Comparison of howRU and EQ-5D measures of health-related quality of life in an outpatient clinic

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Tim Benson

2013-11-01

Full Text Available This paper reports on a head-to-head study of howRU and EQ-5D on patients with cardiovascular disease. howRU is a short generic measure of health-related quality of life comprising 39 words, designed for routine use, which we compare with EQ-5D (230 words. Patients attending a clinic completed both instruments. Completed data were available for 116 patients, 51% female, mean age 56 and SD 20. howRU is shorter, has better readability statistics, a higher completion rate, a wider range of states used and a smaller ceiling effect than EQ-5D. The correlations of howRU with EQ-5D are similar to those of EQ-5D with other validated instruments.

Validity of the EQ-5D as a generic health outcome instrument in a heroin-dependent population

NARCIS (Netherlands)

van der Zanden, Bart P.; Dijkgraaf, Marcel G. W.; Blanken, Peter; de Borgie, Corianne A. J. M.; van Ree, Jan M.; van den Brink, Wim

2006-01-01

OBJECTIVE: To evaluate the validity of the EuroQol (EQ-5D) in a population of chronic, treatment-resistant heroin-dependent patients. METHODS: The EQ-5D is studied relative to the Maudsley Addiction Profile (MAP), the Symptom Checklist (SCL-90) and the European Addiction Severity Index (EuropASI)

Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups

DEFF Research Database (Denmark)

Janssen, M F; Pickard, A Simon; Golicki, Dominik

2012-01-01

PURPOSE: The aim of this study was to assess the measurement properties of the 5-level classification system of the EQ-5D (5L), in comparison with the 3-level EQ-5D (3L). METHODS: Participants (n = 3,919) from six countries, including eight patient groups with chronic conditions (cardiovascular...... of the 3-level system which improves upon the measurement properties, reducing the ceiling while improving discriminatory power and establishing convergent and known-groups validity.......), redistribution properties, ceiling, discriminatory power, convergent validity, and known-groups validity. RESULTS: Missing values were on average 0.8 % for 5L and 1.3 % for 3L. In total, 2.9 % of responses were inconsistent between 5L and 3L. Redistribution from 3L to 5L using EQ dimension-specific rating scales...

Quality of life profile of general Vietnamese population using EQ-5D-5L.

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Nguyen, Long Hoang; Tran, Bach Xuan; Hoang Le, Quynh Ngoc; Tran, Tung Thanh; Latkin, Carl A

2017-10-11

Health-related quality of life (HRQOL) is a vital benchmark to assess the effects of health interventions and policies. Measuring HRQOL of the general population is essential to establish a reference for health outcomes evaluations. However, evidence on HRQOL of general populations in low and middle income countries is very limited. This study aimed to measure HRQOL of the Vietnamese population by using the EuroQol-5 dimensions-5 levels (EQ-5D-5L) instrument and determine its associated factors. A cross-sectional study was performed in Hanoi with 1571 residences in Hanoi, the capital city of Vietnam. EQ-5D-5L and EQ- visual analogue scale (EQ-VAS) were used to assess HRQOL. Potential covariates included socio-demographic characteristics, having acute symptoms in the last four weeks, chronic diseases in the last three months, having multiple health issues, and health service utilisation in the last twelve months. A generalized linear model was employed to identify the association between HRQOL and covariates. Overall, the mean EQ-5D utility index was 0.91 (SD = 0.15), and the mean EQ-VAS score was 87.4 (SD = 14.3). The highest proportion of respondents reporting any problems was in Usual activities (24.3%), followed by Anxiety/Depression (15.2%) and Pain/Discomfort (10.0%), while the lowest percentage was in Self-care (2.5%). Lower HRQOL composite scores were related to unemployment, lower income, higher education, living in urban areas, having chronic diseases, having multiple health issues and using health service. For any health problem self-reported by respondents, the health utility reduced by 0.02 (respiratory diseases) to 0.15 (musculoskeletal diseases). Health utility of the general population and reductions for self-reported health problems in this study are useful for future population health evaluations and comparisons. It also informs the development of interventions to reduce health problems of the general population.

Interpretation and use of the 5-level EQ-5D response labels varied with survey language among Asians in Singapore.

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Luo, Nan; Wang, Ye; How, Choon How; Tay, Ee Guan; Thumboo, Julian; Herdman, Michael

2015-10-01

This study aimed to investigate the comparability of the English, Chinese, and Malay versions of the 5-level EQ-5D (EQ-5D-5L) response labels in Singapore. Visitors to a primary care institution in Singapore (n = 743) were asked to complete two exercises: (1) rating the severity of the EQ-5D-5L response labels presented in English, Chinese, or Malay using a 0-100 numeric rating scale and (2) using the labels to describe various hypothetical health problems. Label ratings and choices between language versions were compared using regression analysis. Perceived severity of the English and Chinese labels was similar. Compared with their English counterparts, the Malay label "slight(ly)" was rated as more severe (adjusted mean difference: 10.5 to 14.5) and "unable"/"extreme(ly)" as less severe (adjusted mean difference: -13.3 to -11.0) (P language versions of the instrument. Future studies need to investigate ways to reduce the variations and increase the cross-cultural measurement equivalence of the instrument. Copyright © 2015 Elsevier Inc. All rights reserved.

Understanding the relationship between the EQ-5D, SF-6D, HAQ and disease activity in inflammatory arthritis.

LENUS (Irish Health Repository)

Adams, Roisin

2012-02-01

BACKGROUND: The growth of economic analyses and in particular cost-utility analyses (CUA), which use the QALY as a measure of outcome, has heightened the interest in the methodologies used to calculate the QALY. The EQ-5D has produced quite different utility values from that of the SF-6D. This article seeks to understand these differences using a cohort of patients with inflammatory arthritis. OBJECTIVE: To examine the relationship between the disease-specific measure, Health Assessment Questionnaire (HAQ) disability index (DI) and the preference-based measures, SF-6D, EQ-5D and European League Against Arthritis (EULAR) Disease Activity Score (DAS) in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA). METHODS: Patients with RA and PsA (n = 504) attending a tertiary rheumatology referral centre completed the HAQ, SF-6D and the EQ-5D before starting biological therapy and again 12 months later. The SF-36 was converted into a utility using the preference-based SF-6D. Clinical outcomes such as the DAS, joint counts and laboratory measures were also recorded. We calculated single index utility scores from the preference-based instruments using UK population norms. We used regression analysis to derive a mapping function and calculated utility scores from the HAQDI and the DAS 28. RESULTS: The mean utility observed at baseline for RA was 0.43 for the EQ-5D and 0.54 for the SF-6D and for PsA was 0.49 for the EQ-5D and 0.57 for the SF-6D. The utility gain demonstrated by the EQ-5D was over twice that of the SF-6D. The EQ-5D scored 17% of the RA group as less than 0 (state defined as worse than death); 7% of this group remained less than 0 at follow-up. The distribution of the utility estimates was similar for both RA and PsA. CONCLUSIONS: Our findings draw attention to the impact of states worse than death on the overall distribution for the EQ-5D derived utilities and how these impact on its use in practice. EQ-5D-derived QALY changes are over twice

Inequalities in Health Status from EQ-5D Findings: A Cross-Sectional Study in Low-Income Communities of Bangladesh

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Sultana, Marufa; Sarker, Abdur Razzaque; Mahumud, Rashidul Alam; Ahmed, Sayem; Ahmed, Wahid; Chakrovorty, Sanchita; Rahman, Hafizur; Islam, Ziaul; Khan, Jahangir A. M.

2016-01-01

Background: Measuring health status by using standardized and validated instrument has become a growing concern over the past few decades throughout the developed and developing countries. The aim of the study was to investigate the overall self-reported health status along with potential inequalities by using EuroQol 5 dimensions (EQ-5D) instrument among low-income people of Bangladesh. Methods: A cross-sectional household survey was conducted in Chandpur district of Bangladesh. Bangla version of the EQ-5D questionnaire was employed along with socio-demographic information. EQ-5D questionnaire composed of 2-part measurements: EQ-5D descriptive system and the visual analogue scale (VAS). For measuring health status, UK-based preference weights were applied while higher score indicated better health status. For facilitating the consistency with EQ-5D score, VASs were converted to a scale with scores ranging from 0 to 1. Multiple logistic regression models were also employed to examine differences among EQ-5D dimensions. Results: A total of 1433 respondents participated in the study. The mean EQ-5D and VAS score was 0.76 and 0.77, respectively. The females were more likely to report any problem than the males (P economic and demographic inequalities in health status was observed in the study. Study suggests to do further investigation with country representative sample to measure the inequalities of overall health status. It would be helpful for policy-maker to find a new way aiming to reduce such inequalities. PMID:27239879

A qualitative examination of the content validity of the EQ-5D-5L in patients with type 2 diabetes.

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Matza, Louis S; Boye, Kristina S; Stewart, Katie D; Curtis, Bradley H; Reaney, Matthew; Landrian, Amanda S

2015-12-01

The EQ-5D is frequently used to derive utilities for patients with type 2 diabetes (T2D). Despite widely available quantitative psychometric data on the EQ-5D, little is known about content validity in this population. Thus, the purpose of this qualitative study was to examine content validity of the EQ-5D in patients with T2D. Patients with T2D in the UK completed concept elicitation interviews, followed by administration of the EQ-5D-5L and cognitive interviewing focused on the instrument's relevance, clarity, and comprehensiveness. A total of 25 participants completed interviews (52.0 % male; mean age = 53.5 years). Approximately half (52 %) reported that the EQ-5D-5L was relevant to their experience with T2D. When asked if each individual item was relevant to their experience with T2D, responses varied widely (24.0 % said the self-care item was relevant; 68.0 % said the anxiety/depression item was relevant). Participants frequently said items were not relevant to themselves, but could be relevant to patients with more severe diabetes. Most participants (92.0 %) reported that T2D and/or its treatment/monitoring requirements had an impact on their quality of life that was not captured by the EQ-5D-5L. Common missing concepts included food awareness/restriction (n = 13, 52.0 %); activities (n = 11, 44.0 %); emotional functioning other than depression/anxiety (n = 8, 32.0 %); and social/relationship functioning (n = 8, 32.0 %). The results highlight strengths and potential limitations of the EQ-5D-5L, including missing content that could be important for some patients with T2D. Suggestions for addressing limitations are provided.

Mapping onto Eq-5 D for patients in poor health

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Brazier John E

2010-11-01

Full Text Available Abstract Background An increasing amount of studies report mapping algorithms which predict EQ-5 D utility values using disease specific non-preference-based measures. Yet many mapping algorithms have been found to systematically overpredict EQ-5 D utility values for patients in poor health. Currently there are no guidelines on how to deal with this problem. This paper is concerned with the question of why overestimation of EQ-5 D utility values occurs for patients in poor health, and explores possible solutions. Method Three existing datasets are used to estimate mapping algorithms and assess existing mapping algorithms from the literature mapping the cancer-specific EORTC-QLQ C-30 and the arthritis-specific Health Assessment Questionnaire (HAQ onto the EQ-5 D. Separate mapping algorithms are estimated for poor health states. Poor health states are defined using a cut-off point for QLQ-C30 and HAQ, which is determined using association with EQ-5 D values. Results All mapping algorithms suffer from overprediction of utility values for patients in poor health. The large decrement of reporting 'extreme problems' in the EQ-5 D tariff, few observations with the most severe level in any EQ-5 D dimension and many observations at the least severe level in any EQ-5 D dimension led to a bimodal distribution of EQ-5 D index values, which is related to the overprediction of utility values for patients in poor health. Separate algorithms are here proposed to predict utility values for patients in poor health, where these are selected using cut-off points for HAQ-DI (> 2.0 and QLQ C-30 ( Conclusion Mapping algorithms overpredict utility values for patients in poor health but are used in cost-effectiveness analyses nonetheless. Guidelines can be developed on when the use of a mapping algorithms is inappropriate, for instance through the identification of cut-off points. Cut-off points on a disease specific questionnaire can be identified through association

What matters most?: evidence-based findings of health dimensions affecting the societal preferences for EQ-5D health states

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Monica Viegas Andrade

2013-01-01

Full Text Available This study analyzes how different health dimensions defined by the EQ-5D-3L instrument affect average individual preferences for health states. This analysis is an important benchmark for the incorporation of health technologies as it takes into consideration Brazilian population preferences in health resource allocation decisions. The EQ-5D instrument defines health in terms of five dimensions (mobility, daily activities, self-care activities, pain/discomfort, and anxiety/depression each divided into three levels of severity. Data came from a valuation study with 3,362 literate individuals aged between 18 and 64 living in urban areas of Minas Gerais State, Brazil. The main results reveal that health utility decreases as the level of severity increases. With regard to health issues, mobility stands out as the most important EQ-5D dimension. Independently of severity levels of the other EQ-5D-3L dimensions, the highest decrements in utilities are associated with severe mobility problems.

Reliability and validity of the EQ-5D-3L for Kashin-Beck disease in China.

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Fang, Hua; Farooq, Umer; Wang, Dimiao; Yu, Fangfang; Younus, Mohammad Imran; Guo, Xiong

2016-01-01

Kashin-Beck Disease (KBD) is an endemic osteoarthropathy in areas which extend from the North-East to the South-West of China. Most of the patients with KBD suffer multiple dysfunctions in major joints causing decreased health status. However because of their low education level and unique living habits, it is hard to find tools to measure the health-related quality of life (HRQOL). European quality of life (EQ-5D-3L) patient-reported instrument is widely used to measure HRQOL. This study aimed to establish the validity and reliability of the Chinese version of the EQ-5D-3L for evaluating HRQOL of KBD individuals in rural area. 368 individuals who were suffering from KBD were recruited through stratified multistage random sampling from Shaanxi province, China. The EQ-5D-3L and the WHOQOL-BREF were administrated in each individual by face to face interview. Test-retest reliability was assessed at 10-14 days intervals. The test-retest reliability was measured by calculating the Kappa coefficients for EQ-5D-3L five dimensions. For the EQ VAS, the intraclass correlation coefficient (ICC) was computed. Convergent and divergent analysis, construct validity was established using Spearman's rank correlation between the EQ-5D-3L and the WHOQOL-BREF. Known groups' validity was examined by comparing groups with a priori expected differences in health-related quality of life (HRQOL). For 362 individuals (98%), comprehensive data of all the EQ-5D-3L dimensions were available. Kappa values of the EQ-5D-3L five items ranged from 0.324 to 0.554. ICC of the EQ VAS was 0.497. For convergent validity, the three items (self-care, usual activity, and mobility) of EQ-5D-3L, index scores, and VAS showed moderate correlations with the physical health domain of the WHOQOL-BREF (r absolute value ranged from 0.339 to 0.475). For divergent validity, the 5 items of EQ-5D-3L showed weak or no correlations with environment and social relationship domains of WHOQOL-BREF. The Chinese EQ-5D-3L

An analysis of Euroqol EQ-5D and Manchester Oxford Foot Questionnaire scores six months following podiatric surgery.

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Maher, Anthony J; Kilmartin, Timothy E

2012-07-09

In the United Kingdom patient-reported outcome measures (PROMS) have been adopted as a key measure of foot surgery outcomes. The intention of this study was to evaluate the responsiveness of a regional outcome measure; the Manchester Oxford Foot Questionnaire (MOXFQ) and a generic measure; the EuroQol EQ-5D, in the context of day care Podiatric Surgery. A prospective audit of 375 consecutive day care surgical admissions was undertaken. All patients attending for surgery, who agreed to participate, were included. Pre operation patients completed the MOXFQ and the EQ-5D. Both questionnaires were completed again at 6 months post operation. Additional data was collected on patient demographics, surgical procedures and complications. Few complications were encountered and most patients (84%) returned for a final review 6 months post operation. Mean MOXFQ scores improved for each domain: pain; 51.7 pre-operation, reduced to 16.5 post-operation, walking; 50.2 reduced to 14.1 and social interaction; 45.7 reduced to 10.6. The minimal clinically important differences (MCID) estimates for the pain domain were exceeded by 82.6% of patients, while 74.8% exceeded the MCID for walking and 68.5% exceeded the MCID for social interaction. A small number of patients (2.9%) deteriorated across all three MOXFQ domains.The EQ-5D Index, summary of health related quality of life, improved from 0.66 pre-operation to 0.86 post operation. The EQ-5D index MCID was exceeded by 79.2% of patients. Index scores deteriorated for 1.8% of patients following surgery. Effect sizes measured following surgery were largest for the MOXFQ domains: Walking; 1.39, Pain; 1.52 and Social Interaction: 1.39. The EQ-5D index effect size was 0.83. The EQ-5D visual analogue scale (VAS) was not influenced by surgery. Both the MOXFQ and EQ-5D index (but not the VAS) appear sensitive to changes in health status at 6 months following elective foot surgery. Both instruments were particularly responsive to changes

Comparison of the SF6D, the EQ5D, and the oswestry disability index in patients with chronic low back pain and degenerative disc disease.

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Johnsen, Lars G; Hellum, Christian; Nygaard, Oystein P; Storheim, Kjersti; Brox, Jens I; Rossvoll, Ivar; Leivseth, Gunnar; Grotle, Margreth

2013-04-26

The need for cost effectiveness analyses in randomized controlled trials that compare treatment options is increasing. The selection of the optimal utility measure is important, and a central question is whether the two most commonly used indexes - the EuroQuol 5D (EQ5D) and the Short Form 6D (SF6D) - can be used interchangeably. The aim of the present study was to compare change scores of the EQ5D and SF6D utility indexes in terms of some important measurement properties. The psychometric properties of the two utility indexes were compared to a disease-specific instrument, the Oswestry Disability Index (ODI), in the setting of a randomized controlled trial for degenerative disc disease. In a randomized controlled multicentre trial, 172 patients who had experienced low back pain for an average of 6 years were randomized to either treatment with an intensive back rehabilitation program or surgery to insert disc prostheses. Patients filled out the ODI, EQ5D, and SF-36 at baseline and two-year follow up. The utility indexes was compared with respect to measurement error, structural validity, criterion validity, responsiveness, and interpretability according to the COSMIN taxonomy. At follow up, 113 patients had change score values for all three instruments. The SF6D had better similarity with the disease-specific instrument (ODI) regarding sensitivity, specificity, and responsiveness. Measurement error was lower for the SF6D (0.056) compared to the EQ5D (0.155). The minimal important change score value was 0.031 for SF6D and 0.173 for EQ5D. The minimal detectable change score value at a 95% confidence level were 0.157 for SF6D and 0.429 for EQ5D, and the difference in mean change score values (SD) between them was 0.23 (0.29) and so exceeded the clinical significant change score value for both instruments. Analysis of psychometric properties indicated that the indexes are unidimensional when considered separately, but that they do not exactly measure the same

Evaluating the sensitivity of EQ-5D in a sample of patients with type 2 diabetes mellitus in two tertiary health care facilities in Nigeria.

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Ekwunife, Obinna Ikechukwu; Ezenduka, Charles C; Uzoma, Bede Emeka

2016-01-12

The EQ-5D instrument is arguably the most well-known and commonly used generic measure of health status internationally. Although the instrument has been employed in outcomes studies of diabetes mellitus in many countries, it has not yet been used in Nigeria. This study was carried out to assess the sensitivity of the EQ-5D instrument in a sample of Nigerian patients with type 2 diabetes mellitus (T2DM). A cross-sectional study was conducted using the EQ-5D instrument to assess the self-reported quality of life of patients with T2DM attending two tertiary healthcare facilities in south eastern Nigeria consenting patients completed the questionnaire while waiting to see a doctor. A priori hypotheses were examined using multiple regression analysis to model the relationship between the dependent variables (EQ VAS and EQ-5D Index) and hypothesized independent variables. A total of 226 patients with T2DM participated in the study. The average age of participants was 57 years (standard deviation 10 years) and 61.1% were male. The EQ VAS score and EQ-5D index averaged 66.19 (standard deviation 15.42) and 0.78 (standard deviation 0.21) respectively. Number of diabetic complications, number of co-morbidities, patient's age and being educated predicted EQ VAS score by -6.76, -6.15, -0.22, and 4.51 respectively. Also, number of diabetic complications, number of co-morbidities, patient's age and being educated predicted EQ-5D index by -0.12, -0.07, -0.003, and 0.06 respectively.. Our findings indicate that the EQ-5D could adequately capture the burden of type 2 diabetes and related complications among Nigerian patients.

[Validity and reliability of the spanish EQ-5D-Y proxy version].

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Gusi, N; Perez-Sousa, M A; Gozalo-Delgado, M; Olivares, P R

2014-10-01

A proxy version of the EQ-5D-Y, a questionnaire to evaluate the Health Related Quality of Life (HRQoL) in children and adolescents, has recently been developed. There are currently no data on the validity and reliability of this tool. The objective of this study was to analyze the validity and reliability of the EQ-5D-Y proxy version. A core set of self-report tools, including the Spanish version of the EQ-5D-Y were administered to a group of Spanish children and adolescents drawn from the general population. A similar core set of internationally standardized proxy tools, including the EQ-5D-Y proxy version were administered to their parents. Test-retest reliability was determined, and correlations with other generic measurements of HRQoL were calculated. Additionally, known group validity was examined by comparing groups with a priori expected differences in HRQoL. The agreement between the self-report and proxy version responses was also calculated. A total of 477 children and adolescents and their parents participated in the study. One week later, 158 participants completed the EQ-5D-Y/EQ-5D-Y proxy to facilitate reliability analysis. Agreement between the test-retest scores was higher than 88% for EQ-5D-Y self-report, and proxy version. Correlations with other health measurements showed similar convergent validity to that observed in the international EQ-5D-Y. Agreement between the self-report and proxy versions ranged from 72.9% to 97.1%. The results provide preliminary evidence of the reliability and validity of the EQ-5D-Y proxy version. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Measuring health-related quality of life in women with endometriosis: comparing the clinimetric properties of the Endometriosis Health Profile-5 (EHP-5) and the EuroQol-5D (EQ-5D).

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Aubry, G; Panel, P; Thiollier, G; Huchon, C; Fauconnier, A

2017-06-01

Which of the Endometriosis Health Profile-5 (EHP-5) and the EuroQol-5D (EQ-5D) is the most efficient to assess quality of life in women suffering from endometriosis? Although EHP-5 and EQ-5D instruments had an excellent responsiveness, EHP-5 has a better discriminative ability than EQ-5 to measure health-related quality of life (HrQoL). Proper measurement of HrQoL is important in endometriosis. While many quality of life instruments are available, few have been completely validated in endometriosis. The EHP-5 and the EQ-5D are short and practical scales, which may be useful. Literature is lacking to determine which one is the most suitable in clinical practice or in clinical research. This prospective and observational study conducted between 1 January 2012 and 31 December 2013 included a total of 253 consecutive women with proven endometriosis, undergoing medical or surgical treatment, in 2 French tertiary care centers. Women over 18 years consulting for painful symptoms of at least 3 months' duration or for infertility, with endometriosis proven histologically or radiologically, were requested to fill in the 2 scales before (T0) and 12 months after treatment (T1). Construct validity consisted in testing presupposed relationships between the scales and the characteristics of the patients or the endometriosis. Responsiveness to change was calculated for all patients and in each treatment group. Effect sizes were used according to Cohen's d method. A total of 216 women filled in completely all the questionnaires at T0 and 133 (61.6%) at T1. EHP-5 and EQ-5D had good discriminative abilities regarding the patients' symptoms, with significant superiority of EHP-5 concerning three of the nine hypotheses. The largest difference was that calculated for the 'intensity of dysmenorrhea' using the Visual Analogic Scale, with respectively effect size from Cohen's d (ES) = 0.86 95% CI (0.54-1.17) for EHP-5 versus 0.48 95% CI (0.16-0.79) for EQ-5D. There were no differences in

Mapping EORTC QLQ-C30 onto EQ-5D for the assessment of cancer patients

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Kim Seon Ha

2012-12-01

Full Text Available Abstract Background The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30 is the instrument most frequently used to measure quality of life in cancer patients, whereas the EQ-5D is widely used to measure and evaluate general health status. Although the EORTC QLQ-C30 has been mapped to EQ-5D utilities, those studies were limited to patients with a single type of cancer. The present study aimed to develop a mapping relationship between the EORTC QLQ-C30 and EQ-5D-based utility values at the individual level. Methods The model was derived using patients with different types of cancer who were receiving chemotherapy. The external validation set comprised outpatients with colon cancer. Ordinary least squares regression was used to estimate the EQ-5D index from the EORTC QLQ-C30 results. The predictability, goodness of fit, and signs of the estimated coefficients of the model were assessed. Predictive ability was determined by calculating the mean absolute error, the estimated proportions with absolute errors > 0.05 and > 0.1, and the root-mean-squared error (RMSE. Results A model that included global health, physical, role, emotional functions, and pain was optimal, with a mean absolute error of 0.069 and an RMSE of 0.095 (normalized RMSE, 8.1%. The explanatory power of this model was 51.6%. The mean absolute error was higher for modeled patients in poor health. Conclusions This mapping algorithm enabled the EORTC QLQ-C30 to be converted to the EQ-5D utility index to assess cancer patients in Korea.

Validation of the EQ-5D in a general population sample in urban China.

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Wang, Hong-Mei; Patrick, Donald L; Edwards, Todd C; Skalicky, Anne M; Zeng, Hai-Yan; Gu, Wen-Wen

2012-02-01

To evaluate the reliability and validity of the EQ-5D in a general population sample in urban China. Thousand and eight hundred respondents in 18 communities of Hangzhou, China were recruited by multi-stage stratified random sampling. Respondents self-administered a questionnaire including the EQ-5D, the SF-36, and demographic questions. Test-retest reliability at 2-week intervals was evaluated using Kappa coefficient, the intraclass correlation coefficient. The standard error of measurement (SEM) was used to indicate the absolute measurement error. Construct validity was established using convergent, discriminant, and known groups analyses. Complete data for all EQ-5D dimensions were available for 1,747 respondents (97%). Kappa values were from 0.35 to 1.0. The ICCs of test-retest reliability were 0.53 for the EQ-5D index score and 0.87 for the EQ VAS score. The SEM values were 0.13 (9.22% range) and 4.20 (4.20% range) for the EQ-5D index and EQ VAS scores, respectively. The Pearson's correlation coefficients between the EQ-5D and the SF-36 were stronger between comparable dimensions than those between less comparable dimensions, demonstrating convergent and discriminant evidence of construct validity. The Chinese EQ-5D distinguished well between known groups: respondents who reported poor general health and chronic diseases had worse HRQoL than those without. Older people, females, people widowed or divorced, and those with a lower socioeconomic status reported poorer HRQoL. Respondents reporting no problems on any EQ-5D dimension had better scores on the SF-36 summary scores than those reporting problems. The Chinese version of the EQ-5D demonstrated acceptable construct validity and fair to moderate levels of test-retest reliability in an urban general population in China.

Canadian valuation of EQ-5D health states: preliminary value set and considerations for future valuation studies.

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Nick Bansback

Full Text Available The EQ-5D is a preference based instrument which provides a description of a respondent's health status, and an empirically derived value for that health state often from a representative sample of the general population. It is commonly used to derive Quality Adjusted Life Year calculations (QALY in economic evaluations. However, values for health states have been found to differ between countries. The objective of this study was to develop a set of values for the EQ-5D health states for use in Canada.Values for 48 different EQ-5D health states were elicited using the Time Trade Off (TTO via a web survey in English. A random effect model was fitted to the data to estimate values for all 243 health states of the EQ-5D. Various model specifications were explored. Comparisons with EQ-5D values from the UK and US were made. Sensitivity analysis explored different transformations of values worse than dead, and exclusion criteria of subjects.The final model was estimated from the values of 1145 subjects with socio-demographics broadly representative of Canadian general population with the exception of Quebec. This yielded a good fit with observed TTO values, with an overall R2 of 0.403 and a mean absolute error of 0.044.A preference-weight algorithm for Canadian studies that include the EQ-5D is developed. The primary limitations regarded the representativeness of the final sample, given the language used (English only, the method of recruitment, and the difficulty in the task. Insights into potential issues for conducting valuation studies in countries as large and diverse as Canada are gained.

Estimating an exchange rate between the EQ-5D-3L and ASCOT.

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Stevens, Katherine; Brazier, John; Rowen, Donna

2018-06-01

The aim was to estimate an exchange rate between EQ-5D-3L and the Adult Social Care Outcome Tool (ASCOT) using preference-based mapping via common time trade-off (TTO) valuations. EQ-5D and ASCOT are useful for examining cost-effectiveness within the health and social care sectors, respectively, but there is a policy need to understand overall benefits and compare across sectors to assess relative value for money. Standard statistical mapping is unsuitable since it relies on conceptual overlap of the measures but EQ-5D and ASCOT have different conceptualisations of quality of life. We use a preference-based mapping approach to estimate the exchange rate using common TTO valuations for both measures. A sample of health states from each measure was valued using TTO by 200 members of the UK adult general population. Regression analyses are used to generate separate equations between EQ-5D-3L and ASCOT values using their original value set and TTO values elicited here. These are solved as simultaneous equations to estimate the relationship between EQ-5D-3L and ASCOT. The relationship for moving from ASCOT to EQ-5D-3L is a linear transformation with an intercept of -0.0488 and gradient of 0.978. This enables QALY gains generated by ASCOT and EQ-5D to be compared across different interventions. This paper estimated an exchange rate between ASCOT and EQ-5D-3L using a preference-based mapping approach that does not compromise the descriptive systems of the two measures. This contributes to the development of preference-based mapping through the use of TTO as the common metric used to estimate the exchange rate between measures.

Assessing quality of life in children and adolescents: development and validation of the Italian version of the EQ-5D-Y

Directory of Open Access Journals (Sweden)

Luciana Scalone

2011-12-01

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Background: Although assessment of Health Related Quality of Life (HRQoL in paediatric populations is gaining interest, it is not sufficiently assessed. While a number of specific paediatric instruments have been developed, some users appear to prefer generic tools such as the EQ-5D, which is a widely used and recommended tool to describe and value health across many different adult populations. We adapted the EQ-5D generic instrument into the EQ-5D-Y(youth for the assessment of HRQoL in children and adolescents, and investigated the feasibility, acceptability, validity and reliability of this new version of the tool.

Methods: The Italian version of the EQ-5D-Y was administered to 415 children and adolescents from a general population aged between 8 and 15, and to 25 paediatric patients diagnosed with Acute Lymphoblastic Leukaemia (ALL.

Results: The Italian version of the EQ-5D-Y was found to be feasible and acceptable for self-completion in the target age-group, with less than 1% refusing to complete it and no invalid answers given. Convergent and divergent validity tested with a child specific standard instrument was satisfactory overall. The test-retest reliability was moderate to good in all the domains of the descriptive system, and the Visual Analogue Scale (VAS showed optimal levels of reliability (Intraclass Correlation Coefficient = 0.82. As regards known-group validity, compared with the youths from general population, the ALL patients reported more difficulties in four of the five domains of the descriptive system and, on average, had a lower VAS score.

Conclusions:The Italian version of the EQ-5D-Y shows to be a promising tool for assessing HRQoL in children and adolescents from 8 to 15 years of age. Future studies should further investigate and optimize its applicability to clinical research and carry out economic evaluations within the health

An Empirical Comparison of the EQ-5D-5L, DEMQOL-U and DEMQOL-Proxy-U in a Post-Hospitalisation Population of Frail Older People Living in Residential Aged Care.

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Ratcliffe, Julie; Flint, Thomas; Easton, Tiffany; Killington, Maggie; Cameron, Ian; Davies, Owen; Whitehead, Craig; Kurrle, Susan; Miller, Michelle; Liu, Enwu; Crotty, Maria

2017-06-01

To empirically compare the measurement properties of the DEMQOL-U and DEMQOL-Proxy-U instruments to the EQ-5D-5L and its proxy version (CEQ-5D-5L) in a population of frail older people living in residential aged care in the post-hospitalisation period following a hip fracture. A battery of instruments to measure health-related quality of life (HRQoL), cognition, and clinical indicators of depression, pain and functioning were administered at baseline and repeated at 4 weeks' follow-up. Descriptive summary statistics were produced and psychometric analyses were conducted to assess the levels of agreement, convergent validity and known group validity between clinical indicators and HRQoL measures. There was a large divergence in mean (SD) utility scores at baseline for the EQ-5D-5L and DEMQOL-U [EQ-5D-5L mean 0.21 (0.19); DEMQOL-U mean 0.79 (0.14)]. At 4 weeks' follow-up, there was a marked improvement in EQ-5D-5L scores whereas DEMQOL-U scores had deteriorated. [EQ-5D-5L mean 0.45 (0.38); DEMQOL-U mean 0.58 (0.38)]. The EQ-5D and CEQ-5D-5L were more responsive to the physical recovery trajectory experienced by frail older people following surgery to repair a fractured hip, whereas the DEMQOL-U and DEMQOL-Proxy-U appeared more responsive to the changes in delirium and dementia symptoms often experienced by frail older people in this period. This study presents important insights into the HRQoL of a relatively under-researched population of post-hospitalisation frail older people in residential care. Further research should investigate the implications for economic evaluation of self-complete versus proxy assessment of HRQoL and the choice of preference-based instrument for the measurement and valuation of HRQoL in older people exhibiting cognitive decline, dementia and other co-morbidities.

Preliminary findings of an investigation into the relationship between national culture and EQ-5D value sets.

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Bailey, Henry; Kind, Paul

2010-10-01

Despite the growing importance of the EQ-5D descriptive system as a basis for the valuation of QALYs in cost-utility analysis, for most countries, there are no EQ-5D value sets. Researchers and policy makers wishing to use the EQ-5D descriptive system in a country for which there is no value set are advised to use one from a nearby or 'similar' population. Factors other than geographic proximity can affect the relative values of EQ-5D states. This study explores the links between national culture and EQ-5D value sets. Rank correlation analysis is used to explore relationships between the relative values of a set of EQ-5D states and dimensions of national culture. The latter are taken from Hofstede's framework which operationalizes national culture in five dimensions. For the data currently available (countries for which EQ-5D value sets and scores on dimensions of culture both exist), moderate and strong correlations were found between the culture dimension of power distance and individualism and the EQ-5D dimensions of pain/discomfort and anxiety/depression. Moderate correlations were also observed between the cultural dimension of masculinity and the EQ-5D dimensions of self care, usual activities and pain/discomfort. Uncertainty avoidance correlates with the EQ-5D dimension of anxiety/depression. The correlation patterns observed are generally consistent with a priori expectations based on the nature of the dimensions of culture and the EQ-5D model. This analysis demonstrates the potential of national culture in providing insight into the drivers of the relative values of EQ-5D dimensions for different countries and in informing decisions about which EQ-5D value sets to use in situations where one does not exist.

An EQ-5D-5L value set based on Uruguayan population preferences.

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Augustovski, Federico; Rey-Ares, Lucila; Irazola, Vilma; Garay, Osvaldo Ulises; Gianneo, Oscar; Fernández, Graciela; Morales, Marcelo; Gibbons, Luz; Ramos-Goñi, Juan Manuel

2016-02-01

To derive a value set from Uruguayan general population using the EQ-5D-5L questionnaire and report population norms. General population individuals were randomly assigned to value 10 health states using composite time trade off and 7 pairs of health states through discrete choice experiments. A stratified sampling with quotas by location, gender, age and socio-economic status was used to respect the Uruguayan population structure. Trained interviewers conducted face-to-face interviews. The EuroQol valuation technology was used to administer the protocol as well as to collect the data. OLS and maximum likelihood robust regression models with or without interactions were tested. We included 794 respondents between 20 and 83 years. Their characteristics were broadly similar to the Uruguayan population. The main effects robust model was chosen to derive social values. Values ranged from -0.264 to 1. States with a misery index = 6 had a mean predicted value of 0.965. When comparing the Uruguayan population with the Argentinian EQ-5D-5L crosswalk value set, the prediction for states which differed from full health only in having one of the dimensions at level 2 were about 0.05 higher in Uruguay. The mean index value, using the selected Uruguayan EQ-5D-5L value set, for the general population in Uruguay was 0.895. In general, older people had worse values and males had slightly better values than females. We derived the EQ-5D-5L Uruguayan value set, the first in Latin America. These results will help inform decision-making using economic evaluations for resource allocation decisions.

Health-related quality of life in pregnant women living with HIV: a comparison of EQ-5D and SF-12.

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Wang, Xiaowen; Guo, Guangping; Zhou, Ling; Zheng, Jiarui; Liang, Xiumin; Li, Zhanqin; Luo, Hongzhuan; Yang, Yuyan; Yang, Liyuan; Tan, Ting; Yu, Jun; Lu, Lin

2017-08-30

HIV. The construct validity was identified for EQ-5D and SF-12 in the study. The respective constructs of EQ-5D and EQ-VAS may not overlap. Pregnant women living with HIV in the study gave more weight to their mental health when they provided a total health rating in EQ-VAS. EQ-VAS could explain the limitations of the EQ-5D dimension scores with ceiling effects in the survey. The results of our study could help to determine the suitable HRQoL instruments for pregnant women living with HIV and provide evidence for the proper comparison of EQ-5D and SF-12.

Quality of life profile and psychometric properties of the EQ-5D-5L in HIV/AIDS patients

Directory of Open Access Journals (Sweden)

Tran Bach

2012-11-01

Full Text Available Abstract Objectives We assessed health-related quality of life (HRQOL, its associated factors, and examined measurement properties of the EuroQol - 5 Dimensions - 5 Levels (EQ-5D-5L in HIV/AIDS patients. Methods A cross-sectional multi-site survey was conducted in 1016 patients (age: 35.4 ± 7.0 years; 63.8% male in three epicenters of Vietnam. Internal consistency reliability, convergent validity, and discriminative validity of the EQ-5D-5L and a visual analogue scale (VAS were evaluated. Tobit censored regression models were used to identify predictors of HRQOL in HIV/AIDS patients. Results The mean EQ-5D-5L single index and VAS were 0.65 (95% Confidence Interval (CI = 0.63; 0.67 and 70.3 (95% CI = 69.2; 71.5. Cronbach’s alpha of five dimensions was 0.85. EQ-5D-5L has a good convergent validity with VAS (0.73. It discriminated patients at different HIV/AIDS stages, duration of ART, and CD4 cell count. Predictors of poorer HRQOL included being female, lower education level, unemployment, alcohol and drug use, CD4 Conclusion The EQ-5D-5L has good measurement properties in HIV/AIDS patients and holds potentials for monitoring ART outcomes. Integration of HRQOL measurement using EQ-5D-5L in HIV/AIDS clinical practice could be helpful for economic evaluation of HIV/AIDS interventions.

A Head-to-Head Comparison of UK SF-6D and Thai and UK EQ-5D-5L Value Sets in Thai Patients with Chronic Diseases.

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Sakthong, Phantipa; Munpan, Wipaporn

2017-10-01

Little was known about the head-to-head comparison of psychometric properties between SF-6D and EQ-5D-5L or the different value sets of EQ-5D-5L. Therefore, this study set out to compare the psychometric properties including agreement, convergent, and known-group validity between the SF-6D and the EQ-5D-5L using the real value sets from Thailand and the UK in patients with chronic diseases. 356 adults taking a medication for at least 3 months were identified from a university hospital in Bangkok, Thailand, between July 2014 and March 2015. Agreement was assessed by intraclass correlation coefficients (ICCs) and Bland-Altman plots. Convergent validity was evaluated using Spearman's rank correlation coefficients between SF-6D and EQ-5D-5L and EQ-VAS and SF-12v2. For known-groups validity, the Mann-Whitney U test and Kruskal-Wallis test were used to examine the associations between SF-6D and EQ-5D-5L and patient characteristics. Agreements between the SF-6D and the EQ-5D-5L using Thai and UK value sets were fair, with ICCs of 0.45 and 0.49, respectively. Bland-Altman plots showed that the majority of the SF-6D index scores were lower than the EQ-5D-5L index scores. Both the EQ-5D-5L value sets were more related to the EQ-VAS and physical health, while the SF-6D was more associated with mental health. Both EQ-5D-5L value sets were more sensitive than the SF-6D in discriminating patients with different levels of more known groups except for adverse drug reactions. The SF-6D and both EQ-5D-5L value sets appeared to be valid but sensitive to different outcomes in Thai patients with chronic diseases.

Cross-cultural measurement equivalence of the EQ-5D-5L items for English-speaking Asians in Singapore.

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Luo, N; Wang, Y; How, C H; Wong, K Y; Shen, L; Tay, E G; Thumboo, J; Herdman, M

2015-06-01

To investigate how the response labels of the 5-level EQ-5D (EQ-5D-5L) items are interpreted and used by English-speaking Chinese and non-Chinese Singaporeans, as a means to assessing whether those items are cross-culturally equivalent health-status measures in this Asian population. In face-to-face interviews, Chinese, Malay and Indian visitors to a primary care institution in Singapore were asked to rate the relative severity conveyed by EQ-5D-5L response labels, each containing the keyword of 'no(t),' 'slight(ly),' 'moderate(ly),' 'severe(ly),' or 'unable'/'extreme(ly),' using a 0-100 numerical rating scale. Participants were also asked to describe 25 hypothetical health states using the EQ-5D-5L response labels. Differences between Chinese and Malay/Indian participants in label interpretation and selection were examined using multivariate regression analysis to adjust for participant characteristics. The differences in adjusted mean severity scores for individual EQ-5D-5L labels between Chinese (n = 148) and non-Chinese (Malay: n = 53; Indian: n = 56) participants ranged from 0.0 to 9.0. The relative severity of the labels to the participants supported the ordinality of the EQ-5D-5L response labels and was similar across ethnic groups. Chinese and non-Chinese participants selected similar response labels to describe each hypothetical health state, with the adjusted odds ratios of selecting any type of the five response labels for non-Chinese versus Chinese participants ranging from 0.92 to 1.15 (p > 0.05 for all). The EQ-5D-5L items are likely to generate equivalent health outcomes between English-speaking Chinese and non-Chinese Singaporeans.

Mapping EQ-5D utilities to GBD 2010 and GBD 2013 disability weights: Results of two pilot studies in Belgium

NARCIS (Netherlands)

C. Maertens De Noordhout (Charline); B. Devleesschauwer (Brecht); Gielens, L.; Plasmans, M.H.D.; J.A. Haagsma (Juanita); N. Speybroeck (Niko)

2017-01-01

textabstractBackground: Utilities and disability weights (DWs) are metrics used for calculating Quality-Adjusted Life Years and Disability-Adjusted Life Years (DALYs), respectively. Utilities can be obtained with multi-attribute instruments such as the EuroQol 5 dimensions questionnaire (EQ-5D). In

Validity and responsiveness of the EQ-5D in assessing and valuing health status in patients with anxiety disorders

Directory of Open Access Journals (Sweden)

Heinrich Sven

2010-05-01

Full Text Available Abstract Background The EQ-5D is a generic questionnaire which generates a health profile as well as index scores for health-related quality of life that may be used in cost-utility analysis. Aims of the study To examine validity and responsiveness of the EQ-5D in patients with anxiety disorders. Methods 389 patients with anxiety disorders completed the EQ-5D at baseline and 6-month follow-up. Subjective measures of quality of life (WHOQOL-BREF and psychopathology (BAI, BDI-II, BSQ, ACQ, MI were used for comparison. Validity was analyzed by assessing associations between EQ-5D scores and related other scores. Responsiveness was analyzed by calculating effect sizes of differences in scores between baseline and follow-up for 3 groups indicating more, constant or less anxiety. Meaningful difference scores for shifting to less or more anxiety were derived by means of regression analysis. Results 88.4% of respondents reported problems in at least one of the EQ-5D dimension at baseline; the mean EQ VAS score was 63.8. The EQ-5D dimension most consistently associated with the measures used for comparison was 'anxiety/depression'. EQ VAS and EQ-5D index scores were highly correlated (|r|>0.5 with scores of the WHOQOL-BREF dimensions 'physical', 'mental' and 'overall' as well as BAI and BDI-II. The EQ-5D index tended to be the most responsive score. Standardized meaningful difference scores were not significantly different between EQ VAS, EQ-5D index and measures used for comparison. Conclusions The EQ-5D seems to be reasonably valid and moderately responsive in patients with anxiety disorders. The EQ-5D index may be suitable for calculating QALYs in economic evaluation of health care interventions for patients with anxiety disorders. Trial registration Current Controlled Trials ISRCTN15716049

An Australian discrete choice experiment to value eq-5d health states.

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Viney, Rosalie; Norman, Richard; Brazier, John; Cronin, Paula; King, Madeleine T; Ratcliffe, Julie; Street, Deborah

2014-06-01

Conventionally, generic quality-of-life health states, defined within multi-attribute utility instruments, have been valued using a Standard Gamble or a Time Trade-Off. Both are grounded in expected utility theory but impose strong assumptions about the form of the utility function. Preference elicitation tasks for both are complicated, limiting the number of health states that each respondent can value and, therefore, that can be valued overall. The usual approach has been to value a set of the possible health states and impute values for the remainder. Discrete Choice Experiments (DCEs) offer an attractive alternative, allowing investigation of more flexible specifications of the utility function and greater coverage of the response surface. We designed a DCE to obtain values for EQ-5D health states and implemented it in an Australia-representative online panel (n = 1,031). A range of specifications investigating non-linear preferences with respect to time and interactions between EQ-5D levels were estimated using a random-effects probit model. The results provide empirical support for a flexible utility function, including at least some two-factor interactions. We then constructed a preference index such that full health and death were valued at 1 and 0, respectively, to provide a DCE-based algorithm for Australian cost-utility analyses. Copyright © 2013 John Wiley & Sons, Ltd.

Validity, responsiveness, and minimal clinically important difference of EQ-5D-5L in stroke patients undergoing rehabilitation.

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Chen, Poyu; Lin, Keh-Chung; Liing, Rong-Jiuan; Wu, Ching-Yi; Chen, Chia-Ling; Chang, Ku-Chou

2016-06-01

To examine the criterion validity, responsiveness, and minimal clinically important difference (MCID) of the EuroQoL 5-Dimensions Questionnaire (EQ-5D-5L) and visual analog scale (EQ-VAS) in people receiving rehabilitation after stroke. The EQ-5D-5L, along with four criterion measures-the Medical Research Council scales for muscle strength, the Fugl-Meyer assessment, the functional independence measure, and the Stroke Impact Scale-was administered to 65 patients with stroke before and after 3- to 4-week therapy. Criterion validity was estimated using the Spearman correlation coefficient. Responsiveness was analyzed by the effect size, standardized response mean (SRM), and criterion responsiveness. The MCID was determined by anchor-based and distribution-based approaches. The percentage of patients exceeding the MCID was also reported. Concurrent validity of the EQ-Index was better compared with the EQ-VAS. The EQ-Index has better power for predicting the rehabilitation outcome in the activities of daily living than other motor-related outcome measures. The EQ-Index was moderately responsive to change (SRM = 0.63), whereas the EQ-VAS was only mildly responsive to change. The MCID estimation of the EQ-Index (the percentage of patients exceeding the MCID) was 0.10 (33.8 %) and 0.10 (33.8 %) based on the anchor-based and distribution-based approaches, respectively, and the estimation of EQ-VAS was 8.61 (41.5 %) and 10.82 (32.3 %). The EQ-Index has shown reasonable concurrent validity, limited predictive validity, and acceptable responsiveness for detecting the health-related quality of life in stroke patients undergoing rehabilitation, but not for EQ-VAS. Future research considering different recovery stages after stroke is warranted to validate these estimations.

HUI2 and HUI3

African Journals Online (AJOL)

Keywords: Health utility index, HUI2, HUI3, Quality of life, Diabetes. Tropical ... in the form of Quality Adjusted Life Years. (QALYs) [5]. ... HUI3 specifically assesses happiness versus depression. .... medication, longer duration of diabetes and.

A social preference valuations set for EQ-5D health states in Flanders, Belgium.

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Cleemput, Irina

2010-04-01

This study aimed at deriving a preference valuation set for EQ-5D health states from the general Flemish public in Belgium. A EuroQol valuation instrument with 16 health states to be valued on a visual analogue scale was sent to a random sample of 2,754 adults. The initial response rate was 35%. Eventually, 548 (20%) respondents provided useable valuations for modeling. Valuations for 245 health states were modeled using a random effects model. The selection of the model was based on two criteria: health state valuations must be consistent, and the difference with the directly observed valuations must be small. A model including a value decrement if any health dimension of the EQ-5D is on the worst level was selected to construct the social health state valuation set. A comparison with health state valuations from other countries showed similarities, especially with those from New Zealand. The use of a single preference valuation set across different health economic evaluations within a country is highly preferable to increase their usability for policy makers. This study contributes to the standardization of outcome measurement in economic evaluations in Belgium.

Does the EQ-5D measure quality of life in schizophrenia?

DEFF Research Database (Denmark)

Halling Hastrup, Lene; Nordentoft, Merete; Hjorthoej, Carsten

2011-01-01

Most health economic evaluations in mental care include outcome measures aimed at specific aspects of health, like symptom improvement, functional improvement and quality of life instead of generic preference based outcome measures. The health economic guidelines (NICE) recommend to include...... a generic preference based outcome measure, like EQ-5D, in health economic evaluations in order to allow for comparisons of health related quality of life of patient groups across different diseases, providing information particular useful to support health policy decisions and cost-effectiveness analysis...... in mental health, but only few studies have addressed the correlation between the EQ-5D and a condition-specific quality of life measure in mental health....

Responsiveness of the anxiety/depression dimension of the 3- and 5-level versions of the EQ-5D in assessing mental health.

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Crick, Katelynn; Al Sayah, Fatima; Ohinmaa, Arto; Johnson, Jeffrey A

2018-06-01

Anxiety and depression disorders are associated with significantly lower health-related quality of life (HRQL). The EQ-5D is a commonly used generic measure of HRQL; it captures mental health through a single domain-the anxiety/depression dimension. Evidence on the responsiveness of this measure in assessing changes in mental health changes is limited. To examine the performance of the anxiety/depression dimension (A/D) of the 3- and 5-level (3L and 5L) versions of the EQ-5D in assessing changes in mental health. Data from two patient populations were used: 495 adults post-discharge from general internal medicine ward (EQ-5D-3L), and 225 type 2 diabetes patients who screened positive for depressive symptoms (EQ-5D-5L). Anchor-based approach along with effect sizes (ES) and ROC analysis was used. Anchors included patient health questionnaire 9-items "PHQ9" and generalized anxiety disorder 2-item questionnaire "GAD2" for EQ-5D-3L, and PHQ9 and SF-12 mental composite summary scores (MCS) for EQ-5D-5L. A/D change was quantified as the difference between follow-up and baseline levels. The A/D dimension of the EQ-5D-3L showed limited responsiveness to changes in depressive symptoms measured by PHQ9 and for anxiety symptoms measured by GAD2, whereby in those who improved or deteriorated in either symptom, more than half of the patients did not have an A/D change. In the ROC analysis, the A/D dimension of the EQ-5D-3L showed weak performance with C-indices ranging from 0.58 to 0.63 and probability of detection of depressive or anxiety symptoms ranging between 20 and 40%, which are all well below acceptable ranges. Similar results were observed for the A/D dimension of the EQ-5D-5L; although the performance was slightly better, it was still below acceptable range. In patients who improved or deteriorated based on the PHQ9 or MCS, around a third had no changes on the A/D dimension. The performance of the A/D dimension of the EQ-5D-5L was also very limited with C

Longitudinal predictive ability of mapping models: examining post-intervention EQ-5D utilities derived from baseline MHAQ data in rheumatoid arthritis patients.

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Kontodimopoulos, Nick; Bozios, Panagiotis; Yfantopoulos, John; Niakas, Dimitris

2013-04-01

The purpose of this methodological study was to to provide insight into the under-addressed issue of the longitudinal predictive ability of mapping models. Post-intervention predicted and reported utilities were compared, and the effect of disease severity on the observed differences was examined. A cohort of 120 rheumatoid arthritis (RA) patients (60.0% female, mean age 59.0) embarking on therapy with biological agents completed the Modified Health Assessment Questionnaire (MHAQ) and the EQ-5D at baseline, and at 3, 6 and 12 months post-intervention. OLS regression produced a mapping equation to estimate post-intervention EQ-5D utilities from baseline MHAQ data. Predicted and reported utilities were compared with t test, and the prediction error was modeled, using fixed effects, in terms of covariates such as age, gender, time, disease duration, treatment, RF, DAS28 score, predicted and reported EQ-5D. The OLS model (RMSE = 0.207, R(2) = 45.2%) consistently underestimated future utilities, with a mean prediction error of 6.5%. Mean absolute differences between reported and predicted EQ-5D utilities at 3, 6 and 12 months exceeded the typically reported MID of the EQ-5D (0.03). According to the fixed-effects model, time, lower predicted EQ-5D and higher DAS28 scores had a significant impact on prediction errors, which appeared increasingly negative for lower reported EQ-5D scores, i.e., predicted utilities tended to be lower than reported ones in more severe health states. This study builds upon existing research having demonstrated the potential usefulness of mapping disease-specific instruments onto utility measures. The specific issue of longitudinal validity is addressed, as mapping models derived from baseline patients need to be validated on post-therapy samples. The underestimation of post-treatment utilities in the present study, at least in more severe patients, warrants further research before it is prudent to conduct cost-utility analyses in the context

Application and measurement properties of EQ-5D to measure quality of life in patients with upper extremity orthopaedic disorders: a systematic literature review.

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Grobet, Cécile; Marks, Miriam; Tecklenburg, Linda; Audigé, Laurent

2018-04-13

The EuroQol-5 Dimension (EQ-5D) is the most widely used generic instrument to measure quality of life (QoL), yet its application in upper extremity orthopaedics as well as its measurement properties remain largely undefined. We implemented a systematic literature review to provide an overview of the application of EQ-5D in patients with upper extremity disorders and analyse its measurement properties. We searched Medline, EMBASE, Cochrane and Scopus databases for clinical studies including orthopaedic patients with surgical interventions of the upper extremity who completed the EQ-5D. For all included studies, the use of EQ-5D and quantitative QoL data were described. Validation studies of EQ-5D were assessed according to COSMIN guidelines and standard measurement properties were examined. Twenty-three studies were included in the review, 19 of which investigated patients with an intervention carried out at the shoulder region. In 15 studies, EQ-5D assessed QoL as the primary outcome. Utility index scores in non-trauma patients generally improved postoperatively, whereas trauma patients did not regain their recalled pre-injury QoL levels. EQ-5D measurement properties were reported in three articles on proximal humerus fractures and carpal tunnel syndrome. Positive ratings were seen for construct validity (Spearman correlation coefficient ≥ 0.70 with the Short Form (SF)-12 or SF-6D health surveys) and reliability (intraclass correlation coefficient ≥ 0.77) with intermediate responsiveness (standardised response means: 0.5-0.9). However, ceiling effects were identified with 16-48% of the patients scoring the maximum QoL. The methodological quality of the three articles varied from fair to good. For surgical interventions of the upper extremity, EQ-5D was mostly applied to assess QoL as a primary outcome in patients with shoulder disorders. Investigations of the measurement properties were rare, but indicate good reliability and validity as well as

Patient Characteristics Impacting Health State Index Scores, Measured by the EQ-5D of Females with Stress Urinary Incontinence Symptoms

NARCIS (Netherlands)

Tincello, Douglas; Sculpher, Mark; Tunn, Ralf; Quail, Deborah; van der Vaart, Huub; Falconer, Christian; Manning, Martina; Timlin, Louise

2010-01-01

Objective: To describe the characteristics of women seeking treatment for symptoms of stress urinary incontinence (SUI) and to investigate the association of SUI symptoms with generic health-related quality of life (HRQoL) as measured by the EuroQol (EQ-5D) instrument. Methods: The Stress Urinary

Standard error of measurement of 5 health utility indexes across the range of health for use in estimating reliability and responsiveness.

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Palta, Mari; Chen, Han-Yang; Kaplan, Robert M; Feeny, David; Cherepanov, Dasha; Fryback, Dennis G

2011-01-01

Standard errors of measurement (SEMs) of health-related quality of life (HRQoL) indexes are not well characterized. SEM is needed to estimate responsiveness statistics, and is a component of reliability. To estimate the SEM of 5 HRQoL indexes. The National Health Measurement Study (NHMS) was a population-based survey. The Clinical Outcomes and Measurement of Health Study (COMHS) provided repeated measures. A total of 3844 randomly selected adults from the noninstitutionalized population aged 35 to 89 y in the contiguous United States and 265 cataract patients. The SF6-36v2™, QWB-SA, EQ-5D, HUI2, and HUI3 were included. An item-response theory approach captured joint variation in indexes into a composite construct of health (theta). The authors estimated 1) the test-retest standard deviation (SEM-TR) from COMHS, 2) the structural standard deviation (SEM-S) around theta from NHMS, and 3) reliability coefficients. SEM-TR was 0.068 (SF-6D), 0.087 (QWB-SA), 0.093 (EQ-5D), 0.100 (HUI2), and 0.134 (HUI3), whereas SEM-S was 0.071, 0.094, 0.084, 0.074, and 0.117, respectively. These yield reliability coefficients 0.66 (COMHS) and 0.71 (NHMS) for SF-6D, 0.59 and 0.64 for QWB-SA, 0.61 and 0.70 for EQ-5D, 0.64 and 0.80 for HUI2, and 0.75 and 0.77 for HUI3, respectively. The SEM varied across levels of health, especially for HUI2, HUI3, and EQ-5D, and was influenced by ceiling effects. Limitations. Repeated measures were 5 mo apart, and estimated theta contained measurement error. The 2 types of SEM are similar and substantial for all the indexes and vary across health.

Estimating EQ-5D values from the Oswestry Disability Index and numeric rating scales for back and leg pain.

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Carreon, Leah Y; Bratcher, Kelly R; Das, Nandita; Nienhuis, Jacob B; Glassman, Steven D

2014-04-15

Cross-sectional cohort. The purpose of this study is to determine whether the EuroQOL-5D (EQ-5D) can be derived from commonly available low back disease-specific health-related quality of life measures. The Oswestry Disability Index (ODI) and numeric rating scales (0-10) for back pain (BP) and leg pain (LP) are widely used disease-specific measures in patients with lumbar degenerative disorders. Increasingly, the EQ-5D is being used as a measure of utility due to ease of administration and scoring. The EQ-5D, ODI, BP, and LP were prospectively collected in 14,544 patients seen in clinic for lumbar degenerative disorders. Pearson correlation coefficients for paired observations from multiple time points between ODI, BP, LP, and EQ-5D were determined. Regression modeling was done to compute the EQ-5D score from the ODI, BP, and LP. The mean age was 53.3 ± 16.4 years and 41% were male. Correlations between the EQ-5D and the ODI, BP, and LP were statistically significant (P < 0.0001) with correlation coefficients of -0.77, -0.50, and -0.57, respectively. The regression equation: [0.97711 + (-0.00687 × ODI) + (-0.01488 × LP) + (-0.01008 × BP)] to predict EQ-5D, had an R2 of 0.61 and a root mean square error of 0.149. The model using ODI alone had an R2 of 0.57 and a root mean square error of 0.156. The model using the individual ODI items had an R2 of 0.64 and a root mean square error of 0.143. The correlation coefficient between the observed and estimated EQ-5D score was 0.78. There was no statistically significant difference between the actual EQ-5D (0.553 ± 0.238) and the estimated EQ-5D score (0.553 ± 0.186) using the ODI, BP, and LP regression model. However, rounding off the coefficients to less than 5 decimal places produced less accurate results. Unlike previous studies showing a robust relationship between low back-specific measures and the Short Form-6D, a similar relationship was not seen between the ODI, BP, LP, and the EQ-5D. Thus, the EQ-5D cannot be

Does the choice of tariff matter?: A comparison of EQ-5D-5L utility scores using Chinese, UK, and Japanese tariffs on patients with psoriasis vulgaris in Central South China.

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Zhao, Yue; Li, Shun-Ping; Liu, Liu; Zhang, Jiang-Lin; Chen, Gang

2017-08-01

There is an increasing trend globally to develop country-specific tariffs that can theoretically better reflect population's preferences on health states for preference-based health-related quality-of-life instruments, also known as multiattribute utility instruments. This study focused on the most recently developed 5-level version of EuroQol-5 Dimension (EQ-5D) questionnaire, 1 of the world's most well-known multiattribute utility instruments, and aimed to empirically explore the agreements and known-group validities of applying the country-specific tariff versus tariffs developed from other countries using a sample of psoriasis vulgaris patients in Mainland China.A convenience sampling framework was adopted to recruit patients diagnosed with psoriasis vulgaris from Xiangya Hospital, Central South University, China, between May 2014 and February 2015. The 5-level EuroQol-5 dimensions (EQ-5D-5L) utilities were scored by using the Chinese, Japanese, and UK tariffs. Health state utilities were compared using a range of nonparametric test. The intraclass correlation coefficients and Bland-Altman plots were used to examine the agreements among the 3 EQ-5D-5L scores. Health state utility decrements between known groups were investigated using both effect size and a regression analysis.In all, 350 patients (aged 16 years or older) were recruited. There were significant differences among the 3 national tariff sets. Overall, 3 tariffs showed excellent agreements (intraclass correlation coefficient >0.90); however, the wide limits of agreement from the Bland-Altman plots suggest that these tariffs cannot be used interchangeably. The EQ-5D-5L scores using the Chinese-specific tariff showed the best known-group validity than the other 2 tariffs in this Chinese patient sample. The evidence from this study supports the choice of the country-specific tariff to be used in Mainland China.

Testing mapping algorithms of the cancer-specific EORTC QLQ-C30 onto EQ-5D in malignant mesothelioma.

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Arnold, David T; Rowen, Donna; Versteegh, Matthijs M; Morley, Anna; Hooper, Clare E; Maskell, Nicholas A

2015-01-23

In order to estimate utilities for cancer studies where the EQ-5D was not used, the EORTC QLQ-C30 can be used to estimate EQ-5D using existing mapping algorithms. Several mapping algorithms exist for this transformation, however, algorithms tend to lose accuracy in patients in poor health states. The aim of this study was to test all existing mapping algorithms of QLQ-C30 onto EQ-5D, in a dataset of patients with malignant pleural mesothelioma, an invariably fatal malignancy where no previous mapping estimation has been published. Health related quality of life (HRQoL) data where both the EQ-5D and QLQ-C30 were used simultaneously was obtained from the UK-based prospective observational SWAMP (South West Area Mesothelioma and Pemetrexed) trial. In the original trial 73 patients with pleural mesothelioma were offered palliative chemotherapy and their HRQoL was assessed across five time points. This data was used to test the nine available mapping algorithms found in the literature, comparing predicted against observed EQ-5D values. The ability of algorithms to predict the mean, minimise error and detect clinically significant differences was assessed. The dataset had a total of 250 observations across 5 timepoints. The linear regression mapping algorithms tested generally performed poorly, over-estimating the predicted compared to observed EQ-5D values, especially when observed EQ-5D was below 0.5. The best performing algorithm used a response mapping method and predicted the mean EQ-5D with accuracy with an average root mean squared error of 0.17 (Standard Deviation; 0.22). This algorithm reliably discriminated between clinically distinct subgroups seen in the primary dataset. This study tested mapping algorithms in a population with poor health states, where they have been previously shown to perform poorly. Further research into EQ-5D estimation should be directed at response mapping methods given its superior performance in this study.

Examining the incremental impact of long-standing health conditions on subjective well-being alongside the EQ-5D.

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Wu, Mengjun; Brazier, John; Relton, Clare; Cooper, Cindy; Smith, Christine; Blackburn, Joanna

2014-04-29

Generic preference-based measures such as the EQ-5D and SF-6D have been criticised for being narrowly focused on a sub-set of dimensions of health. Our study aims to explore whether long-standing health conditions have an incremental impact on subjective well-being alongside the EQ-5D. Using data from the South Yorkshire Cohort study (N = 13,591) collected between 2010 and 2012 on the EQ-5D, long-standing health conditions (self-reported), and subjective well-being measure--life satisfaction using a response scale from 0 (completely dissatisfied) to 10 (completely satisfied), we employed generalised logit regression models. We assessed the impact of EQ-5D and long-standing health conditions together on life satisfaction by examining the size and significance of their estimated odds ratios. The EQ-5D had a significant association with life satisfaction, in which anxiety/depression and then self-care had the largest weights. Some long-standing health conditions were significant in some models, but most did not have an independent impact on life satisfaction. Overall, none of the health conditions had a consistent impact on life satisfaction alongside the EQ-5D. Out study suggests that the impact of long-standing health conditions on life satisfaction is adequately captured by the EQ-5D, although the findings are limited by reliance on self-reported conditions and a single item life satisfaction measure.

The impact of a revised EQ-5D population scoring on preference-based utility scores in an inflammatory arthritis cohort.

LENUS (Irish Health Repository)

Adams, Roisin

2012-02-01

BACKGROUND AND OBJECTIVE: It is well established that there are problems with the EQ-5D. This is due to the original scoring methods used and how negative time trade-off (TTO) values were treated. A revised scoring method has been published. This article applies this to an inflammatory arthritis cohort. The objective is to examine the impact of a revised scoring system for the EQ-5D (UK) TTO on the utility estimates and in the case of rheumatoid arthritis, to explore the impact of using different utility metrics on the incremental cost-effectiveness ratio (ICER) results of an economic model. METHODS: A total of 504 patients with inflammatory arthritis were rescored using revised EQ-5D scoring, which uses an episodic random utility model to deal with negative TTO values. Differences in utility scores were compared and the new mapping coefficients were obtained. These were then used in an economic model to examine the impact on the ICER. RESULTS: In rheumatoid arthritis, the overall change is less for the revised EQ-5D scoring than with the original EQ-5D (TTO) but greater than the SF-6D: EQ-5D UK -0.22 (95% confidence interval [CI] -0.30 to -0.15), revised EQ-5D UK -0.16 (95% CI -0.21 to -0.10) and SF-6D -0.08 (95% CI -0.11 to -0.05). A similar trend is seen in the psoriatic arthritis group. The economic model produced different ICERs, when different utility measures were used; EQ-5D (TTO) euro42,402, SF-6D euro111,788, and revised EQ-5D (TTO) euro57,747. CONCLUSION: In the context of inflammatory arthritis, this article demonstrates that a revised scoring for EQ-5D may have a significant impact on utility estimates and on the output of the economic model.

Societal Preferences for EQ-5D Health States from a Brazilian Population Survey.

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Viegas Andrade, Mônica; Noronha, Kenya; Kind, Paul; Maia, Ana Carolina; Miranda de Menezes, Renata; De Barros Reis, Carla; Nepomuceno Souza, Michelle; Martins, Diego; Gomes, Lucas; Nichele, Daniel; Calazans, Julia; Mascarenhas, Tamires; Carvalho, Lucas; Lins, Camila

2013-12-01

To elicit preference weights for a subset of EuroQol five-dimensional (EQ-5D) questionnaire health states from a representative sample for the state of Minas Gerais, Brazil, using a time trade-off (TTO) method and to analyze these data so as to estimate social preference weights for the complete set of 243 states. Data came from a valuation study with 3362 literate individuals aged between 18 and 64 years living in urban areas. The present study was based on quota sampling by age and sex. Face-to-face interviews were conducted in participants' own homes. A total of 99 EQ-5D questionnaire health states were selected, presorted into 26 blocks of six unique health states. Each participant valued one block together with the full health, worst health, and dead states. Each health state was evaluated by more than 100 individuals. TTO data were modeled at both individual and aggregate levels by using ordinary least squares and random effects methods. Values estimated by different models yielded very similar results with satisfactory goodness-of-fit statistics: the mean absolute error was around 0.03 and fewer than 25% of the states had a mean absolute error greater than 0.05. Dummies coefficients for each level within the EQ-5D questionnaire dimensions of health displayed an internally consistent ordering, with the mobility dimension demonstrating the largest value decrement. The values of mean observed transformed TTO values range from 0.869 to-0.235. The study demonstrates the feasibility of conducting face-to-face interviews using TTO in a Brazilian population setting. The estimated values for EQ-5D questionnaire health states based on this Minas Gerais survey represent an important first step in establishing national Brazilian social preference weights for the EQ-5D questionnaire. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Mapping of the DLQI scores to EQ-5D utility values using ordinal logistic regression.

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Ali, Faraz Mahmood; Kay, Richard; Finlay, Andrew Y; Piguet, Vincent; Kupfer, Joerg; Dalgard, Florence; Salek, M Sam

2017-11-01

The Dermatology Life Quality Index (DLQI) and the European Quality of Life-5 Dimension (EQ-5D) are separate measures that may be used to gather health-related quality of life (HRQoL) information from patients. The EQ-5D is a generic measure from which health utility estimates can be derived, whereas the DLQI is a specialty-specific measure to assess HRQoL. To reduce the burden of multiple measures being administered and to enable a more disease-specific calculation of health utility estimates, we explored an established mathematical technique known as ordinal logistic regression (OLR) to develop an appropriate model to map DLQI data to EQ-5D-based health utility estimates. Retrospective data from 4010 patients were randomly divided five times into two groups for the derivation and testing of the mapping model. Split-half cross-validation was utilized resulting in a total of ten ordinal logistic regression models for each of the five EQ-5D dimensions against age, sex, and all ten items of the DLQI. Using Monte Carlo simulation, predicted health utility estimates were derived and compared against those observed. This method was repeated for both OLR and a previously tested mapping methodology based on linear regression. The model was shown to be highly predictive and its repeated fitting demonstrated a stable model using OLR as well as linear regression. The mean differences between OLR-predicted health utility estimates and observed health utility estimates ranged from 0.0024 to 0.0239 across the ten modeling exercises, with an average overall difference of 0.0120 (a 1.6% underestimate, not of clinical importance). This modeling framework developed in this study will enable researchers to calculate EQ-5D health utility estimates from a specialty-specific study population, reducing patient and economic burden.

Comparing the self-perceived quality of life of multimorbid patients and the general population using the EQ-5D-3L.

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Alexandra A N'Goran

Full Text Available To assess and compare the self-perceived Health Related Quality of Life (HRQoL of multimorbid patients and the general population using health utilities (HU and visual analogue scale (VAS methods.We analyzed data (n = 888 from a national, cross-sectional Swiss study of multimorbid patients recruited in primary care settings. Self-perceived HRQoL was assessed using the EQ-5D-3L instrument, composed of 1 a questionnaire on the five dimensions of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression (EQ-5D dimensions, and 2 a 0-100 (0 = worst- and 100 = best-imaginable health status VAS. We described the EQ-5D dimensions and VAS and computed HU using a standard pan-European value set. HU and VAS are the two components of the overall HRQoL assessment. We examined the proportions of multimorbid patients reporting problems (moderate/severe in each EQ-5D dimension, corresponding proportions without problems, and mean HU and VAS values across patient characteristics. To test differences between subgroups, we used chi-square tests for dichotomous outcomes and T-tests (ANOVA if more than two groups for continuous outcomes. Finally, we compared observed and predicted HU and VAS values.All 888 participants answered every EQ-5D item. Mean (SD HU and VAS values were 0.70 (0.18 and 63.2 (19.2, respectively. HU and VAS were considerably and significantly lower in multimorbid patients than in the general population and were also lower in multimorbid patients below 60 years old and in women. Differences between observed and predicted means (SD were -0.07 (0.18 for HU and -11.8 (20.3 for VAS.Self-perceived HRQoL is considerably and significantly affected by multimorbidity. More attention should be given to developing interventions that improve the HRQoL of multimorbid patients, particularly women and those aged below 60 years old.

Comparing UK, USA and Australian values for EQ-5D as a health utility measure of oral health.

Science.gov (United States)

Brennan, D S; Teusner, D N

2015-09-01

Using generic measures to examine outcomes of oral disorders can add additional information relating to health utility. However, different algorithms are available to generate health states. The aim was to assess UK-, US- and Australian-based algorithms for the EuroQol (EQ-5D) in relation to their discriminative and convergent validity. Methods: Data were collected from adults in Australia aged 30-61 years by mailed survey in 2009-10, including the EQ-5D and a range of self-reported oral health variables, and self-rated oral and general health. Responses were collected from n=1,093 persons (response rate 39.1%). UK-based EQ-5D estimates were lower (0.85) than the USA and Australian estimates (0.91). EQ-5D was associated (pUSA, and from 0.05 to 0.08 for the Australian-based estimates. The effect sizes (ESs) of the associations with all seven oral health variables were similar for the UK (ES=0.26 to 0.49), USA (ES=0.31 to 0.48) and Australian-based (ES=0.31 to 0.46) estimates. EQ-5D was correlated with global dental health for the UK (rho=0.29), USA (rho=0.30) and Australian-based estimates (rho=0.30), and correlations with global general health were the same (rho=0.42) for the UK, USA and Australian-based estimates. EQ-5D exhibited equivalent discriminative validity and convergent validity in relation to oral health variables for the UK, USA and Australian-based estimates.

Testing mapping algorithms of the cancer-specific EORTC QLQ-C30 onto EQ-5D in malignant mesothelioma

NARCIS (Netherlands)

D.T. Arnold (David); D. Rowen (Donna); M.M. Versteegh (Matthijs); A. Morley (Anna); C.E. Hooper (Clare); N.A. Maskell (Nicholas)

2015-01-01

markdownabstract__Background:__ In order to estimate utilities for cancer studies where the EQ-5D was not used, the EORTC QLQ-C30 can be used to estimate EQ-5D using existing mapping algorithms. Several mapping algorithms exist for this transformation, however, algorithms tend to lose accuracy in

Experience-based VAS values for EQ-5D-3L health states in a national general population health survey in China.

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Sun, Sun; Chen, Jiaying; Kind, Paul; Xu, Ling; Zhang, Yaoguang; Burström, Kristina

2015-03-01

To investigate the feasibility of deriving experience-based visual analogue scale (VAS) values for EQ-5D-3L health states using national general population health survey data in China. The EQ-5D-3L was included in the National Health Services Survey (n = 120,709, aged 15-103 years) to measure health-related quality of life. The respondents reported their current health status on a VAS and completed the EQ-5D-3L questionnaire, enabling modelling of the association between the experience-based VAS values and self-reported problems on EQ-5D dimensions and severity levels. VAS values were generally negatively associated with problems reported on the EQ-5D dimensions, and the anxiety/depression dimension had the greatest impact on VAS values. A previously obtained value for dead allowed the values for all 243 EQ-5D-3L health states to be transformed to the 0-1 scale (0 = dead, 1 = full health). This study presents the feasibility of deriving an experience-based VAS values for EQ-5D-3L health states in China. The analysis of these VAS data raises more fundamental issues concerning the universal nature of the classification system and the extent to which Chinese respondents utilise the same concepts of health as defined by this classification system.

Health-related quality of life effects of enzalutamide in patients with metastatic castration-resistant prostate cancer: an in-depth post hoc analysis of EQ-5D data from the PREVAIL trial.

Science.gov (United States)

Devlin, Nancy; Herdman, Michael; Pavesi, Marco; Phung, De; Naidoo, Shevani; Beer, Tomasz M; Tombal, Bertrand; Loriot, Yohann; Ivanescu, Cristina; Parli, Teresa; Balk, Mark; Holmstrom, Stefan

2017-06-23

The effect of enzalutamide on health-related quality of life (HRQoL) in the PREVAIL trial in chemotherapy-naïve men with metastatic castration-resistant prostate cancer was analyzed using the generic EQ-5D instrument. Patients received oral enzalutamide 160 mg/day (n = 872) or placebo (n = 845). EQ-5D index and EQ-5D visual analogue scale (EQ-5D VAS) scores were evaluated at baseline, week 13, and every 12 weeks until week 61 due to sample size reduction thereafter. Changes on individual dimensions were assessed, and Paretian Classification of Health Change (PCHC) and time-to-event analyses were conducted. With enzalutamide, EQ-5D index and EQ-5D VAS scores declined more slowly versus placebo and time to diverge from full health was prolonged. Average decline in EQ-5D index (-0.042 vs. -0.070; P < .0001) and EQ-5D VAS (-1.3 vs. -4.4; P < .0001) was significantly smaller with enzalutamide. There were significant (P < .05) between-group differences favoring enzalutamide in Pain/Discomfort to week 37, Anxiety/Depression at week 13, and Usual Activities at week 25, but no significant differences for Mobility and Self-care. The PCHC analysis showed more enzalutamide patients reporting improvement than placebo patients at weeks 13, 25, and 49 (all P < .05) and week 37 (P = .0512). Enzalutamide was superior (P ≤ .0003) to placebo for time to diverge from full health and time to first deterioration on Pain/Discomfort and Anxiety/Depression dimensions. This in-depth post hoc analysis showed that enzalutamide delayed HRQoL deterioration and had beneficial effects on several HRQoL domains, including Pain/Discomfort and the proportion of patients in full health, compared with placebo, and may help to support future analyses of this type. NCT01212991.

An exploration of differences between Japan and two European countries in the self-reporting and valuation of pain and discomfort on the EQ-5D.

Science.gov (United States)

Feng, Yan; Herdman, Mike; van Nooten, Floortje; Cleeland, Charles; Parkin, David; Ikeda, Shunya; Igarashi, Ataru; Devlin, Nancy J

2017-08-01

To investigate the systematic differences in the self-reporting and valuation of overall health and, in particular, pain/discomfort between three countries (England/UK, Japan, and Spain) on the EQ-5D. Existing datasets were used to explore differences in responses on the EQ-5D descriptive system between Japan (3L and 5L), the UK (3L), England (5L), and Spain (5L), particularly on the dimension of pain/discomfort. The role of different EQ dimensions in determining self-reported overall health scores for the EuroQol visual analog scale (EQ-VAS) was investigated using ordinary least squares regression. Time trade-off (TTO) results from Japanese and UK respondents for the EQ-5D-3L as well as Japanese and English respondents for the EQ-5D-5L were compared using t tests. For the EQ-5D-3L, a higher percentage of respondents in Japan than in the UK reported 'no pain/discomfort' (81.6 vs 67.0%, respectively); for the EQ-5D-5L, the proportions were 79.2% in Spain, 73.2% in Japan, and 63-64% in England, after adjusting for age differences in samples. The 'pain/discomfort' dimension had the largest impact on respondents' self-reported EQ-VAS only for EQ-5D-3L in Japan. Using the EQ-5D-3L, Japanese respondents were considerably less willing to trade off time to avoid pain/discomfort than the UK respondents; for example, moving from health state, 11121 (some problems with pain/discomfort) to 11131 (extreme pain/discomfort) represented a decrement of 0.65 on the observed TTO value in the UK compared with 0.15 in Japan. Using the EQ-5D-5L, Japanese respondents were also less willing to trade off time to avoid pain/discomfort than respondents in England; however, the difference in values was much smaller than that observed using EQ-5D-3L data. This study provides evidence of between-country differences in the self-reporting and valuation of health, including pain/discomfort, when using EQ-5D in general population samples. The results suggest a need for caution when comparing or

Quality of Life Evaluation of Cervical Cancer Inpatients Before and After Chemotherapy by Using the EQ-5D Questionnaire

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Suwendar

2017-03-01

Full Text Available The quality of life is one of success parameters of the treatment effort including chemotherapy in cancer patients. Cancer patients undergoing chemotherapy may experience changes in their quality of life. This study aimed to assess the quality of life of patients with cervical cancer in Indonesia using the EQ‑5D questionnaire pre and post-chemotherapy. The research was an analitycal non-experimental study according to the patient’s perspective using prospective data collection techniques. The research subjects were the patients who suffered from cervical cancer who were hospitalized in class 3 and fullfilled the inclusive requirement. The research was conducted in Dr. Hasan Sadikin Bandung general hospital, from June until December 2015. The study was conducted by the EQ-5D questionnaire. Futhermore, the percentage of the patients’ problems, EQ-5D index (utility and EQ-5D VAS were calculated. Utility and EQ-5D values was analysed statistically using Wilcoxon test (α=5% to determine if there were significant condition changes before and after chemotherapy. The results showed that after the first cycle of chemotherapy, the percentage of patients reporting problem is related to ability to walk/move and the usual activities problem increased, pain/discomfort and anxiety/depression problem decreased, while the self‑care problem did not change. After the first cycle of chemotherapy, the utility and EQ-5D values increased and showed significant improvement (T count value=2.0 and 4.5 respectively in patients with stage I.

Development of the web-based Spanish and Catalan versions of the Euroqol 5D-Y (EQ-5D-Y) and comparison of results with the paper version.

Science.gov (United States)

Robles, Noemí; Rajmil, Luis; Rodriguez-Arjona, Dolors; Azuara, Marta; Codina, Francisco; Raat, Hein; Ravens-Sieberer, Ulrike; Herdman, Michael

2015-06-03

The objectives of the study were to develop web-based Spanish and Catalan versions of the EQ-5D-Y, and to compare scores and psychometric properties with the paper version. Web-based and paper versions of EQ-5D-Y were included in a cross-sectional study in Palafolls (Barcelona), Spain and administered to students (n = 923) aged 8 to 18 years from 2 primary and 1 secondary school and their parents. All students completed both the web-based and paper versions during school time with an interval of at least 2 h between administrations. The order of administration was randomized. Participants completed EQ-5D-Y, a measure of mental health status (the Strengths and Difficulties Questionnaire), and sociodemographic variables using a self-administered questionnaire. Parents questionnaire included parental level of education and presence of chronic conditions in children. Missing values, and floor and ceiling effects were compared between versions. Mean score differences were computed for the visual analogue scale (VAS). Percentage of agreement, kappa index (k) and intraclass correlation coefficient (ICC) were computed to analyze the level of agreement between web-based and paper versions on EQ-5D-Y dimensions and VAS. Known groups validity was analyzed and compared between the two formats. Participation rate was 77 % (n = 715). Both formats of EQ-5D-Y showed low percentages of missing values (n = 2, and 4 to 9 for web and paper versions respectively), and a high ceiling effect by dimension (range from 79 % to 96 %). Percent agreement for EQ-5D-Y dimensions on the web and paper versions was acceptable (range 89 % to 97 %), and k ranged from 0.55 (0.48-0.61, usual activities dimension) to 0.75 (0.68-0.82, mobility dimension). Mean score difference on the VAS was 0.07, and the ICC for VAS scores on the two formats was 0.84 (0.82-0.86). Both formats showed acceptable ability to discriminate according to self-perceived health, reporting chronic conditions, and

Quality of Life Assessment Using EuroQOL EQ-5D Questionnaire in Patients with Deep Infiltrating Endometriosis: The Relation with Symptoms and Locations

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Touboul, C.; Amate, P.; Ballester, M.; Bazot, M.; Fauconnier, A.; Daraï, E.

2013-01-01

The objective of this study was to evaluate the quality of life (QOL) of patients with deep infiltrating endometriosis (DIE) using EuroQOL (EQ-5D) and its correlation with symptoms and locations of endometriotic lesions. One hundred and fifty-nine patients referred for DIE from January 2011 to April 2011 were prospectively invited to complete questionnaires evaluating symptoms associated with endometriosis as well as the EQ-5D questionnaire and health state. Patients also had locations of DIE evaluated by clinical examination and magnetic resonance imaging (MRI). All 159 patients completed the questionnaires. Item response rate was 91.1%. The most intense symptoms were dysmenorrhea (7.1/10), painful defecation (6.3/10), and fatigue (6.0/10). Mean (SD) scores were 77 (14) for the EQ-5D questionnaire and 63.4 (21) for the health state. A relation was observed between the EQ-5D questionnaire and the presence of dysmenorrhea, dyspareunia, cyclic pelvic pain, painful defecation, and diarrhea or constipation. Vaginal and rectal infiltrations were significantly associated with altered EQ-5D and health state scores. The EQ-5D questionnaire is easy to complete and well related to symptoms of DIE. Rectal and vaginal infiltrations were found to be determinant factors of altered QOL by the EQ-5D questionnaire and health state. PMID:26464845

A systematic literature review to compare quality of life in psoriasis with other chronic diseases using EQ-5D-derived utility values

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Møller AH

2015-07-01

Full Text Available Anders Holmen Møller,1 Sandra Erntoft,1 Gabrielle R Vinding,2 Gregor BE Jemec21LEO Pharma A/S, Ballerup, Denmark; 2Department of Dermatology, Roskilde Hospital, Health Sciences Faculty, University of Copenhagen, Copenhagen, DenmarkBackground: Psoriasis is a chronic, immune-mediated dermatological disease associated with substantial economic, clinical, and humanistic burden.Objective: The aim of this study was to understand the disutility of patients with psoriasis vulgaris, using mean baseline EuroQoL five dimensions (EQ-5D index scores reported in the published literature, and to compare this to patients with other chronic diseases.Methods: Two systematic literature searches were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA guidelines. Searches were conducted in ten databases including Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials (CENTRAL. The first search (December 2013 used search terms psoria* AND (EQ5D OR EQ OR EUROQoL. Only publications of original research, which reported baseline EQ-5D scores for mild/moderate/severe psoriasis, were included. The second search (March 2014 used the terms (systematic review AND (EQ5D OR EQ 5D OR EuroQoL. Titles were screened by two independent reviewers. Four independent reviewers reviewed titles and full-length papers. EQ-5D scores for psoriasis patients were qualitatively compared with scores from patients with other chronic diseases identified through the literature search.Results: Of 133 publications on psoriasis, 12 met the inclusion criteria. The mean EQ-5D index scores for psoriasis (all severities ranged from 0.52 (standard deviation: 0.39 to 0.9 (standard deviation: 0.1. Of the 48 results from the second search, six met the inclusion criteria. The reported EQ-5D lower limit for other diseases ranged from 0.20 (Type 2 diabetes mellitus to 0.66 (liver diseases. The highest EQ-5D estimates for other diseases ranged

Does the EQ-5D capture the effects of physical and mental health status on life satisfaction among older people? A path analysis approach.

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Sexton, Eithne; Bennett, Kathleen; Fahey, Tom; Cahir, Caitriona

2017-05-01

To examine the extent to which EQ-5D utility scores capture the effect of mental and physical health status on life satisfaction (LS) in older adults. Retrospective cohort study of 884 patients aged ≥70 years from 15 general practices in Ireland, including medical records, pharmacy claims, and self-completion questionnaire. Path analysis was used to evaluate the direct and indirect effects of: (1) chronic disease burden (based on medications data); (2) activity limitation (basic and instrumental activities of daily living); (3) anxiety symptoms and; (4) depressive symptoms (Hospital Anxiety and Depression Scale) on LS (Life Satisfaction Index Z), via a utility score based on responses to the EQ-5D scale. Utility scores were calculated using UK time trade-off utility weights. Covariates included age and socioeconomic status. The final path model fitted the data well (goodness of fit χ 2  = 7.5, df (7), p = 0.37). The direct effects of chronic disease burden and disability on LS were not statistically significant and were excluded from the final model, indicating that EQ-5D score mediated 100% of the total effect on LS. The direct and indirect effects of anxiety and depression on LS were statistically significant, but the size of the indirect effect was small (4% of the total effect for anxiety and 6% of the total effect for depression). The EQ-5D does not adequately capture the effects of anxiety and depression on LS among older adults, suggesting that it may lead to inaccurate assessments of the effectiveness of interventions in this cohort.

Adverse Selection in Community Based Health Insurance among Informal Workers in Bangladesh: An EQ-5D Assessment

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Sayem Ahmed

2018-01-01

Full Text Available Community-based Health Insurance (CBHI schemes are recommended for providing financial risk protection to low-income informal workers in Bangladesh. We assessed the problem of adverse selection in a pilot CBHI scheme in this context. In total, 1292 (646 insured and 646 uninsured respondents were surveyed using the Bengali version of the EuroQuol-5 dimensions (EQ-5D questionnaire for assessing their health status. The EQ-5D scores were estimated using available regional tariffs. Multiple logistic regression was applied for predicting the association between health status and CBHI scheme enrolment. A higher number of insured reported problems in mobility (7.3%; p = 0.002; self-care (7.1%; p = 0.000 and pain and discomfort (7.7%; p = 0.005 than uninsured. The average EQ-5D score was significantly lower among the insured (0.704 compared to the uninsured (0.749. The regression analysis showed that those who had a problem in mobility (m 1.25–2.17; self-care (OR = 2.29; 95% CI: 1.62–3.25 and pain and discomfort (OR = 1.43; 95% CI: 1.13–1.81 were more likely to join the scheme. Individuals with higher EQ-5D scores (OR = 0.46; 95% CI: 0.31–0.69 were less likely to enroll in the scheme. Given that adverse selection was evident in the pilot CBHI scheme, there should be consideration of this problem when planning scale-up of these kind of schemes.

Health-related quality of life: validity, reliability, and responsiveness of SF-36, 15D, EQ-5D RAQoL, and HAQ in patients with rheumatoid arthritis

DEFF Research Database (Denmark)

Linde, L.; Sørensen, J.; Østergaard, Morten

2008-01-01

OBJECTIVE: To compare validity, reliability, and responsiveness of generic and disease specific health-related quality of life (HRQOL) instruments in rheumatoid arthritis (RA). METHODS: Two samples of patients completed the Medical Outcomes Study Short Form-36 Health Survey (SF-36), EuroQol (EQ)-5D...... and VAS pain were responsive to both improvement and deterioration. CONCLUSION: All instruments were valid measures for HRQOL in RA. The RAQoL and HAQ displayed the best reliability, while the SF-36 bodily pain scale and VAS pain were the most responsive. The choice of instrument should depend......, 15D, Rheumatoid Arthritis Quality of Life Scale (RAQoL), Health Assessment Questionnaire (HAQ), and visual analog scales (VAS) for pain, fatigue, and global RA. Validity (convergent, discriminant, and known-groups) was evaluated in a cross-section of 200 patients. Reliability was evaluated...

Comparing the standard EQ-5D three-level system with a five-level version

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Janssen, Mathieu F.; Birnie, Erwin; Haagsma, Juanita A.; Bonsel, Gouke J.

2008-01-01

OBJECTIVES: The aim of this study is a head-to-head comparison of the performance of the three-level EQ-5D (3L) and a newly developed five-level version (5L). METHODS: Eighty-two respondents valued 15 standardized disease descriptions and their own health on three response scales (3L, 5L, and visual

Assessment of the Swedish EQ-5D experience-based value sets in a total hip replacement population.

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Nemes, Szilárd; Burström, Kristina; Zethraeus, Niklas; Eneqvist, Ted; Garellick, Göran; Rolfson, Ola

2015-12-01

All patients undergoing elective total hip replacement (THR) in Sweden are asked to complete a survey, including the EQ-5D. Thus far, EQ-5D values have been presented using the UK TTO value set based on hypothetical values. Shift to the use of the recently introduced Swedish experience-based value set, derived from a representative Swedish population, is an appealing alternative. To investigate how accurate the Swedish experience-based VAS value set predicts observed EQ VAS values and to compare correlations between Swedish and UK value sets including two provisional value sets derived from the THR population. Pre- and one-year postoperative data from 56,062 THR patients from the Swedish Hip Arthroplasty Register were used. Agreement between the observed and the predicted EQ VAS values was assessed with correlation. Based on pre- and postoperative data, we constructed two provisional VAS value sets. Correlations between observed and calculated values using the Swedish VAS value set were moderate (r = 0.46) in preoperative data and high (r = 0.72) in postoperative data. Correlations between UK and register-based value sets were constantly lower compared to Swedish value sets. Register-based values and Swedish values were highly correlated. The Swedish value sets are more accurate in terms of representation of the Swedish THR patients than the currently used UK TTO value set. We find it feasible to use the experience-based Swedish value sets for further presentation of EQ-5D values in the Swedish THR population.

Usefulness of EQ-5D in Assessing Health Status in Primary Care Patients with Major Depressive Disorder

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Nowicki Marie-Laure

2004-05-01

Full Text Available Abstract Objectives Major depressive disorder (MDD is a prevalent psychiatric disorder associated with impaired patient functioning and reductions in health-related quality of life (HRQL. The present study describes the impact of MDD on patients' HRQL and examines preference-based health state differences by patient features and clinical characteristics. Methods 95 French primary care practitioners recruited 250 patients with a DSM-IV diagnosis of MDD for inclusion in an eight-week follow-up cohort. Patient assessments included the Montgomery Asberg Depression Rating Scale (MADRS, the Clinical Global Impression of Severity (CGI, the Short Form-36 Item scale (SF-36, the Quality of Life Depression Scale (QLDS and the EuroQoL (EQ-5D. Results The mean EQ-5D utility at baseline was 0.33, and 8% of patients rated their health state as worse than death. There were no statistically significant differences in utilities by demographic features. Significant differences were found in mean utilities by level of disease severity assessed by CGI. The different clinical response profiles, assessed by MADRS, were also revealed by EQ-5D at endpoint: 0.85 for responders remitters, 0.72 for responders non-remitter, and 0.58 for non-responders. Even if HRQL and EQ-5D were moderately correlated, they shared only 40% of variance between baseline and endpoint. Conclusions Self-reported patient valuations for depression are important patient-reported outcomes for cost-effectiveness evaluations of new antidepressant compounds and help in further understanding patient compliance with antidepressant treatment.

Diabetes and quality of life: Comparing results from utility instruments and Diabetes-39.

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Chen, Gang; Iezzi, Angelo; McKie, John; Khan, Munir A; Richardson, Jeff

2015-08-01

To compare the Diabetes-39 (D-39) with six multi-attribute utility (MAU) instruments (15D, AQoL-8D, EQ-5D, HUI3, QWB, and SF-6D), and to develop mapping algorithms which could be used to transform the D-39 scores into the MAU scores. Self-reported diabetes sufferers (N=924) and members of the healthy public (N=1760), aged 18 years and over, were recruited from 6 countries (Australia 18%, USA 18%, UK 17%, Canada 16%, Norway 16%, and Germany 15%). Apart from the QWB which was distributed normally, non-parametric rank tests were used to compare subgroup utilities and D-39 scores. Mapping algorithms were estimated using ordinary least squares (OLS) and generalised linear models (GLM). MAU instruments discriminated between diabetes patients and the healthy public; however, utilities varied between instruments. The 15D, SF-6D, AQoL-8D had the strongest correlations with the D-39. Except for the HUI3, there were significant differences by gender. Mapping algorithms based on the OLS estimator consistently gave better goodness-of-fit results. The mean absolute error (MAE) values ranged from 0.061 to 0.147, the root mean square error (RMSE) values 0.083 to 0.198, and the R-square statistics 0.428 and 0.610. Based on MAE and RMSE values the preferred mapping is D-39 into 15D. R-square statistics and the range of predicted utilities indicate the preferred mapping is D-39 into AQoL-8D. Utilities estimated from different MAU instruments differ significantly and the outcome of a study could depend upon the instrument used. The algorithms reported in this paper enable D-39 data to be mapped into utilities predicted from any of six instruments. This provides choice for those conducting cost-utility analyses. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Multinational consistency of a discrete choice model in quantifying health states for the extended 5-level EQ-5D

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Krabbe, P.F.M.; Devlin, N.J.; Stolk, E.A.; Shah, K.K.; Oppe, M.; Van Hout, B.; Quik, E.H.; Pickard, A.S.; Xie, F.

2013-01-01

Objectives: To investigate the feasibility of choice experiments for EQ-5D-5L states using computer-based data collection, and to examine the consistency of the estimated parameters values derived after modeling the stated preference data across countries in a multinational study. Methods: Similar

Level of agreement between patient and proxy responses to the EQ-5D health questionnaire 12 months after injury.

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Gabbe, Belinda J; Lyons, Ronan A; Sutherland, Ann M; Hart, Melissa J; Cameron, Peter A

2012-04-01

Health-related quality of life represents a patient's experiences and expectations and should be collected from the patient. In trauma, collection of information from the patient can be challenging, particularly for subgroups where cognitive impairment is prevalent, increasing reliance on proxy reporting. This study assessed the agreement between patient and proxy reporting of health-related quality of life 12 months after injury. The Victorian State Trauma Registry and Victorian Orthopaedic Trauma Outcomes Registry collect EQ-5D data at 12 months after injury. Cases where data were collected from the patient and proxy were extracted. Agreement between patient and proxy responses was compared using kappa (K) coefficients for the individual EQ-5D items, and Bland-Altman plots and Wilcoxon signed-rank tests for the EQ-5D summary score and visual analog scale (VAS). Agreement between patient and proxy respondents was substantial for the mobility (K = 0.61) and personal care items (K = 0.67) and moderate for the usual activities (K = 0.50), pain/discomfort (K = 0.42), and anxiety/depression items (K = 0.47). The mean difference between proxy and patient-reported scores for the VAS (0.74, 95% confidence interval: -2.73, 4.21) and the EQ-5D summary score (-0.02, 95% confidence interval: -0.07, 0.03) was small, but the limits of agreement were wide (-34.22 to 35.71 for VAS and -0.55 to 0.51 for summary score), suggesting no systematic bias. Although proxy and patient responses for the EQ-5D VAS may differ, the differences show random variability rather than systematic bias. Group comparisons using proxy responses are unlikely to be biased, but proxy responses should be used with caution when assessing individual patient recovery.

Inequalities in health status among rural residents: EQ-5D findings from household survey China.

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Li, Haitao; Wei, Xiaolin; Ma, Aixia; Chung, Roger Y

2014-05-19

This study analyzed inequalities in health status among different socioeconomic and demographic rural residents covered by the New Rural Cooperative Medical System in China. A cross-sectional study was conducted in Lian Yungang City, China. A total of 337 respondents, who were selected by using a multistage stratified systematic random sampling method, completed the surveys. A questionnaire consisting of EQ-5D and demographic and socioeconomic information was adopted for data collection, and was administered by face-to-face interviews. Multiple regression models were employed to examine the differences in the Visual Analogue Scale (VAS) score and the EQ-5D dimensions. Compared with those with lower education attainment, the respondents with higher education levels tended to report a higher VAS score (β = 2.666, 95% CI: 0.978 to 6.310), and were less likely to suffer from pain/discomfort (OR = 3.968; 95% CI: 1.447 to 10.880). The singles were more likely than the married to report moderate or extreme problems in usual activities (OR = 4.583; 95% CI: 1.188 to 17.676) and mobility (OR = 10.666; 95% CI: 2.464 to 6.171). However, no statistically significant differences were identified between the respondents with different income levels in the VAS score and EQ-5D dimensions. This study suggests that the singles and the people with lower education levels are high-risk groups for poorer health status in the Chinese rural population. The findings from this study warrant further investigation.

The time to trade-off method versus the EQ-5D index to determine health utility in patients with rheumatoid arthritis

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Dmitriy Vladimirovich Goryachev

2010-01-01

The values of the utility index calculated by TTO failed to correlate with those of HAQ and EQ-5D. The disease duration was unrelated to the values of the utility index calculated by any of the methods used. The association of TTO index was found only for VAS-GH "thermometer". Conclusion. EQ-5D index and VAS-GH are the methods of choice in determining health utility for a clinicoeconomic analysis in patients with RA.

Do country-specific preference weights matter in the choice of mapping algorithms? The case of mapping the Diabetes-39 onto eight country-specific EQ-5D-5L value sets.

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Lamu, Admassu N; Chen, Gang; Gamst-Klaussen, Thor; Olsen, Jan Abel

2018-03-22

To develop mapping algorithms that transform Diabetes-39 (D-39) scores onto EQ-5D-5L utility values for each of eight recently published country-specific EQ-5D-5L value sets, and to compare mapping functions across the EQ-5D-5L value sets. Data include 924 individuals with self-reported diabetes from six countries. The D-39 dimensions, age and gender were used as potential predictors for EQ-5D-5L utilities, which were scored using value sets from eight countries (England, Netherland, Spain, Canada, Uruguay, China, Japan and Korea). Ordinary least squares, generalised linear model, beta binomial regression, fractional regression, MM estimation and censored least absolute deviation were used to estimate the mapping algorithms. The optimal algorithm for each country-specific value set was primarily selected based on normalised root mean square error (NRMSE), normalised mean absolute error (NMAE) and adjusted-r 2 . Cross-validation with fivefold approach was conducted to test the generalizability of each model. The fractional regression model with loglog as a link function consistently performed best in all country-specific value sets. For instance, the NRMSE (0.1282) and NMAE (0.0914) were the lowest, while adjusted-r 2 was the highest (52.5%) when the English value set was considered. Among D-39 dimensions, the energy and mobility was the only one that was consistently significant for all models. The D-39 can be mapped onto the EQ-5D-5L utilities with good predictive accuracy. The fractional regression model, which is appropriate for handling bounded outcomes, outperformed other candidate methods in all country-specific value sets. However, the regression coefficients differed reflecting preference heterogeneity across countries.

Health utility scores from EQ-5D and health-related quality of life in patients with esophageal cancer: a real-world cross-sectional study.

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Doherty, M K; Leung, Y; Su, J; Naik, H; Patel, D; Eng, L; Kong, Q Q; Mohsin, F; Brown, M C; Espin-Garcia, O; Vennettilli, A; Renouf, D J; Faluyi, O O; Knox, J J; MacKay, H; Wong, R; Howell, D; Mittmann, N; Darling, G E; Cella, D; Xu, W; Liu, G

2018-06-14

Esophageal cancer and its treatment can cause serious morbidity/toxicity. These effects on health-related quality of life (HRQOL) can be measured using disease-specific scales such as FACT-E, generic scales such as EQ-5D-3L, or through symptoms. In a two-year cross-sectional study, we compared HRQOL across esophageal cancer patients treated in an ambulatory clinic and across multiple disease states, among patients with all stages of esophageal cancer. Consenting patients completed FACT-E, EQ-5D, a visual analog scale, and patient reported (PR)-ECOG. Symptom complexes were constructed from FACT-E domains. Responses were categorized by disease state: pre-, during, and post-treatment, surveillance, progression, and palliative chemotherapy. Spearman correlation and multivariable linear regression characterized these associations. In total, 199 patients completed 317 questionnaires. Mean FACT-E and subscale scores dropped from baseline through treatment and recovered during post-treatment surveillance (P < 0.001); EQ-5D health utility scores (HUS) displayed a similar pattern but with smaller differences (P = 0.07), and with evidence of ceiling effect. Among patients with stage II/III esophageal cancer, mean EQ-5D HUS varied across disease states (P < 0.001), along with FACT-E and subscales (P < 0.001). Among patients with advanced disease, there was no significant difference between baseline and on-treatment total scores, but improved esophageal cancer-specific scales were noted (P = 0.003). Strong correlation was observed between EQ-5D and FACT-E (R = 0.73), along with physical and functional subscales. In addition, the association between FACT-E and EQ-5D HUS was maintained in a multivariable model (P < 0.001). We interpret these results to suggest that in a real-world clinic setting, FACT-E, EQ-5D HUS, and symptoms were strongly correlated. Most HRQOL and symptom parameters suggested that patients had worse HRQOL and symptoms during curative therapy

The level of physical exercise is associated with self-reported health status (EQ-5D) in adults with congenital heart disease.

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Sandberg, Camilla; Engström, Karl Gunnar; Dellborg, Mikael; Thilén, Ulf; Wadell, Karin; Johansson, Bengt

2015-02-01

The prognosis in adults with congenital aortic valve disease is usually favourable; nevertheless, a number of medical and social factors might hamper long-term prognosis and quality of life. With a focus on physical exercise level, data from the Swedish National Registry on Congenital Heart Disease (SWEDCON) were analysed and variables associated with health-related quality of life in adults with congenital aortic valve disease were identified. In this registry study, SWEDCON was searched for adult patients with isolated congenital aortic valve disease and valid EuroQol-5Dimensions health questionnaire (EQ-5D) data. This study identified 315 patients. The majority (n = 202, 64%) reported best possible health status (EQ-5D(index) = 1) whereas 113 (35%) reported some impairment (EQ-5D(index)  3 h/week was independently associated with best possible health status (EQ-5D(index) = 1; p = 0.013). Moreover presence of cardiovascular symptoms (p 3 h/week was, as a single variable, associated with best possible health status in adults with congenital aortic valve disease. In contrast, a number of medical and social factors are associated with worse self-reported health status. Among these, symptoms, smoking, and educational level are potential targets for modification and intervention. There is a need for studies investigating the effect of increased level of physical exercise in patients with congenital aortic valve disease. © The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

The use of the EQ-5D-Y health related quality of life outcome measure in children in the Western Cape, South Africa: psychometric properties, feasibility and usefulness - a longitudinal, analytical study.

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Scott, Des; Ferguson, Gillian D; Jelsma, Jennifer

2017-01-19

The EQ-5D-Y, an outcome measure of Health Related Quality of Life (HRQoL) in children, was developed by an international task team in 2010. The multinational feasibility, reliability and validity study which followed was undertaken with mainly healthy children. The aim of this study was to investigate the psychometric properties of the EQ-5D-Y when used to assess the HRQoL of children with different health states. A sample of 224 children between eight and twelve years were grouped according to their health state. The groups included 52 acutely ill children, 67 children with either a chronic health condition or disability and 105 mostly healthy, mainstream school children as a comparator. They were assessed at baseline, at three months and at six months. An analysis of the psychometric properties was performed to assess the reliability, validity and responsiveness of the EQ-5D-Y in the different groups of children. Cohen's kappa, the intraclass correlation coefficient, Pearson Chi-square, Kruskal-Wallis ANOVA and effect size of Wilcoxon Signed-rank test were used to determine the reliability, validity and responsiveness of the instrument. The EQ-5D-Y dimensions were found to be reliable on test-retest (kappa varying from 0.365 to 0.653), except for the Usual Activities dimension (kappa 0.199). The Visual Analogue Scale (VAS) was also reliable (ICC = 0.77). Post-hoc analysis indicated that dimensions were able to discriminate between acutely ill and healthy children (all differences p Wilcoxon Signed-rank test for VAS was 0.43). Six of the nine therapists who took part in the study, found the measure quick and easy to apply, used the information in the management of the child and would continue to use it in future. The EQ-5D-Y could be used with confidence as an outcome measure for acutely-ill children, but demonstrated poorer psychometric properties in children with no health condition or chronic conditions. It appears to be feasible and useful to include the

Associations between community-based physiotherapy for musculoskeletal injury and health related quality of life (EQ-5D): a multi-centre retrospective analysis.

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Caplan, Nick; Robson, H; Robson, A; Barry, G; Wilkes, G

2017-10-25

Community-based musculoskeletal physiotherapy is used to improve function and health related quality of life (HRQoL). The purpose of this retrospective, multi-centre observational study was to determine the association between community-based physiotherapy management for musculoskeletal disorders and changes in HRQoL. Four thousand one hundred twelve patients' data were included in the study. Patients were included if they received a single period of treatment for a musculoskeletal injury or disorder. Patients were only included if they were being treated for a single morbidity. Patients received standard physiotherapy appropriate to their specific disorder, which could include health education/advice, exercise therapy, manual therapy, taping, soft tissue techniques, electrotherapy and/or acupuncture. Health related quality of life was assessed using the EQ-5D index. EQ-5D improved by 0.203 across all patients (d = 1.10). When grouped by anatomical site of symptom, the largest increases in EQ-5D was in foot pain (0.233; d = 1.29) and lumbar pain (0.231; d = 1.13). Improvements in EQ-5D greater than the minimum clinically important difference (MCID) were seen in 68.4% of all patients. The highest proportion of patients with positive responses to treatment were in ankle pain (74.2%) and thoracic pain (73.4%). The hand (40.5%), elbow (34.7%), and hip (33.9%) showed the greatest proportion of patients that did not respond to treatment. Community-based musculoskeletal physiotherapy is associated with improved health related quality of life. A randomised controlled trial is needed to determine any causal relationship between community-based physiotherapy and health related quality of life improvements.

Hui Wei | NREL

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Hui Wei Photo of Hui Wei Hui Wei Researcher IV-Molecular Biology Hui.Wei@nrel.gov | 303-384-6620 consortia system. Additional Publications "In Situ Micro-Spectroscopic Investigation of Lignin in Molecular Biology (2012) "Tracking Dynamics of Biomass Composting by Monitoring the Changes in

Comparación de las escalas EQ-5D y FACT-G en la evaluación de la calidad de vida en pacientes colombianos con cáncer

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Juliet Valdelamar Jiménez

2015-08-01

Full Text Available Objective: To evaluate patterns of correlations between the different dimensions of a scale measuring quality of life (FACT-G and one that measures perceived health and quality of life (EQ-5D in cancer patients. Methods: A descriptive study that evaluated 114 patients with confirmed cancer of breast (40=35.09%, gastric (26=22.8%, prostate (22=19.3%, colon-rectal (17=14.91%. Diagnosis was made at the National Cancer Institute of Colombia, to whom applied the FACT-G and EQ-5D scale. Descriptive analyses were used to summarize the variables, methods of multivariate analysis, factor analysis and multidimensional scaling were used to assess patterns of correlation between the variables of each of the two scales used. Results: The dimensions that showed acceptable correlation values were physical well-being and emotional well-being of the FACT- G with anxiety and depression of the EQ- 5D scale. Factor analysis yielded two factors: (a anxiety / depression or the EQ-5D is better grouped with the components of the FACT- G, and (b physical symptoms of FACT-G with the components of the EQ-5D. Multidimensional scaling analysis suggested that each scale measured different dimensions of the construct quality of life. Conclusion: The FACT-G is oriented to emotional and social interaction, while the EQ-5D is oriented to aspects of physical and functionality.

Mapping the EORTC QLQ-C30 onto the EQ-5D-3L: assessing the external validity of existing mapping algorithms.

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Doble, Brett; Lorgelly, Paula

2016-04-01

To determine the external validity of existing mapping algorithms for predicting EQ-5D-3L utility values from EORTC QLQ-C30 responses and to establish their generalizability in different types of cancer. A main analysis (pooled) sample of 3560 observations (1727 patients) and two disease severity patient samples (496 and 93 patients) with repeated observations over time from Cancer 2015 were used to validate the existing algorithms. Errors were calculated between observed and predicted EQ-5D-3L utility values using a single pooled sample and ten pooled tumour type-specific samples. Predictive accuracy was assessed using mean absolute error (MAE) and standardized root-mean-squared error (RMSE). The association between observed and predicted EQ-5D utility values and other covariates across the distribution was tested using quantile regression. Quality-adjusted life years (QALYs) were calculated using observed and predicted values to test responsiveness. Ten 'preferred' mapping algorithms were identified. Two algorithms estimated via response mapping and ordinary least-squares regression using dummy variables performed well on number of validation criteria, including accurate prediction of the best and worst QLQ-C30 health states, predicted values within the EQ-5D tariff range, relatively small MAEs and RMSEs, and minimal differences between estimated QALYs. Comparison of predictive accuracy across ten tumour type-specific samples highlighted that algorithms are relatively insensitive to grouping by tumour type and affected more by differences in disease severity. Two of the 'preferred' mapping algorithms suggest more accurate predictions, but limitations exist. We recommend extensive scenario analyses if mapped utilities are used in cost-utility analyses.

Estimation of minimal clinically important change of the Japanese version of EQ-5D in patients with chronic noncancer pain: a retrospective research using real-world data.

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Yoshizawa, Kazutake; Kobayashi, Hisanori; Fujie, Motoko; Ogawa, Yoshimasa; Yajima, Tsutomu; Kawai, Koji

2016-03-01

Quality of life (QoL) is routinely assessed and evaluated in medical research. However, in Japan, there is a lack of solid cutoff criteria for evaluating QoL improvement in chronic noncancer pain management. The present study was conducted to identify the minimal clinically important change (MCIC) of the Japanese version of EuroQol-5D 3L(EQ-5D) utility score and numeric rating scale (NRS) with an emphasis on chronic noncancer pain. The data source for this post hoc research was the post-marketing surveillance (PMS) data for a tramadol/acetaminophen combination tablet, which was previously conducted in real-world settings. The parameters extracted from the PMS data were sociodemographic characteristics, NRS, EQ-5D, and dichotomous physician's global impression of treatment effectiveness (PGI). The optimal cutoff points of MCIC for EQ-5D utility and NRS scores were evaluated using receiver operating characteristics (ROC) analysis. An anchor-based approach using PGI was applied. Data of 710 patients with chronic noncancer pain were extracted from the PMS database. The NRS score decreased by 2.7 (standard deviation, 2.3) points, whereas the EQ-5D score increased by 0.16 (0.20) points at 4 weeks from baseline. The changes from baseline in NRS and EQ-5D were significantly correlated (r = 0.53, p 0.80 in both analyses. These results demonstrated novel cutoff criteria for the Japanese version of EQ-5D, focusing on patients with chronic noncancer pain. The obtained criteria were fairly consistent and can be confidently utilized as an evaluation tool in medical research on chronic noncancer pain in Japan, with additional functionality and usability for QoL assessment in pain management practice. The data source of this post hoc research was a PMS study with the identifier number UMIN000015901 at umin.ac.jp, UMIN clinical trial registry (UMIN-CTR).

The impact of differences between patient and general population EQ-5D-3L values on the mean tariff scores of different patient groups.

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Little, Matthew H R; Reitmeir, Peter; Peters, Annette; Leidl, Reiner

2014-06-01

Health states can be valued by those who currently experience a health state (experienced health states [EHS]) or by the general public, who value a set of given health states (GHS) described to them. There has been debate over which method is more appropriate when making resource allocation decisions. This article informs this debate by assessing whether differences between these methods have an effect on the mean EQ-5D-3L tariff scores of different patient groups. The European tariff based on GHS valuations was compared with a German EHS tariff. Comparison was made in the context of EQ-5D-3L health states describing a number of diagnosed chronic diseases (stroke, diabetes, myocardial infarction, and cancer) taken from the Cooperative Health Research in the Augsburg Region population surveys. Comparison was made of both the difference in weighting of the dimensions of the EQ-5D-3L and differences in mean tariff scores for patient groups. Weighting of the dimensions of the EQ-5D-3L were found to be systematically different. The EHS tariff gave significantly lower mean scores for most, but not all, patient groups despite tariff scores being lower for 213 of 243 EQ-5D-3L health states using the GHS tariff. Differences were found to vary between groups, with the largest change in difference being 5.45 in the multiple stoke group. The two tariffs have systematic differences that in certain patient groups could drive the results of an economic evaluation. Therefore, the choice as to which is used may be critical when making resource allocation decisions. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

A cross-sectional assessment of health-related quality of life in Chinese patients with chronic hepatitis c virus infection with EQ-5D.

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Huang, Rui; Rao, Huiying; Shang, Jia; Chen, Hong; Li, Jun; Xie, Qing; Gao, Zhiliang; Wang, Lei; Wei, Jia; Jiang, Jianning; Sun, Jian; Jiang, Jiaji; Wei, Lai

2018-06-15

Hepatitis C virus (HCV) infection is one of the most common liver infections, with a decrement in HRQoL of HCV patients. This study aims to assess Health-related quality of life (HRQoL) in Chinese patients with chronic HCV infection, and to identify significant predictors of the HRQoL in these patients of China. In this cross-sectional observational study, treatment-naïve Han ethnic adults with chronic HCV infection were enrolled. Adopting European Quality of Life scale (EQ-5D) and EuroQOL visual analogue scale (EQ-VAS) were used to qualify HRQoL. Results were reported in descriptive analyses to describe sociodemographic and clinical characteristics. Multiple linear regression analysis was applied to investigate the associations of these variables with HRQoL. Binary logistic regression analysis was performed to identify associations of these variables with HRQoL by dimensions of EQ-5D. Nine hundred ninety-seven patients were enrolled in the study [median age 46.0 (37.0, 56.0) years; male 54.8%]. Mean EQ-5D index and EQ-VAS score were 0.780 ± 0.083 and 77.2 ± 14.8. Multiple Linear regression analysis showed that income (< 2000 RMB, β = - 0.134; 2000-4999 RMB, β = - 0.085), moderate or severe symptoms of discomfort (more than one symptoms, β = - 0.090), disease profile (cirrhosis, β = - 0.114), hyperlipidemia (β = - 0.065) and depression (β = - 0.065) were independently associated with EQ-5D index. Residence (the west, β = 0.087), income (< 2000 RMB, β = - 0.129; 2000-4999 RMB, β = - 0.052), moderate or severe symptoms of discomfort (more than one symptoms, β = - 0.091), disease profile and depression (β = - 0.316) were the influencing factors on EQ-VAS. Binary logistic regression indicated that disease profile and clinical depression were the major influencing factors on all five dimensions of EQ-5D. In this cross-sectional assessment of HCV patients in China, we indicated HRQo

Investigating Differences in Health-Related Quality of Life of Greeks and Albanian Immigrants with the Generic EQ-5D Questionnaire

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Eleni Lahana

2013-01-01

Full Text Available Background. Low socioeconomic status (SES has been related by previous studies to low self-perceived HRQoL. Health is a major determinant of the society’s welfare, and few studies have determined the relevant elements that contribute to health and quality of life in Greece. Aim. The aim of the study was to evaluate and test for differences in HRQoL of Greek and Albanian immigrant population according to ethnicity and their demographic and SES characteristics. Methods. The study was conducted in a sample of 660 age-matched and gender-matched Greeks and Albanian immigrants. Moderate or severe decrease in HRQoL was assessed with the generic tool EQ-5D. Differences were statistically analyzed by t-test and ANOVA. Also, logistic and linear regression analyses were conducted for the dependent variables of the EQ-5D dimensions and VAS scores, respectively. Results. The Albanian immigrants reported better self-perceived health than their Greek counterparts. Health problems increase moderately with age and lower SES and are slightly higher for women than for men. Urbanity and superior education in both Greeks and Albaniansareassociated with worse HRQoL. Conclusion. There are some structural and compositional differences in the self-perceived quality of life between the two ethnicities, as estimated by EQ-5D. The combined information presentstopublic health providers the relevant data to assess health policies according to health needs.

Standard error of measurement of five health utility indexes across the range of health for use in estimating reliability and responsiveness

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Palta, Mari; Chen, Han-Yang; Kaplan, Robert M.; Feeny, David; Cherepanov, Dasha; Fryback, Dennis

2011-01-01

Background Standard errors of measurement (SEMs) of health related quality of life (HRQoL) indexes are not well characterized. SEM is needed to estimate responsiveness statistics and provides guidance on using indexes on the individual and group level. SEM is also a component of reliability. Purpose To estimate SEM of five HRQoL indexes. Design The National Health Measurement Study (NHMS) was a population based telephone survey. The Clinical Outcomes and Measurement of Health Study (COMHS) provided repeated measures 1 and 6 months post cataract surgery. Subjects 3844 randomly selected adults from the non-institutionalized population 35 to 89 years old in the contiguous United States and 265 cataract patients. Measurements The SF6-36v2™, QWB-SA, EQ-5D, HUI2 and HUI3 were included. An item-response theory (IRT) approach captured joint variation in indexes into a composite construct of health (theta). We estimated: (1) the test-retest standard deviation (SEM-TR) from COMHS, (2) the structural standard deviation (SEM-S) around the composite construct from NHMS and (3) corresponding reliability coefficients. Results SEM-TR was 0.068 (SF-6D), 0.087 (QWB-SA), 0.093 (EQ-5D), 0.100 (HUI2) and 0.134 (HUI3), while SEM-S was 0.071, 0.094, 0.084, 0.074 and 0.117, respectively. These translate into reliability coefficients for SF-6D: 0.66 (COMHS) and 0.71 (NHMS), for QWB: 0.59 and 0.64, for EQ-5D: 0.61 and 0.70 for HUI2: 0.64 and 0.80, and for HUI3: 0.75 and 0.77, respectively. The SEM varied considerably across levels of health, especially for HUI2, HUI3 and EQ-5D, and was strongly influenced by ceiling effects. Limitations Repeated measures were five months apart and estimated theta contain measurement error. Conclusions The two types of SEM are similar and substantial for all the indexes, and vary across the range of health. PMID:20935280

Health-related quality of life (EQ-5D) among homeless persons compared to a general population sample in Stockholm County, 2006.

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Sun, Sun; Irestig, Robert; Burström, Bo; Beijer, Ulla; Burström, Kristina

2012-03-01

To describe and compare health-related quality of life (HRQoL) among homeless persons with a general population sample in Stockholm County, 2006, and to analyse the importance of certain social determinants of health among the homeless. Face-to-face interviews with 155 homeless persons and a postal survey to a general population sample, mainly based on the same questionnaire, including questions on social determinants of health and HRQoL measured with the EQ-5D. Chronic illness was three times more common among the homeless. HRQoL was worse among homeless persons than in the general population sample: the homeless reported more problems, especially more severe problems, in all the EQ-5D dimensions and had considerably lower EQ-5D(index) and EQ(VAS) score than the general population. Most problems were reported in the dimension anxiety/depression. Among the homeless, longer duration and more severe degree of homelessness lowered HRQoL, but few determinants were statistically significantly related to HRQoL. Having mental disease significantly lowered HRQoL. This study was an attempt to include hard-to-reach groups in an assessment of population health. Homeless persons had considerably worse HRQoL than the general population and reported most problems in the dimension anxiety/depression. Some diseases may contribute to causing homelessness; others may be seen as consequences. Homeless persons are a vulnerable group in society. Further interview studies are needed based on larger sample of homeless persons to explore health determinants such as sex, age, socioeconomic factors, duration and degree of homelessness, and health-related behaviours among the homeless persons.

INFLUENCIA DE LOS PROBLEMAS CRÓNICOS DE SALUD EN LAS DIMENSIONES DEL CUESTIONARIO EQ-5D: ESTUDIO EN PERSONAS MAYORES INSTITUCIONALIZADAS Y NO INSTITUCIONALIZADAS

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María Concepción Delgado-Sanz

2011-01-01

Full Text Available Fundamento: Las enfermedades crónicas representan factores de riesgo para la calidad de vida relacionada con la salud (CVRS. El objetivo de estudio es analizar la influencia de problemas crónicos de salud autodeclarados en la CVRS, medida a través de las dimensiones del EQ-5D, en personas mayores institucionalizada y no institucionalizada. Métodos: Los datos proceden de dos estudios sobre calidad de vida en personas con 60 o más años de edad, en España, con una muestra de 1.106 personas mayores viviendo en la comunidad, y 234 en centros residenciales. Para analizar la influencia de los problemas crónicos más prevalentes en la CVRS se ajustaron modelos de regresión logística tomando como variable dependiente cada dimensión del EQ-5D y controlando por variables sociodemográficas. Resultados: Los problemas crónicos de salud que influyeron negativamente en la CVRS de los dos grupos de población estudiados, fueron la depresión (rango de OR en las distintas dimensiones del EQ-5D:1,97-6,48, seguida de artrosis/artritis (OR:2,81-6,00, insomnio (OR:2,81-4,61, diabetes (OR:1,68-3,44 e hipertensión arterial (OR:1,42-2,45. Estos problemas afectaron de forma distinta a las dimensiones del EQ-5D y a los dos grupos considerados. Las dimensiones del EQ-5D en las que se observaron más dificultades fueron dolor/malestar y movilidad. Conclusiones: Los resultados de este trabajo indican que el carácter debilitante de las enfermedades crónicas sobre la CVRS es distinto en personas mayores institucionalizadas y no institucionalizadas. Además, destacan la importancia de la promoción de un envejecimiento saludable para atenuar el impacto negativo de los problemas crónicos de la salud sobre la población mayor.

Questioning the differences between general public vs. patient based preferences towards EQ-5D-5L defined hypothetical health states.

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Ogorevc, Marko; Murovec, Nika; Fernandez, Natacha Bolanos; Rupel, Valentina Prevolnik

2017-03-28

The purpose of this article is to explore whether any differences exist between the general population and patient based preferences towards EQ-5D-5L defined hypothetical health states. The article discusses the role of adaptation and self-interest in valuing health states and it also contributes rigorous empirical evidence to the scientific debate on the differences between the patient and general population preferences towards hypothetical health states. Patient preferences were elicited in 2015 with the EQ-5D-5L questionnaire using time trade-off and discrete choice experiment design and compared to the Spanish general population preferences, which were elicited using identical methods. Patients were chosen on a voluntary basis according to their willingness to participate in the survey. They were recruited from patient organisations and a hospital in Madrid, Spain. 282 metastatic breast cancer patients and 333 rheumatoid arthritis patients were included in the sample. The analysis revealed differences in preferences between the general population and patient groups. Based on the results of our analysis, it is suggested that the differences in preferences stem from patients being more able to accurately imagine "non-tangible" dimensions of health states (anxiety or depression, and pain or discomfort) than the general population with less experience in various health states. However, this does not mean that general public values should not be reflected in utilities derived for coverage decision making. Copyright © 2017 Elsevier B.V. All rights reserved.

Household income, income inequality, and health-related quality of life measured by the EQ-5D in Shaanxi, China: a cross-sectional study.

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Tan, Zhijun; Shi, Fuyan; Zhang, Haiyue; Li, Ning; Xu, Yongyong; Liang, Ying

2018-03-14

In advanced economies, economic factors have been found to be associated with many health outcomes, including health-related quality of life (HRQL), and people's health is affected more by income inequality than by absolute income. However, few studies have examined the association of income inequality and absolute income with HRQL in transitional economies using individual data. This paper focuses on the effects of county or district income inequality and absolute income on the HRQL measured by EQ-5D and the differences between rural and urban regions in Shaanxi province, China. Data were collected from the 2008 National Health Service Survey conducted in Shaanxi, China. The EQ-5D index based on Japanese weights was employed as a health indicator. The income inequality was calculated on the basis of self-reported income. The special requirements for complex survey data analysis were considered in the bivariate analysis and linear regression models. The mean of the EQ-5D index was 94.6. The EQ-5D index of people with low income was lower than that in the high-income group (for people in the rural region: 93.2 v 96.1, P gender, education, marital status, employment, medical insurance, and chronic disease, all the coefficients of the low-income group and high income inequality were significantly negative. After stratifying by income group, all the effects of high income inequality remained negative in both income groups. However, the coefficients of the models in the high income group were not statistically significant. Income inequality has damaging effects on HRQL in Shaanxi, China, especially for people with low income. In addition, people living in rural regions were more vulnerable to economic factors.

The impact of age-related macular degeneration on health status utility values.

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Espallargues, Mireia; Czoski-Murray, Carolyn J; Bansback, Nicholas J; Carlton, Jill; Lewis, Grace M; Hughes, Lindsey A; Brand, Christopher S; Brazier, John E

2005-11-01

To estimate health status utility values in patients with age-related macular degeneration (ARMD) associated with visual impairments, by using preference-based measures of health. This was a cross-sectional study involving patients with unilateral or bilateral ARMD who attended a large teaching hospital. Patients underwent visual tests (near and distant visual acuity [VA] and contrast sensitivity [CS]) and completed health status questionnaires including the Index of Visual Function (VF)-14 and three preference-based measures (the Health Utilities Index Mark III [HUI-3], the EuroQoL Health Questionnaire [EQ-5D], and the Short Form 6D Health Status Questionnaire [SF-6D]) and the time tradeoff (TTO). The mean health status is presented for five groups, defined according to the VA in the better-seeing eye and for four CS groups. Two hundred nine patients were recruited with substantial loss of visual function as obtained by visual tests (mean decimal VA in the better-seeing eye: 0.2) and self-report (mean VF-14 score: 41.5). The mean (+/-SD) utilities were 0.34 +/- 0.28 for HUI-3, 0.66 +/- 0.14 for SF-6D, 0.72 +/- 0.22 for EQ-5D, and 0.64 +/- 0.31 for TTO. The HUI-3 had the highest correlation with VA and CS (0.40 and -0.34), followed by TTO (0.25 and -0.21). Across the VA and CS groups, only HUI3 and TTO had a significant linear trend (P preference-based measures used. The HUI-3 seems to be the instrument of choice for use in economic evaluations in which community data are needed. It may be more appropriate to base economic models on CS or some combination of CS and VA rather than on VA alone.

A comparison of the sensitivity of EQ-5D, SF-6D and TTO utility values to changes in vision and perceived visual function in patients with primary open-angle glaucoma

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Bozzani Fiammetta Maria

2012-08-01

Full Text Available Abstract Background Economic viability of treatments for primary open-angle glaucoma (POAG should be assessed objectively to prioritise health care interventions. This study aims to identify the methods for eliciting utility values (UVs most sensitive to differences in visual field and visual functioning in patients with POAG. As a secondary objective, the dimensions of generic health-related and vision-related quality of life most affected by progressive vision loss will be identified. Methods A total of 132 POAG patients were recruited. Three sets of utility values (EuroQoL EQ-5D, Short Form SF-6D, Time Trade Off and a measure of perceived visual functioning from the National Eye Institute Visual Function Questionnaire (VFQ-25 were elicited during face-to-face interviews. The sensitivity of UVs to differences in the binocular visual field, visual acuity and visual functioning measures was analysed using non-parametric statistical methods. Results Median utilities were similar across Integrated Visual Field score quartiles for EQ-5D (P = 0.08 whereas SF-6D and Time-Trade-Off UVs significantly decreased (p = 0.01 and p = 0.001, respectively. The VFQ-25 score varied across Integrated Visual Field and binocular visual acuity groups and was associated with all three UVs (P ≤ 0.001; most of its vision-specific sub-scales were associated with the vision markers. The most affected dimension was driving. A relationship with vision markers was found for the physical component of SF-36 and not for any dimension of EQ-5D. Conclusions The Time-Trade-Off was more sensitive than EQ-5D and SF-6D to changes in vision and visual functioning associated with glaucoma progression but could not measure quality of life changes in the mildest disease stages.

Health-Related Quality of Life of the General German Population in 2015: Results from the EQ-5D-5L.

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Huber, Manuel B; Felix, Julia; Vogelmann, Martin; Leidl, Reiner

2017-04-16

The EQ-5D-5L is a widely used generic instrument to measure health-related quality of life. This study evaluates health perception in a representative sample of the general German population from 2015. To compare results over time, a component analysis technique was used that separates changes in the description and valuation of health states. The whole sample and also subgroups, stratified by sociodemographic parameters as well as disease affliction, were analyzed. In total, 2040 questionnaires (48.4% male, mean age 47.3 year) were included. The dimension with the lowest number of reported problems was self-care (93.0% without problems), and the dimension with the highest proportion of impairment was pain/discomfort (71.2% without problems). Some 64.3% of the study population were identified as problem-free. The visual analog scale (VAS) mean for all participants was 85.1. Low education was connected with significantly lower VAS scores, but the effect was small. Depression, heart disease, and diabetes had a strong significant negative effect on reported VAS means. Results were slightly better than those in a similar 2012 survey; the most important driver was the increase in the share of the study population that reported to be problem-free. In international comparisons, health perception of the general German population is relatively high and, compared with previous German studies, fairly stable over recent years. Elderly and sick people continue to report significant reductions in perceived health states.

Health-related quality of life as measured with EQ-5D among populations with and without specific chronic conditions: a population-based survey in Shaanxi Province, China.

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Tan, Zhijun; Liang, Ying; Liu, Siming; Cao, Wenjun; Tu, Haibo; Guo, Lingxia; Xu, Yongyong

2013-01-01

The aim of this study was to examine health-related quality of life (HRQoL) as measured by EQ-5D and to investigate the influence of chronic conditions and other risk factors on HRQoL based on a distributed sample located in Shaanxi Province, China. A multi-stage stratified cluster sampling method was performed to select subjects. EQ-5D was employed to measure the HRQoL. The likelihood that individuals with selected chronic diseases would report any problem in the EQ-5D dimensions was calculated and tested relative to that of each of the two reference groups. Multivariable linear regression models were used to investigate factors associated with EQ VAS. The most frequently reported problems involved pain/discomfort (8.8%) and anxiety/depression (7.6%). Nearly half of the respondents who reported problems in any of the five dimensions were chronic patients. Higher EQ VAS scores were associated with the male gender, higher level of education, employment, younger age, an urban area of residence, access to free medical service and higher levels of physical activity. Except for anemia, all the selected chronic diseases were indicative of a negative EQ VAS score. The three leading risk factors were cerebrovascular disease, cancer and mental disease. Increases in age, number of chronic conditions and frequency of physical activity were found to have a gradient effect. The results of the present work add to the volume of knowledge regarding population health status in this area, apart from the known health status using mortality and morbidity data. Medical, policy, social and individual attention should be given to the management of chronic diseases and improvement of HRQoL. Longitudinal studies must be performed to monitor changes in HRQoL and to permit evaluation of the outcomes of chronic disease intervention programs.

Comparison of direct and indirect methods of estimating health state utilities for resource allocation: review and empirical analysis.

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Arnold, David; Girling, Alan; Stevens, Andrew; Lilford, Richard

2009-07-22

Utilities (values representing preferences) for healthcare priority setting are typically obtained indirectly by asking patients to fill in a quality of life questionnaire and then converting the results to a utility using population values. We compared such utilities with those obtained directly from patients or the public. Review of studies providing both a direct and indirect utility estimate. Papers reporting comparisons of utilities obtained directly (standard gamble or time tradeoff) or indirectly (European quality of life 5D [EQ-5D], short form 6D [SF-6D], or health utilities index [HUI]) from the same patient. PubMed and Tufts database of utilities. Sign test for paired comparisons between direct and indirect utilities; least squares regression to describe average relations between the different methods. Mean utility scores (or median if means unavailable) for each method, and differences in mean (median) scores between direct and indirect methods. We found 32 studies yielding 83 instances where direct and indirect methods could be compared for health states experienced by adults. The direct methods used were standard gamble in 57 cases and time trade off in 60(34 used both); the indirect methods were EQ-5D (67 cases), SF-6D (13), HUI-2 (5), and HUI-3 (37). Mean utility values were 0.81 (standard gamble) and 0.77 (time tradeoff) for the direct methods; for the indirect methods: 0.59(EQ-5D), 0.63 (SF-6D), 0.75 (HUI-2) and 0.68 (HUI-3). Direct methods of estimating utilities tend to result in higher health ratings than the more widely used indirect methods, and the difference can be substantial.Use of indirect methods could have important implications for decisions about resource allocation: for example, non-lifesaving treatments are relatively more favoured in comparison with lifesaving interventions than when using direct methods.

Probabilistic mapping of descriptive health status responses onto health state utilities using Bayesian networks: an empirical analysis converting SF-12 into EQ-5D utility index in a national US sample.

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Le, Quang A; Doctor, Jason N

2011-05-01

As quality-adjusted life years have become the standard metric in health economic evaluations, mapping health-profile or disease-specific measures onto preference-based measures to obtain quality-adjusted life years has become a solution when health utilities are not directly available. However, current mapping methods are limited due to their predictive validity, reliability, and/or other methodological issues. We employ probability theory together with a graphical model, called a Bayesian network, to convert health-profile measures into preference-based measures and to compare the results to those estimated with current mapping methods. A sample of 19,678 adults who completed both the 12-item Short Form Health Survey (SF-12v2) and EuroQoL 5D (EQ-5D) questionnaires from the 2003 Medical Expenditure Panel Survey was split into training and validation sets. Bayesian networks were constructed to explore the probabilistic relationships between each EQ-5D domain and 12 items of the SF-12v2. The EQ-5D utility scores were estimated on the basis of the predicted probability of each response level of the 5 EQ-5D domains obtained from the Bayesian inference process using the following methods: Monte Carlo simulation, expected utility, and most-likely probability. Results were then compared with current mapping methods including multinomial logistic regression, ordinary least squares, and censored least absolute deviations. The Bayesian networks consistently outperformed other mapping models in the overall sample (mean absolute error=0.077, mean square error=0.013, and R overall=0.802), in different age groups, number of chronic conditions, and ranges of the EQ-5D index. Bayesian networks provide a new robust and natural approach to map health status responses into health utility measures for health economic evaluations.

Quantification of the level descriptors for the standard EQ-5D three-level system and a five-level version according to two methods

NARCIS (Netherlands)

M.F. Janssen (Bas); E. Birnie (Erwin); G.J. Bonsel (Gouke)

2008-01-01

textabstractObjectives: Our aim was to compare the quantitative position of the level descriptors of the standard EQ-5D three-level system (3L) and a newly developed, experimental five-level version (5L) using a direct and a vignette-based indirect method. Methods: Eighty-two respondents took part

Establishing utility values for the 22-item Sino-Nasal Outcome Test (SNOT-22) using a crosswalk to the EuroQol-five-dimensional questionnaire-three-level version (EQ-5D-3L).

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Crump, R Trafford; Lai, Ernest; Liu, Guiping; Janjua, Arif; Sutherland, Jason M

2017-05-01

Chronic rhinosinusitis (CRS) is a common condition for which there are numerous medical and surgical treatments. The 22-item Sino-Nasal Outcome Test (SNOT-22) is a patient-reported outcome measure often used with patients diagnosed with CRS. However, there are no utility values associated with the SNOT-22, limiting its use in comparative effectiveness research. The purpose of this study was to establish utilities for the SNOT-22 by mapping responses to utility values associated with the EuroQol-5-dimensional questionnaire-3-level version (EQ-5D-3L). This study used data collected from patients diagnosed with CRS awaiting bilateral endoscopic sinus surgery in Vancouver, Canada. Study participants completed both the SNOT-22 and the EQ-5D-3L. Ordinary least squares was used for 3 models that estimated the EQ-5D-3L utility values as a function of the SNOT-22 items. A total of 232 participants completed both the SNOT-22 and the EQ-5D-3L. As expected, there was a negative relationship between the SNOT-22 global scores and EQ-5D-3L utility values. Adjusted R 2 for the 3 models ranged from 0.28 to 0.33, and root mean squared errors between 0.23 and 0.24. A nonparametric bootstrap analysis demonstrated robustness of the findings. This study successfully developed a mapping model to associate utility values with responses to the SNOT-22. This model could be used to conduct comparative effectiveness research in CRS to evaluate the various interventions available for treating this condition. © 2017 ARS-AAOA, LLC.

Quantification of the level descriptors for the standard EQ-5D three-level system and a five-level version according to two methods

NARCIS (Netherlands)

Janssen, M. F.; Birnie, E.; Bonsel, G. J.

2008-01-01

OBJECTIVES: Our aim was to compare the quantitative position of the level descriptors of the standard EQ-5D three-level system (3L) and a newly developed, experimental five-level version (5L) using a direct and a vignette-based indirect method. METHODS: Eighty-two respondents took part in the study.

Exploration of the association between quality of life, assessed by the EQ-5D and ICECAP-O, and falls risk, cognitive function and daily function, in older adults with mobility impairments

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Davis Jennifer C

2012-10-01

Full Text Available Abstract Background Our research sought to understand how falls risk, cognitive function, and daily function are associated with health related quality of life (using the EuroQol-5D and quality of life (using the ICECAP-O among older adults with mobility impairments. Methods The EQ-5D and ICECAP-O were administered at 12 months post first clinic attendance at the Vancouver Falls Prevention Clinic. We report descriptive statistics for all baseline characteristics collected at first clinic visit and primary outcomes of interest. Using multivariate stepwise linear regression, we assessed the construct validity of the EQ-5D and ICECAP-O using three dependent measures that are recognized indicators of “impaired mobility” – physiological falls risk, general balance and mobility, and cognitive status among older adults. Results We report data on 215 seniors who attended the Vancouver Falls Prevention Clinic and received their first clinic assessment. Patients had a mean age of 79.3 (6.2 years. After accounting for known covariates (i.e., age and sex, the ICECAP-O domains explained a greater amount of variation in each of the three dependent measures compared with the EQ-5D domains. Conclusion Both the EQ-5D and ICECAP-O demonstrate associations with falls risk and general balance and mobility; however, only the ICECAP-O was associated with cognitive status among older adults with mobility impairments. Trial registration ClinicalTrials.gov Identifier: NCT01022866

A review of preference-based measures for the assessment of quality of life in children and adolescents with cerebral palsy.

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Mpundu-Kaambwa, Christine; Chen, Gang; Huynh, Elisabeth; Russo, Remo; Ratcliffe, Julie

2018-03-22

To examine the psychometric properties and suitability for use within the context of cerebral palsy research in children and adolescents of generic preference-based outcome measures (PROMs). Nine electronic databases were searched in this systematic review. The consensus-based standards for the selection of health measurement instruments (COSMIN) checklist were used to measure the psychometric properties of the PROMs. A meta-analysis was used to pool correlation coefficients for convergent validity using the Schmidt-Hunter method. Heterogeneity was assessed using the I-squared statistic (I 2 ). Four preference-based PROMs were identified from eight studies: Health Utilities Index-Mark 2 and 3 (HUI-2 and HUI-3, respectively), the Assessment Quality of Life-4 dimension (AQoL-4D) and the EuroQol-5 dimension 3 level (EQ-5D-3L). Only the HUI system was primarily developed for application with children/adolescents though health-state values for scoring the PROM were elicited from adults. The HUI-3 covered the most relevant constructs though it excludes important modules of health-related quality of life (HRQOL) such as activity limitations and participation restrictions. In terms of psychometric properties, evidence was presented for only five of COSMIN measurement properties: reliability (HUI3), measurement error (HUI-3), content validity (HUI-2 and HUI-3), Hypotheses testing (HUI-3 and AQoL-4D) and criterion validity (HUI-3). No papers reported on internal consistency, structural validity, cross-cultural validity or responsiveness of the preference-based measures in children and adolescents with cerebral palsy. This review highlights the dearth in studies using preference-based PROMs to measure HRQOL associated with cerebral palsy in children and adolescents. The HUI-3 demonstrated the strongest psychometric properties, though it does not cover all dimensions relevant to this population.

Mapping health assessment questionnaire disability index (HAQ-DI) score, pain visual analog scale (VAS), and disease activity score in 28 joints (DAS28) onto the EuroQol-5D (EQ-5D) utility score with the KORean Observational study Network for Arthritis (KORONA) registry data.

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Kim, Hye-Lin; Kim, Dam; Jang, Eun Jin; Lee, Min-Young; Song, Hyun Jin; Park, Sun-Young; Cho, Soo-Kyung; Sung, Yoon-Kyoung; Choi, Chan-Bum; Won, Soyoung; Bang, So-Young; Cha, Hoon-Suk; Choe, Jung-Yoon; Chung, Won Tae; Hong, Seung-Jae; Jun, Jae-Bum; Kim, Jinseok; Kim, Seong-Kyu; Kim, Tae-Hwan; Kim, Tae-Jong; Koh, Eunmi; Lee, Hwajeong; Lee, Hye-Soon; Lee, Jisoo; Lee, Shin-Seok; Lee, Sung Won; Park, Sung-Hoon; Shim, Seung-Cheol; Yoo, Dae-Hyun; Yoon, Bo Young; Bae, Sang-Cheol; Lee, Eui-Kyung

2016-04-01

The aim of this study was to estimate the mapping model for EuroQol-5D (EQ-5D) utility values using the health assessment questionnaire disability index (HAQ-DI), pain visual analog scale (VAS), and disease activity score in 28 joints (DAS28) in a large, nationwide cohort of rheumatoid arthritis (RA) patients in Korea. The KORean Observational study Network for Arthritis (KORONA) registry data on 3557 patients with RA were used. Data were randomly divided into a modeling set (80 % of the data) and a validation set (20 % of the data). The ordinary least squares (OLS), Tobit, and two-part model methods were employed to construct a model to map to the EQ-5D index. Using a combination of HAQ-DI, pain VAS, and DAS28, four model versions were examined. To evaluate the predictive accuracy of the models, the root-mean-square error (RMSE) and mean absolute error (MAE) were calculated using the validation dataset. A model that included HAQ-DI, pain VAS, and DAS28 produced the highest adjusted R (2) as well as the lowest Akaike information criterion, RMSE, and MAE, regardless of the statistical methods used in modeling set. The mapping equation of the OLS method is given as EQ-5D = 0.95-0.21 × HAQ-DI-0.24 × pain VAS/100-0.01 × DAS28 (adjusted R (2) = 57.6 %, RMSE = 0.1654 and MAE = 0.1222). Also in the validation set, the RMSE and MAE were shown to be the smallest. The model with HAQ-DI, pain VAS, and DAS28 showed the best performance, and this mapping model enabled the estimation of an EQ-5D value for RA patients in whom utility values have not been measured.

Multiattribute health utility scoring for the computerized adaptive measure CAT-5D-QOL was developed and validated.

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Kopec, Jacek A; Sayre, Eric C; Rogers, Pamela; Davis, Aileen M; Badley, Elizabeth M; Anis, Aslam H; Abrahamowicz, Michal; Russell, Lara; Rahman, Md Mushfiqur; Esdaile, John M

2015-10-01

The CAT-5D-QOL is a previously reported item response theory (IRT)-based computerized adaptive tool to measure five domains (attributes) of health-related quality of life. The objective of this study was to develop and validate a multiattribute health utility (MAHU) scoring method for this instrument. The MAHU scoring system was developed in two stages. In phase I, we obtained standard gamble (SG) utilities for 75 hypothetical health states in which only one domain varied (15 states per domain). In phase II, we obtained SG utilities for 256 multiattribute states. We fit a multiplicative regression model to predict SG utilities from the five IRT domain scores. The prediction model was constrained using data from phase I. We validated MAHU scores by comparing them with the Health Utilities Index Mark 3 (HUI3) and directly measured utilities and by assessing between-group discrimination. MAHU scores have a theoretical range from -0.842 to 1. In the validation study, the scores were, on average, higher than HUI3 utilities and lower than directly measured SG utilities. MAHU scores correlated strongly with the HUI3 (Spearman ρ = 0.78) and discriminated well between groups expected to differ in health status. Results reported here provide initial evidence supporting the validity of the MAHU scoring system for the CAT-5D-QOL. Copyright © 2015 Elsevier Inc. All rights reserved.

Do generic utility measures capture what is important to the quality of life of people with multiple sclerosis?

OpenAIRE

Kuspinar, Ayse; Mayo, Nancy E

2013-01-01

Purpose The three most widely used utility measures are the Health Utilities Index Mark 2 and 3 (HUI2 and HUI3), the EuroQol-5D (EQ-5D) and the Short-Form-6D (SF-6D). In line with guidelines for economic evaluation from agencies such as the National Institute for Health and Clinical Excellence (NICE) and the Canadian Agency for Drugs and Technologies in Health (CADTH), these measures are currently being used to evaluate the cost-effectiveness of different interventions in MS. However, the cha...

Analyzing Health-Related Quality of Life Data to Estimate Parameters for Cost-Effectiveness Models: An Example Using Longitudinal EQ-5D Data from the SHIFT Randomized Controlled Trial.

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Griffiths, Alison; Paracha, Noman; Davies, Andrew; Branscombe, Neil; Cowie, Martin R; Sculpher, Mark

2017-03-01

The aim of this article is to discuss methods used to analyze health-related quality of life (HRQoL) data from randomized controlled trials (RCTs) for decision analytic models. The analysis presented in this paper was used to provide HRQoL data for the ivabradine health technology assessment (HTA) submission in chronic heart failure. We have used a large, longitudinal EuroQol five-dimension questionnaire (EQ-5D) dataset from the Systolic Heart Failure Treatment with the I f Inhibitor Ivabradine Trial (SHIFT) (clinicaltrials.gov: NCT02441218) to illustrate issues and methods. HRQoL weights (utility values) were estimated from a mixed regression model developed using SHIFT EQ-5D data (n = 5313 patients). The regression model was used to predict HRQoL outcomes according to treatment, patient characteristics, and key clinical outcomes for patients with a heart rate ≥75 bpm. Ivabradine was associated with an HRQoL weight gain of 0.01. HRQoL weights differed according to New York Heart Association (NYHA) class (NYHA I-IV, no hospitalization: standard care 0.82-0.46; ivabradine 0.84-0.47). A reduction in HRQoL weight was associated with hospitalizations within 30 days of an HRQoL assessment visit, with this reduction varying by NYHA class [-0.07 (NYHA I) to -0.21 (NYHA IV)]. The mixed model explained variation in EQ-5D data according to key clinical outcomes and patient characteristics, providing essential information for long-term predictions of patient HRQoL in the cost-effectiveness model. This model was also used to estimate the loss in HRQoL associated with hospitalizations. In SHIFT many hospitalizations did not occur close to EQ-5D visits; hence, any temporary changes in HRQoL associated with such events would not be captured fully in observed RCT evidence, but could be predicted in our cost-effectiveness analysis using the mixed model. Given the large reduction in hospitalizations associated with ivabradine this was an important feature of the analysis. The

Which Questionnaire Should Be Used to Measure Quality-of-Life Utilities in Patients with Acute Leukemia? An Evaluation of the Validity and Interpretability of the EQ-5D-5L and Preference-Based Questionnaires Derived from the EORTC QLQ-C30.

Science.gov (United States)

van Dongen-Leunis, Annemieke; Redekop, W Ken; Uyl-de Groot, Carin A

The aim of this study was to assess the validity and interpretability of different preference-based questionnaires (generic 5-level EuroQol five-dimensional questionnaire [EQ-5D-5L], cancer-specific Quality of Life Questionnaire Preference-Based Measure, and European Organization of Randomized Controlled Trials 8 Dimension [EORTC-8D]) in patients with acute leukemia. Patients who participated in Hemato-Oncologie voor Volwassenen Nederland (HOVON - the Haemato Oncology Foundation for Adults in the Netherlands) clinical trials between 1999 and 2011 at a single hospital were invited to complete the questionnaires. Interpretability was evaluated by the frequency of incomplete data and highest and lowest possible scores. Content validity was evaluated by exploring the health-related quality-of-life domains included in the questionnaires. Construct validity was assessed using correlations with other quality-of-life scales (EQ-visual analogue scale score and global quality-of-life scale of the EORTC Quality of Life Questionnaire) and ability to distinguish between patients with different health statuses. Questionnaires were returned by 89% (111 of 125) of the patients. Six to seven respondents did not return full questionnaires. Perfect health on the EQ-5D-5L was reported by 32 respondents and many of them (N = 17) did report health problems on other questionnaires. All questionnaires were strongly correlated (range 0.61-0.78) with other quality-of-life scales and yielded substantially different utility values for patients with different health statuses. Nevertheless, the disease-specific preference-based questionnaires showed greater discriminatory power. Although the Quality of Life Questionnaire Preference-Based Measure and the EORTC-8D appear to have better validity, this study does not provide any strong evidence against the use of the EQ-5D-5L for measuring quality-of-life utilities in acute leukemia. However, our findings need to be confirmed in larger longitudinal

Estimation of minimal clinically important change of the Japanese version of EQ-5D in patients with chronic noncancer pain: a retrospective research using real-world data

OpenAIRE

Yoshizawa, Kazutake; Kobayashi, Hisanori; Fujie, Motoko; Ogawa, Yoshimasa; Yajima, Tsutomu; Kawai, Koji

2016-01-01

Background Quality of life (QoL) is routinely assessed and evaluated in medical research. However, in Japan, there is a lack of solid cutoff criteria for evaluating QoL improvement in chronic noncancer pain management. The present study was conducted to identify the minimal clinically important change (MCIC) of the Japanese version of EuroQol-5D 3L(EQ-5D) utility score and numeric rating scale (NRS) with an emphasis on chronic noncancer pain. Methods The data source for this post hoc research...

Marie Curie, les femmes et la science, d'hier à aujourd'hui

CERN Multimedia

CERN. Geneva; Mariotti, Chiara; Vicinanza, Domenico

2017-01-01

Marie Curie, les femmes et la science, d'hier à aujourd'hui Conférence par Hélène Langevin-Joliot Avec la participation de l'Echo du Reculet de Thoiry. L'enregistrement et la liste d'attente sont déjà complets... Mais il n'est pas rare que des personnes réservent et ne viennent pas. Nous réassignerons les places libérées selon la règle "premier arrivé, premier inscrit". Au vu de la forte demande, la conférence sera également disponible en vidéoconférence : lien d'accès "webcast" disponible en bas de cette page. Hélène Langevin-Joliot, directrice de recherche émérite en physique nucléaire fondamentale au CNRS à Orsay, est aussi la fille de Frédéric et Irène Joliot-Curie (prix Nobel de chimie en 1935) et la petite-fille de Pierre Curie (prix Nobel de physique en 1903) et de Marie Curie (prix Nobel de physique en 1903 et prix Nobel de chimie en 1911). Hélène Langevin-Joliot nous parlera de sa vie scientifique, de l’histoire extraordinai...

Do generic utility measures capture what is important to the quality of life of people with multiple sclerosis?

Science.gov (United States)

Kuspinar, Ayse; Mayo, Nancy E

2013-04-25

The three most widely used utility measures are the Health Utilities Index Mark 2 and 3 (HUI2 and HUI3), the EuroQol-5D (EQ-5D) and the Short-Form-6D (SF-6D). In line with guidelines for economic evaluation from agencies such as the National Institute for Health and Clinical Excellence (NICE) and the Canadian Agency for Drugs and Technologies in Health (CADTH), these measures are currently being used to evaluate the cost-effectiveness of different interventions in MS. However, the challenge of using such measures in people with a specific health condition, such as MS, is that they may not capture all of the domains that are impacted upon by the condition. If important domains are missing from the generic measures, the value derived will be higher than the real impact creating invalid comparisons across interventions and populations. Therefore, the objective of this study is to estimate the extent to which generic utility measures capture important domains that are affected by MS. The available study population consisted of men and women who had been registered after 1994 in three participating MS clinics in Greater Montreal, Quebec, Canada. Subjects were first interviewed on an individualized measure of quality of life (QOL) called the Patient Generated Index (PGI). The domains identified with the PGI were then classified and grouped together using the World Health Organization's International Classification of Functioning, Disability and Health (ICF), and mapped onto the HUI2, HUI3, EQ-5D and SF-6D. A total of 185 persons with MS were interviewed on the PGI. The sample was relatively young (mean age 43) and predominantly female. Both men and women had mild disability with a median Expanded Disability Status Scale (EDSS) score of 2. The top 10 domains that patients identified to be the most affected by their MS were, work (62%), fatigue (48%), sports (39%), social life (28%), relationships (23%), walking/mobility (22%), cognition (21%), balance (14%), housework (12

Factors Associated with Health-Related Quality of Life in Korean Patients with Chronic Hepatitis C Infection Using the SF-36 and EQ-5D.

Science.gov (United States)

Jang, Eun Sun; Kim, Young Seok; Kim, Kyung-Ah; Lee, Youn Jae; Chung, Woo Jin; Kim, In Hee; Lee, Byung Seok; Jeong, Sook-Hyang

2018-03-29

This study aimed to describe the Health-related quality of life (HRQoL) outcomes for Korean chronic hepatitis C patients and to investigate the impact of patient and virus-related factors on HRQoL. HRQoL was assessed in 235 HCV-infected patients from 7 nationwide tertiary hospital, including those with liver cirrhosis and hepatocellular carcinoma (HCC), using the Shor-Form 36 (SF-36) version 2 and the European quality of life questionnaire-5 dimensions (EQ-5D-3L). The SF-36 physical (48.8±8.3) and mental (46.2±11.7) component summary scores of the HCV-infected patients were below normal limits. Of the eight domains, general health, vitality, and mental health tended to show low scores. Patients with decompensated cirrhosis had the lowest HRQoL, while HCC and chronic hepatitis patients had similar HRQoL results. The EQ-5D index was low (0.848±0.145) in the HCV infected patients. Multivariable analysis showed age ≤65 years, high monthly family income (>$2,641), low comorbidity score, and sustained virologic response (SVR) were independently associated with favorable HRQoL. HRQoL in Korean patients with chronic HCV infection was low and was affected by cirrhosis severity, SVR, and comorbidity as well as income, which had the strongest effect. Therefore, HRQoL may be improved by antiviral therapy with reasonable costs to prevent cirrhosis progression.

[Summary of Hui prescriptions for treating cough].

Science.gov (United States)

Zhang, Wen-jin; Liu, Yue; Zhang, Xin-hui

2015-02-01

In this study, by using the method of literature research, 35 prescriptions related to asthma therapy has been screened out from Hui medicine through collecting the ancient and modern literature. A comparison of fragrant medicine between the name in Arab and Chinese herbal medicine is done. The countif function in Microsoft Excel 2007 is used to get the prescriptions of the drug on the frequency statistics, summarizing the common drugs of Hui medicine for asthma are Pinellia, almond, white sugar, walnut. According to the commonly used drugs, the pathogeny and treatment principle about Hui medicine for asthma is preliminarily inferred combining literature research and the related Hui medical theory. In this study, those prescriptions have been classified into 21 cases which are effective and can be used in medical therapy according to the relevant literatures with the development of the Hui people in their long process of formation of the unique diet culture, 14 useful and convenient Halal diet therapies are made up according to the indications, therapies, party name and composition. Halal diet and "medicine and food" herbs are preliminarily analyzed and summarized, which can be convenient for the people to reduce pains through the diet and improve health awareness.

Transforming EQ-5D utilities for use in cost–value analysis of health programs.

Science.gov (United States)

Nord, Erik; Johansen, Rune

2015-04-01

In a number of jurisdictions there is increasing interest in incorporating concerns for fairness in models for economic evaluation of health interventions. Cost–value analysis is a name for evaluations with such a broader aim. The most widely held concern for fairness is a concern for the worse off, i.e. the idea that severity of illness should count in determining priorities. In economic evaluations of improvements in health-related quality of life this concern may be taken into account by replacing conventional health state utilities with societal values for health states that are characterised by strong upper end compression and decreasing marginal value of utility gains. We review evidence on the strength of concerns for the worse off--measured at the cardinal level--in 15 articles published in peer-reviewed journals in the time period 1978–2010, with reports from altogether 20 individual studies in nine different countries. We report 116 individual observations of paired comparisons of utility improvements with different start levels. Concerns for severity show up quite strongly across countries, sample types and question framings. By means of regression analyses we fit a societal value function to the data that has the property of decreasing marginal value of utility gains. Using the central tendency in the data we present two plausible transformations of EQ-5D utilities into societal values that reflect concerns for the worse off.

Gebruik van elektriciteit: Domotica: Huis van de toekomst: Klas 4 havo

NARCIS (Netherlands)

van Buuren, O.; van der Lee, M.

2008-01-01

Deze module behandelt elektriciteit en automatisering in huis. We richten ons daarbij ook op het huis van de toekomst. Bij de elektriciteitsleer ligt de nadruk op het gebruik van elektriciteit in huis, bij de automatisering op intelligente systemen in huis. Er komt een vervolg module domotica 2 als

EQ-5D™-derived utility values for different levels of migraine severity from a UK sample of migraineurs

Directory of Open Access Journals (Sweden)

Stafford Megan R

2012-06-01

Full Text Available Abstract Background To estimate utility values for different levels of migraine pain severity from a United Kingdom (UK sample of migraineurs. Methods One hundred and six migraineurs completed the EQ-5D to evaluate their health status for mild, moderate and severe levels of migraine pain severity for a recent migraine attack, and for current health defined as health status within seven days post-migraine attack. Statistical tests were used to evaluate differences in mean utility scores by migraine severity. Results Utility scores for each health state were significantly different from 1.0 (no problems on any EQ-5D dimension (p  Conclusions Results indicate that all levels of migraine pain are associated with significantly reduced utility values. As severity worsened, utility decreased and severe migraine pain was considered a health state worse than death. Results can be used in cost-utility models examining the relative economic value of therapeutic strategies for migraine in the UK.

The impact of influenza on the health related quality of life in China: an EQ-5D survey.

Science.gov (United States)

Yang, Juan; Jit, Mark; Zheng, Yaming; Feng, Luzhao; Liu, Xinxin; Wu, Joseph T; Yu, Hongjie

2017-10-16

Influenza causes considerable morbidity and mortality in China, but its impact on the health-related quality of life (HRQoL) has not been previously measured. We conducted a retrospective telephone survey to assess the impact of influenza on the HRQoL among outpatients and inpatients using the EuroQoL EQ-5D-3 L instrument. Participants were individuals with laboratory-confirmed influenza infection registered by the National Influenza-like-illness Surveillance Network in 2013. We interviewed 839 of 11,098 eligible influenza patients. After excluding those who were unable to complete the HRQoL for the registered influenza episode, 778 patients were included in the analysis. Both outpatients (n = 529) and inpatients (n = 249) most commonly reported problems with pain/discomfort (71.8% of outpatients and 71.9% of inpatients) and anxiety/depression (62.0% of outpatients and 75.1% of inpatients). For individual influenza outpatients, the mean health utility was 0.6142 (SD 0.2006), and the average quality adjusted life days (QALD) loss was 1.62 (SD 1.84) days. The HRQoL of influenza inpatients was worse (mean health utility 0.5851, SD 0.2197; mean QALD loss 3.51 days, SD 4.25) than that of outpatients (p < 0.05). The presence of underlying medical conditions lowered the HRQoL for both outpatients and inpatients (p < 0.05). Influenza illness had a substantial impact on HRQoL. QALD loss due to an acute influenza episode in younger children was comparable to that due to enterovirus A71-associated hand, foot and mouth disease. Our findings are key inputs into disease burden estimates and cost-effectiveness evaluations of influenza-related interventions in China.

Marie Curie, les femmes et la science, d'hier à aujourd'hui - English

CERN Multimedia

CERN. Geneva

2017-01-01

Marie Curie, les femmes et la science, d'hier à aujourd'hui Conférence par Hélène Langevin-Joliot Avec la participation de l'Echo du Reculet de Thoiry. L'enregistrement et la liste d'attente sont déjà complets... Mais il n'est pas rare que des personnes réservent et ne viennent pas. Nous réassignerons les places libérées selon la règle "premier arrivé, premier inscrit". Nous envisageons la possibilité de faire un webcast de la conférence. Plus d'information bientôt. Hélène Langevin-Joliot, directrice de recherche émérite en physique nucléaire fondamentale au CNRS à Orsay, est aussi la fille de Frédéric et Irène Joliot-Curie (prix Nobel de chimie en 1935) et la petite-fille de Pierre Curie (prix Nobel de physique en 1903) et de Marie Curie (prix Nobel de physique en 1903 et prix Nobel de chimie en 1911). Hélène Langevin-Joliot nous parlera de sa vie scientifique, de l’histoire extraordinaire de sa famille et en particulier du rôle des ...

Gebruik van elektriciteit: Domotica: Huis van de toekomst: Klas 4 vwo (docentversie)

NARCIS (Netherlands)

van Buuren, O.; van der Lee, M.

2009-01-01

Deze module behandelt elektriciteit en automatisering in huis. We richten ons daarbij ook op het huis van de toekomst. Bij de elektriciteitsleer ligt de nadruk op het gebruik van elektriciteit in huis, bij de automatisering op intelligente systemen in huis.

Prognostic analysis and comparison of colon cancer in Han and Hui patients.

Science.gov (United States)

Zhang, Mei; Zhao, Qu-Chuan; Liu, Yan-Peng; Yang, Lei; Zhu, Hong-Ming; Chhetri, Jagadish K

2014-05-07

To investigate the relevant prognostic factors and their differences between colorectal cancer (CRC) patients of Chinese Han and Hui ethnicities in the Beijing region. A retrospective analysis of 880 patients diagnosed with CRC at Xuanwu Hospital, Capital Medical University between September 2001 and September 2011 was performed. Among the 880 patients, 398 and 482 were Hui and Han, respectively. Characteristics including sex, age, diet, tumor size, primary tumor site, Dukes' stage and degree of differentiation were analyzed for their influence on prognosis. Data on dietary structures were recorded through a questionnaire survey conducted during the patient's first visit, return visit or follow-up checkups. Among patients with colon cancer, the 5-year survival rate for patients of Hui ethnicity was lower than that for Han patients (P = 0.025). Six risk factors (age of onset, dietary structure, tumor size, Dukes' stage, location of cancer and degree of differentiation) in both Han and Hui patients were identified as prognostic factors (P dietary structure was a statistically significant factor, and diet varied significantly between the two ethnic groups. Dietary structure has a significant influence on colon cancer prognosis among Han and Hui patients with colon cancer in Beijing, which may cause a difference in their survival rates.

[Decipherment and annotation of some terms in the remnant scrolls of Hui hui yao fang (Huihui Formularies)].

Science.gov (United States)

Huang, Y; Wang, J

2017-05-28

The etymology of the terms in Hui hui yao fang ( Huihui Formularies ) is complicated. Their origin might be Arabian, Persian, or Sanskrit, or even the northern dialects of Han language during the Yuan and Ming Dynasties. There are obvious mistakes or indefinite decipherments and interpretations of the terms in Song Xian's Investigated Annotations of Huihui Formularies . There are also missing annotations for those transliterated terms. To tackle such defects, 12 such terms are deciphered and annotated here.

Preserving EQ as per CSA N290.13: EQ of equipment for CANDU NPP

International Nuclear Information System (INIS)

Bordeleau, H.

2006-01-01

EQ is basically a Quality Assurance process that ensures that required safety related equipment will performed their safety functions during accident generating harsh environmental condition. As any good Quality Assurance Program, EQ activities have to be imbedded in the normal tasks of the people at the plant in such a way that it is not an extra concern but part of the things to be assessed and done on a regular basis so that the EQ Status of the equipment will not be compromised. The experience shows us that even with brand new plants there are discrepancies between equipment designed to be installed and that installed (wrong model or wrong instrument). Improper installation was also found. To eliminate these mistakes it is recommended to have a thorough initial inspection during construction or commissioning and later at regular intervals during operation. To avoid new mistakes during maintenance, crews have to be properly qualified and trained on completed procedure with appropriate work report that will required to be scrutinized for possible common cause failure and OPEX report. Procurement and handling of equipment and spare parts require a thorough revision of procurement and storage practices to guarantee proper storage, availability and identification of equipment for EQ replacement. A shelf life program for degradable material shall be implemented. Condition monitoring program could be use to extend life of equipment or as a qualification methods, caution should be use to look very precisely to the critical parameters that need to be monitored and to carefully tailor the monitoring program. EQ program should also consider barriers, they are not EQ equipment; it is usually made out of non-ageing material like metal or concrete. But there could be sealing material used in conjunction with the barriers and these may need special care. The impact of EQ parameters changes related to services conditions, new technical data or condition monitoring has to be

Comparison of the EuroQOL-5D with the Oswestry Disability Index, back and leg pain scores in patients with degenerative lumbar spine pathology.

Science.gov (United States)

Mueller, Benjamin; Carreon, Leah Y; Glassman, Steven D

2013-04-20

Cross-sectional study. To evaluate the response behavior of EuroQOL-5D (EQ-5D) compared with the Oswestry Disability Index (ODI), and back and leg pain scores. Recent changes in policies have highlighted the need for demonstration of both quality and cost effectiveness. In an effort to meet these requirements, surgeons are collecting health-related quality of life and utility data. Unfortunately, the burden of extensive data collection on both physician and patient is considerable. The EQ-5D is a commonly used, easily administered, brief utility measure that can provide both clinical and utility data. The EQ-5D has not yet been validated in spine patients in comparison with established outcome measures. EQ-5D, ODI, back and leg pain (0-10) scores were collected as part of standard clinical practice. Spearman rank correlations between the ODI, back and leg pain scores, and the EQ-5D were determined. A subanalysis to determine dimension-specific effects was done. Data were categorized by level of low back disability and level of back and leg pain. Data from 8385 patients (5046 females, 3339 males), mean age 52 (range, 18-96) were analyzed. There was a strong correlation between EQ-5D and ODI (r = -0.776) and between EQ-5D and back pain (r = -0.648); and moderate correlation between EQ-5D and leg pain scores (r = -0.538). Increasing disability, as measured by ODI, lead to lower EQ-5D scores, with similar response behavior for both back and leg pain scores. All correlations were statistically significant at P < 0.0001. The EQ-5D correlated well with established spine outcome measures, including ODI, and back and leg pain scores. EQ-5D correlated best with ODI scores. Correlation with back pain was stronger than leg pain, but all correlations were relatively strong. The EQ-5D can serve spine surgeons as an effective measure of clinical outcome and health utility for economic analysis.

Instruments for measurement of the quality of life of patients infected with HCV virus

Directory of Open Access Journals (Sweden)

Lidia Sierpińska

2017-05-01

Full Text Available Introduction. Hepatitis C is an important medical and social problem inPoland and worldwide. Among the main tasks of a nurse and physician in the care of this group of chronically ill patients is an improvement in the quality of their life. While assessing the quality of life the essential issue is the level of health, from both the objective and subjective aspects. These tasks may be reliably performed only by means of appropriately selected research methods and instruments. Objective. Presentation of research instruments for investigating the quality of life of patients with the diagnosis of hepatitis C. Materials and method. General and specific research instruments for the assessment of the quality of life were analyzed based on Polish and international literature. Results. Studies of the quality of life of patients with hepatitis C enable recognition of the types of specific problems occurring in their daily functioning. The instruments most frequently used by researchers include the following questionnaires: SF-36, HUI (Health Utility Index, NHP (Nottingham Health Profile, EQ-5D (Quality of Life Questionnaire. The specific tool for the assessment of the quality of life of patients with chronic liver disease due to HCV infection is the questionnaire CLDQ–HCV (Chronic Liver Disease Questionnaire — Hepatitis C. The results of the study provide opportunities for the improvement of the quality of life of these patients by the reorganization of medical, psychological, social and rehabilitation care, which usually lasts for the rest of life. Conclusions. The presented instruments for the assessment of the quality of life of patients with the diagnosis of hepatitis C will allow the researchers recognition of the specific aspects of functioning of these patients in the bio-psycho-social sphere.

Measuring health-related quality of life for child maltreatment: a systematic literature review

Directory of Open Access Journals (Sweden)

Prosser Lisa A

2007-07-01

Full Text Available Abstract Background Child maltreatment causes substantial morbidity and mortality in the U.S. Morbidity associated with child maltreatment can reduce health-related quality of life. Accurately measuring the reduction in quality of life associated with child maltreatment is essential to the economic evaluation of educational programs and interventions to reduce the incidence of child maltreatment. The objective of this study was to review the literature for existing approaches and instruments for measuring quality-of-life for child maltreatment outcomes. Methods We reviewed the current literature to identify current approaches to valuing child maltreatment outcomes for economic evaluations. We also reviewed available preference-based generic QOL instruments (EQ-5D, HUI, QWB, SF-6D for appropriateness in measuring change in quality of life due to child maltreatment. Results We did not identify any studies that directly evaluated quality-of-life in maltreated children. We identified 4 studies that evaluated quality of life for adult survivors of child maltreatment and 8 studies that measured quality-of-life for pediatric injury not related to child maltreatment. No study reported quality-of-life values for children younger than age 3. Currently available preference-based QOL instruments (EQ-5D, HUI, QWB, SF-6D have been developed primarily for adults with the exception of the Health Utilities Index. These instruments do not include many of the domains identified as being important in capturing changes in quality of life for child maltreatment, such as potential for growth and development or psychological sequelae specific to maltreatment. Conclusion Recommendations for valuing preference-based quality-of-life for child maltreatment will vary by developmental level and type of maltreatment. In the short-term, available multi-attribute utility instruments should be considered in the context of the type of child maltreatment being measured. However

Construct validity of patient-reported outcome instruments in US adults with hemophilia: results from the Pain, Functional Impairment, and Quality of life (P-FiQ study

Directory of Open Access Journals (Sweden)

Batt K

2017-08-01

Full Text Available Katharine Batt,1 Michael Recht,2 David L Cooper,3 Neeraj N Iyer,3 Christine L Kempton4 1Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, 2The Hemophilia Center, Oregon Health & Science University, Portland, OR, 3Novo Nordisk Inc., Plainsboro, NJ, 4Departments of Pediatrics and Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA Background: People with hemophilia (PWH experience frequent joint bleeding, resulting in pain and functional impairment. Generic and disease-specific patient-reported outcome (PRO instruments have been used in clinical studies, but rarely in the comprehensive hemophilia care setting. Objective: The objective of this study was to assess construct validity of PRO instruments measuring pain, functional impairment, and health-related quality of life in US PWH with a history of joint pain/bleeding. Methods: Adult male PWH completed 4 PRO instruments (EQ-5D-5L with visual analog scale, Brief Pain Inventory v2 Short Form [BPI], SF-36v2, Hemophilia Activities List [HAL] and underwent a musculoskeletal examination (Hemophilia Joint Health Score v2.1 [HJHS]. Construct validity between index and domain scores was evaluated by Pearson product-moment correlation coefficient. Results: A total of 381 PWH were enrolled. EQ-5D-5L Mobility correlated with BPI, SF-36v2, and HAL domains related to pain, physical function, and activity of the lower extremities. EQ-5D-5L Self-Care correlated only with HAL Self-Care. EQ-5D-5L Usual Activities correlated with BPI Pain Interference and domains within SF-36v2 and HAL related to pain and physical function/activities (particularly those involving the lower extremities. EQ-5D-5L Pain/Discomfort correlated with Bodily Pain and Physical Summary on SF-36v2, HAL Overall Activity, and all BPI pain domains. EQ-5D-5L Anxiety/Depression correlated with social/emotional/mental aspects of SF-36v2. On BPI, most pain domains correlated with Bodily

Development and validation of the alcohol Expectancy Questionnaire Short Form (EQ-SF).

Science.gov (United States)

Mezquita, Laura; Camacho, Laura; Suso-Ribera, Carlos; Ortet, Generós; Ibáñez, Manuel I

2018-01-15

Alcohol expectancies are proximal variables to alcohol use and misuse. In recent decades, different measures have been developed to assess this construct. One of the most frequently used and recommended instruments is the Expectancy Questionnaire (EQ; Leigh y Stacy, 1993). Our aim is to develop a short version of the EQ (EQ-SF) for suitable use in time-limited administrations. Two samples, adolescents (N = 514, 57.20% females) and adults (N = 548, 61.50% females), completed the EQ together with alcohol-use measures. Different item selection strategies were applied to select the 24 items. The EQ-SF structure was explored using confirmatory factor analysis, and measurement invariance was tested running a multi-group analysis comparing groups by sex and age. Reliability was tested using Cronbach's alpha and omega coefficients. Concurrent validity was investigated with regression analyses. The EQ-SF showed acceptable between-groups measurement invariance. Alphas and omegas ranged from .77 to .93. Positive expectancies predicted both alcohol use and alcohol-related problems. Negative expectancies predicted alcohol-related problems. Sex and age moderated these associations. Males with high positive alcohol expectancies showed higher alcohol consumption than females, while adults with high negative alcohol expectancies showed greater alcohol-related problems than adolescents. Different evidence on the validity and reliability of the EQ-SF suggest that it is a suitable instrument to assess alcohol expectancies in the Spanish population.

Framing of mobility items: a source of poor agreement between preference-based health-related quality of life instruments in a population of individuals receiving assisted ventilation.

Science.gov (United States)

Hannan, Liam M; Whitehurst, David G T; Bryan, Stirling; Road, Jeremy D; McDonald, Christine F; Berlowitz, David J; Howard, Mark E

2017-06-01

To explore the influence of descriptive differences in items evaluating mobility on index scores generated from two generic preference-based health-related quality of life (HRQoL) instruments. The study examined cross-sectional data from a postal survey of individuals receiving assisted ventilation in two state/province-wide home mechanical ventilation services, one in British Columbia, Canada and the other in Victoria, Australia. The Assessment of Quality of Life 8-dimension (AQoL-8D) and the EQ-5D-5L were included in the data collection. Graphical illustrations, descriptive statistics, and measures of agreement [intraclass correlation coefficients (ICCs) and Bland-Altman plots] were examined using index scores derived from both instruments. Analyses were performed on the full sample as well as subgroups defined according to respondents' self-reported ability to walk. Of 868 individuals receiving assisted ventilation, 481 (55.4%) completed the questionnaire. Mean index scores were 0.581 (AQoL-8D) and 0.566 (EQ-5D-5L) with 'moderate' agreement demonstrated between the two instruments (ICC = 0.642). One hundred fifty-nine (33.1%) reported level 5 ('I am unable to walk about') on the EQ-5D-5L Mobility item. The walking status of respondents had a marked influence on the comparability of index scores, with a larger mean difference (0.206) and 'slight' agreement (ICC = 0.386) observed when the non-ambulant subgroup was evaluated separately. This study provides further evidence that between-measure discrepancies between preference-based HRQoL instruments are related in part to the framing of mobility-related items. Longitudinal studies are necessary to determine the responsiveness of preference-based HRQoL instruments in cohorts that include non-ambulant individuals.

Unchained Melody: Revisiting the Estimation of SF-6D Values

Science.gov (United States)

Craig, Benjamin M.

2015-01-01

Purpose In the original SF-6D valuation study, the analytical design inherited conventions that detrimentally affected its ability to predict values on a quality-adjusted life year (QALY) scale. Our objective is to estimate UK values for SF-6D states using the original data and multi-attribute utility (MAU) regression after addressing its limitations and to compare the revised SF-6D and EQ-5D value predictions. Methods Using the unaltered data (611 respondents, 3503 SG responses), the parameters of the original MAU model were re-estimated under 3 alternative error specifications, known as the instant, episodic, and angular random utility models. Value predictions on a QALY scale were compared to EQ-5D3L predictions using the 1996 Health Survey for England. Results Contrary to the original results, the revised SF-6D value predictions range below 0 QALYs (i.e., worse than death) and agree largely with EQ-5D predictions after adjusting for scale. Although a QALY is defined as a year in optimal health, the SF-6D sets a higher standard for optimal health than the EQ-5D-3L; therefore, it has larger units on a QALY scale by construction (20.9% more). Conclusions Much of the debate in health valuation has focused on differences between preference elicitation tasks, sampling, and instruments. After correcting errant econometric practices and adjusting for differences in QALY scale between the EQ-5D and SF-6D values, the revised predictions demonstrate convergent validity, making them more suitable for UK economic evaluations compared to original estimates. PMID:26359242

Measurement of utility.

Science.gov (United States)

Thavorncharoensap, Montarat

2014-05-01

The Quality Adjusted Life Year (QALY) is the most widely recommended health outcome measure for use in economic evaluations. The QALY gives a value to the effect of a given health intervention in terms of both quantity and quality. QALYs are calculated by multiplying the duration of time spent in a given health state, in years, by the quality of life weighted, known as utility. Utility can range from 0 (the worst health state-the equivalent of death) to 1 (the best health state-full health). This paper provides an overview of the various methods that can be used to measure utility and outlines the recommended protocol for measuring utility, as described in the Guidelines for Health Technology Assessment in Thailand (second edition). The recommendations are as follows: Wherever possible, primary data collection using EQ-5D-3L in patients using Thai value sets generated from the general public should be used. Where the EQ-5D-3L is considered inappropriate, other methods such as Standard gamble (SG), Time-trade-off (TTO), Visual analogue scale (VAS), Health Utilities Index (HUI), SF-6D, or Quality of well being (QWB) can be used. However, justification and full details on the chosen instrument should always be provided.

Performance of PROMIS Physical Function Compared with KOOS, SF-36, Eq5d And Marx Activity Scale in Patients Who Undergo ACL Reconstruction

Science.gov (United States)

Scott, Elizabeth; Glass, Natalie; Wolf, Brian R.; Hettrich, Carolyn M.; Bollier, Matthew

2018-01-01

Objectives: Anterior cruciate ligament reconstruction is a commonly performed orthopaedic procedure. PROMIS (Patient-Reported Outcome Measurement Information System) was developed by the National Institutes of Health in an effort to advance patient-reported outcome (PRO) instruments by developing question banks for major health domains. Our goal was to compare the responsiveness and construct validity of the PROMIS physical function (PF) computer adaptive test (CAT) with current PRO instruments utilized in patients who undergo anterior cruciate ligament reconstruction. Methods: A total of 174 patients ages 14-53 scheduled to undergo anterior cruciate ligament reconstruction were asked to complete PROMIS PF-CAT, Short Form-36 Health Survey (SF36-PF and -GH), Marx activity rating scale (Marx), Knee Injury and Osteoarthritis Score (KOOS-ADL, -Sport, -QOL), and the EuroQol five dimensions questionnaire (EQ5D) at their preoperative visit. These surveys were repeated at six weeks and six months after surgery. Correlations between PRO instruments was defined as excellent (>0.7), excellent-good (0.61-0.7), good (0.4-0.6), and poor (0.2-0.3) using Spearman Correlation Coefficients. The effect size (Cohen d) and standardized response mean (SRM) were used to describe the responsiveness of each PRO at the 6 week and 6 month follow-up visits and were defined as small (0.2), medium (0.5) and large (0.8). Ceiling and floor effects were defined as present if ≥15% of participants scored the highest or lowest score on a PRO, respectively. Subgroup analyses were performed comparing change in PRO scores at follow-up between participants with and without additional arthroscopic procedures (meniscal debridement and/or repair, microfracture, or OATS vs ACL reconstruction only) using linear mixed models. Results: There were excellent and excellent-good correlations between the PROMIS PF-CAT and physical function PROs including the SF36-PF (r=0.75-0.80, p0.05) to poor correlation with

Cost-effectiveness analysis of cochlear dose reduction by proton beam therapy for medulloblastoma in childhood

International Nuclear Information System (INIS)

Hirano, Emi; Kawabuchi, Koichi; Fuji, Hiroshi; Onoe, Tsuyoshi; Kumar, Vinay; Shirato, Hiroki

2014-01-01

The aim of this study is to evaluate the cost-effectiveness of proton beam therapy with cochlear dose reduction compared with conventional X-ray radiotherapy for medulloblastoma in childhood. We developed a Markov model to describe health states of 6-year-old children with medulloblastoma after treatment with proton or X-ray radiotherapy. The risks of hearing loss were calculated on cochlear dose for each treatment. Three types of health-related quality of life (HRQOL) of EQ-5D, HUI3 and SF-6D were used for estimation of quality-adjusted life years (QALYs). The incremental cost-effectiveness ratio (ICER) for proton beam therapy compared with X-ray radiotherapy was calculated for each HRQOL. Sensitivity analyses were performed to model uncertainty in these parameters. The ICER for EQ-5D, HUI3 and SF-6D were $21 716/QALY, $11 773/QALY, and $20 150/QALY, respectively. One-way sensitivity analyses found that the results were sensitive to discount rate, the risk of hearing loss after proton therapy, and costs of proton irradiation. Cost-effectiveness acceptability curve analysis revealed a 99% probability of proton therapy being cost effective at a societal willingness-to-pay value. Proton beam therapy with cochlear dose reduction improves health outcomes at a cost that is within the acceptable cost-effectiveness range from the payer's standpoint. (author)

Health related quality of life and comorbidity. A descriptive analysis comparing EQ-5D dimensions of patients in the German disease management program for type 2 diabetes and patients in routine care.

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Ose, Dominik; Miksch, Antje; Urban, Elisabeth; Natanzon, Iris; Szecsenyi, Joachim; Kunz, Cornelia Ursula; Freund, Tobias

2011-08-02

The co-occurance of multiple medical conditions has a negative impact on health related quality of life (HRQoL) for patients with type 2 diabetes. These patients demand for intensified care programs. Participation in a disease management program (DMP) for type 2 diabetes has shown to counterbalance this effect. However, it remains unclear which dimensions of HRQoL are influenced by the DMP. The aim of this study was to explore the HRQoL dimensions of patients with type 2 diabetes in the German DMP and patients in routine care (RC). This analysis is part of a comparative evaluation of the German DMP for patients with type 2 diabetes. A questionnaire, including the HRQoL measure EQ-5D, was mailed to a random sample of 3,546 patients with type 2 diabetes (59.3% female). The EQ-5D dimensions were analyzed by grouping patients according to their participation in the German DMP for diabetes into DMP and RC. Compared to patients in DMP, patients in RC reported more problems for the dimensions mobility (P German DMP for type 2 diabetes mellitus show significantly higher ratings of their HRQoL in the dimensions mobility, self care and performing usual activities compared to patients in RC. This difference can also be observed in patients with significant comorbidities. As these dimensions are known to be essential for diabetes care, the German DMP may contribute to improved care even for comorbid diabetes patients.

Rehabilitation and reconstruction of Islamic Architectural Heritage in China: the example of the Ningxia Hui Autonomous Region

OpenAIRE

Huang Lijun; François N. Dubé

2015-01-01

The Ningxia Hui Autonomous Region, located in Northwestern China, has the highest concentration of Hui Muslims in China: around 34% of the local population is Hui Muslim. Following the anti-religious campaigns of the communist regime and the wide destruction of the Cultural Revolution, Hui Muslims began gradually to reclaim their Muslim heritage in the late 70's. A major aspect of the rediscovery of their Islamic heritage was the Rehabilitation and reconstruction of Islamic Architectural buil...

A non-linear beta-binomial regression model for mapping EORTC QLQ- C30 to the EQ-5D-3L in lung cancer patients: a comparison with existing approaches.

Science.gov (United States)

Khan, Iftekhar; Morris, Stephen

2014-11-12

The performance of the Beta Binomial (BB) model is compared with several existing models for mapping the EORTC QLQ-C30 (QLQ-C30) on to the EQ-5D-3L using data from lung cancer trials. Data from 2 separate non small cell lung cancer clinical trials (TOPICAL and SOCCAR) are used to develop and validate the BB model. Comparisons with Linear, TOBIT, Quantile, Quadratic and CLAD models are carried out. The mean prediction error, R(2), proportion predicted outside the valid range, clinical interpretation of coefficients, model fit and estimation of Quality Adjusted Life Years (QALY) are reported and compared. Monte-Carlo simulation is also used. The Beta-Binomial regression model performed 'best' among all models. For TOPICAL and SOCCAR trials, respectively, residual mean square error (RMSE) was 0.09 and 0.11; R(2) was 0.75 and 0.71; observed vs. predicted means were 0.612 vs. 0.608 and 0.750 vs. 0.749. Mean difference in QALY's (observed vs. predicted) were 0.051 vs. 0.053 and 0.164 vs. 0.162 for TOPICAL and SOCCAR respectively. Models tested on independent data show simulated 95% confidence from the BB model containing the observed mean more often (77% and 59% for TOPICAL and SOCCAR respectively) compared to the other models. All algorithms over-predict at poorer health states but the BB model was relatively better, particularly for the SOCCAR data. The BB model may offer superior predictive properties amongst mapping algorithms considered and may be more useful when predicting EQ-5D-3L at poorer health states. We recommend the algorithm derived from the TOPICAL data due to better predictive properties and less uncertainty.

Is there a link between the volume of physical exercise and emotional intelligence (EQ?

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Gáspár Zoltán

2017-03-01

Full Text Available Emotional intelligence (EQ was linked to sport participation. We report two studies in which we tested the link between exercise volume, defined as weekly hours of exercise, and EQ. Volunteers (n = 64 and n = 84 completed the Wong and Law Emotional Intelligence Scale. In Study I, significant correlations between exercise volume and use- and regulation-of-emotions prompted us to use a posteriori grouping into high- and low exercise-volume groups. The former exhibited better use-of-emotions than the latter (p = .007, d = .87. In Study II, using a priori grouping, we replicated the finding from Study I (p = .001, d = .78, and the groups also differed in “self-emotions appraisal” (p = .05, d = .44 and total EQ (p = .017, d = .54. Since the items measuring the use-of-emotions involve motivational aspects of the EQ, we posit that this dimension is “naturally” linked to exercise volume. Our findings also suggest that self-emotions appraisal and the overall EQ are linked to greater volumes of exercise. These results should provide an incentive for longitudinal studies in this area.

Alteração do teor de cálcio no banho de DP para 2,5 mEq/L é eficaz no reestabelecimento dos valores preconizados por diretrizes atuais em pacientes com PTH < 150 pg/dL Low-calcium peritoneal dialysis solution is effective in bringing PTH levels to the range recommended by current guidelines in patients with PTH levels < 150 pg/dL

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Thyago Proença de Moraes

2010-09-01

followed by nephrosclerosis (25% and glomerulonephritis (14%. Converted group presented a greater increase in PTH levels when compared with the control group (Δ194 pg/dL versus Δ 92/dL; p < 0,05. Among patients switched to low calcium solution, 41% reached the target values (PTH 150300 pg/mL compared to 14% whose remain with normal calcium solutions (p < 0.05. There were no differences between groups regarding calcium, phosphorus and alkaline phosphatase. CONCLUSION: In patients with PTH < 150 pg/mL conversion to low calcium solutions (2.5 mEq/L appears to be a simple and effective strategy to bring PTH levels to the range determined by current guidelines when compared with 3.5mEq/L calcium PD solutions.

Comparison of Genetic Variants in Cancer-Related Genes between Chinese Hui and Han Populations.

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Chaoyong Tian

Full Text Available The Chinese Hui population, as the second largest minority ethnic group in China, may have a different genetic background from Han people because of its unique demographic history. In this study, we aimed to identify genetic differences between Han and Hui Chinese from the Ningxia region of China by comparing eighteen single nucleotide polymorphisms in cancer-related genes.DNA samples were collected from 99 Hui and 145 Han people from the Ningxia Hui Autonomous Region in China, and SNPs were detected using an improved multiplex ligase detection reaction method. Genotyping data from six 1000 Genomes Project population samples (99 Utah residents with northern and western European ancestry (CEU, 107 Toscani in Italy (TSI, 108 Yoruba in Ibadan (YRI, 61 of African ancestry in the southwestern US (ASW, 103 Han Chinese in Beijing (CHB, and 104 Japanese in Tokyo (JPT were also included in this study. Differences in the distribution of alleles among the populations were assessed using χ2 tests, and FST was used to measure the degree of population differentiation.We found that the genetic diversity of many SNPs in cancer-related genes in the Hui Chinese in Ningxia was different from that in the Han Chinese in Ningxia. For example, the allele frequencies of four SNPs (rs13361707, rs2274223, rs465498, and rs753955 showed different genetic distributions (p0.000 between the Hui and Han populations.These results suggest that some SNPs associated with cancer-related genes vary among different Chinese ethnic groups. We suggest that population differences should be carefully considered in evaluating cancer risk and prognosis as well as the efficacy of cancer therapy.

Rehabilitation and reconstruction of Islamic Architectural Heritage in China: the example of the Ningxia Hui Autonomous Region

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Huang Lijun

2015-06-01

Full Text Available The Ningxia Hui Autonomous Region, located in Northwestern China, has the highest concentration of Hui Muslims in China: around 34% of the local population is Hui Muslim. Following the anti-religious campaigns of the communist regime and the wide destruction of the Cultural Revolution, Hui Muslims began gradually to reclaim their Muslim heritage in the late 70's. A major aspect of the rediscovery of their Islamic heritage was the Rehabilitation and reconstruction of Islamic Architectural buildings. As of today, Ningxia counts 4,500 mosques and other religious buildings. The present article seeks to introduce the architectural tendencies at play in this reconstruction, specifically the role of competing Arabic and Chinese influences.

Using Health Utility Index (HUI for Measuring the Impact on Health-Related Quality of Life (HRQL Among Individuals with Chronic Diseases

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Frank Mo

2004-01-01

Full Text Available Quality of life is an important indicator in assessing the burden of disease, especially for chronic conditions. The Health Utilities Index (HUI is a recently developed system for measuring the overall health status and health-related quality of life (HRQL of individuals, clinical groups, and general populations. Using the HUI (constructed based on eight attributes: vision, hearing, speech, mobility, dexterity, cognition, emotion, and pain/discomfort to measure the HRQL for chronic disease patients and to detect possible associations between HUI system and various chronic conditions, this study provides information to improve the management of chronic diseases.This study is of interest to data analysts, policy makers, and public health practitioners involved in descriptive clinical studies, clinical trials, program evaluation, population health planning, and assessments. Based on the Canadian Community Health Survey (CCHS for 2000–01, the HUI was used to measure the quality of life for individuals living with various chronic conditions (Alzheimer/other dementia, effects of stroke, urinary incontinence, arthritis/rheumatism, bowel disorder, cataracts, back problems, stomach/intestinal ulcers, emphysema/COPD, chronic bronchitis, epilepsy, heart disease, diabetes, migraine headaches, glaucoma, asthma, fibromyalgia, cancers, high blood pressure, multiple sclerosis, thyroid condition, and other remaining chronic diseases. Logistic Regression Model was employed to estimate the associations between the overall HUI scores and various chronic conditions. The HUI scores ranged from 0.00 (corresponding to a state close to death to 1.00 (corresponding to perfect health; negative scores reflect health states considered worse than death. The mean HUI score by sex and age group indicated the typical quality of life for persons with various chronic conditions. Logistic Regression results showed a strong relationship between low HUI scores (≤ 0.5 and 0.06�

Drying characteristics of hui ink at 25 °C and 35 °C

Science.gov (United States)

Fu, Yang; Yao, Yao; Liu, Le; Wang, Fengwen; Yang, Shuyun

2018-05-01

Temperature and humidity are the main factors affecting the drying of Hui ink. For the experiment, fresh Hui ink billets from two big ink industries were selected. We tried to find the fast and efficient drying conditions of Hui ink and calculate effective diffusion coefficient by performing manual control of temperature and relative humidity (RH). Several dry kinetic models were fitted. A constant temperature incubator was utilized for temperature control, while humidification and dehumidification were implemented accordingly for RH control. Setups of 25 °C and 35 °C were designed, and a relative humidity of 60%, 65%, 70%, and 75% was applied for each temperature. The process of ink drying was recorded, and the drying effect of Hui ink was estimated through expert decision. The appropriate drying temperature and humidity of the Jinbuhuan(J) and Huangshansongyan(H) ink billets from Lao Hu Kai Wen Ink Industry are at (31.99 ± 1.41) °C and (55.84 ± 10.38)% RH, whereas those of the Songyantanhei(ST), Chunyouyan(CY), and Quansongyan(QS) ink billets from Ju Mo Tang Ink Industry are at (23.70 ± 2.19) °C and (60.56 ± 2.16)% RH or (34.56 ± 2.37) °C and (59.16 ± 6.38)% RH; Initial moisture content of Hui ink has great influence on the water loss in the drying process; The effective diffusion coefficient of the ink lump ranges from 8.41538E-07 to 1.95891E-06 m2·s-1, and increases mainly with the temperature's rising; Logarithmic model fits best of the chosen models.

Sensitivity analysis of EQ3

International Nuclear Information System (INIS)

Horwedel, J.E.; Wright, R.Q.; Maerker, R.E.

1990-01-01

A sensitivity analysis of EQ3, a computer code which has been proposed to be used as one link in the overall performance assessment of a national high-level waste repository, has been performed. EQ3 is a geochemical modeling code used to calculate the speciation of a water and its saturation state with respect to mineral phases. The model chosen for the sensitivity analysis is one which is used as a test problem in the documentation of the EQ3 code. Sensitivities are calculated using both the CHAIN and ADGEN options of the GRESS code compiled under G-float FORTRAN on the VAX/VMS and verified by perturbation runs. The analyses were performed with a preliminary Version 1.0 of GRESS which contains several new algorithms that significantly improve the application of ADGEN. Use of ADGEN automates the implementation of the well-known adjoint technique for the efficient calculation of sensitivities of a given response to all the input data. Application of ADGEN to EQ3 results in the calculation of sensitivities of a particular response to 31,000 input parameters in a run time of only 27 times that of the original model. Moreover, calculation of the sensitivities for each additional response increases this factor by only 2.5 percent. This compares very favorably with a running-time factor of 31,000 if direct perturbation runs were used instead. 6 refs., 8 tabs

Bioanalytical and instrumental analysis of thyroid hormone disrupting compounds in water sources along the Yangtze River

International Nuclear Information System (INIS)

Shi Wei; Wang Xiaoyi; Hu Guanjiu; Hao Yingqun; Zhang Xiaowei; Liu Hongling; Wei Si; Wang Xinru; Yu Hongxia

2011-01-01

Thyroid hormone (TH) agonist and antagonist activities of water sources along the Yangtze River in China were surveyed by a green monkey kidney fibroblast (CV-1) cell-based TH reporter gene assay. Instrumental analysis was conducted to identify the responsible thyroid-active compounds. Instrumentally derived L-3,5,3'-triiodothyronine (T 3 ) equivalents (T 3 -EQs) and thyroid receptor (TR) antagonist activity equivalents referring to dibutyl phthalate (DBP-EQs) were calculated from the concentrations of individual congeners. The reporter gene assay demonstrated that three out of eleven water sources contained TR agonist activity equivalents (TR-EQs), ranging from 286 to 293 ng T 3 /L. Anti-thyroid hormone activities were found in all water sources with the TR antagonist activity equivalents referring to DBP (Ant-TR-EQs), ranging from 51.5 to 555.3 μg/L. Comparisons of the equivalents from instrumental and biological assays suggested that high concentrations of DBP and di-2-ethylhexyl phthalate (DEHP) were responsible for the observed TR antagonist activities at some locations along the Yangtze River. - Research highlights: → First of all, we indicated the instrumentally derived L-3,5,3'-triiodothyronine (T 3 ) equivalents (T 3 -EQs) and thyroid receptor (TR) antagonist activity equivalents referring to DBP (DBP-EQs) for the very first time. → Secondly, high concentrations of DBP and DEHP might be responsible for the observed TR antagonist activities at some locations. → Finally, we found that thyroid receptor (TR) antagonist activities were very common in Yangtze River. More attentions should be paid to the TR antagonist activities and the responsible compounds. - In vitro bioassay responses observed in Yangtze River source water extracts showed great TR antagonist activities, and DBP and DEHP were responsible.

Bioanalytical and instrumental analysis of thyroid hormone disrupting compounds in water sources along the Yangtze River

Energy Technology Data Exchange (ETDEWEB)

Shi Wei [State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210093 (China); Wang Xiaoyi [State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210093 (China); Jiangsu Academy of Environmental Science, Nanjing 210036 (China); Hu Guanjiu; Hao Yingqun [State Environmental Protection Key Laboratory of Monitoring and Analysis for Organic Pollutants in Surface Water, Jiangsu Provincial Environmental Monitoring Center, Nanjing 210036 (China); Zhang Xiaowei [State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210093 (China); Liu Hongling, E-mail: hlliu@nju.edu.c [State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210093 (China); Wei Si [State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210093 (China); Wang Xinru [Key Laboratory of Reproductive Medicine and Institute of Toxicology, Nanjing Medical University, Nanjing 210029 (China); Yu Hongxia, E-mail: hongxiayu@nju.edu.c [State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210093 (China)

2011-02-15

Thyroid hormone (TH) agonist and antagonist activities of water sources along the Yangtze River in China were surveyed by a green monkey kidney fibroblast (CV-1) cell-based TH reporter gene assay. Instrumental analysis was conducted to identify the responsible thyroid-active compounds. Instrumentally derived L-3,5,3'-triiodothyronine (T{sub 3}) equivalents (T{sub 3}-EQs) and thyroid receptor (TR) antagonist activity equivalents referring to dibutyl phthalate (DBP-EQs) were calculated from the concentrations of individual congeners. The reporter gene assay demonstrated that three out of eleven water sources contained TR agonist activity equivalents (TR-EQs), ranging from 286 to 293 ng T{sub 3}/L. Anti-thyroid hormone activities were found in all water sources with the TR antagonist activity equivalents referring to DBP (Ant-TR-EQs), ranging from 51.5 to 555.3 {mu}g/L. Comparisons of the equivalents from instrumental and biological assays suggested that high concentrations of DBP and di-2-ethylhexyl phthalate (DEHP) were responsible for the observed TR antagonist activities at some locations along the Yangtze River. - Research highlights: First of all, we indicated the instrumentally derived L-3,5,3'-triiodothyronine (T{sub 3}) equivalents (T{sub 3}-EQs) and thyroid receptor (TR) antagonist activity equivalents referring to DBP (DBP-EQs) for the very first time. Secondly, high concentrations of DBP and DEHP might be responsible for the observed TR antagonist activities at some locations. Finally, we found that thyroid receptor (TR) antagonist activities were very common in Yangtze River. More attentions should be paid to the TR antagonist activities and the responsible compounds. - In vitro bioassay responses observed in Yangtze River source water extracts showed great TR antagonist activities, and DBP and DEHP were responsible.

Intoxicação experimental por monensina em eqüinos

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Bezerra Jr Pedro Soares

2000-01-01

Full Text Available Sete eqüinos foram tratados experimentalmente com monensina sódica. Dois desses animais receberem 3-4 kg/eqüino/dia de uma ração comercial sabidamente implicada em surtos naturais da intoxicação por monensina em eqüinos e que continha 180 ppm±20 da droga. Um eqüino recebeu uma única dose de 5 mg/kg e um outro recebeu 4 doses diárias de 1 mg/kg de monensina sódica originária de um premix. Esses quatro eqüinos morreram ou foram sacrificados in extremis, 3-8 dias após o início da administração da droga. Um quinto eqüino recebeu dose única de 5 mg/kg de monensina, ficou levemente doente e se recuperou. Dois eqüinos não desenvolveram sinais da intoxicação. Um desses eqüinos tinha recebido 40 doses diárias de 0,5 mg/kg de monensina e o outro recebeu 3 kg/dia de uma ração da mesma marca que a usada nas fazendas onde surtos de intoxicação por monensina foram detectados (mas de uma outra partida, mais tarde determinada como contendo menos de 5 ppm de monensina. O aparecimento dos sinais clínicos ocorreu de 2 a 5 dias após a administração da droga e a duração do quadro clínico variou de 24 a 76 horas. Os sinais clínicos incluíam taquicardia, arritmia, gemidos, incoordenação, sudorese, decúbito esternal, decúbito lateral, pedaleios e morte. Em cinco dos eqüinos intoxicados observaram-se marcadas elevações da atividade plasmática de creatina fosfoquinase e, em um eqüino, houve leve aumento da atividade plasmática de aspartato aminotransferase. Os principais achados de necropsia consistiram em áreas brancas ou amarelas, focais ou focalmente extensas e bilateralmente simétricas nos músculos esqueléticos. Essas lesões eram associadas a edema gelatinoso e translúcido das fáscias intermusculares. Quadríceps femoral, adutor, pectíneo, grácil, semi-membranáceo, supra-espinhal, subescapular, braquicefálico e quadríceps femoral estavam entre os músculos esqueléticos mais afetados. Os exames histol

EQ3/6: status and applications

Energy Technology Data Exchange (ETDEWEB)

Wolery, T.J.; Isherwood, D.J.; Jackson, K.J.; Delany, J.M.; Puigdomenech, I.

1984-12-01

EQ3/6 is a set of related computer codes and data files for use in geochemical modeling of aqueous systems. The EQ3/6 package centers around two large computer codes, EQ3NR and EQ6, which are supported by a common thermodynamic data base. EQ3NR is a speciation-solubility code, whose function is to compute a model of the state of an aqueous solution. This code is very flexible in terms of the input that it will accept. EQ6 is a reaction-path code, which calculates models of changes in aqueous systems as they proceed toward a state of overall chemical equilibrium. EQ3/6 prior to FY83 had no capability for modeling brines, because the approximations for calculating the thermodynamic activity of water and the activity coefficients of the solute species were restricted to low ionic strengths ({le} 1.0 molal). An option has been added to use Pitzer`s equations for such calculations. At present, EQ3/6 contains two alternate Pitzer coefficient data bases. Several improvements have been made to the EQ6 code. Prior to FY83, the code could run models of mineral dissolution kinetics, but could not calculate models of precipitation kinetics. This problem has been overcome by additional code development. The speed of non-kinetic EQ6 calculations has recently been enhanced by the creation of two new calculational modes, economy mode and super economy mode. A calculational mode to simulate systems open to large gas reservoirs has also been developed. 34 references.

Solução concentrada de albumina eqüina na fluidoterapia em eqüinos com desidratação leve a moderada

OpenAIRE

Belli,C.B.; Michima,L.E.S.; Latorre,S.M.; Fernandes,W.R.

2008-01-01

Avaliou-se o efeito da solução concentrada de albumina eqüina diluída a 5% em solução fisiológica (SF) durante fluidoterapia em eqüinos, após indução de desidratação leve a moderada, utilizando-se cinco eqüinos adultos, sem alterações clínicas. Cada animal passou por dois protocolos de fluidoterapia: apenas com SF (metade sob pressão e metade em fluxo contínuo - grupo-controle); com solução de albumina eqüina e SF (apenas em fluxo contínuo - grupo experimental). Avaliaram-se peso, exame físic...

Uniform topology on EQ-algebras

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Yang Jiang

2017-04-01

Full Text Available In this paper, we use filters of an EQ-algebra E to induce a uniform structure (E, , and then the part induce a uniform topology in E. We prove that the pair (E, is a topological EQ-algebra, and some properties of (E, are investigated. In particular, we show that (E, is a first-countable, zero-dimensional, disconnected and completely regular space. Finally, by using convergence of nets, the convergence of topological EQ-algebras is obtained.

"Fibromyalgia and quality of life: mapping the revised fibromyalgia impact questionnaire to the preference-based instruments".

Science.gov (United States)

Collado-Mateo, Daniel; Chen, Gang; Garcia-Gordillo, Miguel A; Iezzi, Angelo; Adsuar, José C; Olivares, Pedro R; Gusi, Narcis

2017-05-30

The revised version of the Fibromyalgia Impact Questionnaire (FIQR) is one of the most widely used specific questionnaires in FM studies. However, this questionnaire does not allow calculation of QALYs as it is not a preference-based measure. The aim of this study was to develop mapping algorithm which enable FIQR scores to be transformed into utility scores that can be used in the cost utility analyses. A cross-sectional survey was conducted. One hundred and 92 Spanish women with Fibromyalgia were asked to complete four general quality of life questionnaires, i.e. EQ-5D-5 L, 15D, AQoL-8D and SF-12, and one specific disease instrument, the FIQR. A direct mapping approach was adopted to derive mapping algorithms between the FIQR and each of the four multi-attribute utility (MAU) instruments. Health state utility was treated as the dependent variable in the regression analysis, whilst the FIQR score and age were predictors. The mean utility scores ranged from 0.47 (AQoL-8D) to 0.69 (15D). All correlations between the FIQR total score and MAU instruments utility scores were highly significant (p fibromyalgia specific questionnaire.

Psychometric properties of the Serbian version of the Empathy Quotient (S-EQ

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Dimitrijević Aleksandar

2012-01-01

Full Text Available In the present study we examined psychometric properties of the Serbian translation of the Empathy Quotient scale (S-EQ. The translated version of the EQ was applied on a sample of 694 high-school students. A sub-sample consisting of 375 high-school students also completed the Interpersonal Reactivity Index (IRI, another widely used empathy measure. The following statistical analyses were applied: internal consistency analysis, explanatory (EFA and confirmatory (CFA factor analyses, and factor congruence analysis. Correlation with IRI and gender differences were calculated to demonstrate validity of the instrument. Results show that the Serbian 40-item version of EQ has lower reliability (Cronbach’s alpha = .782 than the original. The originally proposed one factor structure of the instrument was not confirmed. The short version with 28 items showed better reliablity (alpha= .807. The three-factor solution (cognitive empathy, emotional reactivity, and social skills showed good cross-sample stability (Tucker congruence coefficient over .8 but the results of CFA confirmed the solution proposed in the reviewed literature only partially. The mean scores are similar to those obtained in the other studies, and, as expected, women have significantly higher scores than men. Correlations with all subscales of IRI are statistically significant for the first two subscales of EQ, but not for the „social skills.” We concluded that the Serbian version of the „Empathy Quotient” is a useful research tool which can contribute to cross-cultural studies of empathy, although its psychometric characteristics are not as good as those obtained in the original study. We also suggest that a 28-item should be used preferably to the original 40-item version. [Projekat Ministarstva nauke Republike Srbije, br. 179018: Identification, measurement and development of cognitive and emotional competences important for a society oriented to European integrations

Reliability of patient-reported outcome instruments in US adults with hemophilia: the Pain, Functional Impairment and Quality of life (P-FiQ study

Directory of Open Access Journals (Sweden)

Kempton CL

2017-09-01

Full Text Available Christine L Kempton,1 Michael Wang,2 Michael Recht,3 Anne Neff,4 Amy D Shapiro,5 Amit Soni,6 Roshni Kulkarni,7 Tyler W Buckner,2 Katharine Batt,8 Neeraj N Iyer,9 David L Cooper9 1Departments of Pediatrics and Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA; 2Hemophilia and Thrombosis Center, University of Colorado School of Medicine, Aurora, CO, USA; 3The Hemophilia Center, Oregon Health & Science University, Portland, OR, USA; 4Hematology and Medical Oncology, Cleveland Clinic, Cleveland, OH, USA; 5Indiana Hemophilia & Thrombosis Center, Indianapolis, IN, USA; 6Center for Inherited Blood Disorders and CHOC Children’s Hospital/UC Irvine, Orange, CA, USA; 7MSU Center for Bleeding and Clotting Disorders, Michigan State University, East Lansing, MI, USA; 8Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USA; 9Clinical, Medical and Regulatory Affairs, Novo Nordisk Inc., Plainsboro, NJ, USA Background: Hemophilia is marked by frequent joint bleeding, resulting in pain and functional impairment.Objective: This study aimed to assess the reliability of five patient-reported outcome (PRO instruments in people with hemophilia (PWH in a non-bleeding state.Methods: Adult male PWH of any severity and inhibitor status, with a history of joint pain or bleeding, completed a pain history and five PRO instruments (EQ-5D-5L, Brief Pain Inventory v2 [BPI], International Physical Activity Questionnaire [IPAQ], Short Form 36 Health Survey v2 [SF-36v2], and Hemophilia Activities List [HAL] during their routine comprehensive care visit. Patients were approached to complete the PRO instruments again at the end of their visit while in a similar non-bleeding state. Concordance of individual questionnaire items and correlation between domain scores were assessed using intra-class correlation coefficient (ICC.Results: Participants completing the retest (n=164 had a median age of 33.9 years. Median time for

Avaliação de solução concentrada de albumina eqüina na fluidoterapia em eqüinos com desidratação leve a moderada

OpenAIRE

Carla Bargi Belli

2005-01-01

A utilização de colóides é indicada em várias situações, mas nem sempre aplicável na clínica de eqüinos. O objetivo desse trabalho foi avaliar o uso de solução concentrada de albumina eqüina (diluída a 5%) durante fluidoterapia em eqüinos com desidratação leve a moderada, comparando-a com fluidoterapia apenas com solução fisiológica. Foram utilizados dois grupos de cinco eqüinos adultos, sem alterações clínicas. Cada animal passou pelo protocolo dos dois grupos experimentais (fluidoterapia ap...

3D printing of surgical instruments for long-duration space missions.

Science.gov (United States)

Wong, Julielynn Y; Pfahnl, Andreas C

2014-07-01

The first off-Earth fused deposition modeling (FDM) 3D printer will explore thermoplastic manufacturing capabilities in microgravity. This study evaluated the feasibility of FDM 3D printing 10 acrylonitrile butadiene styrene (ABS) thermoplastic surgical instruments on Earth. Three-point bending tests compared stiffness and yield strength between FDM 3D printed and conventionally manufactured ABS thermoplastic. To evaluate the relative speed of using four printed instruments compared to conventional instruments, 13 surgeons completed simulated prepping, draping, incising, and suturing tasks. Each surgeon ranked the performance of six printed instruments using a 5-point Likert scale. At a thickness of 5.75 mm or more, the FDM printing process had a less than 10% detrimental effect on the tested yield strength and stiffness of horizontally printed ABS thermoplastic relative to conventional ABS thermoplastic. Significant weakness was observed when a bending load was applied transversely to a 3D printed layer. All timed tasks were successfully performed using a printed sponge stick, towel clamp, scalpel handle, and toothed forceps. There was no substantial difference in time to completion of simulated surgical tasks with control vs. 3D printed instruments. Of the surgeons, 100%, 92%, 85%, 77%, 77%, and 69% agreed that the printed smooth and tissue forceps, curved and straight hemostats, tissue and right angle clamps, respectively, would perform adequately. It is feasible to 3D print ABS thermoplastic surgical instruments on Earth. Loadbearing structures were designed to be thicker, when possible. Printing orientations were selected so that the printing layering direction of critical structures would not be transverse to bending loads.

Comparison of health-related quality of life and functional recovery measurement tools in out-of-hospital cardiac arrest survivors.

Science.gov (United States)

Andrew, Emily; Nehme, Ziad; Bernard, Stephen; Smith, Karen

2016-10-01

Although a number of validated health-related quality of life (HR-QOL) instruments exist for critical care populations, a standardised approach to assessing the HR-QOL of out-of-hospital cardiac arrest (OHCA) survivors has not been developed. We sought to compare the responses of 12-month OHCA survivors to three HR-QOL and functional recovery instruments, and assess instrument validity. The Victorian Ambulance Cardiac Arrest Registry invited 12-month OHCA survivors to participate in telephone follow-up between January 2011 and December 2015. Responders provided answers to the 12 Item Short Form Health Survey (SF-12), Three-Level EuroQol-5D (EQ-5D-3L) and the Glasgow Outcome Scale-Extended (GOSE). The SF-12 was also used to derive the SF-6D. Responses were used to assess the interpretability and construct validity of the instruments. A total of 1188 patients and proxies responded. Large ceiling effects were observed for the EQ-5D-3L (patients=46%, proxies=23%). Substantial variability was also observed in SF-6D responses for patients who reported full health according to the EQ-5D-3L. For patient responders, the strongest correlations were observed between the EQ-5D-3L index score and SF-6D (ρ=0.65, pGOSE outcome and lower or upper good recovery (pGOSE suggest that these may be useful measures of HR-QOL and functional recovery in OHCA survivors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Concept de Plate-forme Mobile Instrumentée (PMI) pour l'inspection des ouvrages d'art

OpenAIRE

DERKX, F; DUMOULIN, J; SORIN, JL; LEGEAY, V

2002-01-01

L'inspection des ouvrages d'art est une opération nécessaire afin de maintenir le niveau de l'ouvrage et de garantir la sécurité des usagers. C'est une opération normalisée et réalisée périodiquement par des inspecteurs spécialisés. Elle consiste principalement à relever visuellement la totalité des défauts sur l'ensemble de l'ouvrage. Il est question aujourd'hui d'automatiser certaines tâches afin d'améliorer l'efficacité opérationnelle de ces contrôles à l'aide de dispositifs de vision emba...

Health-related quality of life in HIV/AIDS patients on antiretroviral therapy at a tertiary care facility in Zimbabwe.

Science.gov (United States)

Mafirakureva, N; Dzingirai, B; Postma, M J; van Hulst, M; Khoza, S

2016-07-01

Health-related quality of life (HRQoL) is a broad concept reflecting a patient's general subjective perception of the effect of an illness or intervention on physical, psychological and social aspects of their daily life. HRQoL among patients infected with HIV has become an important indicator of impact of disease and treatment outcomes. A cross-sectional survey was carried out at Chitungwiza Central Hospital, Zimbabwe, to assess HRQoL in patients with HIV/AIDS receiving antiretroviral therapy (ART), using two validated instruments. The HIV/AIDS-targeted quality of life (HAT-QoL) and EuroQoL Five-dimensions-Three-level (EQ-5D-3L) instruments were used to assess HRQoL. Internal consistency reliability and convergent validity of the two instruments were also evaluated. For construct validity, the relationships between HRQoL scores and socio-economic and HIV/AIDS-related characteristics were explored. The median scores for the HAT-QoL dimensions ranged from 33.3 (financial worries) to 100 (HIV mastery). A considerably low HAT-QoL dimension score of 50.0 was observed for sexual function. There were ceiling effects for all HAT-QoL dimension scores except for financial worries and disclosure worries. Floor effects were observed for financial worries and sexual function. The median of the EQ-5D-3L index and visual analogue scale (VAS) was 0.81 and 79.0, respectively. There were no floor or ceiling effects for both the EQ-5D-3L index and VAS. The overall scale Cronbach's alpha was 0.83 for HAT-Qol and 0.67 for EQ-5D-3L. HAT-QoL demonstrated good convergent validity with EQ-5D index (0.58) and VAS (0.40). A higher level of HRQoL was positively and significantly related to income, education and employment. The patients' self-reported HRQoL was generally satisfactory in all the HAT-QoL dimensions as well as the two components on the EQ-5D-3L instrument. The two instruments demonstrated good measurement properties in HIV/AIDS patients receiving ART and have potential for use

EQ DAN AQ DALAM PENGEMBANGAN PROFESIONALISME PUSTAKAWAN

Directory of Open Access Journals (Sweden)

Aris Nurohman

2016-05-01

EQ and AQ in developing of librarian profession will aid to self control and emotion management. By EQ and AQ will aid librarians able to manage self complexity, so it will bear intellectual, skill, behavior, leadership, good personality, smart, creative, progressive and broad horizon.

Supplement to nuclear EQ sourcebook: A compilation of documents for nuclear equipment qualification

International Nuclear Information System (INIS)

Anon.

1993-01-01

In the nuclear power industry, environmental and seismic qualification of safety-related electrical and instrumentation equipment is collectively known as Equipment Qualification (EQ). Related technology, as well as regulatory requirements, have evolved rapidly during the last 15 years. For environmental qualification, what began in 1971 with one trial-use guide (IEEE Std 323-1971), now stands as a full complement of Nuclear Regulatory Commission (NRC) rules, guides, and industry standards. As the original 1992 version of the Nuclear EQ Sourcebook was compiled to serve the user-community need for a complete and exhaustive single source of nuclear EQ documentation, this Supplement is published to provide the user community with nuclear EQ documentation revisions and updates that have been published since the publication of the original volume in May of 1992. The first volume of this publication included documents issued before December, 1991. That first volume was well received and also prompted positive response from industry on its usefulness and on recommendations to improve the completeness and enhance the ease of use. This Supplement, therefore, includes new documents, revisions, and updates issued and published since December 1991 and up to and including March 1993. It incorporates various enhancements in order to better serve the user community. One such enhancement included in this Supplement is the new Equipment Classification Index that is described in the User Guide section of this publication. 37 papers, including Bulletins, Federal rules, Generic Letters, Notices, Regulatory Guides, IEEE Standards, IEEE Recommended Practices, and IEEE Guides, have been processed separately for inclusion on the data base

EQ3/6 software test and verification report 9/94

International Nuclear Information System (INIS)

Kishi, T.

1996-02-01

This document is the Software Test and Verification Report (STVR) for the EQ3/6 suite of codes as stipulated in the Individual Software Plan for Initial Qualification of EQ3/6 (ISP-NF-07, Revision 1, 11/25/92). The software codes, EQPT, EQ3NR, EQ6, and the software library EQLIB constitute the EQ3/6 software package. This software test and verification project for EQ3/6 was started under the requirements of the LLNL Yucca Mountain Project Software Quality Assurance Plan (SQAP), Revision 0, December 14, 1989, but QP 3.2, Revision 2, June 21, 1994 is now the operative controlling procedure. This is a ''V and V'' report in the language of QP 3.2, Revision 2. Because the author of this report does not have a background in geochemistry, other technical sources were consulted in order to acquire some familiarity with geochemisty, the terminology minology involved, and to review comparable computational methods especially, geochemical aqueous speciation-solubility calculations. The software for the EQ3/6 package consists of approximately 47,000 lines of FORTRAN77 source code and nine on platforms ranging from workstations to supercomputers. The physical control of EQ3/6 software package and documentation is on a SUN SPARC station. Walkthroughs of each principal software packages, EQPT, EQ3NR, and EQ6 were conducted in order to understand the computational procedures involved, to determine any commonality in procedures, and then to establish a plan for the test and verification of EQ3/6. It became evident that all three phases depended upon solving an n x n matrix by the Newton-Raphson Method. Thus, a great deal of emphasis on the test and verification of this procedure was carried out on the first code in the software package EQPT

EQ3/6 software test and verification report 9/94

Energy Technology Data Exchange (ETDEWEB)

Kishi, T.

1996-02-01

This document is the Software Test and Verification Report (STVR) for the EQ3/6 suite of codes as stipulated in the Individual Software Plan for Initial Qualification of EQ3/6 (ISP-NF-07, Revision 1, 11/25/92). The software codes, EQPT, EQ3NR, EQ6, and the software library EQLIB constitute the EQ3/6 software package. This software test and verification project for EQ3/6 was started under the requirements of the LLNL Yucca Mountain Project Software Quality Assurance Plan (SQAP), Revision 0, December 14, 1989, but QP 3.2, Revision 2, June 21, 1994 is now the operative controlling procedure. This is a ``V and V`` report in the language of QP 3.2, Revision 2. Because the author of this report does not have a background in geochemistry, other technical sources were consulted in order to acquire some familiarity with geochemisty, the terminology minology involved, and to review comparable computational methods especially, geochemical aqueous speciation-solubility calculations. The software for the EQ3/6 package consists of approximately 47,000 lines of FORTRAN77 source code and nine on platforms ranging from workstations to supercomputers. The physical control of EQ3/6 software package and documentation is on a SUN SPARC station. Walkthroughs of each principal software packages, EQPT, EQ3NR, and EQ6 were conducted in order to understand the computational procedures involved, to determine any commonality in procedures, and then to establish a plan for the test and verification of EQ3/6. It became evident that all three phases depended upon solving an n x n matrix by the Newton-Raphson Method. Thus, a great deal of emphasis on the test and verification of this procedure was carried out on the first code in the software package EQPT.

Le chamanisme, un projet d’étude scientifique aujourd’hui. À propos d’un article de H. Rydving

OpenAIRE

Stépanoff, Charles

2013-01-01

Dans son article « Le chamanisme aujourd’hui : constructions et déconstructions d’une illusion scientifique », Håkan Rydving entend démontrer le caractère inopérant et même néfaste des notions de « chamane » et « chamanisme » en anthropologie. Selon lui, leur emploi donne une illusion de familiarité qui nuit à la description circonstanciée du contexte social, historique et culturel des phénomènes étudiés. Il considère ainsi que : « la traduction de böö, noaidi, angakkoq, etc. par ‘chamane’ ca...

Les accélérateurs de particules : vecteurs de découvertes, moteurs de développement.

CERN Multimedia

CERN. Geneva

2014-01-01

English version follows Les accélérateurs de particules : vecteurs de découvertes, moteurs de développement. par Dr. Philippe Lebrun Les accélérateurs de particules existent depuis plus d’un siècle comme instruments de recherche fondamentale qui ont permis la découverte des particules élémentaires et leur étude à des échelles toujours plus fines. Épousant les technologies émergentes dont ils ont stimulé les progrès, ils se sont développés de manière exponentielle tout au long du XXe siècle, pour être aujourd’hui les grands outils de la recherche en physique des particules, mais aussi – comme puissantes sources de rayonnements permettant de sonder la matière – en physique atomique et moléculaire, en physique d...

[Flipping moxibustion of Hui medicine combined with western medication for rheumatoid arthritis with cold dampness bi syndrome].

Science.gov (United States)

Wang, Shunji; Ye, Gaxi; Zhang, Yu; Guan, Shuting; Liu, Xiufen; Ren, Wenjing

2017-10-12

To compare the effects of flipping moxibustion of Hui medicine combined with western medication and simple western medication for rheumatoid arthritis with cold dampness bi syndrome. Eighty patients were randomly assigned into an observation group and a control group, 40 cases in each group. Oral methotrexate (1 time a week) and sulfasalazine (twice a day except the day for methotrexate) were used in the two groups. Patients in the observation group were treated with flipping moxibustion of Hui medicine, twice a week. The main acupoints were Shenshu (BL 23), Guanyuan (CV 4), Zusanli (ST 36), Yinlingquan (SP 9), and the matching acupoints were in the meridians related to the disease location. All the treatment was given for continuous 4 weeks. The TCM symptom score, visual analogue scale (VAS) score, blood sedimentation (ESR), rheumatoid factor (RF) and C-reactive protein (CRP) were observed before and after treatment. The effect was evaluated. The total effect rate in the observation group was 95.0% (38/40), which was better than 77.5% (31/40) in the control group ( P bi syndrome are better than simple western medication, which are safer and more effective.

A systematic literature review of health state utility values in head and neck cancer.

Science.gov (United States)

Meregaglia, Michela; Cairns, John

2017-09-02

Health state utility values (HSUVs) are essential parameters in model-based economic evaluations. This study systematically identifies HSUVs in head and neck cancer and provides guidance for selecting them from a growing body of health-related quality of life studies. We systematically reviewed the published literature by searching PubMed, EMBASE and The Cochrane Library using a pre-defined combination of keywords. The Tufts Cost-Effectiveness Analysis Registry and the School of Health and Related Research Health Utilities Database (ScHARRHUD) specifically containing health utilities were also queried, in addition to the Health Economics Research Centre database of mapping studies. Studies were considered for inclusion if reporting original HSUVs assessed using established techniques. The characteristics of each study including country, design, sample size, cancer subsite addressed and demographics of responders were summarized narratively using a data extraction form. Quality scoring and critical appraisal of the included studies were performed based on published recommendations. Of a total 1048 records identified by the search, 28 studies qualified for data extraction and 346 unique HSUVs were retrieved from them. HSUVs were estimated using direct methods (e.g. standard gamble; n = 10 studies), multi-attribute utility instruments (MAUIs; n = 13) and mapping techniques (n = 3); two studies adopted both direct and indirect approaches. Within the MAUIs, the EuroQol 5-dimension questionnaire (EQ-5D) was the most frequently used (n = 11), followed by the Health Utility Index Mark 3 (HUI3; n = 2), the 15D (n = 2) and the Short Form-Six Dimension (SF-6D; n = 1). Different methods and types of responders (i.e. patients, healthy subjects, clinical experts) influenced the magnitude of HSUVs for comparable health states. Only one mapping study developed an original algorithm using head and neck cancer data. The identified studies were considered

La recherche alpine aujourd’hui

Directory of Open Access Journals (Sweden)

Jean-Jacques Brun

2009-06-01

Full Text Available Alpine research benefits from several international coordination networks, only one of which – ISCAR (the International Scientific Committee on Research in the Alps – works solely in the Alpine arc. The creation of ISCAR is a consequence of the input and involvement of various Alpine partners around the Alpine Convention. Alpine research now aims to promote an integrated vision of Alpine territories focusing on creating and maintaining spatial and temporal networks of sustainable relationships between humans and the other components of the ecosphere. It combines resource usage with conservation of the biological and cultural diversity that makes up the Alpine identity. This article aims to show: (1 how international Alpine research coordination is organised; (2 the role played by the Alpine Convention as a framework of reference for specifically Alpine research; and (3 the role that the ISCAR international commit-tee and the Interreg “Alpine Space” programmes play in uniting research around territorial challenges relating to biodiversity conservation and territorial development.La recherche sur les Alpes bénéficie de plusieurs réseaux de coordination internationaux dont un seul, le comité international recherche alpine (ISCAR, se consacre exclusivement à l’arc alpin. La création de l’ISCAR est une retombée de la mobilisation des divers partenaires alpins autour de la mise en place de la Convention alpine. Aujourd’hui, la recherche alpine vise à promouvoir une vision intégrée des territoires centrée sur la création et le maintien d’un réseau spatial et temporel de relations durables entre les hommes et les autres composantes de l’écosphère. Elle associe étroitement la mise en valeur des ressources et la conservation des diversités biologiques et culturelles qui constituent l’identité alpine. Cet article a pour ambition de montrer : (1 comment s’organise la coordination internationale des recherches sur les

Structural equation modeling with EQS basic concepts, applications, and programming

CERN Document Server

Byrne, Barbara M

2013-01-01

Readers who want a less mathematical alternative to the EQS manual will find exactly what they're looking for in this practical text. Written specifically for those with little to no knowledge of structural equation modeling (SEM) or EQS, the author's goal is to provide a non-mathematical introduction to the basic concepts of SEM by applying these principles to EQS, Version 6.1. The book clearly demonstrates a wide variety of SEM/EQS applications that include confirmatory factor analytic and full latent variable models. Written in a "user-friendly" style, the author "walks" the reader through the varied steps involved in the process of testing SEM models: model specification and estimation, assessment of model fit, EQS output, and interpretation of findings. Each of the book's applications is accompanied by: a statement of the hypothesis being tested, a schematic representation of the model, explanations of the EQS input and output files, tips on how to use the pull-down menus, and the data file upon which ...

Original Research Validation and reliability of the Chichewa ...

African Journals Online (AJOL)

5D is a standardised instrument that measures health-related quality-of-life and explores cost-effectiveness of treatments. ... Fifty-three patients with various musculoskeletal problems were administered the Chichewa EQ-5D-3L and World.

The EQ3/6 software package for geochemical modeling: Current status

International Nuclear Information System (INIS)

Worlery, T.J.; Jackson, K.J.; Bourcier, W.L.; Bruton, C.J.; Viani, B.E.; Knauss, K.G.; Delany, J.M.

1988-07-01

EQ3/6 is a software package for modeling chemical and mineralogic interactions in aqueous geochemical systems. The major components of the package are EQ3NR (a speciation-solubility code), EQ6 (a reaction path code), EQLIB (a supporting library), and a supporting thermodynamic data base. EQ3NR calculates aqueous speciation and saturation indices from analytical data. It can also be used to calculate compositions of buffer solutions for use in laboratory experiments. EQ6 computes reaction path models of both equilibrium step processes and kinetic reaction processes. These models can be computed for closed systems and relatively simple open systems. EQ3/6 is useful in making purely theoretical calculations, in designing, interpreting, and extrapolating laboratory experiments, and in testing and developing submodels and supporting data used in these codes. The thermodynamic data base supports calculations over the range 0-300 degree C. 60 refs., 2 figs

The EQ3/6 software package for geochemical modeling: Current status

Energy Technology Data Exchange (ETDEWEB)

Wolery, T.J.; Jackson, K.J.; Bourcier, W.L.; Bruton, C.J.; Viani, B.E.; Knauss, K.G.; Delany, J.M.

1988-07-01

EQ3/6 is a software package for modeling chemical and mineralogic interactions in aqueous geochemical systems. The major components of the package are EQ3NR (a speciation-solubility code), EQ6 (a reaction path code), EQLIB (a supporting library), and a supporting thermodynamic data base. EQ3NR calculates aqueous speciation and saturation indices from analytical data. It can also be used to calculate compositions of buffer solutions for use in laboratory experiments. EQ6 computes reaction path models of both equilibrium step processes and kinetic reaction processes. These models can be computed for closed systems and relatively simple open systems. EQ3/6 is useful in making purely theoretical calculations, in designing, interpreting, and extrapolating laboratory experiments, and in testing and developing submodels and supporting data used in these codes. The thermodynamic data base supports calculations over the range 0-300{degree}C. 60 refs., 2 figs.

Traduire encore Bertin aujourd'hui : pourquoi faire ? Les nouvelles faces cachées de la Sémiologie Graphique

Science.gov (United States)

Dhieb, Mohsen

2018-05-01

La « Sémiologie Graphique » de Bertin est un ouvrage majeur de la cartographie contemporaine. Cependant, dès sa parution en 1967, cet ouvrage a suscité autant d'intérêt que de méfiance : l'ouvrage n'était pas dans le « moule » de la littérature cartographique en vigueur. Pourtant, si plusieurs de ses principes et concepts fondateurs ont été adoptés, plusieurs autres ne sont pas bien passés ou n'ont pas été mis en pratique. Il y a comme un fossé entre certains énoncés théoriques de l'ouvrage et leur mise en pratique. Certaines affirmations de Bertin peuvent paraître obsolètes aujourd'hui à l'heure du numérique, comme la non prise en compte de l'aspect dynamique ou interactif de la carte. L'avènement récent des SIG, de la géomatique et des systèmes de Cartographie Assistée par Ordinateur a relégué les vieilles méthodes de traitement graphique de l'information au second rang. Dès lors pourquoi traduire encore aujourd'hui, à l'heure du numérique, la « Sémiologie Graphique » ? Justement, d'abord, parce que certains principes restent, en substance, peu connus ; plusieurs aspects demeurent encore à explorer ; certaines méthodes et techniques manuelles délaissées peuvent être revisitées et remises en marche grâce à la visualisation ; des innovations n'ont pas été expérimentées ou implémentées par les moyens numériques. Dans le monde arabe, peu de recherches se sont imprégnées de sémiologie graphique. Lors de la traduction de l'ouvrage en arabe, des points restés obscurs ont été décelés. Ce sont ces quelques idées et réflexions qui nous ont poussés à revivre cette formidable aventure.

Preliminary validation and principal components analysis of the Control of Eating Questionnaire (CoEQ) for the experience of food craving.

Science.gov (United States)

Dalton, M; Finlayson, G; Hill, A; Blundell, J

2015-12-01

The Control of Eating Questionnaire (CoEQ) comprises 21-items that are designed to assess the severity and type of food cravings an individual experiences over the previous 7 days. The CoEQ has been used in clinical trials as a multi-dimensional measure of appetite, craving and mood regulation however its underlying component structure has yet to be determined. The current paper has two aims; (1) to examine the psychometric properties, and internal consistency of the CoEQ; and (2) to provide a preliminary examination of the underlying components by exploring their construct and predictive validity. Data were pooled from four studies in which a total 215 adults (80% women; Age=29.7 ± 10.3; BMI=26.5 ± 5.2) had completed the CoEQ alongside measures of psychometric eating behaviour traits, ad libitum food intake, and body composition. A principal components analysis (PCA) and parallel analysis was conducted to examine the underlying structure of the questionnaire. The resulting subscales were tested for internal consistency (Cronbach's α=0.66-0.88). PCA revealed four components that explained 54.5% of the variance. The components were identified as: Craving Control, Positive Mood, Craving for Sweet, and Craving for Savoury. Associations between the underlying CoEQ subscales and measures of body composition and eating behaviour traits confirmed construct validity of the subscales. The associations between the subscales and snack food selection and intake of palatable snack foods supported the CoEQ's predictive validity. The CoEQ has good psychometric properties with a clear component structure and acceptable internal consistency. This preliminary validation supports the CoEQ as a measure of the experience of food cravings.

Development and validation of a shared decision-making instrument for health-related quality of life one year after total hip replacement based on quality registries data.

Science.gov (United States)

Nemes, Szilard; Rolfson, Ola; Garellick, Göran

2018-02-01

Clinicians considering improvements in health-related quality of life (HRQoL) after total hip replacement (THR) must account for multiple pieces of information. Evidence-based decisions are important to best assess the effect of THR on HRQoL. This work aims at constructing a shared decision-making tool that helps clinicians assessing the future benefits of THR by offering predictions of 1-year postoperative HRQoL of THR patients. We used data from the Swedish Hip Arthroplasty Register. Data from 2008 were used as training set and data from 2009 to 2012 as validation set. We adopted two approaches. First, we assumed a continuous distribution for the EQ-5D index and modelled the postoperative EQ-5D index with regression models. Second, we modelled the five dimensions of the EQ-5D and weighted together the predictions using the UK Time Trade-Off value set. As predictors, we used preoperative EQ-5D dimensions and the EQ-5D index, EQ visual analogue scale, visual analogue scale pain, Charnley classification, age, gender, body mass index, American Society of Anesthesiologists, surgical approach and prosthesis type. Additionally, the tested algorithms were combined in a single predictive tool by stacking. Best predictive power was obtained by the multivariate adaptive regression splines (R 2  = 0.158). However, this was not significantly better than the predictive power of linear regressions (R 2  = 0.157). The stacked model had a predictive power of 17%. Successful implementation of a shared decision-making tool that can aid clinicians and patients in understanding expected improvement in HRQoL following THR would require higher predictive power than we achieved. For a shared decision-making tool to succeed, further variables, such as socioeconomics, need to be considered. © 2016 John Wiley & Sons, Ltd.

The construct validity of the health utilities index mark 3 in assessing health status in lung transplantation

Directory of Open Access Journals (Sweden)

Zuk Dalyce

2010-09-01

Full Text Available Abstract Purpose To assess the cross-sectional construct validity of the Health Utilities Index Mark 3 (HUI3 in lung transplantation. Methods Two hundred and thirteen patients (103 pre-transplant and 110 post-transplant with mean age 53 years old (SD 13 were recruited during a randomized controlled clinical trial at the out-patient clinic in a tertiary institution. At baseline, patients self-completed measures that included the HUI3, EuroQol EQ-5D, Hospital Anxiety and Depression Scale (HADS and socio-demographic questionnaire. Six-minute walk test scores and forced expiratory volume in 1 second data were collected from patient's medical records. A priori hypotheses were formulated by members of the transplant team about the expected degree of association between the measures. Correlation coefficients of Results Of the ninety predictions made, forty three were correct but in 31 the correlation was slightly lower than predicted and in 7 the correlations were much higher than predicted. In 48% of the cases, predicted and observed associations were in agreement. Predictions of associations were off by one category in 42% of the cases; in 10% of the cases the predictions were off by two categories. Conclusions This is the first study providing evidence of cross-sectional construct validity of HUI3 in lung transplantation. Results indicate that the HUI3 was able to capture the burden of lung disease before transplantation and that post-transplant patients enjoyed higher health-related quality of life than pre-transplant patients.

Edentulism and dental prostheses in the elderly: impact on quality of life measured with EuroQol--visual analog scale (EQ-VAS).

Science.gov (United States)

Cano-Gutiérrez, Carlos; Borda, Miguel G; Arciniegas, Antonio J; Borda, Claudia X

2015-01-01

The objective of this study was to measure the impact of edentulism and dental prostheses on quality of life (QOL) in older adults in Bogota, Colombia. Edentulism is a frequent condition in older adults and has great impact on their QOL. No epidemiological data are currently available on edentulism among older adults in Colombia. Data were obtained from the SABE-Bogota study, a cross-sectional study conducted in 2012, and used to analyze the EQ-VAS (Visual Analog Scale) from the EuroQol instrument to measure the perception of quality of life (QOL) in relation to edentulism. The study included 2,000 individuals over 60 years old. The Spearman-Rho correlation was used to analyze the correlation between EQ-VAS and edentulism. Chi-Square, ANOVA and t-test were used to study the differences in EQ-VAS scores between edentulous and healthy subjects. Statistical significance was set at peducation were related to edentulism. Individuals with fewer teeth and dental prostheses had lower EQ-VAS scores (pmeasuring the perception of QOL in dental health scenarios. Edentulism significantly affects QOL in older adults and the use of dental prosthesis does not improve the perception of QOL.

Quality of Life and Utility in Patients with Metastatic Soft Tissue and Bone Sarcoma: The Sarcoma Treatment and Burden of Illness in North America and Europe (SABINE Study

Directory of Open Access Journals (Sweden)

Peter Reichardt

2012-01-01

Full Text Available The aim of the study was to assess health-related quality of life (HRQoL among metastatic soft tissue (mSTS or bone sarcoma (mBS patients who had attained a favourable response to chemotherapy. We employed the EORTC QLQ-C30, the 3-item Cancer-Related Symptoms Questionnaire, and the EQ-5D instrument. HRQoL was evaluated overall and by health state in 120 mSTS/mBS patients enrolled in the SABINE study across nine countries in Europe and North America. Utility was estimated from responses to the EQ-5D instrument using UK population-based weights. The mean EQ-5D utility score was 0.69 for the pooled patient sample with little variation across health states. However, patients with progressive disease reported a clinically significant lower utility (0.56. Among disease symptoms, pain and respiratory symptoms are common. This study showed that mSTS/mBS is associated with reduced HRQoL and utility among patients with metastatic disease.

Investigation of natural radioactivity level of the waters in the Ningxia Hui Autonomous Region

International Nuclear Information System (INIS)

Jing Yupei; Wang Li; Tian Yi; Ai Xianyuan; Liang Ningbu

1995-01-01

This paper reports the investigation results of natural radioactivity level in river, lake, reservoir, spring, well and tap water in the Ningxia Hui Autonomous Region. There were totally 117 samples collected from 84 measuring points. The results show that the radioactivity level of varied water bodies of the region was within normal natural background

回族独特法律意识成因初探%The Preliminary Study on the Hui Ethnicity Unique Legal Consciousness

Institute of Scientific and Technical Information of China (English)

高研秋

2015-01-01

As a special form of social consciousness ,legal consciousness is the general name of people’ s thinking about the law and legal phenomena ,concepts ,ideas ,knowledge and psychology .Contemporary Hui ethnicity legal consciousness ,which is a special awareness of the law ,is different from legal con‐sciousness of Han nationality . Based on the empirical investigation of contemporary Hui ethnicity students’ legal consciousness ,this paper obtained the following causes of Hui ethnicity legal conscious‐ness:the cultural core settled dow n from the formation of the Hui nationality ,w hich survived from the Han cultural identity and change with its own characteristics ;sharia law and ethics contained in Koran and hadith is a determining factor on the formation of Hui ethnicity legal consciousness ;mosque education is a special educational support and place for Hui people learning and passing on their religious law .%法律意识是社会意识的一个特殊形式，是人们关于法和法律现象的思想、理念、观点、知识和心理的总和。当代回族法律意识作为一种特殊群体的法律意识有别于汉族法律意识。本文在实证调查基础之上，得出了以下回族法律意识成因：回族族群的形成过程中，与汉文化的认同与变迁中沉淀下来的“融而不化”、“和而不同”的文化内核；《古兰经》、“圣训”蕴含的伊斯兰教法及道德规范对回族法律意识观的形成具有决定因素；回族群众具有特殊的教育载体及特殊的宗教法传习场所———“经堂”。

Tablatures : Exposition photographique d'instruments virtuels GENESIS

OpenAIRE

Cadoz, Claude

2012-01-01

International audience; Le concept de « composer le son », introduit et expérimenté musicalement par Jean-Claude Risset à partir des années 1960 par la synthèse de sons par ordinateur, prolonge, élargit, dépasse et transforme l'acte d'écriture pour des instruments mécano-acoustiques. Il ne résout cependant pas la question de l'instrumentalité, particulièrement mise à mal avec l'ordinateur. Les technologies de modélisation et de simulation numériques pour « écrire l'instrument pour le composer...

Evaluation of Instrumentation for Measuring Undissolved Water in Aviation Turbine Fuels per ASTM D3240

Science.gov (United States)

2015-11-05

Undissolved Water in Aviation Turbine Fuels per ASTM D3240 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Joel Schmitigal... water ) in Aviation Turbine Fuels per ASTM D3240 15. SUBJECT TERMS fuel, JP-8, aviation fuel, contamination, free water , undissolved water , Aqua-Glo 16...Michigan 48397-5000 Evaluation of Instrumentation for Measuring Undissolved Water in Aviation Turbine Fuels per ASTM D3240 Joel Schmitigal Force

Laminite experimental: aspectos morfológicos, morfométricos e ultra-estruturais das lâminas dérmicas e epidérmicas do casco de eqüinos tratados com a trinitroglicerina

OpenAIRE

Sampaio, Rita de Cássia de Lima [UNESP

2007-01-01

As alterações ultra-estruturais ocorridas nas lâminas epidérmicas e dérmicas de eqüinos com laminite são responsáveis pela rotação ou afundamento da falange distal dentro do casco. Com o objetivo de prevenir esta ocorrência foram estudados os efeitos da sobrecarga de carboidratos (SCHO), assim como da utilização de trinitroglicerina na fase prodrômica da laminite, nas lâminas epidérmicas do casco de quinze eqüinos. A indução da laminite por meio da sobrecarga de carboidratos alterou siginific...

Energy efficiency and CO{sub 2} -eq emissions of forest chip supply chains in Finland 2020

Energy Technology Data Exchange (ETDEWEB)

Kariniemi, A.; Kaerhae, K. (Metsaeteho Oy, Helsinki (Finland)), Email: arto.kariniemi@metsateho.fi, Email: kalle.karha@metsateho.fi

2009-07-01

The research carried out by Metsaeteho Oy calculated what would be the total fuel consumption and CO{sub 2}-eq emissions of forest chip production if the use of forest chips is 24 TWhin 2020 in Finland in accordance with the target set of Long-term Climate and Energy Strategy. CO{sub 2}-eq emissions were determined with Metsaeteho OY's updated Emissions Calculation Model. If the production and consumption of forest chips in Finland are 24 TWh in 2020, then the total CO{sub 2}-eq emissions would be around 245000 tonnes. The volume of diesel consumption was 79 million litres and petrol 1,5 millions litres. Electric rail transportation and chipping at the mill site consumed 15 GWh of electricity. The supply chain with the lowest CO{sub 2}-eq emissions was logging residues comminuted at plant. Conversely, the highest CO{sub 2}-eq emissions came from stump wood when operating with terminal comminuting. Some 3% of the energy content was consumed during the forest chip production. Energy input/output ratio in the total volume was 0.030 MWh/MWh which varied from 0.022 to 0.044 between the supply systems researched. Hence, forest chip production gave a net of some 97% of the energy content delivered at the plant. (orig.)

Proof and Pedagogy in Ancient China: Examples from Liu Hui's Commentary on "JIU ZHANG SUAN SHU".

Science.gov (United States)

Siu, Man-Keung

1993-01-01

Illustrates the pedagogical implications embodied in Liu Hui's discussion on the ancient Chinese mathematical classic "JIU ZHANG SUAN SHU" (Nine Chapters on the Mathematical Art) with respect to aspects of proof and, more generally, the role of proof in mathematics. Provides examples involving area and volume. (Contains 25 references.)…

Validation of the Spine Oncology Study Group-Outcomes Questionnaire to assess quality of life in patients with metastatic spine disease.

Science.gov (United States)

Janssen, Stein J; Teunis, Teun; van Dijk, Eva; Ferrone, Marco L; Shin, John H; Hornicek, Francis; Schwab, Joseph H

2017-06-01

General questionnaires are often used to assess quality of life in patients with spine metastases, although a disease-specific survey did not exist until recently. The Spine Oncology Study Group has developed an outcomes questionnaire (SOSG-OQ) to measure quality of life in these patients. However, a scoring system was not developed, and the questionnaire was not validated in a group of patients, nor was it compared with other general quality of life questionnaires such as the EuroQol 5 Dimensions (EQ-5D) questionnaire. Our primary null hypothesis is that there is no association between the SOSG-OQ and EQ-5D. Our secondary null hypothesis is that there is no difference in coverage and internal consistency between the SOSG-OQ and EQ-5D. We also assess coverage, consistency, and validity of the domains within the SOSG-OQ. A survey study from a tertiary care spine referral center was used for this study. The patient sample consisted of 82 patients with spine metastases, myeloma, or lymphoma. The SOSG-OQ (27 questions, 6 domains) score ranges from 0 to 80, with a higher score indicating worse quality of life. The EQ-5D (5 questions, 5 domains) index score ranges from 0 to 1, with a higher score indicating better quality of life. The association between the SOSG-OQ and EQ-5D index score was assessed using the Spearman rank correlation. Instrument coverage and precision were assessed by determining item completion rate, median score with range, and floor and ceiling effect. Internal consistency was assessed using Cronbach alpha. Multitrait analysis and exploratory factor analysis were used to analyze properties of the individual domains in the SOSG-OQ. The Spearman rank correlation between the SOSG-OQ and EQ-5D questionnaire was high (r=-0.83, pquality of life in patients with metastatic spine disease. The SOSG-OQ is superior to the EQ-5D in terms of coverage and internal consistency but consists of more questions. Copyright © 2015 Elsevier Inc. All rights reserved.

« Comment le sais-tu ? ». La paralepse, aujourd’hui

Directory of Open Access Journals (Sweden)

Frank Wagner

2013-04-01

Full Text Available À partir des définitions genettiennes de la paralepse (excès d’informations par rapport au code modal dominant, il s’agit de cerner les usages et les fonctions du procédé dans la littérature narrative d’aujourd’hui, en relation homo- ou hétérodiégétique, en régime fictionnel ou semi-fictionnel. Des exemples prélevés dans divers récits contemporains (de Roegiers, Toussaint, Carrère, Echenoz permettent de constater que la paralepse assure un renouvellement du soupçon à l’époque actuelle, en jouant un rôle de révélateur épistémologique. En effet, ce procédé narratif paradoxal engage une réflexion en acte sur la fiction, son perspectivisme, ses capacités de modélisation, et ses pouvoirs heuristiques.Based upon Gerard Genette’s definitions of paralepsis, (information exceeding that normally offered by the dominant mode of narrative focalisation, this article seeks to outline the uses and functions of the device in contemporary narrative literature, through its homo and heterodiegetic positioning in both fictional and semi-fictional texts. Examples taken from a variety of contemporary stories (Roegiers, Toussaint, Carrère, Echenoz allow us to see that paralepsis plays a role of epistemological indicator, facilitating a contemporary renewal of suspicion (le soupçon concerning narration. In fact, this paradoxical narrative device brings about a reflection upon fiction, its perspectivism, its modelling capabilities and heuristic capacities.

Where's WALY? : A proof of concept study of the 'wellbeing adjusted life year' using secondary analysis of cross-sectional survey data.

Science.gov (United States)

Johnson, Rebecca; Jenkinson, David; Stinton, Chris; Taylor-Phillips, Sian; Madan, Jason; Stewart-Brown, Sarah; Clarke, Aileen

2016-09-08

The Quality-Adjusted Life Year (QALY) is a measure that combines life extension and health improvement in a single score, reflecting preferences around different types of health gain. It can therefore be used to inform decision-making around allocation of health care resources to mutually exclusive options that would produce qualitatively different health benefits. A number of quality-of-life instruments can be used to calculate QALYs. The EQ-5D is one of the most commonly used, and is the preferred option for submissions to NICE ( https://www.nice.org.uk/process/pmg9/ ). However, it has limitations that might make it unsuitable for use in areas such as public and mental health where interventions may aim to improve well-being. One alternative to the QALY is a Wellbeing-Adjusted Life Year. In this study we explore the need for a Wellbeing-Adjusted Life Year measure by examining the extent to which a measure of wellbeing (the Warwick-Edinburgh Mental Well-being Scale) maps onto the EQ-5D-3L. Secondary analyses were conducted on data from the Coventry Household Survey in which 7469 participants completed the EQ-5D-3L, Warwick-Edinburgh Mental Well-being Scale, and a measure of self-rated health. Data were analysed using descriptive statistics, Pearson's and Spearman's correlations, linear regression, and receiver operating characteristic curves. Approximately 75 % of participants scored the maximum on the EQ-5D-3L. Those with maximum EQ-5D-3L scores reported a wide range of levels of mental wellbeing. Both the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were able to detect differences between those with higher and lower levels of self-reported health. Linear regression indicated that scores on the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were weakly, positively correlated (with R(2) being 0.104 for the index and 0.141 for the visual analogue scale). The Warwick-Edinburgh Mental Well-being Scale maps onto the EQ-5D-3L to only a

Five preference-based indexes in cataract and heart failure patients were not equally responsive to change.

Science.gov (United States)

Kaplan, Robert M; Tally, Steven; Hays, Ron D; Feeny, David; Ganiats, Theodore G; Palta, Mari; Fryback, Dennis G

2011-05-01

To compare the responsiveness to clinical change of five widely used preference-based health-related quality-of-life indexes in two longitudinal cohorts. Five generic instruments were simultaneously administered to 376 adults undergoing cataract surgery and 160 adults in heart failure management programs. Patients were assessed at baseline and reevaluated after 1 and 6 months. The measures were the Short Form (SF)-6D (based on responses scored from SF-36v2), Self-Administered Quality of Well-being Scale (QWB-SA), the EuroQol-5D developed by the EuroQol Group, the Health Utilities Indexes Mark 2 (HUI2) and Mark 3 (HUI3). Cataract patients completed the National Eye Institute Visual Functioning Questionnaire-25, and heart failure patients completed the Minnesota Living with Heart Failure Questionnaire. Responsiveness was estimated by the standardized response mean. For cataract patients, mean changes between baseline and 1-month follow-up for the generic indices ranged from 0.00 (SF-6D) to 0.052 (HUI3) and were statistically significant for all indexes except the SF-6D. For heart failure patients, only the SF-6D showed significant change from baseline to 1 month, whereas only the QWB-SA change was significant between 1 and 6 months. Preference-based methods for measuring health outcomes are not equally responsive to change. Copyright © 2011 Elsevier Inc. All rights reserved.

Preference-based measures to obtain health state utility values for use in economic evaluations with child-based populations: a review and UK-based focus group assessment of patient and parent choices.

Science.gov (United States)

Wolstenholme, Jane L; Bargo, Danielle; Wang, Kay; Harnden, Anthony; Räisänen, Ulla; Abel, Lucy

2018-03-21

No current guidance is available in the UK on the choice of preference-based measure (PBM) that should be used in obtaining health-related quality of life from children. The aim of this study is to review the current usage of PBMs for obtaining health state utility values in child and adolescent populations, and to obtain information on patient and parent-proxy respondent preferences in completing PBMs in the UK. A literature review was conducted to determine which instrument is most frequently used for child-based economic evaluations and whether child or proxy responses are used. Instruments were compared on dimensions, severity levels, elicitation and valuation methods, availability of value sets and validation studies, and the range of utility values generated. Additionally, a series of focus groups of parents and young people (11-20 years) were convened to determine patient and proxy preferences. Five PBMs suitable for child populations were identified, although only the Health Utilities Index 2 (HUI2) and Child Heath Utility 9D (CHU-9D) have UK value sets. 45 papers used PBMs in this population, but many used non-child-specific PBMs. Most respondents were parent proxies, even in adolescent populations. Reported missing data ranged from 0.5 to 49.3%. The focus groups reported their experiences with the EQ-5D-Y and CHU-9D. Both the young persons' group and parent/proxy groups felt that the CHU-9D was more comprehensive but may be harder for a proxy to complete. Some younger children had difficulty understanding the CHU-9D questions, but the young persons' group nonetheless preferred responding directly. The use of PBMs in child populations is increasing, but many studies use PBMs that do not have appropriate value sets. Parent proxies are the most common respondents, but the focus group responses suggest it would be preferred, and may be more informative, for older children to self-report or for child-parent dyads to respond.

EDITORIAL

African Journals Online (AJOL)

TNHJOURNALPH

questionnaire-39 (a disease-specific instrument), the EQ-5D (a generic instrument), a clinical evaluation with the Hoehn and Yahr stage of illness scale and the motor section of the Unified. Parkinson's Disease Rating Scale. They conclude that Patients with Parkinson's disease had much poorer generic and specific health ...

Measuring health-related quality of life in population-based studies of coronary heart disease: comparing six generic indexes and a disease-specific proxy score.

Science.gov (United States)

Garster, Noelle C; Palta, Mari; Sweitzer, Nancy K; Kaplan, Robert M; Fryback, Dennis G

2009-11-01

To compare HRQoL differences with CHD in generic indexes and a proxy CVD-specific score in a nationally representative sample of U.S. adults. The National Health Measurement Study, a cross-sectional random-digit-dialed telephone survey of adults aged 35-89, administered the EQ-5D, QWB-SA, HUI2, HUI3, SF-36v2 (yielding PCS, MCS, and SF-6D), and HALex. Analyses compared 3,350 without CHD (group 1), 265 with CHD not taking chest pain medication (group 2), and 218 with CHD currently taking chest pain medication (group 3), with and without adjustment for demographic variables and comorbidities. Data on 154 patients from heart failure clinics were used to construct a proxy score utilizing generic items probing CVD symptoms. Mean scores differed between CHD groups for all indexes with and without adjustment (P < 0.0001 for all except MCS P = 0.018). Unadjusted group 3 versus 1 differences were about three times larger than for group 2 versus 1. Standardized differences for the proxy score were similar to those for generic indexes, and were about 1.0 for all except MCS for group 3 versus 1. Generic indexes capture differences in HRQoL in population-based studies of CHD similarly to a score constructed from questions probing CVD-specific symptoms.

Business Ethics of The Hui Nationality & Its Contemporary Significance%回族的商业伦理思想及其当代意义

Institute of Scientific and Technical Information of China (English)

张晓华; 吕广文

2012-01-01

　　回族起源于唐宋时期阿拉伯地区的来华商人，是一个以商为本的民族。回族商人在长期的经济活动中形成了一套集法律、宗教、道德于一体的商业伦理思想，在这一独具特色思想的指导下，回民族的经济健康、有序地发展，民族不断繁荣强大。在今天的社会主义市场经济体制下，弘扬回族商业伦理思想，仍然具有十分重要的现实指导意义。%　　The Hui Nationality originated from the Arabian merchants came to china in the Tang and Song Dynasties, it is a business-oriented nation. By the long-term economic activities, Hui merchants formed a set of business ethics incorporating the law, religion and morality. Under the guidance of this unique idea, Hui's economy achieves sound and orderly development, and their nation becomes more and more prosperous and powerful. In the context of today’s socialist market economic system, carrying forward the business ethics of the Hui Nationality sill has important practical and guiding significance.

Are coping strategies and locus of control orientation associated with health-related quality of life in older adults with and without depression?

Science.gov (United States)

Helvik, Anne-Sofie; Bjørkløf, Guro Hanevold; Corazzini, Kirsten; Selbæk, Geir; Laks, Jerson; Østbye, Truls; Engedal, Knut

2016-01-01

The aim of this study was to investigate relationships between coping and health related quality of life (HRQoL) in older adults (aged ≥60 years) with and without depression. This cross-sectional study included 144 depressed inpatients from seven psychogeriatric hospital units in Norway and 106 community-living older adults without depression. HRQoL was measured using Euro Qol Group's EQ-5D Index and visual analog scale (EQ-VAS). Two aspects of coping were of primary interest for HRQoL: locus of control (LOC) and ways of coping (WOC). Measures of depressive symptoms, cognitive functioning, instrumental activities of daily living, and general physical health were included as covariates. In linear regression analyses adjusted for age, stronger external LOC was associated with poorer HRQoL in both depressed and non-depressed older adults. In the fully-specified regression models for both groups, the association between stronger external LOC and poorer HRQoL remained significant for the EQ-VAS score but not the EQ-5D Index. WOC was not associated with HRQoL in either group. Total amount of explained variance in fully-specified models was considerably lower in the sample of depressed, hospitalized older adults (17.1% and 15.5% for EQ-5D index and EQ-VAS, respectively), than in the sample of non-depressed, community-based older adults (45.8% and 48.9% for EQ-5D Index and EQ-VAS, respectively). One aspect of coping (LOC orientation) was associated with HRQoL in both depressed and non-depressed older adult samples, and therefore may be an important target for intervention for both groups. Differences in the amount of variance explained in models for the two groups warrant further research. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Characterization of a Full-Length Endogenous Beta-Retrovirus, EqERV-Beta1, in the Genome of the Horse (Equus caballus

Directory of Open Access Journals (Sweden)

Antoinette C. van der Kuyl

2011-06-01

Full Text Available Information on endogenous retroviruses fixed in the horse (Equus caballus genome is scarce. The recent availability of a draft sequence of the horse genome enables the detection of such integrated viruses by similarity search. Using translated nucleotide fragments from gamma-, beta-, and delta-retroviral genera for initial searches, a full-length beta-retrovirus genome was retrieved from a horse chromosome 5 contig. The provirus, tentatively named EqERV-beta1 (for the first equine endogenous beta-retrovirus, was 10434 nucleotide (nt in length with the usual retroviral genome structure of 5’LTR-gag-pro-pol-env-3’LTR. The LTRs were 1361 nt long, and differed approximately 1% from each other, suggestive of a relatively recent integration. Coding sequences for gag, pro and pol were present in three different reading-frames, as common for beta-retroviruses, and the reading frames were completely open, except that the env gene was interrupted by a single stopcodon. No reading frame was apparent downstream of the env gene, suggesting that EqERV-beta1 does not encode a superantigen like mouse mammary tumor virus (MMTV. A second proviral genome of EqERV-beta1, with no stopcodon in env, is additionally integrated on chromosome 5 downstream of the first virus. Single EqERV-beta1 LTRs were abundantly present on all chromosomes except chromosome 24. Phylogenetically, EqERV-beta1 most closely resembles an unclassified retroviral sequence from cattle (Bos taurus, and the murine beta-retrovirus MMTV.

Interim report on modeling sorption with EQ3/6

International Nuclear Information System (INIS)

Viani, B.

1988-01-01

Reversible, equilibrium models of sorption to be incorporated into the EQ3/6 geochemical modeling package are summarized. Empirical sorption models as formulated in linear, Langmuir, and Freundlich isotherms will be developed as options to EQ3/6. This work will be done at LLNL. Options for modeling sorption using surface- complexation constructs (diffuse, constant capacitance, and triple-layer models) will also be developed. Development of the surface-complexation options will require part of the work be done under contract. 27 refs., 1 fig

Revisão de 26 casos clínicos de duodeno-jejunite proximal em eqüinos (1996-2000

Directory of Open Access Journals (Sweden)

Fernandes Wilson Roberto

2003-01-01

Full Text Available Os dados de 26 eqüinos com duodeno-jejunite proximal (DJP, examinados no HOVET-FMVZ-USP entre dezembro de 1996 e novembro de 2000, foram revisados. Durante esse período, foram atendidos 1555 animais, dos quais 205 apresentavam distúrbios gastrintestinais (13,2%. Os casos de DJP representaram 1,7% do total de eqüinos atendidos. A idade, os achados clínico-laboratoriais e a evolução clínica foram comparados entre eqüinos sobreviventes (grupo 1 e eqüinos não sobreviventes (grupo 2. Vinte eqüinos (76,9% sobreviveram. Todos os animais foram submetidos exclusivamente a tratamento médico. A análise dos resultados foi feita através de comparação entre médias pelo teste t de Student com significância de 5%. Houve diferença significativa entre os dois grupos em relação aos seguintes parâmetros analisados: contagem total de leucócitos no sangue, creatinina sérica e freqüência cardíaca. A principal complicação nos animais recuperados foi laminite (30,8%.

Production and refining of Dacryodes edulis “native pear” seeds oil

African Journals Online (AJOL)

STORAGESEVER

2008-05-02

May 2, 2008 ... ml/g). Bleaching of 0.2% Na2CO3 degummed oil resulted in oil with peroxide value of 20 mgEq/Kg which ... Nigeria, Liberia, Cameroons and Zaire (Boungou, et al., .... Hui YJ Ed., John Wiley and Sons ... Robert Maxwell, pp.

26 CFR 1.1275-5 - Variable rate debt instruments.

Science.gov (United States)

2010-04-01

... nonpublicly traded property. A debt instrument (other than a tax-exempt obligation) that would otherwise... variations in the cost of newly borrowed funds in the currency in which the debt instrument is denominated... on the yield of actively traded personal property (within the meaning of section 1092(d)(1)). (ii...

Quantifying Health Utilities in Patients Undergoing Stereotactic Body Radiation Treatment for Liver Metastases for Use in Future Economic Evaluations.

Science.gov (United States)

Warren, B; Munoz-Schuffenegger, P; Chan, K K W; Chu, W; Helou, J; Erler, D; Chung, H

2017-09-01

Stereotactic body radiation therapy (SBRT) is increasingly used as an option for those with liver metastases. In order to facilitate future economic impact of health technologies, health utility scores may be used. The EuroQOL-5D-3L (EQ-5D) preference-based healthy utility instrument was used to evaluate the impact of treatment with SBRT on health utility scores. Between August 2013 and October 2014, 31 patients treated with 3-5 fractions of SBRT for liver metastases were enrolled in this study. The EQ-5D instrument was administered at baseline, during and up to 6 months post-SBRT. Mean EQ-5D score at baseline was 0.857, which remained stable across the entire study time period. Transient increases in difficulties with mobility (9.7% reported at baseline to 16.1% on the last day of treatment) and usual activities (3.2% reported at baseline to 34.5% on day two) were found during the course of treatment; these returned to baseline levels subsequently. The mean visual analogue score at baseline was 65.8 and remained unchanged throughout treatment and follow-up. The stability of health utility scores and problems reported by patients undergoing treatment indicate that SBRT for liver metastases does not impart a significant adverse effect on quality of life. These results may be used for future economic evaluation of SBRT. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Immediate versus Delayed Sequential Bilateral Cataract Surgery: A Systematic Review and Meta-Analysis.

Directory of Open Access Journals (Sweden)

Monali S Malvankar-Mehta

Full Text Available Immediately sequential bilateral cataract surgery (ISBCS, the cataract surgery that is performed in both eyes simultaneously, is gaining popularity worldwide compared to the traditional treatment paradigm: delayed sequential bilateral cataract surgery (DSBCS, the surgery that is performed in each eye on a different day as a completely separate operation. ISBCS provides advantages to patients and patients' families in the form of fewer hospital visits. Additionally, patients enjoy rapid rehabilitation, lack of anisometropia - potentially reducing accidents and falls, and avoid suboptimal visual function in daily life. The hospital may benefit due to lower cost.To perform a systematic review and meta-analysis to evaluate ISBCS and DSBCS.Databases including MEDLINE, EMBASE, BIOSIS, CINAHL, Health Economic Evaluations Database (HEED, ISI Web of Science (Thomson-Reuters and the Cochrane Library were searched.Not applicable.Literature was systematically reviewed using EPPI-Reviewer 4 gateway. Meta-analysis was conducted using STATA v. 13.0. Standardized mean difference (SMD and 95% confidence intervals (CI were calculated and heterogeneity was assessed using I2 statistics. Fixed-effect and random-effect models were computed based on heterogeneity. Meta-analysis was done by instrument used to calculate utility score.In total, 9,133 records were retrieved from multiple databases and an additional 128 records were identified through grey literature search. Eleven articles with 3,657 subjects were included for analysis. Our meta-analysis results indicated significant improvement in post-operative utility score using TTO, EQ5D, HUI3, VF-7, and VF-14 and a non-significant improvement using Catquest questionnaire for both surgeries. For ISBCS versus DSBCS, utility-specific fixed-effect model provided an overall SMD of the utility score using the TTO method as 0.12 (95% CI: -0.15, 0.40, EQ5D as 0.14 (95% CI: -0.14, 0.41, HUI3 as 0.12 (95% CI: -0.15, 0.40, VF

ERASMUS-F: pathfinder for an E-ELT 3D instrumentation

Science.gov (United States)

Kelz, Andreas; Roth, Martin M.; Bacon, Roland; Bland-Hawthorn, Joss; Nicklas, Harald E.; Bryant, Julia J.; Colless, Matthew; Croom, Scott; Ellis, Simon; Fleischmann, Andreas; Gillingham, Peter; Haynes, Roger; Hopkins, Andrew; Kosmalski, Johan; O'Byrne, John W.; Olaya, Jean-Christophe; Rambold, William N.; Robertson, Gordon

2010-07-01

ERASMUS-F is a pathfinder study for a possible E-ELT 3D-instrumentation, funded by the German Ministry for Education and Research (BMBF). The study investigates the feasibility to combine a broadband optical spectrograph with a new generation of multi-object deployable fibre bundles. The baseline approach is to modify the spectrograph of the Multi-Unit Spectroscopic Explorer (MUSE), which is a VLT integral-field instrument using slicers, with a fibre-fed input. Taking advantage of recent developments in astrophotonics, it is planed to equip such an instrument with fused fibre bundles (hexabundles) that offer larger filling factors than dense-packed classical fibres. The overall project involves an optical and mechanical design study, the specifications of a software package for 3Dspectrophotometry, based upon the experiences with the P3d Data Reduction Software and an investigation of the science case for such an instrument. As a proof-of-concept, the study also involves a pathfinder instrument for the VLT, called the FIREBALL project.

Assessing utility where short measures are required: development of the short Assessment of Quality of Life-8 (AQoL-8) instrument.

Science.gov (United States)

Hawthorne, Graeme

2009-09-01

As researchers seek to include clinical outcomes, the health-related quality of life (HRQoL) of participants and meet economic evaluation demands, they are confronted with collecting disparate outcome data where parsimony is imperative. This study addressed this through construction of a short HRQoL measure, the Assessment of Quality of Life (AQoL)-8 from the original AQoL. Data from the AQoL validation database (N = 996) were reanalyzed using item response theory (IRT) to identify the least fitting items, which were removed. The standard AQoL scoring algorithm and weights were applied. Validity, reliability, and sensitivity tests were carried out using the 2004 South Australian Health Omnibus Survey (N = 3015), including direct comparisons with other short utility measures, the EQ5D and SF6D. The IRT analysis showed that the AQoL was a weak scale (Loevinger H = 0.36) but reliable (Mokken rho = 0.84). Removal of the four weakest items led to an 8-item instrument with two items per subscale, the AQoL-8. The AQoL-8 Loevinger H = 0.38 and Mokken rho = 0.80 suggested similar psychometric properties to the AQoL. It correlated (intraclass correlation coefficient) 0.95 (or 90% of shared variance) with the AQoL. The AQoL-8 was as sensitive to six common health conditions as the AQoL, EQ5D, and SF6D. The utility scores fall on the same life-death scale as those of the AQoL. Where parsimony is imperative, researchers may consider use of the AQoL-8 to collect participant self-report HRQoL data that is suitable for use either as reported outcomes or for the calculation of quality-adjusted life-years for cost-utility analysis.

Health-related quality of life: validity, reliability, and responsiveness of SF-36, 15D, EQ-5D [corrected] RAQoL, and HAQ in patients with rheumatoid arthritis

DEFF Research Database (Denmark)

Linde, Louise; Sørensen, Jan; Ostergaard, Mikkel

2008-01-01

.21-6.47). The longitudinal sample included 80% women, median age 60 years (22-82). Validity: all instruments discriminated between low, moderate, and high DAS28. Reliability: RAQoL and HAQ displayed good repeatability (ICC > 0.95) and internal consistency (Cronbach's alpha > 0.90). Responsiveness: SF-36 bodily pain scale......, 15D, Rheumatoid Arthritis Quality of Life Scale (RAQoL), Health Assessment Questionnaire (HAQ), and visual analog scales (VAS) for pain, fatigue, and global RA. Validity (convergent, discriminant, and known-groups) was evaluated in a cross-section of 200 patients. Reliability was evaluated...... questionnaires (at 2 weeks and 6 months) included questions about changes in health status since baseline. RESULTS: The cross-sectional sample included 77% women, median age 57 years (range 19-87), disease duration 6 years (0-58), with Disease Activity Score 28-joint count (DAS28) of 3.10 (1...

The impact of incident fractures on health-related quality of life: 5 years of data from the Canadian Multicentre Osteoporosis Study.

Science.gov (United States)

Papaioannou, A; Kennedy, C C; Ioannidis, G; Sawka, A; Hopman, W M; Pickard, L; Brown, J P; Josse, R G; Kaiser, S; Anastassiades, T; Goltzman, D; Papadimitropoulos, M; Tenenhouse, A; Prior, J C; Olszynski, W P; Adachi, J D

2009-05-01

Using prospective data from the Canadian Multicentre Osteoporosis Study (CaMos), we compared health utilities index (HUI) scores after 5 years of follow-up among participants (50 years and older) with and without incident clinical fractures. Incident fractures had a negative impact on HUI scores over time. This study examined change in health-related quality of life (HRQL) in those with and without incident clinical fractures as measured by the HUI. The study cohort was 4,820 women and 1,783 men (50 years and older) from the CaMos. The HUI was administered at baseline and year 5. Participants were sub-divided into incident fracture groups (hip, rib, spine, forearm, pelvis, other) and were compared with those without these fractures. The effects of both time and fracture type on HUI scores were examined in multivariable regression analyses. Men and women with hip fractures, compared to those without, had lower HUI measures that ranged from -0.05 to -0.25. Both women and men with spine fractures had significant deficits on the pain attributes (-0.07 to -0.12). In women, self-care (-0.06), mobility and ambulation (-0.05) were also negatively impacted. Women with rib fractures had deficits similar to women with spine fractures, and these effects persisted over time. In men, rib fractures did not significantly affect HUI scores. Pelvic and forearm fractures did not substantially influence HUI scores. The HUI was a sensitive measure of HRQL change over time. These results will inform economic analyses evaluating osteoporosis therapies.

Validez convergente y discriminante del Inventario de Cociente Emocional (EQ-i

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Evangelina Regner

2008-01-01

Full Text Available Desde la aparición del constructo de inteligencia emocional (Salovey & Mayer, 1990 el campo de las habilidades emocionales se ha ido ampliando notablemente, debido a la apa rición de diferentes conceptualizaciones, teorías e instrumentos de medición. Los desarrollos actuales se han centrado en el estudio de la validez de las pruebas utilizadas para medir la inteligencia emocional. El objetivo de la investigación que se informa fue estudiar la validez convergente y discriminante del Inventario de Cociente Emocional (EQ-i de Bar-On (1997a, 1997b en una muestra argentina de 100 personas adultas. Los instrumentos aplicados fueron: el EQ-i, el Inventario Re visado de Personalidad NEO (NEO PI-R de Costa y Mc Crae (1992 y la Prueba de Inteligencia o de Razonamiento Ver bal (RV de Bennett, Seashore y Wesman (1992. Para analizar los datos se realizaron correlaciones entre el EQ-i, el NEO PI-R y RV y regresiones múltiples por pasos sucesivos entre los factores de personalidad del NEO PI-R y las escalas de inteligencia emocional del EQ-i...

The Predictability of Iranian EFL Teachers’ Emotional Quotient (EQ with Their Job Satisfaction

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Pantea Khoshnoodfar

2018-03-01

Full Text Available As teacher education and teacher related issues are under the attention in the past decade in second language (L2 teaching /learning; this research investigated the predictability of Iranian EFL teachers’ emotional quotient (EQ with their job satisfaction. To this end, 90 EFL teachers at English language institutes in Tehran province were selected as the participants. The needed data was gathered by the use of two standardized questionnaires (filled by the participants: EQ and teacher job satisfaction questionnaires. First of all, the normality of the gathered data was checked through using SPSS version 23. Then, the Spearman coefficient of correlation was used to find whether there is any relationship between the participants’ EQ and job satisfaction.  The results proved the two variables had a statistically significant and positive correlation with each other. In the next step, the researchers opted for the multiple regression analysis to achieve the research objective. The present study was a quasi-Experimental including a cause and effect design. The predictor was the independent variable (EQ and the predicted one was the dependent variable (job satisfaction. The findings illustrated a statistically significant and positive predictability of Iranian EFL teachers’ EQ with their job satisfaction. The results of the present research would be useful for second language teacher education courses. It was proven that, since teachers’ EQ can control their job satisfaction, the findings of the present paper could be beneficial in teacher training issues and teacher education.

A review of health utilities across conditions common in paediatric and adult populations

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Hopkins Robert B

2010-01-01

Full Text Available Abstract Background Cost-utility analyses are commonly used in economic evaluations of interventions or conditions that have an impact on health-related quality of life. However, evaluating utilities in children presents several challenges since young children may not have the cognitive ability to complete measurement tasks and thus utility values must be estimated by proxy assessors. Another solution is to use utilities derived from an adult population. To better inform the future conduct of cost-utility analyses in paediatric populations, we reviewed the published literature reporting utilities among children and adults across selected conditions common to paediatric and adult populations. Methods An electronic search of Ovid MEDLINE, EMBASE, and the Cochrane Library up to November 2008 was conducted to identify studies presenting utility values derived from the Health Utilities Index (HUI or EuroQoL-5Dimensions (EQ-5D questionnaires or using time trade off (TTO or standard gamble (SG techniques in children and/or adult populations from randomized controlled trials, comparative or non-comparative observational studies, or cross-sectional studies. The search was targeted to four chronic diseases/conditions common to both children and adults and known to have a negative impact on health-related quality of life (HRQoL. Results After screening 951 citations identified from the literature search, 77 unique studies included in our review evaluated utilities in patients with asthma (n = 25, cancer (n = 23, diabetes mellitus (n = 11, skin diseases (n = 19 or chronic diseases (n = 2, with some studies evaluating multiple conditions. Utility values were estimated using HUI (n = 33, EQ-5D (n = 26, TTO (n = 12, and SG (n = 14, with some studies applying more than one technique to estimate utility values. 21% of studies evaluated utilities in children, of those the majority being in the area of oncology. No utility values for children were reported in skin

A Patient-Assessed Morbidity to Evaluate Outcome in Surgically Treated Vestibular Schwannomas.

Science.gov (United States)

Al-Shudifat, Abdul Rahman; Kahlon, Babar; Höglund, Peter; Lindberg, Sven; Magnusson, Måns; Siesjo, Peter

2016-10-01

Outcome after treatment of vestibular schwannomas can be evaluated by health providers as mortality, recurrence, performance, and morbidity. Because mortality and recurrence are rare events, evaluation has to focus on performance and morbidity. The latter has mostly been reported by health providers. In the present study, we validate 2 new scales for patient-assessed performance and morbidity in comparison with different outcome tools, such as quality of life (QOL) (European Quality of Life-5 dimensions [EQ-5D]), facial nerve score, and work capacity. There were 167 total patients in a retrospective (n = 90) and prospective (n = 50) cohort of surgically treated vestibular schwannomas. A new patient-assessed morbidity score (paMS), a patient-assessed Karnofsky score (paKPS), the patient-assessed QOL (EQ-5D) score, work capacity, and the House-Brackmann facial nerve score were used as outcome measures. Analysis of paMS components and their relation to other outcomes was done as uni- and multivariate analysis. All outcome instruments, except EQ-5D and paKPS, showed a significant decrease postoperatively. Only the facial nerve score (House-Brackmann facial nerve score) differed significantly between the retrospective and prospective cohorts. Out of the 16 components of the paMS, hearing dysfunction, tear dysfunction, balance dysfunction, and eye irritation were most often reported. Both paMS and EQ-5D correlated significantly with work capacity. Standard QOL and performance instruments may not be sufficiently sensitive or specific to measure outcome at the cohort level after surgical treatment of vestibular schwannomas. A morbidity score may yield more detailed information on symptoms that can be relevant for rehabilitation and occupational training after surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

Coordination of CO to the alkaline earth metallocene [(Me₅C₅)₂Ca

OpenAIRE

Selg, Peter; Brintzinger, Hans-Herbert; Andersen, Richard A.; Horváth, István T.

1995-01-01

The exothermic formation of a Ca–CO complex [Eq.(a), ΔHo = −25 kJ mol−1] confirms that CO can bind to a metal center without π back donation from filled d orbitals. In its spectroscopic properties, the calcocene–carbonyl complex resembles "nonclassical" noble metal carbonyl complexes. Cp* = η5-C5Me5.

Judicialização da política pública de assistência farmacêutica e eqüidade

OpenAIRE

Chieffi,Ana Luiza; Barata,Rita Barradas

2009-01-01

O fornecimento de medicamentos por ação judicial, pela Secretaria de Estado da Saúde de São Paulo (SES-SP), tornou-se uma prática rotineira e cada vez mais freqüente. A judicialização do sistema de saúde entra em confronto com princípios básicos do SUS, como o da eqüidade. Este trabalho caracterizou as demandas judiciais para obtenção de medicamentos sob a ótica da judicialização da política pública e da quebra do princípio da eqüidade na dimensão coletiva. O estudo é um trabalho descritivo d...

Association Study between Polycystic Ovarian Syndrome and the Susceptibility Genes Polymorphisms in Hui Chinese Women.

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Lingxia Ha

Full Text Available Polycystic ovary syndrome (PCOS is one of the most common endocrine-metabolic disorders. Evidence of familial aggregation analysis and different clinical traits among different regions and ethnicities indicated that the pathogenesis of PCOS is associated with multiple genetic and environmental factors. Our previous research had identified three susceptibility loci (rs2479106, DENND1A; rs13405728, LHCGR; rs13429458, THADA for PCOS in Han Chinese women. The overall aim of this study was to investigate the relationship between three susceptibility gene polymorphisms and PCOS in Hui ethnic women.151 patients with PCOS (case group and 99 healthy women (control group were recruited from the Reproductive Medicine Center of the General Hospital of Ningxia Medical University. Clinical data and serum hormone characteristics of case and control groups were collected and analyzed. The three susceptibility single-nucleotide polymorphisms have been replicated in both case and control groups. Gene polymorphisms were detected by direct sequencing after polymerase chain reaction.The Body Mass Index, LH, LH/FSH ratio and total testosterone were significantly elevated in PCOS patients compared to control group (P0.05.The present study suggested that the SNP rs13405728 in the LHCGR gene was associated with PCOS in Hui ethnic women, and its TT genotype characterized with higher level of TT, TG and LDL.

Quality of life instruments for economic evaluations in health and social care for older people: a systematic review.

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Makai, Peter; Brouwer, Werner B F; Koopmanschap, Marc A; Stolk, Elly A; Nieboer, Anna P

2014-02-01

Gaining health may not be the main goal of healthcare services aimed at older people, which may (also) seek to improve wellbeing. This emphasizes the need of finding appropriate outcome measures for economic evaluation of such services, particularly in long-term care, capturing more than only health-related quality of life (HrQol). This review assesses the usefulness of HrQol and wellbeing instruments for economic evaluations specifically aimed at older people, focusing on generic and preference-based questionnaires measuring wellbeing in particular. We systematically searched six databases and extracted instruments used to assess HrQol and wellbeing outcomes. Instruments were compared based on their usefulness for economic evaluation of services aimed at older people (dimensions measured, availability of utility scores, extent of validation). We identified 487 articles using 34 generic instruments: 22 wellbeing (two of which were preference-based) and 11 HrQol instruments. While standard HrQol instruments measure physical, social and psychological dimensions, wellbeing instruments contain additional dimensions such as purpose in life and achievement, security, and freedom. We found four promising wellbeing instruments for inclusion in economic evaluation: Ferrans and Powers QLI and the WHO-Qol OLD, ICECAP-O and the ASCOT. Ferrans and Powers QLI and the WHO-Qol OLD are widely validated but lack preference-weights while for ICECAP-O and the ASCOT preference-weights are available, but are less widely validated. Until preference-weights are available for the first two instruments, the ICECAP-O and the ASCOT currently appear to be the most useful instruments for economic evaluations in services aimed at older people. Their limitations are that (1) health dimensions may be captured only partially and (2) the instruments require further validation. Therefore, we currently recommend using the ICECAP-O or the ASCOT alongside the EQ-5D or SF-6D when evaluating interventions

[Evaluation of the quality of life in patients with breast cancer at different TNM stages after standardized treatment].

Science.gov (United States)

Huang, Rong; Huang, Yuan; Tao, Ping; Li, Hui; Wang, Qiong; Li, Hui; Li, Jia-yuan

2013-01-01

To evaluate the quality of life (QOL) in patients with breast cancer at different TNM stages and to estimate the value of EuroQol Five Dimension Indicator (EQ-5D) in measuring QOL among Chinese breast cancer patients. A survey with Quality of Life Instruments for Cancer Patients-Breast Cancer (QLICP-BR) and EQ-5D was undertaken in breast cancer patients who had completed their standardized treatment (except for the endocrine treatment) six months ago. Chi-square test, one-way ANOVA, and covariance analysis were used to evaluate the possible factors influencing the QOL of breast cancer patients. Simultaneously, with the results of Quality of Life Instruments for Cancer Patients-General Module (QLICP-GM, which is included in QLICP-BR.) and the total scores of QLICP-BR as standard, we conducted Pearson correlation analysis to evaluate the value of EQ-5D. A total of 178 female breast cancer survivors were collected from March 2010 to September 2010. There were 47 cases (26.4%) at stage 0 and I, 81 cases (45.5%) at stage II, and 50 cases (28.1%) at stage III and IV. The total standardized score of QLICP-BR was 72.55 ± 3.10 in patients at stage 0 and I, 64.09 ± 2.69 in patients at stage II and 58.21 ± 3.00 in patients at stage III and IV. The total standardized score of QLICP-BR and social domain of patients at stage 0 and I were higher than patients at stage II (all P stage 0 and I were higher than patients at stage III and IV (all P stages when age, degree of education, birth place (metropolis or rural), occupation, domestic income, and medical insurance were controlled (P = 0.002). Correlation analysis indicated that EQ-5D has a positive correlation with QLICP-GM and QLICP-BR (all P stage breast cancer is better than those at late stage. Early diagnosis and treatment can improve QOL of breast cancer patients. Chinese version of EQ-5D can well detect the differences of QOL among patients with different TNM stages, which can be used for evaluating QOL in Chinese

Molecular Mapping of D1, D2 and ms5 Revealed Linkage between the Cotyledon Color Locus D2 and the Male-Sterile Locus ms5 in Soybean

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Alina Ott

2013-07-01

Full Text Available In soybean, genic male sterility can be utilized as a tool to develop hybrid seed. Several male-sterile, female-fertile mutants have been identified in soybean. The male-sterile, female-fertile ms5 mutant was selected after fast neutron irradiation. Male-sterility due to ms5 was associated with the “stay-green” cotyledon color mutation. The cotyledon color trait in soybean is controlled by two loci, D1 and D2. Association between cotyledon color and male-sterility can be instrumental in early phenotypic selection of sterility for hybrid seed production. The use of such selection methods saves time, money, and space, as fewer seeds need to be planted and screened for sterility. The objectives of this study were to compare anther development between male-fertile and male-sterile plants, to investigate the possible linkages among the Ms5, D1 and D2 loci, and to determine if any of the d1 or d2 mutations can be applied in hybrid seed production. The cytological analysis during anther development displayed optically clear, disintegrating microspores and enlarged, engorged pollen in the male-sterile, female-fertile ms5ms5 plants, a common characteristic of male-sterile mutants. The D1 locus was mapped to molecular linkage group (MLG D1a and was flanked by Satt408 and BARCSOYSSR_01_1622. The ms5 and D2 loci were mapped to MLG B1 with a genetic distance ~12.8 cM between them. These results suggest that use of the d2 mutant in the selection of male-sterile line may attenuate the cost hybrid seed production in soybean.

Relationship between the MDS-UPDRS domains and the health-related quality of life of Parkinson's disease patients.

Science.gov (United States)

Martínez-Martín, P; Rodríguez-Blázquez, C; Forjaz, M J; Alvarez-Sánchez, M; Arakaki, T; Bergareche-Yarza, A; Chade, A; Garretto, N; Gershanik, O; Kurtis, M M; Martínez-Castrillo, J C; Mendoza-Rodríguez, A; Moore, H P; Rodríguez-Violante, M; Singer, C; Tilley, B C; Huang, J; Stebbins, G T; Goetz, C G

2014-03-01

The Movement Disorder Society sponsored version of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) is a comprehensive instrument for assessing Parkinson's disease (PD). The present study was aimed at determining the relationships between MDS-UPDRS components and health-related quality of life (HRQoL) evaluations in PD patients. An international, multicenter, cross-sectional study was carried out of 435 PD patients assessed with the MDS-UPDRS, Hoehn and Yahr (HY), Clinical Impression Severity for PD, EQ-5D and PD Questionnaire - eight items (PDQ-8). Spearman's rank correlation coefficients, exploratory factor analysis and multiple linear regression models (dependent variables EQ-5D and PDQ-8) were performed. The participants' age was 66.71 ± 10.32 years (51.5% men). PD duration was 8.52 ± 6.14, and median HY was 2 (range 1-5). The correlation between the EQ-5D index and the MDS-UPDRS ranged from -0.46 (Part IV) to -0.72 (Part II) and for the PDQ-8 index from 0.47 (Part III) to 0.74 (Part II). In multiple regression models with the MDS-UPDRS domains as independent variables, the main determinant for both the EQ-5D index and the PDQ-8 was Part II followed by Part I. After factorial grouping of the cardinal PD manifestations embedded in the MDS-UPDRS Parts III and IV for inclusion into multiple regression models, a factor formed by M-EDL, nM-EDL and fluctuations was the main determinant for both the EQ-5D and PDQ-8 indexes. The MDS-UPDRS component most tightly related with the HRQoL measures was a combination of motor and non-motor experiences of daily living. © 2014 The Author(s) European Journal of Neurology © 2014 EFNS.

CO{sub 2}-EQ emissions of forest chip production in Finland in 2020

Energy Technology Data Exchange (ETDEWEB)

Kariniemi, Arto; Kaerhae, Kalle (Metsaeteho Oy, Helsinki (Finland)), e-mail: arto.kariniemi@metsateho.fi

2010-07-15

The research carried out by Metsaeteho Oy calculated what would be the total fuel consumption and CO{sub 2}-eq emissions of forest chip production if the use of forest chips is 24 TWh in 2020 in Finland in accordance with the target set of Long-term Climate and Energy Strategy. CO{sub 2}-eq emissions were determined with Metsaeteho Oy's updated Emissions Calculation Model. If the production and consumption of forest chips in Finland are 24 TWh in 2020, then the total CO{sub 2}-eq emissions would be around 230,000 tonnes. The volume of diesel consumption was 73 million litres and petrol 1.7 million litres. Electric rail transportation and chipping at the mill site consumed 17 GWh of electricity. The supply chain with the lowest CO{sub 2}-eq emissions was logging residues comminuted at plant. Conversely, the highest CO{sub 2}-eq emissions came from stump wood when operating with terminal comminuting. Less than 3% of the energy content was consumed during the forest chip production. Energy input/output ratio in the total volume was 0.026 MWh/MWh which varied from 0.019 to 0.038 between the supply systems researched. Hence, forest chip production gave a net of some 97% of the energy content delivered at the plant

Calculation of chemical equilibrium between aqueous solution and minerals: the EQ3/6 software package

International Nuclear Information System (INIS)

Wolery, T.J.

1979-01-01

The newly developed EQ/36 software package computes equilibrium models of aqueous geochemical systems. The package contains two principal programs: EQ3 performs distribution-of-species calculations for natural water compositions; EQ6 uses the results of EQ3 to predict the consequences of heating and cooling aqueous solutions and of irreversible reaction in rock--water systems. The programs are valuable for studying such phenomena as the formation of ore bodies, scaling and plugging in geothermal development, and the long-term disposal of nuclear waste. EQ3 and EQ6 are compared with such well-known geochemical codes as SOLMNEQ, WATEQ, REDEQL, MINEQL, and PATHI. The data base allows calculations in the temperature interval 0 to 350 0 C, at either 1 atm-steam saturation pressures or a constant 500 bars. The activity coefficient approximations for aqueous solutes limit modeling to solutions of ionic strength less than about one molal. The mathematical derivations and numerical techniques used in EQ6 are presented in detail. The program uses the Newton--Raphson method to solve the governing equations of chemical equilibrium for a system of specified elemental composition at fixed temperature and pressure. Convergence is aided by optimizing starting estimates and by under-relaxation techniques. The minerals present in the stable phase assemblage are found by several empirical methods. Reaction path models may be generated by using this approach in conjunction with finite differences. This method is analogous to applying high-order predictor--corrector methods to integrate a corresponding set of ordinary differential equations, but avoids propagation of error (drift). 8 figures, 9 tables

Estimation of EuroQol 5-Dimensions health status utility values in hereditary angioedema.

Science.gov (United States)

Aygören-Pürsün, Emel; Bygum, Anette; Beusterien, Kathleen; Hautamaki, Emily; Sisic, Zlatko; Boysen, Henrik B; Caballero, Teresa

2016-01-01

To estimate health status utility (preference) weights for hereditary angioedema (HAE) during an attack and between attacks using data from the Hereditary Angioedema Burden of Illness Study in Europe (HAE-BOIS-Europe) survey. Utility measures quantitatively describe the net impact of a condition on a patient's life; a score of 0.0 reflects death and 1.0 reflects full health. The HAE-BOIS-Europe was a cross-sectional survey conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective. Survey items that overlapped conceptually with the EuroQol 5-Dimensions (EQ-5D) domains (pain/discomfort, mobility, self-care, usual activities, and anxiety/depression) were manually crosswalked to the corresponding UK population-based EQ-5D utility weights. EQ-5D utilities were computed for each respondent in the HAE-BOIS-Europe survey for acute attacks and between attacks. Overall, a total of 111 HAE-BOIS-Europe participants completed all selected survey items and thus allowed for computation of EQ-5D-based utilities. The mean utilities for an HAE attack and between attacks were 0.44 and 0.72, respectively. Utilities for an acute attack were dependent on the severity of pain of the last attack (0.61 for no pain or mild pain, 0.47 for moderate pain, and 0.08 for severe pain). There were no significant differences across countries. Mean utilities derived from the study approach compare sensibly with other disease states for both acute attacks and between attacks. The impacts of HAE translate into substantial health status disutilities associated with acute attacks as well as between attacks, documenting that the detrimental effects of HAE are meaningful from the patient perspective. Results were consistent across countries with regard to pain severity and in comparison to similar disease states. The results can be used to raise awareness of HAE as a serious disease with wide-ranging personal and social impacts.

Bone mineral decreases in the calcanei in men after arthroscopic shoulder surgery: a prospective study over 5 years.

Science.gov (United States)

Elmlund, Anna O; Kartus, Jüri; Ejerhed, Lars

2016-12-01

It is well known that injuries and surgical procedures in the lower extremities affect bone mineral both in the injured limb and in the contralateral limb. The possible effect on bone mineral after upper extremity surgery is not well studied, and the aim of this study was to study the effect on bone mineral in the calcanei after arthroscopic shoulder surgery. Twenty-two men scheduled for arthroscopic shoulder surgery underwent bone mineral area (BMA) mass measurements in both calcanei using the Calscan DXL device prior to surgery and after 6, 18, 36 and 60 months. On every occasion, the Tegner activity score and EuroQoL 5-dimensions (EQ-5D) were assessed. During 5 years, there was a significant decrease in the BMA in both calcanei (p = 0.003). The Tegner activity score decreased from preinjury to the operation and did not increase significantly after the operation. The EQ-5D increased significantly after the operation. The bone mineral in the calcanei in men during the 5-year study period decreased more than the expected age-dependent decline after arthroscopic shoulder surgery. There was an increase in health-related quality of life as measured with the EQ-5D after arthroscopic Bankart reconstruction. Case-control study, Level III.

Mandolin Family Instruments

Science.gov (United States)

Cohen, David J.; Rossing, Thomas D.

The mandolin family of instruments consists of plucked chordophones, each having eight strings in four double courses. With the exception of the mandobass, the courses are tuned in intervals of fifths, as are the strings in violin family instruments. The soprano member of the family is the mandolin, tuned G3-D4-A4-E5. The alto member of the family is the mandola, tuned C3-G3-D4-A4. The mandola is usually referred to simply as the mandola in the USA, but is called the tenor mandola in Europe. The tenor member of the family is the octave mandolin, tuned G2-D3-A3-E4. It is referred to as the octave mandolin in the USA, and as the octave mandola in Europe. The baritone member of the family is the mandocello, or mandoloncello, tuned C2-G2-D3-A3. A variant of the mandocello not common in the USA is the five-course liuto moderno, or simply liuto, designed for solo repertoire. Its courses are tuned C2-G2-D3-A3-E4. A mandobass was also made by more than one manufacturer during the early twentieth century, though none are manufactured today. They were fretted instruments with single string courses tuned E1-A1-D2-G2. There are currently a few luthiers making piccolo mandolins, tuned C4-G4-D5-A5.

3D Printed Surgical Instruments Evaluated by a Simulated Crew of a Mars Mission.

Science.gov (United States)

Wong, Julielynn Y; Pfahnl, Andreas C

2016-09-01

The first space-based fused deposition modeling (FDM) 3D printer became operational in 2014. This study evaluated whether Mars simulation crewmembers of the Hawai'i Space Exploration Analog and Simulation (HI-SEAS) II mission with no prior surgical experience could utilize acrylonitrile butadiene styrene (ABS) thermoplastic surgical instruments FDM 3D printed on Earth to complete simulated surgical tasks. This study sought to examine the feasibility of using 3D printed surgical tools when the primary crew medical officer is incapacitated and the back-up crew medical officer must conduct a surgical procedure during a simulated extended space mission. During a 4 mo duration ground-based analog mission, five simulation crewmembers with no prior surgical experience completed 16 timed sets of simulated prepping, draping, incising, and suturing tasks to evaluate the relative speed of using four ABS thermoplastic instruments printed on Earth compared to conventional instruments. All four simulated surgical tasks were successfully performed using 3D printed instruments by Mars simulation crewmembers with no prior surgical experience. There was no substantial difference in time to completion of simulated tasks with control vs. 3D printed sponge stick, towel clamp, scalpel handle, and toothed forceps. These limited findings support further investigation into the creation of an onboard digital catalog of validated 3D printable surgical instrument design files to support autonomous, crew-administered healthcare on Mars missions. Future work could include addressing sterility, biocompatibility, and having astronaut crew medical officers test a wider range of surgical instruments printed in microgravity during actual surgical procedures. Wong JY, Pfahnl AC. 3D printed surgical instruments evaluated by a simulated crew of a Mars mission. Aerosp Med Hum Perform. 2016; 87(9):806-810.

Correlations between disease-specific and generic health status questionnaires in patients with advanced COPD: a one-year observational study

Directory of Open Access Journals (Sweden)

Wilke Sarah

2012-08-01

Full Text Available Abstract Background Longitudinal studies analyzing the correlations between disease-specific and generic health status questionnaires at different time points in patients with advanced COPD are lacking. The aim of this study was to determine whether and to what extent a disease-specific health status questionnaire (Saint George’s Respiratory Questionnaire, SGRQ correlates with generic health status questionnaires (EuroQol-5-Dimensions, EQ-5D; Assessment of Quality of Life instrument, AQoL; Medical Outcomes Study 36-Item Short-Form Health Survey, SF-36 at four different time points in patients with advanced COPD; and to determine the correlation between the changes in these questionnaires during one-year follow-up. Methods Demographic and clinical characteristics were assessed in 105 outpatients with advanced COPD at baseline. Disease-specific health status (SGRQ and generic health status (EQ-5D, AQoL, SF-36 were assessed at baseline, four, eight, and 12 months. Correlations were determined between SGRQ and EQ-5D, AQoL, and SF-36 scores and changes in these scores. Agreement in direction of change was assessed. Results Eighty-four patients (80% completed one-year follow-up and were included for analysis. SGRQ total score and EQ-5D index score, AQoL total score and SF-36 Physical Component Summary measure (SF-36 PCS score were moderately to strongly correlated. The correlation of the changes between the SGRQ total score and EQ-5D index score, AQoL total score, SF-36 PCS, and SF-36 Mental Component Summary measure (SF-36 MCS score were weak or absent. The direction of changes in SGRQ total scores agreed slightly with the direction of changes in EQ-5D index score, AQoL total score, and SF-36 PCS score. Conclusions At four, eight and 12 months after baseline, SGRQ total scores and EQ-5D index scores, AQoL total scores and SF-36 PCS scores were moderately to strongly correlated, while SGRQ total scores were weakly correlated with SF-36 MCS scores

CRDI - Centre de recherches pour le développement international |

International Development Research Centre (IDRC) Digital Library (Canada)

Lire leurs observations. Nos experts font part de leurs réflexions sur les questions et les approches sur lesquelles se penchent les acteurs du développement international aujourd'hui, ainsi que sur le rôle de la recherche dans la mise au point de solutions. Image. Homme travaillant à l'intérieur d'un grand tube d'acier ...

ÉTUDE DE CAS – Côte d'Ivoire : De la forêt aux champs en Côte d ...

International Development Research Centre (IDRC) Digital Library (Canada)

11 janv. 2011 ... Aujourd'hui, Buyo fait partie de la « nouvelle ceinture du café et du cacao » de la Côte d'Ivoire et est devenu un pôle d'attraction pour les immigrants. La plupart y viennent en quête de terres où s'adonner aux cultures marchandes. Certains trouvent du travail dans lesexploitations forestières ou dans les ...

182 L'erotisme Dans Uwaoma Et Le Beau Monde D'ifeoma ...

African Journals Online (AJOL)

Tracie1

érotisme: Essai de définition. Il importe de mettre en ..... de son temps. Dans le monde d'aujourd'hui à la radio, à la télévision, dans les quotidiens, sur internet, dans les media sociaux tels que le facebook, le you-tube, le blackberry messenger ...

Vers une tarification plate dans le Rhône. Enjeux, limites et perspectives de la restructuration tarifaire sur les lignes régulières départementales

OpenAIRE

Peggy Durand

2007-01-01

Les questions de mobilité au sein des grands bassins de vie et entre les aires urbaines occupent aujourd'hui une place majeure dans les réflexions politiques, notamment à l'échelle départementale. La loi d'Orientation sur les Transports Intérieurs (LOTI) de 1982 a confirmé la compétence des Départements dans la planification et l'organisation des transports collectifs non-urbains de personnes (Art 29). Autorités organisatrices, ils ont aujourd'hui la charge de définir l'offre et les dispositi...

Les reseaux de politique publique comme facteur d'influence du choix des instruments de politique energetique canadienne a des fins environnementales de 1993 a nos jours

Science.gov (United States)

Fathy El Dessouky, Naglaa

Au cours de la derniere decennie, les modes de la gouvernance ont pris place dans un contexte totalement different de celui qu'ils avaient auparavant. Les gouvernements modernes se rendent compte qu'ils perdent de plus en plus leur capacite a elaborer et a gerer les changements d'une maniere autonome. Ainsi, les fonctions et les activites traditionnellement accomplies exclusivement par le gouvernement engagent de nos jours une gamme d'acteurs etatiques et non etatiques. A l'encontre du concept traditionnel de l'Etat controleur, la gouvernance contemporaine est ainsi devenue moins une question d'offre de service et davantage une gestion indirecte des reseaux de politique publique. Dans cette entreprise, les gouvernements contemporains, cherchant plus d'information, de soutien et de legitimite en matiere de formulation des decisions, ont besoin d'etablir des relations avec les divers groupes d'interet qui, a leur tour, voulaient plus de promotion et de protection en faveur de leurs interets a travers leur implication au processus de l'elaboration et de la mise en oeuvre des politiques publiques. Ainsi, l'approche des reseaux de politique publique represente aujourd'hui un courant considerable au sein du champ d'analyse des politiques publiques. Toutefois, les preoccupations des chercheurs pour cette approche, dans le domaine des politiques energetiques a des fins environnementales, semblent recentes, et les etudes realisees sont encore trop peu nombreuses. Au Canada, au debut des annees 1990, le gouvernement ainsi que plusieurs groupes d'interets, des differents secteurs energetique, industriel et environnemental, ont commence a intensifier leurs efforts pour s'attaquer au probleme du changement climatique d'origine energetique, genere surtout par le secteur de l'industrie. Au cours de la derniere decennie, la question touchant plutot le sujet du developpement energetique durable represente le plus important domaine des politiques publiques ayant surgi recemment dans

Impact of genital warts on health related quality of life in men and women in mainland China: a multicenter hospital-based cross-sectional study

Directory of Open Access Journals (Sweden)

Shi Ju-Fang

2012-03-01

Full Text Available Abstract Background Information on the health-related quality of life (HRQoL of patients with genital warts (GW in populations in mainland China is still limited. The aim of the study was to use a generic instrument to measure the impact of genital warts on HRQoL in men and women in this setting. Methods A multi-centre hospital-based cross-sectional study across 18 centers in China was conducted to interview patients using the European quality of life-5 dimension (EQ-5D instrument; respondents' demographic and clinical data were also collected. Results A total of 1,358 GW patients (612 men, 746 women were included in the analysis, with a mean age of 32.0 ± 10.6 years. 56.4% of the patients reported some problems in the dimension of Anxiety/Depression (highest, followed by Pain/Discomfort (24.7% and Mobility (3.5%. The overall visual analogue scale (VAS score of the study population was found to be 65.2 ± 22.0, and the EQ-5D index score was found to be 0.843 ± 0.129 using Japanese preference weights (the Chinese preference was unavailable yet. Patients with lower VAS means and EQ-5D index scores were more often female, living in urban area, and suffering multiple GW (all p values 0.05. Conclusions The HRQoL of patients with GW was substantially lower, compared to a national representative general population in China (VAS = ~80; the findings of different subgroups are informative for future GW prevention and control efforts.

Le socle d'une œuvre, invisible mais essentiel

OpenAIRE

Huguenin, Daniel

2015-01-01

Tiré du site internet du blog des Musées d'art et d'histoire (http://blog.mahgeneve.ch): "Le support se faisant aujourd'hui le plus discret possible, voire invisible. Sa réalisation nécessite une étroite collaboration entre les différents acteurs d'une exposition car le socleur doit allier les besoins de la conservation et de la muséographie.".

Intégration de données temps-réel issues de capteurs dans un entrepôt de données géo-décisionnel

OpenAIRE

Mathieu, Jean

2011-01-01

Nous avons pu, au cours des dernières années, assister à une augmentation du nombre de capteurs utilisés pour mesurer des phénomènes de plus en plus variés. En effet, nous pouvons aujourd'hui utiliser les capteurs pour mesurer un niveau d'eau, une position (GPS), une température et même le rythme cardiaque d'un individu. La grande diversité de capteurs fait d'eux aujourd'hui des outils par excellence en matière d'acquisition de données. En parallèle à cette effervescence, les outils d'analyse...

Design of analytical instrumentation with D-T sealed neutron generators

International Nuclear Information System (INIS)

Qiao Yahua; Wu Jizong; Zheng Weiming; Liu Quanwei; Zhang Min

2008-01-01

Analytical instrumentation with D-T sealed neutron generators source activation, The 14 MeV D-T sealed neutron tube with 10 9 n · s -1 neutron yield is used as generator source. The optimal structure of moderator and shield was achieved by MC computing.The instrumentation's configuration is showed. The instrumentation is made up of the SMY-DT50.8-2.1 sealed neutron tube and the high-voltage power supply system, which center is the sealed neutron generators. 6 cm Pb and 20 cm polythene is chosen as moderator, Pb, polythene and 10 cm boron-PE was chosen as shield .The sample box is far the source from 9 cm, the measurement system were made up of HPGe detector and the sample transforming system. After moderator and shield, the thermal neutron fluence rate at the point of sample is 0.93 × 10 6 n · s -1 cm -2 , which is accorded with design demand, and the laboratory and surroundings reaches the safety standard of the dose levels. (authors)

PENGEMBANGAN BAHAN AJAR MATEMATIKA DENGAN PENDEKATAN KONTEKSTUAL DAN METODE PENEMUAN TERBIMBING UNTUK MENINGKATKAN EQ DAN SQ SISWA SMP AKSELERASI

Directory of Open Access Journals (Sweden)

Yhasinta Agustyarini

2015-05-01

DEVELOPING MATHEMATICS INSTRUCTIONAL MATERIAL USINGCONTEXTUAL APPROACH AND GUIDED INQUIRY METHOD TO INCREASE EQ AND SQ OF ACCELERATION STUDENTS IN JUNIOR HIGH SCHOOL Abstract This research is aimed to describe steps of developing mathematics instructional material using contextual approach and guided inquiry method and describe the quality of the developed product. This research is a developmental research with the main steps cover (1 preliminary investigation, (2 design, (3 realization/construction, (4 test, evaluation, and revision, and (5 implementation. The result of validation by expert jugdement shows that the instructional material that is developed is of valid criteria of very good category. The aspects of practicality was of practice criteria of very good category as seen from the implementation of the learning, evaluation by the teachers, and evaluation by the students. The aspect of effectiveness could be reached from the students’ achievement and EQ and SQ questionnaire. The result of the test shows that more than 80% of the student achieve the minimum score and percentage many of students who are at a high minimum and very high minimum category increase on EQ and SQ questionnaire. The research produced mathematics instructional material and supporting components, consisting of valid, practical, and effective syllabuses, lesson plans, mathematics module, and the valid, practical, and reliable of test. Keywords: development, instructional material, contextual approach, guided inquiry, EQ, SQ, acceleration

The BarOn Emotional Quotient Inventory (EQ-i): Development and psychometric adaptation in Bahasa Indonesia

NARCIS (Netherlands)

Dewi, Z.L.; Halim, M.S.; Derksen, J.J.L.

2015-01-01

The BarOn Emotional Quotient Inventory (EQ-i ; BarOn, 2004) was created to assess emotional intelligence (EI). In our research project we produced the Indonesian version. The EQ-i was translated from English into Bahasa Indonesia and back-translated into English. Test-retest reliabilities and

Evaluation of genetic markers as instruments for Mendelian randomization studies on vitamin D.

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Diane J Berry

Full Text Available Mendelian randomization (MR studies use genetic variants mimicking the influence of a modifiable exposure to assess and quantify a causal association with an outcome, with an aim to avoid problems with confounding and reverse causality affecting other types of observational studies.We evaluated genetic markers that index differences in 25-hydroxyvitamin D (25(OHD as instruments for MR studies on vitamin D.We used data from up-to 6,877 participants in the 1958 British birth cohort with information on genetic markers and 25(OHD. As potential instruments, we selected 20 single nucleotide polymorphisms (SNP which are located in the vitamin D metabolism pathway or affect skin pigmentation/tanning, including 4 SNPs from genome-wide association (GWA meta-analyses on 25(OHD. We analyzed SNP associations with 25(OHD and evaluated the use of allele scores dividing genes to those affecting 25(OHD synthesis (DHCR7, CYP2R1 and metabolism (GC, CYP24A1, CYP27B1. In addition to the GWA SNPs, only two SNPs (CYP27B1, OCA2 showed evidence for association with 25(OHD, with the OCA2 association abolished after lifestyle adjustment. Per allele differences varied between -0.02 and -0.08 nmol/L (P≤0.02 for all, with a 6.1 nmol/L and a 10.2 nmol/L difference in 25(OHD between individuals with highest compared lowest number of risk alleles in synthesis and metabolism allele scores, respectively. Individual SNPs but not allele scores showed associations with lifestyle factors. An exception was geographical region which was associated with synthesis score. Illustrative power calculations (80% power, 5% alpha suggest that approximately 80,000 participants are required to establish a causal effect of vitamin D on blood pressure using the synthesis allele score.Combining SNPs into allele scores provides a more powerful instrument for MR analysis than a single SNP in isolation. Population stratification and the potential for pleiotropic effects need to be considered in MR

Sentinel-5 instrument: status of design, performance, and development

Science.gov (United States)

Gühne, T.; Keim, C.; Bartsch, P.; Weiß, S.; Melf, M.; Seefelder, W.

2017-09-01

The Sentinel-5 instrument is currently under development by a consortium led by Airbus Defence and Space in the frame of the European Union Copernicus program. It is a customer furnished item to the MetOp Second Generation satellite platform, which will provide operational meteorological data for the coming decades. Mission objective of the Sentinel-5 is to monitor the composition of the Earth atmosphere for Copernicus Atmosphere Services by taking measurements of trace gases and aerosols impacting air quality and climate with high resolution and daily global coverage. Therefore the Sentinel-5 provides five dispersive spectrometers covering the UV-VIS (270…500 nm), NIR (685 …773 nm) and SWIR (1590…1675 and 2305…2385 nm) spectral bands with resolutions <=1nm. Spatially the Sentinel-5 provides a 108° field of view with a ground sampling of 7.5 x 7 km2 at Nadir. The development program is post PDR and the build-up of the industrial team is finalised. We report on the instrument architecture and design derived from the driving requirements, the predicted instrument performance, and the general status of the program.

Predictors of health-related quality of life in 500 severely obese patients.

Science.gov (United States)

Warkentin, Lindsey M; Majumdar, Sumit R; Johnson, Jeffrey A; Agborsangaya, Calypse B; Rueda-Clausen, Christian F; Sharma, Arya M; Klarenbach, Scott W; Birch, Daniel W; Karmali, Shahzeer; McCargar, Linda; Fassbender, Konrad; Padwal, Raj S

2014-05-01

To characterize health-related quality of life (HRQL) impairment in severely obese subjects, using several validated instruments. A cross-sectional analysis of 500 severely obese subjects was completed. Short-Form (SF)-12 [Physical (PCS) and Mental (MCS) component summary scores], EuroQol (EQ)-5D [Index and Visual Analog Scale (VAS)], and Impact of Weight on Quality of Life (IWQOL)-Lite were administered. Multivariable linear regression models were performed to identify independent predictors of HRQL. Increasing BMI was associated with lower PCS (-1.33 points per 5 kg/m(2) heavier; P fibromyalgia for PCS (-5.84 points), depression for MCS (-7.49 points), stroke for EQ-index (-0.17 points), less than full-time employment for EQ-VAS (-7.06 points), and coronary disease for IWQOL-Lite (-10.86 points). Chronic pain, depression, and sleep apnea were associated with reduced HRQL using all instruments. The clinical impact of BMI on physical and general HRQL was small, and mental health scores were not associated with BMI. Chronic pain, depression, and sleep apnea were consistently associated with lower HRQL. Copyright © 2014 The Obesity Society.

Valuing Health Using Time Trade-Off and Discrete Choice Experiment Methods: Does Dimension Order Impact on Health State Values?

Science.gov (United States)

Mulhern, Brendan; Shah, Koonal; Janssen, Mathieu F Bas; Longworth, Louise; Ibbotson, Rachel

2016-01-01

Health states defined by multiattribute instruments such as the EuroQol five-dimensional questionnaire with five response levels (EQ-5D-5L) can be valued using time trade-off (TTO) or discrete choice experiment (DCE) methods. A key feature of the tasks is the order in which the health state dimensions are presented. Respondents may use various heuristics to complete the tasks, and therefore the order of the dimensions may impact on the importance assigned to particular states. To assess the impact of different EQ-5D-5L dimension orders on health state values. Preferences for EQ-5D-5L health states were elicited from a broadly representative sample of members of the UK general public. Respondents valued EQ-5D-5L health states using TTO and DCE methods across one of three dimension orderings via face-to-face computer-assisted personal interviews. Differences in mean values and the size of the health dimension coefficients across the arms were compared using difference testing and regression analyses. Descriptive analysis suggested some differences between the mean TTO health state values across the different dimension orderings, but these were not systematic. Regression analysis suggested that the magnitude of the dimension coefficients differs across the different dimension orderings (for both TTO and DCE), but there was no clear pattern. There is some evidence that the order in which the dimensions are presented impacts on the coefficients, which may impact on the health state values provided. The order of dimensions is a key consideration in the design of health state valuation studies. Copyright © 2016. Published by Elsevier Inc.

Field measurements and interpretation of TMI-2 instrumentation: IC-10-dPT

International Nuclear Information System (INIS)

Jones, J.E.; Smith, J.T.; Mathis, M.V.

1982-01-01

This report describes the measurements and results of the Control Rod Drive Bypass Flow IC-10-dPT. This instrument consists of a Bailey Type BY Process Computer Transmitter connected to a readout module by approximately 500 feet of cable through a penetration junction and an instrument mounting junction. The status of this instrument is uncertain, but it was producing a reasonable output reading of zero flow which could indicate it had not failed. As a result, measurements on this instrument were designed to determine if it were properly functioning

Development and validation of a new instrument to measure health-related quality of life in patients with psoriatic arthritis: the VITACORA-19.

Science.gov (United States)

Torre-Alonso, Juan Carlos; Gratacós, Jordi; Rey-Rey, José Santos; Valdazo de Diego, Juan Pablo; Urriticoechea-Arana, Ana; Daudén, Esteban; Moreno, Mireia; Zarco-Montejo, Pedro; Collantes-Estévez, Eduardo; Fernández-López, Juan Antonio

2014-10-01

To develop/validate an instrument to measure health-related quality of life (HRQoL) in patients with psoriatic arthritis (PsA), for use in clinical studies. An item pool of 35 items was generated following standardized procedures. Item reduction was performed using clinimetric and psychometric approaches after administration to 66 patients with PsA. The resulting instrument, the VITACORA-19, consists of 19 items. Its validity content, internal consistency, test-retest reliability, known groups/convergent validity, and sensitivity to change were tested in a longitudinal and multicenter study conducted in 10 hospitals in Spain, with 323 patients who also completed the EuroQol 5-dimensional questionnaire (EQ-5D) and a health status transition item. There were 3 study groups: group A (n = 209, patients with PsA), group B (n = 71, patients with arthritis without psoriatic aspect, patients with arthrosis, and patients with dermatitis), and group C (n = 43, healthy controls). The questionnaire was considered easy/very easy to answer by 94.7% of the patients with PsA. The factorial analysis clearly identified only 1 factor. Cronbach's alpha coefficient and interclass correlation coefficients exceeded 0.90. Statistically significant differences (p measure HRQoL in patients with PsA, has good validity, reliability, and sensitivity to change.

R and D in control, instrumentation, and electronic systems at CRNL

International Nuclear Information System (INIS)

Moeck, E.O.; Stirling, A.J.; Yan, G.

1980-10-01

Research and development in control, instrumentation, and electronics is part of the refinement of the CANDU power plant design and of the R and D work at the Chalk River Nuclear Laboratories. The programs presently being carried out in these areas are described in this report. Many of these projects originated in response to a potential for performance improvements in CANDU power plants and are aimed at extending plant capabilities and applying new technology and ideas to achieve better and less expensive systems. Some of these projects such as the development of in-reactor pressure transducers for fuel testing are to be completed in a matter of months. Others, for example heavy water vapor loss instruments, will have gone through the laboratory development phase within a year or two. More sophisicated developments such as multivariable controllers, computer-based safety systems, and advanced neutron detectors will continue over 4 or 5 years. This time scale also applies to the design and implementation of new control and safety systems for the NRU research reactor. Still others will require more than 5 years to be fully operational. New systems for the detection and location of failed fuel and a total information network with distributed intelligence, to be applied to future power stations, fall into that category. (auth)

La république en Grande-Bretagne aujourd’hui : une idée anglaise

Directory of Open Access Journals (Sweden)

Antoine MIOCHE

2003-10-01

Full Text Available Il peut paraître y avoir un paradoxe à parler de république aujourd’hui en Grande-Bretagne en ceci que seule ou presque la Grande-Bretagne, de ce qui fut le vaste Empire britannique, est demeurée une monarchie. Des États-Unis à la Rhodésie, en passant par l’Inde et l’Irlande (à l’exception importante du nord de l’île, les anciens territoires britanniques ont opté majoritairement pour un régime parlementaire non monarchique, l’Australie, le Canada et la Nouvelle-Zélande étant d’intéressantes ...

Concentrações sangüíneas de lactato em eqüinos durante a prova de fundo do concurso completo de equitação

Directory of Open Access Journals (Sweden)

Gomide Lina Maria Wehrle

2006-01-01

Full Text Available Colheu-se sangue de 13 eqüinos competindo na prova de Fundo do Concurso Completo de Equitação, categoria internacional três estrelas, e dosou-se lactato sangüíneo na manhã antes da prova, antes e imediatamente depois das fases B e D e 10 minutos após a fase D. Foi observado aumento significativo nas concentrações de lactato apenas após o término da fase D, demonstrando que os animais foram submetidos a um grande esforço físico, com desenvolvimento de acidose metabólica decorrente do acúmulo de lactato. Houve diminuição significativa dos valores dez minutos após o término do cross-country, exceto para o eqüino de número 12, único animal a completar o percurso dentro do tempo estipulado, o qual apresentou sinais clínicos de exaustão.

Quality of Life After Stereotactic Body Radiation Therapy for Primary and Metastatic Liver Tumors

International Nuclear Information System (INIS)

Mendez Romero, Alejandra; Wunderink, Wouter; Os, Rob M. van; Nowak, Peter J.C.M.; Heijmen, Ben J.M.; Nuyttens, Joost J.; Brandwijk, Rene P.; Verhoef, Cornelis; IJzermans, Jan N.M.; Levendag, Peter C.

2008-01-01

Purpose: Stereotactic body radiation therapy (SBRT) provides a high local control rate for primary and metastatic liver tumors. The aim of this study is to assess the impact of this treatment on the patient's quality of life. This is the first report of quality of life associated with liver SBRT. Methods and Materials: From October 2002 to March 2007, a total of 28 patients not suitable for other local treatments and with Karnofsky performance status of at least 80% were entered in a Phase I-II study of SBRT for liver tumors. Quality of life was a secondary end point. Two generic quality of life instruments were investigated, EuroQol-5D (EQ-5D) and EuroQoL-Visual Analogue Scale (EQ-5D VAS), in addition to a disease-specific questionnaire, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ C-30). Points of measurement were directly before and 1, 3, and 6 months after treatment. Mean scores and SDs were calculated. Statistical analysis was performed using paired-samples t-test and Student t-test. Results: The calculated EQ-5D index, EQ-5D VAS and QLQ C-30 global health status showed that mean quality of life of the patient group was not significantly influenced by treatment with SBRT; if anything, a tendency toward improvement was found. Conclusions: Stereotactic body radiation therapy combines a high local control rate, by delivering a high dose per fraction, with no significant change in quality of life. Multicenter studies including larger numbers of patients are recommended and under development

Developing a dementia-specific health state classification system for a new preference-based instrument AD-5D.

Science.gov (United States)

Nguyen, Kim-Huong; Mulhern, Brendan; Kularatna, Sanjeewa; Byrnes, Joshua; Moyle, Wendy; Comans, Tracy

2017-01-25

With an ageing population, the number of people with dementia is rising. The economic impact on the health care system is considerable and new treatment methods and approaches to dementia care must be cost effective. Economic evaluation requires valid patient reported outcome measures, and this study aims to develop a dementia-specific health state classification system based on the Quality of Life for Alzheimer's disease (QOL-AD) instrument (nursing home version). This classification system will subsequently be valued to generate a preference-based measure for use in the economic evaluation of interventions for people with dementia. We assessed the dimensionality of the QOL-AD to develop a new classification system. This was done using exploratory and confirmatory factor analysis and further assessment of the structure of the measure to ensure coverage of the key areas of quality of life. Secondly, we used Rasch analysis to test the psychometric performance of the items, and select item(s) to describe each dimension. This was done on 13 items of the QOL-AD (excluding two general health items) using a sample of 284 residents living in long-term care facilities in Australia who had a diagnosis of dementia. A five dimension classification system is proposed resulting from the three factor structure (defined as 'interpersonal environment', 'physical health' and 'self-functioning') derived from the factor analysis and two factors ('memory' and 'mood') from the accompanying review. For the first three dimensions, Rasch analysis selected three questions of the QOL-AD ('living situation', 'physical health', and 'do fun things') with memory and mood questions representing their own dimensions. The resulting classification system (AD-5D) includes many of the health-related quality of life dimensions considered important to people with dementia, including mood, global function and skill in daily living. The development of the AD-5D classification system is an important step

Estimation of EuroQol 5-Dimensions health status utility values in hereditary angioedema

Directory of Open Access Journals (Sweden)

Aygören-Pürsün E

2016-09-01

Full Text Available Emel Aygören-Pürsün,1 Anette Bygum,2 Kathleen Beusterien,3 Emily Hautamaki,4 Zlatko Sisic,5 Henrik B Boysen,6 Teresa Caballero7 1Angioedema Centre, Department for Children and Adolescents, University Hospital Frankfurt, Goethe University, Frankfurt, Germany; 2Hereditary Angioedema Centre Denmark, Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark; 3Outcomes Research Strategies in Health, Washington, DC, 4Patient Reported Outcomes, Oxford Outcomes Inc., an ICON plc company, Bethesda, MD, USA; 5ViroPharma Incorporated, Chatsworth House, Maidenhead, UK; 6HAEi – Hereditary Angioedema International Patient Organization for C1 Inhibitor Deficiencies, Skanderborg, Denmark; 7Allergy Department, Hospital La Paz Institute for Health Research (IdiPaz, Biomedical Research Network on Rare Diseases U754 (CIBERER, University Hospital La Paz, Madrid, Spain Objective: To estimate health status utility (preference weights for hereditary angioedema (HAE during an attack and between attacks using data from the Hereditary Angioedema Burden of Illness Study in Europe (HAE-BOIS-Europe survey. Utility measures quantitatively describe the net impact of a condition on a patient’s life; a score of 0.0 reflects death and 1.0 reflects full health.Study design and methods: The HAE-BOIS-Europe was a cross-sectional survey conducted in Spain, Germany, and Denmark to assess the real-world experience of HAE from the patient perspective. Survey items that overlapped conceptually with the EuroQol 5-Dimensions (EQ-5D domains (pain/discomfort, mobility, self-care, usual activities, and anxiety/depression were manually crosswalked to the corresponding UK population-based EQ-5D utility weights. EQ-5D utilities were computed for each respondent in the HAE-BOIS-Europe survey for acute attacks and between attacks.Results: Overall, a total of 111 HAE-BOIS-Europe participants completed all selected survey items and thus allowed for computation

Health-related quality of life in residents aged 18 years and older with and without disease: findings from the First Provincial Health Services Survey of Hunan, China.

Science.gov (United States)

Deng, Xin; Dong, Peng; Zhang, Lingling; Tian, Danping; Zhang, Lin; Zhang, Wei; Li, Li; Deng, Jing; Ning, Peishan; Hu, Guoqing

2017-09-03

Published research has not considered acute diseases and injuries in assessing the impact of varying disease counts on health-related quality of life (HRQoL). We used Chinese value sets of EQ-5D-3L to examine the relationship between the number of diseases individuals had (including chronic diseases, acute diseases and injuries) and their HRQoL. A total of 19 387 individuals aged 18 years and older were included in the study. Using data from the First Provincial Health Services Survey of Hunan, China, HRQoL was assessed with the EQ-5D-3L scale, a standardized instrument developed by the EuroQoL group. The EQ-5D-3L utility score was calculated using the Chinese EQ-5D-3L value set. This survey coded disease using the list of 133 conditions that was defined by the First Provincial Health Services Survey of Hunan, China, based on the 10th International Classification of Diseases. 126 conditions were disease-related and were therefore included in data analysis. Of 15 245 respondents, urban residents and male constituted 53.0% and 48.2%, respectively. 19.3% of respondents had one disease and 5.0% had at least two diseases. Of the five dimensions of the EQ-5D-3L, the pain/discomfort dimension had the highest proportion of moderate or serious problems among the respondents (14.4%, 95% CI 10.5% to 18.2%). The average Visual Analogue Scale (VAS) score and utility score were 78.0 (95% CI 76.9 to 79.1) and 0.958 (95% CI 0.946 to 0.970), respectively. Residents with 1 and ≥2 diseases had higher proportions of moderate or serious problems in five dimensions of the EQ-5D-3L scale during the previous 2 weeks than those without disease after controlling for location (urban/rural), sex, age, education level and household income, respectively (adjusted ORs: 3.1-3.7 and 4.4-6.6, respectively). The mean of the EQ VAS score was 8.4 and 13.6 points lower in respondents with 1 and ≥2 diseases than in respondents without disease; the corresponding mean score difference was 0

Equilíbrio ácido-base e hidroeletrolítico em eqüinos com cólica

OpenAIRE

Di Filippo,Paula Alessandra; Santana,Aureo Evangelista; Pereira,Gener Tadeu

2008-01-01

Foram utilizados setenta eqüinos distribuídos em três grupos experimentais, G1 (vinte eqüinos hígidos), G2 (vinte e cinco eqüinos com cólica, os quais passaram por tratamento clínico ou cirúrgico e sobreviveram) e G3 (vinte e cinco eqüinos com cólica, os quais passaram por tratamento clínico ou cirúrgico e foram a óbito ou foram sacrificados). Amostras de sangue foram obtidas em dez diferentes momentos, mediante punção da jugular, para estudo do equilíbrio ácido-base e hidroeletrolítico. Os e...

Instrument evaluation no. 18. Mini instruments contamination meter type 5.10 EL

International Nuclear Information System (INIS)

Burgess, P.H.; Iles, W.J.

1980-04-01

An evaluation is given of the general purpose contamination monitor, the Mini-Instruments Type 5-10EL which comprises a probe connected by a coiled extensible cable to a ratemeter. The facilities and controls, radiation characteristics, electrical characteristics, environmental effects, mechanical characteristics, and the manual are considered. A summary is given of the instrument's performance showing that it is a useful general-purpose contamination monitor suitable for the monitoring of beta contamination at a level for non-active areas of 1 DL (3.7 Bq cm -2 (10 -4 μCi cm -2 )) for beta emitters of maximum energy at least that of 14 C, given a normal environmental gamma background. (U.K.)

Mieloencefalite protozoária eqüina (Relato de caso.

Directory of Open Access Journals (Sweden)

R. C. Gonçalves

2005-03-01

Full Text Available RESUMO :O objetivo deste trabalho foi relatar um caso de mieloencefalite protozoária eqüina no Estado de São Paulo, Brasil. O diagnóstico se baseou nos sinais clínicos, no resultado positivo para anticorpos contra Sarcocystis neurona no soro e no líquor pela técnica de Western blot. Palavras chave: Mieloencefalite, Sarcocystis neurona, eqüinos. SUMMARY: The purpose of this work was to present a case of equine protozoal myeloencephalitis (EPM in the State of São Paulo, Brazil. The diagnosis was based on the clinical sings, the positive results of the serum and cerebrospinal fluid analysis (Western blot for antibodies against Sarcocystis neurona. Keywords: Myeloencephalitis, Sarcocystis neurona,

Association between vitamin D receptor gene polymorphism (TaqI)

Indian Academy of Sciences (India)

Home; Journals; Journal of Genetics; Volume 94; Issue 3. Association between vitamin D receptor gene polymorphism (TaqI) and obesity in Chinese population. Hui-Ru Fan Li-Qun Lin Hao Ma Ying Li Chang-Hao Sun. Research Note Volume 94 Issue 3 September 2015 pp 473-478 ...

Association between vitamin D receptor gene polymorphism (TaqI ...

Indian Academy of Sciences (India)

Home; Journals; Journal of Genetics; Volume 94; Issue 3. Association between vitamin D receptor gene polymorphism (TaqI) and obesity in Chinese population. Hui-Ru Fan Li-Qun Lin Hao Ma Ying Li Chang-Hao Sun. Research Note Volume 94 Issue 3 September 2015 pp 473-478 ...

Extension of the EQ3/6 computer codes to geochemical modeling of brines

Energy Technology Data Exchange (ETDEWEB)

Jackson, K.J.; Wolery, T.J.

1984-10-23

Recent modifications to the EQ3/6 geochemical modeling software package provide for the use of Pitzer's equations to calculate the activity coefficients of aqueous species and the activity of water. These changes extend the range of solute concentrations over which the codes can be used to dependably calculate equilibria in geochemical systems, and permit the inclusion of ion pairs, complexes, and undissociated acids and bases as explicit component species in the Pitzer model. Comparisons of calculations made by the EQ3NR and EQ6 compuer codes with experimental data confirm that the modifications not only allow the codes to accurately evaluate activity coefficients in concentrated solutions, but also permit prediction of solubility limits of evaporite minerals in brines at 25/sup 0/C and elevated temperatures. Calculations for a few salts can be made at temperatures up to approx. 300/sup 0/C, but the temperature range for most electrolytes is constrained by the availability of requisite data to values less than or equal to 100/sup 0/C. The implementation of Pitzer's equations in EQ3/6 allows application of these codes to problems involving calculation of geochemical equilibria in brines; such as evaluation of the chemical environment which might be anticipated for nuclear waste canisters located in a salt repository. 26 references, 3 figures, 1 table.

Bruxism and health related quality of life in southern Italy's prison inmates.

Science.gov (United States)

Cavallo, P; Savarese, G; Carpinelli, L

2014-06-01

The aim of this study was to determine the prevalence of self-assessed bruxism, the level of Health Related Quality of Life (HRQoL) and their relationship in a group of male inmates. BASIC RESEARCH DESIGN, SETTING: The present study was cross-sectional, its setting was two penal institutions in Italy. A sample of 280 male prisoners (mean age 39.7 years). Due to the very small number of female prisoners, it was not possible to study both genders. Subjects were administered a questionnaire with items investigating demographic data, self-assessed bruxism and HRQoL using EuroQoL EQ-5D instrument. Bruxism was present in 29.7% of inmates. Results for EQ-5D (in brackets are data for the general population age and gender matched) were: EQ-index 1.3 (0.8), EQ-VAS 62 (80). Percentage reporting a problem for each dimension: Mobility (MO): 7.5 (9.6), Self Care (SC): 6.1 (4.3), Usual Activities (UA): 17.9 (10.1), Pain/discomfort (PD): 43.9 (40.8), Anxiety/depression (AD): 54.6 (31.9). There was a strong correlation between bruxism and EQ-index, showing concordance and dependence and, as expected, discordance and dependence between bruxism and EQ-VAS. Bruxism prevalence is higher and HRQoL is worse in the prison population than in the general population; the presence of bruxism is correlated with lower HRQoL levels, and correlation is stronger for subjects at first prison experience and for higher education levels, thus suggesting higher effect of stress on these subjects.

A comparison of individual and social time trade-off values for health states in the general population

DEFF Research Database (Denmark)

Burström, Kristina; Johannesson, Magnus; Diderichsen, Finn

2005-01-01

and a rating scale (RS) question were included (n=2549 for all three questions). The mean TTO (EQ-5D) value was 0.943 (0.890) in the youngest age-group and 0.699 (0.733) in the oldest age-group. The difference between TTO and EQ-5D values was greater in more severe health status groups was. The same equation......This study aimed to compare directly elicited individual time trade-off (TTO) values in a general population sample with the social values derived using the UK EQ-5D index tariff. In the Stockholm County 1998 postal Public Health Survey (n=4950, 20-88 years), the EQ-5D self-classifier, a TTO...... for the EQ-5D dimensions (pdiffer systematically and that the difference is greater the more severe the health status is. The social EQ-5D index tariff may also underestimate the severity in health status at older ages; age appears...

Statistical pulses generator. Application to nuclear instrumentation (1962); Generateur d'impulsions aleatoires. Application a l'instrumentation nucleaire (1962)

Energy Technology Data Exchange (ETDEWEB)

Beranger, R [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1962-07-01

This report describes a random pulses generator adapted to nuclear instrumentation. After a short survey on the statistical nature of electronic signals, the different ways for generating pulses with a Poisson's time-distribution are studied. The final generator built from a gaseous thyratron in a magnetic field is then described. Several tests are indicated : counting-rate stability, Pearson's criterion, distribution of time-intervals. Applications of the generator in 'whole testing' of nuclear instrumentation are then indicated for sealers, dead time measurements, time analyzers. In this application, pulse-height spectrums have been made by Poissonian sampling of a recurrent or random low-frequency signal. (author) [French] Cette etude decrit un generateur d'impulsions aleatoires et ses applications a l'instrumentation nucleaire. Apres un bref rappel sur la nature statistique des signaux en electronique nucleaire, sont passes en revue les principaux moyens d'obtenir des impulsions distribuees en temps suivant une loi de Poisson. Le generateur utilisant un thyratron a gaz dans un champ magnetique est ensuite decrit; diverses methodes de test sont appliquees (stabilite du taux de comptage, criterium de Pearson, spectre des intervalles ds temps). Les applications du generateur a l'electronique nucleaire dans le domaine des 'essais globaux' sont indiques: test des echelles de comptage et mesure des temps morts, test des analyseurs en temps apres division du taux de comptage par une puissance de deux, test des analyseurs multicanaux en amplitude. Pour cette derniere application, on a realise des spectres d'amplitudes suivant une loi connue, par echantillonnage poissonien d'un signal basse frequence recurrent ou aleatoire. (auteur)

Briefer assessment of social network drinking: A test of the Important People Instrument-5 (IP-5).

Science.gov (United States)

Hallgren, Kevin A; Barnett, Nancy P

2016-12-01

The Important People instrument (IP; Longabaugh et al., 2010) is one of the most commonly used measures of social network drinking. Although its reliability and validity are well-supported, the length of the instrument may limit its use in many settings. The present study evaluated whether a briefer, 5-person version of the IP (IP-5) adequately reproduces scores from the full IP. College freshmen (N = 1,053) reported their own past-month drinking, alcohol-related consequences, and information about drinking in their close social networks at baseline and 1 year later. From this we derived network members' drinking frequency, percentage of drinkers, and percentage of heavy drinkers, assessed for up to 10 (full IP) or 5 (IP-5) network members. We first modeled the expected concordance between full-IP scores and scores from simulated shorter IP instruments by sampling smaller subsets of network members from full IP data. Then, using quasi-experimental methods, we administered the full IP and IP-5 and compared the 2 instruments' score distributions and concurrent and year-lagged associations with participants' alcohol consumption and consequences. Most of the full-IP variance was reproduced from simulated shorter versions of the IP (ICCs ≥ 0.80). The full IP and IP-5 yielded similar score distributions, concurrent associations with drinking (r = 0.22 to 0.52), and year-lagged associations with drinking. The IP-5 retains most of the information about social network drinking from the full IP. The shorter instrument may be useful in clinical and research settings that require frequent measure administration, yielding greater temporal resolution for monitoring social network drinking. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Étude économique des foyers domestiques par la technique d ...

African Journals Online (AJOL)

Les foyers font partie de la vie courante. Chaque ménage en utilise pour la cuisson de ses repas. Dans les pays en développement, la plupart des populations utilisent surtout des foyers à combustibles ligneux. Les effets négatifs sur l'environnement sont aujourd'hui bien connus : poches de désertification, érosion des sols, ...

Controle biológico de ciatostomíneos de eqüinos resistentes a ivermectina e pamoato de pirantel com o fungo Monacrosporium thaumasium

OpenAIRE

Tavela, Alexandre de Oliveira

2010-01-01

A viabilidade de uma formulação do fungo predador de nematóides Monacrosporium thaumasium foi avaliada no controle biológico de ciatostomíneos de eqüinos. Dois grupos (tratado com o fungo e controle) constituídos por seis éguas em cada grupo, mestiças, com idade entre 2,5 a 3,5 anos, foram colocados em pastagens de Cynodon sp. naturalmente infectadas com larvas de ciatostomíneos de eqüinos. No grupo tratado, cada animal recebeu 1g/10 kg de peso corporal (0,2g/10kg de peso vivo de fungo) de pé...

Construct Validity of the SF-12v2 for the Homeless Population with Mental Illness: An Instrument to Measure Self-Reported Mental and Physical Health.

Science.gov (United States)

Chum, Antony; Skosireva, Anna; Tobon, Juliana; Hwang, Stephen

2016-01-01

Self-reported health measures are important indicators used by clinicians and researchers for the evaluation of health interventions, outcome assessment of clinical studies, and identification of health needs to improve resource allocation. However, the application of self-reported health measures relies on developing reliable and valid instruments that are suitable across diverse populations. The main objective of this study is to evaluate the construct validity of the SF-12v.2, an instrument for measuring self-rated physical and mental health, for homeless adults with mental illness. Various interventions have been aimed at improving the health of homeless people with mental illness, and the development of valid instruments to evaluate these interventions is imperative. We measured self-rated mental and physical health from a quota sample of 575 homeless people with mental illness using the SF-12v2, EQ-5D, Colorado Symptoms Index, and physical/mental health visual analogue scales. We examined the construct validity of the SF-12v2 through confirmatory factor analyses (CFA), and using ANOVA/correlation analyses to compare the SF-12v2 to the other instruments to ascertain discriminant/convergent validity. Our CFA showed that the measurement properties of the original SF-12v2 model had a mediocre fit with our empirical data (χ2 = 193.6, df = 43, p physical and mental health status for a homeless population with mental illness.

1,5-Anhydro-D-fructose from D-fructose

DEFF Research Database (Denmark)

Dekany, Gyula; Lundt, Inge; Niedermaier, Fabian

2007-01-01

1,5-Anhydro-D-fructose was efficiently prepared from D-fructose via regiospecific 1,5-anhydro ring formation of 2,3-O-isopropylidene-1-O-methyl(tolyl)sulfonyl-D-fructopyranose and subsequent deprotection.......1,5-Anhydro-D-fructose was efficiently prepared from D-fructose via regiospecific 1,5-anhydro ring formation of 2,3-O-isopropylidene-1-O-methyl(tolyl)sulfonyl-D-fructopyranose and subsequent deprotection....

Appendix I1-2 to Wind HUI Initiative 1: Field Campaign Report

Energy Technology Data Exchange (ETDEWEB)

John Zack; Deborah Hanley; Dora Nakafuji

2012-07-15

This report is an appendix to the Hawaii WindHUI efforts to dev elop and operationalize short-term wind forecasting and wind ramp event forecasting capabilities. The report summarizes the WindNET field campaign deployment experiences and challenges. As part of the WindNET project on the Big Island of Hawaii, AWS Truepower (AWST) conducted a field campaign to assess the viability of deploying a network of monitoring systems to aid in local wind energy forecasting. The data provided at these monitoring locations, which were strategically placed around the Big Island of Hawaii based upon results from the Oahu Wind Integration and Transmission Study (OWITS) observational targeting study (Figure 1), provided predictive indicators for improving wind forecasts and developing responsive strategies for managing real-time, wind-related system events. The goal of the field campaign was to make measurements from a network of remote monitoring devices to improve 1- to 3-hour look ahead forecasts for wind facilities.

Energy and CO{sub 2eq} analysis of the agricultural phase in the sunflower biodiesel chain

Energy Technology Data Exchange (ETDEWEB)

Spugnoli, C.P.; Dainelli, R.; D' avino, L.; Mazzoncini, M.; Lazzeri, L. [DEISTAF Univ. degli Studi di Firenze, Firenze (Italy)

2010-07-01

The suitability of the sunflower for biodiesel production was discussed in terms of the reference values on carbon dioxide equivalents (CO{sub 2eq}) emissions for every phase of the biofuels chain as indicated in the European Union (EU) Directive on renewable energies. A life cycle analysis performed on the agricultural phase of the sunflower showed that CO{sub 2eq} emissions from the cultivation phase exceeded the EU reference value. This paper highlighted the relevance of allocation methods to spread out energy consumption and CO{sub 2eq} emissions among sunflower biodiesel and oilcake. Allocation was made according to the principles of mass content, energy content and the economic value of co-products. The CO{sub 2eq} reductions obtained with the 3 methods were approximately 60, 50 and 25 per cent, respectively when compared to a case without allocation. Since these methods did not distinguish the different functionality of co-products in relation to their real use, this study also considered the method of system expansion and allocation by substitution. The considered equivalent functions of oilcake were animal feed, coal fuel and fertilizer. The results showed that while the substitution with coal gives rise to an emission credit, the others allow only minor improvements. A sensitivity analysis emphasized the significance of fossil fuels and fertilizers on energy depletion and CO{sub 2eq} emissions. It was concluded that only a major revision of farm practices aimed at reducing the use of N-fertilizer, can allow the sunflower to be suitable for biodiesel production in central Italy, given the EU constrains for CO{sub 2eq} emissions.

PP: A graphics post-processor for the EQ6 reaction path code

International Nuclear Information System (INIS)

Stockman, H.W.

1994-09-01

The PP code is a graphics post-processor and plotting program for EQ6, a popular reaction-path code. PP runs on personal computers, allocates memory dynamically, and can handle very large reaction path runs. Plots of simple variable groups, such as fluid and solid phase composition, can be obtained with as few as two keystrokes. Navigation through the list of reaction path variables is simple and efficient. Graphics files can be exported for inclusion in word processing documents and spreadsheets, and experimental data may be imported and superposed on the reaction path runs. The EQ6 thermodynamic database can be searched from within PP, to simplify interpretation of complex plots

Chronic stable angina is associated with lower health-related quality of life: evidence from Chinese patients.

Directory of Open Access Journals (Sweden)

Jing Wu

Full Text Available OBJECTIVES: To compare health-related quality of life (HRQoL between patients with stable angina and the general population in China and to examine factors associated with HRQoL among patients with stable angina. METHODS: A cross-sectional HRQoL survey of stable angina patients recruited from 4 hospitals (n = 411 and the general population recruited from 3 Physical Examination Centers (n = 549 was conducted from July to December, 2011 in two large cities, Tianjin and Chengdu. HRQoL was assessed using the EQ-5D, EQ-VAS, and SF-6D instruments. The health status specific to patients with stable angina was assessed using the Seattle Angina Questionnaire (SAQ. Information on socio-demographic, clinical, and lifestyle factors were also collected. Nested regressions were performed to explore how these factors were associated with HRQoL in patients with stable angina. RESULTS: Compared with the general population (44.2 ± 10 years, 49.9% females, stable angina patients (68.1 ± 12 years, 50.4% females had significantly lower HRQoL scores in EQ-5D utility index (0.75 ± 0.19 vs. 0.90 ± 0.20, p<0.05, SF-6D utility index (0.68 ± 0.12 vs. 0.85 ± 0.11, p<0.05, and EQ-VAS (71.2 ± 12.3 vs. 83.9 ± 10.9, p<0.05. The differences remained (-0.05 for EQ-5D, -9.27 for EQ-VAS and -0.13 for SF-6D after controlling for socio-economic characteristics. SAQ scores showed that stable angina patients experienced impaired disease-specific health status, especially in angina stability (40.5 ± 34.6. Nested regressions indicated stable angina-specific health status explained most of the variation in HRQoL, among which disease perception, physical limitation, and angina stability were the strongest predictors. More physical exercise and better sleep were positively related with HRQoL. CONCLUSIONS: Compared to the general population, stable angina patients were associated with lower HRQoL and lower health utility scores, which were largely impacted by clinical symptoms

Effects of Lowering Dialysate Calcium Concentration on Mineral and Bone Disorders in Chronic Hemodialysis Patients: Conversion from 3.0 mEq/L to 2.75 mEq/L.

Science.gov (United States)

Yamada, Shunsuke; Ueki, Kenji; Tokumoto, Masanori; Suehiro, Takaichi; Kimura, Hiroshi; Taniguchi, Masatomo; Fujimi, Satoru; Kitazono, Takanari; Tsuruya, Kazuhiko

2016-02-01

Selection of a lower dialysate calcium concentration (DCa) can reduce calcium burden and prevent vascular calcification in hemodialysis patients. However, decreased DCa can worsen mineral and bone disorders. This 1-year retrospective observational study evaluated 121 hemodialysis patients at Fukuoka Renal Clinic who underwent conversion of DCa from 3.0 mEq/L to 2.75 mEq/L. The primary outcomes were changes in serum levels of calcium, phosphate, and parathyroid hormone (PTH). The effects of baseline serum calcium and PTH levels on changes in biochemical parameters were also determined. One year after DCa conversion, mean serum calcium level decreased, while serum phosphate, alkaline phosphatase, and PTH concentrations increased. The rate of achievement of target PTH was higher in patients with lower serum PTH level at baseline, while patients with higher baseline serum PTH level tended to exceed the upper limit of the PTH target range. Patients with higher baseline serum calcium concentration showed a greater decrease in serum calcium level and a greater increase in serum PTH level at 1 year. Patients with a lower baseline serum PTH level can benefit from optimal PTH control following conversion of DCa from 3.0 mEq/L to 2.75 mEq/L. However, secondary hyperparathyroidism may be exacerbated in some patients with higher baseline serum calcium (Ca) and PTH levels. These results indicate that an individualized approach can maximize the benefits of Ca unloading after conversion to lower DCa. © 2015 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

De middeleeuwse ambachtelijke wijk van Pamele (stad Oudenaarde, Oost-Vlaanderen). Het onderzoek in het Huis de Lalaing. 1. De pottenbakkersovens

OpenAIRE

De Groote, K.

1994-01-01

In april 1988 werd pottenbakkersafval aangetroffen bij graafwerken op de binnenkoer van het Huis de Lalaing te Oudenaarde. Dankzij de snelle tussenkomst van het stadsbestuur, en in het bijzonder van de toenmalige schepen van cultuur, Jean-Pierre Van der Meiren, werden de werken stilgelegd. Het bedreigde terrein, dat eigendom is van de stad, werd voor archeologisch onderzoek ter beschikking gesteld van het I.A.P.. De opgravingen werden voltooid in januari 1989

La désacidification biologique des vins. Etat de la question, perspectives d'avenir

Directory of Open Access Journals (Sweden)

Aline Lonvaud-Funel

1994-06-01

Sa maîtrise passe par l'utilisation de levains bactériens, dont les plus récents sont ensemencés directement au vin après la fermentation alcoolique. Les résultats des recherches fondamentales sur l'enzyme malolactique permettent aujourd'hui d'envisager la construction de réacteurs enzymatiques et sans doute plus rapidement, le transfert de cette activité enzymatique chez les levures de vinification.

Diabetic complications do not hamper improvement of health-related quality of life over the course of treatment of diabetic foot ulcers - the Eurodiale study.

Science.gov (United States)

Siersma, Volkert; Thorsen, Hanne; Holstein, Per E; Kars, Marleen; Apelqvist, Jan; Jude, Edward B; Piaggesi, Alberto; Bakker, Karel; Edmonds, Michael; Jirkovská, Alexandra; Mauricio, Didac; Reike, Heinrich; Spraul, Maximilian; Uccioli, Luigi; Urbancic, Vilma; van Acker, Kristien; van Baal, Jeff; Schaper, Nicolaas C

2017-07-01

Diabetic complications, and in particular diabetic foot ulcers (DFUs), are associated with low health-related quality of life (HRQoL). We evaluated whether the presence of diabetic complications also influenced the improvement of HRQoL during DFU treatment. 1088 patients presenting for DFU treatment at the centers participating in the Eurodiale study were followed prospectively up to one year. HRQoL was measured both at presentation and after healing or at end of follow up, using EQ-5D: a standardized instrument consisting of five domains and a summary index. The influence of diabetic comorbidity on the course of HRQoL was evaluated for each of the EQ-5D outcomes in multi-level linear regression analyses, adjusting for baseline characteristics. HRQoL improved in all EQ-5D outcomes over the course of treatment for those DFUs that healed. The few significant differences in the development of HRQoL between patients with and without comorbidity showed a more beneficial development for patients with comorbidity in DFUs that did not heal or healed slowly. Comorbidity does not hamper improvement of HRQoL in DFU treatment. On the contrary, HRQoL improved sometimes more in patients with certain comorbidity with hard-to-heal ulcers. Copyright © 2017 Elsevier Inc. All rights reserved.

EQ3/6, a software package for geochemical modeling of aqueous systems: Package overview and installation guide (Version 7.0)

International Nuclear Information System (INIS)

Wolery, T.J.

1992-01-01

EQ3/6 is a software package for geochemical modeling of aqueous systems. This report describes version 7.0. The major components of the package include: EQ3NR, a speciation-solubility code; EQ6, a reaction path code which models water/rock interaction or fluid mixing in either a pure reaction progress mode or a time mode; EQPT, a data file preprocessor, EQLIB, a supporting software library; and five supporting thermodynamic data files. The software deals with the concepts of thermodynamic equilibrium, thermodynamic disequilibrium, and reaction kinetics. The five supporting data files contain both standard state and activity coefficient-related data. Three support the use of the Davies or B equations for the activity coefficients; the other two support the use of Pitzer's equations. The temperature range of the thermodynamic data on the data files varies from 25 degree C only to 0--300 degree C. EQPT takes a formatted data file (a data0 file) and writes an unformatted near-equivalent called a datal file, which is actually the form read by EQ3NR and EQ6. EQ3NR is useful for analyzing groundwater chemistry data, calculating solubility limits, and determining whether certain reactions are in states of partial equilibrium or disequilibrium. It is also required to initialize an EQ6 calculation. EQ6 models the consequences of reacting an aqueous solution with a set of reactants which react irreversibly. It can also model fluid mixing and the consequences of changes in temperature. This code operates both in a pure reaction progress frame and in a time frame

Effect of Exposure to Second-Hand Smoke on the Quality of Life: A Nationwide Population-Based Study from South Korea.

Directory of Open Access Journals (Sweden)

Yeon Wook Kim

Full Text Available Although exposure to second-hand smoke (SHS has been associated with various medical conditions, only limited data are available on its association with health-related quality of life (HRQOL, particularly data obtained with the EQ-5D or EQ visual analogue scale (VAS.This cross-sectional study evaluated 10,532 adult never-smokers who participated in the fifth Korea National Health and Nutrition Examination Survey. By using linear regression models to adjust for possible confounders and incorporating survey weights in analyses, the association between exposure to SHS and HRQOL-measured with the EQ-5D index and the EQ-VAS score-was evaluated. Data were further stratified by the amount of exposure time.After weighted analysis and adjustment, exposure to SHS was significantly associated with lower measures on the EQ-5D index (β = -0.007, P = 0.005 and EQ-VAS score (β = -1.936, P < 0.001. When comparing the unexposed group with the groups exposed <2h/day and ≥2h/day, exposure to a longer duration of SHS was significantly associated with lower scores on the EQ-5D index and the EQ-VAS score.In conclusion, exposure to SHS was associated with reduced HRQOL measured by the EQ-5D index and EQ-VAS score, revealing a dose-response relationship.

From SPOT 5 to Pleiades HR: evolution of the instrumental specifications

Science.gov (United States)

Rosak, A.; Latry, C.; Pascal, V.; Laubier, D.

2017-11-01

Image quality specifications should aimed to fulfil high resolution mission requirements of remote sensing satellites with a minimum cost. The most important trade-off to be taken into account is between Modulation Transfer Function, radiometric noise and sampling scheme. This compromise is the main driver during design optimisation and requirement definition in order to achieve good performances and to minimise the mission cost. For the SPOT 5 satellite, a new compromise had been chosen. The supermode principle of imagery (sampling at 2.5 meter with a pixel size of 5 meter) imp roves the resolution by a factor of four compared with the SPOT 4 satellite (10 meter resolution). This paper presents the image quality specifications of the HRG-SPOT 5 instrument. We introduce all the efforts made on the instrument to achieve good image quality and low radiometric noise, then we compare the results with the SPOT 4 instrument's performances to highlight the improvements achieved. Then, the in-orbit performance will be described. Finally, we will present the new goals of image quality specifications for the new Pleiades-HR satellite for earth observation (0.7 meter resolution) and the instrument concept.

a Circleless "2D/3D Total STATION": a Low Cost Instrument for Surveying, Recording Point Clouds, Documentation, Image Acquisition and Visualisation

Science.gov (United States)

Scherer, M.

2013-07-01

Hardware and software of the universally applicable instrument - referred to as a 2D/3D total station - are described here, as well as its practical use. At its core it consists of a 3D camera - often also called a ToF camera, a pmd camera or a RIM-camera - combined with a common industrial 2D camera. The cameras are rigidly coupled with their optical axes in parallel. A new type of instrument was created mounting this 2D/3D system on a tripod in a specific way. Because of it sharing certain characteristics with a total station and a tacheometer, respectively, the new device was called a 2D/3D total station. It may effectively replace a common total station or a laser scanner in some respects. After a brief overview of the prototype's features this paper then focuses on the methodological characteristics for practical application. Its usability as a universally applicable stand-alone instrument is demonstrated for surveying, recording RGB-coloured point clouds as well as delivering images for documentation and visualisation. Because of its limited range (10m without reflector and 150 m to reflector prisms) and low range accuracy (ca. 2 cm to 3 cm) compared to present-day total stations and laser scanners, the practical usage of the 2D/3D total station is currently limited to acquisition of accidents, forensic purpuses, speleology or facility management, as well as architectural recordings with low requirements regarding accuracy. However, the author is convinced that in the near future advancements in 3D camera technology will allow this type of comparatively low cost instrument to replace the total station as well as the laser scanner in an increasing number of areas.

Spanish Adaptation and Validation of the Transplant Effects Questionnaire (TxEQ-Spanish in Liver Transplant Recipients and Its Relationship to Posttraumatic Growth and Quality of Life

Directory of Open Access Journals (Sweden)

María Á. Pérez-San-Gregorio

2018-04-01

Full Text Available The valid assessment of the impact of transplantation on psychological well-being is highly relevant to optimize treatment. However, to date there is no standardized instrument available in Spain. The Transplant Effects Questionnaire (TxEQ evaluates the specific problems associated with organ transplantation, such as worry about transplant, guilt regarding the donor, disclosure of having undergone transplantation, adherence to medical treatment and responsibility toward the donor, family, friends, or medical staff. Against this backdrop the English original version of the TxEQ was translated into Spanish and validated in a sample of 240 liver transplant recipients. Participants also filled in the Posttraumatic Growth Inventory (PTGI, and the 12-Item Short Form Health Survey (SF-12v.2. Confirmatory factor analysis of the TxEQ-Spanish revealed a five-factor structure equivalent to the English original version, and satisfactory internal consistency (Cronbach's alpha: worry α = 0.82, guilt α = 0.77, disclosure α = 0.91, adherence α = 0.82, responsibility α = 0.83. Results showed that better mental quality of life was associated with higher adherence and disclosure, as well as less worry and guilt. Higher posttraumatic growth was significantly associated with worry, guilt, and responsibility. Interestingly, the most powerful predictor of posttraumatic growth was worry. Analysis of variance showed an interaction effect of PTG and mental quality of life on adherence, with medium PTG being associated with significantly stronger adherence in participants with better mental quality of life. In conclusion our study could successfully adapt and validate the Spanish version of the TxEQ in a large sample of liver transplant recipients. Our findings show a complex relationship between emotional reactions to transplantation, mental quality of life, and posttraumatic growth, which give further insight into inner processes supporting psychological well

Health-related quality of life in relation to disease activity in adults with hereditary angioedema in Sweden.

Science.gov (United States)

Nordenfelt, Patrik; Nilsson, Mats; Lindfors, Anders; Wahlgren, Carl-Fredrik; Björkander, Janne

2017-11-30

Health-related quality of life (HR-QoL) is impaired in patients with hereditary angioedema (HAE) but has not yet been satisfactorily described. To study HR-QoL in patients with HAE by combining different HR-QoL instruments with disease activity assessment. All adults in the Swedish HAE registry were invited to take part in this questionnaire study, which used the generic HR-QoL instruments, EuroQol 5 Dimensions 5 Level (EQ-5D-5L) and the RAND Corporation Short Form 36 (RAND-36), the disease-specific Angioedema Quality of Life instrument (AE-QoL), the recently introduced Angioedema Activity Score (AAS) form, and questionnaires on sick leave and prophylactic medication. Sixty-four of 133 adults (26 men, 38 women) between 18 and 91 years old responded. The most affected HR-QoL dimensions in the EQ-5D-5L were pain/discomfort and anxiety/depression; in the RAND-36, energy/fatigue, general health, pain; and, in the AE-QoL, fears/shame and fatigue/mood. Women had lower HR-QoL in the RAND-36 for general health and energy/fatigue (p 0 had significantly impaired HR-QoL. There were significant associations (p depression, and fatigue/mood are important aspects of HAE but the AE-QoL disregards pain. HR-QoL was not significantly affected by prophylaxis. Increased disease activity was associated with impaired HR-QoL, which justifies more active disease management.

Outcome Assessment for Cost-Utility Evaluations: SF-6D vs. EQ-5D

DEFF Research Database (Denmark)

Søgaard, Rikke; Christiansen, Terkel; Christensen, Finn Bjarke

2010-01-01

What was formerly known as medicine has now become health care, an amalgam of several disciplines, including health economics. The role of health economics is fairly straightforward, namely to facilitate priority-setting under the objective of maximizing population health. For that purpose, cost...

EQ3/6, a software package for geochemical modeling of aqueous systems: Package overview and installation guide (Version 7.0)

Energy Technology Data Exchange (ETDEWEB)

Wolery, T.J.

1992-09-14

EQ3/6 is a software package for geochemical modeling of aqueous systems. This report describes version 7.0. The major components of the package include: EQ3NR, a speciation-solubility code; EQ6, a reaction path code which models water/rock interaction or fluid mixing in either a pure reaction progress mode or a time mode; EQPT, a data file preprocessor, EQLIB, a supporting software library; and five supporting thermodynamic data files. The software deals with the concepts of thermodynamic equilibrium, thermodynamic disequilibrium, and reaction kinetics. The five supporting data files contain both standard state and activity coefficient-related data. Three support the use of the Davies or B-dot equations for the activity coefficients; the other two support the use of Pitzer`s equations. The temperature range of the thermodynamic data on the data files varies from 25{degree}C only to 0--300{degree}C. EQPT takes a formatted data file (a data0 file) and writes an unformatted near-equivalent called a datal file, which is actually the form read by EQ3NR and EQ6. EQ3NR is useful for analyzing groundwater chemistry data, calculating solubility limits, and determining whether certain reactions are in states of partial equilibrium or disequilibrium. It is also required to initialize an EQ6 calculation. EQ6 models the consequences of reacting an aqueous solution with a set of reactants which react irreversibly. It can also model fluid mixing and the consequences of changes in temperature. This code operates both in a pure reaction progress frame and in a time frame.

Hyperfine structure in 5s4d 3D-5snf transitions of 87Sr

International Nuclear Information System (INIS)

Bushaw, B.A.; Kluge, H.J.; Lantzsch, J.; Schwalbach, R.; Stenner, J.; Stevens, H.; Wendt, K.; Zimmer, K.

1993-01-01

The hyperfine spectra of the 5s4d 3 D 1 -5s20f, 5s4d 3 D 2 -5s23f, and 5s4d 3 D 3 -5s32f transitions of 87 Sr (I=9/2) have been measured by collinear fast beam laser spectroscopy. The structure in the upper configurations is highly perturbed by fine structure splitting that is of comparable size to the hyperfine interaction energy. These perturbations can be adequately treated with conventional matrix diagonalization methods, using the 5s-electron magnetic dipole interaction term a 5s and the unperturbed fine structure splittings as input parameters. Additionally, hyperfine constants for the lower 5s4d 3 D configurations, including the A- and B-factors and a separation of the individual s- and d-electron contributions to these factors, are derived. (orig.)

Health-related quality of life after deep vein thrombosis

DEFF Research Database (Denmark)

Utne, Kristin Kornelia; Tavoly, Mazdak; Wik, Hilde Skuterud

2016-01-01

were to evaluate long-term HRQoL following DVT and to compare that with age and sex matched control group and to population norms as well as to investigate possible predictors for reduced HRQoL. METHODS: HRQoL was evaluated in 254 patients with confirmed DVT using the generic EQ-5D and the diseases...... specific VEINES-QOL/Sym questionnaire, whereas PTS was assessed by the Villalta scale. Patients were asked to give the EQ-5D questionnaire to two friends of same age- (±5 years) and sex (buddy controls). RESULTS: Patients scored significantly lower on all dimensions of EQ-5D compared to controls. EQ-5D...

Nuclear EQ sourcebook: A compilation of documents for nuclear equipment qualification

International Nuclear Information System (INIS)

Anon.

1992-01-01

In the nuclear power industry, environmental and seismic qualification of safety-related electrical and instrumentation equipment is collectively known as Equipment Qualification (EQ). Related technology, as well as regulatory requirements, have evolved rapidly during the last 15 years. For environmental qualification, what began in 1971 with one trial-use guide (IEEE Std 323-1971), now stands as a full complement of Nuclear Regulatory Commission (NRC) rules, guides and industry standards. In addition to the Institute of Electrical and Electronics Engineers (IEEE), the American Society of Mechanical Engineers (ASME) has also undertaken development of its own set of standards for use in qualifying safety-related mechanical equipment. To ensure that the original design and qualification is preserved, engineers need to select and use the correct set of NRC regulations, regulatory guides, industry standards, and generic correspondence. Given that the total number of these documents exceed 200, this task becomes resource intensive. This compilation is the first known publication available to serve the user-community need for a complete and exhaustive single source. Approximately 180 items (Bulletins, Federal Rules, Generic Letters, Notices, Regulatory Guides, IEEE Standards, IEEE Recommended Practices, and IEEE Guides) have been processed separately for inclusion on the data base

Development of Highly Survivable Power and Communication System for NPP Instruments under Severe Accident

Energy Technology Data Exchange (ETDEWEB)

Yoo, Seung J.; Gu, Beom W.; Nguyen, Duy T.; Choi, Bo H.; Rim, Chun T. [KAIST, Daejeon (Korea, Republic of); Lee, So I. [KHNP CRI, Daejeon (Korea, Republic of)

2014-10-15

According to the detail report from the Fukushima nuclear accident, the failure of conventional instruments is mainly due to the following reasons. 1) Insufficient backup battery capacity after the station black out (SBO) 2) The malfunction or damage of instruments due to the extremely harsh ambient condition after the severe accident 3) The cut-off of power and communication cable due to the physical shocks of hydrogen explosion after the severe accident Since the current equipment qualification (EQ) for the NPP instruments is based on the design basis accident such as loss of coolant accident (LOCA), conventional instruments, which are examined under EQ condition, cannot guarantee their normal operation during the severe accident. A 7m-long-distance wireless power transfer and a radio frequency (RF) communication were introduced with conventional wired system to increase a redundancy. A heat isolation box and a harness are adopted to provide a protection from the expected physical shocks such as missiles and drastic increase of ambient temperature and pressure. A detail design principle of the highly survivable power and communication system, which has 4 sub-systems of a DCRS wireless power transfer, a Zigbee wireless communication, a GFRP harness, and a passive type router with a fly back regulator, has been presented in this paper. Each sub-system has been designed to have a robust operation characteristic regardless of the estimated physical shocks after the severe accident.

Development of Highly Survivable Power and Communication System for NPP Instruments under Severe Accident

International Nuclear Information System (INIS)

Yoo, Seung J.; Gu, Beom W.; Nguyen, Duy T.; Choi, Bo H.; Rim, Chun T.; Lee, So I.

2014-01-01

According to the detail report from the Fukushima nuclear accident, the failure of conventional instruments is mainly due to the following reasons. 1) Insufficient backup battery capacity after the station black out (SBO) 2) The malfunction or damage of instruments due to the extremely harsh ambient condition after the severe accident 3) The cut-off of power and communication cable due to the physical shocks of hydrogen explosion after the severe accident Since the current equipment qualification (EQ) for the NPP instruments is based on the design basis accident such as loss of coolant accident (LOCA), conventional instruments, which are examined under EQ condition, cannot guarantee their normal operation during the severe accident. A 7m-long-distance wireless power transfer and a radio frequency (RF) communication were introduced with conventional wired system to increase a redundancy. A heat isolation box and a harness are adopted to provide a protection from the expected physical shocks such as missiles and drastic increase of ambient temperature and pressure. A detail design principle of the highly survivable power and communication system, which has 4 sub-systems of a DCRS wireless power transfer, a Zigbee wireless communication, a GFRP harness, and a passive type router with a fly back regulator, has been presented in this paper. Each sub-system has been designed to have a robust operation characteristic regardless of the estimated physical shocks after the severe accident

Tourisme durable en zone de montagne : définition et enjeux

OpenAIRE

ZEGHNI, Sylvain

2014-01-01

La montagne est depuis longtemps un territoire de tourisme. Paradoxalement, pendant longtemps, la France a connu un déficit d'exploitation touristique hivernale de son massif. Les plans neige des années 60 et 70 eurent pour ambition de rattraper ce retard et de faire de notre pays la première destination de sport d'hiver. Cette ambition ayant été atteinte, le tourisme hivernal en zone de montagne est aujourd'hui un puissant levier économique d'aménagement et de développement. Il n'en reste pa...

Regards croisés d'un physicien et d'un dessinateur sur Einstein et la physique the recipe of the Universe

CERN Multimedia

CERN. Geneva

2006-01-01

Rencontre donnée par John Ellis et Fiami. Partez à la découverte de la physique avec un auteur de bande dessinée qui vous fera découvrir six étapes cruciales de l’histoire de la connaissance, en compagnie de son héros Albert Einstein. Après ce voyage littéraire, un physicien du CERN vous expliquera les enjeux de la physique aujourd’hui, plus de 100 ans après Einstein.

Instrumentation of air conditioning and ventilation system - R-5 project

International Nuclear Information System (INIS)

Kulkarni, P.B.; Naik, C.D.; Narasingha Rao, S.N.

1977-01-01

A detailed account of instrumentation proposed for airconditioning and ventilation system in the R-5, 100 MW thermal research reactor, under construction is presented. Controls and instrumentation provided in this system are electronic, pneumatic and hydraulic in nature depending on the application. They cater to the accurate operation of the system and maintain the conditions strictly within desired tolerances. (S.K.K.)

EQPT, a data file preprocessor for the EQ3/6 software package: User's guide and related documentation (Version 7.0)

International Nuclear Information System (INIS)

Daveler, S.A.; Wolery, T.J.

1992-01-01

EQPT is a data file preprocessor for the EQ3/6 software package. EQ3/6 currently contains five primary data files, called datao files. These files comprise alternative data sets. These data files contain both standard state and activity coefficient-related data. Three (com, sup, and nea) support the use of the Davies or B equations for the activity coefficients; the other two (hmw and pit) support the use of Pitzer's (1973, 1975) equations. The temperature range of the thermodynamic data on these data files varies from 25 degrees C only to 0-300 degrees C. The principal modeling codes in EQ3/6, EQ3NR and EQ6, do not read a data0 file, however. Instead, these codes read an unformatted equivalent called a data1 file. EQPT writes a datal file, using the corresponding data0 file as input. In processing a data0 file, EQPT checks the data for common errors, such as unbalanced reactions. It also conducts two kinds of data transformation. Interpolating polynomials are fit to data which are input on temperature adds. The coefficients of these polynomials are then written on the datal file in place of the original temperature grids. A second transformation pertains only to data files tied to Pitzer's equations. The commonly reported observable Pitzer coefficient parameters are mapped into a set of primitive parameters by means of a set of conventional relations. These primitive form parameters are then written onto the datal file in place of their observable counterparts. Usage of the primitive form parameters makes it easier to evaluate Pitzer's equations in EQ3NR and EQ6. EQPT and the other codes in the EQ3/6 package are written in FORTRAN 77 and have been developed to run under the UNIX operating system on computers ranging from workstations to supercomputers

Amal comme l'espoir : Une coopérative d'huile d'argan a changé la ...

International Development Research Centre (IDRC) Digital Library (Canada)

1 nov. 2010 ... Ma vie a changé. J'étais condamnée à ne jamais sortir de la maison. Aujourd'hui, je gagne de l'argent et je peux envoyer mes enfants à l'école. » Ainsi parle une femme qui est revenue à la vie grâce à la coopérative exclusivement féminine de Tamanar. Dans la région d'Essaouira au Maroc, une ...

(NS5-brane, D5-brane, D3-brane) bound state, open D3-brane, open D5-brane limits, and SL(2,Z) duality

International Nuclear Information System (INIS)

Mitra, Indranil; Roy, Shibaji

2002-01-01

We generalize the nonthreshold bound state in type IIB supergravity of the form (NS5-brane, D5-brane, D3-brane) constructed by the present authors [J. High Energy Phys. 02, 026 (2001)] to a nonzero asymptotic value of the axion (χ 0 ). We identify the decoupling limits corresponding to both the open D3-brane theory and open D5-brane theory for this supergravity solution as expected. However, we do not find any noncommutative Yang-Mills theory (NCYM) limit for this solution in the presence of NS5-branes. We then study the SL(2,Z) duality symmetry of type IIB theory for both open D3-brane (OD3) limit and open D5-brane (OD5) limit. We find that for OD3 theory, a generic SL(2,Z) duality always gives another OD3 theory irrespective of the value of χ 0 being rational or not. This indicates that OD3 theory is self-dual. But, under a special set of SL(2,Z) transformations for which χ 0 is rational, OD3 theory goes over to a (5+1)-dimensional NCYM theory and these two theories in this case are related to each other by strong-weak duality symmetry. On the other hand, for OD5 theory, a generic SL(2,Z) duality gives another OD5 theory if χ 0 is irrational, but when χ 0 is rational it gives the little string theory limit indicating that OD5 theory is S dual to the type IIB little string theory

Development and application of an educational 3D X-ray CT instrument

International Nuclear Information System (INIS)

Arakawa, Etsuo; Iwami, Ryutaro; Motohisa, Yasuko; Kamezawa, Chika; Kamogawa, Masashi; Voegeli, Wolfgang

2016-01-01

A three-dimensional (3D) X-ray computed tomography (CT) instrument for radiation education was developed. The structure of the instrument is such that the main parts, i.e. the X-ray source, specimen rotation stage, and two-dimensional detector can be easily observed. An experiment using a fruit of green pepper as a specimen was performed. CT images and intermediate steps for obtaining them, i.e. radiographs, sinograms after Radon transform, and real and imaginary parts of Fourier components in reciprocal space during inverse Radon transform are shown. We propose that these images will help students to understand the principle and mechanism of X-ray CT instruments visually. (author)

Reliability and validity of a self-administration version of DEMQOL-Proxy.

Science.gov (United States)

Hendriks, A A Jolijn; Smith, Sarah C; Chrysanthaki, Theopisti; Black, Nick

2017-07-01

This study aimed to investigate the reliability and validity of a self-administered version of DEMQOL-Proxy, a disease-specific instrument that measures health-related quality of life in people with dementia. The sample consisted of 173 informal carers of people with dementia, aged 29 to 89 years old. Carers were mostly female, White/White British and closely related to the patient. They completed DEMQOL-Proxy (self-administered), EQ-5D-3L (proxy reported about the person with dementia), EQ-5D-3L (self-reported about their own health) and the Zarit Burden Interview. Using well-established methods from classical test theory, we evaluated scale level acceptability, reliability and convergent, discriminant and known-groups validity of DEMQOL-Proxy. DEMQOL-Proxy (self-administered) showed high acceptability (3.5% missing data and 0% scores at floor or ceiling), high internal consistency reliability (α = 0.93) and good convergent and discriminant validity. Amongst others, we found a moderately high correlation with EQ-5D-3L proxy reported (r = 0.52) and low to essentially zero correlations with EQ-5D-3L self-reported (r = 0.20) and carer and patient background variables (r ≤ 0.20). As predicted, DEMQOL-Proxy (self-administered) showed a modest correlation with DEMQOL (r = 0.32). Known-groups differences on health-related quality of life (comparing people with versus people without cognitive impairment) were of moderate effect size (d = 0.38) and in the expected direction. DEMQOL-Proxy (self-administered) has comparable acceptability, reliability and validity with DEMQOL-Proxy (interviewer administered). DEMQOL-Proxy (self-administered) can be used in a wider variety of contexts than its interviewer-administered version, including routine use in busy clinics. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Health-related quality of life and Chlamydia trachomatis infection in sexually experienced female inner-city students: a community-based cross-sectional study.

Science.gov (United States)

Sri, Trisha; Southgate, Eleanor; Kerry, Sarah R; Nightingale, Claire; Oakeshott, Pippa

2017-03-01

This cross-sectional study was undertaken to compare health-related quality of life (EQ-5D) in women with and without undiagnosed Chlamydia trachomatis infection. We analysed data from 2401 multi-ethnic sexually active female students aged 16-27 years who were recruited to a randomised controlled trial of chlamydia screening - the prevention of pelvic infection trial in 2004-2006. At recruitment, all participants were asked to provide self-taken vaginal swabs for chlamydia testing and to complete a sexual health questionnaire including quality of life (EQ-5D). Most women (69%) had an EQ-5D of one representing 'perfect health' in the five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. We therefore compared the proportion of women with an EQ-5D score life, but EQ-5D may not be the best tool to measure it in this group.

Erratum to: Interpersonal discrimination and health-related quality of life among black and white men and women in the United States.

Science.gov (United States)

Sellers, Sherrill L; Cherepanov, Dasha; Hanmer, Janel; Fryback, Dennis G; Palta, Mari

2013-08-01

We assessed associations between discrimination and health-related quality of life among black and white men and women in the United States. We examined data from the National Health Measurement Study, a nationally representative sample of 3,648 adults aged 35-89 in the non-institutionalized US population. These data include self-reported lifetime and everyday discrimination as well as several health utility indexes (EQ-5D, HUI3, and SF-6D). Multiple regression was used to compute mean health utility scores adjusted for age, income, education, and chronic diseases for each race-by-gender subgroup. Black men and women reported more discrimination than white men and women. Health utility tended to be worse as reported discrimination increased. With a few exceptions, differences between mean health utility scores in the lowest and highest discrimination groups exceeded the 0.03 difference generally considered to be a clinically significant difference. Persons who experienced discrimination tended to score lower on health utility measures. The study also revealed a complex relationship between experiences of discrimination and race and gender. Because of these differential social and demographic relationships caution is urged when interpreting self-rated health measures in research, clinical, and policy settings.

Patients undergoing subacute rehabilitation have accurate expectations of their health-related quality of life at discharge

Directory of Open Access Journals (Sweden)

McPhail Steven

2012-08-01

Full Text Available Abstract Background Expectations held by patients and health professionals may affect treatment choices and participation (by both patients and health professionals in therapeutic interventions in contemporary patient-centered healthcare environments. If patients in rehabilitation settings overestimate their discharge health-related quality of life, they may become despondent as their progress falls short of their expectations. On the other hand, underestimating their discharge health-related quality of life may lead to a lack of motivation to participate in therapies if they do not perceive likely benefit. There is a scarcity of empirical evidence evaluating whether patients’ expectations of future health states are accurate. The purpose of this study is to evaluate the accuracy with which older patients admitted for subacute in-hospital rehabilitation can anticipate their discharge health-related quality of life. Methods A prospective longitudinal cohort investigation of agreement between patients’ anticipated discharge health-related quality of life (as reported on the EQ-5D instrument at admission to a rehabilitation unit and their actual self-reported health-related quality of life at the time of discharge from this unit was undertaken. The mini-mental state examination was used as an indicator of patients’ cognitive ability. Results Overall, 232(85% patients had all assessment data completed and were included in analysis. Kappa scores ranged from 0.42-0.68 across the five EQ-5D domains and two patient cognition groups. The percentage of exact correct matches within each domain ranged from 69% to 85% across domains and cognition groups. Overall 40% of participants in each cognition group correctly anticipated all of their self-reported discharge EQ-5D domain responses. Conclusions Patients admitted for subacute in-hospital rehabilitation were able to anticipate their discharge health-related quality of life on the EQ-5D instrument

Comparative evaluation of cyclic fatigue resistance of D-RaCe and ProTaper retreatment instruments in curved artificial canals.

Science.gov (United States)

Topçuoğlu, H S; Topçuoğlu, G; Aktı, A

2016-06-01

To compare the cyclic fatigue resistance of D-RaCe and ProTaper rotary nickel-titanium (NiTi) retreatment files when used in curved artificial canals. A total of 120 new D-RaCe DR2 and ProTaper D3 retreatment files were tested in stainless steel artificial canals having 45° and 60° angles of curvature. Thirty instruments of each of the file systems were tested in both angles of curvature (n = 30). The retreatment instruments were rotated until fracture to calculate the number of cycles to failure. The length of each fractured fragment was recorded. Data were analysed by independent sample t-test. Fractured surfaces of the instruments were analysed by scanning electron microscopy. In the canal with 45° angle of curvature, no significant difference was observed between the retreatment systems (P > 0.05); on the other hand, in the canal with 60° angle of curvature, D-RaCe DR2 instruments had greater cyclic fatigue resistance than ProTaper D3 (P  0.05). The fracture surfaces of the instruments had morphologic characteristics of ductile fracture. D-RaCe DR2 instrument exhibited greater cyclic fatigue resistance than ProTaper D3 only in root canals with 60° angle of curvature. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Intoxicação em eqüino por Ricinus communis: relato de caso.

Directory of Open Access Journals (Sweden)

R. Y. A. Baccarin

2005-03-01

Full Text Available RESUMO: A intoxicação por Ricinus communis (Euphorbiaceae geralmente ocorre após a ingestão acidental de suas folhas ou sementes, podendo causar distúrbios neuromusculares e gastrintestinais. Um eqüino da raça Mangalarga Marchador de 4 anos de idade foi atendido no setor de Clínica de Eqüinos do Hospital Veterinário (HOVET da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo (FMVZ-USP após ter ingerido e aspirado um filtrado preparado à base de frutos de mamona. O animal apresentava pleuropneumonia, alterações de comportamento, comprometimentos hepático e renal, peritonite e desidratação. PALAVRAS-CHAVE: Eqüino, Ricinus communis, pleuropneumonia. SUMMARY: The Ricinus communis (Euphorbiaceae intoxication generally occurs after accidental ingestion of its leaves or seeds, and may cause neuromuscular and gastrintestinal disturbance. An equine, Mangalarga Marchador breed, 4-year old, was attended at the section of Clínica de Eqüinos from the Hospital Veterinário (HOVET of Faculdade de Medicina Veterinária e Zootecnia of Universidade de São Paulo (FMVZ-USP after ingestion and aspiration of a R. communis fruits filtrate. The animal presented pleuropneumonia, behavioural alterations, hepatic and renal disturbances, peritonitis and dehydration. KEYWORDS: Equine, Ricinus communis, pleuropneumonia.

Common generic measures of health related quality of life in injured patients.

Science.gov (United States)

Shearer, David; Morshed, Saam

2011-03-01

The measurement of health-related quality of life (HRQOL) through generic outcome instruments is important for comparisons of populations across disease states and interventions. The growing number of questionnaires available has made selection and interpretation more difficult. Profile instruments such as the SF-36 and Sickness Impact Profile provide insight into various domains of health with established population norms. Preference-based measures, including the EQ-5D, Health Utilities Index, SF-6D, and QWB-SA are used to generate utility scores, which can be used for cost-effectiveness analysis and therefore have particular relevance in health policy. Both types of generic measures have been used in clinical trials in injured populations to assess the relative impact of interventions on quality-of-life. Comparisons of internal consistency and test-retest reliability across measures reveal minimal differences between instruments, and reported values are acceptable for group comparisons but insufficient for individual clinical use. There is a dearth of studies evaluating the validity of these measures in the trauma population, but available data suggest most of the available instruments are acceptable. Populations that may require special consideration are patients with head, spinal cord, and upper-extremity injuries. Practical issues to consider in selecting a questionnaire include time for completion, which ranges from less than 2 min for the EQ-5D to 20-30 min for the Sickness Impact Profile. Selection of the appropriate measure ultimately depends largely on the population to be studied and whether utility-estimation is desired. Copyright © 2010 Elsevier Ltd. All rights reserved.

Cardiotoxicity of tricyclic antidepressant treated by 2650 mEq sodium bicarbonate: A case report.

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Amiri, Hassan; Zamani, Nasim; Hassanian-Moghaddam, Hossein; Shadnia, Shahin

2016-01-01

Poisoning with tricyclic antidepressants is an important cause of drug-related self-poisoning in the developed world and a very common cause of poisoning and mortality in developing countries. Electrocardiographic manifestations of most tricyclic antidepressant-poisoned patients resolve by the administration of 1-2 mEq/kg of sodium bicarbonate. Some rare cases have been reported who have been resistant to the long-term or high doses of bicarbonate administration. We present a case of acute tricyclic antidepressant toxicity referring with status epilepticus, hypotension, and refractory QRS complex widening that resolved after the intravenous administration of 2650 mEq sodium bicarbonate.

Multi-Objective Optimization of Building Energy Design to Reconcile Collective and Private Perspectives: CO2-eq vs. Discounted Payback Time

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Mohamed Hamdy

2017-07-01

Full Text Available Building energy design is a multi-objective optimization problem where collective and private perspectives conflict each other. For instance, whereas the collectivity pursues the minimization of environmental impact, the private pursues the maximization of financial viability. Solving such trade-off design problems usually involves a big computational cost for exploring a huge solution domain including a large number of design options. To reduce that computational cost, a bi-objective simulation-based optimization algorithm, developed in a previous study, is applied in the present investigation. The algorithm is implemented for minimizing the CO2-eq emissions and the discounted payback time (DPB of a single-family house in cold climate, where 13,456 design solutions including building envelope and heating system options are explored and compared to a predefined reference case. The whole building life is considered by assuming a calculation period of 30 years. The results show that the type of heating system significantly affects energy performance; notably, the ground source heat pump leads to the highest reduction in CO2-eq emissions, around 1300 kgCO2-eq/m2, with 17 year DPB; the oil fire boiler can provide the lowest DPB, equal to 8.5 years, with 850 kgCO2-eq/m2 reduction. In addition, it is shown that using too high levels of thermal insulation is not an effective solution as it causes unacceptable levels of summertime overheating. Finally a multi-objective decision making approach is proposed in order to enable the stakeholders to choice among the optimal solutions according to the weight given to each objective, and thus to each perspective.

2081-IJBCS-Article-Emmanuel Bassene

African Journals Online (AJOL)

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polyphénols totaux obtenues sont 13,56% et 5,6% Eq d'acide tannique respectivement dans les feuilles et les inflorescences mâles. ... DPPH, les résultats obtenus en mg Eq d'acide ascorbique sont 4 et 5 mg Eq respectivement dans les extraits d'acétate éthyle et ..... pathologies liées au stress oxydatif. REFERENCES.

Asie | CRDI - Centre de recherches pour le développement ...

International Development Research Centre (IDRC) Digital Library (Canada)

... défis agricoles, environnementaux, technologiques, sociaux et économiques de l'Asie. Grâce à nos investissements stratégiques, nous aidons les acteurs régionaux à participer plus efficacement à résolution des problèmes régionaux. Qu'en résulte-t-il ? Des dirigeants régionaux forts, pour aujourd'hui et pour demain.

Identification and phylogenetic analysis of a sheep pox virus isolated from the Ningxia Hui Autonomous Region of China.

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