Comparison between EQ-5D-5L and PROMIS-10 to evaluate health-related quality of life 3 months after stroke:a cross-sectional multicenter study

BACKGROUND: Although the use of patient-reported outcome measures to assess Health-Related Quality of Life (HRQoL) has been advocated, it is still open to debate which patient-reported outcome measure should be preferred to evaluate HRQoL after stroke.AIM: To compare the measurement properties (including concurrent validity and discriminant ability) between the 5-dimensional 5-level Euro-Qol (EQ-5D-5L) and the Patient-Reported Outcomes Measurement Information System 10-Question Global Health Short Form (PROMIS-10) to evaluate HRQoL 3 months after stroke.DESIGN: Cross-sectional study.SETTING: Neurology outpatient clinics in 6 Dutch hospitals.POPULATION: The participants 360 consecutive individuals with stroke. Their median age was 71 years, 143 (39.7%) were female and 335 (93.0%) had suffered an ischemic stroke.METHODS: The EQ-5D-5L, PROMIS-10, modified Rankin Scale and two items on experienced decrease in health and activities post-stroke were administered by a stroke nurse or nurse practitioner through a telephone interview 3 months after stroke. The internal consistency, distribution, floor/ceiling effects, inter-correlations and discriminant ability (using the modified Rankin Scale and experienced decrease in health and in activities post-stroke as external anchors) were calculated for both the EQ-5D-5L and PROMIS-10.RESULTS: Ninety-six percent of the participants were living at home and 50.9% experienced minimal or no disabilities (modified Rankin Scale 0-1) 3 months after stroke. A ceiling effect and a non-normal left skewed distribution were observed in the EQ-5D-5L. The PROMIS-10 showed higher internal consistency (alpha=0.90) compared to the EQ-5D-5L (alpha=0.75). Both the EQ-5D-5L and the PROMIS-10 were strongly correlated with the modified Rankin Scale (r=0.62 and 0.60 respectively). The PROMIS-10 showed better discriminant ability in less affected individuals with stroke, whereas the EQ-5D-5L showed slightly better discriminant ability in more affected individuals with stroke.CONCLUSIONS: Both EQ-5D-5L and PROMIS-10 prove to be useful instruments to evaluate HRQoL in patients who are living at home 3 months after stroke.CLINICAL REHABILITATION IMPACT: The clinical rehabilitation impact depended on the setting and underlying goal which patient-reported outcome measure is preferred to evaluate HRQoL 3 months after stroke. The PROMIS-10 should be preferred to detect differences in less affected stroke patients, whereas the EQ-5D-5L provides slightly more information in more affected stroke patients.Paroxysmal Cerebral Disorder

LAYERS: a decision-support tool to illustrate and assess the supply and value chain for the energy transition

Climate change mitigation strategies are developed at international, national, and local authority levels. Technological solutions such as renewable energies (RE) and electric vehicles (EV) have geographically widespread knock-on effects on raw materials. In this paper, a decision-support and data-visualization tool named “LAYERS” is presented, which applies a material flow analysis to illustrate the complex connections along supply chains for carbon technologies. A case study focuses on cobalt for lithium-ion batteries (LIB) required for EVs. It relates real business data from mining and manufacturing to actual EV registrations in the UK to visualize the intended and unintended consequences of the demand for cobalt. LAYERS integrates a geographic information systems (GIS) architecture, database scheme, and whole series of stored procedures and functions. By means of a 3D visualization based on GIS, LAYERS conveys a clear understanding of the location of raw materials (from reserves, to mining, refining, manufacturing, and use) across the globe. This highlights to decision makers the often hidden but far-reaching geo-political implications of the growing demands for a range of raw materials that are needed to meet long-term carbon-reduction targets

The impact of raw fermented milk products on perceived health and mood among Dutch adults

Purpose: The purpose of this paper was to evaluate health conditions prior to and at least two months after the start of consuming raw fermented milk (RFM) products. Design/methodology/approach: One-Item health score, 1-item immunity score, immune status (ISQ), mood, bowel and skin conditions were rated for the period prior and post switching to RFM products. A linear mixed model was used to evaluate the post to prior RFM health and mood scores, taking into account gender, location of living and health group. Data from 390 participants (mean age of 54 years old) were included for the analysis, of which 277 (45 per cent) were allocated to the poor health group. Participants were allocated to the poor health group if they reported being immune depressed or suffering from a chronic disease prior to RFM; otherwise, they were allocated to the normal health group. Findings: The highest intake of RFM was from RF kefir. Post RFM, people consumed around 1 glass (200 ml) of RF kefir per day. After switching to RFM, significant improvements on health and mood scores were reported. The strongest improvements after switching to RFM consumption were seen in subjects from the poor health group. With the exception of skin score, all measured health items significantly improved (p < 0.001). Health, immunity, bowel and mood scores increased with around 20 per cent in the poor health group and around 8 per cent in the normal health group. Women had more health complaints prior to RFM and had stronger health improvement post RFM compared to men. Bowel and mood scores were overall lower in women than in men. Living location had no significant impact on RFM-related health changes. This consumer survey suggests that positive health and mood changes are associated with the consumption of RFM products. Originality/value: The consumption of RFM products improved the self-reported health status of adults. Immune-depressed people or people suffering from a chronic disease prior to RFM reported the strongest impact on their health, immunity, bowel and mood scores post switching RFM consumption compared to people with a normal health

Effect of raw milk consumption on perceived health, mood and immune functioning among US adults with a poor and normal health : a retrospective questionnaire based study

Introduction: Raw milk consumption is controversially discussed, and people are looking for raw milk due to expected positive health impacts. The purpose of this consumer survey was to evaluate health conditions prior to and after consuming of raw milk (RM). Methods: An on-line survey was distributed in Spring 2018 among existing consumers of raw milk. One-Item health score, 1-item immunity score, immune status (ISQ), mood, bowel and skin conditions were rated retrospectively based on validated questionnaires. Data from 327 participants (age 54 years) were included, of which 156 (48%) were allocated to the poor health group after they reported being immune depressed or suffering from a chronic disease. Others were allocated to the normal health group. Milk consumption pattern before and after changing of the milk diet were recorded. All health outcomes were evaluated according a linear mixed model in SPSS. Results: Health, perceived immunity, bowel and mood scores increased post RM consumption with around 35% in the poor health group (P < 0.001), and around 9% in the normal health group (P < 0.001). Bowel and mood scores were overall lower in women than in men. Outcomes were independent of the origin of raw farm milk. Conclusions: This consumer survey suggests that positive health and mood changes are associated with the consumption of raw milk. Effects were strongest in people with a self-reported poor health status as well as in women

Effect of raw milk consumption on perceived health, mood and immune functioning among US adults with a poor and normal health: A retrospective questionnaire based study

INTRODUCTION: Raw milk consumption is controversially discussed, and people are looking for raw milk due to expected positive health impacts. The purpose of this consumer survey was to evaluate health conditions prior to and after consuming of raw milk (RM). METHODS: An on-line survey was distributed in Spring 2018 among existing consumers of raw milk. One-Item health score, 1-item immunity score, immune status (ISQ), mood, bowel and skin conditions were rated retrospectively based on validated questionnaires. Data from 327 participants (age 54 years) were included, of which 156 (48%) were allocated to the poor health group after they reported being immune depressed or suffering from a chronic disease. Others were allocated to the normal health group. Milk consumption pattern before and after changing of the milk diet were recorded. All health outcomes were evaluated according a linear mixed model in SPSS. RESULTS: Health, perceived immunity, bowel and mood scores increased post RM consumption with around 35% in the poor health group (P < 0.001), and around 9% in the normal health group (P < 0.001). Bowel and mood scores were overall lower in women than in men. Outcomes were independent of the origin of raw farm milk. CONCLUSIONS: This consumer survey suggests that positive health and mood changes are associated with the consumption of raw milk. Effects were strongest in people with a self-reported poor health status as well as in women

The secretome of Agaricus bisporus: Temporal dynamics of plant polysaccharides and lignin degradation

Summary: Despite substantial lignocellulose conversion during mycelial growth, previous transcriptome and proteome studies have not yet revealed how secretomes from the edible mushroom Agaricus bisporus develop and whether they modify lignin models in vitro. To clarify these aspects, A. bisporus secretomes collected throughout a 15-day industrial substrate production and from axenic lab-cultures were subjected to proteomics, and tested on polysaccharides and lignin models. Secretomes (day 6–15) comprised A. bisporus endo-acting and substituent-removing glycoside hydrolases, whereas β-xylosidase and glucosidase activities gradually decreased. Laccases appeared from day 6 onwards. From day 10 onwards, many oxidoreductases were found, with numerous multicopper oxidases (MCO), aryl alcohol oxidases (AAO), glyoxal oxidases (GLOX), a manganese peroxidase (MnP), and unspecific peroxygenases (UPO). Secretomes modified dimeric lignin models, thereby catalyzing syringylglycerol-β-guaiacyl ether (SBG) cleavage, guaiacylglycerol-β-guaiacyl ether (GBG) polymerization, and non-phenolic veratrylglycerol-β-guaiacyl ether (VBG) oxidation. We explored A. bisporus secretomes and insights obtained can help to better understand biomass valorization

Development and validation of the immune status questionnaire (ISQ)

The self-assessment of perceived immune status is important, as this subjective observation leads individuals to decide whether or not to seek medical help or adapt their lifestyle. In addition, it can be used in clinical settings and research. The aim of this series of studies was to develop and validate a short questionnaire to assess perceived immune functioning. Five surveys were conducted among Dutch and International young healthy adults (18–30 years old), and two others among older age groups with various health complaints. For the first study, an existing immune functioning scale was modified and elaborated resulting in 23 immune-health-related items, of which the occurrence was rated on a 5-point Likert scale. A student sample was surveyed, and the results were used to shorten the 23-item listing into a 7-item scale with a predictive validity of 85%. Items include “sudden high fever”, “diarrhea”, “headache”, “skin problems (e.g., acne and eczema)”, “muscle and joint pain”, “common cold” and “coughing”. The scale is named Immune Status Questionnaire (ISQ), and it aims to assess perceived immune status over the preceding year. The second study revealed that the ISQ score correlated significantly with a 1-item perceived immune functioning (r = 0.383, p < 0.0001). In the third study, the final Likert scale descriptors were determined (“never”, “sometimes”, “regularly”, “often” and “(almost) always)”. The fourth study showed that the test–retest reliability of the ISQ is acceptable (r = 0.80). The fifth study demonstrated the association of ISQ scores with various neuropsychological and health correlates in an international sample, including perceived health and immune fitness, as well as levels of stress, fatigue, depression and anxiety. Study 6 demonstrated significant associations between ISQ scores and experiencing irritable bowel syndrome (IBS) symptoms in a sample of insomnia patients. Study 7 compared the effect of a dietary intervention in participants reporting “poor health” versus “normal health”. It is shown that ISQ scores can differentiate between those with poor and normal health, and that an effective intervention is associated with a significant improvement in ISQ scores. Data from Study 7 were further used to determine an ISQ cut-off value for reduced immune functioning, and a direct comparison with 1-item perceived immune functioning scores enabled constructing the final scoring format of the ISQ. In conclusion, the ISQ has appropriate face, content, and construct validity and is a reliable, stable and valid method to assess the past 12 month’s perceived immune status