Long term follow-up of health-related quality of life in young adults born very preterm or with a very low birth weight

Background\ud \ud The purpose was, first, to evaluate changes in health-related quality of life (HRQL) in a cohort of very low birth weight (VLBW; <1500 g.) or very preterm (< 32 weeks of gestation) children between ages 14 and 19, and second, to identify correlates of HRQL at age 19. \ud \ud Methods\ud \ud HRQL was assessed using the Health Utilities Index Mark 3 (HUI3). In order to explore correlates of HRQL, we performed a hierarchical regression analysis. \ud \ud Results\ud \ud Surviving VLBW children (n = 959) from a 1983 Dutch nation-wide cohort were eligible; 630 participated both at age 14 and 19; 54 at age 19 only. The mean HRQL score decreased from 0.87 to 0.86. The HRQL of 45% was stable, 25% were better and 30% were worse. A regression model showed internalizing problems were related most strongly to HRQL. \ud \ud Conclusions\ud \ud In the transition from adolescence to young adulthood, HRQL in Dutch VLBW children was stable at the group level but varied at the individual level. HRQL was negatively associated with internalizing problems and also with physical handicaps. Long-term follow-up studies on the impact of VLBW on HRQL are all the more called for, given the growing number of vulnerable infants surviving the neonatal period.\u

The risk of disability for the insured with overweight or obesity:A 10 year follow-up study

Overgewicht en obesitas vormen een steeds groter probleem in de westerse landen. Uit onderzoek blijkt dat het bij werknemers leidt tot een verhoogde kans op ziekteverzuim en arbeidsongeschiktheid. Tot op heden is deze relatie niet onderzocht bij zelfstandig verzekerden.Doel van dit onderzoek was om te bepalen of een premieopslag voor overgewicht samenhangt met het arbeidsongeschiktheidsvolume gedurende een follow-upperiode van 10 jaar na acceptatie.Voor dit onderzoek is gebruik gemaakt van twee bestanden: (1) deelbestand overgewicht (1993-1999), bestaande uit 515 verzekerden met overgewicht met een follow-upduur van 10 jaar na acceptatie. De groep is ingedeeld in opslag van &lt;25% of ≥25%; (2) een totaalbestand van alle verzekerden bij De Amersfoortse Verzekeringen die in de periode 1993-1999 de polis hebben gesloten. Follow-upgegevens over de kans op arbeidsongeschiktheid zijn in dit bestand verzameld in het eerste arbeidsongeschiktheidsjaar. De resultaten van dit onderzoek bevestigen dat zelfstandig verzekerden met overgewicht een verhoogde kans op arbeidsongeschiktheid hebben. De resultaten geven aanleiding te veronderstellen dat overgewicht een verhoogde kans geeft op arbeidsongeschiktheid gedurende een follow-upperiode van 10 jaar. Het arbeidsongeschiktheidsvolume blijkt echter niet groter naarmate de opslag voor overgewicht groter is. De prevalentie van hart- en vaatziekten en stofwisselingsproblemen blijkt nauwelijks te verschillen tussen de beide groepen opslag.Overweight and obesity are a growing problem in western countries. Research among employees has shown that they may lead to an increased risk of absenteeism and disability. To date, this relationship has not been studied for overweight self-employed workers. This group has to pay a (considerable) surcharge on their disability insurance premium. The aim of this study was to determine whether the insurance surcharge for overweight shows a correlation with the disability volume during a follow-up period of 10 years after acceptance. For this study we used two files consisting of: (1) a subpopulation of 515 overweight insured with a follow-up duration of 10 years after acceptance between 1993-1999. The group is classified in two subgroups based on the surcharge of &lt;25% or &gt;25%. (2) The total population accepted for insurance by the Dutch disability income insurance company 'De Amersfoortse' in the period 1993-1999. Follow-up dataon the risk of disability in this file was collected in the first year of absenteeism. The results of this study confirm that overweight and obesity increase the risk of absenteeism and disability during a 10-year follow-up period. No differences were found between the subgroups for the frequency and duration of absenteeism. The prevalence of cardiovascular disease and metabolic problems hardly differs between the two subgroups.</p

Evaluation design of a reactivation care program to prevent functional loss in hospitalised elderly: A cohort study including a randomised controlled trial

Background: Elderly persons admitted to the hospital are at risk for hospital related functional loss. This evaluation aims to compare the effects of different levels of (integrated) health intervention care programs on preventing hospital related functional loss among elderly patients by comparing a new intervention program to two usual care progra

Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies