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Burden
Kinds of Burden Terms modified by Burden Selected AbstractsREPRODUCTIVE BURDEN, LOCOMOTOR PERFORMANCE, AND THE COST OF REPRODUCTION IN FREE RANGING LIZARDSEVOLUTION, Issue 4 2000Donald B. Miles Abstract. A reduction in the locomotor capacity of gravid females is considered to be a cost of reproduction if it leads to an increased risk of mortality. In this study, we measured the change in endurance between gravid and postgravid female side-blotched lizards (Uta stansburiana) as a test of the cost of reproduction. We also altered reproductive investment in some females by direct ovarian manipulation (yolkectomy), which decreased reproductive burden by 30%. Regardless of experimental treatment, all females had lower endurance when gravid. Endurance was 28% lower in gravid females from the yolkectomy treatment and 31% lower in the unmanipulated females relative to postoviposition females. The experimental reduction in clutch mass resulted in a 21% increase in endurance of gravid yolkectomy females relative to control females. Postovipositional endurance was significantly higher in the yolkectomized females than unmanipulated females, which suggests that the cost of reproduction carries over to postoviposition performance. Unmanipulated females exhibited a significant negative association between endurance and size-specific burden. Endurance was not correlated with clutch size or size-specific burden in the yolkectomy females. Survivorship to the second clutch was higher in the yolkectomy females. The results from a logistic regression showed the probability of survival to the second clutch was significantly and positively associated with endurance after controlling for the effects of treatment. Our analyses demonstrated that the decrement in performance associated with current reproductive investment represents a cost of reproduction expressed as diminished locomotor performance and lowered survivorship to the next clutch. [source] ECONOMIC BURDEN OF INFORMAL CAREGIVERS FOR ELDERLY CHINESE IN HONG KONGJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2008Joyce H. S. You PharmD No abstract is available for this article. [source] Estimating the burden of disease attributable to illicit drug use and mental disorders: what is ,Global Burden of Disease 2005' and why does it matter?ADDICTION, Issue 9 2009Louisa Degenhardt ABSTRACT Background The estimated impact of illicit drug use and mental disorders upon population health needs to be understood because there is evidence that they produce substantial loss of life and disability, and information is needed on the comparative population health impact of different diseases and risk factors to help focus policy, service and research planning and execution. Aims To provide an overview of a global project, running since the end of 2007,Global Burden of Disease (GBD) 2005. Methods The new GBD aims to update comprehensively the findings of the first GBD exercise. It aims to provide regional and global estimates of the burden of disease attributable to hundreds of diseases, injuries and their risk factors. Groups have been assembled to provide expert advice on the parameters needed to inform these estimates; here, we provide a brief summary of the broad range of work being undertaken by the group examining illicit drug use and mental disorders. Discussion The estimates of the contribution of mental disorders and illicit drugs to GBD will inform and potentially shape the focus of researchers, clinicians and governments in the years to come. We hope that interested readers might be encouraged to submit new data or feedback on the work completed thus far, as well as the work that is still under way and yet to be completed. [source] The course of cervical dystonia and patient satisfaction with long-term botulinum toxin A treatmentEUROPEAN JOURNAL OF NEUROLOGY, Issue 3 2005I. M. Skogseid In 78 patients with idiopathic cervical dystonia (CD), we studied the course of the disease and the patients' satisfaction with long-term botulinum toxin A (BTX) treatment (median 5.5 years, range 1.5,10). On a seven-point scale ranging from excellent to worsening, the effect of treatment was scored as excellent or good by 52% of patients and moderate by 33%. The independent scores of the treating neurologists were excellent or good in 65% and moderate in 27%, respectively, and correlated well with the patients' scores. The ,Global Burden of Disease', as expressed on Visual Analog Scales (VAS, 0,10) before and at evaluation of treatment, was reduced by a median of 4 in individual patients. By combining these outcome measures, 67% of the patients were characterized as having a good effect, and 33% an unsatisfactory effect. This outcome (good or unsatisfactory effect) was independent of the severity of head deviation or complexity pattern of CD prior to treatment, the delay from onset to start of BTX treatment, or the number of treatments. The complexity pattern remained stable during treatment in 64% of the patients, became less complex in 19%, whereas 17% of the patients developed more complex patterns. [source] Factors Associated With Burden of Primary Headache in a Specialty ClinicHEADACHE, Issue 6 2003Eugene M. Cassidy MRCPsych Objective.,To examine factors associated with social, occupational, and psychological burden of common primary headache (migraine and tension-type headache). Background.,The personal and social burden of primary headache is high. Health, occupational, social, and psychological factors contributing to burden in people with disabling headache have not been fully unravelled. Methods.,One hundred eighty consecutive patients with either migraine or tension-type headache attending a specialty headache outpatient clinic for the first time were evaluated over a 9-month period. Headache subtype was operationally defined according to International Headache Society criteria. Headache frequency, duration, and severity were recorded. Occupational and social disability were quantified using the Migraine Disability Assessment questionnaire. Psychological burden was quantified using the 28-item General Health Questionnaire, the Beck Depression Inventory, and the State-Trait Anxiety Inventory. Premorbid vulnerability to life stress was quantified using the neuroticism subscale of the Eysenck Personality Inventory. Results.,Patients with frequent (chronic) headache scored higher on the Migraine Disability Assessment questionnaire and had higher Beck Depression Inventory and General Health Questionnaire depression scores than those with less frequent (episodic) headache. Frequency of headache, but not pain severity, duration, or diagnosis, predicted both Migraine Disability Assessment total disability and General Health Questionnaire/Beck Depression Inventory depression. Neuroticism was predictive of depression but not disability. Patients with chronic migraine had the highest depression and disability scores. Conclusion.,The number of days per month with headache is a key determinant of headache-related burden in those attending specialty clinics. Frequent (chronic) headache is associated with significantly higher psychopathology scores and general social impairment, but the direction of this relationship is not clear. Those with migraine and chronicity are the most impaired. [source] Burden of liver disease in the United States: Summary of a workshopHEPATOLOGY, Issue 1 2002W. Ray Kim 200 First St. First page of article [source] High score on the Relative Stress Scale, a marker of possible psychiatric disorder in family carers of patients with dementiaINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 3 2007Ingun Ulstein Abstract Objective To compare the scores on the Relative Stress Scale (RSS) with those on the General Health Questionnaire (GHQ) and the Geriatric Depression Scale (GDS), and to establish a cut-off score for RSS in order to distinguish carers with symptoms of psychiatric disorders from those without. Methods One hundred and ninety-four carers of 194 patients suffering from dementia according to ICD-10 were included in the study. Burden of care was assessed by the 15-items RSS, and psychiatric symptoms by means of the GHQ-30 and the 30-items GDS. A case score above 5 on GHQ and above 13 on GDS were used to define carers with probable psychiatric morbidity. Sensitivity (SS), specificity (SP), accuracy and likelihood ratio for a positive test (LR+) were calculated for different cut-points of the RSS. Results Fifty-six percent of the carers had a GHQ score above 5, and 22% had a GDS score above 13. A two-step cluster analysis using 192 of the 194 carers, identified three groups of carers; a low risk group for psychiatric morbidity (LRG), 82 carers with GHQ,,,5 and GDS,,,13; a medium risk group (MRG), 69 carers with GHQ,>,5 and GDS,,,13; and a high-risk group (HRG), 40 carers with GHQ,>,5 and GDS,>,13. The optimal RSS cut-off to distinguish between the LRG and the others was,>,23 (SS 0.72, SP 0.82, accuracy 0.76, LR,+,4.0), whereas the optimal cut-off to separate the HRG from the others was,>30 (SS 0.74, SP 0.87, accuracy 0.84, LR,+,5.7). Conclusion The RSS is a useful instrument to stratify carers according to their risk of psychiatric morbidity. Copyright © 2006 John Wiley & Sons, Ltd. [source] Burden of stroke in Brunei DarussalamINTERNATIONAL JOURNAL OF STROKE, Issue 5 2009S. H. Nainar Brunei Darussalam, located on the north-west coast of Borneo, has a total area of 5765 km2 (1). Divided into four districts , Brunei-Muara, Belait, Temburong and Tutong with the majority of the population living in the Brunei-Muara District, approximately 74% of the population is urban with an overall population of 390 000, male/female ratio 1·13 : 1 (2). The main ethnic group is Malay (66·6%), which comprises the different Brunei indigenous communities of Malay, Belait, Bisaya, Brunei, Dusun, Kedayan, Murut and Tutong. Chinese ethnicity comprises 11% while other undefined ethnicities 22·4%. Approximately, 39·2% are aged below 19 years, 2·8% over 65 years with a median age of 26 years. Brunei's gross national income per capita (PPP international $) is 49 900 (3). [source] Burden of stroke in SingaporeINTERNATIONAL JOURNAL OF STROKE, Issue 1 2008N. Venketasubramanian Stroke is Singapore's fourth leading cause of death, with a crude death rate of 40·4/100 000 in 2006, a prevalence of 3·65% and an incidence of 1·8/1000, and is among the top 10 causes of hospitalization. Approximately one-quarter of strokes are hemorrhagic. Hospital care for acute stroke costs about US$5000. Subsidized healthcare is widely available for primary level and hospital care, as are rehabilitative services. A national stroke support group has been established. With our rapidly aging population, coupled with the high prevalence of stroke risk factors in the community, the burden of stroke is expected to increase dramatically in the years to come, posing challenges to the healthcare system and society. A national disease management plan incorporating high-quality clinical care coupled with research would be essential. [source] Burden of stroke in Maori and Pacific peoples of New ZealandINTERNATIONAL JOURNAL OF STROKE, Issue 3 2007Valery L. Feigin Studying ethnic particularities of stroke epidemiology may not only provide a clue to the causes of the observed racial/ethnic differences in stroke mortality but is also important for appropriate, culturally specific health care planning, prevention in stroke and improved health outcomes. This overview of published population-based stroke incidence studies and other relevant research in the multi-ethnic New Zealand population demonstrates an obvious ethnic disparity in stroke in New Zealand, with the greatest and increasing burden of stroke being imposed on Maori, who are indigenous, and Pacific people, who have migrated and settled in this country. These data warrant urgent and effective measures to be undertaken by health policy makers and health care providers to reverse the unfavourable trends in stroke and improve Maori and Pacific people's health. [source] Burden of stroke in ChinaINTERNATIONAL JOURNAL OF STROKE, Issue 3 2007Yi Long Wang Stroke is second leading cause of death in China, however, there are very few data available in the English literature to reflect the burden. We summarize the current epidemiological trends and estimate of the burden of stroke in recent reports available in Chinese. [source] Burden of stroke in ThailandINTERNATIONAL JOURNAL OF STROKE, Issue 2 2007Niphon Poungvarin No abstract is available for this article. [source] Assessment and Interpretation of Comorbidity Burden in Older Adults with CancerJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2009Siran M. Koroukian PhD OBJECTIVES: To evaluate the associations between comorbidities, functional limitations, geriatric syndromes, treatment patterns, and outcomes in a population-based cohort of older patients diagnosed with colorectal cancer and receiving home health care. DESIGN: Retrospective study. SETTING: Data from the Ohio Cancer Incidence Surveillance System, Medicare claims and enrollment files, and the home health care Outcome and Assessment Information Set. PARTICIPANTS: Ohio residents diagnosed with incident colorectal cancer in 1999 to 2001 and receiving home health care in the 30 days before or after cancer diagnosis (N=957). MEASUREMENTS: Outcome measures included receipt of cancer treatment and survival through 2005. RESULTS: Not having surgery was associated negatively with comorbidities but positively with functional limitations and geriatric syndromes. Receipt of chemotherapy was negatively associated with comorbidities and functional limitations. The presence of two or more geriatric syndromes was significantly associated with unfavorable survival outcomes when analyzing overall survival and disease-specific survival (DSS). Having limitations in two or more activities of daily living was associated with unfavorable overall survival but not with DSS. Comorbity was associated with favorable DSS at borderline level of statistical significance but not with overall survival. CONCLUSION: The findings highlight the importance of incorporating functional limitations and geriatric syndrome data in geriatric oncology outcomes studies. [source] Unmet Desire for Caregiver-Patient Communication and Increased Caregiver BurdenJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2005Terri R. Fried MD Objectives: To examine the adequacy of caregiver-patient communication in serious illness and its relationship to caregiver burden. Design: Cross-sectional cohort study. Setting: Participants' homes. Participants: One hundred ninety-three persons aged 60 and older seriously ill with cancer, congestive heart failure, or chronic obstructive pulmonary disease and their caregivers. Measurements: Communication concerns, measured in terms of agreement with statements regarding desire for and difficulty with communication about the patient's illness. Caregiver burden, measured using a 10-item subset of the Zarit Burden Inventory, with scores ranging from 0 to 40 and higher scores indicating greater burden. Results: Of caregivers, 39.9% desired more communication, and 37.3% reported that communication was difficult. Of patients, 20.2% desired more communication, and 22.3% reported that communication was difficult. Disagreement regarding communication concerns was frequent in caregiver-patient pairs; of caregivers who desired more communication, 83.1% of patients did not, and of patients who desired more communication, 66.7% of caregivers did not. Caregivers who desired more communication had significantly higher caregiver burden scores than did caregivers who did not (9.2 vs 4.7, P<.001), even after adjusting for patient's diagnosis, income, and functional status and caregivers' age, sex, and relationship to the patient. Conclusion: A large proportion of caregivers and seriously ill older persons had an unmet desire for increased communication, although they frequently disagreed with each other about this desire. Caregivers' desire for increased communication may be a modifiable determinant of caregiver burden. [source] Characterization of the Electroanatomical Substrate in Human Atrial Fibrillation: The Relationship between Changes in Atrial Volume, Refractoriness, Wavefront Propagation Velocities, and AF BurdenJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 3 2007PIPIN KOJODJOJO M.R.C.P. Introduction: Progressive remodeling occurs in experimental models of AF whereby slowing of conduction, shortening of refractoriness, and atrial dilatation are associated with an increased vulnerability to atrial fibrillation (AF). This study investigates the relative changes in atrial geometry and electrophysiology with increasing AF burden in humans. Methods and Results: Patients undergoing ablation of AF or left-sided accessory pathways were recruited. Atrial volumes were determined by echocardiography. Wavefront propagation velocities (WPV), specifically in the direction of activation, were calculated from pre-ablation activation (CartoÔ) maps of both atria. Dispersion, adaptation of, and effective refractoriness (ERP) were measured at 3 sites. A composite arrhythmogenic index (Atrial Volume/WPV × ERP) was derived to compare the degree of electroanatomical remodeling with AF burden. Fifty-nine patients (22 paroxysmal AF, 19 recurrent persistent AF, and 18 controls) were recruited. AF subjects had slower right atrial WPV (P = 0.01), but no difference in left atrial WPV compared with controls. ERP was reduced globally (P < 0.05), with increased dispersion (P < 0.05). WPV and ERP did not distinguish between patients with paroxysmal or persistent AF. Biatrial volumes were greater only in patients with persistent AF (P < 0.01). There was a stepwise increase in the AI with increasing AF burden (P < 0.0001). Conclusion: An arrhythmogenic substrate exists in human AF, characterized by globally decreased refractoriness with greater dispersion, slower right atrial conduction, and atrial dilatation. Persistence of AF is not accompanied by any further electrical remodeling, but only atrial dilatation. The degree of electroanatomical remodeling is associated with the clinical pattern of AF. [source] Atrial Fibrillation Burden During the Post-Implant Period After CRT Using Device-Based DiagnosticsJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 8 2006BURKHARD HÜGL M.D. Aims: Cardiac resynchronization therapy (CRT) is increasingly used in congestive heart failure (CHF) patients (with cardiac dyssynchrony). In addition to delivering therapy, CRT devices offer a variety of diagnostic tools for continuous long-term monitoring of clinically relevant information (i.e., occurrence and duration of arrhythmia episodes). Methods and Results: Eighty-four patients with drug-refractory CHF in NYHA-class II,IV received a CRT device. The response to CRT was assessed by determining NYHA class at baseline and at 3 months follow-up. Atrial fibrillation (AF) burden (defined as time of AF per day) was continuously measured by the device. A significant gradual reduction of AF burden (from 9.88 ± 12.61 to 4.20 ± 9.24 [hours/day]) and number of patients experiencing AF episodes (from 26 to 13) were observed during CRT. Conclusions: (1) Diagnostic features for long-term monitoring of physiological variables provide useful information on the state and course of AF and may improve disease management. (2) AF burden reduces over time during the first 3 months after CRT implantation. [source] Total Atrioventricular Nodal Ablation Increases Atrial Fibrillation Burden in Patients with Paroxysmal Atrial Fibrillation Despite Continuation of Antiarrhythmic Drug TherapyJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 12 2003RIK WILLEMS M.D. Introduction: Total atrioventricular nodal (TAVN) ablation and pacing is an accepted and safe treatment for patients with drug-refractory paroxysmal atrial fibrillation (AF). Many patients develop permanent AF within the first 6 months after TAVN ablation. This usually is ascribed to the cessation of antiarrhythmic drug therapy. We hypothesized that TAVN ablation itself creates an atrial substrate prone to AF. Methods and Results: Patients participating in the Atrial Pacing Periablation for Paroxysmal Atrial Fibrillation (PA3) study who remained on stable antiarrhythmic drug therapy throughout follow-up were included in this analysis. AF burden and the development of persistent AF in the preablation period were compared to two consecutive postablation periods. Echocardiographic changes also were evaluated. Twenty-two patients remained on stable drug therapy (9 men and 13 women, age 59 ± 3 years). One patient developed persistent AF preablation compared to 10 postablation (P < 0.05). AF burden preablation was 3.0 ± 1.2 hours/day and increased to 10.4 ± 2.2 hours/day and 11.8 ± 2.3 hours/day in the two postablation follow-up periods (P < 0.05). In patients with fractional shortening (FS) >30% prior to ablation, FS decreased significantly from 39.4%± 1.3% to 36.4%± 1.7% (P < 0.05). In contrast, in patients with a FS ,30% prior to ablation, FS increased from 27%± 0.8% to 33.6 ± 1.7% (P < 0.05). Conclusion: TAVN ablation increases AF burden and facilitates the development of persistent AF in patients with paroxysmal AF despite the continuation of antiarrhythmic drugs. Loss of AV and/or interventricular synchrony may lead to altered cardiac hemodynamics resulting in atrial stretch and increasing AF burden. (J Cardiovasc Electrophysiol, Vol. 14, pp. 1296-1301, December 2003) [source] The Bond and Burden of CaringJOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING, Issue 1 2006Linda Finke RN [source] The Burden of Disease and the Cost of Illness Attributable to Alcohol Drinking,Results of a National StudyALCOHOLISM, Issue 8 2010Helena Cortez-Pinto Background and Aims:, The World Health Organization estimated that 3.2% of the burden of disease around the world is attributable to the consumption of alcohol. The aim of this study is to estimate the burden of disease attributable to alcohol consumption in Portugal. Methods:, Burden and costs of diseases attributable to alcohol drinking were estimated based on demographic and health statistics available for 2005, using the Disability-Adjusted Life Years (DALY) lost generated by death or disability. Results:, In Portugal, 3.8% of deaths are attributable to alcohol (4,059 of 107,839). After measuring the DALY generated by mortality data, the proportion of disease attributable to alcohol was 5.0%, with men having 5.6% of deaths and 6.2% of disease burden, while female figures were, respectively, 1.8 and 2.4%. Considering the sum of death and disability DALYs, liver diseases represented the main source of the burden attributable to alcohol with 31.5% of total DALYs, followed by traffic accidents (28.2%) and several types of cancer (19.2%). As for the cost of illness incurred by the health system, our results indicate that ,95.1 millions are attributable to alcohol-related disease admissions (liver diseases, cancer, traffic accidents, and external causes) while the ambulatory costs of alcohol-related diseases were estimated in ,95.9 million, totaling ,191.0 million direct costs, representing 0.13% of Gross Domestic Product and 1.25% of total national health expenditures. An alternative analysis was carried out using higher consumption levels so as to replicate aggregate alcohol consumption statistics. In this case, DALYs lost increased by 11.7% and health costs by 23%. Conclusion:, Our results confirm that alcohol is an important health risk factor in Portugal and a heavy economic burden for the health system, with hepatic diseases ranking first as a source of burden of disease attributable to alcohol. [source] Effects of L-Asparaginase on Plasma Amino Acid Profiles and Tumor Burden in Cats with LymphomaJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 4 2007A.K. LeBlanc Background: L-Asparaginase (Elspara), is an Escherichia coli -derived enzyme that depletes lymphoma cells of asparagine, inhibiting protein synthesis and resulting in cell death. The single agent response rate in cats with lymphoma and impact of L-asparaginase on plasma amino acid concentrations is unknown. Hypotheses: L-Asparaginase significantly reduces plasma asparagine concentrations and has demonstrable efficacy against untreated lymphoma in cats. Animals: Thirteen cats with confirmed lymphoma (LSA) of any anatomic site were given 1 dose 400 IU/kg IM) of L-asparaginase for initial LSA treatment. Methods: Plasma collected at 0, 2, and 7 days after L-asparaginase therapy was assayed for ammonia, asparagine, aspartic acid, glutamine, and glutamic acid concentrations. Cats were restaged 7 days later to assess tumor response. Results: Eight cats had T-cell LSA, 4 cats had B-cell LSA, and 1 cat's immunophenotype was unknown. Two complete and 2 partial responses to L-asparaginase were seen. Four cats had stable disease, and 5 cats had progressive disease. Ammonia and aspartic acid concentrations were increased from baseline at 2 and 7 days posttreatment. Asparagine concentrations were decreased from baseline at 2 days but not 7 days posttreatment. Glutamic acid concentrations were increased at day 2 compared to day 7 posttreatment but not compared to baseline. Glutamine concentrations were unchanged. Conclusions and Clinical Importance: L-Asparaginase significantly reduced asparagine concentrations within 2 days of treatment, but this effect was lost within 7 days. The apparent overall response rate of feline LSA to L-asparaginase in this study was 30%. [source] Quality of life in acute and maintenance treatment of non-erosive and mild erosive gastro-oesophageal reflux diseaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2005F. PACE Summary Background:, Quality of life has been assessed in a large, multicentre randomized, open label study. Aim:, To evaluate the economic and clinical consequences of two different maintenance treatment modalities, administered to 6017 gastro-oesophageal reflux disease patients at 451 gastroenterological centres in Italy. Methods:, Adult gastro-oesophageal reflux disease patients received, at enrolment, an acute treatment of esomeprazole 40 mg/day for 4 weeks and, if successfully treated, were randomized into two maintenance treatment strategies: esomeprazole 20 mg/day or esomeprazole on demand for 6 months. A baseline endoscopy allowed the exclusion of grade II,IV oesophagitis according to Savary,Miller's classification. Burden of gastro-oesophageal reflux disease was measured at baseline by the generic questionnaire Short-Form 36 and by a disease specific instrument, quality of life in reflux and dyspepsia (QOLRAD), also administered at start and conclusion of maintenance period. Investigators were required to collect patient judgement about the degree of satisfaction with treatment effect on heartburn, with a 7-point scale. Results:, A comparison between Short-Form 36 scores and the normative source of the Italian general population suggested that symptomatic gastro-oesophageal reflux disease patients experience a worse quality of life than the general population. At the end of the 4-week treatment with esomeprazole 40 mg all (QOLRAD) dimensions showed a statistically significant (P < 0.0001) and clinically meaningful improvement. Satisfaction level towards treatment was reported high in the total enrolled population after acute treatment with esomeprazole 40 mg/day (96.2% satisfied and 64.4% very satisfied). A statistically significant difference in (QOLRAD) scores was registered at the end of maintenance phase in favour of the continuous regimen, nevertheless the size of this difference was very small in all dimensions; similarly, the proportion of patients very satisfied was slightly higher in the continuous treatment arm (64.5%) than in the on-demand arm (59.7%). Conclusions:, Gastro-oesophageal reflux disease can significantly impair health-related quality of life and esomeprazole therapy allows immediate relief in the acute phase of the disease. Quality of life improvement was maintained during the 6-month follow-up with a slight difference in term of quality of life in reflux and dyspepsia scores and patients' satisfaction in favour of the continuous treatment strategy. [source] Burden of disease related to Parkinson's disease in Spain in the year 2000MOVEMENT DISORDERS, Issue 11 2005Esther Cubo MD Abstract We measured the burden caused by Parkinson's disease (PD) in Spain during the year 2000 and compared it against PD burden worldwide and in the European A subregion. Burden of disease (BoD) is an important factor in health policy. Disability-adjusted life years (DALY) as a measure of BoD is the result of adding years of life lost (YLL) and years lived with disability (YLD). The burden of PD (BPD) has not been studied in Spain. YLL were obtained from the Spanish death certificates and YLD from the estimated number of incident PD cases and the average PD duration. PD disability was calculated, using the Disability Weights for Diseases in the Netherlands. Prior PD DALY data for Europe and the world were obtained from the 2001 World Health Organization World Health Report. A discount rate of 3% and age-weighting modulation factor with K = 1 were used. In Spain, PD generated 67,582 DALY, comprising 6,351 (9.4%) YLL and 61,231 (90.6%) YLD. Most PD DALY (57.5%) occurred in the population 60 to 74 years of age. When PD DALY estimates were adjusted using the world population in 2000, Spain registered a PD DALY rate of 84 per 100,000 population, higher than both the world and European A subregion rates (24 and 35 per 100,000 population, respectively). PD burden in Spain in 2000 was high, with disability being the major contributing factor. Although BPD in Spain was greater than both world and European A subregion BPD, these differences should nevertheless be interpreted with caution. © 2005 Movement Disorder Society [source] Burden of parkinsonism: A population-based studyMOVEMENT DISORDERS, Issue 3 2003FRCPC, Mark Guttman MD Abstract Parkinson's disease (PD) is associated with a significant burden of illness and cost to society, which has been difficult to quantify. Our objective was to use linked administrative databases from the population of Ontario, Canada, to assess the prevalence of parkinsonism, physician- and drug-related costs, and hospital utilization for parkinsonian patients compared with age/sex matched controls. An inception cohort of parkinsonian cases from 1993/1994 was age and sex matched (1:2) to controls and followed for 6 years. Patients were identified by the diagnostic code for PD, the use of specific PD drugs, or a combination. The parkinsonian case cohort (15,304) was matched to (30,608) controls that did not have parkinsonism. The age-adjusted prevalence rates were 3.63 for men and for 3.24 women per 1,000 (increased by 5.4% for men and 9.8% for women). Physician costs were 1.4 times more, there were 1.44 times more hospital admissions, admissions were on average 1.19 times longer, and drug costs were 3.0 times more for parkinsonian cases. We conclude that the substantially higher physician and drug costs as well as hospitalization rates compared with controls clearly suggest that parkinsonism is associated with large direct costs to society. © 2002 Movement Disorder Society [source] The burden of overweight and obesity-related ill health in the UKOBESITY REVIEWS, Issue 5 2007S. Allender Summary This paper reviews previous cost studies of overweight and obesity in the UK. It proposes a method for estimating the economic and health costs of overweight and obesity in the UK which could also be used in other countries. Costs of obesity studies were identified via a systematic search of electronic databases. Information from the WHO Burden of Disease Project was used to calculate the mortality and morbidity cost of overweight and obesity. Population attributable fractions for diseases attributable to overweight and obesity were applied to National Health Service (NHS) cost data to estimate direct financial costs. We estimate the direct cost of overweight and obesity to the NHS at £3.2 billion. Other estimates of the cost of obesity range between £480 million in 1998 and £1.1 billion in 2004 [Correction added after online publication 11 June 2007: ,of the cost of obesity' added after ,Other estimates']. There is wide variation in methods and estimates for the cost of overweight and obesity to the health systems of developed countries. The method presented here could be used to calculate the costs of overweight and obesity in other countries. Public health initiatives are required to address the increasing prevalence of overweight and obesity and reduce associated healthcare costs. [source] Health-related and diabetes-related quality of life in Japanese children and adolescents with type 1 and type 2 diabetesPEDIATRICS INTERNATIONAL, Issue 2 2010Nobue Nakamura Abstract Background:, The aim of this study was to assess (i) the health-related quality of life (HR-QOL) of primary, junior and high school children with type 1 and type 2 diabetes and to compare it with that of healthy school children; and (ii) to compare the diabetes-related QOL (DR-QOL) and the QOL of parents of children with diabetes, between type 1 and type 2 diabetes in Japan. Methods:, Overall, 471 patients aged 9,18 years (368 with type 1 and 103 with type 2 diabetes) and their parents were involved. QOL was assessed using a self-administered questionnaire. Results:, The total score for HR-QOL of primary and junior school children with type 1 diabetes was significantly higher than that of those with type 2 diabetes and healthy controls. However, there were no significant differences in high school children. Some subscales regarding HR-QOL were significantly lower for children with type 2 diabetes than for children with type 1 diabetes or healthy controls. The DR-QOL of children with type 1 and type 2 diabetes did not significantly differ. The Family Burden and Family Involvement were significantly greater in parents of children with type 1 diabetes. There were significantly positive correlations between HR-QOL and DR-QOL in both groups. In type 1 diabetes only, there were significant negative correlations between glycated hemoglobin and some subscales of the HR-QOL and QOL of parents of children with diabetes, and weak positive correlation between glycated hemoglobin and Family Burden. Conclusions:, The HR-QOL of school children with type 1 diabetes was higher than that of those with type 2 diabetes and healthy school children. The QOL of school children with type 1 diabetes was not impaired. [source] Party Identification in Emotional and Political Context: A ReplicationPOLITICAL PSYCHOLOGY, Issue 6 2007Francis Neely While testing an affective measure of party identification Burden and Klofstad (2005) found that using the phrase, "feel that you are," in place of, "think of yourself as," significantly shifted PID in a Republican direction. I adopt the theoretical framework of Affective Intelligence (Marcus, Neuman, & MacKuen, 2000) to specify how the timing of their question-wording experiment may have influenced the results. I suggest that the outcome was a function of (a) anxiety present during the survey, which ran just after 9/11 of 2001, coupled with (b) a political environment that favored Republicans. In a 2005 survey I replicate the experiment and collect new measures with which to test expectations. I find no significant shift in PID, and provisional support for the Affective Intelligence explanation. The results validate Burden and Klofstad's measure, qualify their findings, and test the application of the theory of Affective Intelligence to party dispositions. Alternative explanations and directions for further research are discussed. [source] Immigration Assumptions in Projecting the US Social Security BurdenPOPULATION AND DEVELOPMENT REVIEW, Issue 4 2008Article first published online: 5 DEC 200 First page of article [source] Burden and coping strategies in mothers of patients with schizophrenia in JapanPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 3 2008Setsuko Hanzawa phd Aim:, The present study was conducted to identify factors contributing to burden of care in 57 mothers caring for patients with schizophrenia. Methods:, Members of the Federation of Families of People with Mental Illness in Nagasaki Prefecture were evaluated using well-validated scales to evaluate burden of care (eight-item short version of the Japanese version of the Zarit Caregiver Burden Interview), general health status (General Health Questionnaire 12-item version), difficulty in life, coping strategies, emotional support, and understanding of mental illness and disorders. Results:, Burden of care was significantly associated with general health status and difficulty in life. Conclusion:, On multiple regression it was found that ,social interests' and ,resignation', both of which are the subscales of coping strategies, exerted significant and independent effects with respect to burden of care. [source] Classifying subgroups of patients with symptoms of acute coronary syndromes: A cluster analysisRESEARCH IN NURSING & HEALTH, Issue 5 2010Holli A. DeVon Abstract The purpose of the study was to identify subgroups of patients presenting with acute coronary syndromes based on symptom clusters. Two hundred fifty-six patients completed a symptom assessment in their hospital rooms. Latent class cluster analysis and analysis of variance were used to classify subgroups of patients according to selected clinical characteristics. Four subgroups were identified and labeled as Heavy Symptom Burden, Chest Pain Only, Sweating and Weak, and Short of Breath and Weak (model fit ,2 [130,891, n,=,256],=,867.5, p,=,1.00). The largest group of patients experienced classic symptoms of chest pain and shortness of breath but not sweating. Younger patients were more likely to cluster in the Heavy Symptom Burden group (F,=,5.08, p,=,.002). Interpretation of the clinical significance of these groupings requires further study. © 2010 Wiley Periodicals, Inc. Res Nurs Health 33:386,397, 2010 [source] Interventions to reduce the burden of caregiving for an adult with dementia: A meta-analysis,RESEARCH IN NURSING & HEALTH, Issue 5 2001Gayle J. Acton Abstract Because of conflicting results, in order to clarify the state of the science it was necessary to do a systematic analysis of the literature on research testing the effect of interventions on the burden of persons caring for family members with dementia. The purpose of this study was to evaluate, using meta-analytic techniques, those intervention strategies (support group, education, psychoeducation, counseling, respite care, and multicomponent) designed to help caregivers cope with the burden of caregiving. Using meta-analytic methods developed by Glass, McGraw, and Smith (1981) and Hedges and Olkin (1985), 24 published research reports testing 27 treatments for caregivers of adults with dementia were synthesized. Overall, the analysis showed that collectively the interventions had no effect on caregiver burden. Only the category of multicomponent interventions significantly reduced caregiver burden. Burden may be too global an outcome to be affected consistently by intervention. Better and more precise measures are needed to evaluate the effects of caregiver interventions properly. © 2001 John Wiley & Sons, Inc. Res Nurs Health 24:349,360, 2001 [source] | |||||||||||||||||||||||||||||||||||||||||||||||||