Comparing the mapping between EQ-5D-5L, EQ-5D-3L and the EORTC-QLQ-C30 in non-small cell lung cancer patients

BACKGROUND: Several mapping algorithms have been published with the EORTC-QLQ-C30 for estimating EQ-5D-3L utilities. However, none are available with EQ-5D-5L. Moreover, a comparison between mapping algorithms in the same set of patients has not been performed for these two instruments simultaneously. In this prospective data set of 100 non-small cell lung cancer (NSCLC) patients, we investigate three mapping algorithms using the EQ-5D-3L and EQ-5D-5L and compare their performance. METHODS: A prospective non-interventional cohort of 100 NSCLC patients were followed up for 12 months. EQ-5D-3L, EQ-5D-5L and EORTC-QLQ-C30 were assessed monthly. EQ-5D-5L was completed at least 1 week after EQ-5D-3L. A random effects linear regression model, a beta-binomial (BB) and a Limited Variable Dependent Mixture (LVDM) model were used to determine a mapping algorithm between EQ-5D-3L, EQ-5D-5L and QLQ-C30. Simulation and cross validation and other statistical measures were used to compare the performances of the algorithms. RESULTS: Mapping from the EQ-5D-5L was better: lower AIC, RMSE, MAE and higher R(2) were reported with the EQ-5D-5L than with EQ-5D-3L regardless of the functional form of the algorithm. The BB model proved to be more useful for both instruments: for the EQ-5D-5L, AIC was –485, R(2) of 75 %, MAE of 0.075 and RMSE was 0.092. This was –385, 69 %, 0.099 and 0.113 for EQ-5D-3L respectively. The mean observed vs. predicted utilities were 0.572 vs. 0.577 and 0.515 vs. 0.523 for EQ-5D-5L and EQ-5D-3L respectively, for OLS; for BB, these were 0.572 vs. 0.575 and 0.515 vs. 0.518 respectively and for LVDMM 0.532 vs 0.515 and 0.569 vs 0.572 respectively. Less over-prediction at poorer health states was observed with EQ-5D-5L. CONCLUSIONS: The BB mapping algorithm is confirmed to offer a better fit for both EQ-5D-3L and EQ-5D-5L. The results confirm previous and more recent results on the use of BB type modelling approaches for mapping. It is recommended that in studies where EQ-5D utilities have not been collected, an EQ-5D-5L mapping algorithm is used

La empresa social como detonadora de calidad de vida y desarrollo sustentable en comunidades rurales

The aim of this paper is to analyze the mechanisms by which an indigenoussocial enterprise contributes to a rural community’s sustainable developmentand improves the quality of life of its inhabitants. The work followsa qualitative methodology and uses the case study as a research technique.The theoretical framework deployed to identify the nature of the dynamicsinvolved is social entrepreneurship, as a means of fighting poverty andchanging patterns of socio-economic exclusion. The research suggests thatsocial enterprise uses four main mechanisms to promote rural sustainabledevelopment in the community where it operates: innovation in the exploitationmethods of natural resources, labor as a source of quality of life,bonding and development of local suppliers; and the equitable sharing ofbenefits between the economic, social and environmental dimensions.El objetivo de este trabajo es analizar los mecanismos por los cuales unaempresa social indígena contribuye al desarrollo rural sustentable de sucomunidad y mejora la calidad de vida de sus habitantes. El trabajo sigueuna metodología cualitativa y utiliza el estudio de caso como técnica deinvestigación. El marco teórico para identificar la naturaleza del fenómenoes el emprendimiento social como mecanismo de combate a la pobreza y elcambio de patrones de exclusión socioeconómica. Los resultados del estudiosugieren que la empresa social utiliza cuatro mecanismos principales parafomentar el desarrollo rural sustentable en la comunidad donde opera: lainnovación en los métodos de explotación de los recursos naturales, el trabajocomo fuente de calidad de vida, la vinculación y desarrollo de proveedoreslocales, y la repartición equitativa de los beneficios entre la dimensióneconómica, social y ambiental

Fluoride Consumption and Its Impact on Oral Health

Objective. The purpose of this study was to evaluate caries and dental fluorosis among Mexican preschoolers and school-aged children in a non-endemic zone for fluorosis and to measure its biological indicators. Methods. DMFT, DMFS, dmft, dmfs, and CDI indexes were applied. Fluoride urinary excretion and fluoride concentrations in home water, table salt, bottled water, bottled drinks, and toothpaste were determined. Results. Schoolchildren presented fluorosis (CDI = 0.96) and dental caries (DMFT = 2.64 and DMFS = 3.97). Preschoolers presented dmft = 4.85 and dmfs = 8.80. DMFT and DMFS were lower in children with mild to moderate dental fluorosis (DF). Variable fluoride concentrations were found in the analyzed products (home water = 0.18–0.44 ppm F, table salt = 0–485 ppm F, bottled water = 0.18–0.47 ppm F, juices = 0.08–1.42 ppm F, nectars = 0.07–1.30 ppm F, bottled drinks = 0.10–1.70 ppm F, toothpaste = 0–2,053 ppm F). Mean daily fluoride excretion was 422 ± 176 µg/24 h for schoolchildren and 367 ± 150 µg/24 h for preschoolers. Conclusions. Data from our study show that, despite values of excretion within an optimal fluoride intake range, the prevalence of caries was significant in both groups, and 60% of the 11- to 12-year-old children presented with dental fluorosis. In addition, variable fluoride concentrations in products frequently consumed by children were found