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To investigate the effect of mobilization with movement (MWM) on pulmonary functions in subjects with thoracic hyperkyphosis. This randomized single-blinded controlled trial included a sample of 50 subjects (age 18 − 25 years old) with thoracic hyperkyphosis. Subjects were randomly allocated into two groups; the Real MWM group (n = 25) which received thoracic MWM plus standard postural correction exercises, and the Sham MWM group (n = 25) which received sham MWM plus standard postural correction exercises. Digital X-ray and handheld spirometer were used to measure selected pulmonary function tests (FVC, FEV1/FVC ratio, MVV) respectively. Within-group comparisons demonstrated a statistically significant improvement in all outcome measures in both groups. The between-group comparisons demonstrated significant improvement in the MWM compared to the Sham group regarding the value of FVC, FEV1/FVC ratio, and MVV (P <.05). In young adults with thoracic hyperkyphosis, MWM plus postural exercise produces better improvements in FVC, FEV1, FEV1/FVC, and MVV compared to sham MWM plus postural exercise. [ABSTRACT FROM AUTHOR]

The SARS-CoV-2 coronavirus pandemic has led to increased food insecurity levels. This cross-sectional study examines the prevalence and determinants of food insecurity during the two-month (1 April to 1 June 2022) city-wide lockdown in Shanghai. The data was collected via an online questionnaire from 3230 adult Shanghai residents during the lockdown. Food insecurity was measured using an adapted version of the Household Food Insecurity Access Scale. Nearly 70% of participants reported being exposed to food insecurity. Using multivariable logistic regressions, we examined the associations between key correlates (i.e. age, income, lockdown-related income loss, migration, employment status, social capital, preparedness, and received social support) and overall food insecurity while adjusting for ethnicity, gender, education, household size, and marital status. Results showed that compared to local Shanghai residents, migrants (i.e, permanent migrants with Hukou (OR = 2.16), permanent migrants without Hukou (OR = 2.06), temporary migrants (OR = 2.74)), and participants with less than or greather than 50% lockdown-related income loss (OR = 2.60, OR = 3.09), were associated with higher odds of overall food insecurity. Participants with greater preparedness (OR = 0.66), greater bonding social capital (OR = 0.93), and greater bridging social capital (OR = 0.94), had lower odds of overall food insecurity. Targeted interventions are needed to enhance food resilience and health equity among vulnerable populations. [ABSTRACT FROM AUTHOR]

Purpose: Research suggests social support may protect sexual minorities from the harmful effects of victimization that undermine mental and sexual health wellness; however, this relationship has been underexplored among a diverse youth population. We examined the association between lifetime homonegative victimization, perceived stress in the last month, and resilience factors among a diverse sample of adolescent sexual minority males. Methods: Data were collected between June 2018 and April 2020 as part of the MyPEEPS Mobile study, a multi-site randomized controlled trial evaluating the effectiveness of a mobile behavioral HIV prevention intervention for adolescents living in the U.S. We analyzed baseline survey data from 542 sexual minority males, aged 13–18 years. We used bivariate analyses to examine relationships among variables and multivariable linear regression models to determine if resilience factors attenuated the association between homonegative victimization and perceived stress. Results: Perceived stress was positively associated with younger age, internalized homophobia, experiencing verbal victimization, threats of being outed, and threats of physical violence. Relying on online friends for support and having good family relations both attenuated the relationship between verbal victimization and perceived stress. However, neither of these resilience factors significantly weakened the associations between perceived stress, threats of physical violence, and being outed. Conclusion: Resilience factors, including peer and family support, may play an attenuating role in the relationship between homonegative victimization and perceived stress among adolescent sexual minority males. ClinicalTrials.gov Identifier: NCT03167606 [ABSTRACT FROM AUTHOR]

Non-binary and genderqueer (NBGQ) individuals do not identify with a binary gender identity. Some but not all NBGQ individuals identify as transgender, and it is currently unclear on which aspects of mental and sexual well-being NBGQ and binary transgender individuals may differ. To compare NBGQ, binary transgender and cisgender individuals on variables related to mental well-being, sexual well-being, and sexual self-concept discrepancies. We conducted an online questionnaire study in 125 transgender men, 72 transgender women, 78 NBGQ individuals, 98 cisgender men, and 107 cisgender women. For most variables, NBGQ individuals did not differ from binary transgender individuals. These two groups differed only on gender dysphoria and transgender specific body image worries, which were both lower in the NBGQ group. Compared to the cisgender group, NBGQ individuals scored higher on gender dysphoria, actual/ought sexual self-concept discrepancies, and actual/ideal sexual self-concept discrepancies, and lower on general life satisfaction and sexual esteem related to body perception. These results offer a first quantitative analysis of sexual well-being in NBGQ individuals, and highlight that – while both groups face unique challenges – NBGQ individuals encounter similar difficulties concerning mental and sexual well-being as binary transgender individuals. [ABSTRACT FROM AUTHOR]

Objectives: A prospective observational cohort study was conducted to (1) determine the prevalence of Mechanical Diagnosis and Therapy (MDT) syndromes for patients with shoulder impairments and (2) report the interaction between MDT classification and clinical outcomes, including pain intensity and disability, at discharge. Methods: Clinical outcome measures were completed at intake and discharge by 115 patients. A two-way mixed model analysis of variance with subsequent pairwise comparisons was done to examine differences in clinical outcomes between the following MDT classifications: Shoulder Derangement, Shoulder Dysfunction, and Other. Results: The primary findings were that (1) 44.3 (35.3, 53.4), 40.0 (31.0, 48.9), and 15.6 (9.0, 22.3) percent of patients' conditions were classified as Shoulder Derangement, Shoulder Dysfunction, and Other, respectively, (2) all groups managed via MDT methods made clinically significant improvements in disability and pain intensity at discharge, (3) a statistically significant difference in pain intensity at discharge was observed between the Shoulder Derangement and the Shoulder Dysfunction classifications (p = 0.01), and (4) patients with the Shoulder Derangement classification were discharged, on average, 35.3 days earlier than the Shoulder Dysfunction classification and 28.3 days earlier than the Other classification. Discussion: This study confirms previous reports that the Shoulder Derangement and Shoulder Dysfunction classifications are common and represent distinct clinical trajectories when assessed and managed via MDT methods. [ABSTRACT FROM AUTHOR]

Objectives: Determine whether the achievement of the centralization phenomenon on initial assessment of patients with low back pain (LBP) can be predicted by history and physical examination variables. Methods: Ninety patients referred to physical therapy due to LBP completed pain, disability, and fear-avoidance questionnaires, followed by a complete history and a physical examination based on mechanical diagnosis and therapy principles. Patients were subsequently classified as centralizers or noncentralizers. Univariate, followed by multivariate analysis was performed to identify history and physical examination variables that predicted the occurrence of the CP. Factors retained in the multivariate analysis were used to develop a clinical prediction rule (CPR). Results: Twenty-eight patients (31%) were classified as centralizers immediately following assessment. Three predictors were retained in the multivariate analysis: (1) modified Oswestry Disability Index score lower than 33%; (2) intensity of the most distal symptom lower than 6/10; and (3) back pain equal to or greater than leg pain. The resultant CPR indicated the presence of all three variables increased the post-test likelihood of the CP to 57%. Discussion: The findings of this study suggest the CP may be considerably more likely in less severe cases of LBP characterized by lower disability, lower intensity of distal symptoms, and a greater back-versus-leg pain intensity. Pending future validation, the CPR developed in this study may aide decision making regarding the initial management strategy of patients with LBP. [ABSTRACT FROM AUTHOR]

Objectives: To investigate differences in pressure pain thresholds (PPTs) and longitudinal mechanosensitivity of the greater occipital nerve (GON) between patients with side-dominant head and neck pain (SDHNP) and healthy controls. Evaluation of neural sensitivity is not a standard procedure in the physical examination of headache patients but may influence treatment decisions. Methods: Two blinded investigators evaluated PPTs on two different locations bilaterally over the GON as well as the occipitalis longsitting-slump (OLSS) in subjects with SDHNP (n = 38)) and healthy controls (n = 38). Results: Pressure pain sensitivity of the GON was lower at the occiput in patients compared to controls (p = 0.001). Differences in pressure sensitivity of the GON at the nucheal line, or between the dominant headache side and the non-dominant side were not found (p > 0.05). The OLSS showed significant higher pain intensity in SDHNP (p < 0.001). In comparison to the non-dominant side, the dominant side was significantly more sensitive (p = 0.004). Discussion: Palpation of the GON at the occiput and the OLSS may be potentially relevant tests in SDHNP. One explanation for an increased bilateral sensitivity may be sensitization mechanisms. Future research should investigate the efficacy of neurodynamic techniques directed at the GON. [ABSTRACT FROM AUTHOR]

Objective. To evaluate how municipality-based post-discharge follow-up visits including a general practitioner and municipal nurse affect early readmission among high-risk older people discharged from a hospital department of internal medicine. Design and setting. Centrally randomized single-centre pragmatic controlled trial comparing intervention and usual care with investigator-blinded outcome assessment. Intervention. The intervention was home visits with a general practitioner and municipal nurse within seven days of discharge focusing on medication, rehabilitation plan, functional level, and need for further health care initiatives. The visit was concluded by planning one or two further visits. Controls received standard health care services. Patients. People aged 65  years discharged from Holbæk University Hospital, Denmark, in 2012 considered at high risk of readmission. Main outcome measures. The primary outcome was readmission within 30 days. Secondary outcomes at 30 and 180 days included readmission, primary health care, and municipal services. Outcomes were register-based and analysis used the intention-to-treat principle. Results. A total of 270 and 261 patients were randomized to intervention and control groups, respectively. The groups were similar in baseline characteristics. In all 149 planned discharge follow-up visits were carried out (55%). Within 30 days, 24% of the intervention group and 23% of the control group were readmitted (p  0.93). No significant differences were found for any other secondary outcomes except that the intervention group received more municipal nursing services. Conclusion. This municipality-based follow-up intervention was only feasible in half the planned visits. The intervention as delivered had no effect on readmission or subsequent use of primary or secondary health care services. [ABSTRACT FROM AUTHOR]

Objective. To study the effects of applying an emergency department (ED) triage system, combined with extensive publicity in local media about the “right” use of emergency services, on the division of work between ED nurses and general practitioners (GPs). Design. An observational and quasi-experimental study based on before–after comparisons. Setting. Implementation of the ABCDE triage system in a Finnish combined ED where secondary care is adjacent, and in a traditional primary care ED where secondary care is located elsewhere. Subjects. GPs and nurses from two different primary care EDs. Main outcome measures. Numbers of monthly visits to different professional groups before and after intervention in the studied primary care EDs and numbers of monthly visits to doctors in the local secondary care ED. Results. The beginning of the triage process increased temporarily the number of independent consultations and patient record entries by ED nurses in both types of studied primary care EDs and reduced the number of patient visits to a doctor compared with previous years but had no effect on doctor visits in the adjacent secondary care ED. No further decrease in the number of nurse or GP visits was observed by inhibiting the entrance of non-urgent patients. Conclusion. The ABCDE triage system combined with public guidance may reduce non-urgent patient visits to doctors in different kinds of primary care EDs without increasing visits in the secondary care ED. However, the additional work to implement the ABCDE system is mainly directed to nurses, which may pose a challenge for staffing. [ABSTRACT FROM AUTHOR]