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Purpose: The aim of this study is to investigate the validity and reliability of the Selective Control of Upper Extremity Scale (SCUES) in patients with stroke. Materials and Methods: Forty-two patients with stroke aged 18–75 years, were included in the study. Patients were video-recorded while SCUES was administered. The videos were scored to determine the intrarater and inter-rater reliability. Fugl Meyer Assessment of Upper Extremity (FMA-UE), Box and Block test (BBT) and Brunnstrom Stages of Motor Recovery were measured to evaluate validity of SCUES. Spearman correlation analysis was used to assess the validity of SCUES. Intraclass correlation coefficient (ICC), Kappa (κ) and weighted Kappa (κw) were calculated to determine intrarater and inter-rater reliability. Results: There were significant positive high correlations between SCUES and FMA-UE and BBT and Brunnstrom upper extremity proximal and distal values (rho = 0.944, p = 0.01; rho = 0,875, p = 0.01; rho = 0.84, p = 0.01, rho = 0.82, p = 0.01; respectively) showing validity of SCUES. The ICC value of inter-rater reliability of SCUES was 0,99 (%95 CI: 0,989-0,997, p = 0,001) showing excellent reliability. κ and κ w values for inter-rater and intrarater reliability of individual SCUES items were above 0.7 indicating excellent reliability. ICC of SCUES and FMA-UE indicated excellent intrarater reliability (ICC = 0,99; %95 CI: 0,989–0,997, p = 0,001; ICC = 0.943; %95 CI: 0.9–0.97, p = 0,0001, consecutively). Conclusions: SCUES showed similar validity and reliability with FMA-UE and SCUES can be used in the evaluation of upper extremity selective motor control in patients with stroke. IMPLICATIONS FOR REHABILITATION: The Selective Control of Upper Extremity Scale (SCUES) stands out from existing outcome assessment tools for upper extremity motor control in stroke patients by enabling the evaluation of various quantifiers of selective motor function. SCUES assesses not only the accompanying movements of the trunk or additional joints beyond the targeted joint but also the presence of mirror movements, along with assessing the limited dynamic range of motion. SCUES appears valid and reliable in patients with stroke, indicating its potential use in evaluating upper extremity selective motor control and assessing the outcomes of interventions aimed at enhancing selective motor control. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic impacted healthcare delivery, especially for people with chronic disease. We investigated telehealth use by persons with multiple sclerosis (MS) during the COVID-19 pandemic and their suggestions to improve their telehealth experience. Methods: From persons with MS, we collected data on demographic, disease-related and social determinants of health, telehealth use during the COVID-19 pandemic, satisfaction with telehealth, and suggestions to improve telehealth. We conducted univariate log-binomial regression to establish factors associated with telehealth use versus no use, summarised experiences and suggestions for improvement with frequency tables, and conducted thematic analysis on free-text suggestions for improvement. Results: Of 1,485 participants, 69.8% used telehealth during the first phase of the COVID-19 pandemic. Only small differences were observed for demographic, disease and social health determinants between telehealth users and non-users. Most participants who used telehealth had good or very good experiences (new providers:74.3%; existing providers:78.6%). The most common suggestion for improving telehealth experience was "guidance on preparing for telehealth sessions." Participants also wanted expansion in telehealth availability and utility. Conclusion: Persons with MS in Australia commonly used telehealth during the COVID-19 pandemic and were generally satisfied with their experiences. Implementing the suggested improvements will help optimise telehealth for persons with MS. Registration: N/A. IMPLICATIONS FOR REHABILITATION: Australians with multiple sclerosis (MS) had good or very good experiences of telehealth during the first year of the pandemic. Telehealth is a useful consultation tool for many rehabilitation professions and may be appropriate for use across the whole MS population. To improve the delivery of rehabilitation through telehealth, provision of better guidance on preparing for telehealth consultations and provision of digital equipment to monitor their health is wanted by persons with MS. Rehabilitation professionals and researchers should take opportunities to identify if proficiency in the English language and cultural background may influence experiences with telehealth in persons with MS. [ABSTRACT FROM AUTHOR]

Purpose: Intensified acute in-hospital physiotherapy (IP) after hip fracture (HF) may enhance patient's ability to regain basic mobility at discharge. The primary objective was to assess the feasibility of IP. Secondary to estimate the effect of IP on regained basic mobility at discharge. Materials and methods: In a pragmatic, randomized, unblinded feasibility trial, 60 patients (mean age 79 years, 41 women) with HF and an independent pre-fracture basic mobility level were randomized (2:1) to IP with two daily sessions on weekdays focusing on functional training and weight-bearing activities (n = 40) versus usual care (UC) physiotherapy once daily (n = 20). Feasibility outcomes included physiotherapy completion rates, reasons for non-successful completion, and adverse events. The primary effect outcome was recovery of basic mobility (Cumulated Ambulation Score (CAS)). Results: Eighty-two percent of the sessions in the IP group were successfully- or partially completed versus 94% of the sessions in the UC group. No adverse events occurred. The main reason for not completing physiotherapy was fatigue. At discharge (median 7 days), 50% in the IP group had regained their pre-fracture basic mobility level (CAS = 6) versus 16% in the UC group; odds ratio = 5.33, 95%CI [1.3;21.5]. Conclusions: IP seems feasible for patients after HF surgery, and it may enhance recovery. Fatigue was the primary obstacle to completing IP. Implications for rehabilitation: Two daily physiotherapy sessions focusing on functional training and weight-bearing activities are feasible for patients after isolated hip fracture surgery, including subtrochanteric fracture, and may enhance recovery of basic mobility at discharge. During hospitalization, patient participation in intensified physiotherapy is mainly restricted by fatigue. Systematic assessment and management of fatigue may improve the completion of physiotherapy and recovery of basic mobility. [ABSTRACT FROM AUTHOR]

Purpose: To identify and examine subgroups of people with spinal cord injury (SCI) with different patterns of lived experience, and examine hidden impairments and disability among functionally independent and ambulant people. Materials and methods: Latent profile analysis of population-based data from the Australian arm of the International Spinal Cord Injury (InSCI) Community survey (n = 1579). Results: Latent subgroups reflected levels of functional independence and extent of problems with health, activity/participation, environmental barriers, and self-efficacy. Quality of life (QoL), psychological profiles, and activity/participation were often as good or better in participants who reported lower (vs. higher) functional independence alongside comparable burden of health problems and environmental barriers. QoL, mental health, and vitality reflected self-efficacy and problem burdens more closely than functional independence. Ambulant participants reported a substantial burden of underlying, potentially hidden impairments, with QoL and mental health similar to wheelchair users. Conclusion: Hidden disability among more independent and/or ambulant people with SCI can affect well-being substantially. Early and ongoing access to support, rehabilitation, and SCI specialist services is important irrespective of cause, type, severity of injury, and level of functional independence. Improved access to SCI expertise and equity of care would help to improve early recognition and management of hidden disability. Trial registration: Not applicable. IMPLICATIONS FOR REHABILITATION: Hidden disability can substantially affect the well-being and quality of life of people with spinal cord injury (SCI) who appear to be functioning well and independently. Early and ongoing access to rehabilitation and SCI specialist services is important for people with SCI of any cause, type, severity, and level of functional independence. The potential for and implications of hidden disability are key considerations for the broader community of health practitioners who manage people with SCI, to ensure that appropriate referrals to specialist SCI services occur. Hidden disability is a key consideration in the design and implementation of disability support systems. [ABSTRACT FROM AUTHOR]

Purpose: Systematically organizing participation effects may guide participation-based research designs in rehabilitation. This perspective paper uses existing evidence on Pathways and Resources for Engagement and Participation (PREP) to showcase the multitude of effects from a single intervention and synthesize the magnitude of these effects. Methods: An outcome matrix of participation effects comprising three dimensions (intermediate, instrumental, ultimate) and two levels (transient, enduring) was used to systematically map PREP's effects. Forest plot demonstrated clinically important changes in the Canadian Occupational Performance Measure (COPM) across studies. Effect sizes were calculated. Results: The majority of outcomes from 11 studies were mapped to ultimate-transient effects (e.g., changes in participation of self-chosen activities), followed by instrumental-transient effects (e.g., changes in motor body functions). Fewer outcomes were mapped to ultimate-enduring effects (e.g., changes of participation for a longer period or across settings) or intermediate-enduring effects (e.g., therapist-applied knowledge), demonstrating the gaps for investigating enduring effects. COPM changes in most studies (89%) showed clinical significance with small to large effects. Conclusions: Systematic mapping from PREP example guides categorizing multidimensional outcomes. Future participation-based studies can employ individual-based mixed-methods designs to delve into the long-lasting enduring outcomes of youth capacity-building and the transformative process of pursuing meaningful participation goals. IMPLICATIONS FOR REHABILITATION: Systematically organizing participation effects according to the proposed matrix enhances understanding of multidimentisonal outcomes from a single participation-based intervention. Child/youth-engaging interventions like Pathways and Resources for Engagement and Participation (PREP) can offer a multitude of benefits that promote outcomes of participation and physical and mental health, enhancing efficient/effective rehabilitation services. It is essential that future intervention designs prioritize long-lasting/enduring effects across broad settings and capture underlying processes and capacity building of children/youth toward sustainable participation outcomes. [ABSTRACT FROM AUTHOR]

Smartphone addiction adversely affects adolescent psychological wellbeing. However, little is known about the role of academic procrastination and school burnout in this relationship. The main objective of the current study was to examine the associations between smartphone addiction and psychological wellbeing, a multiple mediation analysis that included academic procrastination and school burnout. The participants consisted of 409 adolescents whose ages ranged between 13 and 19 years (Mage = 16.024, SD = 1.674). Analyses revealed the serial mediating role of academic procrastination and school burnout between smartphone addiction and psychological wellbeing was accepted. Overall, these results suggested that the smartphone addiction is a risk factor for adolescents' psychological wellbeing and that academic procrastination and school burnout also increase this risk. [ABSTRACT FROM AUTHOR]

The aim of the present cross-sectional study was to investigate the relationship between academic self-efficacy, life goals and subjective well-being of middle school students. The study group for the research comprised 434 middle school students. According to the findings, subjective well-being was correlated at a significant level with academic self-efficacy and life goals. Regression analysis revealed that academic self-efficacy and life goals significantly explained subjective well-being. The research findings provide important data about variables related to the subjective well-being of middle school students. Due to the research results, studies to increase academic self-efficacy and develop life goals for middle school students will contribute to increasing students' subjective well-being. For experts working in the field, the research findings will encourage the emergence of new research ideas related to other variables associated with the subjective well-being of middle school students. [ABSTRACT FROM AUTHOR]

The aim of this research was to investigate the associations between attachment styles, mental well-being and psychological vulnerability. The sample comprised a total of 257 university students including 205 women (79.8%) and 52 men (20.2%). The ages of university students varied from 18 to 34 years [Mage = 21.37, SD = 2.13]. The Process Macro (Model 4) application was used to test the mediation analysis. According to mediation analysis findings, secure attachment style (ab = −.20, SE =.05, 95% CI [−.31, −.09]), anxious-ambivalent attachment style (ab =.08, SE =.02, 95% CI [.04,.13]), and avoidant attachment style (ab =.08, SE =.02, 95% CI [.03,.14]) had significant indirect effects on psychological vulnerability. Additionally, mental well-being had full mediation role in the association between secure attachment style and psychological vulnerability, while mental well-being was determined to have partial mediation role in the associations between anxious-ambivalent and avoidant attachment styles with psychological vulnerability. [ABSTRACT FROM AUTHOR]

This study introduced Satir Growth Model (SGM) into career intervention to enhance Chinese college freshmen's career adaptability. The effect of SGM-based career intervention was examined by the randomised controlled trial design. Results indicated that the experimental group experienced a significant increase in career exploration and career adaptability after seven sessions of the SGM-based career intervention. Our study also found that career exploration could partly mediate the relationship between experimental condition and career adaptability. One year later, the experimental group accomplished a follow-up test, which showed that the effect of SGM-based career intervention could remain in a long run. These results suggested that the SGM-based career intervention could be a new approach for the enhancement of career adaptability. [ABSTRACT FROM AUTHOR]

Alcohol Use Disorder is a complex and broad condition with multiple pathways to resolution. Only a small proportion of people with AUD seek formal treatment or support, whilst lower severity AUD is particularly under-addressed. In part, this reflects common misconceptions about AUD as an always severe condition requiring lifelong abstinence. The present study sought to investigate the impact of an online programme focused on supporting participants (n = 928) looking to change their drinking behaviors on outcomes of self-reported happiness with drinking and other well-being outcomes. Results showed that post-intervention, all participants reported significantly increased happiness with their drinking, greater drink-refusal self-efficacy, and improvements in how drinking impacted multiple well-being domains such as sleep and emotions. Importantly, it was found that all participants were happier with their drinking regardless of whether their goal was to abstain from drinking or to reduce their drinking. These results add to evidence highlighting the need to broaden the accessibility and range of options available to support a wider range of people with AUD, particularly via increasing understanding and acceptance of non-abstinent routes to AUD resolution. [ABSTRACT FROM AUTHOR]

Background: Prior studies suggest that lower levels of mindfulness contribute to the motivation of using alcohol to cope with distress. Research examining this possibility is scarce or limited to alcohol, but not marijuana, related outcomes. Objectives: We examined separate models (for alcohol and for marijuana) to determine the associations between trait mindfulness (describing, acting with awareness, non-judging, non-reactivity) and alcohol and marijuana outcomes (use indicators and negative consequences) via emotional psychopathology (i.e., a latent variable assessing symptoms of depression and anxiety) and alcohol/marijuana coping motives. Results: The final analytic sample consisted of 456 participants (Mean age = 22.96 ± 3.12 years; 66.2% women) for the alcohol model; and 232 participants (Mean age = 22.96 ± 3.01 years; 66.2% women) for the marijuana model. Two path models were conducted, such that indirect paths were examined for each trait mindfulness facet on alcohol/marijuana outcomes (e.g., describing → emotional psychopathology → alcohol coping motives → binge drinking frequency). Within the comprehensive alcohol model, describing, acting with awareness, non-judging and non-reactivity were associated with less binge drinking frequency and lower number of alcohol-related negative consequences via lower severity of emotional psychopathology symptoms and lower endorsement of drinking to cope motives. For the marijuana model, describing, acting with awareness, and non-judging of inner experience were associated with less marijuana quantity (grams) consumed and lower number of marijuana-related negative consequences via lower severity of emotional psychopathology symptoms and lower endorsement of marijuana coping motives. Conclusions: Prevention and intervention programs of alcohol and marijuana in Argentina may benefit from improving mindfulness skills and targeting emotional psychopathology and motives to use drugs, to prevent or reduce negative drug-related consequences. [ABSTRACT FROM AUTHOR]

Objectives. Cognitive-Behaviorally Based Interventions (CBIs) are evidence-based treatments for alcohol and other drug (AOD) use with potential variable effectiveness by population sub-groups. This study used evidence synthesis to examine treatment effect by demographic and study context factors in clinical trials of CBI for AOD. Methods. Studies were systematically identified, and their characteristics and outcome data were extracted and summarized. Standardized mean differences were calculated for within- and between-condition effects on substance use outcomes. Demographic and study context moderators were identified during data acquisition and several sensitivity analyses were conducted. Results. The sample included K = 29 trials and a total of 15 study-level moderators were examined. Information on participants' age, biological sex, and race were reported in at least 26 trials, but information on gender identity, sexual orientation, and ethnicity were reported infrequently or in non-inclusive ways. The mean between-condition effect size was small and moderately heterogenous (d = 0.158, 95% CI = 0.079, 0.238, I2 = 46%) and the mean within-condition effect size was large and showed high heterogeneity (dz = 1.147, 95% CI = 0.811, 1.482, - I2 = 96%). The specific drug targeted in the study and whether biological assay-based outcomes were used moderated between-condition CBI efficacy and the inclusion of co-occurring mental health conditions and study publication date moderated within-condition CBI effects. Conclusions. Results provide preliminary data on study context factors associated with effect estimates in United States based clinical trials of CBI for AOD. [ABSTRACT FROM AUTHOR]

Objectives: Agricultural workers are at risk of heat-related illness, which is preventable. Few field studies have compared farmworker-relevant heat exposure in different conditions. We examined heat exposure over time in different potential shade and work locations to inform future occupational heat prevention approaches. Methods: We assessed heat exposure in Eastern Washington State (WA) cherry and grape fields in August 2022. QUESTemp° monitors recorded Wet Bulb Globe Temperature (WBGT) and Black Globe Temperature (BGT) every 10 min from approximately 07:00–14:00 for three days in the center of crop rows (mid-row), under portable shade structures (shade), and in open field (open) locations. Linear mixed effects regression (LMER) models compared WBGT and BGT among field locations. Hourly time-weighted average WBGT and comparisons with occupational exposure limits (OELs) were computed for different hypothetical work-rest cycles during the hottest sampling hours, assuming different worker effort levels, rest locations (mid-row versus shade), and acclimatization statuses. Results: Across all crops and locations during the study period, the mean/SD air temperature was 31°C (88°F)/3.9°C (6.9°F), with a maximum temperature of 39°C (102°F) and a mean/SD relative humidity of 30%/9.6%. LMER models suggested no significant difference in mid-row versus open WBGT but significantly lower WBGT in shade versus open locations for both cherries (main effect −5.14: 95% confidence interval [CI] −6.97,−3.32) and grapes (−6.20: 95%CI −7.73,−4.67), though this difference diminished over the course of the day. BGT was significantly higher in the mid-row than the shade (cherries main effect 14.33: 95%CI 9.52,19.13 and grapes 17.10: 95%CI 13.44,20.75). During the hottest sampling hour, the exceedances of OELs were reduced with assumptions of increased shaded break lengths, reduced effort level, and acclimatization. Conclusions: Shade canopies, but not the crops studied, provided significant reductions in heat exposure. We observed increased protection from heat assuming longer shaded breaks and reduced effort levels. Results highlight the need for additional field research on the effectiveness, feasibility, and acceptability of different shade types and work-rest cycles to guide employer optimization of best practices for worker protections, including acclimatization before high heat, sufficient shaded rest time, reduced effort levels as the day warms, and avoiding work in peak heat. [ABSTRACT FROM AUTHOR]

This study used the Actor-Partner Interdependence Model to examine how parents' adult attachment influences their their own and the partners' co-parenting and parent-child relationships. Participants were from a cross-sectional sample of 1313 Chinese heterosexual married couples (fathers' Mage = 39.74, SD = 5.61; mothers' Mage = 37.55, SD = 5.04) whose biological children were pupils (Mage = 10.25, SD = 2.35). Results revealed that: (a) Couple members' actor effects from adult attachment avoidance to positive and negative co-parenting and parent-child closeness and conflict were found both significant; (b) The actor effects from adult attachment anxiety to negative co-parenting and parent-child conflict were found significant, whereas only partner effect from attachment avoidance to positive co-parenting and from attachment anxiety to parent-child conflict were significant. The results highlight the negative effects of parents' attachment avoidance and anxiety on their partners' parenting function. [ABSTRACT FROM AUTHOR]

Objective: US Hispanics have several health disparities, greater tobacco/nicotine-related illnesses, lower access to smoking cessation, and lower rates of cessation. Understanding cultural constructs linked to tobacco/nicotine use may provide a greater understanding of future cultural adaptations of cessation interventions. This study used a multidimensional acculturation framework, with cultural practices, identity, and values, to test links between measures of acculturation stress, multidimensional acculturation (language-based enculturation and acculturation, cultural identity, familism), and tobacco/nicotine use, and interactions with gender. Design: Participants were 391 adult Latin American immigrants (69% women); 12% self-reported tobacco/nicotine use in the past six months. Results: Path analysis showed acculturative stress, β =.16, and acculturation, β =.20, were positively related to tobacco/nicotine use. Enculturation, familism, and Hispanic cultural identity were not related to tobacco/nicotine use. There were no significant acculturation by enculturation or gender interactions, but women were less likely to use tobacco/nicotine than men, β = −.36. Conclusion: Findings suggest that tobacco/nicotine cessation interventions for Latino immigrants may be enhanced with an emphasis on the mitigation of acculturative stress, attention to the adoption of US cultural practices, and gender. Future research should examine specific sources of acculturative stress or social norms related to tobacco/nicotine use. [ABSTRACT FROM AUTHOR]

Video game play is a pervasive behavior, and researchers suggest there may be both adaptive and maladaptive consequences of gaming. Using Self-Determination Theory and the Dualistic Model of Passion frameworks, the purpose of this study was to examine the relationships between passion, psychological needs, and problematic gaming. Across two studies and an integrative data analysis (IDA) that pooled the data of Studies 1 and 2, we hypothesized that (H1) greater psychological need frustration would be indirectly related to greater problematic gaming through greater obsessive passion and that (H2) greater psychological need satisfaction would be indirectly related to lower problematic video gaming via greater harmonious passion. We also tested alternative models in which passion (harmonious and obsessive) were related problematic gaming through to psychological needs (satisfaction and frustration). Across the two studies and IDA, we found that psychological need frustration was associated problematic gaming via obsessive passion, supporting our first hypothesis. Similarly, our alternative model also indicated that obsessive passion was related to problematic gaming via psychological need frustration in all three studies. In contrast, we did not find support for hypothesis two in either study and the IDA as psychological need satisfaction was not associated with lower problematic gaming via harmonious passion. In fact, we found that in Studies 1 and 2 as well as the IDA, psychological need frustration was related to problematic gaming through harmonious passion. Our results suggest that psychological need frustration and obsessive passion may be more important indicators of problem gaming compared to psychological need satisfaction and harmonious passion. Therefore, efforts to mitigate psychological need frustration in daily life and obsessive passion for gaming may be critical for reducing problem gaming. [ABSTRACT FROM AUTHOR]

This study employed a Reasoned Action Approach to investigate two communication behaviors that were being built into a statewide behavioral health campaign: initiating a conversation about one's own mental health struggles, and starting a conversation to discuss someone else's mental health difficulties. We examined whether the extent of attitudes, perceived norms, and perceived behavioral control regarding intent to perform these behaviors varied by racial identity. Using original survey data from Texans (N = 2,033), we conducted regression analyses for the two communication behaviors and found that intention to seek help was primarily explained by instrumental attitude, injunctive norm, descriptive norm, and perceived capacity; and intention to start a conversation to help someone else was primarily explained by instrumental attitude, injunctive norm, and perceived capacity. Additionally, we identified important common and distinct determinants of the two behaviors across different racial groups. Implications for health communication campaign message development and audience segmentation are discussed. [ABSTRACT FROM AUTHOR]

This study examined associations between perceived discrimination, treatment adherence self-efficacy, and depressive symptoms among people living with HIV (PLHIV) in the Southern United States. Cross-sectional survey data were collected from 402 PLHIV who self-reported on interpersonal discrimination experiences based on HIV status, sexuality, gender, income, and living condition. Participants also reported on adherence self-efficacy and depressive symptoms. We employed K-means clustering to identify groups based on discrimination experiences, and logistic regressions to examine group differences on adherence self-efficacy and depressive symptoms. Results suggested three groups: a cluster with high perceived discrimination across all identities/conditions (n = 41; 11%; Cluster 1); a cluster with high perceived discrimination based on HIV status, income, and living condition (n = 49; 13%; Cluster 2); and a cluster with low perceived discrimination across all identities/conditions (n = 288; 76%; Cluster 3). Compared to Cluster 3, Cluster 1 and 2 had 2.22 times (p =.037) and 3.98 times (p<.001) greater odds of reporting depressive symptoms. Compared to Cluster 3, Cluster 2 had 3.40 times (p =.003) greater odds of reporting lower adherence self-efficacy. Findings demonstrate the need for individual-level support for PLHIV with discrimination histories, and broader efforts to end the stigma, discrimination, and marginalization of PLHIV based on HIV status and other characteristics. [ABSTRACT FROM AUTHOR]

Research is developing regarding the beneficial association of spirituality with numerous health outcomes in people living with HIV (PLWH); however, little attention has been paid to the association of these variables with forgiveness and acceptance of HIV status. This cross-sectional study used a sample of 648 PLWH from the United States aged 18–61 to test the mediating effects of forgiveness and acceptance of HIV status on the relationship of spirituality and life satisfaction. As expected, self-forgiveness and acceptance straightforwardly and serially explained the links between spirituality and life satisfaction, while forgiveness of others was not a significant mediator for this relationship. The data obtained suggest that spirituality and self-forgiveness are two important targets for future experimental research, and therapeutic interventions on these variables may have a synergistic effect of increasing acceptance and improving well-being in PLWH. [ABSTRACT FROM AUTHOR]

We investigated the effects of exercise training on bone mineral density (BMD) in people living with Human Immunodeficiency Virus (PLHIV). Pubmed, Scopus, Cochrane Library, and ScienceDirect databases were searched for trials investigating exercise training-induced changes in BMD of PLHIV at baseline vs. post-intervention assessed by dual-energy X-ray absorptiometry (DXA). Hedge effect sizes (ES) were calculated incorporating fixed effects for BMD variation assumptions. Disaggregated comparisons were performed for trials with more than one intervention or BMD site assessment. Seven trials included 210 PLHIV and 35 non-HIV-infected controls. Methodological quality evaluated using the Physiotherapy Evidence Database (PEDro) scale ranged from poor to moderate. Interventions applied isolated resistance, combined aerobic and resistance, and multimodal exercise protocols performed 3 d/wk for 12-to 104 week. One controlled and another uncontrolled trial presented significant effects, reporting improvements at the femoral neck and total (ES 2.14 and 0.49, respectively). Magnitude of those specific ES influenced the overall effect (controlled and uncontrolled trials), which was small but significant (k = 12, ES 0.277, 95% confidence interval 0.120-0.434). Resistance training may promote favorable adaptations in BMD of PLHIV, particularly in femur. Future research should elucidate the optimal dose-response relationship and physiological mechanisms underlying exercise-induced adaptations on the BMD of PLHIV. [ABSTRACT FROM AUTHOR]

The purpose of this interventional experimental study was to determine the effect of health education program on physical activity and blood pressure in middle-aged women with pre-hypertension in Kohdasht. Eighty middle-aged women with pre-hypertension were selected and divided into two groups randomly. After the one-month online training program for intervention group, by conducting an interview, the data was completed using questionnaire and it was analyzed using spss 27 software (significance level of 0.05). Before the intervention, there was no significant difference between the two groups. After 3 months of follow-up, a significant increase in attitude, perceived behavioral control and behavioral intention related to physical activity was observed in the intervention group compared to the control group (P <.05). Also, the average blood pressure in the intervention group was higher than the control group. Considering the effect of the online health education program based on the theory of planned behavior in improving the stages of changing physical activity and reducing blood pressure, the use of these developed models with an emphasis on modifying the subjective norm related to physical activity in the field of prevention is recommended for high blood pressure. [ABSTRACT FROM AUTHOR]

Background: Patient-centred care must consider service consumers' needs and improve their health and well-being as well as their satisfaction and the quality of their healthcare assistance. However, individuals experiencing mental illness often struggle with barriers and misunderstandings by health care professionals. Nursing Faculties are uniquely positioned to reduce stigmatising attitudes via new educational interventions that could align nursing curricula and individuals with mental illness needs. However, there are few studies about the stigma toward mental illness among nursing students in Spain. Objectives: The present study aimed to analyse the effect of a 9-month educational intervention on the level of stigma in nursing students. Design: a one-group pre-postintervention design with no control group was conducted. Methods: A total of 194 nursing students completed the EVEPEM scale before and after the intervention. The intervention comprised 55 hours of campus sessions and 150 h practicum in mental health settings. Results: A destigmatising tendency was captured by a large main effect and a statistically significant stigma reduction. Conclusions: The educational 9-month intervention was effective in reducing students' stigma by providing theoretical education, personal contact with mental health service consumers, and critical reflection activities. [ABSTRACT FROM AUTHOR]

We aimed to explore attitudes and training experiences of medical students toward gender medicine (GM). A cross-sectional study with convenience sampling was conducted (sample size = 430). To assess predictors of high GM consideration in patient management, a multivariable logistic regression was performed. A total of 82% considered sex and gender important; 61% stated that they would use GM skills in their careers. A total of 76% had never discussed GM with their tutors, with differences between male and female students (p =.002). Predictors of high GM consideration were: age (adjOR = 1.4, 95%CI = 1.1–1.8) and the impression that tutors considered patients' sex and gender during practice (adjOR = 3.9, 95%CI = 2.0–7.6). Thus, participants considered GM important, but some students were unsure whether it could be useful in practice. The strongest predictor of high GM consideration was the tutors' good example during training. It would be advisable to implement the teaching of this topic during both courses and traineeships. [ABSTRACT FROM AUTHOR]

Background: A growing body of research examining the effect of exercise on cognitive function in stroke patients, while findings of available studies were conflicting. Objectives: We aimed to estimate the effect of exercise on cognitive function in stroke patients. Methods: For this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, Cochrane, and Scopus electronic databases, through 13 March 2023. The three-level restricted maximum likelihood random effects model was used to synthesize the data. Results: Twenty-five studies met the inclusion criteria. There was a significant effect of exercise on improving cognitive function in stroke patients (Cohen's d = 0.37, 95% CI, 0.16 to 0.58, p < 0.01, I2 = 22.12%). Subgroup analysis showed that exercise significantly improved memory. In addition, aerobic exercise, exercise conducted 12 weeks or more, 3 times or more per week, less than 60 minutes per session, less than 180 minutes per week, and up to 12 months post-stroke increased cognitive function significantly. Conclusions: Exercise improved cognitive function in stroke patients. To improve cognitive function, this meta-analysis provides clinicians with evidence to recommend that stroke patients participate in aerobic exercise at least 3 times per week for 30–60 minutes, with a goal of 180 minutes per week being achieved by increasing the frequency of exercise. Exercise initiated within 12 months post-stroke and continued for 12 weeks or more is most beneficial for improving cognitive function. [ABSTRACT FROM AUTHOR]

Background: Performing activities of daily living comprise an important risk factor for falls among non-bedridden stroke inpatients in rehabilitation departments. Objectives: To explore the correlation between Barthel Index score and the occurrence of falls in non-bedridden stroke rehabilitation inpatients. Methods: In this cross-sectional study, information of patients grouped as non-bedridden patients by the Longshi Scale was collected. Results: A total of 3097 patients were included in this study, with a fall incidence of 10.43%. After adjusting covariates, the total score of Barthel Index and falls in non-bedridden inpatients after stroke presented an inverted U-shaped curve relationship, in which inflection point was 60. The effect sizes on the left and right sides of infection point were 1.02 (95%CI 1.00–1.04) and 0.97 (95%CI 0.96–0.99), respectively. Conclusions: Non-bedridden stroke patients with moderate activities of daily living (ADL) capacity may be at particularly increased risk of falls in rehabilitation departments. [ABSTRACT FROM AUTHOR]

Objectives: Resilience during old age reflects the capacity to adapt to changes and challenges associated with normative aging and is an important component of successful aging. Belief in the incremental theory of intelligence and personality could help older adults maintain cognitive functioning and social engagement, which may further contribute to their resilience. The current study investigated how implicit theories of intelligence and personality affected older adults' resilience and examined cognitive functioning and social participation as two mediators. Method: A total of 108 older adults aged 60–92 were recruited and completed relevant scales and cognitive tasks. Path analyses were conducted to estimate the expected mediation model. Results: The incremental theory of intelligence, but not personality, was positively related to older adults' resilience. Both cognitive functioning and social participation mediated the effect of the implicit theory of intelligence in the model without covariates. When background variables were controlled, the mediation effect of cognitive functioning remained significant, while the link between the implicit theory of intelligence and social participation was weakened. Conclusion: Older adults' implicit theory of intelligence plays a significant role in fostering resilience in late adulthood, especially through maintaining older adults' cognitive functioning. [ABSTRACT FROM AUTHOR]

Background: Self-Esteem (SE) may be a reason why students use substances. A dysfunctional family may be an issue that leads students to use drugs. There has been limited research on how drug use (DU) is a consequence of family dysfunction. Aims: This study examines the associations between SE and DU and the moderating effects of dimensions of family dysfunction (problem-solving, communications, roles, affective response, affective involvement, behavior control, and general functioning) on this association. Methods: 450 students completed the Psychoactive Substance Use Questionnaire, Family Assessment Device, and Index of Self-Esteem. Results: The results indicated that roles significantly moderated the association between self-esteem and drug use, while the moderation effects of all other family dysfunction dimensions were insignificant. Conclusions: The association between self-esteem and drug use and how roles moderate this association emphasize the need to create awareness in families and schools where these students can easily understand the consequences of their behavior. [ABSTRACT FROM AUTHOR]

Background: Although changes to prescribing guidelines appear to have resulted in fewer prescriptions from doctors, no recent study has looked at changes to where prescription drugs of misuse are obtained and how they have differed by gender and race among adolescents and young adults. Objectives: This study examines trends in the source of prescription drug misuse between 2015 and 2019 for adolescents and young adults and observes how they have differed between demographic groups in this population. Methods: Data were from the 2015 – 2019 National Survey on Drug Use and Health. Trend analysis was performed using logistic regression models with year as a predictor of prescription drug source, with separate models created for individual demographic groups. Results: Findings indicate that the likelihood of having received a prescription benzodiazepine or stimulant from friends or family for free has decreased for many groups, while the likelihood of having purchased benzodiazepines or stimulants from a drug dealer or stranger has increased. Changes observed for prescription opioids include increased likelihood of receiving from a doctor for 12–17-year-olds and increased likelihood of stealing from friends/family for many groups. Conclusion: Possible explanations for these changes and implications for practice and policy are discussed. [ABSTRACT FROM AUTHOR]

Objective: This study examined employment prior to discharge and the source of treatment payment as physical recovery capital that predicts the completion of treatment for cocaine use. Methods: The 2020 Treatment Episode Data Set: Discharges of the United States was analyzed using binary logistic regression to estimate the adjusted odds ratio of treatment completion with employment and the primary source of payment among those whose primary substance of use was cocaine. Results: A significant increase in the odds of completing treatment was observed among those with full-time or part-time employment. By contrast, those not in the labor force had significantly lower odds of treatment completion. Significantly high odds of treatment completion were also noted among those whose primary source of payment was private insurance or government payment schemes. Conclusions: Treatment services should include the promotion of employment or offer sub-services that assist in securing a job. Future studies should investigate the impact of Medicaid on treatment completion when the Institutions for Mental Diseases (IMD) service exclusion waivers for Medicaid funding are further adopted by states. The policy for substance treatment under Medicare needs to be improved for older people to access treatment facilities and options. [ABSTRACT FROM AUTHOR]

Background: Medical students are potential role models for the community in tobacco control. Therefore, we aimed to determine the prevalence and dynamics of tobacco smoking among their grades. Methods: A questionnaire prepared in cooperation with the "World Health Organization" was completed online by 697 medical students in 2020 as a randomized cross-sectional study covering all medical school grades. Results: The prevalence of smoking among pre-grade 1 students was 3.3%, while it was 23% in grade-6. The highest prevalence was 31% in grade-2. Of the 135 current smokers, 43% smoked their first cigarette in medical school. "Having smoker best friends" was the most critical factor in starting smoking. Of current smokers, 59.3% want to quit. Only 20.7% of students who tried to quit smoking received professional help. Students took only a 1-hour lecture on tobacco control in the first two years. Conclusion: While there was almost no smoking in pre-grade 1, the high prevalence seen in grade-2 indicates that psychosocial support mechanisms and tobacco control lectures should be developed to prevent students. University administrations should implement adequate programs and increase awareness that will lead to a reduction in diseases in the student population and thus in the general population. [ABSTRACT FROM AUTHOR]

Objective: The term psychotic experiences (PEs) encompass subclinical hallucinatory and delusional experiences. There are limited number of studies on PEs clinical and socio-demographic characteristics. We aimed to investigate the association between PEs and patterns of cannabis use, cognitive functions, schizotypy and childhood traumas. Methods: Participants were recruited from specialized units using the snowball method. All of the participants were regular cannabis users. Participants with PEs and without PEs were compared by looking into socio-demographic and clinical correlates. Significant variables at univariate comparisons were included in binary multivariate logistic regression analysis with PEs as the dependent variable. Results: Forty participants were recruited (20 with PEs, 20 without PEs). Adolescence onset of cannabis use (χ2 = 8.120; p < 0.05), positive schizotypy (t = 3.762; p < 0.01), Trail Making Test A (TMT A) Scores (u = 98.5; p < 0.01) and emotional neglect (u = 128; p = 0.05) were significantly associated with PEs. The binary regression model included a significant contribution of positive schizotypy (OR = 1.16, CI 1.025–1.330) and TMT A Score (OR = 1.22, CI 1.03–1.44). Conclusions: Results showed a novel positive association of PEs with adolescent-onset cannabis use, TMT A Scores, positive schizotypy and emotional neglect. PEs were predicted independently by positive schizotypy and TMT A Scores. [ABSTRACT FROM AUTHOR]

Objective: The objective of the present study was to determine the prevalence of addictive behaviors among in-school and out-of-school adolescents of age 13–19 years in Chandigarh, India. Methods: Problem Behavior Theory (PBT) was used to identify the risk and protective factors for addictive problem behaviors among adolescents. Results: A total of 1634 adolescents were included from in-school (n = 1134) and out-of-school (n = 500) categories. The prevalence of addictive behaviors was 19.1% (current smoking 6%, alcohol drinking 6.1%, and drug use 7%) among adolescents aged 13 to 19. Significant predictors of smoking were being male (aOR = 4.43; 95%CI: 1.92,10.20; p <.001) and having a working father (aOR = 3.19; 95%CI: 1.10, 9.20; p <.05). Total protective score [smoking: aOR = 0.99; 95% CI:0.97, 0.99: p <.05; alcohol use: aOR:0.98;95% CI:0.97,0.99; p <.01; drug use: OR:0.99, 95%CI: 0.98,0.99; p <.05] and total risk score [smoking: aOR = 1.14; 95%CI:1.11, 1.17: p <.001; alcohol use: aOR:1.10;95% CI:1.07,1.12; p <.001; drug use: aOR:1.05, 95%CI: 1.04,1.06 p <.001] were significantly associated with all three addictive behaviors. Conclusions: The current study's findings can inform the development of intervention programs focusing on both adolescents and communities (social environment surrounding adolescents) to enhance the protection of adolescents at risk for addictive behaviors. [ABSTRACT FROM AUTHOR]

Objective: This study aims to investigate smoking behavior among individuals with diabetes and assess the differences of total cholesterol to HDL-C ratio based on smoking status. Methods: A retrospective cohort study included 1082 diabetic patients from a regional hospital in central Taiwan between 2016 and 2020. Chi-square, McNemar test, and logistic regression analysis were conducted for the inferential statistical analysis. Results: About 15.2% were current tobacco smokers. There are several risk factors related to cigarette smoking, including being male (OR = 9.780), younger than 55 years old (OR = 3.649), having lower levels of education (≦9 years and 10–12 years) (OR = 3.001 and 2.097, respectively), being a current alcohol drinker (OR = 3.366), and being a non-regular exerciser (OR = 1.968). Diabetic patients who were current cigarette smokers had a higher distribution of TC/HDL-C ratio≧5 compared to ex-smokers or nonsmokers (14.6% vs. 7.0%, p =.002). More nonsmokers or abstainers changed their TC/HDL-C ratio from abnormal (≧5) to normal (<5) compared to current smokers (67 vs. 39, p =.008). Conclusions: Cigarette smoking has been shown to have negative effects on the body's metabolism and lead to complications in diabetic patients. Therefore, it is crucial to design intervention strategies that encourage current smokers to quit smoking and evaluate the effectiveness of these interventions. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate substance use and its association with eating attitudes and behaviors among male Palestinian refugees. Methods: In a cross-sectional study, male Palestinian refugees(N = 566) were recruited to fill out self-administrated questionnaire on eating attitudes and behaviors (EAT-26) and to give urine samples to test current illicit drug use. Results: The response rate was 47.7%. Substance use was highly prevalent among participants (28.9%). The percentage of participants with eating disorders (ED) among substance users was as follows: Any illicit drug (30.8%), benzodiazepine (32.6%), methamphetamines(40.7%), amphetamine (39.3%), tetrahydrocannabinol (25.8%), barbiturates (20%),and alcohol (12.50%). Obese participants were at higher risk of having ED(OR = 2.344, p <.05) than underweight participants. Binge eaters were more likely to be tetrahydrocannabinol users (OR = 2.745, p <.05). Increased riskof self-induced vomiting behavior was associated with binge behavior (OR = 5.97, p <.05, laxative use (OR = 26.38, p <.01), barbiturates use (OR = 59.36, p <.05), waterpipe smoking (OR = 8.62, p <.05), vape smoking (OR = 10.37, p <.05), and inversely associated with age (OR = 0.832, p <.001). Conclusion: Findings from this study demonstrated a substantially increased frequency of substance use among Palestinian refugees with ED and unhealthy weight control behaviors. This study highlighted new challenge for the health system to deal with new emerging health conditions among male refugees. [ABSTRACT FROM AUTHOR]

Objective: The aims of this study were to determine the amount of smoking, the presence of back pain and the severity of pain, and to examine whether there was a relationship between smoking and back pain. Methods: The sample of the study consisted of 100 randomly selected students who were educated at university and had back pain. In individuals, a 22-question questionnaire and 21-question Beck Depression Scale were used, questioning parameters such as sociodemographic characteristics, physical activity levels, previous health problems, smoking status, as well as pain assessment tests. The results were analyzed by appropriate statistical methods. Results: Morning back pain was found to be higher in smokers compared to nonsmokers. (p <.05) BECK Depression Scale scores of smokers were found to be significantly different compared to nonsmokers (p =.00). In addition, it was observed that smokers needed more psychological medical support than nonsmokers (p =.00). Conclusions: This study revealed that although some significant results were found between smoking and some factors that cause back pain, there was no significant difference between smokers and nonsmokers. [ABSTRACT FROM AUTHOR]

Background: Research on alcohol-related problems often examines individual problem types in isolation or uses scales that provide a single cumulative severity score for alcohol-related harms. This study aims to assess the patterns of seventeen distinct alcohol-related problems and how they co-occur. Methods: The East Bay Neighborhood Study surveyed a community sample of 864 adults who drank in the past year in Alameda County, California. Participants reported if they experienced each of seventeen alcohol-related problems in the last year. Latent class analysis assessed subgroups of problems. Logistic regression models examined associations between class membership, sociodemographics, and alcohol use. Results: A two-class model best fit the data. The multiple problems class (18% of respondents) was characterized by experiencing problems of all types and almost all experiences of legal, violence, and risky sex-related problems. The none/few problems class (82%) was characterized by a low prevalence of all problem types, with only a small proportion experiencing hangovers. In adjusted models, only older age (AOR = 0.90, 95% CI = 0.88–0.92) had lower odds of multiple problems class membership. Conclusions: Numerous alcohol-related problems co-occurred within a small subgroup of people who drank in the last year, while the majority experienced few problems. Results suggest that focusing on singular alcohol-related problems may overlook patterns of concurrent problems in high-risk groups. [ABSTRACT FROM AUTHOR]

Background: The present study aimed to identify sociodemographic characteristics, risky behaviors, type of drug use, and service use variables associated with emergency department (ED) use and hospitalization among people who inject drugs (PWID). Methods: Studies in English published from January 1, 1995, to December 15, 2021, were searched for on PubMed, Scopus, Cochrane, and Web of Science to identify primary studies on ED use and hospitalization among PWID. Results: After a detailed assessment of 17,348 outputs, a total of 19 studies met the eligibility criteria for inclusion in the analysis. Greater risks of ED use and hospitalization among PWID were associated with (i) a history of homelessness, (ii) HIV-positive status, and (iii) injecting drugs more than four times per day. Individuals were more likely to use the ED if they (i) had a history of physical abuse, (ii) were using cocaine and methamphetamine, and (iii) had used primary care services. Women and individuals with chronic physical illnesses were more likely to be hospitalized. Conclusions: The present study is the first to integrate determinants related to ED use and hospitalization based on sociodemographic characteristics, risky behaviors, type of drug, and service use determinants among PWID. To reduce ED use and hospitalization among PWID, the paper also recommends various strategies could be implemented. [ABSTRACT FROM AUTHOR]

Background: Individuals with disabilities are more likely to use substances and have cardiovascular disease (CVD) than individuals without disabilities. CVD is associated with drug use, which increases the risk for poor CVD outcomes. Our aim was to test the association between CVD and lifetime drug use (LDU) among those with vision loss (VL) and/or hearing loss (HL) and assess if disability type moderated this association. Methods: Multivariable logistic regression incorporating complex survey design was used to estimate adjusted odds ratios (AOR) using data from NHANES 2013–2018. Results: Although not quite statistically significant (p ≥.05), the magnitude of effect modification was large. The effect was positive among those with VL (AOR = 1.55, 95% confidence interval (CI) = 0.73, 3.30) or HL (AOR = 1.69, 95% CI = 0.56, 5.11), but among those with both CVD was associated with 75% lower odds of LDU (AOR = 0.25, 95% CI = 0.06, 1.05). After adjusting for multiple comparisons, the CVD effect was significantly different between those with VL versus both VL and HL (p <.05), and nearly significantly different between those with HL versus both (p ≥.05). Conclusions: Additional research could focus on the relationship between CVD and LDU among persons with sensory disabilities. [ABSTRACT FROM AUTHOR]

Purpose: The aims were to translate the Evaluation of Daily Activity Questionnaire (EDAQ) into Turkish, then test validity and reliability in people with rheumatoid arthritis (RA) in Turkey. Material and Methods: Phase 1: The EDAQ was forward and backward translated, culturally adapted following cognitive debriefing interviews with participants with RA (n = 10) and finalized by an expert committee. Phase 2: Participants (n = 215) completed a questionnaire including the EDAQ, Health Assessment Questionnaire (HAQ), and Short-Form 36 v1 (SF-36v1). Two weeks later, the EDAQ was again completed for test–retest reliability (n = 82:38%). Internal construct validity was assessed using Rasch analysis. Internal consistency, concurrent validity, and test–retest reliability were assessed. Results: Following cultural adaptation, one item was removed, and examples increased or changed. Cronbach's α values were 0.71 − 0.93 for all EDAQ domains, that is, acceptable to good. The EDAQ met Rasch model requirements for fit (excellent construct validity: p > 0.05). Concurrent validity was moderate to strong for most EDAQ domains with HAQ (rs 0.49–0.81) and SF-36-v1 Physical Function (rs 0.42–0.70). There was excellent test–retest reliability for all domains (ICC (2,1): 0.95–1.00). Conclusion: The Turkish EDAQ is a valid, reliable measure of daily activity ability for use in practice and research with Turkish speakers with RA. IMPLICATIONS FOR REHABILITATION: The Evaluation of Daily Activity Questionnaire provides a comprehensive evaluation of daily activity ability for people with rheumatic and musculoskeletal diseases. The Turkish Evaluation of Daily Activity Questionnaire is a valid, reliable patient-reported outcome measure in patients with rheumatoid arthritis, who considered it easy to complete. The Turkish Evaluation of Daily Activity Questionnaire is suitable for use in clinical practice and research to evaluate daily activity ability in people with rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

Purpose: To determine prevalence of musculoskeletal complaints (MSCs) in adults with major congenital upper limb differences (CoULD) compared to able-bodied controls, and to examine associations of MSCs and disability with various biopsychosocial factors. Materials and methods: Questionnaire-based cross-sectional study assessing MSCs, disability (using the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH)), general and mental health status, physical work demands, and upper extremity range of motion. Results: Seventy-one individuals with CoULD (participation rate: 41%) and 71 controls matched on age, gender, and education were included (49% female, mean age 28.9 years). Year prevalence of MSCs was significantly higher in the CoULD group (35%) than in the control group (18%). The CoULD group was less often employed and had lower scores on all measures of upper limb range of motion and hand grip. MSCs were associated with higher DASH scores and higher reported work demands. Disability was associated with female gender, more joints with limited range of motion, unemployment, and lower general and mental health. Factors associated with disability did not differ between groups. Conclusions: MSCs are a frequent problem in young adults with major CoULD. To prevent or reduce MSC and disability, clinicians and researchers should be aware of the associated factors. Implications for rehabilitation: The year prevalence of musculoskeletal complaints (MSCs) in those with major congenital upper limb differences (CoULD) was approximately double to that of the control group, implying a potential relationship between CoULD and MSCs. Rehabilitation professionals should develop personalized strategies to manage work demands in those with CoULD, considering the association between MSCs and higher reported work demands. Recognizing the impact of a negatively perceived body image on mental health, clinicians should integrate psychological counseling into rehabilitation treatments to support mental well-being and improve overall quality of life in those with CoULD. Rehabilitation professionals should educate individuals with CoULD about the potential associations between upper limb work demands, MSCs, and disability. [ABSTRACT FROM AUTHOR]

Purpose: This study evaluated whether anthropometric measurements and the five times sit-to-stand test could be used to identify dynapenia. The cut-off values of accurate screening tools for identifying dynapenia were also established. Materials and methods: This was a cross-sectional study conducted on individuals ≥ 60 years old (N = 529). All participants underwent handgrip strength measurement, anthropometric measurements and the five times sit-to-stand test. The participants whose handgrip strength was < 28 kg for men and < 18 kg for women were considered to have dynapenia. The association between the recorded variables and dynapenia was determined using logistic regression, and cut-off values were established by performing the Receiver Operating Characteristic curve analysis. Results: The prevalence of dynapenia was 35.42% in men and 25.61% in women. For males, both calf circumference (≤ 35.2 cm) and the five times sit-to-stand test (≥ 14.6 s) could be used as accurate tools for dynapenia. For females, only the five times sit-to-stand test (≥ 11.8 s) had sufficient accuracy to be used as a screening tool for dynapenia. Conclusions: The five times sit-to-stand test was an accurate screening tool for identifying dynapenia. The calf circumference could be only used as a screening tool in males. IMPLICATIONS FOR REHABILITATION: Calf circumference and the five times a sit-to-stand test can be used as accurate screening tools in males with dynapenia. Only the five times sit-to-stand test had sufficient accuracy in females with dynapenia. The optimal cut-off values established for older males and females are only applicable to the Asian population. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the relationship between physical activity (PA) levels and short-term changes in skeletal muscle characteristics in patients with subacute hemiparetic stroke. Materials and Methods: This prospective observational study included 76 patients with stroke who received inpatient care in a convalescent rehabilitation ward. The PA level was measured as the duration of daily total PA (≥ 1.5 metabolic equivalents) using a triaxial accelerometer for 7 days after admission. The outcomes were changes in the quadriceps muscle quality and quantity on the affected and unaffected sides, as assessed by ultrasonography at admission and 1 month after admission. Results: Multiple regression analysis indicated that the duration of total PA was significantly associated with a percentage change in quadriceps muscle quality (p = 0.011) and quantity (p = 0.012) on the affected side. However, no significant relationship was observed between the muscle quality and quantity on the unaffected side. Conclusions: The results revealed that PA was associated with changes in the quadriceps muscle quality and quantity on the affected side in patients with subacute hemiparetic stroke. These findings highlight the importance of promoting PA in stroke rehabilitation to improve muscle properties and functional outcomes. IMPLICATIONS FOR REHABILITATION: Improving skeletal muscle quality and quantity is an important goal in post-stroke rehabilitation. We investigated physical activity and post-stroke changes in muscle properties. Physical activity is related to changes in muscle quantity and quality on the affected side. Promoting physical activity is essential for improving muscle quantity and quality on the affected side. [ABSTRACT FROM AUTHOR]

Introduction: Studies analyzing postures and mobility of the thoracic spine in the context of cervicogenic headache are missing. Insight in these parameters is needed since the cervical and thoracic spine are biomechanically related. Objective: To compare self-perceived optimal and habitual postures, active-assisted maximal range of motion, and repositioning error of the upper-thoracic and lower-thoracic spine between a cervicogenic headache-group and matched healthy control-group before and after a 30 min-laptop-task. Methods: A non-randomized longitudinal design was used to compare thoracic postures and mobility between 18 participants with cervicogenic headache (29–51 years) and 18 matched healthy controls (26–52 years). Outcomes were: self-perceived optimal and habitual postures, active-assisted maximal range of motion, and repositioning error of the upper-thoracic and lower-thoracic spine evaluated in sitting with a 3D-Vicon motion analysis system. Results: Habitual upper-thoracic postures in the cervicogenic headache-group were significantly (p =.04) less located toward the maximal range of motion for flexion compared to the control-group, self-perceived optimal upper-thoracic posture was significantly (p =.004) more extended in the cervicogenic headache-group compared to the control-group, and self-perceived optimal lower-thoracic posture could not be reestablished in the cervicogenic headache-group after the laptop-task (p =.009). Conclusion: Thoracic postures differ between a cervicogenic headache-group and control-group. These differences were detected by expressing the habitual thoracic posture relative to its maximal range of motion, and by analyzing the possibility of repositioning the thoracic spine after a headache provoking activity. Longitudinal studies are needed to determine the contribution of these musculoskeletal dysfunctions to the pathophysiology of cervicogenic headache. [ABSTRACT FROM AUTHOR]

Background: Identifying the minimal clinically important difference (MCID) contributes to the ability to determine the efficacy of physiotherapy interventions and make good clinical decisions. Purpose: The purpose of this study was to estimate the MCID for 6-minute walking distance (6MWD) among inpatients with subacute cardiac disease using multiple anchor-based methods. Methods: This study was a secondary data analysis using only data from a multicenter longitudinal observational study in which 6MWD was measured at two time points. Based on the changes in 6MWD between baseline measurement and follow-up approximately 1 week after baseline measurement, the global rating of change scales (GRCs) of patients and physiotherapists, anchor method receiver operator operating characteristic curves, predictive models, and adjusted models were used to calculate the MCID. Results: Participants comprised 35 patients. Mean (standard deviation) 6MWD was 228.9 m (121.1 m) at baseline and 270.1 m (125.0 m) at follow-up. MCID for each GRC was 27.5–35.6 m for patients and 32.5–38.6 m for physiotherapists. Conclusion: The MCID in 6MWD in patients with subacute cardiovascular disease is 27.5–38.6 m. This value may be useful in determining the effectiveness of physiotherapy interventions and for decision-making. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of exercise therapy on neuropathic symptoms, signs, psychosocial aspects, and physical function in people with diabetic neuropathy (DN). Methods: A search in PubMed, Web of Science, Physiotherapy Evidence (PEDro), and Cochrane databases was performed from inception to Invalid Date NaN,. Randomized clinical trials (RCTs) were selected in patients with DN comparing exercise therapy with a control group. The studies' methodological quality was assessed with the PEDro scale. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the overall quality. Results: Eleven RCTs (n = 517 participants) were included. Nine studies showed high methodological quality. Mean (MD) and standardized mean differences (SMD) were observed in favor of exercise therapy for symptoms (MD = −1.05; confidence interval 95% = −1.90 to −0.20), signs (SMD = −0.66; confidence interval 95%= −1 to −0.32), and physical function (SMD = −0.45; confidence interval 95% = −0.66 to −0.24). No changes were found in psychosocial aspects (SMD = −0.37; confidence interval 95% = −0.92 to 0.18). The overall quality of evidence was very low. Conclusion: The quality of evidence suggesting that exercise therapy provides short-term benefits in neuropathic symptoms, signs, and physical function in patients with DN is very low. Furthermore, there were no effects found on psychosocial aspects. [ABSTRACT FROM AUTHOR]

Purpose: To assess the Consultation And Relational Empathy (CARE) measure as a tool for examiners to assess medical students' empathy during Objective and Structured Clinical Examinations (OSCEs), as the best tool for assessing empathy during OSCEs remains unknown. Methods: We first assessed the psychometric properties of the CARE measure, completed simultaneously by examiners and standardized patients (SP, either teachers - SPteacher - or civil society members - SPcivil society), for each student, at the end of an OSCE station. We then assessed the qualitative/quantitative agreement between examiners and SP. Results: We included 129 students, distributed in eight groups, four groups for each SP type. The CARE measure showed satisfactory psychometric properties in the context of the study but moderate, and even poor inter-rater reliability for some items. Considering paired observations, examiners scored lower than SPs (p < 0.001) regardless of the SP type. However, the difference in score was greater when the SP was a SPteacher rather than a SPcivil society (p < 0.01). Conclusion: Despite acceptable psychometric properties, inter-rater reliability of the CARE measure between examiners and SP was unsatisfactory. The choice of examiner as well as the type of SP seems critical to ensure a fair measure of empathy during OSCEs. [ABSTRACT FROM AUTHOR]

This study examined the effects of resistance training (RT), Tai Chi (TC) and combination intervention (RT & TC) on the oxidative stress, blood glucose and lipid metabolism and quality of life of elderly patients with type 2 diabetes mellitus (T2DM). Ninety-four elderly patients with T2DM were randomly divided into an RT group (RTG, n = 23), TC group (TCG, n = 24), combination intervention group (CIG, n = 24) and control group (CG, n = 23). All participants were given nutrition and medication. On this basis, RTG, TCG and CIG were administered for 24 weeks (3 times/week, 40 minutes/time). Observation indicators were malondialdehyde (MDA), superoxide dismutase (SOD), 8-hydroxy-2 deoxyguanosine (8-OHdG), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), haemoglobin A1c (HbA1c) and diabetes specific quality of life (DSQL). RT, TC and joint intervention can reduce the oxidative stress damage on elderly patients with T2DM to different degrees, control the levels of blood sugar and blood lipid and improve the quality of life. Compared with single intervention, combination intervention can further reduce the level of oxidative stress but has no additional benefits on blood glucose and lipid control and quality of life. [ABSTRACT FROM AUTHOR]

Multiple exercises included in strength training involve greater activation of the quadriceps compared to hamstring muscles, which may lead to knee joint imbalances. The aim of this study was to examine the ratio of surface electromyography (sEMG) activity hamstring and quadriceps muscle groups (hamstring-to-quadriceps activation ratio; H:Q EMG), as well as lateral to medial hamstring activation ratio (LH:MH) in parallel squat, Romanian deadlift, hip thrust, lying leg curl and seated knee extension. The H:Q EMG was greater during lying leg curl compared to other exercises during both the concentric and eccentric phase, however the Romanian deadlift and hip thrust also resulted in relatively high H:Q EMG. Pairwise comparisons revealed that LH:MH was greater in the parallel squat compared to the Romanian deadlift and hip thrust in the concentric phase, and compared to the Romanian deadlift and hip thrust during the eccentric phase. Our data suggests that the lying leg curl promotes the greatest hamstring activation and H:Q EMG, amongst the exercises investigated, while also providing relatively homogenous LH:MH. The lying leg curl should be considered as a primary exercise in rehabilitation and training programmes, aiming to proportionally activate LH:MH and increase H:Q EMG, which may improve knee muscle balance. [ABSTRACT FROM AUTHOR]

The aims of the study were to build models using logistic regression analysis of flexibility and strength tests to prospectively predict risk factors for anterior cruciate ligament tear (ACL-tear) in female soccer (FS) players, and to determine training cut-off for risk factors of the predictive model built. A prospective cohort study of 95 female players (aged 14–33 years) was conducted. Age, anthropometric data, soccer history, lower limb range of motion (ROM) and hip maximal isometric strength (MIS) were measured. At the prospective follow-up after 12 months, 7.4% of the players had developed an ACL-tear. The model showed a significant relationship (χ2(93) = 30.531, p < 0.001) between the ACL-tear and the predictor variables (leg length, HAD-NH [hip adduction] MIS, asymmetric ROM [ankle dorsiflexion with knee extended (AD-KE) and with knee flexed (AD-KF), and HE (hip extension)], hip ROM [HIR (internal rotation) and HAB (abduction)]). The Akaike Information Criteria (AIC) and Bayesian Information Criteria (BIC) for model fit were 30.24 and 51.79, respectively. The value R2 showed good model fit, 76.5% for Nagelkerke´s R2, 71.4% for McFadden´s R2 and 67.5% for Tjur´s R2. For the screening test, cut-off for leg length of ≥0.40 m, for HIR ROM of ≤44º and for asymmetry of HE ROM of ≥5° were set, which have an acceptable (AUC ≥ 0.755) discriminatory ability for the development of ACL-tear. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the awareness and knowledge of professional team sport athletes about ACL injuries, injury prevention programs, and the return to sports after ACL injuries. A total of 419 athletes representing soccer, basketball, volleyball and handball sports were included in the study. We utilized a 15-item self-report survey to assess the awareness of athletes about ACL injury, ACL injury prevention program, and return to sport after ACL injuries. Male and soccer players participated in prevention programs more than female athletes (p = 0.001). Participation in prevention programs was significantly higher in the ≥ 18 years old group than in the < 18 years old group (p = 0.040). Participants who were informed about ACL injuries were 8.4 times more likely to participate in the ACL injuries prevention program than others (OR: 8.38, 95% CI: 3.823–18.376, p < 0.001). The majority of participants believed that return to sport after ACL injury takes 6 months and 81.4% of them thought that it is not possible to do sport without an ACL. This study revealed that the awareness and performance of ACL prevention training programs among professional team sport athletes were insufficient. The athletes' knowledge regarding return to sports after ACL injuries was also inadequate. Improving athletes' knowledge of ACL injuries may lead to increased participation in ACL injury prevention programs. Thus, the provision of tailored educational interventions to athletes could potentially enhance their awareness and understanding of ACL injuries, consequently contributing towards the prevention of such injuries. [ABSTRACT FROM AUTHOR]