The effect of gender and age on the association between weight status and health-related quality of life in Australian adolescents

Evidence suggests an inverse relationship between excess weight and health-related quality of life (HRQoL) in children and adolescents, however little is known about whether this association is moderated by variables such as gender and age. This study aimed to investigate these relationships.

The study protocol of: 'initiating end of life care in stroke: clinical decision- making around prognosis'

 Background: The initiation of end of life care in an acute stroke context should be focused on those patients and families with greatest need. This requires clinicians to synthesise information on prognosis, patterns (trajectories) of dying and patient and family preferences. Within acute stroke, prognostic models are available to identify risks of dying, but variability in dying trajectories makes it difficult for clinicians to know when to commence palliative interventions. This study aims to investigate clinicians’ use of different types of evidence in decisions to initiate end of life care within trajectories typical of the acute stroke population.
Methods/design: This two-phase, mixed methods study comprises investigation of dying trajectories in acute stroke (Phase 1), and the use of clinical scenarios to investigate clinical decision-making in the initiation of palliative care (Phase 2). It will be conducted in four acute stroke services in North Wales and North West England. Patient and public involvement is integral to this research, with service users involved at each stage.
Discussion: This study will be the first to examine whether patterns of dying reported in other diagnostic groups are transferable to acute stroke care. The strengths and limitations of the study will be considered. This research will produce comprehensive understanding of the nature of clinical decision-making around end of life care in an acute stroke context, which in turn will inform the development of interventions to further build staff knowledge, skills and confidence in this challenging aspect of acute stroke care.

Costs of bronchoalveolar lavage-directed therapy in the first 5 years of life for children with cystic fibrosis.

To determine whether bronchoalveolar lavage (BAL)-directed therapy for infants and young children with cystic fibrosis (CF), rather than standard therapy, was justified on the grounds of a decrease in average costs and whether the use of BAL reduced treatment costs associated with hospital admissions.

Adulthood fracture and quality of life : A population-based study of Australian men

Background: Our objective was to investigate associations between adulthood fracture and quality of life (QOL) in men. Methods: For 448 men aged 50-85 years and enrolled in the Geelong Osteoporosis Study, we measured QOL using the validated (Australian) World Health Organization Quality of Life-Brief Version (WHOQOL-Bref) in the domains of physical health, psychological health, social relationships, and the environment. Self-reported adulthood fractures were categorized as recent or non-recent ( ≤ 10 years or > 10 years pre-QOL assessment, respectively). Lifestyle and health information were self-reported. Results: One hundred seventy four men (38.8%) sustained at least one fracture, 26% of which had occurred within the last 10 years. Compared with men who had never had an adulthood fracture, a non-recent fracture was more likely associated with poorer QOL in the physical health domain (age-adjusted odds ratio [OR] 0.47, 95% confidence interval [95%CI] 0.27-0.83), but not in any other domain. Men who had sustained a recent fracture reported a lower QOL in the domain of psychological health (age-adjusted OR 0.48, 95%CI 0.24-0.97), with a trend observed for lower QOL in the domains of physical health and environment. No further associations were observed. All results were sustained in further models that were adjusted for smoking, alcohol, physical inactivity, and body mass index. Conclusions: We present novel data examining associations between fracture status and QOL in a populationbased sample of Australian men using the WHOQOL-Bref. Recent fractures were associated with poorer QOL in the domain of psychological health while non-recent fractures were more likely associated poorer QOL for physical health. These findings have important implications for healthcare post-fracture.

Comorbid depression and health-related quality of life in patients with coronary artery disease.

This article reviews recent studies relating to the impact of depression and its treatment on the health-related quality of life (HRQOL) of patients with coronary artery disease (CAD).

Airplane grows in the tummy of clouds: living through relations in the early years of life

Using a child's expression that illustrates his mental image of constituted relations of living things, the author conceptualizes relationality, an interrelated view of being, and its importance for early childhood education. The difference between relation and interaction, and the significance of inter-human relationship are discussed as significant aspects for early childhood teachers to understand as they work with children. In particular, this paper seeks to provide insights into the potential contribution of relationality towards early childhood teaching practice.

Changes in quality of life associated with fragility fractures: Australian arm of the International Cost and Utility Related to Osteoporotic Fractures Study (AusICUROS).

We investigated change in health-related quality of life due to fracture in Australian adults aged over 50 years. Fractures reduce quality of life with the loss sustained at least over 12 months. At a population level, the loss was equivalent to 65 days in full health per fracture.

The effectiveness of life-cycle pricing for consumer durables

This quasi-experimental study examines consumer reactions to including projected energy and carbon costs in print ads for a TV, using an online survey of 2566 Australian consumers. This study determines whether consumers' temporal orientation (past vs. future) moderates these reactions. Participants rate ads that include both energy and carbon costs as the most useful for buying a TV and as having higher perceived value. However, this fact does not affect likelihood of purchase. Participants with a high temporal orientation to the past react less favorably to ads that include carbon costs. This study shows that informing consumers about life-cycle costs does not substantially affect purchase decisions for durable goods but affects perceptions of value and usefulness of pricing information in ads.

Associations of diet quality with health-related quality of life in older Australian men and women

This study investigated associations between diet quality measures and quality of life two years later. Adults 55-65 years participating in the Wellbeing, Eating and Exercise for a Long Life (WELL) study in Victoria, Australia (n = 1150 men and n = 1307 women) completed a postal survey including a 111-item food frequency questionnaire in 2010. Diet quality in 2010 was assessed via the dietary guideline index (DGI), recommended food score (RFS) and Mediterranean diet score (MDS). The RAND 36-item survey assessed health-related quality of life in 2012. Associations were assessed using logistic regression adjusted for covariates. In men, DGI and RFS were associated with better reported energy (OR = 1.79, CI: 1.25, 2.55 and OR = 1.56, CI: 1.11, 2.19 respectively), and DGI was additionally associated with better general health (OR = 1.54, 95% CI: 1.08, 2.20), and overall mental component summary scale (OR = 1.51, CI: 1.07, 2.15) in the fully adjusted model. In women, associations between two indices of diet quality (DGI, RFS) physical function (OR = 1.66, CI: 1.19, 2.31 and OR = 1.70, CI: 1.21, 2.37 respectively) and general health (OR = 1.83, CI: 1.32, 2.54 and OR = 1.54, CI: 1.11, 2.14 respectively) were observed. DGI was also associated with overall physical component summary score (OR = 1.56, CI: 1.12, 2.17). Additional associations between emotional wellbeing and DGI (OR = 1.40, CI: 1.01, 1.93) and RFS (OR = 1.44, CI: 1.04, 1.99), and MDS and energy (OR = 1.53, CI: 1.11, 2.10) were observed in the fully adjusted model, in women only. Older adults with better quality diets report better health-related quality of life, with additional associations with emotional wellbeing observed in women.

A new computerized adaptive test advancing the measurement of health-related quality of life (HRQoL) in children: the Kids-CAT

Purpose: Assessing health-related quality of life (HRQoL) via Computerized Adaptive Tests (CAT) provides greater measurement precision coupled with a lower test burden compared to conventional tests. Currently, there are no European pediatric HRQoL CATs available. This manuscript aims at describing the development of a HRQoL CAT for children and adolescents: the Kids-CAT, which was developed based on the established KIDSCREEN-27 HRQoL domain structure. Methods: The Kids-CAT was developed combining classical test theory and item response theory methods and using large archival data of European KIDSCREEN norm studies (n = 10,577–19,580). Methods were applied in line with the US PROMIS project. Item bank development included the investigation of unidimensionality, local independence, exploration of Differential Item Functioning (DIF), evaluation of Item Response Curves (IRCs), estimation and norming of item parameters as well as first CAT simulations. Results: The Kids-CAT was successfully built covering five item banks (with 26–46 items each) to measure physical well-being, psychological well-being, parent relations, social support and peers, and school well-being. The Kids-CAT item banks proved excellent psychometric properties: high content validity, unidimensionality, local independence, low DIF, and model conform IRCs. In CAT simulations, seven items were needed to achieve a measurement precision between.8 and.9 (reliability). It has a child-friendly design, is easy accessible online and gives immediate feedback reports of scores. Conclusions: The Kids-CAT has the potential to advance pediatric HRQoL measurement by making it less burdensome and enhancing the patient–doctor communication.

The ProCaSP study: quality of life outcomes of prostate cancer patients after radiotherapy or radical prostatectomy in a cohort study urological oncology

Background: This study describes and compares health-related quality of life (HRQOL) of prostate cancer patients who received either radical prostatectomy (nerve-sparing, nsRP, or non-nerve-sparing, nnsRP) or radiotherapy (external RT, brachytherapy, or both combined) for treatment of localised prostate cancer. Methods: The prospective, multicenter cohort study included 529 patients. Questionnaires included the IIEF, QLQ-C30, and PORPUS-P. Data were collected before (baseline), three, six, twelve, and twenty-four months after treatment. Differences between groups' baseline characteristics were assessed; changes over time were analysed with generalised estimating equations (GEE). Missing values were treated with multiple imputation. Further, scores at baseline and end of follow-up were compared to German reference data. Results: The typical time trend was a decrease of average HRQOL three months after treatment followed by (partial) recovery. RP patients experienced considerable impairment in sexual functioning. The covariate-adjusted GEE identified a significant - but not clinically relevant - treatment effect for diarrhoea (b∈=∈7.0 for RT, p∈=∈0.006) and PORPUS-P (b∈=∈2.3 for nsRP, b∈=∈2.2 for RT, p∈=∈0.045) compared to the reference nnsRP. Most of the HRQOL scores were comparable to German norm values. Conclusions: Findings from previous research were reproduced in a specific setting of a patient cohort in the German health care system. According to the principle of evidence-based medicine, this strengthens the messages regarding treatment in prostate cancer and its impacts on patients' health-related quality of life. After adjustment for baseline HRQOL and other covariates, RT patients reported increased symptoms of diarrhoea, and nnsRP patients decreased prostate-specific HRQOL. RP patients experienced considerable impairment in sexual functioning. These differences should be taken into account by physicians when choosing the best therapy for a patient.

Erratum to: A new computerized adaptive test advancing the measurement of health-related quality of life (HRQoL) in children: the Kids-CAT

Abstract
Purpose
Assessing health-related quality of life (HRQoL) via Computerized Adaptive Tests (CAT) provides greater measurement precision coupled with a lower test burden compared to conventional tests. Currently, there are no European pediatric HRQoL CATs available. This manuscript aims at describing the development of a HRQoL CAT for children and adolescents: the Kids-CAT, which was developed based on the established KIDSCREEN-27 HRQoL domain structure.
Methods
The Kids-CAT was developed combining classical test theory and item response theory methods and using large archival data of European KIDSCREEN norm studies (n=10,577–19,580). Methods were applied in line with the US PROMIS project. Item bank development included the investigation of unidimensionality, local independence, exploration of Differential Item Functioning (DIF), evaluation of Item Response Curves (IRCs), estimation and norming of item parameters as well as first CAT simulations.
Results
The Kids-CAT was successfully built covering five item banks (with 26–46 items each) to measure physical well-being, psychological well-being, parent relations, social support and peers, and school well-being. The Kids-CAT item banks proved excellent psychometric properties: high content validity, unidimensionality, local independence, low DIF, and model conform IRCs. In CAT simulations, seven items were needed to achieve a measurement precision between .8 and .9 (reliability). It has a child-friendly design, is easy accessible online and gives immediate feedback reports of scores.
Conclusions
The Kids-CAT has the potential to advance pediatric HRQoL measurement by making it less burdensome and enhancing the patient–doctor communication.