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To quantify the burden of ocular injuries on deployed US service members by calculating disability-adjusted life years (DALYs). Retrospective, observational cohort study. US service members with ocular injuries sustained in combat zones from January 1, 2001 to May 19, 2020. Health states and duration of injuries were identified using data from the Defense and Veterans Eye Injury and Vision Registry. These health states were mapped to disability weights from the Global Burden of Disease (GBD) study. Average duration of injury or illness was calculated until remission or death. For the latter, life expectancy at age of sustaining injury, as identified from US Life Tables from the National Vital Statistics Reports 2020, was used. Using Defense Manpower Data Center reports capturing number of service members deployed per year, incidence rates were calculated for ocular injury and DALYs. Disability-adjusted life years of ocular injury. Seventeen thousand five hundred fifty-five patients sustained ocular injury that incurred DALYs. In total, these injuries resulted in 11 214 DALYs (average, 0.64 DALYs per included patient and 20.6 DALYs per 10 000 US service members per year). Severe impairment of distance vision (77.9%) and blindness (10.6%) were the primary contributors of DALYs. Although only 9.3% of patients sustained a permanent ocular injury, permanent disability accounted for 99.5% of total DALYs. The average yearly incidence rate of ocular injury was 32.0 cases per 10 000 US service members. Foreign body was the most frequent injury type (2754 occurrences), followed by abrasion (2419 occurrences) and multiple injury types (1429 occurrences). The most DALYs occurred in patients with multiple injury types (2485 DALYs), followed by abrasion (accounting for 725 DALYs) and foreign body (accounting for 461 DALYs). We report higher average DALYs per case ratio among US service members compared with the general population studied by the GBD study, highlighting the differences in probabilities of permanent injury between the two studies. Our study provides understanding of the impact of ocular injuries on active-duty service members and lays the groundwork for further research and interventions to mitigate their burden. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article. [ABSTRACT FROM AUTHOR]

Purpose: This cross-sectional study aims to understand the relationship between responses on the Anxiety/Depression (A/D) dimension of the EQ-5D-5L and symptoms of anxiety and depression on the GAD-7 and PHQ-9 instruments. In doing so, we investigate the comparative performance of the dimension between diagnostic groups (i.e. anxiety (GAD-7); depression (PHQ-9); anxiety & depression versus none). We additionally investigate the discriminatory performance between sub-populations based on gender, age, education and self-reported chronic conditions., Methods: 19,902 general population participants completed a health survey in May/June 2020, from five European countries and the United States. Performance of A/D was calculated using the Area Under the Receiver Operating Characteristic curve (AUROC), and was compared to having anxiety (GAD-7 ≥ 8), depression (PHQ-9 ≥ 10) and both versus none for the total population and sub-populations. Several additional sensitivity analyses were conducted, including calculations of the optimal A/D cut-off., Results: The performance in the total sample was good (AUROC > 0.8) and did not differ significantly between diagnostic groups. The performance differed significantly between the age groups, with worse performance in the younger groups, and differed between those with a singular chronic condition, with worse performance in those indicating having an anxiety or depression disorder. The performance did not differ significantly by gender, education, nor total chronic conditions., Conclusion: The A/D dimension captures symptoms of anxiety, depression or both equally well. Performance is worse in the younger population. Interpretation in those with a self-reported anxiety or depression disorder should be further investigated. This is the first-of-its-kind large population sample performance analysis, where we present evidence that the performance of the A/D dimension differs between ages, and thus intra-age comparative results may be flawed., (© 2024. The Author(s).)

Purpose: To determine whether (1) healthcare access at onset of the pandemic and (2) age, gender, socioeconomic status (SES), and pre-existing health status were associated with change in health-related quality-of-life (HRQoL) during the COVID-19 pandemic. The study includes a general population sample of five countries., Methods: An online questionnaire was administered to respondents from Greece, Italy, the Netherlands, the UK, and the US at the onset of the COVID-19 pandemic between April 22nd and May 5th of 2020, and 1 year later between May 23rd and June 29th of 2021. The questionnaire included questions on demographic background, health status, and HRQoL. The primary outcome was change in HRQoL as measured by the EQ-5D-5L instrument. Specifically, the EQ-5D-5L index and EQ VAS were used. Healthcare access was quantified with regard to the respondent's ease of getting an appointment, waiting time, and opportunity to contact the provider and during analysis dichotomized into "sufficient" versus "insufficient". Linear regression analysis was performed with change in HRQoL as dependent variable and background variables as independent variables., Results: In total, 6,765 respondents completed the second questionnaire. 19.8% of total respondents reported insufficient healthcare access. Respondents with insufficient healthcare had both more improved and deteriorated HRQoL compared to respondents with sufficient healthcare, whose HRQoL remained unchanged. We did not find significant interactions between age, gender, SES and/or chronic disease status with healthcare access at onset of the COVID-19 pandemic., Conclusion: Healthcare access was not associated with cumulative differences in change in HRQoL over a 1-year period in strata of age, gender, SES, and chronic disease status., (© 2024. The Author(s).)

Background: The COVID-19 pandemic has had multiple health and behavioral effects in the general population worldwide, including effects on nutritional and lifestyle behavior such as alcohol consumption. This study aimed to determine the frequency of and predictors for change in alcohol consumption two years after onset of the COVID-19 pandemic among participants from the general population of six countries., Methods: Longitudinal study design with 4999 participants (47% male; aged 18-75 years) from a general population cohort from six countries: Greece, Italy, the Netherlands, Sweden, the United Kingdom (UK) and the United States of America (US)., Measurements: Three web-based surveys at different time waves: T1 = 22 April-1 June 2020; T2 = 2 May-29 June 2021 and T3 = 29 April-25 June 2022. The surveys included questions on self-reported retrospective alcohol consumption, demographics, health, anxiety and depression symptoms and recent life events., Results: Of 4999 respondents, most (82.3%) reported no change in drinking habits during the pandemic, whereas 12.5% reported drinking less and 5.1% drinking more. Predictive factors for increased alcohol consumption include age 35-54 years, male gender, high educational level, moderate-severe depression symptoms, excessive drinking before the COVID-19 pandemic, no change in general health status and job loss. Predictive factors for decreased alcohol consumption were age 18-34 years, male gender, having chronic disease(s), moderate-severe depression symptoms, excessive drinking before the pandemic and job loss., Conclusion: The proportion of participants who reported a decrease in alcohol consumption during the COVID-19 pandemic was higher compared to those who reported an increase. Excessive drinking before the pandemic, depression symptoms and job loss were predictors for both drinking more and drinking less alcohol during the COVID-19 pandemic with an stronger association for an increase in alcohol consumption.

Background: In order to gain insight into the health impact of violence related injury, the psychological consequences should be taken into account. There has been uncertainty regarding the prevalence of posttraumatic stress disorder (PTSD), acute stress disorder (ASD), and depression among patients with violence related injury. An overview of prevalence rates may inform our understanding of both prognosis and recovery for these patients. Therefore, we aim to provide an overview of the published literature reporting the prevalence rates and trajectories of PTSD, ASD, and depression following violence related injury, and to assess the quality of the studies included., Methods: A systematic review was conducted in order to provide an overview of the published literature reporting the prevalence of PTSD, ASD and depression following violence related injury treated at the emergency department or hospital. The EMBASE, MEDLINE, Cochrane Central, PubMed, and PsycINFO databases were searched systematically. The quality of the included studies was assessed., Results: We included sixteen studies reporting the prevalence rates of PTSD, ASD, or depression. Clear prevalence trajectories could not be identified because the range of prevalence rates was diverse at each time point. Heterogeneity resulting from the use of different diagnostic instruments limited comparability. The included studies were susceptible to bias due to low response rates and loss to follow-up., Conclusions: The differences in diagnostic instruments limited comparability of the prevalence rates. Therefore, clear prevalence trajectories could not be identified. Study participation and loss to follow-up require more attention in future studies. Uniformity in diagnostic procedures is needed in order to draw general conclusions on the prevalence of PTSD, ASD, and depression following violence related injury.