This study measures the use and relative importance of different measures of health-related quality of life (HRQOL) as predictors of mortality in a large sample of older US adults. We used Cox proportional hazards models to analyze the association between general self-reported health and three “healthy days” (HDs) measures of HRQOL and mortality at short-term (90-day) and long-term (2.5 years) follow-up. The data were from Cohorts 6 through 8 of the Medicare Health Outcomes Survey, a national sample of older adults who completed baseline surveys in 2003–2005. At the long term, reduced HRQOL in general health and all categories of the HDs were separately and significantly associated with greater mortality (P <0.001). In multivariate analysis of long-term mortality, at least one HD category remained significant for each measure, but the associations between mental health and mortality were inconsistent. For short-term mortality, the physical health measures had larger hazard ratios, but fewer categories were significant. Hazard ratios decreased over time for all measures of HRQOL except mental health. In conclusion, HRQOL measures were shown to be significant predictors of short- and long-term mortality, further supporting their value in health surveillance and as markers of risk for targeted prevention efforts. Although all four measures of HRQOL significantly predicted mortality, general self-rated health and age were more important predictors than the HDs.

OBJECTIVE. We assessed the prevalence of fear of falling (FoF) in a sample of people with chronic stroke and compared multiple variables (balance, anxiety, depression, activity and participation, and stroke severity) in people with and without FoF. METHOD. This study was a secondary analysis of data collected from a cross-sectional study of mobility after stroke in 77 participants with chronic stroke (&gt;6 mo poststroke). RESULTS. Of the 77 participants, 51 (66%) reported experiencing FoF. People with FoF had significantly decreased balance (p &lt; .001) and activity and participation (p = .006) and significantly increased anxiety (p = .007). People with FoF also had significantly worse stroke severity (p = .001). CONCLUSION. FoF is a prevalent concern in the chronic stroke population. The presence of FoF was associated with a variety of negative consequences. Occupational therapy practitioners should address FoF to help clients manage FoF and possibly improve recovery.

Carcinoma of unknown primary origin (CUP) accounts for 3-5% of cancer cases and is the fourth most common cause of cancer death in the UK. CUP management is challenging, partly owing to the heterogeneity of the condition and its presentation, but also owing to the lack of dedicated clinical services for these patients. The recent National Institute for Health and Clinical Excellence (NICE) guidelines on metastatic malignancy of unknown primary origin were developed to improve the co-ordination of diagnostic and clinical services at hospitals treating cancer patients in England and Wales, in particular by the setting up of CUP teams to manage these patients. Radiologists have a vital role in the diagnosis of these patients and should work closely with the CUP team to streamline the diagnostic pathway. This article summarises areas of the NICE guidelines relevant to radiology and discusses the radiological management of patients with CUP, including initial investigation, the importance of biopsy, the management of specific presentations, special investigations and organisational issues.

No abstract