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European Heart Journal. Quality of Care... Jun 2024Ischemic heart disease (IHD) has been a significant public health issue worldwide. This study aims to predict the global burden of IHD in a timely and comprehensive...
AIMS
Ischemic heart disease (IHD) has been a significant public health issue worldwide. This study aims to predict the global burden of IHD in a timely and comprehensive manner.
METHODS AND RESULTS
Incidence, prevalence, deaths, and disability-adjusted life years (DALYs) for IHD from 1990 to 2021 were derived from the Global Burden of Disease 2021 database and three models (linear, exponential, and Poisson regression) were used to estimate their trends over time at the global, regional, and national levels by age, sex, and country groups, with the gross domestic product per capita was applied to adjust the model. The model results revealed that the global burden of IHD is expected to increase continuously by 2050. By 2050, global IHD incidence, prevalence, deaths, and DALYs are projected to reach 67.3 million, 510 million, 16 million, and 302 million, respectively, which represents an increase of 116%, 106%, 80%, and 62% from 2021. Moreover, the results showed that regions with lower socio-demographic index (SDI) bore a greater burden of IHD than those with higher SDI, with men having a higher burden of IHD than women. People over 70 years old account for a major part of the burden of IHD, and premature death of IHD is also becoming more serious.
CONCLUSION
The global burden of IHD will increase further by 2050, potentially due to population aging and economic disparities. Hence, it is necessary to strengthen the prevention of IHD and formulate targeted strategies according to different SDI regions and special populations.
PubMed: 38918062
DOI: 10.1093/ehjqcco/qcae049 -
American Journal on Intellectual and... Jul 2024Although natural supports benefit individuals with intellectual and developmental disabilities (IDD), little is known about natural support provided within specific life...
Although natural supports benefit individuals with intellectual and developmental disabilities (IDD), little is known about natural support provided within specific life domains or how race/ethnicity or support from professionals impacts the extent of natural support one receives. In this study, 518 parents of adults with IDD responded to a national survey about natural supports, including who provides support, the number of supporters, and variables that predict natural supports. Family most often provided support, although professionals and family friends were frequent supporters in several domains. Natural support was most extensive in health, least extensive in employment and housing. Individuals with IDD who regularly participated in daytime activities and/or identified as Black had more extensive natural support. Implications are discussed.
Topics: Humans; Developmental Disabilities; Intellectual Disability; Adult; Male; Female; Middle Aged; Social Support; Young Adult; Employment; Aged; Parents; Family; Adolescent
PubMed: 38917997
DOI: 10.1352/1944-7558-129.4.247 -
American Journal on Intellectual and... Jul 2024Understanding factors that can improve the quality of life (QOL) of older caregivers of people with intellectual and developmental disabilities (IDD) is important in...
Understanding factors that can improve the quality of life (QOL) of older caregivers of people with intellectual and developmental disabilities (IDD) is important in broadening participation in family empowerment interventions. The purpose of this study was to identify the factors influencing the QOL of older caregivers (50+) of adults with IDD who participated in a peer-mediated state-wide family support project. The research study used a quasi-experimental research design grounded in the family quality of life (FQOL) framework, with pretest and posttest data gathered from 82 caregivers. Correlation and regression analyses were conducted to identify factors influencing changes in the QOL of study participants. Findings indicated that improvements in caregiver QOL after participating in the project could be explained by caregiver's employment status, increased global FQOL, and decreased caregiver stress and depression.
Topics: Humans; Caregivers; Quality of Life; Male; Female; Middle Aged; Aged; Intellectual Disability; Developmental Disabilities; Social Support; Family; Stress, Psychological; Depression; Aged, 80 and over; Family Support
PubMed: 38917996
DOI: 10.1352/1944-7558-129.4.308 -
American Journal on Intellectual and... Jul 2024This study examines the intervention effect of a culturally tailored parent education program in reducing depressive symptoms among Latina mothers of autistic children.... (Randomized Controlled Trial)
Randomized Controlled Trial
This study examines the intervention effect of a culturally tailored parent education program in reducing depressive symptoms among Latina mothers of autistic children. In this two-site randomized waitlist-control study (n = 109 mother-child dyads), a peer-to-peer mentoring (promotora) model was used to deliver an intervention that was designed to increase mothers' self-efficacy and use of evidence-based strategies. We assessed mothers' depressive symptom (CES-D) scores at three time points and used linear mixed models to determine whether their scores significantly changed from baseline to postintervention (Time 2) and at 4 months postintervention (Time 3). Results show that mothers in the intervention group reported a significant decrease in mean depressive symptom scores at Time 2 and that the effect was maintained at Time 3 with intermediate to medium effect sizes. There were no differences in results across sites. Findings suggest that Parents Taking Action, a culturally tailored intervention led by peer mentors, showed a significant effect both immediately after the intervention and 4 months postintervention in reducing depressive symptoms among Latina mothers of autistic children.
Topics: Humans; Hispanic or Latino; Female; Mothers; Depression; Adult; Child; Male; Autistic Disorder; Child, Preschool; Self Efficacy
PubMed: 38917994
DOI: 10.1352/1944-7558-129.4.294 -
Ageing Research Reviews Jun 2024To evaluate the trends and cross-country inequalities of global osteoarthritis (OA) burden over the last 30 years, and further predicted its changes to 2035. (Review)
Review
OBJECTIVE
To evaluate the trends and cross-country inequalities of global osteoarthritis (OA) burden over the last 30 years, and further predicted its changes to 2035.
METHODS
The estimates and 95% uncertainty intervals (UIs) for incidence, prevalence, and disability-adjusted life-years (DALYs) of OA were extracted from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. We described OA epidemiology at global, regional, and national levels, analyzed 1990-2019 trends in OA burden from overall, local, and multi-dimension scopes, decomposed OA burden according to population size, age structure, and epidemiologic changes, quantified cross-country inequalities in OA burden using standard health equity methods recommended by World Health Organization, and predicted changes of OA burden to 2035.
RESULTS
GBD 2019 estimated 527,811,871 (95% UIs: 478,667,549 to 584,793,491) prevalent cases, 41,467,542 (95% UIs: 36,875,471 to 46,438,409) incident cases and 18,948,965 (95% UsI:9,571,298 to 37,659,660) DALYs cases of OA worldwide in 2019, with the highest cases in East Asia and highest age-standardized rate (ASR) in high-income North America. The global burden of OA increased overall from 1990 to 2019 with the fastest growth observed in the first decade of the 21st century. Decomposition analysis revealed that OA knee (62.78%), women (60.47%), and middle sociodemographic index (SDI) quintile (32.35%) were responsible for the most significant DALYs, whose changes were primarily driven by population growth and aging. A significant increase in SDI-related inequalities was detected, and the gap in DALYs between the highest SDI country and the lowest SDI country increased from 179.5 (95% CI: 149.3 to 209.8) per 100,000 in 1990 to 341.9 (95% CI: 309.5 to 374.4) per 100,000 in 2019. Notably, although the ASR of incidence, prevalence, and DALYs of OA was predicted to decrease annually from 2020 to 2035, the case number of these metrics was predicted to keeping increasing, with predicted values of 52,870,737 (95% UI: 39,330,063 to 66,411,411), 727,532,373 (95% UI: 542,765,783 to 912,298,962), and 25,986,983 (95% UI: 19,216,928 to 32,757,038) in 2035, respectively.
CONCLUSIONS
As a major public health issue, the global burden of OA showed an overall increasing trend from 1990 to 2019, which was primarily driven by population growth and aging. Countries with high SDI shouldered disproportionately high OA burden, and the SDI-related inequalities across countries exacerbated over time. This study highlighted great challenges in the control and management of OA, including both growing case number and distributive inequalities worldwide, which may be instructive for better making public health policy and reasonably allocating medical source.
PubMed: 38917934
DOI: 10.1016/j.arr.2024.102382 -
Asian Spine Journal Jun 2024Retrospective cohort study.
STUDY DESIGN
Retrospective cohort study.
PURPOSE
To investigate the long-term clinical and radiological outcomes of selective fusion for rotatory olisthesis (RO) in degenerative lumbar scoliosis (DLS).
OVERVIEW OF LITERATURE
DLS is often associated with RO, and selective fusion of RO is a common surgical treatment option. However, the clinical and radiological outcomes remain controversial.
METHODS
A cohort of 54 consecutive patients with DLS and RO was included in the study. All the included patients underwent selective RO fusion and at least 2 years of follow-up. They were divided into two groups: group 1 with a curve <30° and group 2 with a curve ≥30°. The clinical outcomes were evaluated by the Oswestry Disability Index (ODI) and Numerical Rating Scale. The radiological assessment included RO location, offset and subluxated-disc orientation, Cobb angle, and coronal as well as sagittal alignments.
RESULTS
The offset value was greater in group 2 than in group 1 (13.4±4.7 mm vs. 9.3±3.5 mm, p<0.001). The subluxated disc was mainly oriented to the concave side in group 2 (15/21) but to the convex side in group 1 (20/33) (p =0.022). Group 2 had a higher rate of postoperative adjacent RO than group 1 (14/21 vs. 1/33, p<0.001). The ODI was comparable between both groups preoperatively but higher at the final follow-up in group 2 (34.9±9.5) than in group 1 (24.4±6.2). In the multiple logistic regression analysis, the thoracolumbar/lumbar curve was identified as the risk factor for postoperative adjacent RO (odds ratio, 1.400; p=0.007). The receiver operating characteristic analysis verified it with an area under the curve of 0.960 (p<0.001).
CONCLUSIONS
The clinical and radiological outcomes were maintained well in group 1 but not in group 2. Selective RO fusion in DLS with a lumbar curve <30° is a rational option. However, it should be avoided in those with a lumbar curve >30° because of a higher complication rate and a worse clinical outcome at the final follow-up.
PubMed: 38917856
DOI: 10.31616/asj.2023.0365 -
Arthritis Research & Therapy Jun 2024Juvenile idiopathic arthritis (JIA) comprises a heterogeneous group of conditions that can cause marked disability and diminished quality of life. Data on predictors of...
BACKGROUND
Juvenile idiopathic arthritis (JIA) comprises a heterogeneous group of conditions that can cause marked disability and diminished quality of life. Data on predictors of clinical response are insufficient to guide selection of the appropriate biologic agent for individual patients. This study aimed to investigate the propensity of S100A8/9 and S100A12 as predictive biomarkers of abatacept response in polyarticular-course juvenile idiopathic arthritis (pJIA).
METHODS
Data from a phase 3 trial (NCT01844518) of subcutaneous abatacept in patients with active pJIA (n = 219) were used in this exploratory analysis. Association between biomarker levels at baseline and improvements in JIA-American College of Rheumatology (ACR) criteria responses or baseline disease activity (measured by Juvenile Arthritis Disease Activity Score in 27 joints using C-reactive protein [JADAS27-CRP]) were assessed. Biomarker level changes from baseline to month 4 were assessed for disease outcome prediction up to 21 months.
RESULTS
At baseline, 158 patients had available biomarker samples. Lower baseline S100A8/9 levels (≤ 3295 ng/mL) were associated with greater odds of achieving JIA-ACR90 (odds ratio [OR]: 2.54 [95% confidence interval (CI): 1.25-5.18]), JIA-ACR100 (OR: 3.72 [95% CI: 1.48-9.37]), JIA-ACR inactive disease (ID; OR: 4.25 [95% CI: 2.03-8.92]), JADAS27-CRP ID (OR: 2.34 [95% CI: 1.02-5.39]) at month 4, and JIA-ACR ID (OR: 3.01 [95% CI: 1.57-5.78]) at month 16. Lower baseline S100A12 levels (≤ 176 ng/mL) were associated with greater odds of achieving JIA-ACR90 (OR: 2.52 [95% CI: 1.23-5.13]), JIA-ACR100 (OR: 3.68 [95% CI: 1.46-9.28]), JIA-ACR ID (OR: 3.66 [95% CI: 1.76-7.61]), JIA-ACR90 (OR: 2.03 [95% CI: 1.07-3.87]), JIA-ACR100 (OR: 2.14 [95% CI: 1.10-4.17]), and JIA-ACR ID (OR: 4.22 [95% CI: 2.15-8.29]) at month 16. From baseline to month 4, decreases in S100A8/9 and S100A12 generally exceeded 50% among JIA-ACR90/100/ID responders.
CONCLUSION
Lower baseline levels of S100A8/9 and S100A12 proteins predicted better response to abatacept treatment than higher levels and may serve as early predictive biomarkers in pJIA. Decreases in these biomarker levels may also predict longer-term response to abatacept in pJIA.
PubMed: 38918871
DOI: 10.1186/s13075-024-03347-0 -
Archives of Public Health = Archives... Jun 2024Sarcopenia is an age-related clinical syndrome, which is associated with numerous adverse outcomes among older adults. The relationship between sarcopenia and activities...
Associations between Sarcopenia and trajectories of activities of daily living disability: a nationwide longitudinal study of middle-aged and older adults in China from 2011 to 2018.
BACKGROUND
Sarcopenia is an age-related clinical syndrome, which is associated with numerous adverse outcomes among older adults. The relationship between sarcopenia and activities of daily living (ADL) disability has been studied in China, but these findings usually focused on a single time point. The patterns of ADL can change over time and vary among individuals. Therefore, it is necessary to explore the association between sarcopenia and trajectories of ADL disability.
METHODS
According to Asian Working Group for Sarcopenia (AWGS) 2019 criteria, muscle mass, muscle strength, and physical performance measurements were measured to diagnose sarcopenia. A six-item ADL score was used to measure ADL disability, and trajectories of ADL disability were identified by the latent class trajectory modelling (LCTM). Multiple logistic regression models were performed to examine the association between sarcopenia and trajectories of ADL disability.
RESULTS
Among 9113 middle-aged and older adults, three trajectories of ADL disability were determined according to changes in ADL score during follow-up, including a mild-high trajectory (n = 648, 7.11%), followed by the low-mild trajectory (n = 3120, 34.24%) and low-low trajectory (n = 5345, 58.65%). After adjustment for covariates, severe sarcopenia was significantly associated with higher risks of being in the mild-high trajectory group (OR = 3.31, 95%CI: 2.10-5.22) and the low-mild trajectory group (OR = 1.44, 95%CI: 1.05-1.98), compared with the low-low trajectory group. This association was still observed when stratified by age and gender. In addition, participants with sarcopenic obesity were associated with a higher risk of ADL disability (OR = 3.99; 95% CI: 2.50-6.09).
CONCLUSIONS
Among the middle-aged and older Chinese adults, sarcopenia and sarcopenic obesity were both associated with persistent higher trajectories of ADL disability. It suggested that early interventions to sarcopenia and sarcopenic obesity among the middle-aged and older adults may reduce the progression of ADL disability.
PubMed: 38918853
DOI: 10.1186/s13690-024-01329-x -
Chiropractic & Manual Therapies Jun 2024Prognostic research in low back pain (LBP) is essential for understanding and managing the condition. This study aimed to, (1) describe the proportions with...
BACKGROUND
Prognostic research in low back pain (LBP) is essential for understanding and managing the condition. This study aimed to, (1) describe the proportions with mild-moderate and severe pain and disability at baseline, 1-year and 4-year follow-up, and (2) investigate prognostic factors for improvement in pain and disability over 4 years in a cohort of secondary care LBP patients.
METHODS
This was a secondary analysis of a cohort of patients with LBP aged 18-40 years recruited from a non-surgical outpatient spine clinic between March 2011 and October 2013 (n = 1037). Questionnaires were collected at baseline, 1-year, and 4-year follow-up. Disability was assessed using the Roland Morris Disability Questionnaire (RMDQ 0-100) and pain intensity using the Numeric Rating Scale (NRS 0-10). 'Mild-moderate pain' was defined as NRS < 7 and 'severe pain' as NRS ≥ 7. Likewise, 'mild-moderate disability' was defined as RMDQ < 58.3, and 'severe disability' was RMDQ ≥ 58.3. In the prognostic analysis, improvement in pain and disability over 4 years was defined as meeting both criteria: decrease of ≥ 2 on the NRS and of ≥ 20.8 on the RMDQ. Sixteen candidate prognostic factors were assessed by multivariate logistic regression.
RESULTS
Among patients with information available at all three time points (n = 241), 54%/48% had persistent mild-moderate pain/disability, while only 7%/15% had persistent severe pain/disability. Of patients included in the multivariate prognostic analysis regarding improvement over 4 years (n = 498), 32% had improved in pain and disability after 4 years. Positive associations were found for pain intensity (OR 1.34 [95%CI: 1.17-1.54]), disability (OR 1.01 [1.00-1.02]), and regular employment or studying (OR 1.67 [1.06-2.64]), and negative associations for episode duration (OR 0.99 [0.99-1.00]) and risk of persistent pain (OR 0.58 [0.38-0.88]).
CONCLUSION
Patients with persistent LBP in secondary care had mostly mild-moderate pain and disability consistently at all three time points, with few having consistently severe symptoms over 4 years. Moreover, approximately half of the included patients improved in pain and disability. We found that pain intensity, disability, episode duration, regular employment or studying, and risk of persistent pain predicted a long-term improvement. However, the limited availability of complete follow-up data may affect generalisability.
PubMed: 38918850
DOI: 10.1186/s12998-024-00546-z -
BMC Geriatrics Jun 2024Quantifying the informal caregiver burden is important for understanding the risk factors associated with caregiver overload and for evaluating the effectiveness of...
BACKGROUND
Quantifying the informal caregiver burden is important for understanding the risk factors associated with caregiver overload and for evaluating the effectiveness of services provided in Long-term Care (LTC).
OBJECTIVE
This study aimed to develop and validate a Caregiver Strain Index (CSI)-based score for quantifying the informal caregiver burden, while the original dataset did not fully cover evaluation items commonly included in international assessments. Subsequently, we utilized the CSI-based score to pinpoint key caregiver burden risk factors, examine the initial timing of LTC services adoption, and assess the impact of LTC services on reducing caregiver burden.
METHODS
The study analyzed over 28,000 LTC cases in Southern Taiwan from August 2019 to December 2022. Through multiple regression analysis, we identified significant risk factors associated with caregiver burden and examined changes in this burden after utilizing various services. Survival analysis was employed to explore the relationship between adopting the first LTC services and varying levels of caregiver burden.
RESULTS
We identified 126 significant risk factors for caregiver burden. The most critical factors included caregiving for other disabled family members or children under the age of three (β = 0.74, p < 0.001), the employment status of the caregiver (β = 0.30-0.53, p < 0.001), the frailty of the care recipient (β = 0.28-0.31, p < 0.001), and the behavioral symptoms of dementia in care recipients (β = 0.28-2.60, p < 0.05). Generally, caregivers facing higher burdens sought LTC services earlier, and providing home care services alleviated the caregiver's burden.
CONCLUSION
This comprehensive study suggests policy refinements to recognize high-risk caregivers better early and provide timely support to improve the overall well-being of both informal caregivers and care recipients.
PubMed: 38918715
DOI: 10.1186/s12877-024-05136-5