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P Kind

Publications and source records attributed to P Kind.

158 records · Page 9Linked to original sources
PubMedDate not supplied

The time trade-off method: results from a general population study.

An important consideration when establishing priorities in health care is the likely effects that alternative allocations of resources will have on health-related quality-of-life (HRQoL). This paper reports on a large-scale national study that elicited the relative valuations attached by the general public to different states of health (defined in HRQoL terms). Health state valuations were derived using the time trade-off (TTO) method. The data from 3395 respondents were highly consistent, suggesting that it is feasible to use the TTO method to elicit valuations from the general public. The paper shows that valuations for severe health states appear to be affected by the age and the sex of the respondent; those aged 18-59 have higher valuations than those aged 60 or over and men have higher valuations than women. These results contradict those reported elsewhere and suggest that the small samples used in other studies may be concealing real differences that exist between population sub-groups. This has important implications for public policy decisions.

Adolescent↗
PubMedDate not supplied

Health-related quality of life in type 2 diabetes (TARDIS-2).

BACKGROUND: Type 2 diabetes is now recognized as a major public health concern but its burden on society is under-researched. METHODS: T(2)ARDIS was a postal survey of 1578 people with type 2 diabetes across four UK centres, incorporating measures of resource use, treatment satisfaction and health-related quality of life (HrQoL). The findings included data on the EQ-5D that enabled the HrQoL burden of the disease to be established by comparison with equivalent data for the general population and the diabetic population as a whole from the 1996 Health Survey of England. RESULTS: The results indicate a significant deficit experienced by people with type 2 diabetes vs. their age group peers in the general population. The proportion of T(2)ARDIS respondents reporting problems increases in relation to the presence of complications, and microvascular complications appear to have more impact than macrovascular complications. CONCLUSIONS: This confirms the need for treatment policies to focus on reducing the risk of such complications and hence improve patients' HrQoL.

Age Distribution↗
PubMedDate not supplied

[Lupus erythematodesus profundus].

A 4 year old boy with lupus panniculitis since the third month is presented. Typical discoid lupus erythematosus lesions were also present. There were no signs of systemic involvement. Lupus panniculitis is an uncommon subtype of cutaneous lupus erythematosus. Our case is very unusual as the lesions developed already 3 month after birth. Clinical manifestation, therapy and histopathology of lupus panniculitis are discussed.

Adipose Tissue↗
PubMedDate not supplied

Identification of proteins downregulated during the postnatal development of the cat visual cortex.

To identify proteins that play a role in the development of the mammalian visual cortex, we have used an immunosuppression and rapid immunization strategy to generate monoclonal antibodies to antigens that are present in area 17 of the cat during the peak of cortical plasticity but are downregulated near the end of the plastic period. We report here the immunohistochemical and immunobiochemical characterization of six monoclonal antibodies that identify antigens preferentially expressed in the cat visual cortex at 5 weeks of age. Monoclonal antibodies Cat-305 and Cat-306 detect three immunoreactive elements that are not present at birth but are present at 5 weeks. The majority of immunoreactivity is associated with a population of cells in the white matter that are absent at 15 weeks of age. At both 5 and 15 weeks, a very small number of neurons show intense immunoreactivity throughout all processes, resembling that achieved with a Golgi stain. In addition, a diffuse band of immunoreactivity in layer IV is largely restricted to cortical areas 17 and 18. Cat-307 recognizes a 150 kDa soluble protein present in small cytoplasmic inclusions. These cytoplasmic "dot" are present in all layers, but are most prominent in layer V. Cat-307 immunoreactivity is present at birth and is completely downregulated by 15 weeks. Cat-104 and Cat-105 recognize a 200 kDa insoluble protein present at birth and at 5 weeks, but markedly downregulated by 15 weeks. At birth, the white matter, subplate, and layer I are most densely labeled, while at 5 weeks labeling is densest in layers II, III, and V. Cat-402 recognizes a number of high-molecular-weight antigens that are differentially expressed at 5 and 15 weeks of age. Stained non-neuronal cells that resemble protoplasmic astrocytes are present in all layers at both 5 and 15 weeks. At 5 weeks, but not at birth or 15 weeks, darkly immunoreactive radial processes are observed that run through the full depth of the cortex. We show here that immunoreactivity for several different monoclonal antibodies is detected selectively during the period of maximal developmental plasticity. The results demonstrate that the cat visual cortex at 5 weeks of age is molecularly distinct from the cortex at 15 weeks.

Animals↗
PubMedDate not supplied

Modelling cost-effectiveness issues in the treatment of clinical depression.

The cost to the National Health Service of treatment for clinical depression for England and Wales has been estimated as being in the area of 416 million pounds (1990 price level), and the social burden in terms of increased morbidity and mortality due to depression is known to be considerable. Prescription of antidepressants is the most common treatment for people with clinical depression. The majority are diagnosed by general practitioners who issue 95% of all prescriptions for antidepressants. In 1992 the English National Health Service spent 81.1 million pounds on antidepressant drugs. However, the understanding of the disease process, the health, and economic impact of various treatment options are surrounded by much uncertainty. Few cost-effectiveness studies of antidepressive treatments can be found in the literature. They are often based on small sample sizes, a short time horizon, and a narrow focus on subjective measures of process or intermediate outcome and are therefore less than robust when generalized to a wider population of patients with clinical depression. We have developed a stochastic simulation model aimed at analysing cost-effectiveness aspects of treatment for depression and have used it to test the consequences of a range of treatment policies. Features of the model are discussed in this paper. The model is described with a flow chart that shows patients' pathways through the health-care system. Based on the incidence approach, the model simulates a cohort of patients, using decision and chance nodes which occur during treatment. A range of critical decision variables can be changed to assess the consequences for cost-effectiveness.

Antidepressive Agents↗
PubMedDate not supplied

A comparison of United Kingdom and Spanish general population time trade-off values for EQ-5D health states.

Few studies have compared preference values for health states obtained in different countries. The present study compared Spanish and United Kingdom (UK) time trade-off values for EuroQol-5D health states. The same preference elicitation protocol was followed in both countries. Differences in values for 43 health states rated directly were analyzed using t tests, and regression coefficients generated by random effects modeling were compared by aggregating the 2 value sets and using dummy variables to analyze country effect by dimension and level of severity. For the milder health states, Spanish and UK value assignation was similar; for intermediate health states, Spanish values were both higher and lower than UK values, whereas for health states worse than death, UK values were generally higher than Spanish values. There were statistically significant differences (P < 0.01) in values for 34.9% of health states rated directly, and some preference reversals between countries. UK raters ascribed greater importance to dimensions of pain/discomfort and anxiety/depression, whereas Spanish raters placed more importance on functional dimensions of mobility and self-care. Further analysis is required to determine how these differences affect cost-effectiveness and cost-utility analyses.

Adolescent↗