Mouse Models of Osteoarthritis: A Summary of Models and Outcomes Assessment

Osteoarthritis (OA) is a multidimensional health problem and a common chronic disease. It has a substantial impact onpatient quality of life and is a common cause of pain and mobility issues in older adults. The functional limitations, lack of curative treatments, and cost to society all demonstrate the need for translational and clinical research. The use of OA models in mice is important for achieving a better understanding of the disease. Models with clinical relevance are needed to achieve 2 main goals: to assess the impact of the OA disease (pain and function) and to study the efficacy of potential treatments. However, few OA models include practical strategies for functional assessment of the mice. OA signs in mice incorporate complex interrelations between pain and dysfunction. The current review provides a comprehensive compilation of mousemodels of OA and animal evaluations that include static and dynamic clinical assessment of the mice, merging evaluationof pain and function by using automatic and noninvasive techniques. These new techniques allow simultaneous recordingof spontaneous activity from thousands of home cages and also monitor environment conditions. Technologies such as videographyand computational approaches can also be used to improve pain assessment in rodents but these new tools must first be validated experimentally. An example of a new tool is the digital ventilated cage, which is an automated home-cage monitor that records spontaneous activity in the cages.

The Myth of Care Coordination: Whether Professional Care Coordination Improved Older Adults’ Health Outcomes?

Background Current evidence on the effects of Care Coordination (CC) on older adults’ well-being and health service utilization is inconsistent. Previous studies are mostly limited to regional data and focus mostly on nurse-led CC instead of layperson Care Coordinators like family caregivers. This study explores the effects of having CC in a national sample of U.S. older adults and whether the coordinators’ professionalism impacts the effect of having CC on multidimensional health outcomes (Health outcomes were conceptualized as physical health, healthcare utilization, and care encounters). Methods Data were from the 2016 and 2018 waves of the Health and Retirement Study (HRS) (n=1,372). Multivariate regression models were used to examine the effects of CC on multidimensional health outcomes in 2016 and the longitudinal effects of having CC. We also tested the effect of Care Coordinators’ professionalism on the multidimensional health outcomes. All models controlled for sociodemographic characteristics and health status. Results Findings suggest that having CC doesn’t have a positive effect on older adults’ health outcomes. Having CC was associated with an increased number of acute diseases (β = 0.16, p < .001) and nonacute diseases (β = 0.21, p < .01) in longterm. The results regarding cross-sectional effects show that receiving care from a Coordinator was related to increased health service utilization. Participants with professional Care Coordinators were more likely to report receiving person-centered care (OR=1.60, p<.05). Conclusion This study demonstrates the limited effects of CCs on older adults’ physical health outcomes, and emphasized the importance of care coordinators’ qualifications.

Dynamic reflections of multidimensional health poverty in Pakistan

The recent methodological development has entirely shifted the identification of poor in the multidimensional spectrum; thereby addressing the multiple health spheres. The present research primarily examines the dynamics of multidimensional health poverty on the basis of HIES & PSLM nationwide survey data from 2013–14 to 2018–19. The study employed Alkire & Foster Alkire, S (2007) Multidimensional Poverty Index to estimate the seven distinct dimensions of health aspects to identify the poor. The results of health poverty demonstrate a declining trend over time at national, provincial and regional level in Pakistan. Interestingly, the regional statistics indicated the poverty as a rural phenomenon of Pakistan. Comparative measures of provinces reveal that Baluchistan has been a severe victim of health poverty at overall as well as regional level during the study period. The population decomposition elaborates that individuals residing in two most populated provinces Punjab & Sindh, were the major contributor to overall profile of health poverty. Findings of dimensional decomposition exposes that five key dimensions i.e. use of health services, quality of health services, maternal health, child health and malnutrition have contributed to the overall profile of multidimensional health poverty.

Health locus of control among patients operated on for colorectal cancer

<b>Introduction:</b> An important factor determining health-oriented behavior is the health locus of control (HLC). Patients with cancer differ in health practices and perception of the disease. <br/><b>Aim:</b> Assessment of the influence of demographic factors and somatic symptoms of the disease on HLC in patients treated for colorectal cancer. <br/><b>Materials and methods:</b> The study included 160 people divided into patients with colorectal cancer (CRC) and healthy people. The Multidimensional Health Locus of Control Scale was used in the adaptation of Z. Juczyński. The scale includes three dimensions of health perception, which depends on internal control, impact of others and random. <br/><b> Results:</b> The study group consisted of 80 patients with CRC (51.2% women), and the control group 80 healthy people (57.7% women). In our analysis, we found that people with CRC were significantly more dependent on their own health control on the influence of external factors, such as doctors and nurses, than healthy people (27.11±5.43 vs. 19.64±7.77; p=<0.001). Similarly, patients with CRC significantly more than healthy people considered random as a dimension responsible for HLC (23.05±5.95 vs 20.36±7.45; p=0.012). Men with CRC more than women conditioned HLC on random influence (24.21±5.94 vs. 21.95±5.91; p=0.044). People with secondary and higher education made the HLC more dependent on internal control (26.98±5.98 vs. 23.14±5.74; p=0.041). <br/><b>Conclusions:</b> Patients with CRC made their sense of health control dependent on external dimensions: influence of others and random. Men with CRC were more likely to condition their health control on random events than women. Secondary and higher education guaranteed greater autonomy in undertaking health behaviors.

937Rasch analysis of the Health Literacy Questionnaire in the Understanding Multiple Sclerosis online course cohort

Background We have built a six-week free online course to improve multiple sclerosis (MS)-related knowledge, health literacy (HL), and resilience among members of the MS community and interested laypeople, entitled Understanding MS. To evaluate the effectiveness of the course, we require an appropriate tool to measure HL in this cohort. Objective To evaluate the psychometric properties of the multidimensional Health Literacy Questionnaire (HLQ) in a cohort of Understanding MS online course enrolees. Methods Participants who enrolled in the first two open enrolments of the Understanding MS online course completed the HLQ (n = 1182) in an online survey prior to beginning course materials. We used Rasch analysis to assess the measurement properties of the HLQ. Results The nine subscales of the HLQ each had a good fit with the Rasch model; they were unidimensional, had good internal consistency and reliability and no item bias or local dependency measurement gaps were identified for participants with low or high scores in each of the nine subscales, creating a ceiling effect, meaning that the HLQ cannot reliably measure change in HL over time for these participants. The HLQ is a reliable measurement tool to assess change in HL for people with low to moderate HL levels who have room to improve, which is our target group. Conclusion The HLQ is useful for assessing HL in this and similar cohorts, but the assessment of HL change should consider the limitations described above. Key messages The HLQ has excellent measurement properties and is appropriate for assessing HL

A Self-Report Multidimensional Health Assessment Questionnaire (MDHAQ) for Face-To-Face or Telemedicine Encounters to Assess Clinical Severity (RAPID3) and Screen for Fibromyalgia (FAST) and Depression (DEP)

Purpose of Review To update the clinical value of a patient self-report multidimensional health assessment questionnaire (MDHAQ). Recent Findings The MDHAQ includes 10 individual quantitative scores for physical function, pain, patient global assessment, fatigue, sleep, anxiety, depression, morning stiffness, change in status, and exercise status, and 5 indices, RAPID3 (routine assessment of patient index data) to assess clinical status in all diseases studied, FAST3 (fibromyalgia assessment screening tool) and MDHAQ-Dep (depression) to screen for fibromyalgia and/or depression, RADAI self-report of specific painful joints and joint count, and a symptom checklist for review of systems, and recognition of flares and medication adverse events. The MDHAQ also uniquely queries traditional “medical” information concerning comorbidities, falls, trauma, new symptoms, illnesses, surgeries, hospitalizations, emergencies, medication changes, and medication side effects. Three MDHAQ versions include long for new patients, short for new and return patients, and telemedicine. An electronic MDHAQ (eMDHAQ) has been developed with software that can interface with any electronic medical record (EMR) through the HL7 FHIR standard. However, EMR collaboration and implementation have proven difficult. Summary An MDHAQ provides a quantitative overview of patient status with far more information and documentation than an interview, involving minimal extra work for the physician.

The Dark Side of the Quarantine: Night Eating, Sleep Quality and the Health Locus of Control in Women

Aims: Staying at home for a prolonged period and the stress experienced due to the COVID-19 quarantine may affect sleep quality and night eating behaviours of individuals. This study aimed to identify the relationship between night eating behaviour, sleep quality, and perceptions of health locus of control in women during the pandemic. Methods: A questionnaire form evaluating demographic information, nutritional habits, health information and anthropometric measurements was conducted along with the Night Eating Syndrome (NES) Scale, Pittsburgh Sleep Quality Index (PUKI), and Multidimensional Health Locus of Control (A) form. Results: With a mean age of 33.0 ± 8.0 years 529 women participated in the study. The mean night eating scale score was 14.44 ± 4.72 and the mean PUKI score was 6.44 ± 2.90. Higher night eating scores were observed in participants with a chance locus of control perception when compared to participants with internal health locus of control perception (p <.05). Obese participants have lower sleep quality compared to normal and overweight participants (p <.05). It was also found that night eating behaviours significantly predicted sleep quality (R = .364, R2 =.133; p <.01) and explained about 13.3 % of the total variance of sleep quality. Conclusion: In this study conducted during the quarantine period, we showed that night eating behaviours significantly predict sleep quality, and individuals with a high perception of chance locus of control had a higher night eating scores than individuals with high perception of internal health locus of control.

Heterogeneous Health Classes for Older Adults in China: Based on Multidimensional Health

Background The concept of health is multidimensional, so the evaluation of the health status of the elderly and the analysis of the influencing factors should also be multidimensional. This study aims to identify the heterogeneity of the health status of Chinese older adults. Methods Data were derived from the China Health and Retirement Longitudinal Study (CHARLS) 2015 (n = 4190). Latent class analysis was performed based on 6 health indicators, including self-reported health status, the number of chronic diseases, activity of daily living (ADL), depressive symptoms, cognitive ability, and social activities participation. Logistic regression was used to analyze the predictive effect of demographic characteristics variables on different health classes of older adults. Results Three health latent classes were identified and labeled as Relatively Healthy Group (n = 1003, 23.94%), Multiple Chronic Conditions with High Social Participation Group (n = 1744, 41.62%), and Frail Group (n = 1443, 34.44%). The health status of Chinese older adults is not optimistic. In particular, our study found that older adults with multiple chronic diseases had the highest social participation frequency among the three classes. When Frail Group was the reference, the logistic regression results showed that older-aged adults, those without spouses, those with low educational level, and those with agricultural household registration were more likely to be Frail Group. Conclusion There is heterogeneity in the health status of older adults, and identifying the health status of older adults from a multidimensional health perspective can help provide better health services to them based on health latent classes.