an "exposure-response" research paradigm. Through a soundscape intervention experiment involving 98 participants, it analyzed the perceived restorativeness evaluations and both physiological and psychological responses of populations with different psychological states. Overall, this article explored the restorativeness of soundscapes for individuals with psychological disorders in a solitary listening condition, with specific soundscapes such as rain sounds, bird songs, and river sounds demonstrating restorative effects. Individuals with psychological disorders rated rain sounds highest, while psychologically healthy individuals gave the highest ratings to bird songs.

Public spending and sustainable economic development

Purpose Despite the increase in public spending by Sub-Saharan African (SSA) Governments in a bid to foster the growth of human capital and sustainable development, they continue to experience a very slow rate of progress. This study aims to investigate the impacts of public spending on sustainable economic development in SSA. Design/methodology/approach The study adopts the system generalized method of moments to account for cross-sectional dependence and endogeneity for 38 SSA countries from 1996 to 2019. Findings The findings indicate that public spending inhibits sustainable economic development while human capital enhances sustainable economic development in SSA. Furthermore, the study equally reveals that the development-inhibiting role of public spending is modulated through human capital and governance quality. Public spending interacts with human capital and governance quality to produce negative net effects and positive synergy effects, respectively. Originality/value Based on these findings, the study suggests that governments in SSA countries should discourage heavy dependence on public spending. Policies that provide a framework for financial incentives in the domain of health and education should be encouraged to increase investment in human capital.

Validation of the Portuguese Version of IBD-Control Questionnaire and Comparison with IBD-Disk

Introduction: The IBD-Control questionnaire and IBD-Disk are two patient-reported outcome measures designed to evaluate the impact of inflammatory bowel disease (IBD) on different health domains. Unlike IBD-Disk, there is no fully published validated Portuguese version of IBD-Control. Furthermore, the two instruments have not yet been compared. We aimed to translate and validate IBD-Control in Portugal and compare it with IBD-Disk. Methods: After translation into Portuguese, the IBD-Control was administered to IBD patients, at baseline (T0), after 1–4 weeks (T1), and >3 months (T2). Patients also completed the Portuguese versions of the PRO2, EQ-5D, SIBDQ, and IBD-Disk. We assessed the reliability, validity, responsiveness, and interpretability of IBD-Control. We compared the usability (3 questions) and the ability to identify good disease control (area under the curve [AUC]) of IBD-Control and IBD-Disk. Results: At T0, the IBD-Control was completed by 142 patients (108 Crohn’s disease, 34 ulcerative colitis). At T1 and T2, 68 and 101 patients completed the questionnaire, respectively. Factor analysis confirmed the one-dimensionality of the scale with 8 items (IBD-Control-8). Internal consistency (Cronbach’s alpha) was 0.80. Test-retest reproducibility for stable patients (n = 54) was high (intraclass correlation coefficient-0.86). IBD-Control-8 significantly correlated (r between 0.55 and 0.82; p ≤ 0.001) with PRO2, EQ-5D, SIBDQ and IBD-Disk. The variation in IBD-Control-8 between T0 and T2 correlated significantly (r between 0.48 and 0.53; p ≤ 0.01) with the variation in PRO2 (only for Crohn’s disease), SIBDQ and IBD-Disk. The IBD-Control-8 significantly discriminated between well and poorly controlled disease (15 ± 2 vs. 11 ± 4; p < 0.001). No significant differences were observed between IBD-Control-8 and IBD-Disk regarding usability and the ability to identify good disease control (AUC: −0.79 vs. 0.76, respectively). Conclusions: The IBD-Control is reliable and valid for measuring disease control from the perspective of patients with IBD in Portugal, presenting no significant differences regarding usability and assessment of disease control when compared to IBD-Disk.

Assessing the Impact of Health Disparities on Latinx Immigrant Young Adults’ Critical Consciousness Development

This study tested a theory-based model linking the impacts of the COVID-19 pandemic on health domains (i.e. work, home life, social life, emotional health, physical distancing) with critical consciousness (CC) development among a diverse sample of 291 Latinx immigrants ages 18–30. Results from global and local fit indices using structural equation modeling (SEM) demonstrated good model fit. Greater pandemic health impact from the COVID-19 pandemic was linked to greater critical reflection and action, but not agency. Tests of indirect effects with bootstrapping showed that CC development among Latinx immigrants took place in ways that align with theoretical postulations.

Application of a Question Answering System in the Ontology-Based Health Domain and Question Templates to Improve the Quality of Answers

Developing an effective Question Answering System (QAS) to address a wide range of health-related inquiries presents a significant challenge. This study introduces an innovative approach using an ontology-based QAS within the health domain, leveraging the Resource Description Framework (RDF) and SPARQL query language. By utilizing ontology, the system can more accurately map health concepts, improving the relevance and precision of its responses. Additionally, the incorporation of structured Question Templates enhances the system’s ability to understand and respond to diverse user queries. The system's performance was evaluated using Black Box Testing, which demonstrated that it consistently provides accurate and relevant answers. The system achieved a Mean Average Precision (MAP) of 79.6%, indicating its potential to effectively address a broad spectrum of health issues.

Pregnancy intentions and outcomes among young married women in Nepal

BackgroundApproximately 44% of Nepalese women ages 15–49, desiring to avoid pregnancy, do not use modern contraceptives, resulting in an estimated 539,000 unintended pregnancies annually. ObjectivesThis study aims to investigate the association between young, newly married women's pregnancy intentions and subsequent pregnancies. Study designData were collected longitudinally from 200 recently married women aged 18–25 in Nepal. Surveys conducted every six months over 18 months covered various health domains. The study used mixed-effects logistic regression models to account for repeated measurement of correlated data over time. The primary outcome was pregnancy. Pregnancy intention was determined based on responses to, “When would you like to have a child in case you were to have one?” Participants were recategorized into a dichotomous variable for analytical purposes: “Right away” or “Not right away.” ResultsA total of 133 participants became pregnant during the study, with sociodemographic characteristics showing minimal differences between pregnant and nonpregnant groups. Women intending to become pregnant right away had significantly higher odds of becoming pregnant (OR, 4.03; 95% CI, 2.51–6.48) after adjusting for covariates. Among those not intending immediate pregnancy, over 70% became pregnant, suggesting potential barriers to achieving reproductive goals. ConclusionsYoung, newly married women in Nepal intending immediate pregnancy have higher odds of becoming pregnant. However, a substantial proportion of those hoping to delay pregnancy still experience unintended pregnancies, indicating challenges in meeting reproductive goals. The findings underscore the need for addressing barriers to contraceptive access and societal norms impacting women's reproductive autonomy in Nepal.

Examining the impact of socioeconomic and demographic factors on women’s health: A survey-based study of menstrual hygiene, pregnancy, and postpregnancy care in the Gonds Tribe of Sonbhadra, Uttar Pradesh

ABSTRACT Introduction: The Gonds tribe, indigenous to the Sonbhadra region in Uttar Pradesh, India, faces unique challenges and disparities in women’s health, particularly in the domains of menstrual health, pregnancy, and postpregnancy care. This study aims to shed light on the demographic patterns of these critical aspects of women’s health among the Gonds tribe, providing valuable insights for healthcare interventions and policy development. Aim: This study explores the demographic and socioeconomic factors affecting Gond women’s health, focusing on menstrual hygiene and life stages before, during, and after pregnancy. Methodology: We collected data on menstruation wellness behaviors, pregnancy experiences, and postpregnancy care by conducting an extensive survey among Gonds women in the Sonbhadra area. In addition, focus groups and qualitative interviews were used to acquire greater knowledge of the socioeconomic and social factors impacting these health-distinctive characteristics. Result: The Chi-square test shows no significant link between age group and menstrual hygiene product use. Young women (under 18) mostly use cotton cloth (56%). Women aged 18–49 prefer cotton cloth (53.2%). Women 50+ use cotton cloth (43.2%), cotton (29.7%), and sanitary napkins (27%). Marital status affects product use and cycle regularity. Cultural beliefs and education influence healthcare decisions. Menstrual hygiene mainly involves cotton cloth (45%) and cotton (26.1%). Conclusion: In conclusion, our analysis uncovers key insights: Marital status, healthcare access, education, cultural beliefs, and reproductive health practices influence community healthcare decisions. These findings inform tailored interventions to enhance health outcomes and equity.

Trisomy 21 and Congenital Heart Disease: Impact on Health and Functional Outcomes From Birth Through Adolescence: AScientific Statement From the American Heart Association.

Due to improvements in recognition and management of their multisystem disease, the long-term survival of infants, children, and adolescents with trisomy 21 and congenital heart disease now matches children with congenital heart disease and no genetic condition in many scenarios. Although this improved survival is a triumph, individuals with trisomy 21 and congenital heart disease have unique and complex care needs in the domains of physical, developmental, and psychosocial health, which affect functional status and quality of life. Pulmonary hypertension and single ventricle heart disease are 2 known cardiovascular conditions that reduce life expectancy in individuals with trisomy 21. Multisystem involvement with respiratory, endocrine, gastrointestinal, hematological, neurological, and sensory systems can interact with cardiovascular health concerns to amplify adverse effects. Neurodevelopmental, psychological, and functional challenges can also affect quality of life. A highly coordinated interdisciplinary care team model, or medical home, can help address these complex and interactive conditions from infancy through the transition to adult care settings. The purpose of this Scientific Statement is to identify ongoing cardiovascular and multisystem, developmental, and psychosocial health concerns for children with trisomy 21 and congenital heart disease from birth through adolescence and to provide a framework for monitoring and management to optimize quality of life and functional status.

Towards a comprehensive COVID-19 non-pharmaceutical interventions’ index for the province of Québec

ObjectivesThe primary objective of this project was to develop a comprehensive COVID-19 non-pharmaceutical interventions’ index for the province of Québec (QCnPI-Index). The resulting database systematically categorizes, multiple non-pharmaceutical interventions implemented in the 17 administrative regions (AR) of the province of Québec to mitigate the spread of COVID-19 in the form of an index.Data descriptionData represent interventions and groups of interventions implemented during the COVID-19 period in Québec. They are a compilation of policies, guidelines, and governmental interventions related to COVID-19, considering temporal and geographical dimensions. Data were collected for all 17 AR of Québec using dates as unit of analysis, from March 2020 to April 2022. They were first collected and then coded by an interdisciplinary research team to form the foundation of the QCnPI-Index.ContributionThis quantitative instrument offers the necessary granularity for nuanced spatial and temporal studies within the province of Québec, using AR, for instance, as unit of analysis. With this database, pre-, during-, and post-COVID periods can thus be better analyzed. Additionally, the innovative methodologies employed for data collection, coding, and weighting offer valuable insights that may have broader applications in public health, epidemiology, and other research domains. The QCnPI-Index could be instrumental for public health, epidemiology, and transportation researchers investigating the multifaceted impacts of non-pharmaceutical interventions on various societal domains, such as road safety, alcohol and cannabis consumption, and/or mental health, in the province of Québec.

Test–retest Reliability of Perceived Wellness Survey among Community-dwelling Geriatric Population: An Observational Study

Abstract Introduction: The aging population faces unique challenges, so incorporating their perspective is necessary for providing patient-centered care and enhancing the quality of life for older adults. However, this self-assessed well-being of the elderly population is not extensively documented, despite being a key approach in the health and welfare domain. The Perceived Wellness Survey (PWS), designed to assess well-being across multiple dimensions, could be suitable for determining wellness among the elderly. Therefore, this study seeks to evaluate the test–retest reliability of the PWS among the geriatric population. Subjects and Methods: An observational study was conducted which included 100 subjects in the age group of 60–74 years, at a government tertiary care hospital, in Mumbai, after procuring approval from the departmental review board. The participants completed the questionnaire at two different time points, separated by 1 week. The test–retest reliability was assessed using the Pearson’s product-moment correlation coefficient test, and the internal consistency was tested by Cronbach’s alpha. Results: One hundred subjects were recruited, of which 45% were female and 55% were male, with a mean age of 66.38 ± 3.96 years. The Pearson coefficients for test–retest reliability among observations varied between 0.870 and 0.946, indicating good reliability. Internal consistency ranges between 0.930 and 0.970, suggesting excellent reliability. Conclusion: The PWS is a reliable and internally consistent tool for assessing wellness perception among the geriatric population.

Treatment adherence and quality of life in colombian patients with lupus nephritis.

As with many other chronic diseases, systemic lupus erythematosus (SLE) and lupus nephritis (LN) have significant impacts on the health-related quality of life (HRQoL). Medication non-adherence is a significant challenge in the management of SLE, with consistently up to 75% of patients being non-adherent with their SLE medications. There is a need to assess the patient's perspective using patient-reported outcomes (PROs) to better understand the current impact of LN on HRQoL and treatment adherence in our region. The aim of this study was to explore the relationship between HRQoL and treatment adherence in patients with LN from the Colombian Caribbean. A cross-sectional study was conducted from June to December 2022, including patients with biopsy-proven LN. HRQoL and treatment adherence were assessed using the Lupus Quality of Life (LupusQoL) and the Compliance Questionnaire in Rheumatology 19 (CQR19) instruments, respectively. Patients were categorized as adherent or non-adherent based on medication intake (defined as >80% correct dosage). Principal component analysis (PCA) was employed to identify principal components between adherent and non-adherent patients. A total of 42 patients with LN were included. Of these, 38 (90%) were female, and the mean age was 31 ± 10 years. Proliferative class IV was the predominant histopathological profile (90%). Twenty-five (60%) patients were categorized as non-adherent. Across all LupusQoL domains, a comprehensive range of responses was observed. Pain, planning, and intimate relationships domains remained unaffected, while burden to others domain had the lowest score. Poorer planning score correlated with older age (r = -0.72; p < .05) and longer disease duration (r = -0.74; p < .05). SLEDAI-2K correlated with the pain domain (r = -0.78; p < .05). Non-adherent patients exhibited significantly worse pain domain scores compared to adherent counterparts (p < .05). PCA showed strong interactions between planning and pain, as well as between physical health and body image domains. LupusQoL pain domain scores were significantly worse in non-adherent patients compared to adherent patients. Effective pain management could be a determinant in HRQoL and treatment adherence rates in our population.