Identifying domains of health-related quality of life: the perspective of individuals with low back pain

Abstract Background Identifying the most relevant HRQOL domains for LBP from the perspective of individuals with lived experience with LBP is necessary to prioritize domains that will be most informative for evaluating the impact of pain and interventions while overcoming the burden of using long-form assessment tools. This study aimed to identify which domains of HRQOL are most important from the perspective of individuals with chronic LBP. Methods Semi-structured interviews were conducted with 26 individuals with LBP. Participants first responded to questions related to the impact of their LBP on their HRQOL. Then, using a card sorting method, they were asked to select and indicate HRQOL domains that were most relevant to them from a list of 18 cards that represented different HRQOL domains. Participants were asked to explain the reasoning for their selection. Results Participants identified physical activity restriction (50%), severity of pain (31%), social activity restriction (23%), and work performance restriction (23%) as the most important domains. The most frequently selected HRQOL domains during card sorting were social function (69%), pain intensity (62%), physical function (58%), fatigue (58%), and pain interference (42%). Conclusion The most important domains of HRQOL perceived by participants were pain intensity, social function, physical function, fatigue, and pain interference. Identifying these domains will inform clinical decision-making and guide treatment choices for health care providers

Annual population dynamics of mango fruit flies (Diptera: Tephritidae) in West Africa: socioeconomic aspects, host phenology and implications for management

Introduction. Losses in West African commercial mango orchards due to fruit fly infestations have exceeded 50% by the middle of the crop season since 2005, resulting in considerable income loss for the growers. Materials and methods. In 2009, weekly monitoring of adult fruit fly species of economic significance was carried out in eight West African countries at 12 sites across five agro-ecological zones: (i) Humid Forest, (ii) Guinean savanna, (iii) Southern Sudan, (iv) Northern Sudan, and (v) Sahelian. Trapping was performed using methyl eugenol and terpinyl acetate in 288 Tephri-traps, targeting Bactrocera invadens and Ceratitis cosyra. Results. The data showed that B. invadens was present throughout the year in the Forest zone, abundant for 7 months, with a peak in May at the end of the mango season, C. cosyra being totally absent. In the Guinean savanna zone, B. invadens was abundant for 6-7 months, with a peak at the beginning of June coinciding with the season, with a few C. cosyra. In the Southern Sudan zone, B. invadens was abundant for 6 months, with a peak in mid-June during the season, C. cosyra peaking in April. In the Northern Sudan zone, B. invadens was abundant for 5 months, with a peak at the end of June at the end of the season, C. cosyra peaking in May. In the Sahelian zone, B. invadens was abundant for 4 months, peaking in August during the season, C. cosyra peaking just before. These preliminary results showed that the exotic species, B. invadens, was present at high levels [mean peak of 378 flies per trap per day (FTD)] in all agro-ecological zones, while the native species, C. cosyra, preferred the drier zones of West Africa, with lower population levels (mean peak of 77 FTD). Conclusion. Detection trapping of male flies with parapheromones is a useful indicator of field population levels and could be used to deploy control measures (IPM package) in a timely manner when the Economic Injury Level is reached. Control strategies for these quarantine mango fruit fly species are discussed with respect to agro-ecological zones and the phenological stages of the mango tree

Decision aids for people facing health treatment or screening decisions

Copyright \ua9 2024 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.Background: Patient decision aids are interventions designed to support people making health decisions. At a minimum, patient decision aids make the decision explicit, provide evidence-based information about the options and associated benefits/harms, and help clarify personal values for features of options. This is an update of a Cochrane review that was first published in 2003 and last updated in 2017. Objectives: To assess the effects of patient decision aids in adults considering treatment or screening decisions using an integrated knowledge translation approach. Search methods: We conducted the updated search for the period of 2015 (last search date) to March 2022 in CENTRAL, MEDLINE, Embase, PsycINFO, EBSCO, and grey literature. The cumulative search covers database origins to March 2022. Selection criteria: We included published randomized controlled trials comparing patient decision aids to usual care. Usual care was defined as general information, risk assessment, clinical practice guideline summaries for health consumers, placebo intervention (e.g. information on another topic), or no intervention. Data collection and analysis: Two authors independently screened citations for inclusion, extracted intervention and outcome data, and assessed risk of bias using the Cochrane risk of bias tool. Primary outcomes, based on the International Patient Decision Aid Standards (IPDAS), were attributes related to the choice made (informed values-based choice congruence) and the decision-making process, such as knowledge, accurate risk perceptions, feeling informed, clear values, participation in decision-making, and adverse events. Secondary outcomes were choice, confidence in decision-making, adherence to the chosen option, preference-linked health outcomes, and impact on the healthcare system (e.g. consultation length). We pooled results using mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs), applying a random-effects model. We conducted a subgroup analysis of 105 studies that were included in the previous review version compared to those published since that update (n = 104 studies). We used Grading of Recommendations Assessment, Development, and Evaluation (GRADE) to assess the certainty of the evidence. Main results: This update added 104 new studies for a total of 209 studies involving 107,698 participants. The patient decision aids focused on 71 different decisions. The most common decisions were about cardiovascular treatments (n = 22 studies), cancer screening (n = 17 studies colorectal, 15 prostate, 12 breast), cancer treatments (e.g. 15 breast, 11 prostate), mental health treatments (n = 10 studies), and joint replacement surgery (n = 9 studies). When assessing risk of bias in the included studies, we rated two items as mostly unclear (selective reporting: 100 studies; blinding of participants/personnel: 161 studies), due to inadequate reporting. Of the 209 included studies, 34 had at least one item rated as high risk of bias. There was moderate-certainty evidence that patient decision aids probably increase the congruence between informed values and care choices compared to usual care (RR 1.75, 95% CI 1.44 to 2.13; 21 studies, 9377 participants). Regarding attributes related to the decision-making process and compared to usual care, there was high-certainty evidence that patient decision aids result in improved participants\u27 knowledge (MD 11.90/100, 95% CI 10.60 to 13.19; 107 studies, 25,492 participants), accuracy of risk perceptions (RR 1.94, 95% CI 1.61 to 2.34; 25 studies, 7796 participants), and decreased decisional conflict related to feeling uninformed (MD -10.02, 95% CI -12.31 to -7.74; 58 studies, 12,104 participants), indecision about personal values (MD -7.86, 95% CI -9.69 to -6.02; 55 studies, 11,880 participants), and proportion of people who were passive in decision-making (clinician-controlled) (RR 0.72, 95% CI 0.59 to 0.88; 21 studies, 4348 participants). For adverse outcomes, there was high-certainty evidence that there was no difference in decision regret between the patient decision aid and usual care groups (MD -1.23, 95% CI -3.05 to 0.59; 22 studies, 3707 participants). Of note, there was no difference in the length of consultation when patient decision aids were used in preparation for the consultation (MD -2.97 minutes, 95% CI -7.84 to 1.90; 5 studies, 420 participants). When patient decision aids were used during the consultation with the clinician, the length of consultation was 1.5 minutes longer (MD 1.50 minutes, 95% CI 0.79 to 2.20; 8 studies, 2702 participants). We found the same direction of effect when we compared results for patient decision aid studies reported in the previous update compared to studies conducted since 2015. Authors\u27 conclusions: Compared to usual care, across a wide variety of decisions, patient decision aids probably helped more adults reach informed values-congruent choices. They led to large increases in knowledge, accurate risk perceptions, and an active role in decision-making. Our updated review also found that patient decision aids increased patients’ feeling informed and clear about their personal values. There was no difference in decision regret between people using decision aids versus those receiving usual care. Further studies are needed to assess the impact of patient decision aids on adherence and downstream effects on cost and resource use