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Migrant and mixed households have higher poverty than non-migrant households. This is partly because single-earner two-adult households are more prevalent in migrant and mixed households and because such households have different job characteristics. One crucial job characteristic is teleworkability. Whether or not individuals can work from home has become a dividing factor in the labour market. While much research has focused on how teleworkability affects poverty in the majority population, less attention has been devoted to migrant and mixed two-adult households. Using the German Microcensus (2019), we construct work arrangements based on the number of earners in the household and their job‘s teleworkability to predict poverty for non-migrant (N = 49,507), mixed (N = 6,818), and migrant households (N = 8,922). Descriptive statistics show that, in Germany, migrant and mixed households have more single-earner and non-teleworkable work arrangements. Results from logistic regressions report higher poverty for non-teleworkable and single-earner work arrangements, putting mixed and migrant households at an increased disadvantage. Furthermore, we find that migrant (and mixed) households not only have a higher prevalence of high-poverty work arrangements but also higher poverty than non-migrant and mixed households within the same work arrangements. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effectiveness of radial extracorporeal shock wave therapy (r ESWT) as an additional treatment modality for spastic equinus deformity in chronic hemiplegic patients. Methods: 100 eligible stroke patients with calf muscles spasticity were randomized into 2 groups. Group I: 50 patients exposed to rESWT 1.500 pulses, 0.10 mJ to 0.3mJ/mm2, with a frequency 4 Hz once weekly for one month. Group II: 50 patients exposed to Sham rESWT once weekly for one month. Clinical, electrophysiological & musculoskeletal ultrasound assessments were done for all patients. Results: After controlling baseline as covariate, the trend for modified Ashworth scale (MAS), Passive ankle dorsiflexion motion (PADFM), 10 meters walk test (10-MWT), and Ratio of maximum H reflex to maximum M response (H/M ratio) after one & two months was significantly different between the two groups, with improvement of all clinical and electrophysiological parameters in group I. Conclusion: ESWT represents a useful non-invasive, additional modality for the reduction of foot spasticity and equinus deformity in stroke patients. Implications for Rehabilitation: Extracorporeal shock wave therapy represents a useful non-invasive, additional modality for reduction of foot spasticity and equinus deformity in chronic stroke patients. The application of such a modality improves limb posture, range of motion, and muscle extensibility. Early extracorporeal shock wave rehabilitative intervention in stroke patients reduces fat infiltration and fibrosis replacement of spastic muscle. [ABSTRACT FROM AUTHOR]

Purpose: Cognitive fatigue is commonly reported and described as disabling by patients recovering from neurological conditions including stroke. However, cognitive fatigue is usually underdiagnosed among stroke survivors which leads to a lack of specific treatments for this condition. Therefore, the aim of this study was to explore post-stroke cognitive fatigue as it is experienced by stroke survivors. Methods: This qualitative research followed the principles of descriptive phenomenology within a constructivist paradigm. Individual semi-structured interviews were conducted with stroke survivors experiencing post-stroke cognitive fatigue recruited through the Heart and Stroke Foundation, the Canadian Partnership for Stroke Recovery, and social media posts. Data were analyzed through inductive content analysis. Results: Eleven stroke survivors participated. The analysis revealed five themes illustrating the experience and descriptions of post-stroke cognitive fatigue: (1) characteristics, (2) aggravating factors, (3) management, (4) effect of cognitive fatigue on daily life, and (5) social awareness and support. Conclusion: This study highlights the complexity of post-stroke cognitive fatigue. Cognitive fatigue becomes more evident after discharge; therefore, clinicians should consistently screen for it and provide proper education to the patients and their carers. IMPLICATIONS FOR REHABILITATION: Cognitive fatigue is a complex phenomenon that can negatively affect the daily life of stroke survivors. Sensory-overloaded environments, emotional distress, poor sleep, and engaging in complex cognitive tasks can trigger post-stroke cognitive fatigue. More education on the concept of cognitive fatigue should be provided to healthcare providers to be able to identify and manage this symptom properly. [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 estimate the effect of integrating custom-designed hand therapy video games (HTVG) with contralaterally controlled functional electrical stimulation (CCFES) therapy. Methods: Fifty-two stroke survivors with chronic (>6 months) upper limb hemiplegia were randomized to 12 weeks of CCFES or CCFES + HTVG. Treatment involved self-administration of technology-mediated therapy at home plus therapist-administered CCFES-assisted task practice in the lab. Pre- and post-treatment assessments were made of hand dexterity, upper limb impairment and activity limitation, and cognitive function. Results: No significant between-group differences were found on any outcome measure, and the average magnitudes of improvement within both groups were small. The incidence of technical problems with study devices at home was greater for the CCFES + HTVG group. This negatively affected adherence and may partially explain the absence of effect of HTVG. At end-of-treatment, large majorities of both treatment groups had positive perceptions of treatment efficacy and expressed enthusiasm for the treatments. Conclusion: This study makes an important contribution to the research literature on the importance of environmental factors, concomitant impairments, and technology simplification when designing technology-based therapies intended to be self-administered at home. This study failed to show any added benefit of HTVG to CCFES therapy. Clinicaltrials.gov (NCT03058796). IMPLICATIONS FOR REHABILITATION: Contralaterally controlled functional electrical stimulation (CCFES) is an emerging therapy for upper limb rehabilitation after stroke that is designed, in part, to be self-administered at home. While movement-soliciting video games have shown promise in rehabilitation, this study failed to show a significant added benefit of integrating CCFES with hand therapy video games. For technology-based therapies intended to be self-administered at home, this study brings to light the importance of making every component of rehabilitation technology as user friendly and trouble-free as possible. For technology-based therapies intended to be self-administered at home, this study brings to light the importance of assuring that the home environment is conducive to home-based therapy. [ABSTRACT FROM AUTHOR]

Purpose: To explore families' experiences of participating in a family intervention, targeting families living with the consequences of acquired brain injury (ABI) or spinal cord injury (SCI). Materials and methods: Individuals with ABI or SCI and their family members were recruited from a randomised controlled trial investigating the effectiveness of the manual-based family intervention, which consisted of eight weekly sessions. Semi-structured interviews were conducted with 16 families (n = 33). The data were analyzed through reflexive thematic analysis. Results: One central theme was developed "A sense of belonging together again", describing the value of the reciprocal format of the family intervention, where individuals with ABI or SCI and their family members gained new insights into each other while building up their relationship. The central theme was supported by three additional themes: "Strengthened communication and emotional control", "Acknowledging the changed life situation" and "Being seen as a whole person". Conclusions: The family intervention supported the families to strengthen family cohesion and to be capable to manage the changed life situation. The findings emphasize the importance of a family-centered approach in neurorehabilitation, and how healthcare professionals play a significant role in facilitating families to achieve a balanced level of family cohesion. IMPLICATIONS FOR REHABILITATION: Acquiring an injury to the brain or spinal cord constitutes a severe life change for the entire family and therefore a family-centered approach in neurorehabilitation is crucial. As individuals with injury and their family members often feel disconnected during rehabilitation, healthcare professionals play a significant role in facilitating the family to share their experiences with each other to strengthen family cohesion. Not all families are aware of their need for support. Thus, healthcare professionals should pay particular attention to identify the individual family's needs for being supported. During conversations with families, healthcare professionals should focus on the balance between separateness and togetherness in the family system to support the families in achieving a balanced level of family cohesion. [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 focus group study aimed to explore experiences and perceptions on post-stroke fatigue guidance in Dutch rehabilitation and follow-up care among people/patients with stroke and health professionals. Methods: Ten persons with stroke and twelve health professionals with different professions within stroke rehabilitation or follow-up care in the Netherlands were purposively sampled and included. Eight online focus group interviews were conducted. We analysed the data using reflexive thematic analysis. Results: Three themes were identified. Guidance in fatigue management did not always match the needs of people/patients with stroke. Professionals were positive about the provided fatigue guidance (e.g. advice on activity pacing), but found it could be better tailored to the situation of people/patients with stroke. Professionals believe the right time for post-stroke fatigue guidance is when people/patients with stroke are motivated to change physical activity behaviour to manage fatigue – mostly several months after stroke – while people/patients with stroke preferred information on post-stroke fatigue well before discharge. Follow-up care and suggestions for improvement described that follow-up support after rehabilitation by a stroke coach is not implemented nationwide, while people/patients with stroke and professionals expressed a need for it. Conclusions: The study findings will help guide improvement of fatigue guidance in stroke rehabilitation programmes and stroke follow-up care aiming to improve physical activity, functioning, participation, and health. IMPLICATIONS FOR REHABILITATION: We recommend fatigue guidance, including peer support, to be accessible to all people after stroke and for health professionals to pay attention to acceptance of the stroke. To improve fatigue guidance, we suggest providing information on post-stroke fatigue to people after stroke and their relatives well before discharge from stroke rehabilitation. Tailored advice on activity pacing during and after stroke rehabilitation is important to fill the current unmet need of people after stroke to manage fatigue and to gradually improve participation, physical activity behaviour and health. We recommend to health professionals working in stroke rehabilitation to tailor the rehabilitation schedule to their patients' energy level and perception of fatigue levels. [ABSTRACT FROM AUTHOR]

Purpose: To develop a virtual reality (VR) based intervention targeting community walking requirements. Methods: Two focus groups each involving 7 clinicians allowed exploring optimal features, needed support and perceived favorable/unfavorable factors associated with the use of the VR-based intervention from the clinicians' perspective. Three stroke survivors and 2 clinicians further interacted with the intervention and filled questionnaires related to acceptability and favorable/unfavorable perceptions on the VR intervention. Stroke participants additionally rated their perceived effort (NASA Tax Load Index), presence (Slater-Usoh-Steed) and cybersickness (Simulator Sickness Questionnaire). Results: Results identified optimal features (patient eligibility criteria, task complexity), needed support (training, human assistance), as well as favorable (cognitive stimulation, engagement, representativeness of therapeutic goals) and unfavorable factors (misalignment with a natural walking pattern, client suitability, generalization to real-life) associated with the intervention. Acceptability scores following the interaction with the tool were 28 and 42 (max 56) for clinicians and ranged from 43 to 52 for stroke participants. Stroke participants reported moderate perceptions of effort (range:20-33/max:60), high levels of presence (29-42/42) and minimal cybersickness (0-3/64). Conclusion: Findings collected in the early development phase of the VR intervention will allow addressing favorable/unfavorable factors and incorporating desired optimal features, prior to conducting effectiveness and implementation studies. IMPLICATIONS FOR REHABILITATION: This study presents the development process of a new virtual reality (VR) intervention for community walking and participation in stroke survivors. Results from the focus group and hands-on pilot trial suggest that the VR intervention is feasible and accepted by clinicians and stroke survivors. Addressing favorable/unfavorable factors and incorporating features desired by clinicians in the development of the VR tool should promote its eventual implementation in clinical setting. [ABSTRACT FROM AUTHOR]

Purpose: Little is known about the outcomes that are most important to prosthesis users and funders. A Prosthetic Interventions Core Outcome Set (PI-COS) will help researchers and practitioners measure outcomes that are the most important to prosthesis users and funders. Materials and methods: Prosthesis users and funders rated the importance of 121 International Classification of Functioning, Disability, and Health (ICF) second-level categories using a two-round Delphi survey. A Consensus Meeting using the nominal group technique resolved rating differences between groups. The ICF second-level categories were ranked according to importance and a K-Means Cluster Analysis helped establish the PI-COS. Results: 65 users and 8 funders completed the Delphi surveys, followed by a Consensus Meeting. 26 ICF second-level categories were considered important to prosthesis users and funders and a PI-COS of 14 ICF second-level categories drawn predominantly from five ICF chapters was established: Sensory Functions and Pain (b2), Neuromusculoskeletal and Movement-related Functions (b7), General Tasks and Demands (d2), Mobility (d4), and Products and Technology (e1). Conclusions: The PI-COS describes the outcomes that are most important to prosthesis users and funders. The PI-COS can help focus on the most important outcome measures in clinical practice and research, including future prosthetic health economic evaluations. [ABSTRACT FROM AUTHOR]

Background: Exercise-based cardiac rehabilitation improves clinical outcomes and quality of life. Technology-enabled delivery of remote cardiac rehabilitation is as effective in improving health outcomes as in-person delivery and has the potential to transform clinical service delivery. However, for the successful translation of research to clinical practice, interventions must be adequately reported in the literature. Methods: Systematic review of MedLine, CINAHL, PubMed and SPORT Discus databases applying PRISMA guidance. Randomised controlled trials of remote or hybrid technology-enabled exercise-based cardiac rehabilitation interventions were included. Completeness of reporting was evaluated against the TIDieR checklist. Results: The search strategy returned 162 articles which, following screening, resulted in 12 randomised trials being included containing data for 1588 participants. No trial fully reported their rehabilitation intervention as per the 12-item TIDieR checklist, with a median score of eight out of 12 categories. Notably, intervention detail, dosage and modification were comparatively poorly reported. Conclusion: Technology-enabled remotely delivered cardiac rehabilitation may be effective at improving cardiovascular fitness; however, the quality of reporting of these interventions in randomised trials is insufficient for replication which has material implications for translation into clinical practice. [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 synthesizes participant and outcome data from peer-reviewed Intensive Comprehensive Aphasia Programme (ICAP) studies. Methods: A systematic review was conducted following PRISMA guidelines. Study eligibility criteria were specified in relation to population, intervention, comparison, outcome, and design considerations. Data were extracted according to six research questions. Narrative synthesis was used. Results: Twenty-one studies were included covering 13 ICAPs (N = 485, aged 18–86 years, between 11 and 335 months post-stroke). Twenty-seven participant selection criteria were identified. Fifty-six outcome measures spanning the WHO-ICF were used, with the majority assessing the body function domain. Only eight studies employed an experimental design with data appropriate for analysis and synthesis. Risk of bias was noted across this sub-group. Participants improved in word-finding, communication, activity/participation, and communication-related quality of life, and maintained their gains; however, except for word finding, evidence of effect came from isolated studies. Factors influencing outcomes were rarely considered. Some drop-outs, missed sessions, and fatigue were noted. Some studies reported IPD alongside group analyses. Conclusions: ICAP selection criteria need justification and should contribute to the understanding of candidacy for this treatment model. Rationalisation of ICAP treatment content and outcome measurement is required, spanning all WHO-ICF domains. Employment of the core outcome set for aphasia would enable data synthesis and facilitate comparisons between the ICAP and other therapy models. Implications for Rehabilitation: Healthcare professionals can use this review to appreciate that the evidence base for intensive and comprehensive aphasia programmes is emerging and based on studies of varying methodological quality and thus findings are not conclusive. Patients across the lifespan and across a range of aphasia severities, and patients who are independent or have support for activities of daily living, can participate in intensive and comprehensive aphasia programmes. Patients can expect improved word finding ability from participation in an intensive and comprehensive aphasia programme, and some patients can experience benefits in functional communication, communication confidence, and aphasia-related quality of life. Outcome measurement from intensive and comprehensive aphasia programmes should encompass language functioning, communication activities/participation, quality of life, and outcomes for family members, and ideally environmental and personal factors should be considered. [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]

Purpose: To examine associations between illness perception, also called illness cognitions or appraisals, disposition of passive coping, and symptoms of anxiety and depression, and to test whether passive coping mediates the associations between illness perception and symptoms of anxiety and depression. Materials and methods: Longitudinal, multicentre study. Participants were inpatients of spinal cord injury (SCI) rehabilitation. Measures included the Brief Illness Perception Questionnaire (B-IPQ), the Utrecht Coping List passive coping subscale (UCL-P), and the Hospital Anxiety and Depression Scale (HADS). Mediation was tested with the PROCESS tool. Results: The questionnaires were completed by 121 participants at admission and at discharge. Of them, 70% were male, 58% had a paraplegia, and 82% an incomplete lesion. Weak to strong (0.294–0.650) significant associations were found between each pair of study variables. The use of passive coping strategies mediated the associations between illness perception and symptoms of anxiety and depression. Conclusion: Symptoms of anxiety and depression were more frequent in people who have a threatening illness perception combined with a lower use of passive coping strategies. Therefore, it is advised that patients are screened and treated for threatening illness perception and high use of passive coping strategies during rehabilitation after SCI. IMPLICATIONS FOR REHABILITATION: For rehabilitation professionals it is recommended to screen inpatients with spinal cord injury (SCI) for illness perception and disposition of passive coping to identify those who may be more vulnerable for symptoms of anxiety and depression at admission. Inpatients with SCI who report a threatening illness perception in combination with a high use of passive coping at admission, have an increased risk for symptoms of anxiety and depression. For rehabilitation professionals it is recommended to repeat this screening to support careful planning of psychological (follow-up) treatment and coordination of care at discharge. [ABSTRACT FROM AUTHOR]

Purpose: After stroke, upper limb somatosensation can be impaired which affects motor control. Vision is often used to compensate for this. A clinical assessment which assesses the combined sensorimotor function in the absence of vision would be beneficial in studies targeting sensorimotor improvement. Methods and materials: We adapted the Action Research Arm Test (ARAT) to be performed without vision and called this modified version the sensorimotor ARAT (sARAT). Sixty healthy participants and 22 participants with chronic stroke performed the ARAT, sARAT, Fugl-Meyer upper extremity assessment (FM-UE) and Erasmus modified Nottingham sensory assessment (EmNSA). Discriminative validity of sARAT was evaluated by comparing performance between healthy participants and participants with chronic stroke. Convergent validity was evaluated by correlating sARAT with FM-UE and EmNSA. Results: Participants with stroke performed worse on the sARAT compared to healthy participants (p < 0.001), with median scores of 52 (IQR 32-57) and 57 (IQR 57-57), respectively. The sARAT showed high correlations with FM-UE and EmNSA (r = 0.80-0.90). Conclusions: The sARAT shows good discriminative and convergent validity in people with chronic stroke. It allows a quick assessment of the combined upper limb sensorimotor function, by performing the well-known ARAT with the eyes closed. IMPLICATIONS FOR REHABILITATION: The sensorimotor adaptation of the Action Research Arm Test (sARAT) is a clinical assessment of upper limb activity which is performed with the eyes closed. Combining the gold standard ARAT with the sensorimotor adaptation sARAT can inform about the influence of somatosensory impairments on upper limb activity in stroke survivors when vision is blocked. The sARAT shows good discriminative and convergent validity in persons with chronic stroke. [ABSTRACT FROM AUTHOR]

Purpose: Life after any amputation can be significantly altered and can have a significant impact on quality of life (QoL). However, most of the evidence base involves older aged amputees, therefore there is a lack of understanding about the impact of amputation on QoL and the factors that predict QoL in younger amputees. The aim of this review is to identify the factors that predict QoL in young amputees. Methods: MEDLINE, CINAHL, EMBASE, PsycINFO, Web of Science were searched to identify articles that measured QoL in young amputees. Articles were independently assessed by two assessors. Data was extracted from the selected articles and a narrative synthesis performed. Results: 18 articles were included in this review. QoL outcome measures varied between studies. The quality of evidence was generally low. This review identified, gender, age, cause of amputation, level of amputation, phantom pain, ability to use a prosthesis, physical function, depression, anxiety, body image, type of prosthesis as predictors of QoL. Conclusion: This review identified modifiable and non-modifiable predictors of QoL in young amputees. Future research needs to focus on exploring the modifiable predictors of QoL as these are the aspects that can be improved to enhance QoL. IMPLICATIONS FOR REHABILITATION: Life after any amputation can be significantly altered and can have a significant impact on quality of life (QoL). Gender, age, cause of amputation, level of amputation, phantom pain, ability to use a prosthesis, physical function, depression and anxiety, body image and type of prosthesis were identified as predictors of QoL. The ability to use a prosthesis and access to advanced prosthetic technology are important predictors of QoL as they allow for improved mobility, which in turn increases independence and therefore QoL. [ABSTRACT FROM AUTHOR]

AbstractA TeachMeet is an informal gathering arranged by teachers to share and discuss practice with peers in a social setting. This paper focuses on reporting one fundamental finding of an in-depth exploration of TeachMeet, relating to the characteristics of the events; other findings are reported independently. TeachMeet originated in 2006, adopting participant-driven unconference practices and exploiting emergent social media channels and becoming a global phenomenon. This paper reports findings from a sensemaking exploration of TeachMeet events (n. = 15) in which analysis of data from observations highlighted elements most commonly present, which characterise the events. Data collected were analysed using Descriptive Statistics and Interpretative Phenomenological Analysis. This analysis found TeachMeets to be voluntary, open, non-hierarchical events attended by teachers from all levels and sectors, during which the three characteristic elements at play were (i) the catalytic role of the facilitator, (ii) the impact of nanopresentations, and (iii) the Open Space dynamic. The element of connectivity via social media was influential during and between events. We conclude that these elements in combination characterise this novel phenomenon for informal open professional learning among peers, at gatherings convened by and for teachers to share their experiences in the convivial setting of a TeachMeet. [ABSTRACT FROM AUTHOR]

ContextObjectivesMethodsResultsConclusionKey messageEnd-of-life palliative care aims to provide comprehensive care and can be marked by somatic, psychosocial, and spiritual distresses, requiring interdisciplinary care. However, interdisciplinary care is costly, and palliative care services, similar to all other medical services, are pressurized to be as cost-effective as possible.To describe the case complexity of palliative care inpatients, we evaluated possible correlations between complexity and the provision of care and identified complexity subgroups.Patients (N = 222) hospitalized in a specialist palliative care unit in Switzerland were assessed for biopsychosocial complexity using INTERMED. Based on a chart review, INTERMED scores were determined at admission and at the end of hospitalization or at death. Descriptive statistics and Pearson’s correlation coefficients were used to estimate the association between biopsychosocial complexity and the amount and type of care provided. Principal component analysis (PCA) was conducted to explain variance and identify patient subgroups.Almost all patients (98.7%) qualified as complex, as indicated by INTERMED. Provision of care was positively correlated (r = 0.23, p = 0.0008) with INTERMED scores upon admission. The change in the INTERMED score during the stay correlated negatively with the provision of care (r = −0.27, p = 0.0001). PCA performed with two factors explained 49% of the total variance and identified two subgroups that differed in the INTERMED psychosocial-item scores.Inpatients receiving specialist palliative care showed the highest complexity score of all populations assessed to date using INTERMED. Correlations between biopsychosocial complexity and care provided, and between care and decrease in complexity scores can be considered indicators of care efficiency. Patient subgroups with specific requirements (psychosocial burden) suggested that palliative care teams require specialist palliative care collaborators.Palliative care provision correlates with case complexity and is effective. [ABSTRACT FROM AUTHOR]

This study assessed the rate of a.) the total and b.) specific psychiatric comorbidities among the three severity ratings for Anorexia Nervosa (AN): DSM-5, ICD-11 and overvaluation of weight and shape (OWS). The sample comprised 312 treatment-seeking patients with AN (mean age = 26.9). Weight and height were taken at intake to calculate BMI, the foundation for the DSM-5 and ICD-11 severity indices. The EDE-Q was used to assess OWS, and the Mini International Neuropsychiatric Interview was conducted to assess psychiatric comorbidities. For the DSM-5, the mild severity group showed a higher total number of psychiatric comorbidities, especially for panic, social anxiety, generalised anxiety, and post-traumatic stress disorders compared to the severe and extremely severe groups. ICD-11 and OWS severity groups did not significantly differ in total comorbidities, except for major depressive disorder and obsessive-compulsive disorders being more prevalent in the "significantly low BMI" ICD-11 group. The high OWS group displayed a notably higher rate of major depressive disorder than the low OWS group. The study underscores inconsistent patterns across the three severity systems, emphasising the need to recognise the current limitations of the assessed severity classification systems in AN assessment and guiding treatment. [ABSTRACT FROM AUTHOR]

This study aimed to explore disordered eating behaviors in gender-affirming treatment (GAT)-seeking transgender (TG) adults and cisgender people, in addition to analyzing the association between gender dysphoria intensity, body mass index, and disordered eating behaviors. Data were collected from 132 GAT-seeking TG people with gender dysphoria who had never received GAT (91 TG men, 41 TG women), and 153 cisgender (99 cisgender men, 54 cisgender women) participants from Turkey. The Utrecht Gender Dysphoria Scale was used to evaluate the intensity of gender dysphoria. Eating Disorder Examination Questionnaire and Questionnaire on Eating and Weight Patterns-5 were utilized to assess disordered eating. There was no difference between TG women and TG men in terms of ED psychopathology. The most prominent characteristic in all four groups was shape concern, which was significantly higher in TG men and TG women when compared to cisgender men and cisgender women. Binge eating was notably more frequent in TG men and TG women compared to cisgender men, with 11% of the TG men and 7.3% of the TG women meeting the criteria for possible binge eating disorder. Screening for disordered eating behaviors, particularly binge eating, may be recommended in routine care for TG people. [ABSTRACT FROM AUTHOR]

Understanding the co-occurrence of food insecurity and eating disorders is a pressing concern. Several factors have been hypothesized to increase risk for eating disorders in women with food insecurity including dietary restriction, body weight, and weight-related bias, but few studies have tested these factors simultaneously to determine which are associated most strongly with eating disorder status. We tested cross-sectional associations of dietary restriction, current body mass index (BMI), weight suppression (i.e. the difference between current weight and highest weight), and weight bias with eating disorder diagnosis in a sample of 99 self-identified women with current food insecurity (54% White; mean [SD] age = 40.26 [14.33] years). Participants completed two virtual study visits consisting of electronic questionnaires and interviews. A binary logistic regression model was conducted to test relations between the hypothesized correlates and eating disorder diagnostic status in the past 12 months, controlling for age, food insecurity severity, and body dissatisfaction. Higher levels of weight suppression and weight bias, but not current BMI, were significantly associated with the presence of an eating disorder. Contrary to our hypothesis, greater dietary restriction was associated with lower likelihood of eating disorder diagnosis. Results suggest high levels of weight bias and weight suppression characterize women with food insecurity who meet criteria for an eating disorder. Women who experience food insecurity and have lost a relatively great deal of weight and/or hold biases about high weight should be screened for eating pathology in clinical settings. [ABSTRACT FROM AUTHOR]

Muscularity-oriented disordered eating (MODE) is a novel class of eating behaviors characterised by abnormal dietary alterations aimed towards building lean muscle. Although traditionally shown to affect men, emerging evidence suggests that increasingly more women are striving for the muscular and lean ideal, resulting in engagement of MODE behaviors. Prior research examining MODE in women is limited, yet emerging evidence from cross-sectional studies have established associations between MODE and poor mental health indices in this population. However, the temporal order of these associations in women is not yet known. Thus, the current study examined possible bi-directional associations between MODE behaviors and common mental health outcomes (depression, anxiety, loneliness). Adult women completed online study measures at baseline (Time 1 [T1]; n = 1760) and three-month follow-up (Time 2 [T2]; n = 1180). Cross-lagged panel models were computed to test for possible bi-directional relationships between MODE and the relevant mental health constructs. Findings showed that higher MODE levels at T1 significantly predicted increased depressive and anxiety symptoms (but not loneliness) at T2, and loneliness at T1 (but not depression/anxiety) significantly predicted MODE at T2. Effect sizes were small, so findings should be interpreted with this in mind. This is the first study to establish temporal relationships between MODE and mental health outcomes in adult women. Findings suggest that clinicians may benefit from inquiring about MODE behaviors for proper screening, assessment, and intervention, and potentially addressing loneliness to decrease risk of MODE. [ABSTRACT FROM AUTHOR]

Background: Co-use of stimulants and opioids is often deliberate. However, the possibility remains that some people are unintentionally consuming fentanyl. To advance understanding of overdose risk, we examined the rate of concordance between self-reported fentanyl use and corresponding urine toxicology screen results. Methods: Between August 2022–August 2023, 411 participants (adults who reported any non-medical drug use in the past three months) in Nevada and New Mexico completed a cross-sectional survey, of whom 64% (n = 270; the analytical sample) also completed a urine toxicology screen, which detects fentanyl use in the past three days. Positive predictive value, negative predictive value, sensitivity, and specificity were calculated using self-reported past three-day fentanyl use (yes/no) and urine toxicology screen results for the presence of fentanyl (positive/negative). Results: Of the 270 participants who provided a urine sample, 268 are included in the descriptive statistics (two with inconclusive urine toxicology screen results were excluded). Of the 268 participants, 146 (54.5%) had a fentanyl-positive urine toxicology screen result, 122 (45.5%) had a fentanyl-negative urine toxicology screen result, 137 (51.1%) reported past three-day fentanyl use, and 130 (48.5%) reported no past three-day fentanyl use. Only 6.9% of those with a fentanyl-positive urine toxicology screen did not report recent fentanyl use. The sensitivity of self-reported fentanyl use was 93%, specificity was 97%, positive predictive value was 97%, and negative predictive value was 92%. Discussion: The rate of unanticipated exposure to fentanyl (that is, positive urine screen and negative self-report) in this sample was low, at 6.9%. This runs counter to the national narrative that there is widespread unknown contamination of fentanyl in the drug supply. Conclusion: Future research is needed to further explore how people who use multiple substances interpret their overdose risk and what harm reduction methods they employ. [ABSTRACT FROM AUTHOR]

Objective: Attachment style and social support networks (SSN) are associated with suicide ideation (SI) and suicide attempt (SA). How these two factors interact is important to understanding the mechanisms of risk for suicidal behaviors and identifying interventions. Method: Using the Army Study to Assess Risk and Resilience in Servicemembers New Soldier Study (N = 38,507 soldiers), we examined how three attachment styles (preoccupied, fearful, and secure) and SSN (smaller vs larger) were associated with lifetime SI, SA, and SA among soldiers with SI. The interaction of each attachment style by SSN was examined. Results: All three attachment styles were associated with SI and SA in the total sample (for SA: preoccupied OR = 2.82, fearful OR = 2.84, and secure OR = 0.76). Preoccupied and fearful attachment were associated with SA among suicide ideators. Smaller SSN was associated with a higher risk for all three outcomes (range of ORs = 1.23–1.52). The association of SSN with SI and with SA among suicide ideators was significantly modified by the presence or absence of preoccupied attachment style. Among soldiers without preoccupied attachment, larger SSN was associated with lower risk of SI. Among suicide ideators with preoccupied attachment, a larger SSN was associated with lower risk of SA. Conclusion: This study highlights the need for increased understanding of the role of attachment style and social networks in suicide risk, in particular preoccupied attachment among soldiers with SI. A critical next step is to explore these relationships prospectively to guide intervention development. [ABSTRACT FROM AUTHOR]

Background: U.S. military veterans may be reluctant to disclose suicidal thoughts and behaviors. Suicide-specific cognitions, which generally avoid direct mention of suicide, may be reliable indicators of risk among those reluctant to disclose such thoughts and behaviors. Methods: Data from a population-based, cross-sectional study of 2,430 U.S. military veterans were analyzed to examine the associations between the Brief Suicide Cognitions Scale (B-SCS), suicidal ideation, and suicide planning. Results: After adjusting for age, sex, number of adverse childhood experiences, cumulative trauma burden, depressive symptom severity, and lifetime history of suicide attempt, total scores on the B-SCS (excluding the item mentioning suicide) were uniquely associated with suicidal ideation (odds ratio [OR] = 1.23, 95% confidence interval [CI] = 1.15–1.32) and suicide planning (OR = 1.27, 95%CI = 1.18–1.37). Exploratory post-hoc analyses revealed that difficulties with solving and coping with one's problems were uniquely linked to these outcomes. Conclusions: Assessment of suicide-specific cognitions may help to enhance suicide detection and prevention in veterans, especially in those who may not directly disclose thoughts of suicide. Intervention efforts to bolster perceived deficits in coping and problem-solving may help mitigate suicide risk in this population. [ABSTRACT FROM AUTHOR]

With current estimates of up to one in three children experiencing some form of sexual violence in sports, the need for effective measures to prevent sexual violence in sports is high. Survivors' narratives of sexual violence in sports uncover the lack of (adequate) bystander action and the urgent need for stakeholder education to effectively prevent sexual violence in youth sports. This study presents the "All Aboard" educational program, targeting youth sports coaches in Flanders (Belgium). The program aimed to stimulate the intentions of youth coaches to engage in positive bystander behavior to adequately detect, assess, and respond to signs of sexual violence toward young athletes. After two pilot studies, this program was implemented in nine Flemish sports clubs. Coaches' readiness to change, intentions and attitudes, perceived norms, and perceived behavioral control were measured before and after they participated in the program using the "And what would you do?" questionnaire, constructed according to the Reasoned Action Approach. After the program, positive change was found in coaches' intentions to be a positive bystander, e.g., they acknowledged the value of being a positive bystander, felt more comfortable being a positive bystander and believed that doing so would improve the situation. This article is one of the first to report on an evidence-based intervention program to prevent sexual violence in sports by fostering positive attitudes toward positive bystander behaviors by coaches. Opportunities and challenges of implementing education to prevent sexual violence in local sports clubs are discussed. Lay summary: Sexual violence is very common in youth sports and therefore education about this topic is crucial. The "All Aboard" program teaches youth coaches how to act as a positive bystander in the detection and response to situations of sexual violence. The program has successfully improved coaches' attitudes and willingness to intervene. IMPLICATIONS FOR PRACTICE: Coaches' intentions to be a positive bystander can be positively influenced by a bystander intervention. To effectively safeguard youth sports participants, coaches and other club actors (e.g., sport psychology consultants, safeguarding officer) should receive education on positive bystander behaviors so that signs of (sexual) violence are recognized and followed-up with an appropriate response. All stakeholders in a sports club have a responsibility to respond when it comes to incidents of sexual violence. In particular, sport psychology consultants and safeguarding officers are crucial in supporting those experiencing sexual violence, but also in guiding coaches, parents and sport club managers when faced with situations of sexual violence. [ABSTRACT FROM AUTHOR]

Emerging research supports that some former collegiate athletes (FCAs) can become physically inactive after retiring from sport, which can exacerbate unfavorable changes in long-term health. While researchers have addressed transitional difficulties FCAs may experience after retiring, little empirical evidence exists on how to promote healthy post-sport physical activity (PA) levels for those who are insufficiently active. Because of FCAs' past sports training, considering their opinions for effective PA program components may be beneficial in early stages of behavioral intervention development. As such, 17 insufficiently active former National Collegiate Athletic Association Division I athletes engaged in semi-structured interviews exploring their post-sport PA experiences and perceptions of effective program characteristics. Using Consensual Qualitative Research procedures, five domains were constructed. Three domains were discussed in a previous article; this paper overviews the remaining two, which describe participants' opinions of what would effectively promote PA in their population: (a) a desire for an 'athletics-lite' atmosphere in an FCA-targeted intervention, and (b) using technology to positively engage former athletes in their PA transition. While participants believed an athletics-based program where they are provided feedback and individualized workouts would be effective in maintaining PA, this may indicate underdeveloped autonomy in some FCAs regarding PA maintenance post-sport. Initially utilizing college sports personnel in a program may aid FCAs at risk of inactivity in transferring skills used in sport to independent PA maintenance after retiring. Further, the introduction and use of technology may help facilitate self-monitoring of progress, social support, and individualization when external resources are unavailable. Lay summary: Seventeen, inactive former college athletes (FCAs) were interviewed to understand enablers for promoting physical activity (PA) in their population. Utilizing sport/exercise personnel to help FCAs become more autonomous in their behavior and promoting self-monitoring through technology may help those in this population who struggle to maintain PA post-sport. IMPLICATIONS FOR PRACTICE: On-campus programs should consider involving athletics personnel (e.g., coaches, athletic trainers, certified mental performance consultants) and, pending available resources, outside experts (e.g., exercise physiologists) to deliver techniques, strategies, and education to explicitly support retiring student-athletes in maintaining PA after retirement. The perceived need for an athletics atmosphere, such as a coach-figure and teammates to be competitive with, may indicate underdeveloped autonomy for maintaining PA in insufficiently active FCAs. While athletics personnel may be useful in early promotion of PA, programs should strive to help them build more self-determined forms of motivation and be self-sufficient in maintaining PA post-sport. Programs may consider promoting the maintenance of PA to students-athletes via the use of wearable devices, PA applications, and online resources to promote self-monitoring of behavior, facilitate social support, and provide education on healthy PA practices. [ABSTRACT FROM AUTHOR]

In competitive sport environments, coaches and sport psychology practitioners work to optimize individual and team performance. One strategy identified as a key to optimal sport performance is athlete self-awareness. This study evaluated the efficacy of a novel, online post-event reflection (PER) tool. Using a mixed methods design, 22 members of a competitive women's ice hockey team completed the PER across one season. The PER demonstrated efficacy through tailored insight used as a basis for athlete discussions, complementing other performance-related feedback. Follow-up interviews with three team members and the head coach provided additional support for the efficacy of the PER. Lay summary: In competitive sport environments, coaches and sport psychology practitioners work to optimize individual and team performance. This study provides evidence to support the use a novel, online post-event reflection tool by athletes, coaches, and sport psychology practitioners to enhance athlete self-awareness of mental skills and performance. IMPLICATIONS FOR PRACTICE: When striving to optimize performance, coaches and sport psychology practitioners should consider strategies to enhance athlete self-awareness The post event reflection (PER) tool is an effective online tool for athletes, coaches, and sport psychology practitioners to enhance athlete self-awareness of mental skills and performance The PER is also a valuable diagnostic tool for coaches and sport psychology practitioners to identify individual athlete and team patterns in mental skills and performance [ABSTRACT FROM AUTHOR]

Veterans navigating the military-to-civilian transition appear at elevated risk for suicide. However, research on the transition-suicide association often fails to consider co-occurring risk factors. The independent association of time since military discharge and suicide among veterans therefore remains unclear. Data from 1,495 post-Vietnam community veterans provided estimates of suicide risk, military-based stressful experiences, connection to military identity, and recency of military discharge. Hierarchical regression analyses examined independent, incremental utility of factors associated with suicide risk after controlling for quality of life, age, and duration of military service among the total veteran sample and a subsample discharged from military service within five years prior. The resulting model explained 41% of variance in suicide risk in the total veteran sample and 51% of variance in suicide risk in the recently discharged subsample. Recency of discharge, combat exposure, moral injury, poor quality of life, and poor psychological wellness showed statistically significant, independent associations with suicide risk, whereas connection to military identity did not show significant, independent associations. Results highlight the salience of the military-to-civilian transition as an independent risk factor for veteran suicide even after controlling for military-based stressful experiences, military identity, quality of life, age, and service duration. [ABSTRACT FROM AUTHOR]

The role of tweety homolog 3 (TTYH3) has been studied in several cancers, including hepatocellular carcinoma, cholangiocarcinoma, and gastric cancer. The results showed that TTYH3 is highly expression in cervical cancer tissues and cells and high TTYH3 expression correlates with poor prognosis in patients with cervical cancer. TTYH3 markedly reduced the apoptosis rate and promoted proliferation, migration, and invasion. Silencing of TTYH3 has been shown to have an inhibitory effect on cervical cancer progression. Moreover, TTYH3 enhanced EMT and activated Wnt/β-catenin signaling. Furthermore, TTYH3 knockdown inhibited the tumor growth in vivo. In conclusion, TTYH3 promoted cervical cancer progression by activating the Wnt/β-catenin signaling. HIGHLIGHTS: TTYH3 is upregulated in cervical cancer tissue and cells. TTYH3 promotes cervical cancer cell proliferation. TTYH3 inhibits cervical cancer cell apoptosis. TTYH3 induces cervical cancer cell migration and invasion. TTYH3 activates the Wnt signaling in cervical cancer cell. [ABSTRACT FROM AUTHOR]

Background: A minority of patients with MSS tumors present a high tumor mutation burden (TMB) without underlying MMR defects. Methods: Publicly available genomic series were assessed for identification of patients with MSS gastric gastroesophageal junction, and esophageal adenocarcinomas and a high TMB, defined as more than 10 mutations per Mb. These were compared with MSS cancers and a low TMB for genetic alterations and for survival outcomes. Results: Patients with MSS cancers with high TMB in the MSK series were older but did not differ in other clinicopathologic parameters compared with MSS patients with low TMB. Mutations in tumor suppressors TP53 and APC and oncogenes KRAS and ERBB4 as well as amplifications of ERBB2 were more prevalent in the high TMB group of MSS cancers. Mutations in DDR associated genes, in epigenetic modifiers and in genes associated with immune response were more prevalent in the hIgh TMB group patients. However, high TMB was not associated with an improved survival in MSS gastric/gastroesophageal junction/esophageal adenocarcinomas (Log Rank p = 0.5). Conclusion: MSS Gastric/gastroesophageal junction/esophageal adenocarcinomas with TMB above 10 mutations per Mb possess a genomic landscape with increased alteration frequencies in common gastroesophageal cancer genes and pathways. [ABSTRACT FROM AUTHOR]

We aimed to examine the relationship between body image and the meaning of life among women with breast cancer. The analytic sample included 142 women with breast cancer, and data were collected using a standardized questionnaire through face-to-face interviews. We used Kolmogorov–Smirnov test, Pearson test, Spearman and Mann–Whitney U test to determine the relationship between the research variables. We found an association between the mean score of body image and the mean score of the meaning of life. As the average score of body image increases, the score of the meaning of life increases (p < 0.05). Findings indicated that the body image score increases by increasing the score of the meaning of life and its dimensions, especially existential vacuum and acceptance of death. Future research and targeted treatments should consider the role of body image in shaping the meaning of life among women with breast cancer. [ABSTRACT FROM AUTHOR]

Prior research indicates that APOE-e4 allele(s) and working without compensation may be independently associated with risk for cognitive decline. This study investigated whether the interaction of type of work (paid versus unpaid) and presence of APOE-e4 allele(s) was associated with cognitive dysfunction in women in mid- and late-life. Participants included 340 females (mean age = 74.7 years) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset. A two-way ANOVA to assess the simple main effects of type of work and APOE-e4 allele status on cognition as well as their interaction was performed. A two-way ANCOVA including age, education, and marital status as covariates was also conducted. The presence of one or two APOE-e4 allele(s) and unpaid work was associated with greater cognitive dysfunction. A significant interaction effect revealed engagement in paid work, regardless of the presence of APOE-e4 allele(s), was associated with better cognitive functioning. Consistent with prior literature, women who engage in unpaid forms of labor for the majority of their life may be at higher risk for cognitive decline, regardless of presence of APOE-e4 allele(s). Further research is needed to identify the factors related to unpaid labor that may increase risk for cognitive dysfunction. [ABSTRACT FROM AUTHOR]

Prior research suggests that using photo-based social media may increase body image concerns among young women. Consumption of versus contribution to social media may moderate this relationship, and the type of content contributed (e.g., self-images or "selfies") may further account for variations. A critical limitation of the extant scholarship is a lack of attention to understudied groups, such as older women. Using a cross-sectional sample of 238 midlife women (Mage = 50.92), this study investigated the relationship between social media behavior, perceived effects of social media use, and body image indices. Results indicated that our sample of midlife women contributed mainly photos of their current setting and family, contrasting with prior work among younger women. Results suggested that the type of content contributed may be more pertinent to body image than social media behavior generally, and highlighted complex relationships. Posting photos broadly was associated only with lower drive for youthfulness. However, selfie posting specifically was associated with greater facial satisfaction as well as greater positive (e.g., connectedness) and negative (e.g., appearance concerns) perceived effects of social media, but not drive for youthfulness. Results suggest that the type of content contributed to social media may be a particularly important factor for body image, and highlight complex relationships potentially influenced by unmeasured factors such as social media use motivations. Together, these findings contribute to a fuller understanding of social media and body image and call for further theoretically-driven work in this area to guide effective prevention resources. [ABSTRACT FROM AUTHOR]

Background: The current workforce does not meet the demand for physiotherapy services in Australia. Future demand is predicted to expand driven primarily by the aging population. Previous research describes significant attrition and short career intentions of junior physiotherapists. Objective: This study explored factors associated with physiotherapy graduates' early career intentions and satisfaction. Method: Four cohorts of student physiotherapists completed two online surveys designed specifically for this study assessing their immediate and future career intentions and satisfaction. Surveys were completed after undergraduate training (Student Survey) and 2 years later (Practitioner Survey). Question formats included single or multiple select, Likert scale, and free-text responses. Responses were analyzed via descriptive statistics and content and relational analysis. Results: Despite most early career practitioners (83%) reporting career satisfaction, 27% intended to pursue long-term physiotherapy careers (>20 years) and 15% intended to work for 5 years or less. Fewer (11%) reported a longer career intention and 26% a shorter career intention compared to their student survey. Extrinsic occupational factors, such as support, were mentioned as influential in increasing intended future career length since course completion. Conclusion: This study found some evidence of factors contributing to shorter career intentions of early career physiotherapists. Specific support of early career physiotherapists may encourage longer career intentions and help build future workforce capacity. [ABSTRACT FROM AUTHOR]

Background: Few studies have evaluated the effects of structured early mobilization (EM) protocols on the level of mobilization in critical care patients. Objective: To evaluate the impact of a structured EM protocol on the level of mobilization, muscle strength, and the level of activities of daily living (LADL) after intensive care unit (ICU) and hospital discharge. Methods: This randomized clinical trial (U1111-1245-4840) included adults patients who were randomized into two groups: intervention (n = 40) and control (n = 45). The intervention group underwent conventional physiotherapy and structured EM protocols, and the control group underwent conventional physiotherapy. The level of mobilization from 0 (no mobilization) to 5 (walking), muscle strength (Medical Research Council scale), LADL (Katz Index), and incidence of complications were evaluated. Results: The level of mobilization from day 1 to day 7 increased in the intervention group compared with the control group (p <.05). Muscle strength did not change during the protocol in the intervention and control groups {day 1 [effect size (r) = 0.15, p =.161], at ICU discharge [r = 0.16, p =.145], and after ICU discharge [r = 0.16, p =.191]}. The LADL did not differ between the intervention and control groups after ICU discharge [4 (1–6) vs. 3 (1–5), p =.702] or 30 days after hospital discharge [6 (5–6) vs. 6 (5–6), p =.945]. The structured EM protocol was safe, and no severe complications were observed during the protocol. Conclusion: A structured EM protocol increased the level of mobilization without improving muscle strength and the LADL compared with conventional physiotherapy. [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]

Background: The evidence supporting the application of pain neuroscience education (PNE) in patients with chronic low back pain (LBP) remains some arguments. Objective: This review aims to investigate the effect of PNE alone and combined with physical therapy or exercise for chronic LBP. Methods: PubMed, Embase, Web of Science, and the Cochrane databases were searched from establishment to June 3, 2023. Randomized controlled trials (RCT) evaluating the effect of PNE in patients with chronic LBP were considered eligible. Data were analyzed using a random-effects model (I2 >50%) or a fixed-effects model (I2 <50%) and trials were appraised using the Cochrane ROB tool. Meta-regression was conducted to assess the moderator factors. Results: Seventeen studies (1078 participants) were included in this review. PNE plus exercise and PNE plus physiotherapy both showed a reduction of short-term pain (mean differences [MD] −1.14 [−1.55, −0.72]; MD −1.15 [−1.67, −0.64]) and disability (standardized mean difference [SMD] −0.80 [−1.13, −0.47]; SMD −0.85 [−1.29, −0.40]) than physiotherapy or exercise alone. Meta-regression showed that only single PNE session duration was associated with a greater reduction in pain (P <.05). Subgroup results showed that a single PNE session exceeding 60 minutes (MD −2.04), 4 to 8 sessions (MD −1.34), intervention for 7 to 12 weeks (MD −1.32), and a group-based approach (MD −1.76) may be more beneficial. Conclusion: This review indicates that adding PNE to treatment programs would lead to more efficacious effects for chronic LBP. Additionally, we preliminarily extracted dose-effect relationships for PNE intervention, providing guidance for clinicians to design effective PNE sessions. [ABSTRACT FROM AUTHOR]

Background: Social media offer opportunities for informal learning and are increasingly adopted by health professionals as learning tools. However, little is known of how new graduate physiotherapists engage with social media for learning. Purpose: This study aimed to explore new graduate physiotherapists' perceptions and use of social media as learning tools during their transition into professional practice. Methods: This study used a qualitative general inductive approach. New graduate physiotherapists (n = 16) were recruited through purposive snowball sampling and participated in semi-structured interviews. Data were subjected to a general inductive analytical method. Results: Four themes were generated: 1) social media as tools for learning; 2) navigating and engaging with social media as a learner; 3) thinking critically about social media; and 4) relevance to practice. Conclusion: New graduate physiotherapists use social media as adjunct learning tools which can be positioned within several frameworks, including the Situated Learning Theory. However, new graduates voice uncertainties regarding information credibility, the importance of critical thinking skills in navigating information, and concerns regarding blurred work-life boundaries. Recommendations are made for research to further understand social media as emerging learning tools, especially for new graduates who are experiencing insufficient workplace support. [ABSTRACT FROM AUTHOR]

Background and Purpose: The impact of the COVID-19 pandemic on physiotherapy education meant that innovative responses were needed quickly. This paper describes a scholarly approach to changes within an entry-level physiotherapy program where one of its clinical placements was replaced with a fully online unit during 2020, as well as exploring the experiences of students who completed this newly developed online unit. Methods: A mixed methods approach was used. Sixteen of a possible 31 students responded to an online survey comprising quantitative and open-ended questions. Results: The majority of participants were satisfied with the unit and reported that: the unit helped them to learn valuable skills; feedback from educators was helpful; and that they were able to apply to future contexts. Small numbers of students were more ambivalent about the use of online media and tools including discussion boards, the workload and being part of a learning community. Conclusion: The online unit described in this research is evidence that non-traditional forms of clinical education might also address clinically important learning outcomes, provide sustainable options and alleviate some of the stresses that both tertiary providers and healthcare settings endure. However, these types of placement experiences require a paradigm shift from educators, the profession, accrediting bodies and even future students. [ABSTRACT FROM AUTHOR]

Background: Social participation levels of individuals with Multiple Sclerosis (iwMS) are lower than those of healthy individuals. Objective: This study aimed to evaluate to which extent the walking capacity, balance, and fear of falling (FoF) affect the community integration levels of iwMS. Methods: Thirty-nine iwMS were evaluated for their participation levels [The Community Integration Questionnaire (CIQ)], walking capacity [The Six-Minute Walk Test (6MWT)], balance [Kinesthetic Ability Trainer (SportKAT®)], and FoF [The Modified Falls Efficacy Scale (MFES)]. Correlation and regression analyses were performed to detect the effects of SportKAT®, 6MWT, and MFES on CIQ. Results: CIQ scores were significantly correlated with 6MWT (p =.043) and MFES (p =.005) scores, while CIQ was not related with static (for two feet test p =.356, for right single-leg stance test p =.412, for left single-leg stance test p =.730) and dynamic balance (for clockwise test p =.097, for counterclockwise test p =.540) measured with the SportKAT®. It was found that CIQ could be predicted by 6MWT and MFES at the level of 16% and 25%, respectively. Conclusion: FoF and walking capacity are associated with community integration in iwMS. Therefore, physiotherapy and rehabilitation programs of iwMS should be combined with treatment goals to increase community integration, balance, and gait and decrease the disability and FoF from an early stage. Comprehensive studies examining other factors that may impact participation in iwMS with different levels of disability are needed. [ABSTRACT FROM AUTHOR]

Background: The use of screening questionnaires (SQ) to evaluate affective or cognitive tendencies (CAT) in persons with low back pain (LBP) is recommended by clinical practice guidelines (CPG) yet few physical therapists (PTs) have adopted these recommendations. Objective: To develop and implement a tailored knowledge translation (KT) intervention in an outpatient rehabilitation practice to facilitate the uptake of SQ for CAT in persons with LBP. Methods: In a mixed-methods study, using the knowledge to action framework, PTs (n = 12) collaborated with research clinicians to improve the use of three SQ: 1) Primary Care Evaluation of Mental Disorders for Depressive Symptoms; 2) Fear-Avoidance Beliefs Questionnaire; and 3) Pain Catastrophizing Scale. Success of the intervention was measured through questionnaires, focus groups and chart audit. Results: A multimodal intervention to overcome specific identified barriers (i.e. time, forgetfulness, and lack of knowledge) was implemented. There was a 10% increase in the use of at least one SQ. PTs reported increased knowledge and use of the SQ but reported time and lack of confidence as barriers to implementation. Conclusion: It was concluded that SQ for CAT can be successfully implemented; however, PTs felt unprepared to use the screening results to evaluate persons with CAT and more extensive training is recommended to change this practice pattern. [ABSTRACT FROM AUTHOR]

Introduction: Inter-individual variability may contribute to impaired cervicocephalic kinesthetic sensibility (CKS) in patients with nonspecific neck pain. Objectives: To identify subgroups of participants with nonspecific neck pain based on cervical joint position errors (JPEs) and to determine potential factors associated with identified subgroups. Methods: One hundred participants with nonspecific neck pain (unidentified pathoanatomical cause) and 50 controls were recruited. JPEs were measured in cervical extension and rotation, using a laser pointer. JPEs were expressed as absolute (AEs), constant (CEs), and variable (VEs) errors. Clinical characteristics were pain intensity, duration, disability, side of pain, dizziness, psychological features, and range of motion. All tests were performed within 1 day. A cluster analysis was conducted based on AEs. A logistic regression was used to identify factors associated with the cluster groups. Results: Analysis divided neck pain participants into two groups: cluster 1 with greater impaired CKS (n = 36) and cluster 2 with lesser impaired CKS (n = 64). The AEs (all cervical movements) and CE (left rotation) were larger in cluster 1 than 2 (p ≤.002). Overall, participants in clusters 1 and 2 had larger AEs, CEs, and VEs than controls (p ≤.04). The presence of dizziness was a risk factor associated with cluster 1 (OR=2.5, p =.04). The other characteristics were not associated with the cluster groups (p ≥.09). Conclusion: The AEs identified two subgroups of patients with nonspecific neck pain. Participants in subgroup 1 had greater impaired CKS, and participants in subgroup 2 had lesser impaired CKS. Dizziness was a potential risk factor associated with greater impaired CKS. [ABSTRACT FROM AUTHOR]

Background: Pain catastrophization (PC) is related to motor control changes in individuals with nonspecific chronic low back pain (NSCLBP). However, differences in dynamic balance control based on the level of PC still remain unclear in these individuals. Objective: The aim of this study was to compare the dynamic balance control between healthy controls and individuals with NSCLBP with high and low PC. Methods: Forty individuals with NSCLBP and 20 healthy participants were enrolled in this cross-sectional study. Individuals with NSCLBP were classified into two groups of high and low PC. Dynamic balance control was assessed using the Modified Star Excursion Balance Test (MSEBT), Five-Time Sit-to-Stand Test (FTSST), and Timed Up and Go Test (TUGT). Results: Statistical analyses showed that mean values of reach distances in the anterior, posteromedial, and posterolateral directions of the MSEBT were significantly lower in individuals with NSCLBP with high PC compared to low PC (p =.04, p =.01, and p =.04, respectively) and healthy controls (p <.001, p =.001, and p =.006, respectively). In addition, for both the FTSS and TUG tests, the mean time was significantly greater in individuals with NSCLBP with high PC compared to low PC (p <.001 and p =.004, respectively) and healthy controls (p <.001). Conclusions: Our results showed poor dynamic balance control in individuals with NSCLBP with high PC. This suggests that PC could contribute to the impaired dynamic balance control in individuals with NSCLBP. Combining balance exercises and cognitive-behavioral treatments targeting PC may be useful for the improvement of dynamic balance control in individuals with NSCLBP with high PC. [ABSTRACT FROM AUTHOR]

Background: Changes in the trunk and lower limbs' sagittal movements may cause patellofemoral pain (PFP) because they influence the forces acting on this joint. Objectives: To compare trunk and lower limb sagittal kinematics between women with and without PFP during functional tests and to verify whether sagittal trunk kinematics are correlated with those of the knees and ankles. Methods: A total of 30 women with PFP and 30 asymptomatic women performed single-leg squat (SLS) and step-down (SD) tests and were filmed by a camera in the sagittal plane. The trunk inclination angle, forward knee displacement, and ankle angle were calculated. Results: The PFP group exhibited less trunk flexion (SLS, p =.006; SD, p =.016) and greater forward knee displacement (SLS, p =.001; SD, p =.004) than the asymptomatic group; there was no significant difference in ankle angle (SLS, p =.074; SD, p =.278). Correlation analysis revealed that decreased trunk flexion was associated with increased forward knee displacement (SLS, r = −0.439, p =.000; SD, r = −0.365, p =.004) and ankle dorsiflexion (SLS, r = −0.339, p =.008; SD, r = −0.356, p =.005). Conclusion: Women with PFP present kinematic alterations of the trunk and knee in the sagittal plane during unipodal activities. Furthermore, the trunk and lower limb sagittal movements were interdependent. [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]

Background: The criteria to determine walking performance of people with mobility limitations from developed countries have been already reported. However, these criteria may not be suitable to be applied for people with mobility limitations from developing countries due to the differences in sociodemographic characteristics and environmental conditions. Objective: To explore cutoff points of walking speed to determine walking performance of individuals with mobility limitations from a developing country. Methods: Individuals with mobility limitations from a developing country (n = 136) were cross-sectionally interviewed and assessed for their demographics and walking performance. Then they were assessed for their walking speed using the 10-meter walk test. Results: Walking speeds of ≥0.30 m/s, ≥ 0.40 m/s, and ≥0.65 m/s could optimally indicate the ability of outside-home walking, limited-community walking, and full-community walking, respectively (sensitivity = 78%–84%, specificity = 81%–93%, and area under the receiver operating characteristic curve [AUC] > 0.90). Moreover, a walking speed of ≥0.35 m/s could suggest the ability of functional walking (sensitivity = 78%; specificity = 83%; and AUC = 0.89). Conclusions: With the need of standard practical measure for early screening and monitoring of functional alteration over time, the present walking speed cutoff points may be clinically applied to suggest walking performance in daily living specifically for individuals with mobility limitations from a developing country. [ABSTRACT FROM AUTHOR]

Background: The demand for physiotherapy student clinical placements is increasing in many countries, including Australia, and there is continued reliance on physiotherapists to assume the student clinical educator role. Exploring factors influencing physiotherapists' decision to be involved in clinical education is essential to maintaining and building clinical education capacity for the future. Objective: To explore factors influencing Australian physiotherapists' decision to be involved in student clinical education. Methods: A qualitative study using data collected from a valid and reliable online survey tool. Respondents were physiotherapists representing public and private workplaces across varied geographical settings in Australia. Data were thematically analyzed. Results: Surveys were completed by 170 physiotherapists. Most respondents were employed in hospital (81/170, 48%) and private (53/170, 31%) settings in metropolitan locations (105/170, 62%). Six themes representing factors influencing physiotherapists' involvement in student clinical education were identified, including perceptions of: professional duty, personal benefits or gains, suitability of workplace, support requirements, role related challenges, and readiness to be a clinical educator. Conclusion: Many factors influence physiotherapists' decisions to assume the clinical educator role. This study could assist clinical education stakeholders to provide practical and targeted strategies to overcome challenges, and optimize support, for physiotherapists in the clinical educator role. [ABSTRACT FROM AUTHOR]