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The Ja-Kids Longitudinal Study (JA-Kids) aims to improve the health and development of Jamaican children by identifying social, demographic, environmental and clinical factors that help or hinder these processes. As clinical indicators relied on maternal reporting, we aim to evaluate the quality of the self-reported data. Women were recruited across Jamaica during pregnancy or at delivery from July 1–30 September 2011. Indicators were compared between women recruited while pregnant and at delivery to understand possible differences between the sub-populations. Variables reported more than once between pregnancy and delivery were assessed to evaluate level of agreement (reliability). Clinical indicators from the literature were contrasted with study findings to determine how maternal reporting align with published prevalence (validity). Intra-class correlation and the kappa (κ) statistic were used to assess reliability while chi-squared, Fisher's-exact or students-t were used to compare differences over time; p values ≤0.05 were considered statistically significant. Women recruited during pregnancy (n = 3970) were younger, less parous and possibly more socially disadvantaged than those recruited at delivery (n = 5803). Socio-demographic and selected clinical indicators showed good to moderate (0.421 < κ < 0.681) reporting consistency between pregnancy and delivery for previous C-section (κ = 0.681), pre-existing diabetes mellitus (κ = 0.616) and prior twin gestations (0.580). Most conditions however showed only fair agreement (0.21 < κ < 0.40) including previous gestational hypertension (κ = 0.387), asthma (κ = 0.365), premature rupture of membranes (κ = 0.324), eclampsia (κ = 0.257) and essential hypertension (κ = 0.213). Infectious conditions had poor reliability. Prevalence rates for most conditions, except sickle cell disease, were lower than the published literature. Complications and outcomes which were well defined for women were better reported than those requiring clinical judgment (e.g. prior C-section versus specific hypertensive disorders of pregnancy). NCDs with only episodic acute effects were not well reported, e.g. asthma, hypertension and sickle cell disease. Maternal reporting of pregnancy complications needs to be interpreted with caution. [ABSTRACT FROM AUTHOR]

Professionals with lived experience (LE) of mental distress might better understand service users, educate colleagues, and serve as role models. This exploratory quantitative study asked U.S. social work education leaders if they perceive positives and negatives of professionals having LE; what advice they would offer students with LE; and analyzed whether certain experiences influenced responses. Having LE and/or close relationships with people with LE was associated with perceiving positives, which was associated with advising students about using LE to help others. Perceiving negatives was associated with advising about difficulties. Implications are offered for preparing professionals to use LE in practice. [ABSTRACT FROM AUTHOR]

Gynecological examination has an very place among to maintain women's health. Negative attitudes and anxiety about gynecological examination may affect coming to the examination. In this study, we aimed to determine the effect of online training and counseling on women's attitudes and anxiety toward the gynecological examination. We randomized 100 women participating in the study into experimental and control groups. We concluded that online training and counseling had a positive effect on the attitudes of women in the experimental group toward gynecological examination. Also we determined that online training and counseling reduced women's state anxiety toward gynecological examinations. In this study, we determined that online training and counseling positively improved women's attitudes toward gynecological examination. We also found that online training and counseling reduced women's state anxiety about gynecological examinations. In the literature, most of the studies on gynecological examination have a descriptive design. This study is important since it contributes to scientific knowledge in determining the attitudes and anxiety levels of women that may affect their status of undergoing gynecological examination. [ABSTRACT FROM AUTHOR]

The incidence of paediatric fractures among winter sport athletes is not adequately studied. Our objective was to categorize fractures that occurred in paediatric skiers and snowboarders at a single ski resort. X-rays of 756 skiers/snowboarders aged 3–17 diagnosed with a fracture were categorized using the Salter-Harris (SH) classification. SH fractures were seen in 158 (21%) patients, with 123 (77%) being Type II. There were no significant differences between patients with a SH fracture and patients with a non-SH fracture for age, sex, snowboarding or skiing, mechanism of injury, terrain or the resort conditions on the day of injury. The most common mechanism of injury was falling onto snow while collisions resulted in more severe injuries. Compared to fractures without growth plate involvement, a higher proportion of SH fractures were seen in the humerus, radius, fibula and thumb; a lower proportion of SH fractures were observed at the tibia and clavicle. [ABSTRACT FROM AUTHOR]

Caregivers of people living with dementia (PLWD) are often tasked with making decisions about their loved one's daily care and healthcare treatment, causing stress and decision-making fatigue. Many caregivers engage in health information seeking to improve their health literacy for optimal decision-making, though there is limited knowledge about the strategies used to increase their health literacy. This study involved a survey of caregivers in Alabama, most of whom were African American and/or living in rural communities that have historically underserved. The findings shed light on caregivers' experiences in seeking out health-related information and their perceptions of various sources of information. [ABSTRACT FROM AUTHOR]

This study aimed to assess the effect of individualized enteral nutrition management based on the prognostic nutrition index (PNI) on surgical patients with oral malignancies. This quasi-experimental pilot study consecutively included patients diagnosed with oral malignancies who underwent radical surgery in Ningbo No. 2 Hospital between January 2020 and May 2023. The primary outcome was PNI. A total of 71 patients with oral malignancies were enrolled, and 35 patients received PNI-based individualized enteral nutrition management. The PNI group displayed significantly higher PNI than the routine enteral nutrition support group (1st week postoperatively: 39.86 ± 3.86 vs. 37.29 ± 4.23, p < 0.001. 2nd weeks postoperatively: 44.17 ± 4.36 vs. 40.72 ± 3.40, p < 0.001). The surgical suture removal time and length of hospital stay (both p < 0.001) in the PNI group were significantly shorter than in the routine enteral nutrition support group. At 1 month postoperatively, the PNI group had significantly higher scores of QoL (p = 0.002) than the routine enteral nutrition support group. The individualized enteral nutrition management based on the PNI could improve the nutritional status of postoperative patients with oral malignancy, which could facilitate postoperative rehabilitation and improve overall QoL. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the additional effects of perioperative immunonutrition (IMN) compared with preoperative immunonutrition (IMN) on anthropometric, nutritional, and biochemical parameters, hospital stay and postoperative complications in patients with colorectal cancer. Oral supplementation enriched with arginine, omega-3 fatty acids, and dietary nucleotides was given to 25 patients before and after the operation (Group 2); 25 patients received the same formula before surgery and standard isocaloric nutrition following the operation (Group 1). Postoperative body weight, body mass index (BMI), and middle upper arm circumference (MUAC) of Group 1 decreased more than Group 2 during follow-up (p < 0.05). The biochemical parameters, C-reactive protein (CRP), aspartate aminotransferase (AST) and fasting plasma glucose (FPG) were higher, and albumin was lower than the baseline in Group 1 compared to Group 2 (p < 0.05). There was a negative correlation between CRP and Nutrition Risk Screening (NRS) 2002 scores, and prealbumin and NRS 2002 scores had a positive correlation (p = 0.007, r = 0.384; p = 0.012, r = 0.352). There was no difference in hospital stay and postoperative complications between the groups (p > 0.05). Perioperative immunonutrition, compared to preoperative immunonutrition, can be used as a positive and effective approach in improving some anthropometric measurements and biochemical parameters in patients undergoing colorectal cancer surgery. [ABSTRACT FROM AUTHOR]

Background: The health measures imposed by COVID-19 on workplaces created adverse communication settings. Our cross-sectional study aimed to document the nature and severity of the vocal difficulties experienced by educational professionals a few weeks after the implementation of health measures in schools and early childhood settings in Quebec, Canada while teaching in class. Methods: To this end, we conducted a self-report survey containing nine close-ended questions and one open-ended question regarding self-reported vocal difficulties and the implementation of health measures. The survey was answered by 194 educational professionals in October 2020. Results: Since the introduction of the health measures, respondents reported often or always: having difficulty making themselves heard (66.5%), needing to strain their voice (68.1%), having throat pain after work (38.1%), and being concerned about their vocal health (25.2%). 35.6% perceived that their voice changed moderately or a lot and 75.3% did not feel equipped to take care of their vocal health. Fisher's exact tests revealed the difficulties overall were more present in women (p < 0.05). Discussion: The qualitative analysis of open-ended question answers shows a circular process at play, where the vocal responses to the COVID-19-induced communication barriers contribute to creating more problematic communication settings, thus increasing the challenges for vocal health. Better equipping the professionals to take care of their vocal health by developing resources in their professional settings to help them face vocal challenges in both every day as well as extreme situations, should be a priority. [ABSTRACT FROM AUTHOR]

Team climate and attributes of primary healthcare (PHC) are key elements for collaborative practice. Few researchers have explored the relationship between team climate and patients' perceptions of PHC. This study aimed to assess the association between team climate and patients' perceptions of primary healthcare attributes. A quantitative approach was adopted. In Stage 1, Team climate was assessed using Team Climate Inventory in 118 Family Health Strategy (FHS) teams at a PHC setting. In Stage 2, Patients' perceptions of PHC attributes were assessed using the Primary Care Assessment Tool (PCATool) in a sample of 844 patients enrolled in teams studied in Stage 1. Cluster analysis was used to identify team climate groups. The analysis used multilevel linear regression models. Patients assigned to teams with the highest team climate scores had the highest PHC attributes scores. Patients who reported affiliation at the team level had the highest PCATool scores overall. They also scored higher on the attributes of comprehensiveness and coordinated care compared to patients with affiliation to the health unit. In conclusion, patients under the care of FHS teams exhibiting a more favorable team climate had more positive patient perceptions of PHC attributes. [ABSTRACT FROM AUTHOR]

This study aimed to adapt a Spanish translation of the Oswestry Disability Index (ODI) into a cross-cultural version for the Mexican population. The objectives were to verify the validity and reliability of the adapted ODI and to compare pain perception between patients with and without obesity. We included 102 patients with low back pain from two neurosurgery departments in Mexico. The ODI questionnaire was translated and culturally adapted. Validity and construct were evaluated using exploratory factor analysis, and the external convergent validity was assessed by correlating ODI scores with pain intensity, age, and obesity. Test-retest reliability was calculated using the intraclass correlation coefficient, and confirmatory analysis was employed to validate the factorial structure. Patients with obesity were older and had higher pain scores than patients without obesity. The exploratory analysis of the ODI in Mexican Spanish showed good reliability (Cronbach's alpha of 0.923) and validity (factorial loading range, 0.681 − 0.818). The confirmatory analysis showed almost null or very low discrepancy between the proposed model and the real data. A Spanish translation of ODI was cross-culturally adapted for the Mexican population. The Mexican version of the ODI showed good reliability and validity in Mexican culture. The Oswestry Disability Index (ODI) is a widely used tool to measure physical disability in daily activities due to low back pain. A Spanish-language version has not been culturally adapted and validated for Mexican habits and lifestyle. This study describes the process of the Spanish ODI translation and cultural adaptation, showing it is a reliable and valid tool for assessing disability in patients with low back pain, with a good factorial structure. [ABSTRACT FROM AUTHOR]

Patient activation is associated with treatment adherence, self-accountability for healthcare and a healthy lifestyle change. Mobile health (m-Health) apps can lead to greater patient treatment adherence and health behaviour change. This study aimed to evaluate the health behaviour change of elderly people through a healthcare programme focused on activation with the support of technology. Three phases were conducted: (1) pre-intervention – design of the intervention protocol and the app, (2) intervention – randomised clinical trial with 41 overweight/obese elderly people. m-Health app-supported group psychotherapy was compared with group psychotherapy only and individual psychotherapy (control) and (3) post-intervention – statistical analysis, intervention's assistant interviews and app heuristics evaluation. By crossing the results, the study has shown that there was no significant difference in the activation level before and after intervention between groups. However, there was a significant increase from the initial mean score to the final one when considering the three groups together. Group therapy, whether with or without the support of the app, was more effective for behaviour change measured by the achievement of the goals, than individual psychotherapy. The lack of impact on group therapy with app support calls into question which and how much technology support is useful. [ABSTRACT FROM AUTHOR]

To evaluate the balance in patients with total knee arthroplasty (TKA) and knee osteoarthrosis (KOA), measured by postural stability computerized evaluation (PSCE), and to evaluate the effect of post-TKA patients' characteristics in their performance on PSCE. An observational cross-sectional study was conducted in two sets of patients: (A) patients with KOA and primary TKA surgery scheduled and (B) patients who underwent primary TKA >9 months. Sociodemographic, radiographic, clinical and PSCE parameters (using the Biodex Balance System) were assessed. Post-TKA patients placed more load on the replaced knee than the contralateral osteoarthritic knee (p = 0.027). They had less imbalance on the balance tests performed with the eyes open, on stable (p = 0.032), and unstable platforms (p = 0.022). These patients also showed better postural stability in monopodalic stance, both standing on the TKA (p = 0.010) and contralateral knee (p = 0.017). Age, weight, pain on the operated knee, extension deficit on the operated knee, and Berg Balance Scale scores on post-TKA patients were significantly associated with their performance on PSCE tests. PSCE can be useful to quantify the balance of post-TKA and KOA patients. Total knee arthroplasty is the definitive treatment for knee osteoarthrosis and it has several benefits, but its effect on balance is still unknown. Postural stability computerized evaluation is used to evaluate balance on vestibular diseases and it has been recently studied on musculoskeletal conditions. Postural stability computerized evaluation may be useful to evaluate patients' balance before and after total knee arthroplasty. [ABSTRACT FROM AUTHOR]

Objective: To evaluate requests for legal abortion due to pregnancies resulting from sexual violence (SV) in a reference service, and characterise and compare the outcome groups. Retrospective cohort study with review of medical records of women assisted between 2015 and 2020. The variables were socio-demographic and SV characteristics, gestational age, reactions towards pregnancy and outcome. We compared outcome groups using the chi-square test, Fisher's exact test and the Kruskal–Wallis test. The significance level was 5%. We evaluated the medical records of 235 women, of which 153(65%) had undergone to abortion; 17(7.2%) had a spontaneous abortion; 19(8%) remained pregnant; 25(10.6%) had an abortion denied; and 21(8.9%) had been lost to follow-up. Out of the total number of women, 44(18.7%) were adolescents, 152(65.2%) were white and 201(88.5%) had an education ≥9 years. Women who remained pregnant had a known aggressor, disclosed the pregnancy (p < 0.001) and were more ambivalent (p < 0.001) than the other groups. Gestational age was higher in the denied abortion group than in the performed abortion group (p < 0.001). Feelings related to decision-making about abortion affected all groups, with differences. It is important to give women space to be heard, so they can make their own decisions. Abortion care is possible in places with restrictive laws; however, women with more vulnerable characteristics did not seek the service. Legal restrictions interfere with women's decision-making about abortion and can promote inequality in gaining access to health services. [ABSTRACT FROM AUTHOR]

To examine whether extended compared to standard level of physiotherapy is feasible and has beneficial effects on physical function in ICU survivors. This prospective pilot study with a before and after design included patients discharged from ICU to a surgical ward. The comparison group were recruited between January and April 2019 and received standard level of physiotherapy. The intervention group were recruited between May and December 2019 and received extended physiotherapy, corresponding to 50% additional physiotherapist, working 4 hours per weekday. The intervention participants received an individual rehabilitation plan developed in collaboration with a ward-based physiotherapist, and an extended number of sessions provided by the extra resource included practicing individualized exercises, for example walking and stair climbing. Physical function was measured with the Chelsea Critical Care Physical Assessment tool (CPAx) at ICU discharge, during hospital stay and discharge. Group differences were analyzed using the Mann–Whitney U-test and Chi2 test. Out of 46 eligible patients, 39 (85%) fulfilled the study (comparison n = 12, intervention n = 27) and were included in the final analyses. No adverse events occurred, and the attendance rate was high (98.5%). There were no statistically significant differences between the groups regarding physical function, hospital stay, and readmissions, but there were tendencies to better outcomes in all these parameters in favor of the intervention group. Additionally, patients in the intervention group had statistically significantly higher scores in the CPAx items "transferring from bed to chair" (median 5 vs 4, p =.039) and "stepping" (median 5 vs 4, p =.005) at hospital discharge. This pilot study indicates that extended physiotherapy after ICU discharge is feasible and does not entail patient safety risks. However, determining the potential beneficial effects for the patients remains to be evaluated in a larger trial. [ABSTRACT FROM AUTHOR]

Coronavirus Disease 2019 (COVID-19) became a significant challenge for the work and personal experience of physiotherapists (PTs) To investigate how the work activities of PTs in a region in Italy have changed, describe the reasons for change, perceived competence, and effectiveness of professional education, and explore their personal experience We adopted a monocentric convergent mixed-methods light–questionnaire variant study. The questionnaire contains both closed-ended and open-ended questions. Quantitative and qualitative data were combined to interpret the results Among 78 respondents (response rate 24.4%), 87.2% worked during the pandemic, 52.9% treated patients with COVID-19, and 45.6% changed their working activities. Professional competence was perceived as low in intensive and sub-intensive care settings. The major critical aspect of professional education was respiratory rehabilitation. Life-learning education was judged as effective, even if mainly focused on safety. Nine themes emerged from the analysis of the PTs' experiences: 1) Physiotherapy during COVID-19; 2) Fear and negative feelings; 3) Positive aspects; 4) Organization and management; 5) Prevention measures; 6) Patients; 7) Change; 8) Information; and 9) Professional education PTs who have direct experience with patients with COVID-19 showed great resilience. They overcame the first phase of disorientation and fear, despite a specific lack of competence in the respiratory field. [ABSTRACT FROM AUTHOR]

The risk of injury in archery is supposedly low. However, relations between pain, shooting phases and types of bow have not been studied. Understanding the biomechanical mechanisms of archery-related injuries. Online survey for archers from all types of bow. Variables were analyzed using contingency tables and chi-squared tests. 396 surveys were completed. 36.9% of the archers had practiced archery for more than 10 years, 23.3% between 5 and 10 years. Olympic recurve bow was the most commonly used (38.2%), followed by traditional (23.3%) and compound (22.0%). 57.3% of the archers suffered some kind of injury during archery practice. Drawing shoulder (28.2%) and neck/back injuries (19.9%) were the most prevalent, preventing 50.3% of those who suffered them from continuing archery practice. There was a moderate association between drawing arm injuries and symptomatology in the drawing phase, especially in the shoulder region (0.55), elbow (0.20), and hand (0.13), and to a lesser extent in the neck/back (0.28). Our results show that injury chronicity is frequent on archery. Correlations between types of bow, phases of the shoot and areas of pain could be a starting point for future studies on the repercussions of different types of injuries in archery practice. [ABSTRACT FROM AUTHOR]

Adolescents with chronic illnesses face unparalleled challenges. To better understand these challenges and their impact on mental well-being, the Strengths and Difficulties Questionnaire Dysregulation Profile (SDQ-DP) was employed as a clinical assessment tool. The primary aim of our cross-sectional study conducted at a tertiary care center was to assess the prevalence of high SDQ-DP scores and its association with depressive symptoms, suicidal behaviors, and health-related quality of life (HRQoL) among adolescents aged 10–18 years diagnosed with various chronic illnesses. Among the 130 participants, 11.5% exhibited high SDQ-DP scores. Adolescents with high SDQ-DP scores displayed significantly higher rates of depression (aOR 12.37, 95% CI 2.15–71.19), suicidal ideation (aOR 18.68, 95%CI 2.72–128.33), suicidal plan (aOR 23.02, 95%CI 3.48–152.24), suicidal attempt (aOR 25.48, 95%CI 2.83–229.17) and diminished HRQoL (p < 0.001). This study has supported the correlation between high SDQ-DP scores and compromised mental well-being, highlighting the tool's clinical significance. [ABSTRACT FROM AUTHOR]

Early cardiac rehabilitation using non-invasive ventilation (NIV) and aerobic exercise may reduce the length of hospital stay in patients with heart failure (HF), however, there is still no evidence of this effect on patients in the intensive care unit (ICU). to investigate the effects of aerobic exercise (AE) performed simultaneously with non-invasive ventilation (NIV) on the length of intensive care stay (LICUS) in patients diagnosed with decompensated heart failure (HF) admitted to the intensive care units (ICU). Twenty-eight patients admitted to the intensive care unit (ICU) because of decompensation of HF were randomised into two groups: the intervention group (AE + NIV), and a control group. The intervention group's treatment strategy involved simultaneous AE with NIV daily. The control group performed non-simultaneous AE and NIV daily during their ICU stay. The primary outcome was LICUS. The secondary outcomes were the length of hospital stay, peripheral and respiratory muscle strength, functional status, functional classification, and exercise tolerance. The mean LICUS was shorter in AE + NIV than in the control group (6.3 ± 4.7 days vs 8.3 ± 3.6 days, respectively; p = 0.015). Secondary outcomes were similar between groups, except for exercise hemodynamics, which was improved in AE + NIV, as showed by the decreased diastolic blood pressure immediately after the exercise tolerance test. The use of AE simultaneous with NIV reduced the LICUS of patients admitted to the ICU because of decompensated HF. This innovative approach is a promising tool for accelerating ICU discharge during the in-hospital rehabilitation of patients with HF. [ABSTRACT FROM AUTHOR]

This article describes data on the gender distribution of mental health disorders among adolescents of Togo, West Africa. The sample size of this study included 242 patients. Gender and mental health disorders according to the definition of International Classification of Disease, tenth revision (ICD-10) were considered. Females were significantly more likely to develop a mental health disorder than males (61.16% vs 38.84% of the sample), and females were significantly 3 times more likely to develop Somatoform Disorders- Other Neurotic Disorders compared to males. Males were significantly 2 times more likely to develop Acute and Transient Psychotic Disorders. [ABSTRACT FROM AUTHOR]

This study was designed to evaluate the effect of selenium supplementation in inactive moderate-severe Graves' orbitopathy (GO) patients. This study was a single-center, placebo-controlled, double-masked, randomized trial. Inactive moderate-severe GO participants were randomized to receive six months of 200 micrograms/day of selenium supplementation or placebo. Thorough eye exams, clinical activity score (CAS), Graves' Ophthalmopathy quality of life questionnaire (GO-QOL), and serum selenium level were evaluated at baseline and 6 months after the interventions. The chi-squared or Fisher's exact test was used to compare categorical variables. The t-test and the paired t-test were used to compare continuous variables between two independent samples and two dependent samples, respectively. A total of 25 participants were enrolled, 13 in the selenium group and 12 in the placebo group. Both groups had adequate baseline serum selenium levels at 98.96 ± 15.63 mcg/L and 102.55 ± 17.71 mcg/L, respectively. After 6 months of intervention, the selenium group showed a greater improvement in palpebral aperture (mean difference: −1.4 ± 1.7 mm, p =.04) compared to the placebo group (−0.3 ± 2.7 mm). Notably, 5(41.67%) people in the placebo group developed larger palpebral apertures. Proptosis, ocular motility, and soft tissue signs did not change significantly. GO-QOL and CAS score improvement showed no statistically significant difference between both groups. Minor adverse effects were observed. Selenium supplementation has a positive effect on eyelid aperture even in inactive moderate-to-severe GO patients with a sufficient baseline selenium level. [ABSTRACT FROM AUTHOR]

Innovation is an organizational learning process that demands a reflexive perspective to take on uncertainties and question deeply held assumptions, propelling leadership and organizational structures forward. Discussions on the relationships between innovation and reflexivity predominantly focus on individuals rather than considering it a shared capability within an organization. This study elucidates the impact of reflexive-learning-based leadership development on promoting collective reflexivity, navigating its implications for organizational leadership and structures in innovation. A reflexive-learning-based leadership development program is a set of collective actions comprising four fundamental steps: acknowledging problems, reassessing assumptions, thinking of alternatives, and developing new perspectives. This study demonstrates its effectiveness in developing collective reflexivity within an engineering organization by repurposing the After-Action Review (AAR) as reflexive learning training. The findings underscore reflexive learning, making leaders exhibit the traits of ambiguity tolerance and interdisciplinary knowledge that favor innovation. This research contributes to an academic framework, opening avenues for future investigations into organizational development from a reflexive perspective and providing a proven managerial practice to improvise an effective solution to overcome those uncertainties in real-world innovations. [ABSTRACT FROM AUTHOR]

Without standard guidelines, there is a critical need to examine anal cancer screening uptake in the South which has the highest HIV incidence in the U.S. We identified factors associated with screening among men living with HIV (MLHIV) at a large academic HIV outpatient clinic in Alabama. Relationships between sociodemographic, clinical, sexual risk characteristics and screening were examined using T-tests, Fisher's exact, Chi-square, and logistic regression analyses. Unadjusted and adjusted odds ratios (AOR) were computed to estimate the odds of screening. Among 1,114 men, 52% had received annual anal cytology (pap) screening. Men who were screened were more likely to have multiple sexual partners compared to men who were not screened (22.8% vs. 14.8%, p = 0.002). Among men with one partner, the youngest were almost five times more likely to be screened compared to middle-aged men (AOR = 4.93, 95% CI: 2.34–10.39). Heterosexual men had lower odds and men who reported unprotected anal sex had higher odds of screening. Our findings suggest a racial disparity, with older black MLHIV being the least likely to be screened. In the South, MLHIV who are older, black, heterosexual, or live in high social vulnerability counties may be less likely to receive annual anal cancer screening. [ABSTRACT FROM AUTHOR]

Astragaloside IV (AST) has been confirmed to have antiasthmatic effects. However, the underline mechanism is unclear. The study aimed to explore the treatment mechanism of AST based on autophagy of memory T cells. AST treatment significantly decreased the number of T effector cells in asthma mice blood and the nude mice that received AST-treated TCMs had relieved inflammation compared with the untreated group; meanwhile, we found that AST significantly decreased the autophagy level and inhibited OX40/OX40L signal pathway of lymphocytes. The results highlighted that AST regulated autophagy to inhibit differentiation of effector T-cell phenotype. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of exercises by mechanical hippotherapy devices on postural control, balance, mobility, and Quality of Life in patients with stroke. This was a randomized controlled clinical trial with a total of 30 which were randomly divided into two groups. The participants in the mechanical hippotherapy group (MHG) (n = 15) were given exercises with a mechanical hippotherapy device for 15 min in addition to intensive conventional treatments (45 min), while the control group (CG) (n = 15) received additional 15 min of postural control and balance exercises for five days per week for four consecutive weeks. The primary outcome was The Berg Balance Scale (BBS). Secondary outcomes were the Fugl–Meyer (FM) Rating Scale, Biodex Balance Measurement (BBM), Trunk Impairment Scale (TIS), the Timed Up and Go Test (TUG) and quality of Life Short Form (SF-36). In the MHG, FM-Lower extremity score (−6.4, p = 0.024), FM-Upper extremity score (−12.87, p = 0.013), TIS (−5.87, p = 0.04) and TUG (5.73, p = 0.027) improved statistically significant compared to CG. Exercises using mechanical hippotherapy devices could improve postural control, functional mobility and balance in patients with stroke. It may also improve the quality of life. NCT03528993 NCT03528993 It was concluded from our results that mechanical hippotherapy could be included in the treatment programs of stroke patients. [ABSTRACT FROM AUTHOR]

Orthotic devices may be prescribed for the management of foot and ankle deformities caused by Charcot-Marie-Tooth disease (CMT). However, the actual use of these devices is variable. No studies have evaluated the impact of prescription, delivery and follow-up of orthotic devices on their use. We aimed to describe the relationship between the pathways followed by individuals with CMT and orthotic device use. Exploratory, cross-sectional, 35-item survey of orthotic device management. Individuals with CMT were recruited from CMT-France Association. Of the 940 respondents, 795 were included, mean age of 52.9 (SD 16.9) years. Rate of orthotic device use was 49.2% (391/795). The most frequent reason for non-use was a poor fit. Non-use was related to the orthotic device type, the health professionals consulted, and the severity of the CMT-related impairments. Follow-up visits (38.7%), re-evaluation of orthotic devices (25.3%) and consultations with the Physical and Rehabilitation Medicine physician were infrequent (28.3%). Orthotic devices are massively underused. Follow-up and re-evaluation are infrequent. Care pathways, prescription and delivery of orthotic devices must be optimized to meet the expectations of people with CMT. Device fitting, individual needs, and changes in the clinical state must be re-evaluated regularly by specialists to improve orthotic device use. Foot deformities and foot drop contribute to disability in people with Charcot Marie Tooth Disease but use of orthotic devices is poor. To improve orthotic device use, regular multidisciplinary consultations and regular re-evaluation of the device by specialists in neuro-orthopaedics are important. The device fit should be regularly re-evaluated by the prescribing doctor or the practitioner who made the device. Regular multimodal evaluation of foot deformity, including muscle strength and length, and the individual's needs and expectations is also important to improve orthotic device use. [ABSTRACT FROM AUTHOR]

Patients with systemic sclerosis (SSc) are at high risk for pulmonary and vascular complications. Smoking is an important risk factor for respiratory symptoms and vascular complications of many diseases in the general population. However, studies on the role of smoking in SSc are insufficient. This study aimed to compare pulmonary function, respiratory symptoms, functional level, and health-related quality of life (HRQoL) in patients with SSc according to smoking status and to assess the correlation between cigarette consumption and these parameters in patients with SSc. Seventy-two patients with SSc (smoker group; n = 35 or nonsmoker group; n = 37) were included. The pulmonary function test was measured with a spirometer. Respiratory symptoms were questioned and the perceived severity of dyspnea and fatigue was evaluated. The functional levels were determined by questioning the patients' average daily walking distance, exercise habits, and daily sedentary time. HRQoL was assessed by Scleroderma Health Assessment Questionnaire. The rate of respiratory symptoms including dyspnea, cough, and sputum were higher in the smoker group (p<.001, p =.041, and p<.001, respectively). Also, the perceived severity of dyspnea and fatigue was higher in the smoker group (p <.05). The mean daily walking distance, exercise habits, and overall HRQoL were lower (p =.004, p =.002, and p =.034, respectively) and the sedentary time and vascular complications were higher (p<.001 and p =.038, respectively) in the smoker group. However, there was no significant difference between the two groups in terms of the pulmonary function test (p >.05). There was a weak to moderate correlation between cigarette consumption and respiratory symptoms, dyspnea and fatigue severity, functional level, and HRQoL in the smoker group (0.001 ≤ p ≤.024). Smoking may increase respiratory symptoms and vascular complications and decrease the functional level and HRQoL in patients with SSc. To maintain functional independence in patients with SSc, awareness of the harms of smoking should be increased and smoking cessation should be encouraged, along with physiotherapy and rehabilitation programs including exercise and physical activity recommendations. [ABSTRACT FROM AUTHOR]

Elderly individuals with neurodegenerative diseases, such as Parkinson's disease (PD), may experience difficulties when performing functional tasks. To analyze the handgrip strength, pulling force, and ground reaction forces (GRF) of individuals with and without PD when boarding a bus while performing both simple (ST) and dual tasks (DT). This case-control study addressed 31 individuals with PD (GPD) and 30 healthy individuals (GHI). Assessments were performed in ST and DT situations using a bus model (prototype). Handgrip strength and pulling force were measured in both upper limbs using a dynamometer, and GRF was measured using a force platform. The GPD's and GHI's performances were compared in both ST and DT, and the individuals were classified as fallers according to the Falls Efficacy Scale. In the inter-group comparison, the GPD presented significantly lower maximum force using their right hand, in handgrip strength (30.43 vs. 36.62, P =.022), and pulling force (10.77 vs 12.81, P =.037). The left hand's pulling force proved to be the most demanding for the GPD, during ST (6.35 vs. 4.76, P =.006) and DT (6.32 vs 4.74, P =.008). The GPD also took longer to perform ST (6.14 vs. 4.67, P <.001) and DT (6.08 vs. 4.81, P =.002). Additionally, the GPD was more afraid of falling compared to the GHI (34.74 vs. 24.77, P <.001). Boarding a bus is a complex task for individuals with PD because they present lower maximum strength in the upper limbs and more significant functional expenditure than their healthy counterparts. [ABSTRACT FROM AUTHOR]

The aim is to pilot a low-touch program for reducing benzodiazepine receptor agonist (BZRA; benzodiazepines, z-drugs) prescriptions among older veterans. Pilot randomized controlled trial consists of 2,009 veterans aged ≥ 65 years who received BZRA prescriptions from a Veterans Health Administration pharmacy (Colorado or Montana) during the prior 18 months. Active: Arm 1 was a mailed brochure about BZRA risks that also included information about a free, online cognitive behavioral therapy for the insomnia (CBTI) program. Arm 2 was a mailed brochure (same as arm 1) and telephone reinforcement call. Control: Arm 3 was a mailed brochure without insomnia treatment information. Active BZRA prescriptions at follow-up (6 and 12 months) were measured. In logistic regression analyses, the odds of BZRA prescription at 6- and 12-month follow-ups were not significantly different for arm 1 or 2 (active) versus arm 3 (control), including models adjusted for demographics and prescription characteristics (p-values >0.36). Although we observed no differences in active BZRA prescriptions, this pilot study provides guidance for conducting a future study, indicating a need for a more potent intervention. A full-scale trial testing an optimized program would provide conclusive results. Mailing information about BZRA risks and CBTI did not affect BZRA prescriptions. [ABSTRACT FROM AUTHOR]

The Human Immunodeficiency Virus (HIV) epidemic remains a major public health issue worldwide. In Vietnam, the HIV epidemic is essentially driven by people who inject drugs (PWID). This study aims to compare mortality and loss to follow-up (LTFU) between PWID and other patients. From June 2017 to April 2018, HIV-infected adults were enrolled in a prospective cohort from time of ART initiation in six provinces of North Vietnam. The end date was July 2020. Mortality and LTFU were described using competing-risk survival models. Factors associated with mortality and with LTFU were identified using Cox models with a competing-risk approach. Of the 578 participants, 261 (45.2%) were PWID and almost exclusively male. 49 patients died, corresponding to a mortality rate (95% confidence interval (CI)) of 3.7 (2.8–4.9) per 100 person-months, and 79 were lost to follow-up, corresponding to a rate (95% CI) of 6.0 (4.8–7.4) per 100 person-months. PWID were at higher risk of death but not of LTFU. Overall, LTFU was high in both groups. Latecomers to clinical visits were more at risk of both death and LTFU. Therefore, this should be a warning to clinical teams and preventive actions taken in these patients. Trial registration: ClinicalTrials.gov identifier: NCT03249493.. [ABSTRACT FROM AUTHOR]

To evaluate the immediate and 4-week effects of compression garments (CG) on balance using a force platform during 8 different visual, static, and dynamic conditions in hypermobile Ehlers-Danlos Syndrome (hEDS) patients. Thirty-six participants were randomly assigned to a group: physiotherapy alone (PT, n = 19) or physiotherapy and daily CG wearing for 4 weeks (PT + CG, n = 17). Both attended 12 physiotherapy sessions (strengthening, proprioception, and balance exercises) for 4 weeks. Primary outcome: sway velocity of the centre of pressure (COP) measured before, immediately with the CG, and at 4 weeks. Secondary outcomes: ellipse area, Romberg quotient, and pain. Sway velocity in dynamic conditions decreased immediately with the CG. After 4 weeks of intervention, sway velocity (95% CI 4.36–39.23, effect size 0.93) and area (95% CI 146–3274, effect size 0.45) on the laterally oscillating platform with eyes-closed improved more in the PT + CG group than the PT group. Romberg quotient on foam cushion improved more in the PT + CG than the PT group. Pain decreased in both groups after 4 weeks with no between-group difference. CG combined with physiotherapy improved dynamic balance measured with COP variables significantly more than physiotherapy alone in people with hEDS. NCT03359135 Compression garments immediately improve balance in people with hypermobile Ehlers-Danlos Syndrome (hEDS) Compression garments combined with regular physiotherapy improve balance in people with hEDS after 4 weeks of treatment Compression garments could compensate for proprioceptive impairment in hEDS [ABSTRACT FROM AUTHOR]

To evaluate the efficacy of environment-based intervention on participation outcomes and parent efficacy in autistic children. Twenty-one autistic children 6–10 years old and their parents were randomized to environment-based intervention (n = 11) or usual care (n = 10). The environment-based intervention targets individualized participation goals in leisure and community activities through changing environment and activity demands. The study outcomes were Canadian Occupational Performance Measure (COPM), Goal attainment scaling (GAS), and Parent Empowerment and Efficacy Measure (PEEM). Assessments included baseline, 12 weeks (post-test), and 24 weeks (follow-up). Mixed ANOVAs were used to examine within-group and between-group effects in outcome variables. The COPM performance and satisfaction scores and GAS T-scores increased after environment-based intervention from baseline to 12 weeks and 24 weeks (p < 0.001) but did not significantly differ from usual care. The medium to large effect sizes of COPM performance and GAS T-scores favored the environment-based intervention. For the PEEM scores, no significant differences were found. Environment-based intervention may support school-age autistic children to participate in self-chosen activities over time. The intervention effects on participation goals and parent efficacy, however, were inconclusive and need further research. Environmental barriers are important attributes to participation restriction in autistic children. Interventions focusing on modifying the task and environment is viable in supporting the participation of autistic children. The environment-based intervention appears to improve the participation goals in leisure and community-based activities over time. The environment-focused strategies may include providing social support, enabling access to a sensory-friendly environment, finding inclusive programs, adapting task demands, and managing routines. [ABSTRACT FROM AUTHOR]

Cervical arterial dissection (CAD) is an important cause of stroke in young people which may be missed because early features may mimic migraine or a musculoskeletal presentation. The study aimed to develop a diagnostic support tool for early identification of CAD. Retrospective observational study Tertiary hospital Radiologically confirmed CAD cases (n = 37), non-CAD stroke cases (n = 20), and healthy controls (n = 100). The presence of CAD is confirmed with imaging. Predictive variables included risk factors and clinical characteristics of CAD. Variables with a p-value <0.2 included in a multivariable model. Predictive utility of the model is assessed by calculating area underthe ROC curve (AUC). The model including four variables: age 40–55 years (vs < 40), trauma, recent onset headache, and > 2 neurological features, demonstrated excellent discrimination: AUC of 0.953 (95% CI: 0.916, 0.987). A predictive scoring system (total score/7) identified an optimal threshold of ≥ 3 points, with a sensitivity of 87% and specificity of 79%. The study identified a diagnostic support tool with four variables to predict increased risk of CAD. Validation in a clinical sample is needed to confirm variables and refine descriptors to enable clinicians to efficiently apply the tool. Optimum cutoff scores of ≥ 3/7 points will help identify those in whom CAD should be considered and further investigation instigated. The potential impact of the tool is to improve early recognition of CAD in those with acute headache or neck pain, thereby facilitating more timely medical intervention, preventing inappropriate treatment, and improving patient outcomes. Wordcount: 3195 [ABSTRACT FROM AUTHOR]

Exercise protects against somatic comorbidities and positively affects cognitive function and psychiatric symptoms in patients with severe mental illness. In forensic psychiatry, exercise is a novel concept. Staff at inpatient care facilities may be important resources for successful intervention. Little is known about staff's knowledge, attitudes and behaviors regarding exercise in forensic psychiatric care. To translate, culturally adapt and test the feasibility of the Exercise in Mental Health Questionnaire-Health Professionals Version (EMIQ-HP) in the Swedish context, and to use this EMIQ-HP-Swedish version to describe staff's knowledge, attitudes and behaviors regarding exercise. The EMIQ-HP was translated, culturally adapted, pilot-tested and thereafter used in a cross-sectional nationwide survey. Ten of 25 clinics and 239 health professionals (50.1%) participated. Two parts of the EMIQ-HP-Swedish version showed problems. Most participants considered exercise to be a low-risk treatment (92.4%) that is beneficial (99.2%). Training in exercise prescription was reported by 16.3%. Half of participants (52.7%) prescribed exercise and 50.0% of those undertook formal assessments prior to prescribing. Creation of the EMIQ-HP-Swedish version was successful, despite some clarity problems. Exercise appears to be prescribed informally by non-experts in Swedish forensic psychiatric care and does not address treatment goals. [ABSTRACT FROM AUTHOR]

This study aimed to determine the prevalence of dizziness and its associated factors in patients with COM at two otologic referral centres in a middle-income country. Cross-sectional study. Adults with and without COM diagnosis from two otology-referral centres in Bogotá (Colombia) were included. Dizziness and quality of life were assessed using the "Chronic Suppurative Otitis Media Questionnaire-12" (COMQ-12), and sociodemographic questionnaires were applied. Otoscopic evaluation and audiometric data were collected. A total of 231 adults. Of the 231 participants, up to 64.5% (n = 149) reported at least mild inconvenience due to dizziness. Factors associated with dizziness included female sex (aPR: 1.23; 95% CI: 1.04–1.46), chronic suppurative otitis media (aPR: 3.02; 95% CI: 1.21–7.52), and severe tinnitus (aPR: 1.75; 95% CI: 1.24–2.48). An interaction was found between socioeconomic status and educational level, with more frequent reports of dizziness in the middle/high economic status and secondary education (aPR: 3.09; 95% CI: 0.52–18.55; p < 0.001). Differences of 14 points in symptom severity and 18.5 points in the total score of the COMQ-12 were found between the groups with dizziness and without dizziness. Dizziness was frequent in patients with COM and was associated with severe tinnitus and quality of life deterioration. [ABSTRACT FROM AUTHOR]

To solicit information/suggestions from prostate cancer survivors to improve survivorship experiences specific to work/workability. The study employed a qualitative/phenomenological approach. Black/African-American and white prostate cancer survivors who: (1) had prostatectomy or radiation therapy 6–36 months prior, (2) were working for pay within 30 days before having treatment, and (3) expected to be working for pay 6 months later (n = 45) were eligible for this study. Survivors were engaged in 60-to-90-minute structured interviews. Content analysis was used to ascertain prominent themes. Participants had the following recommendations for survivors: ask about research on treatment options and side effects; speak with other survivors about cancer diagnosis; and inform family/friends and employers about needed accommodations. Considerations for family/friends emphasized the significance of instrumental (e.g. help finding information) and emotional support (e.g. encouragement). Employer/co-worker considerations most often related to work-related accommodations/support and avoiding stigmatization of the survivor. Considerations for healthcare providers commonly included the provision of unbiased, plain-language communication about treatment options and side effects. No major differences existed by race. Needs of employed PrCA survivors, regardless of their race or treatment type, are commonly related to their desire for informational, instrumental, and/or emotional support from family/friends, employers/co-workers, and healthcare providers. The requested supports are most often related to the side effects of prostate cancer treatment. [ABSTRACT FROM AUTHOR]

Background: Transgender individuals are known to be at a higher risk for certain chronic conditions compared to cisgender individuals. Similarly, research also shows justice-involved individuals have a higher risk of chronic conditions compared to non-justice-involved individuals.Aim: This study aims to investigate the differences in chronic disease diagnoses between transgender and cisgender individuals who either utilized healthcare services provided by a US county health system or who were incarcerated in the same county’s jail. Method: We leveraged electronic health record data from a United States county health system, including data from the local jail, to evaluate the difference in diagnosis of certain chronic conditions among transgender and cisgender individuals. We also compared individuals who experienced incarceration and those who did not. Results: We found transgender individuals experiencing recent incarceration were more likely to be diagnosed with substance use disorder, HIV/AIDS, and Hepatitis C than cisgender individuals. Transgender individuals not experiencing recent incarceration were more likely to be diagnosed with HIV/AIDS, seizure disorder, major depressive disorder, and bipolar disorder than cisgender individuals. Conclusion: These results highlight how transgender individuals may be disproportionately impacted by certain diseases within and outside carceral settings. [ABSTRACT FROM AUTHOR]

The use of donated expressed breast milk (DBM) is encouraged in South Africa, with donor milk banks and legislated policies and programmes available in hospitals serving populations with a high HIV prevalence. Concerns over poor attitudes amongst mothers towards DBM seem to persist. A cross-sectional mixed-methods approach was used in a cohort of mothers of neonates in a regional hospital. Between April 2021 and January 2022, survey data on knowledge, awareness and attitudes towards DBM was collected. Qualitative data from open-ended questions were thematically analysed. Comparative analysis using independent sample t-tests and logistic regression to determine differences in variables and to understand associations related to knowledge was conducted. A total of 163 mothers with a mean (SD) age of 27.1 ± 6.3 years were included; 49.7% of mothers had post-high-school qualifications, 82.8% were unemployed and 87.0% received social security. Some 64.4% had inadequate knowledge of DBM. Awareness of DBM had the strongest association with better knowledge concerning DBM and AdjOR (25.25 95% CI 10.60–68.40; p < 0.001). Negative attitudes towards DBM were largely driven by a lack of knowledge regarding human immunodeficiency virus (HIV) screening of donor mothers and fears of HIV transmission when using DBM. Lack of awareness concerning DBM was associated with poor knowledge of DBM, which may drive poor uptake of this critical nutritional source for at-risk neonates. Implementing targeted awareness programmes on DBM, which begin in the antenatal period and specifically address HIV screening of donor mothers, could address the poor uptake of DBM. [ABSTRACT FROM AUTHOR]

Ovarian cancer is considered the most fatal and costly gynecologic cancer. Although personalized therapies have improved ovarian cancer prognosis, they have resulted in increased financial toxicity concerns among this population. This study evaluated financial toxicity in patients with advanced ovarian cancer. Using secondary data from a study of barriers to palliative care, financial toxicity (FT) was measured through the Comprehensive Score for Financial Toxicity scale. Univariate and bivariate analyses were used to assess the relationship between selected demographic (i.e., age, race, ethnicity, education, place of birth, insurance type, yearly household income, employment status) and treatment-specific variables (i.e., years since diagnosis, surgery, chemotherapy, radiation, hormonal and targeted therapy) with clinically relevant financial toxicity. Characteristics were compared using Fisher's exact or chi squared tests. A total of 38 participants with advanced ovarian cancer were included in this study; 24% (n = 9) reported clinically significant FT. Income (p =.001), place of birth (p =.048) and employment status (p =.001) were related to FT. Study findings highlight that advanced ovarian cancer patients experience high FT, particularly those with low income, who are not able to work and were born outside the US. Further research using larger datasets and more representative samples is needed to inform intervention development and implementation. [ABSTRACT FROM AUTHOR]

Evaluate the potential of a wheelchair assistive technology (StandBar) to promote power wheelchair users' ability to safely stand independently from their power wheelchair and determine the impact of the device use on psychological well-being for both power wheelchair users and their caregivers. A convenience sample of 11 power wheelchair users and caregiver dyads provided study data. Participants included power wheelchair users who were existing StandBar users or currently in training with the StandBar as part of their rehabilitation. Assessments were conducted at baseline and at six-month follow-up and included physiological assessments and functional testing with and without the StandBar. Monthly follow-up phone calls were completed to collect information on adverse events (e.g., falls, hospitalizations, and skin breakdown). A qualitative interview assessed StandBar users' and caregivers' perception at six-month follow-up. StandBar use provided power wheelchair users a higher level of independence, confidence, and safety. All participants highly recommended StandBar use to others with similar levels of functional impairment. StandBar use allowed many participants the ability to complete functional tasks that were otherwise not possible without assistance. Qualitative interviews reported improved independence and psychological well-being for StandBar users as well as reduced levels of anxiety and burden of care by caregivers. The StandBar is a cost-effective assistive technology that promotes independence and functionality for power wheelchair users and improves the psychological well-being of users and their caregivers. StandBar allows power wheelchair users to: Minimize negative effects of immobilization. Increase independence for activities of daily living (grooming, hygiene, toileting, transfers) and instrumental activities of daily living (social experiences). Improve their quality of life through increasing independence and confidence. Reduce need for assistance and corresponding caregiver burden. [ABSTRACT FROM AUTHOR]

Bladder and bowel poststroke dysfunctions negatively impact patients' health. Stroke-related characteristics associated to these dysfunctions are poorly known. This study aims to estimate the prevalence of new-onset poststroke bladder and bowel dysfunctions, characterize their associated factors, and describe the dysfunctions' clinical approach. Cross-sectional study including 157 patients admitted to a single hospital's stroke unit with a first-ever stroke, during 3 months. An 18-item questionnaire was applied to assess dysfunctions pre and poststroke. The McNemar test was used to compare pre and poststroke prevalence. A logistic regression was used to estimate associations (OR, 95% CI) between individual characteristics and new-onset dysfunctions. We had 113 (72%) respondents. There was a significant increase in the prevalence of bladder and bowel dysfunctions poststroke (p < 0.001). Higher stroke severity was significantly associated with both new-onset poststroke bladder and bowel dysfunctions (OR = 15.00, 95% CI [4.92,45.76] and OR = 5.87,95%CI [2.14,16.12], respectively). Total anterior circulation strokes, cardioembolic strokes, and lower functionality at discharge were also significantly associated with both dysfunctions. Thirteen patients (11.5%) reported that health professionals addressed these dysfunctions. Poststroke bladder and bowel dysfunctions are highly prevalent. Being aware of their epidemiology helps draw attention to patients at higher risk of developing these dysfunctions, enhancing the rehabilitation process. Poststroke bladder and bowel dysfunctions are highly prevalent and under-recognised consequences of stroke. Being aware of their epidemiology and associated factors may help identify patients at higher risk of developing these dysfunctions. It is necessary to raise clinical awareness to ensure a more efficient diagnostic and therapeutic approach, enhancing patients' rehabilitation process, quality of life and lowering collateral societal burden. [ABSTRACT FROM AUTHOR]

Verbal and oral apraxia are two possible consequences of stroke. It seems that there are not sufficient studies regarding the frequency of these disorders. This study aimed to evaluate the frequency of Verbal and oral apraxia. In addition, the relationship between apraxia and some variables such as age, gender, and education, as well as the relationship between types of apraxia with each other, and damaged areas of the brain in apraxia of the oral system in Persian-speaking patients with stroke were studied. In this descriptive-analytical study, 42 patients participated using the convenient sampling method. Verbal and oral apraxia were assessed using the oral and verbal apraxia tasks for adults test. Data were analyzed using independent t-test, Chi-square, and Fisher's exact test. The frequency of patients with oral apraxia was 35.7%, those with verbal apraxia was 2.3%, and the combination of both verbal and oral apraxia was 4.7%. People with apraxia were significantly older than those without apraxia. There was not any significant relationship between apraxia and gender, apraxia and education, and oral apraxia with verbal apraxia (p < 0.05). The present study's findings showed the high frequency of post-stroke apraxia and the high rate of its incidence with age. [ABSTRACT FROM AUTHOR]

Self-medication is the use of drugs to treat self-diagnosed illnesses or symptoms, on one's own initiative, without the guidance of a healthcare professional. Poison centers play an important role in understanding the relationship between self-medication and poisoning. The objective of this study is to evaluate the clinical and epidemiological profile of patients exposed to and/or poisoned by different drugs through self-medication. This retrospective, cross-sectional, and descriptive study analyzed data from 2014 to 2020, provided by the Toxicological Information and Assistance Center of Santa Catarina, Brazil. Data were selected, tabulated, and analyzed by using descriptive statistics and group comparison with the chi-square test or Fisher's exact test. A P value <0.05 was considered statistically significant. There were 683 cases of self-medication identified. Most patients were female (62.8 percent) and between 20 and 29 years old (26.1 percent). A toxic dose of a substance was administered in only 22.8 percent of the cases, and five deaths were recorded. The most commonly used medications were anxiolytics (18 percent), followed by analgesics and antipyretics (15.4 percent). Paracetamol was the drug used in three of the five cases that resulted in deaths. This study demonstrates the prevalence of self-medication among women aged between 20 and 29 years old. Statistical analysis failed to show a relationship between a toxic dose and clinical manifestations. Anxiolytics, analgesics, and antipyretics are the most reported medications probably because healthcare professionals are mostly the ones who contact the center. Analgesics and antipyretics account for more than fifty percent of the deaths caused by self-medication in the present report. Some limitations such as secondary sources are related. We highlight the importance of health professionals in promoting the rational use of medicines, as well as poison centers in assisting the population and raising their awareness regarding the issue. [ABSTRACT FROM AUTHOR]

Microbial keratitis (MK) is a potentially blinding corneal disease caused by an array of microbial etiologies. However, the lack of early organism identification is a barrier to optimal care. We investigated clinician confidence in their diagnosis of organism type on initial presentation and the relationship between confidence and presenting features. This research presents secondary data analysis of 72 patients from the Automated Quantitative Ulcer Analysis (AQUA) study. Cornea specialists reported their confidence in organism identification. Presenting sample characteristics were recorded including patient demographics, health history, infection morphology, symptoms, and circumstances of infection. The association between confidence and presenting characteristics was investigated with 2-sample t-tests, Wilcoxon tests, and Chi-square or Fisher's exact tests. Clinicians reported being "confident or very confident" in their diagnosis of the causal organism in MK infections for 39 patients (54%) and "not confident" for 33 patients (46%). Confidence was not significantly associated with patient demographics, morphologic features, or symptoms related to MK. MK cases where clinicians reported they were confident, versus not confident in their diagnosis, showed significantly smaller percentages of previous corneal disease (0% versus 15%, p = 0.017), were not seen by an outside provider first (69% versus 94%, p = 0.015), or had no prior labs drawn (8% versus 33%, p = 0.046), and a significantly larger percentage of cases wore contact lenses (54% versus 28%, p = 0.029). In almost half of MK cases, cornea specialists reported lack of confidence in identifying the infection type. Confidence was related to ocular history and circumstances of infection but not by observable signs and symptoms or patient demographics. Tools are needed to assist clinicians with early diagnosis of MK infection type to expedite care and healing. [ABSTRACT FROM AUTHOR]

The main objective of this study was to explore the benefits of the use of educational audio-visual materials in facilitating learning for students with hearing loss. The study analysed whether students with hearing loss had a visual learning preference when they watched an audio-visual and if the images present contributed to the retention of more information by this group. The study sample was made up of 28 participants, from 7 to 9 years old, of whom 14 had prelingual hearing loss and 14 were age- and sex-matched students without hearing loss. They were all schooled together in general education classrooms in an oral modality. They were asked to watch an educational video and then to describe its contents orally. The results obtained from analysing the references to the video content indicate that, despite the fact that the hard of hearing group made greater reference to video content transmitted from the images than the group without hearing loss, the effect does not achieve statistical significance. The study reinforces the idea that deafness does not determine a specific learning preference. [ABSTRACT FROM AUTHOR]

The lack of objective prognostication tools for severe traumatic brain injury (TBI) causes variability in the application of withdrawal of life-saving treatment (WLST). We aimed to determine whether WLST in persons with severe TBI is associated with known indicators of poor prognosis. This retrospective descriptive study focused on adult (18–64 years) and geriatric (≥65 years) patients with severe TBI who were admitted between August 1, 2018 and July 31, 2021 at a Level I trauma center and subsequently underwent WLST. The data collected from the Trauma Registry and electronic health records included information regarding demographic characteristics, injury severity, clinical variables, and length of hospital stay and were used to examine the indicators of poor prognosis and WLST. Among the 164 participants with TBI who met the inclusion criteria, 61.0% were geriatric, and 122 (74.4%) patients had 0 or only 1 of the poor prognostic indicators prior to WLST. The non-geriatric group had more indicators of poor prognosis than the geriatric group. Participants with fewer indicators of poor prognosis had a longer length-of-stay. In severe TBI cases, standardized prognostication tools can help guide informed WLST decisions, particularly in geriatric patients, improving care consistency. [ABSTRACT FROM AUTHOR]

To investigate the influence of visual contextual information on emotion recognition of ambiguous facial expressions in depression and schizophrenia spectrum disorders. Method: Ambiguous facial expressions and emotional contexts representing anger, disgust, fear, joy, sadness and surprise were validated in a pre-test with healthy independent raters. Afterwards, 20 healthy participants (8 women, 12 men; mean age 24.35 ± 2.85 years), 20 participants with schizophrenia spectrum disorders (9 women, 11 men; mean age 40.25 ± 11.68 years) and 19 participants with depression (11 women, 8 men; mean age 43.74 ± 12.65 years) rated the emotional content of nine different faces in seven different emotion-suggesting contexts. The proportions of context-congruent answers and differences between emotion ratings in each context were analysed using non-parametric Kruskal-Wallis and explorative, paired Wilcoxon tests. Correlational analyses explored the influence of clinical symptoms assessed by clinician-administered scales. Results: The overall proportion of context-congruent answers did not differ between participants with depression and schizophrenia spectrum disorders compared to healthy participants. Participants with schizophrenia spectrum disorders were more susceptible to anger-suggesting contexts and participants with depression were more susceptible to fear-suggesting contexts. Differences in emotion recognition were associated with the severity of depressive, but not psychotic, symptoms. Conclusion: Despite increased susceptibility to anger-suggesting cues in schizophrenia and to fear-suggesting cues in depression, visual contextual influence remains largely consistent with healthy participants. Preserved emotional responsiveness suggests an efficacy of emotion training but emphasizes the need for additional research focusing on other factors contributing to social interaction deficits. [ABSTRACT FROM AUTHOR]

Babbling is an important precursor to speech in infancy, and deviations from the typical babbling development can predict later difficulties in speech, language, and communication. This cross-sectional study aimed to investigate babbling and early speech in Swedish extremely premature infants. Samples of babbling were collected from 20 extremely premature infants (EPT group) at the corrected age of 12 months. Data collection was home-based and consisted of an audio-video recording of each infant playing with a parent. Presence of canonical babbling (CB), and three oral stop variables distinctive of typical babbling, and consonant inventory were assessed. The assessment was performed during a standardised observation of babbling. Data from the EPT group were compared to previously collected data of a reference group of 20 10-month-old infants without known medical diagnoses. The results showed that the EPT group had a lower proportion of infants producing CB, and that they used a significantly smaller consonant inventory compared to the reference group. Although not statistically significant, oral stops were less frequently found in the EPT group. The findings of a restricted consonant inventory and low proportion of CB in the EPT group are not surprising considering that the group has been found to be at risk of speech and language delay in toddlerhood. Still, further research is needed to explore whether babbling at 12 months can predict speech and language skills at an older age in extremely premature infants. [ABSTRACT FROM AUTHOR]

Background: During the ongoing opioid epidemic, Cuyahoga County (second largest in Ohio) reported overdose mortality rates (54/per 100,000) higher than the national average. Prior research demonstrates that people who use drugs often use alone but there is minimal research on people who died of overdose while using alone. The objective of this study is to examine sociodemographic, toxicologic, and injury characteristics, and emergency medical response to overdose decedents who died using drugs alone. Method: Data from the Cuyahoga County Medical Examiner's Office (2016–2020, N = 2944) on unintentional overdose deaths in adults was tabulated including socio-demographic, toxicologic, and injury-related information. Decedents using drugs alone were identified and compared to those not using alone via Chi-square and Fisher's exact tests. We further fit a multivariate logistic regression model to evaluate socio-demographic, toxicologic, and injury-related factors associated with increased odds of using alone. All results are reported with 95% confidence intervals. Result: Among decedents, 75% (n = 2205) were using drugs alone. Decedents using alone were more likely to be using drugs at home (p = 0.001) or be found dead at the scene (p < 0.001) and less likely to receive naloxone (p < 0.001) have other person/bystander, not using, present (p = 0.002). Using drugs at home (aOR = 1.61[1.19–2.20]) was associated with higher odds of using alone; and being married (aOR = 0.57[0.38–0.86]), having history of illicit drug use (aOR = 0.25[0.08–0.81]) and other person present, who was not using (aOR = 0.58[0.42–0.79]) were associated with lower odds of using alone. Conclusion: New harm reduction approaches targeting people using drugs alone are needed to reduce overdose deaths. [ABSTRACT FROM AUTHOR]

Cement workers are exposed to various kinds of occupational hazards, dust being the most hazardous. Despite certain exposure limits on the emission of air pollutants in place, several people die each year due to complications from respiratory disease. This study aimed to assess the prevalence of chronic respiratory symptoms among workers exposed to cement dust. A quantitative, descriptive cross-sectional design was employed among 81 workers from two cement production companies in Gauteng, South Africa in 2018. A self-administered questionnaire, anthropometric measurements, and a spirometry test were used as data collection tools. Data were analyzed using Wilcoxon rank sum, binary logistic regression, Pearson's chi-squared, and Fischer's exact tests. Respiratory symptoms such as wheezing, recurring blocked nose, sneezing/stuffy nose, fatigue/tiredness, rapid breathing, soreness/watery eyes, and breathlessness were significantly prevalent among participants from both facilities. Engineering and housekeeping control measures such as the use of High-Efficiency Particulate Air (HEPA) vacuums to clean up dust and proper use of Personal Protective Equipment (PPE) where workers are exposed to dust particles should be implemented. [ABSTRACT FROM AUTHOR]

To explore the feasibility of an exergame prototype in residential individuals with major neurocognitive disorder (MNCD). Participants were randomly assigned to a 12-week stepping exergame training or traditional exercise (active control group). Semi-structured interviews were conducted after six and 12 weeks of exergaming. Qualitative data were thematically analysed using NVivo 12. The Short Physical Performance Battery, one minute sit-to-stand test, Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory, Cornell Scale for Depression in Dementia, and Dementia Quality of Life were assessed at baseline and post intervention using a Quade's ANCOVA. Seven older adults with MNCD in the exergame and 11 in the active control group completed the study [mean age = 83.2 ± 6.5 years; 94.4% female; SPPB score = 7.3 ± 2.4]. Results indicated that the VITAAL exergame prototype was experienced as enjoyable and beneficial. The post-MMSE score was higher (η2=.02, p = 0.01, F = 8.1) following exergaming versus traditional exercise. The findings suggest that the exergame prototype is accepted by individuals with MNCD residing in a long-term care facility when they are able to participate and under the condition that they are extensively guided. The preliminary efficacy results revealed higher post-MMSE scores after exergaming versus traditional exercise. Future trials should confirm or refute these findings. The trial was registered in ClinicalTrials.gov (Identifier: NCT04436315) The VITAAL exergame prototype is accepted by individuals with MNCD residing in a long-term care facility who are able to participate. Supervision of exergaming by health professionals is essential for successful implementation. The VITAAL exergame prototype might maintain cognitive levels in major neurocognitive disorder longer than walking combined with standardised squatting and stepping exercises. [ABSTRACT FROM AUTHOR]