scholarly journals Impact of Chorea on Self-care Activity, Employment, and Health-care Resource Use in Patients with Huntington’s Disease

2021 ◽  
Vol 8 (1) ◽  
pp. 99-105
Author(s):  
Jonathan DeCourcy ◽  
Jennifer Mellor ◽  
Charlotte Johnston ◽  
Ravi G Iyer ◽  
Daniel O Claassen
Keyword(s):  
Health Care ◽  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Employment Status ◽  
Negative Impact ◽  
Self Care ◽  
The United States ◽  
Health Care Resource ◽  
Full Time ◽  
The Impact

Background: Chorea is recognized as a prototypic motor feature of Huntington’s disease (HD), but its effect on health-related quality of life (HRQoL) has not been fully explored. This study describes the impact of chorea on HRQoL in patients with HD. Objective: To determine the impact of HD-related chorea on employment, self-care activities, activities of daily living, and health-care resource utilization (HCRU). Methods: Data were drawn from the Adelphi HD Disease Specific Programme, a real-world point-in-time survey of 144 neurologists and 427 patients in the United States between July and October 2017. HD patients with and without chorea were identified and examined for differences in employment status, reasons for employment changes, self-care activities, and modifications to cope with involuntary movements. Bivariate tests and inverse probability weighted regression adjustment methods were used to determine differences in outcomes between patients with and without chorea. Results: HD patients with (n=287) and without (n=140) chorea were identified. Patients with chorea were less likely to be employed full-time (16.7% vs 25.7%; P<0.04) and more likely to be on long-term sick leave (17.4% vs 5.0%; P<0.01). The onset of motor symptoms in HD-related chorea patients coincided with a change in employment status (42.7% vs 20.8%; P<0.01). Among those still working (n=145), more than two-fifths of patients with chorea required changes to their workplace and required these changes more frequently (45% vs 17%; P<0.001). HD patients with chorea required aid to help them get around significantly more frequently than those without chorea (55% vs 34%; P<0.001). Discussion: These results demonstrate that HD patients with chorea experienced greater negative impact to employment, self-care activities, and HCRU than patients without chorea experienced. These patients were more likely to stop working due to motor, cognitive, and behavioral symptoms; require modifications in the home and workplace; and need more assistance from caregivers than patients without chorea. Conclusions: Patients with HD-related chorea have greater detriments to emotional, interpersonal, and professional functioning that could be improved by reducing chorea.

scholarly journals Impact of Caryolanemagnolol on Gait and Functional Mobility on Individuals with Huntington’s Disease

2015 ◽  
Vol 14 (9) ◽  
pp. 1713-1717
Author(s):  
Ran Du
Keyword(s):  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Rating Scale ◽  
Negative Impact ◽  
Dynamic Balance ◽  
Functional Mobility ◽  
Stand Test ◽  
Mobility Test ◽  
Sit To Stand ◽  
The Impact

Purpose: To highlight the impact of caryolanemagnolol on gait measures in forward walking, balance and mobility measures, as well as in hand and forearm function measures.Methods: Twenty patients with Huntington’s disease (HD) on stable doses of caryolanemagnolol were evaluated after medication and again following resumption of medication. The improvement in spatiotemporal gait parameters was measured by GAITRite, balance and/or mobility using Tinetti mobility test (TMT), five times sit-to-stand test (5TSST), and six-condition Romberg tests, as well as the function of the hand and forearm by finger tapping and Luria tests on Huntington's disease rating scale (UHDRS) motor scale.Results: The results demonstrated significant improvement in the unified UHDRS motor scores, Tinetti mobility test (TMT) total and balance subscale scores, and the five times sit-to-stand test when oncaryolanemagnolol compared to off-caryolanemagnolol. Spatiotemporal gait measures, the six condition Romberg test, and UHDRS hand and forearm function items remained unaffected on caryolanemagnolol treatment. Improved TMT and 5TSST performance when on drug indicates that caryolanemagnolol use may improve balance and functional mobility in individuals with HD.Conclusions: Caryolanemagnolol improves chorea and functional mobility by improving dynamic balance in individuals without any negative impact on motor function in walking and transfers.Keywords: Huntington's disease, Caryolanemagnolol, Gait measures, Choreic movements, Mobility tests

Health Communication: Implications for Diverse Populations

2011 ◽  
Vol 18 (1) ◽  
pp. 12-19
Author(s):  
Amy Hasselkus
Keyword(s):  
Health Care ◽  
Health Communication ◽  
Negative Impact ◽  
Linguistically Diverse ◽  
Good Health ◽  
The United States ◽  
Poor Health ◽  
Health Care Decisions ◽  
Diverse Backgrounds ◽  
Health Related

The need for improved communication about health-related topics is evident in statistics about the health literacy of adults living in the United States. The negative impact of poor health communication is huge, resulting in poor health outcomes, health disparities, and high health care costs. The importance of good health communication is relevant to all patient populations, including those from culturally and linguistically diverse backgrounds. Efforts are underway at all levels, from individual professionals to the federal government, to improve the information patients receive so that they can make appropriate health care decisions. This article describes these efforts and discusses how speech-language pathologists and audiologists may be impacted.

The Politics of Part-Time Work: Gender, Employment Status, and Preferences for Redistribution

2020 ◽  
pp. 1-38
Author(s):  
David S. Pedulla ◽  
Michael J. Donnelly
Keyword(s):  
Employment Status ◽  
General Social Survey ◽  
The United States ◽  
Limited Attention ◽  
Full Time ◽  
Cross Sectional ◽  
Preferences For Redistribution ◽  
Time Work ◽  
Part Time ◽  
Part Time Work

Abstract The social and economic forces that shape attitudes toward the welfare state are of central concern to social scientists. Scholarship in this area has paid limited attention to how working part-time, the employment status of nearly 20% of the U.S. workforce, affects redistribution preferences. In this article, we theoretically develop and empirically test an argument about the ways that part-time work, and its relationship to gender, shape redistribution preferences. We articulate two gender-differentiated pathways—one material and one about threats to social status—through which part-time work and gender may jointly shape individuals’ preferences for redistribution. We test our argument using cross-sectional and panel data from the General Social Survey in the United States. We find that the positive relationship between part-time employment, compared to full-time employment, and redistribution preferences is stronger for men than for women. Indeed, we do not detect a relationship between part-time work and redistribution preferences among women. Our results provide support for a gendered relationship between part-time employment and redistribution preferences and demonstrate that both material and status-based mechanisms shape this association.

scholarly journals Long-Term Employment Outcomes among Female Cancer Survivors

2020 ◽  
Vol 17 (8) ◽  
pp. 2751 ◽  
Author(s):  
Christine C. Ekenga ◽  
Eunsun Kwon ◽  
BoRin Kim ◽  
Sojung Park
Keyword(s):  
Cancer Survivors ◽  
Employment Status ◽  
The United States ◽  
Employment Outcomes ◽  
Hours Worked ◽  
Professional Workers ◽  
Working Age ◽  
The Impact ◽  
Female Cancer Survivors

Advances in early detection and treatment have led to a growing population of female cancer survivors, many of whom are of working age. We examined the relationship between cancer and long-term (>5 years) employment outcomes in a nationally representative sample of working-age women in the United States. Data from nine waves of the Health and Retirement Study were used to examine employment status and weekly hours worked among cancer survivors (n = 483) and women without cancer (n = 6605). We used random slope regression models to estimate the impact of cancer and occupation type on employment outcomes. There was no difference in employment status between cancer survivors and women without cancer at baseline; however, during follow-up, cancer survivors were more likely to be employed than women without cancer (odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.11–1.58). Among 6–10-year survivors, professional workers were less likely (OR = 0.40, 95% CI: 0.21–0.74) to be employed than manual workers. Among >10-year survivors, professional workers averaged fewer weekly hours worked (−2.4 h, 95% CI: −4.4–−0.47) than manual workers. The impact of cancer on long-term employment outcomes may differ by occupation type. Identifying the occupation-specific mechanisms associated with the return to work will be critical to developing targeted strategies to promote employment in the growing female cancer survivor population.

scholarly journals High food insecurity in Latinx families and associated COVID-19 infection in the Greater Bay Area, California

BMC Nutrition ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Milagro Escobar ◽  
Andrea DeCastro Mendez ◽  
Maria Romero Encinas ◽  
Sofia Villagomez ◽  
Janet M. Wojcicki
Keyword(s):  
Food Security ◽  
Food Insecurity ◽  
San Francisco ◽  
Employment Status ◽  
The United States ◽  
Household Food Security ◽  
Bay Area ◽  
Household Food ◽  
History Of ◽  
The Impact

Abstract Background Food insecurity impacts nearly one-in-four Latinx households in the United States and has been exacerbated by the novel coronavirus or COVID-19 pandemic. Methods We examined the impact of COVID-19 on household and child food security in three preexisting, longitudinal, Latinx urban cohorts in the San Francisco Bay Area (N = 375 households, 1875 individuals). Households were initially recruited during pregnancy and postpartum at Zuckerberg San Francisco General Hospital (ZSFG) and UCSF Benioff prior to the COVID-19 pandemic. For this COVID-19 sub-study, participants responded to a 15-min telephonic interview. Participants answered 18 questions from the US Food Security Food Module (US HFSSM) and questions on types of food consumption, housing and employment status, and history of COVID-19 infection as per community or hospital-based testing. Food security and insecurity levels were compared with prior year metrics. Results We found low levels of household food security in Latinx families (by cohort: 29.2%; 34.2%; 60.0%) and child food security (56.9%, 54.1%, 78.0%) with differences between cohorts explained by self-reported levels of education and employment status. Food security levels were much lower than those reported previously in two cohorts where data had been recorded from prior years. Reported history of COVID-19 infection in households was 4.8% (95% Confidence Interval (CI); 1.5–14.3%); 7.2% (95%CI, 3.6–13.9%) and 3.5% (95%CI, 1.7–7.2%) by cohort and was associated with food insecurity in the two larger cohorts (p = 0.03; p = 0.01 respectively). Conclusions Latinx families in the Bay Area with children are experiencing a sharp rise in food insecurity levels during the COVID-19 epidemic. Food insecurity, similar to other indices of poverty, is associated with increased risk for COVID-19 infection. Comprehensive interventions are needed to address food insecurity in Latinx populations and further studies are needed to better assess independent associations between household food insecurity, poor nutritional health and risk of COVID-19 infection.

Abnormal Spinal Cord Myelination due to Oligodendrocyte Dysfunction in a Model of Huntington’s Disease

2021 ◽  
pp. 1-8
Author(s):  
Costanza Ferrari Bardile ◽  
Harwin Sidik ◽  
Reynard Quek ◽  
Nur Amirah Binte Mohammad Yusof ◽  
Marta Garcia-Miralles ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Huntington's Disease ◽  
Huntington’S Disease ◽  
Oligodendrocyte Progenitor Cells ◽  
Wild Type ◽  
Specific Expression ◽  
Relative Contribution ◽  
Related Proteins ◽  
The Impact ◽  
Cervical Area

Background: The relative contribution of grey matter (GM) and white matter (WM) degeneration to the progressive brain atrophy in Huntington’s disease (HD) has been well studied. The pathology of the spinal cord in HD is comparatively less well documented. Objective: We aim to characterize spinal cord WM abnormalities in a mouse model of HD and evaluate whether selective removal of mutant huntingtin (mHTT) from oligodendroglia rescues these deficits. Methods: Histological assessments were used to determine the area of GM and WM in the spinal cord of 12-month-old BACHD mice, while electron microscopy was used to analyze myelin fibers in the cervical area of the spinal cord. To investigate the impact of inactivation of mHTT in oligodendroglia on these measures, we used the previously described BACHDxNG2Cre mouse line where mHTT is specifically reduced in oligodendrocyte progenitor cells. Results: We show that spinal GM and WM areas are significantly atrophied in HD mice compared to wild-type controls. We further demonstrate that specific reduction of mHTT in oligodendroglial cells rescues the atrophy of spinal cord WM, but not GM, observed in HD mice. Inactivation of mHTT in oligodendroglia had no effect on the density of oligodendroglial cells but enhanced the expression of myelin-related proteins in the spinal cord. Conclusion: Our findings demonstrate that the myelination abnormalities observed in brain WM structures in HD extend to the spinal cord and suggest that specific expression of mHTT in oligodendrocytes contributes to such abnormalities.

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