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Promotion of self-care is an important issue in the treatment of chronic diseases such as venous leg ulcers, as adequate self-care can prevent complications and ulcer recurrence. However, only a few tools have been developed and tested to assess the knowledge of patients with venous leg ulcers. This study aimed to translate, adapt and validate in an Italian language and context a questionnaire to assess the knowledge of patients with venous leg ulcers about their disease (pathophysiology, risk factors, lifestyle changes due to ulcer) and the proper management of the ulcer to prevent recurrence. This is a cross-sectional study divided into two phases: (1) translation and cross-cultural adaptation of the 'Educational Interventions in Venous Leg Ulcer Patients' tool in a six-stage process and (2) validation and reliability study with patients with active ulceration. There was great agreement for the English-to-Italian translation. In content validation, the tool showed good applicability among experts. Adjustments were made to improve semantic equivalence, and the questionnaire was made to be easy and quick to administer. The results of the target population showed a low level of knowledge among the patients. Knowing the deficiencies of the patients makes it possible to create educational projects to improve their abilities. Now more than ever, it is necessary to improve self-care and patient knowledge, allowing home care, improving autonomy, and avoiding hospital care that results in higher costs and risks. This questionnaire could be used in future studies to identify topics that need to be reinforced through education and to improve the awareness and self-care of these patients., (© 2023 The Authors. Wound Repair and Regeneration published by Wiley Periodicals LLC on behalf of The Wound Healing Society.)

Introduction: Parkinson's disease (PD) is associated with a progressive inability to accomplish essential activities of daily living (ADL) resulting in a loss of autonomy and quality of life. Accurate measurement of ADL in PD is important to monitor disease progression and optimize care. Despite its relevance, it is still unclear which measurement instruments are the most suitable for evaluating ADL in people with PD., Objective: To identify and critically appraise which measurement instruments have been used to assess ADL in PD., Methods: A systematic review was conducted using the databases CENTRAL, MEDLINE, and PEDro from their inception to October 2021 to identify all observational and experimental studies conducted in PD or atypical parkinsonism that included an ADL assessment. Titles and abstracts were screened independently by two authors. The clinimetric properties of the measurement instruments were assessed, and the instruments were classified as "recommended," "suggested," or "listed.", Results: A total of 129 articles were included, with 37 measurement instruments used. The Unified Parkinson's Disease Rating Scale (UPDRS), the Schwab & England ADL scale (S&E scale), the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), the Barthel Index, the Lawton-Brody Instrumental Activities of Daily Living Scale, the Functional Independence Measure (FIM) and the Alzheimer's Disease Cooperative Study - ADL (ADCS-ADL) scale were the seven most frequently cited measurement instruments. Of these, only two included an assessment of basic and instrumental ADL., Conclusion: MDS-UPDRS and the S&E scale were the only two scales that could be classified as recommended. For the MDS-UPDRS, either the full version or only Part II, which is focused on ADL, can be used. Future studies should explore the use of wearable devices to assess ADL remotely and more continuously., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Bouça-Machado, Fernandes, Ranzato, Beneby, Nzwalo and Ferreira.)

Child victims of sexual abuse may present with physical findings whose interpretation requires the most exhaustive evaluation and an accurate collection of a detailed history. Genital bleeding is usually considered as an acute sign, related to a trauma that occurred shortly before its appearance. We report a case of a 34-month-old child who was referred to the emergency room with a significant vaginal hemorrhage, originating from a wide laceration of the posterior fourchette, and a negative history for accidental trauma. The characteristics of the lesion, compared to the temporal evolution of the healing process, and the witnesses' depositions led us to assume that the time elapsed between the abusive event and the physical examination was longer in respect to what had appeared at the first sight. The judicial reconstruction of the events confirmed our assumption, allowing the charge of the right abuse perpetrator. As the literature regarding this eventuality is very poor, we report this case to stress the importance for physicians to consider that an active bleeding may be the manifestation of a trauma that occurred very long before.

The entities responsible for isolated vaginal bleeding are a broad spectrum of diseases. Vaginal bleeding in a prepubertal child is always treated as an alarming symptom both by parents and professionals. Most often, one of the first hypotheses is that a sexual abuse may be occurred and the clinical work up is oriented to explore it and eventually confirm or substantiante another diagnosis. Among the possible differential diagnosis urethral prolapse has to be considered. We report the case of a 6 years-old Caucasian girl referred to our Service for a mild vaginal bleeding and with the suspicion of sexual abuse, excluded after the confirmation of the presence of urethral prolapse. The clinical picture and workup are described and compared with a review of the international literature on the issue., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Background and Aims: Development of simple and accurate indicators of frailty is an important research goal in aging societies. One-leg standing balance (OLSB) has been proposed as a component of a clinical index of frailty., Methods: We analyzed relationships between results of OLSB testing and multiple health risk factors and impairment/disability indicators in a sample of elderly subjects (N=102) participating in the Anchyses Project. Subjects were aged >65, lived in a home for the aged in Rovigo, Italy, and had no ADL dependencies or recent acute illnesses., Results: More than half (53%) failed the OLSB test while 36% were able to balance without difficulty. Significant differences were observed among OLSB performance groups in forced vital capacity (p=0.025), dynamometry (p=0.001), age, physical activity, and IADL dependency (all p<0.001)., Conclusions: OLSB performance is a marker of frailty and thus a potentially useful predictor of functional decline.

Child abuse has recently been recognized by the World Health Organization as a major worldwide health problem impairing the health and welfare of children and adolescents. This paper attempts to look at child abuse from a public health perspective taking into account the vast cultural diversity in which children and adolescents live focusing on the issue of abuse and violence in a broad public health perspective, and trying to highlight the need for greater attention to be given to possible country-specific interventions.

The correlation between reduction of the coronal pulp cavity and chronological age was examined in a sample of 846 intact teeth from 433 individuals of known age and sex. Panoramic (rotational) radiography was used to measure the height (mm) of the crown (CH = coronal height) and the height (mm) of the coronal pulp cavity (CPCH = coronal pulp cavity height) of 425 premolars and 421 molars from 213 males and 220 females. The tooth-coronal index (TCI) after Ikeda et al. [1985] Jpn. J. For. Med. 39:244-250) was computed for each tooth and regressed on real age. The correlation coefficients ranged from -0.92 (molars, combined sample, right side) to -0.87 (female molars), with an S.E. of the estimate ranging from 5.88-6.66 years. Correlations were slightly higher in males than females. The equations obtained allowed estimation of age in a sample of 100 teeth from both sexes (not used for the regression) with an error of +/- 5 years in 81.4% of cases for male molars. The regression formulae for estimating age obtained from the recent sample were tested on a historical sample of 100 teeth from 100-year-old skeletons with an error of +/- 5 years in 70.3% of cases for male molars. This study illustrates the potential value of a little-known aging method which can be easily applied to estimate age in both living individuals and skeletal material of unknown age.