Related Quality Of Life Scale Research Articles

Smoking has detrimental effects on voice related Quality of Life of University Teachers.

To compare voice related quality of life of smoker and non-smoker university teachers. This Cross-Sectional descriptive study was conducted at Riphah International University over a period of six months January to June, 2022. A sample of N=352 University teachers of both genders, aged 25 to 65 years, who were faculty members and working at least 8 hours per day in teaching positions with at least one-year experience were included in the study. Demographic sheet, Voice Related Quality of Life (VRQOL) and Voice Handicap Index (VHI) were used for data collection and analysis conducted on SPSS Version 21. Mean scores of VRQOL and VHI for smokers and non-smokers were compared using Mann Whitney U Test. & Spearman's correlation was utilized to determine any association between the tool scores. P<0.01 was considered significant. Results reveal that the mean score of Voice related quality of life scale was significantly (p=0.000) higher in smokers compared to non-smokers indicating worse voice quality in smokers. Similarly, voice handicap index scores were much higher in smokers (p=0.000) indicating more handicap in the smokers. The study concludes that smoking has a detrimental effect on voice and voice related quality of life of university teachers and voice related quality of life as determined by VRQOL scale is significantly better in non-smokers.

The hemophilia quality of life scale: a systematic review.

Quality of life refers to the degree of well-being a person feels. The development of a hemophilia-targeting quality of life scale is important for hemophiliacs and their treating physicians. Textual analysis. First, a review of studies on quality of life, hemophilia and related quality of life scales was conducted; Subsequently, two rounds of systematic searches of the Springer database were conducted to filter the literature on universal quality of life scale studies and hemophilia-targeting quality of life scale studies by title and abstract, and then textual analysis was performed. The former included 77,456 articles, 26,117 chapters and 7,086 related bibliographies, while the latter initially retrieved 211 entries articles, 118 chapters and 43 related bibliographies. Through filtering, the former contains 22 documents, yielding 1,431 valid word stems, and the latter contains 9 documents, yielding 1,541 valid word stems. While universal quality of life scales mostly fit into the broad framework of WHOQOL- BREF, the development of hemophilia-targeting quality of life scales inclines towards pains that patients suffer and technology advances in pharmaceutical. The current hemophilia QOL scales are mainly based on the HR-QoL, others mainly based on the HR-QoL as the master version. At the same time, the popularization of existing hemophilia quality of life scales in developing countries like China is not high, and the development of hemophilia quality of life scales is insufficient.

Clinical efficacy and safety evaluation of acupuncture combined with moxibustion in treatment of allergic rhinitis

To evaluate the clinical efficacy and safety of acupuncture combined with moxibustion on allergic rhinitis. Using the random number table, 80 patients with allergic rhinitis were divided into a medication group and an acupuncture combined with moxibustion (acu-mox) group, 40 cases in each one. In the medication group, ioratadine tables were prescribed for oral administration, one tablet daily for 10 days as 1 session , 3 sessions of treatment were required. In the acupuncture combined with moxibustion group, bilateral Yingxiang (LI20), Yintang (EX-HN3), bilateral Hegu (LI4) and bilateral Shenshu (BL23) were selected as the main points and stimulated with acupuncture and moxibustion; and the acupoint prescription was modified according to symptoms. This combined treatment was given once every day, stimulating for 30 min each time, and 10 treatments made 1 course, for 3 courses of treatment totally. Before and after treatment, the scores for symptoms and physical signs, as well as the score of rhino-conjunctivitis related quality of life scale (R-QOL) were evaluated separately. The sample of the inferior turbinate mucosa tissue was collected and the distribution of eosinophil (EOS) was scored using HE staining and Sheldeny evaluation. Using enzyme-linked immunosorbent assay (ELISA), the contents of serum immunoglobulin E (IgE), retinoic-acid-receptor-related orphan nuclear receptor γt (RORγt), forkhead box protein P3 (Foxp3), interleukin-17 (IL-17), IL-27 and IL-33 were determined. The clinical efficacy was evaluated in the patients with allergic rhinitis of two groups and all the adverse reactions were recorded during treatment. The scores of symptoms and physical signs as well as the score of R-QOL, and EOS distribution score and the contents of serum IgE, RORγt, IL-17 and IL-33 were all reduced as compared with those before treatment in each group (P<0.05), and the contents of serum Foxp3 and IL-27 were increased as compared with those before treatment in each group (P<0.05). After treatment, the scores of symptoms and physical signs as well as the score of R-QOL, and the contents of serum IgE, RORγt and IL-33 in the acu-mox group were lower than those in the medication group (P<0.05), and the contents of serum Foxp3 and IL-27 were higher than those of the medication group (P<0.05). The total effective rate of the acu-mox group was 100.0% (40/40), significantly higher than 82.5% (33/40) in the medication group (P<0.05). No ob-vious adverse reaction was found in either group during and after treatment. Acupuncture combined with moxibustion is significantly effective and safe in treatment of allergic rhinitis. Its effect mechanism may be related to the balance modulation of Th1/Th2 and Th17/Treg cells mediated by naive CD4+T cells.

Impact of COVID-19 on utilization of nonpharmacological and pharmacological treatments for chronic low back pain and clinical outcomes.

The novel coronavirus 2019 (COVID-19) pandemic has impacted the delivery of health care services throughout the United States, including those for patients with chronic pain. To measure changes in patients' utilization of nonpharmacological and pharmacological treatments for chronic low back pain and related outcomes during the COVID-19 pandemic. A pre-post study was conducted within the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation (PRECISION Pain Research Registry) using data in the 3 months before and 3-6months after the declaration of a national emergency related to COVID-19. Participants 21-79 years old with chronic low back pain were included in the study and provided self reported data at relevant quarterly encounters. Use of exercise therapy, yoga, massage therapy, spinal manipulation, acupuncture, cognitive behavioral therapy, nonsteroidal antiinflammatory drugs, and opioids for low back pain was measured. The primary outcomes were low back pain intensity and back related functioning measured with a numerical rating scale and the Roland Morris Disability Questionnaire, respectively. Secondary outcomes included health related quality of life scales measured with the Patient Reported Outcomes Measurement Information System, including scales for physical function, anxiety, depression, low energy/fatigue, sleep disturbance, participation in social roles and activities, and pain interference with activities. A total of 476 participants were included in this study. The mean age of participants at baseline was 54.0 years (standard deviation, ±13.2 years; range, 22-81 years). There were 349 (73.3%) female participants and 127 (26.7%) male participants in the study. Utilization of exercise therapy (odds ratio [OR], 0.37; 95% confidence interval [CI], 0.23-0.57), massage therapy (OR, 0.46; 95% CI, 0.25-0.83), and spinal manipulation (OR, 0.53; 95% CI, 0.29-0.93) decreased during the pandemic. A reduction in NSAID use was also observed (OR, 0.67; 95% CI, 0.45-0.99). Participants reported a significant, but not clinically relevant, improvement in low back pain intensity during the pandemic (mean improvement, 0.19; 95% CI, 0.03-0.34; Cohen's d, 0.11). However, White participants reported a significant improvement in low back pain intensity (mean improvement, 0.28; 95% CI, 0.10-0.46), whereas Black participants did not (mean improvement,-0.13; 95% CI,-0.46 to 0.19; p for interaction=0.03). Overall, there was a significant and clinically relevant improvement in pain interference with activities (mean improvement, 1.11; 95% CI, 0.20-2.02; Cohen's d, 0.20). The use of NSAIDs during the pandemic was associated with marginal increases in low back pain intensity. Overall, decreased utilization of treatments for chronic low back pain did not adversely impact pain and functioning outcomes during the first 6 months of the pandemic. However, Black participants experienced significantly worse pain outcomes than their White counterparts.

Impact of Urinary Incontinence on Psychological Well-being and Quality Of Life among Elderly People

Background: Urinary incontinence is a highly prevalent health problem among elderly people with a relevant impact on physical and psychological aspects of life with consequent effect on the quality of life. Aim: Study aimed to assess the impact of urinary incontinence on psychological well-being and quality of life among elderly people. Research design: A descriptive design was utilized to fulfill the aim of this study. Setting: The study was conducted in Urological outpatient clinic at Benha University Hospital at Benha City, Kaluobia Governorate. Sample: The sample of the study was purposive sample of (100) elderly people who are attending at the above mentioned settings. Tools: Tool (I):- A structured interviewing questionnaire sheet which comprised of two parts: part (1) socio-demographic characteristics & part (2) clinical characteristics of the studied sample. Tool (II): Goldberg’s psychological well-being scale, and Tool (III) Incontinence related quality of life scale. Results: Findings showed that nearly two thirds of the studied sample had low level of psychological well-being while, more than two thirds of them had low level of quality of life and also, there was a highly statistically significant positive correlation between total Goldberg’s psychological well-being Scale and total Incontinence-related quality of life scale. Conclusion: Based on the result of this study it was concluded that urinary incontinence is a chronic disease that has a negative impact on psychological well-being of elderly people which subsequently impacts negatively on their quality of life in the form of performing activities of daily living and enjoying their normal life. Recommendation: The study recommended that recurrent assessment for psychological status and all quality of life domains for elderly people should be a part of the routine nursing care.

Health related quality of life scales in women diagnosed with gynecological and breast cancer: the role of resilience. A systematic review

Health related quality of life scales in women diagnosed with gynecological and breast cancer: the role of resilience. A systematic review

Clinical management and outcome assessment of generalized anxiety disorder or panic disorder in refractory gastro-esophageal reflux disease: Evidence from a prospective interventional study of benzodiazepines and sertraline

ObjectiveThe aim of the study was to investigate the relationship between Gastro-esophageal reflux diseases (GERD) related symptoms and psychological symptomatology, as well as clinically diagnosed generalized anxiety disorder (GAD) or panic disorder (PD) and effectiveness of Sertraline and benzodiazepines in controlling these conditions. MethodologyA 6 months prospective study was conducted in gastroenterology outpatient department of a tertiary care referral hospital. Refractory GERD was diagnosed by assessing proton pump inhibitor failure over 4 week trial of standard doses of PPIs. Therapy with Benzodiazepines and Sertraline was initiated in patients with refractory GERD having panic and anxiety symptoms associated with refractory GERD. Effectiveness of the therapy was measured using panic and agoraphobia scale and Hamilton anxiety scale. Reduction in the severity of GERD symptoms was assessed using GERD – Health related quality of life scale. ResultsThe occurrence of PD or GAD in patients with refractory GERD in our sample was found to be 68% and 32% respectively. There was a significant decrease in the score of GERD HRQOL after the administration of sertraline and benzodiazepines when compared to the score of GERD HRQOL before administration of interventional drugs (p = 0.001). ConclusionOur study investigated the role of anxiety and panic in refractory GERD and their effect on quality of life. The results indicated that quality of life of patients were highly improved as indicated by severity scores after administration with sertraline and benzodiazepines. The novel therapy of sertraline and benzodiazepines are highly effective in controlling reflux like symptoms and coexisting anxiety and panic disorder in refractory GERD.

Impact of early childhood caries on quality of life: Child and parent perspectives

BackgroundThe aim of present study was to examine early childhood caries' impact on oral health-related quality of life from children's self report and parental perception. Methods200 healthy children in the age group of 3–5 years and their parents/guardians were enrolled in the study. 100 children diagnosed with early childhood caries (interventional group) and 100 children without caries (control group) along with their parents/guardians participated in face to face interview and responded to Michigan oral health related quality of life scale - child and parent version. Four weeks after full mouth rehabilitation children with ECC and their parents responded to a survey for a follow-up assessment. Data was analyzed and evaluated using Statistical Package for Social Sciences Version 21.0 statistical software and Chi square test. ResultsIn our study we have found that ECC subjects had poorer oral health-related quality of life compared to caries free subjects. Further one month follow up after complete treatment, the oral health-related QoL improved significantly in ECC children. ConclusionsEarly childhood caries has a definite negative impact on the OHRQoL of children. At one month follow up after complete oral rehabilitation, the quality of life improved significanty as assessed by children's self reports as well as parental perceptions of their child's OHRQoL.

Health related quality of life in chronic venous disease: Systematic literature review

Excepting life-threatening situations, improvement of health-related quality-of-life is the main therapeutic goal in chronic disease. The purpose of this review was to study the different ways of assessing Quality-of-Life (QoL) in patients with chronic venous disease (CVD) (CEAP classes C3 to C6). A literature search was conducted with three databases: MEDLINE, WEB OF SCIENCE and COCHRANE LIBRARY in order to identify articles with the PRISMA reporting guidelines. Then we compared psychometric performance of general and specific QoL questionnaires for a French population with CVD. A total of 481 articles were identified, from which 25 were selected and analyzed. CIVIQ 20, CIVIQ 14 and VEINES Qol/sym are the specific health related QoL scales validated for a French population with CVD. VEINES Qol/sym was specifically validated in patients with leg ulcer or post-thrombotic syndrome (PTS). CIVIQ 14 is a CIVIQ 20 optimized to be used more widely in international studies and validated in milder forms of the CVD spectrum (C0 à C4). The general health related QoL scales are SF-36, SF-12 and EQ-5D. EQ-5D is simple and provides health state utility values. CIVIQ 14 is a simple specific health-related QoL scale for less severe CVD. VEINES Qol/sym was developed for severe CVD and PTS but clinically relevant point scales remain to be assessed. EQ-5D is a generic scale to be preferred to assess economic impact based on a cost-utility analysis.

Development and validation of the Chinese version of dry eye related quality of life scale

BackgroundTo develop the Chinese version of quality of life scale for dry eye patients based on the Impact of Dry Eye on Everyday Life (IDEEL) questionnaire and to assess the reliability and validity of the developed scale.MethodsThe original IDEEL was adapted cross-culturally to Chinese language and further developed following standard procedures. A total of 100 Chinese patients diagnosed with dry eye syndrome were included to investigate the psychometric properties of the Chinese version of scale. Psychometric tests included internal consistency (Cronbach’s ɑ coefficients), construct validity (exploratory factor analysis), and known-groups validity (the analysis of variance).ResultsThe Chinese version of Dry Eye Related Quality of Life (CDERQOL) Scale contains 45 items classified into 5 domains. Good to excellent internal consistency reliability was demonstrated for all 5 domains (Cronbach’s ɑ coefficients range from 0.716 to 0.913). Construct validity assessment indicated a consistent factorial structure of the CDERQOL scale with hypothesized construct, with the exception of “Dry Eye Symptom-Bother” domain. All domain scores were detected with significant difference across three severity groups of dry eye patients (P < 0.05) except for “Satisfaction with Treatment” domain, indicating good known-groups validity.ConclusionsThe results indicated that the CDERQOL scale is a reliable and valid instrument for patients with dry eye syndrome among Chinese population, and could be used as a supplementary diagnostic and treatment-effectiveness measure.

Calidad de vida del paciente asmático con beclometasona/formoterol. Análisis de coste-utilidad

AimTo perform a cost-utility analysis on asthmatic patients on beclomethasone/formoterol fixed combination in Primary Health Care.Material and methods Non-probability sampling was used to select a group of asthmatic patients with moderate/severe persistent severity (GEMA 2009), treated with beclomethasone/formoterol fixed combination, over 18 years, had given their informed consent. The study observation period was 6 months. The variables studied were: age, sex, duration of disease, health resources used, analysis of health related quality of life by EQ-5D and SF-36, and the specific Asthma Quality of Life Questionnaire. For the qualitative variables, the frequency and percentages were calculated, and for the quantitative variables, the mean, SD and 95% CI. Chi-square, Student t-test and ANOVA were used for statistical inference. Comparisons were made with a statistical significance of 0.05. ResultsOf the 64 patients that completed the study, 59.4% were female. The mean age was 49 years, and mean disease duration was 93 months. For asthma control, 53% of patients had a prescription pattern of one/12h. All health related quality of life scales were modified with respect to the baseline and the differences were statistically significant. Our patients had a better health related quality of life than Spanish asthma cohort. The incremental cost utility beclomethasone/formoterol versus usual treatment option was € 6,256/QALY.

Pilot Study of the Malay Maslach Burnout Inventory and Malay Work-Related Quality of Life Scale in Malaysia

It was important to establish a reliable Malay Maslach Burnout Inventory (MBI) and Malay work related quality of life scale (WRQoL) to address the issue of burnout and work related quality of life in Malaysia. Specifically, the MBI instrument encompassed Maslach Burnout Inventory – Health Services Survey (MBI-HSS), Maslach Burnout Inventory – General Services (MBI-GS), Maslach Burnout Inventory – Educators Surveys (MBI-ES). The English versions of MBI and WRQoL instruments were translated into Malay based on forward and backward translation methods. A pilot study was conducted to assess the properties of these translated instruments. A weighted kappa was used to measure the strength of agreement between the English and Malay instruments, while Cronbach’s alpha was used to assess the internal reliability of the translated instruments. Weighted kappa revealed moderate to almost perfect strength of agreement between the English and Malay versions of instruments. The overall Cronbach’s alpha of at least 0.90 clearly indicated items in the translated instruments measured the same concept or construct. This study demonstrated the properties of Malay versions of the MBI-HSS, MBI-GS, MBI-ES and WRQoL instruments were culturally appropriate and acceptable to be used in Malaysia.

Quality of life after treatment for acoustic neuroma using the new PANQOL Scale

Objectives: To compare quality of life in acoustic neuroma patients undergoing different treatment algorithms using the PANQOL scale, a new validated and disease specific quality of life instrument. Study Design: Cross-sectional observational study. Methods: One hundred forty-three patients with acoustic neuromas and 40 general otolaryngology controls completed the 26 question PANQOL scale and the SF-36 general health related quality of life scale. PANQOL data was analyzed in relation to chart medical data. Results: The only PANQOL domain to show a significant difference between conservative, gamma knife, and microsurgery treatment groups was the face domain, which was worst in the microsurgery group and best in the conservative group. The SF-36 did not capture any significant differences between treatment groups. All treatment groups had significantly lower PANQOL hearing and balance scores compared to controls. Acoustic neuroma cases had a significantly better PANQOL general health score compared to general otolaryngology controls. Conservative management cases showed an inverse correlation between tumor size and PANQOL face and pain scores. Gamma knife cases showed an inverse correlation between tumor size and PANQOL general health, energy and total scores, and also an inverse correlation between time since treatment and PANQOL face score. Microsurgery cases showed an inverse correlation between tumor size and PANQOL pain score. Conclusions: Individual PANQOL domain scores showed important correlations with patient and tumor characteristics that were unique to different treatment algorithms. Only PANQOL hearing and balance scores were significantly worse in cases compared to controls. The PANQOL scale should prove useful in future prospective studies.

Dementia in residential care: education intervention trial (DIRECT); protocol for a randomised controlled trial

BackgroundThere is scope to improve the quality of life (QOL) of people with dementia living in residential care facilities (RCF). The DIRECT study will determine if delivery of education to General Practitioners (GPs) and care staff improves the quality of life of residential care recipients with cognitive impairment.Methods/DesignA prospective randomised controlled trial conduced in residential aged care facilities in the metropolitan area of Perth, Western Australia. Participants are care facility residents, aged 65 years and older and with mini-mental state examination scores less than 25. GPs and care facility staff have been independently randomised to intervention or control groups. An education programme, designed to meet the perceived needs of learners, will be delivered to GPs and care staff in the intervention groups. The primary outcome of the study will be quality of life of the people with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD) and Alzheimer Disease Related QOL Scale (ADRQL), 4 weeks and 6 months after the conclusion of the education intervention.ResultsRecruitment of 351 people with dementia, cared for by staff in 39 residential facilities and 55 GPs, was undertaken between May 2007 and July 2008. Collection of baseline data is complete. Education has been delivered to GPs and Care staff between September 2008 and July 2009. Follow- up data collection is underway.DiscussionThe study results will have tangible implications for proprietors, managers and staff from the residential care sector and policy makers. The results have potential to directly benefit the quality of life of both patients and carers.Trial registrationThese trial methods have been prospectively registered (ACTRN12607000417482).

Frailty and health related quality of life in older Mexican Americans

BackgroundPrevious research on frailty in older adults has focused on morbidity and mortality. The purpose of this study was to elicit the relationship between being non-frail, pre-frail, or frail and health related quality of life in a representative sample of older Mexican Americans surveyed in 2005–2006.MethodsData were from a representative subsample of the Hispanic Established Populations Epidemiologic Studies of the Elderly (EPESE) and included 1008 older adults living in the community (mean (sd) age = 82.3(4.3)). Multiple regression analyses examined the relationship between frailty status and the eight SF-36 health related quality of life subscales and two summary scales. Models also adjusted for the participants' sociodemographic and health status.ResultsWe found that, after adjusting for sociodemographic and health related covariables, being pre-frail or frail was significantly associated (p < 0.001) with lower scores on all physical and cognitive health related quality of life scales than being non-frail.ConclusionWhen compared to persons who are not frail, older Mexican American individuals identified as frail and pre-frail exhibit significantly lower health related quality of life scores. Future research should assess potential mediating factors in an effort to improve quality of life for frail elders in this population.

The reliability and validity of the Vertigo Symptom Scale and the Vertigo Dizziness Imbalance Questionnaires in a Turkish patient population with Benign Paroxysmal Positional Vertigo

The aim of this study was to adapt the Vertigo Symptom Scale (VSS) and the Vertigo Dizziness Imbalance (VDI) Questionnaires to the Turkish population and investigate the reliability and validity of the Turkish version. One hundred and three patients with Benign Paroxysmal Positional Vertigo (BPPV) were included in the study. The patients were evaluated with the VSS and the VDI twice, at recruitment and 24 hours later. To perform concurrent validity study study, patients were also assessed by the Beck Depression Inventory (BDI) and the Medical Outcomes Survey Short Form 36 (SF-36) which were formerly proved to be valid and reliable for use in Turkish population. The internal consistency of the VSS, VDI-symptom scale, and VDI-health-related quality of life scale were good with Cronbach's alpha of 0.91, 0.85, and 0.93 respectively which showed high reliability for the Turkish versions. Test-retest reliability was also good, with a high intraclass correlation coefficient (ICC) between the two time points; being 0.83 for the VSS, 0.90 for the VDI-symptom scale and 0.89 for the VDI-health related quality of life scale. Regarding concurrent validity, significant expected correlations were detected between the VSS and BDI (r = 0.55 p < 0.001) and the VSS and SF-36 (r = -0.43 p < 0.001). Significant low correlations were detected between the VDI-SS and BDI (r = 0.20 p < 0.05) and the VDI-SS and SF-36 (r = -0.21 p < 0.05). High correlations were observed between the VDI-HRQoL and BDI (r = -0.75 p < 0.001) and the VDI-HRQoL and SF-36 (r = 0.82, p < 0.001) which indicates high concurrent validity. The correlation between VDI-SS subscale scores and VDI-HRQoL subscale scores were 0.028 (P = 0.778) at the first time point. From the perspective of discriminant validity, it means that the VDI-SS measures a construct different from the one underlying the VDI-HRQoL. The adaptation of the VSS and VDI to the Turkish population was successful and both scales were found to be valid and reliable. Thus, they can be used in Turkish people with BPPV for assessment and monitoring the treatments. Besides, the results of the national studies in which these Turkish versions are used can be compared with those of the international studies.

Relationship of Optimism–Pessimism and Health-Related Quality of Life in Breast Cancer Survivors

ABSTRACT Few studies have investigated the influence of optimism–pessimism in breast cancer survivors. This study used a retrospective design with 268 adult women who completed the Minnesota Multiphasic Personality Inventory (MMPI) as part of their medical care approximately 10 years prior to their breast cancer diagnosis and Medical Outcome Study Short-Form General Health Survey (SF-36 or SF-12), on average, 8 years after diagnosis. MMPI pessimism scores were divided into quartiles, and t tests were used to determine differences between those highest and lowest in pessimism on health-related quality-of-life (QOL) measures, demographics, and disease status. The mean age at diagnosis of breast cancer was 63 years, and 74% had early-stage breast cancer. Patients age 65 years and older were significantly lower on physical health–related QOL scales. There were no significant differences in health-related QOL scores by stage of disease. Patients with a pessimistic explanatory style were significantly lower on all of the health-related QOL scores, compared to those with a nonpessimistic style. Breast cancer survivors who exhibit a pessimistic explanatory style report lower health-related QOL for years after receiving a cancer diagnosis, compared to nonpessimistic women.

Levenswaardering bij ouderen (LWO): de validering van een meetinstrument

The goal of this study is the adaptation and validation of the Dutch translation of Lawton's "Valuation of Life" scale. In developing this scale Lawton et al. argued that the usual health related quality of life scales had a limited contribution in explaining health utility and desired length of life and that the "Valuation of Life" is intended to cover a specific quality of life domain not related to health. The translated scale has been implemented in the 4th observation of the Longitudinal Aging Study Amsterdam (LASA) in 2001-2002. In total 1139 respondents between 65 and 95 years old reacted to the written questionnaire. After extensive structural analyses of the data we concluded that the Dutch version of the scale could be reduced from the original 19-item to a 12-item scale. In addition this scale could be divided in three 4-items-subscales, clearly labelled as Resilience, Ambition and Vitality. The new scale as well as the subscales hardly overlap with the data of two health related quality of life scales while the overlap with the more or less objective health measures (discriminant validity) remains limited. It appears that the Dutch "Valuation of Life" scale is to a certain extend related to other positive affect measures as Self evaluation, Mastery and Self-efficiency (concurrent validity). For the moment we agree that the Dutch scale measures an important and specific domain of quality of life without any reference to health issues in the scale. Whether these data contribute in explaining health utility and desired length of life remains to be demonstrated in another publication.

Prospective comparative study on cost‐effectiveness of subthalamic stimulation and best medical treatment in advanced Parkinson's disease

This is an open, prospective, longitudinal study designed to compare two cohorts of patients with advanced Parkinson's disease during 1 year, one undergoing bilateral subthalamic stimulation (STN-DBS) and the other receiving the best medical treatment (BMT), with respect to the clinical effects observed and the medical expenses produced. Assessments were done by using clinical measures and a generic health related quality of life scale. A questionnaire was used to collect direct healthcare resources. As a measure of cost-effectiveness, we calculated life years gained adjusted by health-related quality of life (QALY) and the incremental cost-effectiveness ratio (ICER). Clinical and demographic variables of both groups were comparable at baseline. Total UPDRS scores improved from 50.5 +/- 3.6 to 28.5 +/- 3.8 in STN-DBS patients and worsened from 44.3 +/- 3.3 to 54.2 +/- 4 in the control group. Pharmacological costs in the operated patients were 3,799 +/- 940 euro, while in the BMT group the costs were 13,208 +/- 4,966 euro. Other medical costs were 1,280 +/- 720 euro in the STN-DBS group and 4,017 +/- 2,962 euro in BMT patients. Nondirect medical costs were 4,079 +/- 1,289 in operated patients and 2,787 +/- 1,209 euro in the BMT group. Mean QALYs were 0.7611 +/- 0.03 in STN-DBS and 0.5401 +/- 0.06 in BMT patients. In STN-DBS patients, the ICER needed to obtain an improvement of one point in the total UPDRS score was of 239.8 euro and the ICER/QALY was of 34,389 euro. Cost-effectiveness parameters were mostly related to the degree of clinical improvement and the reduction of pharmacological costs after STN-DBS. An ICER of 34,389 euro/QALY is within appropriate limits to consider subthalamic stimulation as an efficient therapy.

Effectiveness of lifestyle counseling by certified expert nurse of Japan for non-insulin-treated diabetic outpatients: A 1-year randomized controlled trial

We examine whether one-to-one lifestyle counseling for non-insulin-treated diabetic outpatients by a Certified Expert Nurse (CEN) can improve patients’ health outcomes. Participants were randomly assigned to a 1-year lifestyle intervention ( n = 67) or to a usual care group ( n = 67). Main outcome measures were changes from baseline in: HbA 1C and score of health related quality of life scales (SF-36 and Problem Areas in Diabetes Scale). Cognitive/behavioral modification for 1 year and satisfaction in CEN counseling was also measured by self-produced items. We found no significant differences in HbA 1C, BMI, blood pressure, serum lipids, or health related quality of life over 1 year between the two groups. Patients in the intervention group, however, showed modest but more favorable modification of cognition ( p = 0.004) and behavior ( p < 0.001) than subjects in usual care group. The low attrition rate (9%), more frequent hospital visit (12 ± 2 times versus 11 ± 3 times; p = 0.03) and high degree of satisfaction (95%) in the intervention group indicate feasibility of the monthly CEN counseling in the outpatient settings of Japanese hospitals. Future research should confirm the long-term effectiveness of the CEN counseling on clinical outcomes and the cost effectiveness of a possibly time-consuming intervention.