Health Summary Research Articles

A comparative study of porcine antihuman lymphocyte globulin versus antithymocyte globulin-fresenius in an allogeneic hematopoietic cell transplantation conditioning regimen for severe aplastic anemia

ABSTRACT Objectives To compare the outcomes of antihuman T lymphocyte globulin (ATG-F) and porcine antihuman lymphocyte globulin (p-ALG) as part of a conditioning regimen in hematopoietic stem cell transplantation (HSCT) for severe aplastic anemia (SAA). Methods we performed a retrospective analysis, evaluating the outcome of patients with SAA who received ATG-F based conditioning (n = 26) with those receiving p-ALG conditioning (n = 34). Results The median time to neutrophil engraftment was 11 days (range, 8 − 38) and 11 days (range, 9 − 24) in the p-ALG and ATG-F groups (P = 0.857); the median platelet engraftment time was 15 (range, 9 − 330) days and 13 (range, 10 − 56) days (P = 0.155). There were no significant differences in grades II − IV acute graft-versus-host disease (aGVHD), grades III − IV aGVHD, chronic GVHD (cGVHD), and the moderate-severe cGVHD between the ATG-F and p-ALG groups (P>0.05). Discussion Patients in the ATG-F group functioned significantly better on role-physical (P = 0.006), general health (P = 0.029), and physical component summary (P = 0.009). The estimated overall survival and failure free survival rates at 5 years were 88.5% ± 6.3% vs. 82.4% ± 6.5% (P = 0.515), 84.6% ± 7.1% vs. 79.4% ± 6.9%, respectively (P = 0.579). The infection rates were 61.53% and 47.05%, respectively (P = 0.265). Conclusion As part of the conditioning regimen, p-ALG achieved a similar efficacy as ATG-F without increasing the incidence of transplantation complications in SAA patients.

The Significant Association between Health Examination Results and Population Health: A Cross-Sectional Ecological Study Using a Nation-Wide Health Checkup Database in Japan.

In Japan, population health with life expectancy (LE) and healthy life expectancy (HALE) as indicators varies across the 47 prefectures (administrative regions). This study investigates how health examination results, including attitude toward improving life habits, are associated with population health. The association between health checkup variables and summary population health outcomes (i.e., life expectancy and healthy life expectancy) was investigated using a cross-sectional ecological design with prefectures as the unit of analysis. The medical records, aggregated by prefecture, gender, and age in the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) Open Data Japan, were used as health checkup variables. Body weight, blood pressure, liver enzymes, drinking habits, smoking habits, diabetes, serum lipids, and answers to questions regarding attitude toward improving health habits were significantly correlated to population health outcomes. Multiple regression analysis also revealed significant influence of these variables on population health. This study highlights that health examination results, including attitude toward improving health habits, are positively associated with population health. Consequently, implementing measures to improve health habits in response to the examination results could help the population maintain a healthy life.

Energetic improvement of smart Healthcare system using Internet of Things

In this modern era, each and every individual needs a global communication without any range and timeline restrictions. A well-known Internet of Things (IoT) provides such support to individuals and organization to provide range free communication services without any hurdles. This paper introduces a new methodology called Healthcare Processing with IoT Surveillance (HPIoTS), in which it adopts some latest technologies to provide an efficient support to monitor the healthcare of the respective patient and report those details properly to the server end with the help of Internet of Things. This proposed scheme of HPIoTS enables a shrewd Healthcare framework in Internet of Things platform, in which it screen a patient fundamental health oriented issues with surrounding atmosphere ratios such as temperature, humidity level, position and so on. In this framework, a smart health assisted gadget is designed with different sensors to catch the health related information from the patients’ side such as: Heart Rate Monitoring Sensor, Pressure Sensor, Temperature and Humidity Level Monitoring Sensor and MEMS Sensor. The association of these sensors made a device more perfect to acquire the health summary of the patients periodically and pushed into the server end without any timing delay and human interventions. The maximum error rate of this proposed approach is estimated around less than 5% as well as this will be proved properly in results sections via graphical proofs. This paper adopts the machine learning strategy to predict the patient health related issues and provides a good accuracy level of 97% in result. The proposed approach guarantees the efficiency of the healthcare monitoring system by using Healthcare Processing with IoT Surveillance (HPIoTS) as well as the resulting accuracy levels are proved on the results section with proper graphical outcomes.

Health Related Quality of Life of Children with Thalassemia Major in Two Selected Hospitals in Sri Lanka

Introduction: Thalassemia is an inherited hemoglobin disorder. There are two types; thalassemia major and minor. Thalassemia major directly affects children’s physical, emotional, social and school functions. Health Related Quality of Life (HRQoL) is an important indicator to assess the health of human. Methods: A cross sectional study was conducted using 60 children (age 2-12 years) with thalassemia major who attended clinics in two selected hospitals in Sri Lanka from July to September 2018. Demographic data and risk factors were collected using a self-administered questionnaire. HRQoL data were collected using the Pediatric Quality of Life Inventory Version 4.0 Generic Core Scale. Data were analyzed using SPSS. Results: Mean values of the total functioning scores of physical, emotional, social and school were 89.42 (±9.20), 87.83 (±10.43), 95.00 (±7.53) and 78.75 (±14.13) respectively. Age of the children was significantly associated with emotional functioning (p=0.046), school functioning (p=0.023), psychosocial health (p=0.021) and the total summary score (p=0.006). Total number of blood transfusions per year of the patient was significantly associated with physical functioning (p=0.002), psychosocial health (p=0.045) and total summary score (p=0.034). Conclusions: Age and the total number of blood transfusions per year significantly affect the HRQoL of children with thalassemia major. Gender, type of iron chelation and age at first blood transfusion did not affect HRQoL of the children.Keywords: HRQoL, Thalassemia major, Haemoglobin disorder

Cardiac rehabilitation in women; comparison of enrollment, adherence and outcomes between heart failure and coronary artery disease

BackgroundThere is paucity of data on cardiac rehabilitation (CR) enrollment and outcomes in women with heart failure (HF). MethodsIn this retrospective analysis, we compared enrollment, adherence and outcomes between women with HF versus coronary artery disease (CAD)-related indications referred to a university-affiliated CR program from June 2014–July 2018. A multivariate regression analysis was performed to adjust for imbalanced variables at baseline and baseline value of each outcome to compare change in outcomes between HF and CAD groups ResultsA total of 538 women (HF=63 vs CAD=475) were included in the study. At baseline, women with HF were younger, had lower attendance to CR intake and worse perceived health, higher AACVPR risk category and lower exercise capacity but had similar enrollment, weight and dieatry habits when compared to women with CAD. Adjusted analyses showed that almost all cardiac rehabilitation outcomes except for positive affect (anxiety, depression symptoms, negative affect, dietary habits, perceived physical and mental health summary scores, exercise duration and capacity) improved significantly from baseline and in a similar fashion in both groups. Weight loss was significantly greater for women with CAD versus those with HF (CAD: Δ -1.12 ± 2.23 kg versus HF: Δ -0.66 ± 2.78 kg, p = 0.03). ConclusionDespite a lower attendance to CR intake, lower perceived physical health and higher baseline AACVPR risk in women with HF, they have similar CR enrollment, adherence and completion rates compared to women with CAD. Both groups showed significant but similar improvements from baseline in almost all cardiac rehabilitation outcomes. These findings should alert cardiology providers to help overcome obstacles for women with HF to attend CR intake.

Effective use of online depression information and associated literacies among US college students.

Mental health issues, such as depression, are rising among young people, who may benefit from online depression-related information. However, the competencies required to search for health information on the Internet and evaluate it before use may be poor among this population. This research aimed to investigate how college students use the Internet for solving problems in realistic case scenarios relevant to depression and to understand whether various literature-indicated literacies and factors may predict effective utilization of relevant online resources. We designed a web-based questionnaire survey including four depression-related case scenarios. A total of 218 undergraduate students who were enrolled in a Northeastern public US university were invited to participate in the survey in 2016, with 192 completed responses being included in this analysis (response rate = 88%; the participants' median age = 20; 79% female). Approximately half of the participants (47%) answered the depression-related questions in the case scenarios with 90% or higher accuracy. In a multiple linear regression model, prior depression knowledge and eHealth information literacy significantly predicted the effective use of online depression information. However, medical literacy and critical health literacy were not significant predictors. A few additional demographic and experience related factors were positively associated with the effective Internet use (e.g. female, non-Hispanic, psychology or health science major and prior experience with depression). These findings identify a need for college students to develop domain-specific knowledge and literacies in order to facilitate effective use of online information about depression.

Social Capital in Old People Living with HIV Is Associated with Quality of Life: A Cross-Sectional Study in China.

Objective Old people living with HIV (PLWH) are experiencing a lower quality of life (QoL) than their younger counterparts and have received insufficient attention in China. Given that social capital has been proven to be effective in improving QoL in other countries, we aimed to examine the association between social capital and QoL among old PLWH in China. Methods The data presented in this study was based on the baseline sample of an ongoing observational prospective cohort study, which was carried out from November 2018 to February 2019. Participants were old PLWH aged ≥50 in Sichuan, China, and were recruited by stratified multistage cluster sampling from 30 communities/towns. A total of 529 eligible participants finished the face-to-face investigation to measure their social capital (i.e., individual and family- (IF-) based social capital and community and society- (CS-) based social capital) and QoL. The QoL's dimensions of physical health summary (PCS) and mental health summary (MCS) were taken as dependent variables. Stepwise linear regression models were used to examine the association between social capital and QoL. Results After considering all significant covariates, the PCS was nonsignificantly correlated with IF-based social capital (β = −0.08, 95% CI [-0.28-0.11]) and CS-based social capital (β = 0.28, 95% CI [-0.03-0.59]), and MCS was significantly correlated with IF-based social capital (β = 0.77, 95% CI [0.54-0.99], p < 0.001) and CS-based social capital (β = 0.40, 95% CI [0.08-0.72], p < 0.05). Conclusion Targeted interventions related to building up social capital should be applied to improve the QoL of old PLWH. Providing extra relief funds and allowances might be helpful to improve PCS; improving community networking and engagement and improving family care might be helpful to improve MCS among this vulnerable population.

Quality of life in children with tuberous sclerosis complex: A pediatric cohort study.

AimsTo evaluate the quality‐of‐life (QOL) impairment and identify the possible risk factors in patients with tuberous sclerosis complex (TSC) in China.MethodsThe parent proxy‐report PedsQL 4.0 Generic Core Scales were administered to 124 caregivers of children with TSC (aged 2‐18 years). For comparison, the survey was also conducted in a demographically group‐matched sample of healthy controls (HCs) (aged 2‐18 years).ResultsA total of 124 children with TSC and 206 HCs were recruited. The mean parent proxy‐report total scale score, physical health summary score, and psychosocial health summary score for children with TSC were 65.0 (SD 19.7), 77.6 (SD 22.9), and 58.0 (SD 21.3), respectively, compared with the HC values of 83.6 (SD 14.3), 87.2 (SD 16.9), and 82.8 (SD 15.9). There were statistically significant differences between the two groups (P < .0001). TSC2 mutation (P = .033), epilepsy (P = .011), seizure before 2 years old (P = .001), course of epilepsy (more than 2 years) (P = .001), high reported seizure frequency (more than once a month) (HRSF) (P = .007), multiple antiepileptic drugs (≥2) (P = .002), intellectual disability (ID) (mild and moderate ID, P < .0001, and severe and profound ID, P < .0001), and TANDs (P < .0001) (ADHD, P = .004; agoraphobia, P = .007; and social anxiety disorder, P < .0001) were closely related to lower QOL scores.ConclusionThis study is the first large cohort study on QOL in children with TSC in China. The results of the PedsQL 4.0 indicated that the QOL of children with TSC is significantly lower than that of HCs. TSC2 mutation, epilepsy, early onset, long disease course and HRSF, ID, and TANDs are risk factors for poor QOL.

Sickle cell disease patients' health-related quality of life in the southern region of Saudi Arabia.

Research that focuses on the health-related quality of life of patients with sickle cell disease remains challenging in Saudi Arabia. This study aims to assess the health-related quality of life of sickle cell disease patients and determine the factors that contribute to a poorer quality of life in the Asir Region or southern region, compared with other regions in Saudi Arabia. Sickle cell disease patients attending Asir General Hospital and Abu Aresh General Hospital were consecutively invited to enrol in the study from November 2019 to April 2020. The Medical Outcomes Study (SF-36) questionnaire was used to assess the health-related quality of life of patients with sickle cell disease. This study included 107 individuals (22 males and 85 females) with sickle cell disease, with a mean age of 25±7.851. The mean physical health summary and mental health summary were 60.6±23.4 and 52.12±22.37, respectively. Exercise and family support affected the physical health, mental health and vitality scores positively, while swelling and fever had a negative effect on physical and mental health. Furthermore, more educated patients demonstrated significantly better mental health than uneducated or less educated patients (P=.031). Patients with sickle cell disease exhibited a poor health-related quality of life. Interventions such as a comprehensive center for sickle cell disease should consider improvements in health-related quality of life important outcomes.

295P Assessment of the impact of palliative care on the quality of life in advanced non-small cell lung cancer patients

During the last two decades, health-related quality of life (QoL) measurements have been an important issue in understanding the difficulties perceived in many diseases. It is important to assess the health-related quality of life to know the extent of diseases and conditions affecting individual’s general well-being. Studies have shown the effect various determinants of Quality of Life (QoL) in lung cancer patients. This study was done to assess the QoL in individuals with non- small cell lung cancer undergoing palliative care. Materials and Method: Data on QoL were collected using a modified MOS-SF form-32. The study was done in 27 individuals before and after providing supportive or palliative care. A random mixed linear model was used to assess impact of palliative care on Quality of Life with Physical Health Summary score and Mental Health Summary score as main outcomes. All the possible confounding factors were controlled in the study. When values were compared before and after giving palliative care the Physical Health Summary score decreased considerably. (diff=-2.12; 95% CI: [-4.08, -0.63]) with small to medium effect sizes. The PHS Score remained lower after being on palliative care for more than 2 years (diff=-5.86; 95% CI: [-7.89, -3.63]).]). The Mental Health summary score didn’t change significantly after giving palliative care (diff=-5.86; 95% CI: [-7.89, -3.63]). The Mental Health summary score was higher after HAART for more than 5 years when compared prior to infection. Quality of life is an important determinant in the course of lung cancer. Palliative or supportive care can play a vital role in improving the quality of life in patients with lung cancer.

Behavioral Changes in Children with Constipation: A Cross Sectional Study in the Lebanese Population

Background: Although constipation is a common childhood problem, its global burden was still quite unknown because data from many regions in the world were missing, Lebanon being one of them. This study mainly aimed to assess the effect of constipation on behavioral changes (physical, emotional, social, and school functioning). It was also destined to determine the difference in quality of life between constipated and non-constipated children and to provide the public health community with a study to identify the need of early management. Methods: A cross sectional questionnaire-based survey was conducted by Lebanese University students in 86 children half of whom were constipated. Recruitment took place at Rafic Hariri University Hospital. Results: A statistically significant difference was noted between constipated and nonconstipated children in physical functioning (mean score for non-constipated patients = 75.99; mean score for constipated = 46.44; (P-value &lt; 0.002). Non constipated children also had significantly higher (P-value &lt; 0.001) Emotional Health Summary Score (65.62; 17.71), Social Health Summary Score (75; 18.87), School Health Summary Score (71.58; 14.93), Psychosocial Health Summary Score (71.08; 12.19) than constipated children. Furthermore, the overall PedsQL total scale was significantly higher (P-value &lt; 0.001) in non-constipated children (72.9; 12.45) compared to the constipated (50.86; 11.23). Conclusion: This study showed lower overall QOL in children with constipation, as well as impaired school, social, physical, and emotional functioning. This study shows the importance of evaluating and tackling all the components of wellbeing by pediatricians.

Utjecaj duhovnosti na subjektivni osjećaj zdravlja

The goal of this study was to investigate whether spiritual life influences the subjective feeling of health in individuals and whether this influence was significant. Methods: We used the SF-36 questionnaire to investigate the opinions of a religious prayer group on their personal health in comparison with participants who were not members. The questionnaire was completed by 51 members of the prayer group and as many participants in the control group. Results: The analysis showed that the prayer group had higher ratings in all scales on subjective health perception in comparison with the control group and the general population in Croatia. There were statistically significant differences in the prayer group in comparison with the control group on the scales for general health, vitality, emotional limitations, mental health, and mental component summary. In comparison with the Croatian population, the prayer group had statistically significant differences in all scores except social functioning. Conclusion: The study indicates that the quality of religious life is an important factor in a person’s perception of their own mental and physical health.

The assessment of affective temperament and life quality in myofascial pain syndrome patients

Objectives Myofascial Pain Syndrome (MPS) is known as a chronic pain syndrome, which is often associated with decreased life quality, depressive, and anxiety disorders. Affective temperament characteristics are mental illness signs that may assist in anticipating and detecting a tendency to depression and anxiety in MPS. The properties and impacts of affective temperament on pain, disability, life quality, depressive, and anxiety disorders in MPS patients were intended to explore by this study. Patients and methods This case-control study was carried out in the physical medicine and rehabilitation clinic of a university hospital, Turkey, from October 2018 to January 2019 with 51 MPS patients and 47 healthy controls (HC). Physical examination, clinical history, visual analog scale (VAS), neck disability index (NDI), Short Form (36) Health Survey (SF-36), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego- Autoquestionnaire (TEMPS-A) scale were performed for all volunteers. Results TEMPS-A depressive, cyclothymic, and anxious scores were remarkably higher in MPS patients than in the HC group. In MPS patients, SF 36 physical and mental health summary scores were remarkably lower than the control group. Additionally, BDI and BAI scores were significantly higher in patients with MPS than in the control group. There was a significant positive correlation between depressive and anxious temperament scores and NDI. Moreover, a negative correlation was found between the SF36 physical health summary score and depressive and anxious temperament scores. Also, the mental health summary score was negatively correlated with depressive, cyclothymic, and anxious temperament scores. Conclusion This research assesses for the first time of the affective temperament characteristics of MPS patients. KEY POINTS Myofascial pain syndrome patients have distinct temperaments than the control group. Myofascial pain syndrome patients had remarkably higher TEMPS-A depressive, cyclothymic, and anxious scores than the healthy control group. Life quality, clinical severity, and courses can be affected by differences in temperament. Clinicians can readily apply the TEMPS-A temperament scale in patient application to demonstrate these differences. The anticipation of a psychiatric situation plays a more significant role in evaluating the higher mood symptom rates and their effect on life quality.

Flint Kids Cook: positive influence of a farmers' market cooking and nutrition programme on health-related quality of life of US children in a low-income, urban community.

To examine changes in health-related quality of life (HRQoL) among youth who participated in Flint Kids Cook, a 6-week healthy cooking programme for children, and assess whether changes in HRQoL were associated with changes in cooking self-efficacy, attitude towards cooking (ATC) and diet. Pre-post survey (Pediatric Quality of Life Inventory, Block Kids Food Screener, 8-item cooking self-efficacy, 6-item ATC) using child self-report at baseline and programme exit. Analysis involved paired sample t-tests and Pearson's correlations. Farmers' market in Flint, Michigan, USA. Children (n 186; 55·9 % female, 72·6 % African American) participated in Flint Kids Cook from October 2017 to February 2020 (mean age 10·55 ± 1·83 years; range 8-15). Mean HRQoL summary score improved (P < 0·001) from baseline (77·22 ± 14·27) to programme exit (81·62 ± 14·43), as did mean psychosocial health summary score (74·68 ± 15·68 v. 79·04 ± 16·46, P = 0·001). Similarly, physical (P = 0·016), emotional (P = 0·002), social (P = 0·037), and school functioning (P = 0·002) improved. There was a correlation between change in HRQoL summary score and change in ATC (r = -0·194, P = 0·025) as well as change in cooking self-efficacy (r = -0·234, P = 0·008). Changes in HRQoL and psychosocial health summary scores were not correlated with dietary changes, which included decreased added sugar (P = 0·019) and fruit juice (P = 0·004) intake. This study is the first to report modest yet significant improvements in HRQoL among children and adolescents who participated in a healthy cooking programme. Results suggest that cooking programmes for youth may provide important psychosocial health benefits that are unrelated to dietary changes.

Decomposition of years of life lost due to premature death (YLL): a method for spatial and temporal comparative assessment

BackgroundAcceptance of Disability-Adjusted Life Year (DALY) as a measure of health summary and progression has increased over the years, which in turn has instigated comparative analysis studies of DALY across time and geography. Thus, it is important to explore methodological underpinnings of comparative analysis.ResultsA crude comparison of disease burden across time or space may mislead the interpretation of the health system’s performance because the quantum and pattern of DALY can be influenced by the age structure of the society. A significant proportion of this burden is due to the Years of Life Lost (YLL) component. The paper proposes a mathematical exposition to decompose the change in YLL over time or region into burden attributed to a) population age structure, b) death rate, and c) age at death gradient.ConclusionWe reasoned that the death rate and age at death burden gradient signify the real contribution of the health systems. Hence, the method of decomposition can be utilized to measure the health service progression of a region in real terms.

Mindfulness-Based College: A Stage 1 Randomized Controlled Trial for University Student Well-Being.

To evaluate effects of a mindfulness-based program, adapted to the young adult life course stage (age, 18-29 years), named Mindfulness-Based College (MB-College). The primary outcome was a young adult health summary score, composed of key health risk factors: body mass index, physical activity, fruit and vegetable intake, alcohol consumption, stress, loneliness, and sleep duration. Secondary outcomes were hypothesized self-regulation mechanisms, including attention control, interoceptive awareness, and emotion regulation. This was a stage 1 randomized controlled trial of the 9-week MB-College program (n = 47) versus enhanced usual care control (n = 49) including students from three universities. Assessments were at baseline, during the beginning of the college term when stress is typically lower, and at MB-College completion (3-month follow-up), when term-related stress is typically higher. Intention-to-treat, linear regression analyses estimated the marginal effects of MB-College versus control on the outcomes. MB-College participants (mean age = 20 years, 68% female, 37% racial minorities) demonstrated improved health summary scores at follow-up compared with control participants whose health summary scores worsened (marginal effect for MB-College versus control = 0.23; p = .004). Effects on loneliness were pronounced (marginal effect = -3.11 for the Revised University of Los Angeles Loneliness Scale score; p = .03). Secondary analyses showed significant impacts of MB-College on hypothesized self-regulation mechanisms (e.g., Sustained Attention to Response Task correct no-go percent, p = .0008; Multidimensional Assessment of Interoceptive Awareness, p < .0001; Center for Epidemiologic Studies-Depression scale, p = .03). Findings of this early stage clinical trial suggest that MB-College may foster well-being in young adults.Trial Registration: NCT03124446.

Effects of growth hormone receptor antagonism and somatostatin analog administration on quality of life in acromegaly.

Acromegaly is associated with impaired quality of life (QoL). We investigated the effects of biochemical control of acromegaly by growth hormone receptor antagonism vs somatostatin analog therapy on QoL. Cross-sectional. 116 subjects: n=55 receiving a somatostatin analog (SSA group); n=29 receiving pegvisomant (PEG group); n=32 active acromegaly on no medical therapy (ACTIVE group). Acromegaly QoL Questionnaire (AcroQoL), Rand 36-Item Short Form Survey (SF-36) and Gastrointestinal QoL Index (GIQLI); fasting glucose, insulin and IGF-1 levels (LC/MS, Quest Diagnostics). There were no group differences in mean age, BMI or sex [(whole cohort mean ± SD) age 52±14years, BMI 30±6kg/m2 , and male sex 38%]. Mean IGF-1 Z-scores were higher in ACTIVE (3.9±1.0) vs SSA and PEG, which did not differ from one another (0.5±0.7 and 0.5±0.7, P<.0001 vs ACTIVE). Eighty-three per cent of PEG previously received somatostatin analogs, which had been discontinued due to lack of efficacy (52%) or side effects (41%). There were no differences in the four QoL primary end-points (AcroQoL Global Score, SF-36 Physical Component Summary Score, SF-36 Mental Health Summary Score and GIQLI Global Score) between SSA and PEG. Higher HbA1c, BMI and IGF-1 Z-scores were associated with poorer QoL in several domains. Our data support a comparable QoL in patients receiving pegvisomant vs somatostatin analogs, despite the fact that the vast majority receiving pegvisomant did not respond to or were not able to tolerate somatostatin analogs.

Analysis of related factors and evaluation of quality of life of osteonecrosis of femoral head after internal fixation of femoral neck fracture

To explore the risk factors of osteonecrosis of femoral head after internal fixation of femoral neck fracture in young patients, to describe the quality of life of patients with surviving femoral head, and to quantify the predictive factors. From January 2013 to December 2016, 172 patients (174 hips) with femoral neck fracture treated by closed reduction and cannulated screw internal fixation were selected for retrospective analysis. The general data of the patients were summarized, including age, gender, body mass index, trauma mechanism, trauma operation interval, trauma season and whether the internal fixation was removed. The imaging data included the Garden classification and Pauwel classification of fractures, femoral head retroversion angle, postoperative fracture reduction, screw distribution. Single factor analysis and multi-factor Logistic regression analysis were carried out to explore the risk factors of femoral head necrosis and internal fixation failure. The patients who survived the internal fixation were followed up. The quality of life of the patients was evaluated by the health survey of SF-36. The Harris score of hip joint function was used to evaluate the hip joint function. The predictors of the quality of life of the patients after the operation of femoral neck fracture were analyzed by multiple linear regression analysis. Total 172 patients(174 hips) were included in the study, 29 patients(16.67%) had necrosis of the femoral head. In multivariate Logistic regression analysis, the significant differences were reduction quality (OR=0.126, P=0.027) and posterior inclination angle (OR=4.380, P=0.010). One hundred and thirty six patients (137 hips) who survived the femoral head were included in the quality of life survey. Harris score was 90.14±7.92, including excellent 96 hips (70.07%), good 28 hips (20.44%), medium 13 hips (9.49%) and poor 0 hip. In SF-36 score, physical health summary (PCS) was 46.12±9.12, mental health summary(MCS) was 50.21±3.97, there was no linear correlation between them (P>0.05). In multiple linear regression analysis, the variables with significant difference in PCS were reduction quality and retroversion angle, and the variables with significant difference in MCS were fracture displacement and trauma mechanism. Poor reduction quality and posterior inclination angle>15° are the risk factors of femoral head necrosis. The function of hip joint and MCS of patients with femoral neck fracture recovered well, but PCS could not recover to the average level of normal people. The reduction quality and retroversion angle could be used as the predictors of PCS, and the displacement and trauma mechanism of fracture could be used as the predictors of MCS.

Divergent Trends in the Effects of Early-Life Factors on Adult Health.

Life course theories have shaped social and health scientists' understanding of the origins and pathways of health, aging, and mortality. However, few studies have examined how these origins might have changed across cohorts. This study investigates the impact of birth, childhood, and adolescence factors on adult health across birth cohorts born in the second half of the 20th century in the United States. Data come from the Panel Study of Income Dynamics Family and Individual Files 1968-2013 and the Childbirth and Adoption History File 1985-2013. Multilevel growth models are used to capture the growth trajectories of two adult health outcomes: self-rated health and health summary index. We find the association between three pre-adulthood factors (birth weight, mother's education, childhood family income-to-needs ratio) and health outcomes weakens in more recent cohorts, while the association strengthens for the other two early life factors (early-life disease index and parental smoking status before age 17). These findings demonstrate the complexity of the social-to-biological embodiment across the life course, and suggest that the effects of early-life factors on adult health can increase or decrease across cohorts due to macro social, economic, policy, technological, and medical changes. They also illuminate the long-term debate on the period and cohort effects in shaping the health trend, and suggest that the cohort effect is multidimensional and is weaker or stronger depending on the dimension of early life examined.

Associations between in-school-hours physical activity and child health-related quality of life: A cross-sectional study in a sample of Australian primary school children.

The aim of the current study was to examine the association between Australian primary school children’s objectively measured in-school-hours weekly physical activity (PA) and their health-related quality of life (HRQoL). A cross-sectional study of 1128 Grade 2 and 3 children, aged 7–9 years, from 62 primary schools was conducted in New South Wales, Australia between October 2017 and April 2018. Children’s PA was assessed via an accelerometer worn for five days during school hours. Their parents completed a telephone interview, answering demographic, child HRQoL and out-of-school-hours PA questions. Children’s in-school-hours PA was classified as total PA and moderate-to-vigorous PA (MVPA). HRQoL scores were aggregated and reported at the high construct level domains (Total Quality of Life (Total HRQoL), Physical and Psychosocial Health Summary Scores). Multiple linear mixed regression analyses accounting for clustering were conducted to evaluate the association between children’s in-school-hours weekly PA and their HRQoL. After adjusting for potential confounders, significant positive associations were found between children’s in-school-hours weekly total PA and Total HRQoL (0.62 units, 95% CI: 0.29; 0.94, p < 0.001), Physical (0.71 units, 95% CI: 0.38; 1.04, p ≤ 0.001) and Psychosocial (0.58 units, 95% CI: 0.19; 0.97, p = 0.004) scores, with a stronger association observed between average weekly MVPA than average weekly total PA. There were also positive associations between PA and HRQoL for each sex when analysed separately. Our findings demonstrate a positive association between children’s objectively-measured in-school-hours PA and parent-reported child HRQoL, strengthening evidence supporting the continued implementation of school-based PA programs for broader health outcomes.