Test–Retest Reliability of Capability Measurement in the UK General Population

Although philosophically attractive, it may be difficult, in practice, to measure individuals' capabilities (what they are able to do in their lives) as opposed to their functionings (what they actually do). To examine whether capability information could be reliably self‐reported, we administered a measure of self‐reported capability (the Investigating Choice Experiments Capability Measure for Adults, ICECAP‐A) on two occasions, 2 weeks apart, alongside a self‐reported health measure (the EuroQol Five Dimensional Questionnaire with 3 levels, EQ‐5D‐3L). We found that respondents were able to report capabilities with a moderate level of consistency, although somewhat less reliably than their health status. The more socially orientated nature of some of the capability questions may account for the difference. © 2014 The Authors Health Economics Published by John Wiley & Sons Ltd.     

Self-Rated Health Among Saudi Adults: Findings from a National Survey, 2013

Self-rated health reflects a person’s integrated perception of health, including its biological, psychological, and social dimensions. It is a predictor of morbidity and mortality. To assess the current status of self-rated health and associated factors in the Kingdom of Saudi Arabia, we analyzed data from the Saudi Health Interview Survey. We conducted a large national survey of adults aged 15 years or older. A total of 10,735 participants completed a standardized health questionnaire. Respondents rated their health with a five-point scale. Data on socio-demographic characteristics, chronic diseases, health-related habits and behaviors, and anthropometric measurements were collected. Associated factors of self-rated health were analyzed using a backward elimination multivariate logistic regression model. More than 77 % of respondents rated their health as excellent/very good. Female sex [odds ratio (OR) 1.52, 95 % confidence interval (CI) 1.24–1.88], decades of age (OR 1.35, 95 % CI 1.25–1.46), diagnosed diabetes mellitus (OR 1.54, 95 % CI 1.22–1.93), diagnosed hypercholesterolemia (OR 1.37, 95 % CI 1.06–1.79), diagnosed hypertension (OR 1.55, 95 % CI 1.22–1.96), number of other diagnosed chronic diseases (OR 1.69, 95 % CI 1.41–2.03), limited vigorous activity (OR 3.59, 95 % CI 2.84–4.53), need for special equipment (OR 2.62, 95 % CI 1.96–3.51), and more than 3 h of daily television/computer screen time (OR 1.59, 95 % CI1.11–2.29) were positively associated with poor/fair health. Smoking, obesity, and physical inactivity were not associated with self-reported health. We found that preventable risk factors are not associated with Saudis’ self-rated health. This optimistic perception of health poses a challenge for preventive interventions in the Kingdom and calls for campaigns to educate the public about the harm of unhealthy behaviors.     

Public health challenges in the political economy of conflict: the case of Syria

Recent uprisings in the Arab world and a full‐scale war in Syria are widely viewed as popular demand for political voice against repressive regimes. However, growing economic inequalities and serious economic dysfunction played a role as trigger for conflict than is commonly accepted. Tunisia, Egypt and Syria all implemented policies of liberalization over the past two decades, leading to the worsening of living standards for the majority. The various forms of liberalization played a significant role in embedding social division and discontent whose outcomes affected other countries of the region with the onset of market reforms in nascent welfare states. Egypt, for example, was viewed by the World Bank as an economic ‘best performer’, despite regular riots over food prices, job losses and land expropriation for tourism. Tunisia was praised by donors just prior to the uprising (in 2010), for ‘weathering well’ the global economic downturn through ‘sound macroeconomic management’. In Syria, the market economy made its mark over the 90s, but macroeconomic adjustment policies were implemented in a bilateral agreement with the European Union and approved by the International Monetary Fund in 2003. The economic stabilization programme that followed had limited concern for social impacts such as jobs losses, price rises and national debt, which ultimately caused immense hardship for the population at large, acting as a trigger for the initial uprising in 2011, prior to its transformation into a fully blown conflict. This article focuses on reforms implemented in the health sector and sets these in the context of the current political economy of Syria. It suggests that a protective approach to public health services during and in the aftermath of conflict may increase the possibilities of reconstruction and reconciliation between warring sides. Copyright © 2015 John Wiley & Sons, Ltd.     

New Antifungal Compounds from Aspergillus terreus Isolated from Desert Soil

Two new butyrolactone I derivatives: 3‐[3‐hydroxy‐4‐(3‐methyl‐but‐2‐enyl)‐phenyl]‐5‐(?4‐hydroxybenzyl)‐4‐methyl‐dihydrofuran‐2(3H)‐one (1) and (Z)‐3‐[3‐hydroxy‐4‐(3‐methyl‐but‐2‐enyl)‐phenyl]‐5‐(?4‐hydroxybenzylidene)‐4‐methyl‐dihydrofuran‐2(3H)‐one (2), in addition to the previously described (S)‐methyl‐4‐hydroxy‐2‐[4‐hydroxy‐3‐(3‐methyl‐but‐2‐enyl)‐benzyl]‐3‐(4‐hydroxy‐phenyl)‐5‐oxo‐2,5‐dihydro‐furan‐2‐carboxylic acid methyl ester (3), were identified from a strain of Aspergillus terreus Thom (Trichocomaceae) isolated from desert soil. The antifungal activities of both intra‐ and extracellular metabolites of A. terreus grown on yeast extract sucrose and malt extract media were determined. Only the secondary metabolites of A. terreus grown on yeast extract sucrose medium were active against Aspergillus fumigatus RCMB 002008. The antifungal activity of A. terreus was attributed to the presence of the compounds (1) and (2), whose minimum inhibitory concentrations (MIC) against A. fumigatus were found to be 32.00 and 16.00 µg/mL respectively. Structure elucidation was carried out using UV spectrometry, electrospray ionization mass spectrometry (ESIMS), high resolution electron impact (HREIMS) spectrometry, ¹H‐ and ¹³ C‐NMR, proton–proton correlation spectroscopy (¹H–¹H Cosy), distortionless enhancement by polarization transfer (DEPT), heteronuclear single quantum coherence (HSQC) and heteronuclear multiple bond correlations (HMBC) spectroscopy. Copyright © 2012 John Wiley & Sons, Ltd.     

The Role of Curcumin Administration in Patients with Major Depressive Disorder: Mini Meta‐Analysis of Clinical Trials

Major depression is a common, recurrent, and chronic disease that negatively affects the quality of life and increases the risk of mortality. Several studies have demonstrated that curcumin, the yellow‐pigmented substance of the turmeric, possesses antidepressant properties. The aim of this review is to meta‐analytically assess the antidepressant effect of curcumin in patients with major depressive disorders. We extensively searched the literature until August 2015. The random‐effect model was used to calculate the pooled standardized difference of means (SMD). Subgroup analyses were also performed to examine the effect of different study characteristics on the overall model. Six clinical trials met the inclusion criteria. Overall, curcumin administration showed a significantly higher reduction in depression symptoms [SMD = ?0.34; 95% confidence interval (CI) = ?0.56, ?0.13; p = 0.002]. Subgroup analyses showed that curcumin had the highest effect when given to middle‐aged patients (SMD = ?0.36; 95% CI = ?0.59; ?0.13; p = 0.002), for longer duration of administration (SMD = ?0.40; 95% CI = ?0.64, ?0.16; p = 0.001), and at higher doses (SMD = ?0.36; 95% CI = ?0.59, ?0.13; p = 0.002). The administration of new formulation of curcumin (BCM‐95) had non‐significantly higher effect on depression as compared with the conventional curcumin–piperine formula. We conclude that there is supporting evidence that curcumin administration reduces depressive symptoms in patients with major depression. Copyright © 2015 John Wiley & Sons, Ltd.     

Health literacy and logical inconsistencies in valuations of hypothetical health states: results from the Canadian EQ-5D-5L valuation study

Objectives

To examine the association of health literacy with logical inconsistencies in time trade-off valuations of hypothetical health states described by the EQ-5D-5L classification system.

Methods

Data from the EQ-5D-5L Canadian Valuation study were used. Health literacy was assessed using the Brief Health Literacy Screen. A health state valuation was considered logically inconsistent if a respondent gave the same or lower value for a very mild health state compared to the value given to 55555, or gave the same or lower value for a very mild health state compared to value assigned to the majority of the health states that are dominated by the very mild health state.

Results

Average age of respondents (N?=?1209) was 48 (SD?=?17) years, 45% were male, 7% reported inadequate health literacy, and 11% had a logical inconsistency. In adjusted analysis, participants with inadequate health literacy were 2.2 (95%CI: 1.2, 4.0; p?=?0.014) times more likely to provide an inconsistent valuation compared to those with adequate health literacy. More specifically, those who had problems in “understanding written information” and “reading health information” were more likely to have a logical inconsistency compared to those who did not. However, lacking “confidence in completing medical forms” was not associated with logical inconsistencies.

Conclusions

Health literacy was associated with logical inconsistencies in valuations of hypothetical health states described by the EQ-5D-5L classification system. Valuations studies should consider assessing health literacy, and explore better ways to introduce the valuation tasks or use simpler approaches of health preferences elicitation for individuals with inadequate health literacy.

     

Inhibition of heme oxygenase-1 partially reverses the arsenite-mediated decrease of CYP1A1, CYP1A2, CYP3A23, and CYP3A2 catalytic activity in isolated rat hepatocytes

Heme oxygenase (HO-1), the rate-limiting enzyme in the physiological breakdown of heme, is ubiquitous, and its expression can be increased by arsenite [As(III)], and similar other stimuli that induce cellular oxidative stress. Interestingly, it has been shown that the As(III)-induced HO-1 is inversely correlated with a decrease in cytochromes P450 (P450s) activity; however, the direct role for HO-1 in the inhibition of P450 enzymes remains unknown. Our results showed that As(III) at a concentration of 5 μM decreased the constitutive and inducible expression of CYP1A1, CYP1A2, CYP3A23, and CYP3A2 at the mRNA, protein, and catalytic activity levels. Moreover, As(III) decreased the nuclear accumulation of aryl hydrocarbon receptor (AhR) and pregnane X receptor without increasing their degradation. As(III) also increased the binding of cytosolic AhR to heat shock protein 90 and hepatitis B virus X-associated protein 2. In the presence of 2,3,7,8-tetrachlorodibenzo-p-dioxin as an inducer for CYP1A and rifampin as an inducer for CYP3A, As(III) decreased the enzymatic activity of the four P450s more than it decreased their mRNA or protein expression levels. It is noteworthy that treatment with the competitive HO-1 inhibitor, tin-mesoporphyrin, or supplementing external heme partially reversed the As(III)-mediated decrease in activities of the four P450s. In conclusion, the current study provides the first evidence that As(III) decreases CYP1A1, CYP1A2, CYP3A23, and CYP3A2 expression in freshly isolated rat primary hepatocytes. Furthermore, inhibiting the As(III)-mediated induction of HO-1 partially restores the enzymatic activity of these P450s that was initially decreased by As(III), confirming the direct role of HO-1 in the inhibition of P450s.