EQ-5D-3L Derived Population Norms for Health Related Quality of Life in Sri Lanka

Background Health Related Quality of Life (HRQoL) is an important outcome measure in health economic evaluation that guides health resource allocations. Population norms for HRQoL are an essential ingredient in health economics and in the evaluation of population health. The aim of this study was to produce EQ-5D-3L-derived population norms for Sri Lanka. Method A population sample (n =  780) was selected from four districts of Sri Lanka. A stratified cluster sampling approach with probability proportionate to size was employed. Twenty six clusters of 30 participants each were selected; each participant completed the EQ-5D-3L in a face-to-face interview. Utility weights for their EQ-5D-3L health states were assigned using the Sri Lankan EQ-5D-3L algorithm. The population norms are reported by age and socio-economic variables. Results The EQ-5D-3L was completed by 736 people, representing a 94% response rate. Sixty per cent of the sample reported being in full health. The percentage of people responding to any problems in the five EQ-5D-3L dimensions increased with age. The mean EQ-5D-3L weight was 0.85 (SD 0.008; 95%CI 0.84-0.87). The mean EQ-5D-3L weight was significantly associated with age, housing type, disease experience and religiosity. People above 70 years of age were 7.5 times more likely to report mobility problems and 3.7 times more likely to report pain/discomfort than those aged 18-29 years. Those with a tertiary education were five times less likely to report any HRQoL problems than those without a tertiary education. A person living in a shanty was 4.3 more likely to have problems in usual activities than a person living in a single house. Conclusion The population norms in Sri Lanka vary with socio-demographic characteristics. The socioeconomically disadvantaged have a lower HRQoL. The trends of population norms observed in this lower middle income country were generally similar to those previously reported in high income countries

Compartmentalization of Cells Bearing "Rheumatic” Cell Surface Antigens in Peripheral Blood and Tonsils in Rheumatic Heart Disease

Monoclonal antibodies that recognize "rheumatic” antigens of peripheral blood non-T cells were used to study the compartmentalization of such cells in peripheral blood and tonsils of individuals with rheumatic heart disease (RHD) and suitable control subjects. The peripheral blood of most (71%) of the 42 individuals with RHD contained cells reacting with monoclonal antibody 83S19.23 or 256S.10, whereas these cells were present in only 17% of the 41 control subjects (P < .02). However, none of 21 individuals with RHD had such cells in their tonsils, although they were present in the tonsils of 50% of the 40 control subjects (P < .03). These results may reflect a failure in RHD of organ-specific homing of cells with the epitopes recognized by the antibodies. The presence of these cells in tonsils may be important in the immune response to streptococcal pharyngeal infection, and their absence in RHD may be involved in the unusual immune responses characteristic of this diseas

Cover crops and interrow tillage for weed control in short season maize (Zea mays)

Abstract Weed competition can cause substantial maize (Zea mays L.) yield reductions. Interseeding maize with cover crops or a combination of interrow cultivation and interseeded cover crops are possible alternative methods of weed control. This study was conducted to examine the potential of interrow cultivation plus cover crops to reduce weed density in maize without reducing the grain yield. Field experiments were conducted in 1993 and 1994 at two sites in Québec to determine the effects of planting 12 cover crops with maize on weed control. Fall rye (Secale cereal L.), hairy vetch (Vicia villosa Roth), a mixture of red clover (Trifolium pratense L.) and ryegrass (Lolium multiflorum Lam), a mixture of white clover (Trifolium repens L.) and ryegrass, subterranean clover (Trifolium subterraneum L.), yellow sweet clover (Meliotus officinalis Lam), black medic (Medicago lupulina L.), Persian clover (Trifolium resupinatum L.), strawberry clover (Trifolium fragiferum L.), crimson clover (Trifolium incarnatum L.), alfalfa (Medicago sativa L.), and berseem clover (Trifolium alexandrinum L.) were seeded at two planting dates, 10 and 20 days after maize emergence. Interrow cultivation was carried out weekly until forage seeding, with a final cultivation being conducted just prior to cover crop seeding. Cover crop planting date did not affect maize yields or the ability of interrow tillage plus cover crops to suppress the development of weed populations. Maize yield was less affected by the interseeded cover crops under conditions of adequate rainfall. Corn planted in fields heavily infested with weeds resulted in substantial yield reductions even when rainfall was adequate. Except for 1993 at l&apos;Assomption interrow tillage plus cover crop treatments had consistently lower weed biomass when compared to the weedy control. Most of the weed control was due to the interrow cultivation performed prior to seeding of the cover crops. The lowest weed density occurred in the herbicide treated plots. The ability of interrow tillage plus cover crops to suppress the development of weeds was affected by the level of weed infestation, the growing conditions and location. The cover crops provide additional weed control but the interrrow tillage or some herbicide application may still be necessary

Host stage preference and parasitism behaviour of Aenasius bambawaleian an encyrtid parasitoid of Phenacoccus solenopsis

In Pakistan, the cotton mealybug, Phenacoccus solenopsis Tinsley (Sternorrhyncha (Homoptera): Pseudococcidae), is a serious pest of many cultivated plants. A parasitoid, Aenasius bambawalei Hayat (Hymenoptera: Encyrtidae), is associated with P. solenopsis. In order to mass rear A. bambawalei for a biological control program, it is important to investigate the parasitoid’s host stage preference and its parasitism behavior for P. solenopsis in order to optimize production. The present tudy showed that under both choice and no choice conditions, the parasitoid preferred 3rd instar and pre-reproductive host stage mealybugs for parasitism. Parasitoid larva developing inside the host exhibited a greater longevity, shorter developmental period and longer body size in these preferred host stages. Our study also confirmed that A. bambawalei showed no attraction to male mealybugs and no host feeding on any host stage was recorded. The ability of the parasitoid to effectively discriminate between suitable and non-suitable stages means that it is feasible to rear it on a mixed population

Measuring the impact and costs of a universal group based parenting programme : protocol and implementation of a trial

Background Sub-optimal parenting is a common risk factor for a wide range of negative health, social and educational outcomes. Most parenting programmes have been developed in the USA in the context of delinquency prevention for targeted or indicated groups and the main theoretical underpinning for these programmes is behaviour management. The Family Links Nurturing Programme (FLNP) focuses on family relationships as well as behaviour management and is offered on a universal basis. As a result it may be better placed to improve health and educational outcomes. Developed in the UK voluntary sector, FLNP is popular with practitioners, has impressed policy makers throughout the UK, has been found to be effective in before/after and qualitative studies, but lacks a randomised controlled trial (RCT) evidence base. Methods/Design A multi-centre, investigator blind, randomised controlled trial of the FLNP with a target sample of 288 south Wales families who have a child aged 2-4 yrs living in or near to Flying Start/Sure Start areas. Changes in parenting, parent child relations and parent and child wellbeing are assessed with validated measures immediately and at 6 months post intervention. Economic components include cost consequences and cost utility analyses based on parental ranking of states of quality of life. Attendance and completion rates and fidelity to the FLNP course delivery are assessed. A nested qualitative study will assess reasons for participation and non-participation and the perceived value of the programme to families. By the end of May 2010, 287 families have been recruited into the trial across four areas of south Wales. Recruitment has not met the planned timescales with barriers including professional anxiety about families entering the control arm of the trial, family concern about video and audio recording, programme facilitator concern about the recording of FLNP sessions for fidelity purposes and delays due to the new UK research governance procedures. Discussion Whilst there are strong theoretical arguments to support universal provision of parenting programmes, few universal programmes have been subjected to randomised controlled trials. In this paper we describe a RCT protocol with quantitative and qualitative outcome measures and an economic evaluation designed to provide clear evidence with regard to effectiveness and costs. We describe challenges implementing the protocol and how we are addressing these

Suicidal Ideation, Suicidal Plan and Suicidal Attempts Among Those with Major Depressive Disorder

Abstract Introduction: The aims of the study were to identify the prevalence and sociodemographic and clinical correlates of suicidal behaviours using data from a cross-sectional survey among those with major depressive disorder (MDD) in Singapore. Materials and Methods: The Singapore Mental Health Study (SMHS) was a cross-sectional epidemiological study that surveyed Singapore residents (Singapore citizens and permanent residents) aged 18 years and above. The assessment of mental disorders was established using version 3.0 of the Composite International Diagnostic Interview (CIDI 3.0). For the purposes of this study, suicidal behaviour was assessed by questions which were asked to respondents who answered positively to the screening questions in the CIDI 3.0 &quot;Depression&quot; module. Results: The prevalence of suicidal ideation, plan and attempt among those with lifetime MDD was 43.6%, 13.7% and 12.3%, respectively. We found that suicidal ideation, plan and attempt were signifi cantly associated with ethnicity, education and income. The rate of those who had sought some professional help was higher among those with suicidal plan (71.7%) and attempt (72.3%) as compared to those with suicidal ideation (48.7%) and those with MDD but no suicidal behaviour (29%). Conclusion: Individuals with MDD and suicidal behaviour do differ from their non-suicidal counterparts as they have a different sociodemographic and clinical profi le. There is a need for more research and a better understanding of this population which in turn could lead to the development and implementation of relevant interventions

European Society of Cardiology quality indicators for the prevention and management of cancer therapy-related cardiovascular toxicity in cancer treatment.

AIMS: To develop quality indicators (QIs) for the evaluation of the prevention and management of cancer therapy-related cardiovascular toxicity. METHODS AND RESULTS: We followed the European Society of Cardiology (ESC) methodology for QI development which comprises (i) identifying the key domains of care for the prevention and management of cancer therapy-related cardiovascular toxicity in patients on cancer treatment, (ii) performing a systematic review of the literature to develop candidate QIs, and (iii) selecting of the final set of QIs using a modified Delphi process. Work was undertaken in parallel with the writing of the 2022 ESC Guidelines on Cardio-Oncology and in collaboration with the European Haematology Association, the European Society for Therapeutic Radiology and Oncology and the International Cardio-Oncology Society. In total, 5 main and 9 secondary QIs were selected across five domains of care: (i) Structural framework, (ii) Baseline cardiovascular risk assessment, (iii) Cancer therapy related cardiovascular toxicity, (iv) Predictors of outcomes, and (v) Monitoring of cardiovascular complications during cancer therapy. CONCLUSION: We present the ESC Cardio-Oncology QIs with their development process and provide an overview of the scientific rationale for their selection. These indicators are aimed at quantifying and improving the adherence to guideline-recommended clinical practice and improving patient outcomes

European Society of Cardiology quality indicators for the prevention and management of cancer therapy-related cardiovascular toxicity in cancer treatment.

AIMS: To develop quality indicators (QIs) for the evaluation of the prevention and management of cancer therapy-related cardiovascular toxicity. METHODS AND RESULTS: We followed the European Society of Cardiology (ESC) methodology for QI development which comprises (i) identifying the key domains of care for the prevention and management of cancer therapy-related cardiovascular toxicity in patients on cancer treatment, (ii) performing a systematic review of the literature to develop candidate QIs, and (iii) selecting of the final set of QIs using a modified Delphi process. Work was undertaken in parallel with the writing of the 2022 ESC Guidelines on Cardio-Oncology and in collaboration with the European Haematology Association, the European Society for Therapeutic Radiology and Oncology and the International Cardio-Oncology Society. In total, 5 main and 9 secondary QIs were selected across five domains of care: (i) Structural framework, (ii) Baseline cardiovascular risk assessment, (iii) Cancer therapy related cardiovascular toxicity, (iv) Predictors of outcomes, and (v) Monitoring of cardiovascular complications during cancer therapy. CONCLUSION: We present the ESC Cardio-Oncology QIs with their development process and provide an overview of the scientific rationale for their selection. These indicators are aimed at quantifying and improving the adherence to guideline-recommended clinical practice and improving patient outcomes