Western Australian adolescent emotional wellbeing during the COVID-19 pandemic in 2020

Background The impacts of the COVID-19 pandemic have been vast and are not limited to physical health. Many adolescents have experienced disruptions to daily life, including changes in their school routine and family’s financial or emotional security, potentially impacting their emotional wellbeing. In low COVID-19 prevalence settings, the impact of isolation has been mitigated for most young people through continued face-to-face schooling, yet there may still be significant impacts on their wellbeing that could be attributed to the pandemic. Methods We report on data from 32,849 surveys from Year 7–12 students in 40 schools over two 2020 survey cycles (June/July: 19,240; October: 13,609), drawn from a study of 79 primary and secondary schools across Western Australia, Australia. The Child Health Utility Index (CHU9D) was used to measure difficulties and distress in responding secondary school students only. Using comparable Australian data collected six years prior to the pandemic, the CHU9D was calibrated against the Kessler-10 to establish a reliable threshold for CHU9D-rated distress. Results Compared to 14% of responding 12–18-year-olds in 2013/2014, in both 2020 survey cycles almost 40% of secondary students returned a CHU9D score above a threshold indicative of elevated difficulties and distress. Student distress increased significantly between June and October 2020. Female students, those in older Grades, those with few friendships or perceived poor quality friendships, and those with poor connectedness to school were more likely to score above the threshold. Conclusions In a large dataset collected during the first year of the COVID-19 pandemic, the proportion of secondary school students with scores indicative of difficulties and distress was substantially higher than a 2013/2014 benchmark, and distress increased as the pandemic progressed, despite the low local prevalence of COVID-19. This may indicate a general decline in social and emotional wellbeing exacerbated by the events of the pandemic. Trial registration: ANZCTRN (ACTRN12620000922976). Retrospectively registered 17/08/2020. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380429&isReview=true.

Trends in Partial Disability-Free Life Expectancy between the Ages of 45 and 70 in Canada, 2000–2014

To better evaluate the benefits of a possible increase in the normal retirement age, this article proposes to examine recent trends in the health status of Canadians between 45 and 70 years of age. Using the Sullivan method, trends from 2000 to 2014 in partial disability-free life expectancy (PDFLE) between the ages of 45 and 70 years are computed. Disability is estimated using attributes of the Health Utility Index correlated with the capacity to work, and is looked at by level of severity. Data from the Canadian Community Health Survey were used to estimate the prevalence of disability. Results reveal a slight increase in partial life expectancy between the ages of 45 and 70, and a larger number of those years spent in poor health since the beginning of the 2000s. Hence, this study brings no evidence in support of the postponement of the normal retirement age if this policy were solely based on gains in life expectancy.

Health Utility and Its Risk Factors in University Staff in China: A Cross-Sectional Survey from an Occupational Health Perspective

Backgrounds: The health of university staff is a major occupational health concern worldwide. Studies have reported low health-related quality of life (HRQOL), low job satisfaction and poor mental health in this occupational group. However, none of previous studies have measured health utility and compared it to a national norm. Therefore, this study was conducted to gain a deeper understanding of the HRQOL of university staff in China and to identify risk factors influential to their health. Methods: This was a cross-sectional survey conducted in a public university in China. Participants were interviewed face-to-face for demographic and socioeconomic information and health conditions. The Chinese version of the EQ-5D-5L instrument was used to measure HRQOL for calculating health utility. The relationship between health utility and sample characteristics was first examined using t-test and correlation analysis. Multivariate generalized linear models were further applied to evaluate the significance of these associations while adjusting for other variables. Results: The sample (n=154) had a mean age of 40.65 years and slightly more females (51.30%). The overall prevalence of diseases or symptoms was 81.17%. Participants attained the means (SDs) of 0.945 (0.073) and 83.00 (11.32) for the health utility and visual analogue scale respectively. The most affected domain was the anxiety/depression with 40.26% of participants reporting problems and 37.66% of the sample reported problems in the pain/discomfort domain. There were less than 5% participants reported problems in the mobility, self-care or daily activity domains individually. Multivariate models revealed that psychological/emotional conditions were associated with the largest utility loss of -0.067 (95%CI: -0.089, -0.045) followed by having a Master’s degree or higher (-0.048, 95%CI: -0.09, -0.005) and pain in body parts other than head, neck and back (-0.034, 95%CI: -0.055, -0.014).Conclusions: University staff in China may have worse HRQOL than the general population, which manifested mainly with the pain/discomfort and anxiety/depression domains. The significant factors for utility loss were having a Master’s degree or higher, psychological conditions and pain in body parts other than the head, neck and back. Targeted health promotion policies and programs should be created to benefit this occupational group and society overall.

Evaluation of health-related quality of life of Covid-19 patients: a hospital-based study in South Central Ethiopia

Background Covid-19 causes a wide range of symptoms in patients, ranging from mild manifestations to severe disease and death. This study assessed the health-related quality of life (HRQOL) and associated factors of Covid-19 patients using primary data from confirmed cases in South Central Ethiopia. Methods We employed a facility-based, cross-sectional study design and conducted the study at the Bokoji Hospital Covid-19 treatment centre. A structured questionnaire and the EQ-5D-3L scale were used to collect the data for analysis. The HRQOL results measured by the EQ-5D-3L tool were converted to a health state utility (HSU) using the Zimbabwe tariff. The average health utility index and HSU–visual analogue scale across diverse sociodemographic and clinical characteristics were compared using the Mann–Whitney U test or Kruskal–Wallis test. We employed a multiple linear regression to examine factors associated with HSU values simultaneously. The data were analysed using STATA version 15. Results The overall mean HSU score from the EQ-5D was 0.688 (SD: 0.285), and the median was 0.787 (IQR 0.596, 0.833). The mean HSU from the visual analogue scale score was 0.69 (SD: 0.129), with a median of 0.70 (IQR 0.60, 0.80). Those who received dexamethasone and intranasal oxygen supplement, those with comorbidity, those older than 55 years and those with a hospital stay of more than 15 days had significantly lower HSU scores than their counterparts (p < .001). Conclusion Covid-19 substantially impaired the HRQOL of patients in Ethiopia, especially among elderly patients and those with comorbidity. Therefore, clinical follow-up and psychological treatment should be encouraged for these groups. Moreover, the health utility values from this study can be used to evaluate quality adjusted life years for future cost-effectiveness analyses of prevention and treatment interventions against Covid-19.

Value of willingness to pay for a QALY gained in Iran; a modified chained-approach

Background Due to the lack of a constant Willingness to Pay per one additional Quality Adjusted Life Years gained based on the preferences of Iran’s general public, the cost-effectiveness of health system interventions is unclear and making it challenging to apply economic evaluation to health resources priority setting. Methods We have measured this cost-effectiveness threshold with the participation of 2854 individuals from five provinces, each representing an income quintile, using a modified Time Trade-Off-based Chained-Approach. In this online-based empirical survey, to extract the health utility value, participants were randomly assigned to one of two green (21121) and yellow (22222) health scenarios designed based on the earlier validated EQ-5D-3L questionnaire. Results Across the two health state versions, mean values for one QALY gain (rounded) ranged from $6740-$7400 and $6480-$7120, respectively, for aggregate and trimmed models, which are equivalent to 1.35-1.18 times of the GDP per capita. Log-linear Multivariate OLS regression analysis confirmed that respondents were more likely to pay if their income, disutility, and education level were higher than their counterparts. Conclusions In the health system of Iran, any intervention that is with the incremental cost-effectiveness ratio, equal to and less than 7402.12 USD, will be considered cost-effective.

Analysis of Correlation between Quality of Life and Subjective Evaluation of Air Quality—Empirical Research Based on CHARLS 2018 Data

This paper mainly focuses on the relationship between the subjective evaluation of air quality and the quality of life (QOL) of middle-aged and elderly residents in China. The 2018 China Health and Retirement Longitudinal Study (CHARLS) project database is the key sources of data, from which 16,736 valid samples were used in our research. Multivariate linear regression analysis and binomial logistic regression model were applied to detect the impact of the subjective evaluation of air quality on QOL, which was evaluated in two dimensions, which are health utility and experienced utility, using the health utility EQ-5D score and the experienced utility of life satisfaction score. Our results show that there is a significant positive correlation between the subjective evaluation of air quality and the two dimensions of QOL. Age, education, marital status and sleep status also have a relatively great impact on the QOL of residents. This worked studied the overall QOL of middle-aged and elderly residents in China, while policy suggestions regarding high-quality air public goods are also given in the paper.

Health-Related Quality of Life in Multiple System Atrophy using EQ-5D-5L: A Large Cross-Sectional Study in China

Background Multiple system atrophy (MSA) is a rare neurodegenerative disease, featuring autonomic failure plus parkinsonism and/or cerebellar ataxia. These symptoms impact the health-related quality of life (HRQoL) of MSA. Objective We aimed to evaluate the HRQoL of MSA with a preference-based instrument, the five-level EuroQol five-dimensions questionnaire (EQ-5D-5L), for the first time.Methods EQ-5D-5L was used to evaluate the HRQoL. The result of HRQoL was displayed as heath utility index and visual analog scale (EQ-VAS) score. Specific scales were used to measure the disease severity, cognition, frontal lobe function, anxiety, depression, fatigue, and sleep disorders. The forward logistic model was used to explore the determinants of HRQoL in MSA.Results A total of 205 patients with cerebellar variant (MSA-C, 53.9%) and 175 patients with parkinsonian variant (MSA-P, 46.1%) patients were included in the study. The mean scores of the health utility index and EQ-VAS were 0.558 and 59.5, respectively. Mobility was reported by the largest proportion (92.1%) of MSA patients, followed by usual activities (88.7%), self-care (81.3%), anxiety/depression (72.1%), and pain/discomfort (53.9%). The determinants of the lower health utility index in MSA were female sex, greater total Unified Multiple System Atrophy Rating Scale (UMSARS) scores, fatigue, and Parkinson's disease-related sleep problems (PD-SP). Lower EQ-VAS score was associated with greater total UMSARS scores, fatigue, PD-SP, and anxiety symptom. MSA-P patients reported more frequent problems in pain/discomfort than MSA-C patients, while MSA-C patients reported more problems in mobility than MSA-P patients. Conclusion Patients with MSA had poor HRQoL evaluated by EQ-5D-5L. The most frequent affected problem is mobility in the Chinese MSA population. Besides the severity of MSA, fatigue, PD-SP and anxiety were determinants for poor HRQoL. Our research provides important information to improve the health status of patients with MSA.