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Rhythmic auditory stimulation (RAS) has been shown to improve gait parameters in several neurological diseases, both in walk-training interventions and in one-time walking tests, but the effect in myasthenia gravis (MG) is unknown. The aim of this study was to examine if RAS improves walking distance and gait speed in patients with generalised myasthenia gravis (gMG) in the 6-minute walk test (6MWT). Forty-eight patients with gMG walked two 6MWTs under different conditions: (1) walking with RAS with a frequency of 100% of the patient's fastest gait speed, (2) walking with RAS with a frequency of 110% of the patient's fastest gait speed, or (3) walking in silence. RAS with a frequency of 110% of the patient's fastest gait speed increased the walking distance by 8.3 metres in the 6MWT vs standard 6MWT (p = 0.01), without increasing average walking heart rate (HR) or Borg scores. This study indicates that RAS may improve gait speed and walking distance in patients with gMG without additional exertion as judged by HR and Borg scores. Based on these results, RAS could be used as part of a physical rehabilitation program for patients with gMG. [ABSTRACT FROM AUTHOR]

It is believed that clinical management of osteoarthritis should address muscle weakness to improve physical function and prevent disability and frailty This sub-study investigated the effects of supervised progressive resistance training (RT), supervised Nordic Walking (NW), and unsupervised home-based exercise (HBE) on muscle and functional performance; and associations between these exercise-induced changes in persons with hip osteoarthritis. Forty-two patients with hip osteoarthritis were recruited from a larger RCT (NCT01387867). All the groups (RT, n = 15; NW, n = 12; HBE, n = 15) exercised 1 h 3 times/week for 4 months. Quadriceps cross-sectional area (QCSA, MRI-determined); quadriceps strength (QMVC); leg extensor power (LEP); functional performance (chair stands (30sCS); stair climbs (TSC); and 6-minute walk (6MWT)) were assessed at baseline and 4 months. Per protocol analyses (one-way ANOVA and Bonferroni test) showed significant between-group differences for improvements in QCSA in the most symptomatic leg favoring RT versus NW (2.3 cm2, 95% CI [0.6, 3.9]) and HBE (2.3 cm2 [0.8, 3.9]); and 30sCS (1.8 repetitions [0.2–3.3]), and 6MWT (35.1 m [3.5–66.7]) favoring NW versus HBE. Associations existed between exercise-induced changes in QCSA and QMVC (r = 0.366, p =.019) for the most symptomatic leg and between changes in 6MWT and QMVC (r = 0.320, p =.04) and LEP (r = 0.381, p =.01), respectively, for the least symptomatic leg. Resistance training appeared effective for improving muscle mass, but less effective for improving muscle strength, power, and functional performance. Only exercise-induced changes in muscle strength and power of the least symptomatic leg, not the most symptomatic leg, were related to changes in functional performance. [ABSTRACT FROM AUTHOR]

Knowledge regarding the impact of curricula with behavioral medicine content and competencies (BMCC) on physical therapy (PT) students' clinical reasoning skills is lacking. The primary objective was to compare the clinical reasoning skills, focusing on clients' behavioral change, of entry-level PT students with or without BMCC in their curricula. The secondary objective was to compare students' attitudes and beliefs in a biomedical and biopsychosocial practice orientation. Swedish final-semester PT students (n = 151) completed the Reasoning 4 Change (R4C) instrument and the Pain Attitudes and Beliefs Scale for Physiotherapists. A blueprint was used for curricular categorization. The independent t-test was used. Students attending programs with BMCC curricula (n = 61) had superior scores compared with students without BMCC curricula (n = 90) in the following R4C variables, all of which were related to clinical reasoning focused on behavioral change: Knowledge, Cognition, Self-efficacy, Input from the client, Functional behavioral analysis, and Strategies for behavioral change. Students who did not receive BMCC curricula scored higher in the R4C contextual factors and reported a greater biomedical practice orientation than students receiving BMCC curricula. There was no difference in the biopsychosocial practice orientation between groups. Our findings support the benefit of structured entry-level PT curricula with BMCC on final-semester students' clinical reasoning skills focused on behavioral change and their level of biomedical practice orientation. Further, our findings elucidated educational opportunities to augment students' self-efficacy and strengthen their behavioral competencies in clinical reasoning. For the generalizability of the results further research in other contexts is needed. [ABSTRACT FROM AUTHOR]

Rapid dissemination of mobile technology provides substantial opportunity for overcoming challenges reaching rural and marginalized populations. We assessed feasibility and acceptability of longitudinal mobile data capture among women undergoing fistula surgery in Uganda (n = 60) in 2014–2015. Participants were followed for 12 months following surgery, with data captured quarterly, followed by interviews at 12 months. Participant retention was high (97%). Most respondents reported no difficulty with mobile data capture (range 93%–100%), and preferred mobile interview (88%–100%). Mobile data capture saved 1000 person-hours of transit and organizational time. Phone-based mobile data collection provided social support. Our results support this method for longitudinal studies among geographically and socially marginalized populations. [ABSTRACT FROM AUTHOR]

Relatives of terminally ill patients most often experience distress. Advance Care Planning (ACP) has been developed to plan end-of-life care and support patients and relatives. ACP has been shown to have a positive impact on relatives of terminally ill patients and may affect their healthcare-seeking behaviour. The aim of the study was to investigate associations between ACP and relatives' contacts with general practitioners (GPs) and hospital admissions. Based on a prior randomized controlled trial we conducted a prospective longitudinal study. Relatives of patients formerly randomized into one ACP conversation or control group were included. Information regarding relatives' GP and hospital contacts was achieved through healthcare registries using personal Civil Registration numbers. The content, distribution, and median number of GP and hospital contacts were analyzed in two time windows: the caregiving period (from randomization until loss) and the bereavement period (from loss until six months after). No significant difference in the median number of GP or hospital contacts between the two groups was found. However, in the caregiving period, we found a significant difference in the distribution of GP contacts (p = 0.022); More relatives in the control group had no contact with their GP. The prior ACP conversation did not affect the median number of GP or hospital contacts among relatives, but statistically significantly more relatives in the ACP group had a least one GP contact in the caregiving period. The study emphasizes the importance of performing ACP trials with outcomes in relation to relatives and patients. [ABSTRACT FROM AUTHOR]

To analyze the association of autonomic dysfunction symptoms with stress in Brazilian university professors of the Speech Language–Pathology course during the Covid-19 pandemic. Fifty-five Brazilian university professors participated in the study, with a mean age of 42 years and 10 months old (±8.75), 49 female and six male subjects. The evaluated outcomes were the symptoms of stress and self-assessment of autonomic dysfunction symptoms. The results were inferentially analyzed using binary logistic regression and chi-squared tests (p <.05). In 54.54% of the university professors presented stress, with a predominance of psychological symptoms and a higher frequency resistance phase. Stress was a risk factor for the high occurrence of autonomic dysfunction symptoms related (OR 5.841) and unrelated (OR 29.750) to voice. There was an association between the predominance of psychological symptoms and the higher occurrence of autonomic dysfunction symptoms related to voice (p <.001). There was an association between autonomic dysfunction symptoms and stress in Brazilian university professors during the Covid-19 pandemic. [ABSTRACT FROM AUTHOR]

Canada is among several countries to have implemented 'end-demand' criminalization frameworks for sex work. Drawing on interviews with sex workers (n = 200) in five cities, we employed multivariate logistic regression to identify associations with workplace violence. We also analysed descriptive data on trafficking and on workplace violence under end-demand legislation. In the past 12 months, being unable to call 911 in a safety emergency at work for fear of police detection (Adjusted Odd Ratio AOR: 4.307, 95% Confidence Interval CI: 1.697 –10.927), being unable to screen clients due to fear of police detection (AOR: 2.175, 95% CI: 1.074 –4.405), having experienced anti-sex work housing policy/eviction (AOR: 2.031, 95% CI: 0.897–4.598), and being Indigenous (Adjusted Odd Ratio (AOR): 2.167, 95% Confidence Interval (CI): 1.060–4.428) were all independently associated with workplace violence in the past 12 months. Of those who worked prior to the law change (n = 167), a majority of respondents (80.24% (134)) reported that violence in the workplace had increased or stayed the same compared to the previous criminalization model and 87.43% (n = 146) reported it was harder or the same to get help in an emergency. [ABSTRACT FROM AUTHOR]

The frequent association between mental disorders and HIV infection may be related to several risk factors. The present study aims to determine the prevalence of depression and its associated factors in people living with HIV/AIDS (PLWHA) who attended four outpatient clinics in Fortaleza, Brazil, between September 2014 and April 2015. In addition to the Mini International Neuropsychiatric Interview questionnaire, which was used to identify the prevalence of depressive disorder, the researchers applied a sociodemographic questionnaire, and the Hamilton Depression Scale to classify the severity of depression. In all, 257 participants were included in the analyses. The overall lifetime prevalence of depression was identified to be 29.2% (19.5% in men and 44.9% in women). The prevalence of a current depressive episode was 18.7%. Mild, moderate, and severe depression was identified in 2.1%, 12.5%, and 85.4%, respectively. The factors related to depression were: gender, marital status, income, educational level, current employment status, and family history of depression. This study highlights the importance of lifetime depression as a disorder of high prevalence in PLWHA, and associated with risk factors that are difficult or impossible to be modified. Early diagnosis and treatment of depression may improve quality of life in PLWHA. [ABSTRACT FROM AUTHOR]

Background: The Smoke-free Policy represents a challenge in mental health services. Aim: To compare the stages of a smoke-free policy in a psychiatric hospital, according to the prevalence of smokers, hospital admission acceptance by hospitalized people, psychiatric complications, and the prescription of psychotropic drugs. Methods: Cross-sectional study was conducted with a comparison before and after implementing the Smoke-free Policy in a psychiatric hospital. Secondary data were obtained in 2020 from the medical records of 573 discharged people from psychiatric hospitalizations between September 2017 and August 2018. Fisher's exact test and the Kruskal-Wallis test were applied. Results: In the transition stage, there were more hospitalizations by court order, discharge motivated by the patient's disruptiveness behavior, administration of psychotropic drugs before the schedule time, physical aggression, physical/chemical restraints, length of stay, and dosage of psychotropic drugs. After the ban, there was a reduction in discharges motivated by the patient's disruptiveness behavior and an increase in discharge due to improvement in psychiatric symptoms, less occurrence of anticipation or modification in the use of psychotropic drugs, and fewer attempts to escape, aggressiveness, and physical restraint. Conclusion: The implementation of the Smoke-free Policy has a positive impact on psychiatric hospitalizations, with an increase in discharge due to improvement in psychiatric symptoms and a reduction in discharges due to other reasons. However, the transition stage requires greater attention from the nursing team, as the moment of adaptation to new rules and routines is followed by a momentary worsened behavior of those hospitalized. [ABSTRACT FROM AUTHOR]

To investigate the sustainability of Robot-assisted upper limb therapy (RT-UL) as part of routine occupational therapy and physiotherapy clinical practice. Two separate audits, 12 months apart, of RT-UL computer data records were undertaken to determine sustainability in a subacute rehabilitation unit. Records of the two audits were compared in terms of the number of early subacute stroke survivors using RT-UL, the number of RT-UL sessions, duration of RT-UL sessions, and disciplines prescribing RT-UL. During Audit 1 58% (n = 18) of stroke survivors received RT-UL compared to 50% (n = 7) in Audit 2. The total number of RT-UL sessions reduced between audits (148 vs. 36 sessions) reflecting the overall reduction in admission rates for stroke survivors. There was no significant difference between audits in the average number of RT-UL sessions per patient (p = 0.203) nor the length of sessions (p = 0.762). Patients engaged in active therapy more than three-quarters of the time when on the robotic device. Physiotherapists were the primary prescribers of RT-UL when compared to occupational therapists. RT-UL was in continued and regular use with stroke survivors 2 years after initial implementation within an inpatient rehabilitation setting. RT-UL practice was intensive and used routinely with patients. RT-UL is a sustainable and intensive intervention for stroke survivors within an inpatient rehabilitative setting. The cost-benefits of RT-UL should be evaluated from the perspective of the whole rehabilitation service not just at an individual patient level. RT-UL may be considered a "bridging" form of UL practice for those with more limited active UL movement until there is sufficient UL movement and power for more complex real-world task-specific practice. [ABSTRACT FROM AUTHOR]

Urinary incontinence (UI) is a common pelvic floor dysfunction in pregnancy. The relationship between biomechanical changes and pregnancy-related UI has not been fully elucidated. To investigate the association of various musculoskeletal and anthropometric changes in pregnancy that affect gestational UI. The study was conducted with 275 pregnant women. Ninety-three, 110 and 72 women were in first, second and third trimesters, respectively. Incontinence Impact Questionnaire for UI, Urogenital Distress Inventory-Short Form and Incontinence Severity Index were applied. Lumbar lordosis measurement was performed by Baseline Bubble Inclinometer while diastasis recti abdominis (DRA) measurement was carried out by finger-width method. Manual muscle test for rectus abdominis and right and left external oblique abdominal muscles, and Benign joint hypermobility test with Beighton scoring method were also applied as musculoskeletal measurements. Tape measurement at the waist, umbilical and hip levels, caliper with bi-iliac and bi-trochanteric diameters were also recorded as anthropometric measurements. Significant associated factors for UI were: umbilical DRA (OR = 1.57; p =.012); rectus abdominis muscle strength (values of 3 and below, OR = 1.2; p =.014); umbilical environment (OR = 1.1; p =.029); bi-iliac diameter (OR = 1.1; p =.05;) and bi-trochanteric diameter (OR = 1.3; p =.05), respectively. Changing musculoskeletal and anthropometric characteristics of pregnant women should be taken into consideration in UI follow-up during pregnancy. [ABSTRACT FROM AUTHOR]

Postoperative complications of gastrectomy for gastric cancer affect the efficacy of surgery. It is of clinical significance to identify high-risk patients with postoperative complications as early as possible. A total of 206 patients who underwent gastrectomy were enrolled in this study. Univariate and multivariate analyses were used to determine the risk factors for postoperative complications. The cutoff value and diagnostic accuracy of the C-reactive protein/albumin ratio were calculated by receiver operating characteristic curves. A total of 64 (31.1%) patients developed postoperative complications. Multivariate analysis confirmed that the C-reactive protein/albumin ratio on the first day after operation was an independent risk factor for postoperative complications (OR = 2.538, 95%CI: 1.346–4.785, P = 0.004). The cutoff value of the C-reactive protein/albumin ratio on the first day after operation was 2.105 calculated by receiver operating characteristic curves. Patients with a C-reactive protein/albumin ratio greater than 2.105 had a higher incidence of postoperative complications (43.2% vs 22.0%, P = 0.001) and longer postoperative hospital stay (15.3 ± 1.2 vs 13.0 ± 0.5, P = 0.042) than patients with less than 2.105. Patients with C-reactive protein/albumin ratio greater than 2.105 on the first day after operation are more likely to have postoperative complications. [ABSTRACT FROM AUTHOR]

This study aims to assess the annual prevalence, associated factors, and characteristics of musculoskeletal disorders among Lebanese national-level athletes. Lebanese athletes aged 18 and over and who competed in a top-level national championship during an entire athletics season were invited to participate in the study. Data were collected through questionnaire assessing self-reported injury during the past year. Injury, dependent variable of the study, was defined as a musculoskeletal condition that made the athlete partially or completely abstains from training or competition for a 1-week minimum injury period. Among the 250 eligible athletes, 210 (84.0%) (25.5±6.7 years) completed the questionnaire. The 1-year retrospective injury prevalence was 51.9% (95% confidence interval, 45.1%-58.7%). Injured athletes reported 150 injuries: 128 (85.3%) affected the lower extremities, and 111 (74.0%) occurred during training. The most common type was muscle cramps/spasm (n=53; 35.3%); and overuse (n=121; 80.7%) was the predominant cause. Athletes who mainly practiced endurance disciplines (-p-value=0.042), who participated in international athletics championships (-p-value=0.047), and who were taking chronic medications (-p-value=0.049) had more injuries in the past year. These findings may help inform potential injury prevention programs, which should target injuries affecting the lower extremities, and consider the factors associated with injury risk among Lebanese athletes. [ABSTRACT FROM AUTHOR]

Given that physical activity can improve health, the present study was conducted to affect education based on the theory of planned behavior on the promotion of physical activity and awareness in the prevention of diabetes in students. This parallel quasi-experimental study with two equal groups of intervention and control was carried out in three stages by multistage sampling method. Students who were physically ill or had absence were excluded from the study. Only the intervention group received the required intervention and the evaluation was done before, immediately after and 3 months after the intervention in both groups. The educational program was implemented in various forms such as oral, pamphlets, brain storming, group discussions, role play for behavior modeling, and written media such as posters, and exercise demonstrations. Data collection was performed in primary schools of Mashhad. The questionnaire was contained; demographic information, diabetes awareness, physical activity based on the theory of planned behavior and physical activity (IPAQ). Data analysis was done by SPSS-16 software using Fisher's exact test, Chi-square, and marginal longitudinal models at the significance level of 0.05. The mean scores of knowledge (p < 0.001), subjective norm (p < 0.001), perceived behavior control (p = 0.015) and physical activity (p < 0.001) immediately after the intervention were higher in the intervention group compared to the control group and the differences were significant. Results of this study supported the effectiveness of education based on theory of planned behavior in the promotion of physical activity and knowledge of students regarding diabetes prevention. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare recovery time and duration of active rehabilitation following concussion between adolescents with and without attention-deficit/hyperactivity disorder (ADHD). A retrospective cohort study was conducted among adolescents presenting to a specialty concussion clinic. One-quarter of the eligible episodes of care were selected. The final sample included 540 adolescents (ages 13–17 years, median age 15 years; 49.8% girls), of which 65 (12.0%) had a pre-injury diagnosis of ADHD. Days to recovery and days of active rehabilitation were examined. ADHD was not associated with recovery time (ADHD: median = 49 days, IQR = 25–77; No ADHD: median = 47 days, IQR = 29–85) in univariate (Z = −0.45; p = 0.65) or multivariable analyses (Hazard Ratio: 1.17 (0.85–1.61); χ2(1) = 0.95; p = 0.33). The duration of active rehabilitation services received did not differ between youth with ADHD (median = 38.5 days, IQR = 27.5–54.5) and without ADHD (median = 37.5 days, IQR = 18.5–66) in univariate (Z = −0.19; p = 0.85) or multivariable analyses (Hazard Ratio: 1.04 (0.67–1.63); χ2(1) = 0.03; p = 0.85). Our findings support accumulating evidence that ADHD, in and of itself, is not a risk factor for longer recovery or worse outcomes following pediatric concussion. [ABSTRACT FROM AUTHOR]

Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention intervention; however, most studies of PrEP adherence and persistence among men who have sex with men (MSM) have been conducted with MSM who live in urban areas. The experiences of PrEP-using MSM in non-urban areas might differ due to increased barriers to culturally competent care. We examined similarities and differences among urban and non-urban PrEP-using MSM in the southern United States, the region with the highest number of annual HIV diagnoses. We surveyed a total of 78 (n = 25 non-urban, n = 53 urban) PrEP-using MSM. Self-reported adherence was high across all participants. No differences were observed with respect to PrEP persistence, source of PrEP, or reasons for PrEP initiation. Fewer non-urban than urban men reported STI testing in the past 12 months. Overall, we observed few differences comparing urban and non-urban PrEP-using MSM. Additional studies are needed to describe differences in PrEP initiation comparing urban and non-urban MSM. [ABSTRACT FROM AUTHOR]

Background: Athletes are subjected to disciplinary action for even unintentional doping. This study aimed to clarify the effectiveness of prior checks on athletes' drug regimens by medical personnel with knowledge of anti-doping to prevent unintentional doping. Methods: This is a retrospective evaluation of the inquiries to the Anti-Doping Committee by the Japan Table Tennis Association national team athletes and athlete support personnel between 2011 and 2019 regarding whether the drug in question was permitted and whether it contained any prohibited substance. Discrete evaluations were performed for ethical and over-the-counter drugs, in addition to the evaluation of all drugs. Additionally, we evaluated the drugs according to therapeutic category and World Anti-Doping Agency's classification. Results: Overall, 85/1238 (6.9%) ethical drugs, 49/259 (18.9%) over-the-counter drugs and 134/1497 (9.0%) total drugs were considered as not allowed for use. The proportion of over-the-counter drugs judged as not allowed for use was higher than that of ethical drugs (p < 0.001). When tabulating the drugs not allowed for use in the therapeutic category, numerous prohibited substances were identified in adrenal hormone preparations, Kampo products, synthetic narcotics, antitussives, antihemorrhoidals, and bronchodilators among ethical drugs and in cold remedies, gastrointestinal drugs, and antitussives and expectorants among over-the-counter drugs. Conclusions: Of the ethical and over-the-counter drugs that elite athletes wanted to use, approximately 10% were not allowed because of the risk of unintentional doping. These results suggest that conducting prior checks of the athletes' drug regimens by medical personnel with anti-doping knowledge are effective measures to prevent unintentional doping. [ABSTRACT FROM AUTHOR]

Examining the effects of an oculomotor rehabilitation program in subacute brain injury patients presenting with external ophthalmoplegia. This case-control study included 33 patients with subacute brain injury accompanied by external ophthalmoplegia (15 cases, 18 controls) from a hospital rehabilitation ward. Participants underwent comprehensive rehabilitation for 8 weeks. The patients participated in an oculomotor rehabilitation program, which involved inducing pursuit, fixation, saccade, and vergence for 20 min daily, 6 days a week for 8 weeks. We assessed improvements in the angle of strabismus; visual function index (VFI), which evaluates inconvenience in daily life; and diplopia after 8 weeks in the two groups using statistical methods. The program resulted in an immediate strabismus angle improvement (p < 0.001). Strabismus angle change over the 8-week period was significantly higher (p < 0.001) in patients (22.9 ± 12.3°) than in control participants (8.3 ± 7.6°). VFI change was significantly greater (p = 0.003) in patients (7.1 ± 5.1 points) than in control participants (2.7 ± 2.4 points). The patients exhibited significantly higher diplopia improvement rates while looking straight ahead and in the direction of paralysis than did control participants (p = 0.021 and p = 0.037, respectively). This program improved external ophthalmoplegia without any specialized environmental configurations or personnel, which ensures wide clinical applications. Our oculomotor rehabilitation program improved external ophthalmoplegia in subacute brain injury patients. The program promotes pursuit, fixation, saccades, and vergence. The patients lay in the supine position and it places a little burden on them. The program can be completed within 20 min daily, requires no special environmental configurations, and can be performed by anyone. [ABSTRACT FROM AUTHOR]

Measures of ethical behaviours in research may be subject to social desirability bias (SDB). Most behavioural aspects of software piracy research are a subset of ethical research. Few studies of software piracy have explicitly addressed the issue of SDB. In this article, the extent of SDB that may be present in software piracy is empirically assessed. This was done by comparing SDB in software piracy under three conditions using the 40-item Balanced Inventory of Desirable Responding (BIDR) scale. First, software piracy behaviour was examined in an experimental setting with actual money at stake. This allowed subject behaviour to be observed rather than inferred from self-report responses. Second, a survey was conducted to test the extent of software piracy based on subject self-report responses. Third, the extent of software piracy was also assessed based on peer-report responses (i.e.: the subject reported whether their peers would pirate). A comparison of the responses in the three conditions allows us to draw inferences about SDB in software piracy research. Self-report surveys exhibited high levels of SDB. The behaviour in the experimental condition, and responses in the peer-report survey method, did not exhibit SDB. [ABSTRACT FROM AUTHOR]

Improvements in diagnosis and treatment of head and neck cancer (HNC) patients have resulted in improved long-term survival rates. However, a variety of symptoms and comorbidities, often secondary to the cancer and its treatments, are experienced by a relevant number of survivors. So, the aim of this study was to determine the global functional impairment in HNC survivors 1 year after radiotherapy treatment. A descriptive case-control study was performed. HNC survivors were recruited from San Cecilio Clinical University Hospital in Granada. The main variables included were functionality and quality of life. 30 HNC survivors were included in our study. Significant differences were found in the WHO-DAS 2.0 test, with a worse score in the HNC group in most subscales (p < 0.05), and poorer scores in the COMP test, performance (p < 0.001) and satisfaction (p < 0.001). Significant differences were also found in most QLQ-30 subscales (p < 0.05) and the QLQ-H&N35. In regard to the EQ-5D, significant differences were found between groups, with worse results in the HNC group (p < 0.05). HNC survivors presented a poorer global function and a worse quality of life and health status 1 year after the radiotherapy treatment. Moreover, a good correlation was found between functionality and quality of life outcomes. A worse quality of life and health status are shown in head and neck survivors 1 year after radiotherapy. Global functionality is related to quality of life outcomes in head and neck cancer survivors. There is a need to recognise the need for and to provide longer term rehabilitation. [ABSTRACT FROM AUTHOR]

To translate the "Physical Activity Scale for Individuals with Physical Disabilities (PASIPD)" into Turkish, to make a cultural adaptation, and to examine the psychometric properties including validity and reliability. During the translation period cross-cultural adaptation design proposed by guideline was used. Patients completed the Turkish version of the PASIPD and it was applied again a week later. To determine the reliability and internal consistency, Cronbach's alpha coefficient was calculated. Test–retest reliability was determined by using intraclass correlation coefficient (ICC) and Pearson's correlation analysis. Construct validity was examined with factor analysis. Convergent validity was examined by comparing PASIPD with Functional Independent Measurement (FIM), Nottingham Health Profile (NHP), and Craig Handicap Assessment and Reporting Technique Short (CHART-SF), and criterion validity was examined by comparing PASIPD with Manual wheelchair propulsion tests scores. Cronbach's alpha coefficient was 0.725. The ICC coefficient for the test–retest reliability was 0.851. PASIPD was explained by three factors. The ratio of explaining the total variance of these 3 factors was determined as 51.66%. FIM (r = 0.307, p = 0.040) and CHART-SF were moderately positively correlated with PASIPD total score. The correlation between the total score of PASIPD and NHP was r = −0.443 (p = 0.002). 20 Meters Propulsion (r = −0.404, p = 0.005) and Slalom Tests (r = −0.305, p = 0.037) were highly negative and 6 min Push Propulsion (r = 0.456, p = 0.001) were moderately positive with PASIPD total score. The Turkish version of the PASIPD is a valid and reliable scale in patients with spinal cord injury. The Turkish and cross-culturally adapted version of PASIPD is a useful physical activity scale to evaluate the physical activity level of SCI. The Turkish version of the PASIPD is a valid and reliable scale and can be used in Turkish patients with SCI. PASIPD can be used to compare physical activity levels between disability types and groups with and without disabilities. PASIPD can be used to evaluate the effectiveness of attempts to increase physical activity in patients with SCI. [ABSTRACT FROM AUTHOR]

This study investigated whether dual tasks comprising cognitive tasks and occupations related to daily living can improve the mental and cognitive function of Japanese community-dwelling older adults. Participants included 30 older adults, equally divided into intervention and control groups. The outcome measures were memory, attention, depression, and health-related quality of life. No adverse effects of the intervention were observed in any participant in the intervention group. Logical memory I, logical memory II, and Center for Epidemiologic Studies Depression Scale scores showed a significant interaction. Dual tasks combining cognitive tasks and occupations may help improve delayed recall and alleviate depression. A novel attempt to integrate cognitive stimulation and activities valued by individuals may help mediate age-related cognitive function decline and reduce depressive symptoms in community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Individuals with disabilities are disproportionately affected by intimate partner violence and face resultant compromised occupational functioning. Yet limited research exists regarding how occupational therapy practitioners can assist this population. This retrospective, cross-sectional study aims to facilitate better understanding of the relationship between intimate partner violence and occupational functioning among survivors with disabilities. Domestic violence shelter resident records covering a six-year service period were reviewed, assessing relationships between several measures of functioning and sample demographics, disability diagnosis, and participant abuse histories. Findings suggest that there may be a relationship between occupational functioning, disability type, and types of intimate partner violence sustained. [ABSTRACT FROM AUTHOR]

A method for assessing balance that differentiates between balance deficit can help guide effective interventions for preventing falls in older adults. This study aimed to clarify the relationship between balance control systems and falls, and to examine the ability of the Brief-Balance Evaluation Systems Test (BESTest) to evaluate balance deficits in older adults. Overall, 109 community-dwelling older adults participated in this study. The history of falls in the last year was investigated. Balance deficits were assessed using the Brief-BESTest, the functional reach test, the Timed up and Go Test, and the one leg balance test. We analyzed the difference between the fallers and non-fallers across two different age groups. Among younger-older group participants (age < 75 years), there were no significant differences between fallers and non-fallers across all variables. Among older-older group participants (age ≥ 75 years), there were significant differences in the Brief-BESTest total (p=.011; fallers, 13.5 versus non-fallers, 17.0) and section IV scores (postural responses of the Brief-BESTest; p=.026, 2.0 versus 5.0). There was no significant difference in other balance measurements. The postural responses assessed by the Brief-BESTest may serve important functions and may be associated with falls in older adults. [ABSTRACT FROM AUTHOR]

To evaluate the feasibility and safety of percutaneous transluminal forceps biopsy (PTFB) with an adjustable curved sheath in patients with obstructive jaundice. Forty-two patients who underwent PTFB with an adjustable curved sheath were analyzed retrospectively. Sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV) and accuracy were calculated for all populations and in different situations. Technical success and safety were evaluated. The technical success rate was 100%. Thirty-five of 42 cases were diagnosed malignant diseases, the sensitivity of PTFB with an adjustable curved sheath was 74.29% (26/35), the specificity was 100%, the positive predictive value was 100%, the negative predictive value was 43.75% (7/16), and the accuracy rate was 78.57% (33/42). There was a better sensitivity for bile duct malignancies when compared with non-bile duct malignancies (p = 0.012). No statistical difference was found in the sensitivity of the upper part of the biliary tree and the lower part of the biliary tree, and none in the sensitivity of different approaches (left vs. right). The complication rate was 11.90%, and no serious complications were observed. PTFB with an adjustable curved sheath is an effective and safe technique, without being limited by approaches and obstruction sites. [ABSTRACT FROM AUTHOR]

Grounded by the ecological systems perspectives proposed by Bronfenbrenner (1977, 1979) and Fivush and Merrill (2016), the present study was conducted to examine whether autobiographical memory (AM) and self-construal differed in young adults raised in the same macrosystem, but with unique microsystems. European American (EA) participants were born in the United States to mothers who were born in the United States (n = 61) and Chinese American (CA) participants were born in the United States to mothers who were born in China (n = 47). Participants completed an online study in which they reported on and rated aspects of their earliest memory; they also completed measures of self-construal and acculturation. EA participants identified more with mainstream American culture relative to CA participants, who identified to a greater extent with their heritage culture. EA participants also talked and thought more about their earliest memories relative to CA participants; interactions between group and sex were found for social words. Group differences were not observed on measures of self-construal. These findings indicate that microsystem-level factors are associated with differences in AM in young adults even when individuals are born and raised in the same macro-level cultural environment. [ABSTRACT FROM AUTHOR]

Objective: We examined the association between care recipient's physical, mental, and cognitive health conditions and caregivers' psychological distress in Vietnamese older care recipients and their caregivers. Methods: The Vietnamese Aging and Care Survey was developed for care recipients, and adult-child and spousal caregivers, and inquired about their sociodemographics and health-related variables. Results: Data were collected on 58 caregiver-care recipient dyads. Adult-child and spousal caregivers were on average 43 and 70 years-old respectively. The vast majority were female (76%) and born in Vietnam (97%). Adult-child caregivers reported more caregiver burden than spousal caregivers. Care recipients were on average 75 years-old. Care recipients of adult-child caregivers reported more depressive symptoms than care recipients of spousal caregivers and were more likely to have mild dementia. Care recipients' health had no effect on caregiver depressive symptoms but their educational attainment was associated with caregiver burden and depressive symptoms. Conclusions: This study showed care recipients and caregivers' years of education were positively associated with caregivers' psychological distress. Vietnamese families lived in ethnic enclaves and shared caregiving responsibilities within the family. However, using available outside resources may alleviate psychological distress of not only caregivers but also families as a whole. Clinical Implications: Healthcare professionals should encourage educated caregivers and educated care recipients to use outside resources to ease caregiving duties. [ABSTRACT FROM AUTHOR]

To verify the factors associated with the need of tube feeding (TF) during patients post-ischemic stroke hospitalization. This is a retrospective study with 70 adult post-ischemic hemispheric stroke adult patients hospitalized in the Neurology department at a tertiary public hospital in Santa Catarina, Brazil. We investigated associations between the need of a feeding tube during hospitalization and the variables age, gender, admission and discharge NIHSS and FOIS, length of hospital stay in days, presence of thrombolytic therapy, extensive stroke, hemisphere affected, prior stroke, pneumonia during hospitalization, presence of signs of laryngeal penetration and laryngotracheal aspiration and dysphagia in the first and last swallowing clinical evaluation. A total of 33 participants used tube feeding. There was a significant relationship among tube feeding and the following parameters: NIHSS (p value.001), FOIS (p value.001), extensive stroke (p value.034), left hemisphere involvement (p value.035), pneumonia during hospitalization (p value.001), length of hospital stay in days (p value.001), signs of laryngotracheal penetration/aspiration (p value.001) and dysphagia in speech-language assessment (p value.001). Tube feeding during patients hospitalization after ischemic hemispheric stroke was predicted by the severity of stroke and signs of airway permeation. Swallowing difficulty is one of the most common post-stroke consequences. There are few studies on the characterization of post-stroke patients with tube feeding. Tube feeding after ischemic stroke predictors were severity of stroke and signs of airway permeation. [ABSTRACT FROM AUTHOR]

This study examines the quality and reliability of videos about white spot lesions (WSLs) uploaded to YouTube. The keyword required for searching was analyzed using the Google Trends online application, which determined a "white spot lesion." The first 140 videos about WSLs were watched and 85 of them were evaluated. The videos watched were divided into two categories according to their reliability score (RS): low reliability and medium/high reliability. The videos also examined the global quality index (GQS) and video information and quality index (VIQI) data for the videos. Pearson's chi-squared test, Fisher's exact test, and multivariate analysis of variance were used to evaluate the data. It was determined that there were more videos about WSLs with medium/high reliability (65.9%) than with low reliability and that most of the videos were uploaded by clinics (49.4%). The videos contained more information about WSLs in terms of definition (70.6%), treatment indication (77.6%), treatment advantage (77.6%), and treatment procedure (76.5%). It was also determined that the mean GQS, VIQI, and RS values differed according to video reliability category, and only the mean interaction index values differed significantly according to video source (p <.05). Most YouTube videos about WSLs examined in this study were of medium/high reliability. Thus, it can be concluded that the videos about WSLs on YouTube are generally reliable. [ABSTRACT FROM AUTHOR]

Turkish school counsellors (N = 113) were surveyed on their basal knowledge, resources for keeping up, and suggestions with respect to attention-deficit/hyperactivity disorder (ADHD) and learning disorders (LD). Suggestions were then subjected to thematic content analysis and classified as child-centred, teacher-centred or parent-centred approaches. Counsellors primarily suggested child-centred approaches for ADHD and teacher-centred approaches for LD. They highlighted the need for ensuring that schools accommodate to the realities of these students. Although some of the counsellors were more sensitive to abusive labelling and unnecessary medication, the majority of them were not against medication for ADHD. They felt less competent to cope with children with LD, and mostly suggested ways of keeping them from being alienated from family and friends. [ABSTRACT FROM AUTHOR]

To investigate whether whole-body vibration (WBV) plus hip-knee muscle strengthening is more efficient in relieving pain and improving function than hip-knee strengthening alone. Thirty-six participants with patellofemoral pain syndrome (PFPS) were recruited and randomly allocated to either the (1) hip-knee strengthening only (HK group, n = 18) or (2) WBV plus hip-knee strengthening group (WHK group, n = 18). All participants attended 18 physiotherapy sessions (3 sessions/week, 40 min/session) over 6 weeks. Data on symptoms, function, surface electromyography (sEMG) signals from the vastus medialis and gluteus medius, and quality of life were evaluated at baseline (T0), 6 weeks after (T6), and the 12-week follow-up (T18). Significant group × time interactions were found for the VAS score (p < 0.001) and vastus medialis performance (p ≤ 0.015). The WHK group exhibited a greater pain relief than did the HK group at T18 (p ≤ 0.014). The WHK group exhibited significantly larger improvements in the RMS value than did the HK group at T6 (p ≤ 0.011). The present study shows that 6 weeks of WBV plus hip-knee strengthening can improve vastus medialis performance and maintain long-term pain relief to a significantly greater extent than can hip-knee strengthening alone. The present study shows that 6 weeks of WBV plus hip-knee strengthening can improve vastus medialis performance and maintain long-term pain relief to a significantly greater extent than can hip-knee strengthening alone. [ABSTRACT FROM AUTHOR]

The present study aimed to investigate the association between preoperative physical activity (PA) and postoperative functional recovery in gastrointestinal cancer patients. In this prospective study, we included 101 patients who underwent colorectal or gastric cancer surgery. Primary outcome was 6-minute walk distance (6MWD) decline ratio ((postoperative 6MWD value – preoperative 6MWD value)/preoperative 6MWD value × 100 (%)), which was determined as postoperative functional recovery. Patients were divided into two groups according to the median of 6MWD decline ratio: above the median (non-decline group) and below the median (decline group). The International Physical Activity Questionnaire (IPAQ-SV) (the usual seven-day short version) was used to assess preoperative PA and sedentary time. Multivariate logistic regression analysis was performed to identify predictive factors of postoperative functional recovery. Preoperative PA (odds ratio (OR): 3.812; 95% confidence interval (CI): 1.326–10.956; p = 0.01), 6MWD (OR: 1.006; 95% CI: 1.002–1.011; p < 0.01), C-reactive protein (OR: 4.138; 95% CI: 1.383–12.377; p = 0.01), and combined resection (OR: 3.425; 95% CI: 1.101–10.649; p = 0.03) were associated with postoperative functional recovery. Preoperative PA is a predictor of postoperative functional recovery in patients who undergoing gastrointestinal cancer surgery. The association between preoperative physical activity (PA) and postoperative functional recovery has been unclear in gastrointestinal cancer patients. We indicated that preoperative PA predicts postoperative functional recovery. Patients who low preoperative PA need to be monitored carefully in the postoperative course. Patients with low preoperative PA may need enhanced postoperative rehabilitation to reduce postoperative functional decline. [ABSTRACT FROM AUTHOR]

This study compares lower limb muscle strength and endurance in adults with hip osteoarthritis, to an age-matched control group. Thirteen adults with moderate-to-severe hip osteoarthritis (as graded by the Oxford Hip Score) and fifteen older adults participated. Maximal voluntary isometric contraction of the knee extensors, knee flexors and hip abductors and isotonic endurance of the knee extensors were measured using a dynamometer. Function was assessed using the 30-second chair stand test, the 40 m fast-paced walk test and a stair negotiation test. Data were compared between groups using t-tests. Participants with hip osteoarthritis demonstrated weakness in the affected limb when compared to the control limb during knee flexion (34%, p = 0.004) and hip abduction (46%, p = 0.001). Weakness was also observed in the contralateral knee flexors (31%, p = 0.01). When compared to the control limb, the knee extensors of the hip osteoarthritis group were exhausted prematurely in the affected (70%, p = 0.001) and contralateral limb (62%, p = 0.005). The hip osteoarthritis group took twice as long to stair climb (p = 0.002), walked 40% slower, (p < 0.001), and had a 35% lower sit-stand performance (p < 0.001). Moderate-to-severe hip osteoarthritis may be characterised by bilateral deficits in lower-limb maximal strength, markedly lower knee extensor endurance and impaired functional performance. In addition to bilateral deficits in maximal strength of the hip and knee muscles, moderate-to-severe hip osteoarthritis may be characterised by markedly lower muscular endurance of the knee extensors and impaired functional performance. The endurance capacity of the knee extensors can play an important role in daily function, and thus it is important to consider endurance training principles when prescribing exercise for this patient group. Research studies evaluating exercise programmes underpinned by endurance training principles are required to understand the benefits to patients with hip osteoarthritis, and to inform specific exercise prescription in clinical practice. [ABSTRACT FROM AUTHOR]

The Patient Determined Disease Steps (PDDS) is a patient-reported outcome that measures disease severity in People with Multiple Sclerosis (PwMS). It is crucial to have instruments in various languages to ease the use and interpretation of clinical and research findings among PwMS. To translate the PDDS into the Arabic language and explore its reliability and criterion validity with the EDSS, and convergent validity with fatigue, walking, and balance assessments. Backward and forward translation methods were used to generate the PDDS translated version (PDDS-A). A total of 115 PwMS, mean age: 33.7 (SD, 10.6) completed the PDDS-A, the EDSS, and the Modified Fatigue Impact Scale Arabic version (MFIS-A). A sub-sample N = 89 performed walking and balance assessments. The PDDS-A was reevaluated after 2–3 weeks to measure its test-retest reliability. There was a strong correlation between the PDDS-A and EDSS (rho = 0.864). PDDS-A was moderately associated with the MFIS-A total score (rho = 0.598) and its subcomponents (physical: rho = 0.642, and cognitive: rho = 0.474). The PDDS-A showed significant correlations with walking endurance and speed, and balance. There was excellent test-retest reliability: 0.942 (95% CI 0.896–0.968). The PDDS-A is a reliable and valid tool that can be used among Arabic-speaking PwMS. [ABSTRACT FROM AUTHOR]

Children with hemiplegic cerebral palsy (hCP) experience a disorganized muscle activation pattern that adversely affect their ability to respond to balance perturbations. This study examined the effect of plyometric exercises on muscle-activation strategies and response-capacity to balance threats in children with hCP. In a pre-, posttest control-group study, 34 children with hCP were allocated randomly to either the control group (n = 17; received a traditional physical rehabilitation program, lasted for 45 minutes/session, twice/week for three successive months) or the plyometric group (n = 17; received a progressive plyometric training program in three blocks, twice/week over three months plus the traditional physical rehabilitation). Quadriceps/hamstring co-contraction ratio (Q/H Co-CR) and response-capacity to balance threats were assessed pre- and post-treatment. Post-treatment, the Q/H Co-CR and balance control improved significantly in the control (P =.03, P =.0003 respectively) and plyomteric group (P =.001, P ˂ 0.001 respectively). However, the plyometric group showed better improvements in Q/H Co-CR (P =.0001) and balance control (P =.027) when compared to the control group. Incorporation of plyometric exercises into traditional physical rehabilitation could improve muscle-activation strategies and enhance balance control in children with hCP. [ABSTRACT FROM AUTHOR]

Research is important for the development of physiotherapy practice, but several countries have a rather short history of physiotherapy as an academic profession. This study investigated physiotherapists' experiences and attitudes toward scientific research in Austria, where physiotherapists have only been qualifying at bachelor level since 2009. A convenience sample of 597 qualified physiotherapists completed an anonymous cross-sectional online survey. Most respondents were female (n = 467, 78.2%) and in age groups between: 26–35 years (n = 149, 25.0%); 36–45 years (n = 178, 29.8%); and 46–55 years (n = 173, 29.0%). Seventeen respondents (2.8%) held doctoral degrees, and 61 (10.2%) had substantial research experience beyond undergraduate or master-level student research. More positive research attitudes were observed in participants who were male, younger, without children, had completed their physiotherapy qualification since 2009, were engaged in teaching and education, and held postgraduate degrees. Most frequently reported barriers and/or enabling factors for physiotherapy research were time, training, finances and a "critical mass" of research activity. These findings highlight low levels of research activity among physiotherapists in Austria, despite general appreciation of the importance of research for the profession. The identified attitudinal profiles, barriers, and facilitators may inform initiatives for advancing physiotherapy research in the Austrian context. [ABSTRACT FROM AUTHOR]

Using data from a cross-sectional online survey among social work students (N = 457) in the US, our study explored differences in mental health status based on sociodemographic characteristics and preventive behaviors during the COVID-19 pandemic. Results showed disparate experiences related to anxiety, depression, self-harming thoughts, stress and hopelessness by age, gender, employment status, marital status, education, number of children, living arrangement, and mask-wearing and social distancing preventive behaviors. Findings provide implications to mitigate both the current and prolonged impact of the pandemic among social work students who will be playing crucial roles in the provision and delivery of health and human services. [ABSTRACT FROM AUTHOR]

Pharmacists are increasingly called upon to make dispensing decisions when presented with prescriptions for opioids. Risk mitigation strategies have been implemented to assist pharmacists in making these decisions, but they have also increased the complexity of decision-making. The primary objective of this study was to describe change in pharmacist comfort levels with opioid prescription dispensing over the previous year. This was a cross-sectional, multi-state, 16-item survey disseminated to the general membership of 2 state-level professional pharmacy organizations in November 2018. Of 274 pharmacists who opened the questionnaire, 195 (n = 195) completed at least 80% of the survey and were included. Three-fourths (74.6%) of the respondents noted community/retail as their practice site. When asked about change in comfort with dispensing opioids, 19.6% reported an increase in comfort level, 42.5% reported a decrease in comfort level, and 38.0% reported no change. When asked about information that may increase comfort in dispensing opioids, respondents noted diagnosis, morphine milligram equivalent, prior treatments, past medical history, drug monitoring program verification, and previous treatment trials with opioids. Comfort with dispensing opioids decreased over a 12-month period among pharmacists surveyed. Improved communication between prescriber and pharmacist, as well as enhanced access to patient health information, is critical to reduce barriers to care for patients. [ABSTRACT FROM AUTHOR]

Youth living with perinatally acquired HIV (YLPHIV) have been found to have a range of mental disorders. Some adult HIV studies have linked mental health to adverse metabolic outcomes due to dysregulation of the sympathetic nervous system and hypothalamic–pituitary–adrenal axis, but this association has not previously been explored in YLPHIV. We investigated the association of mental health measures with metabolic outcomes in YLPHIV and HIV-uninfected youth (HIV-U) and linear regression was used to assess the adjusted associations. Overall, 203 YLPHIV (median age = 10.7years; 52% female; mean duration on ART 8 years, 12% CD4 count <500 cells/µL, 18% viral load >50 copies/mL) and 44 HIV-U (median age = 10.3 years; 55% female) were enrolled. YLPHIV had higher median total cholesterol (4.2 vs 3.9 mmol/L, p = 0.049) and triglyceride (0.9 vs 0.7 mmol/L, p < 0.001) compared to HIV-U. We found higher percentage of poor functional competence (40% vs 25%, p = 0.02) and self-concept (23% vs 9%, p = 0.03) and higher depression (6% vs 2%, p < 0.01), anger (6% vs 2%, p = 0.04) and disruptive behaviour (4% vs 0%, p < 0.01) in YLPHIV as compared to HIV-U. Among YLPHIV, higher scores of anger were associated with higher total cholesterol and higher low-density lipoprotein (ß = 0.010, p = 0.041 and ß = 0.012, p = 0.048 respectively) and disruptive behaviour with higher low-density lipoprotein (ß = 0.010, p = 0.043) after adjusting for age, sex and BMIZ. This is the one of first study to investigate the association of mental health with metabolic outcomes among YLPHIV. The association of increased anger and disruptive behaviour with increased lipid concentration is a novel finding. Further longitudinal studies are needed to evaluate the causal relationships between mental health and metabolic outcomes. [ABSTRACT FROM AUTHOR]

This study sought to identify Iranian preschool children's (N = 318) knowledge of genital and non-genital body parts. Assessment consisted of children naming selected external body parts in drawings of same-sex counterparts. Results indicated that almost all children knew the correct terms for their non-genital body parts, but few knew the correct terminology for their genitals. Many used slang terms and some appeared embarrassed or reluctant to reply (girls were more likely than boys not to respond). No statistically significant difference between the sex of children in knowledge of correct names of all genitals emerged. Boys knew the correct name of their genitalia (penis) significantly more than girls. Results indicated children are learning the names of their body parts but not their genitals, perhaps indicative of a lack of sexual health education that may be representative of the conservative culture in Iran. It is critical for young children to learn about their genitals as this knowledge provides the foundation for subsequent sex education and facilitates discussion about bodily safety to prevent sexual abuse. When children learn these names, it can facilitate disclosure of abuse and can assist those working with young children in medical settings, child protection and legal arenas. [ABSTRACT FROM AUTHOR]

To determine any factors that predict how an individual will adapt to post-stroke hemianopic visual field loss, with close monitoring of the adaptation process from an early stage. The Hemianopia Adaptation Study (HAST) is a prospective observational longitudinal cohort clinical study. Adult stroke survivors (n = 144) with new onset homonymous hemianopia were monitored using standardised mobility assessment course (MAC) as the primary outcome measure of adaptation. Several baseline variables were found to be good predictors of adaptation. Three variables were associated with adaptation status at 12-weeks post-stroke: inferior % visual field, % total MAC omissions, and MAC completion time (seconds). Baseline measurements of these variables can predict the adaptation at 12 weeks with moderate to high accuracy (area under ROC curve, 0.82, 95% CI 0.74–0.90). A cut-off score of ≤25% target omissions is suggested to predict which individuals are likely to adapt by 12-weeks post-stroke following gold standard care. Adaptation to hemianopia is a personal journey with several factors being important for prediction of its presence, including MAC outcomes and extent of inferior visual field loss. A clinical recommendation is made for inclusion of the MAC as part of a functional assessment for hemianopia. The mobility assessment course (MAC) should be considered as an assessment of mobility/scanning in the rehabilitation of patients with homonymous hemianopia. A cut-off score of ≤25% omissions on MAC could be employed to determine those likely to adapt to hemianopia long-term. Targeted support and therapy for patients with significant visual loss in the inferior visual field area should be considered. [ABSTRACT FROM AUTHOR]

In rural sub-Saharan Africa, preventable delays in accessing emergency care remain a dominant factor in maternal and neonatal deaths. The MOMENTUM study is a pragmatic cohort investigation designed to measure the "Three Delays", i.e. delays in recognizing need for care (Type 1), reaching care (Type 2), and receiving care (Type 3) within a remote island health system on Lake Victoria, Kenya. The study utilizes an adaptive methodology to provide actionable data for a locally-directed "Health Navigation" intervention. We present analysis of 56 maternal and neonatal emergency cases occurring between January 2019 and February 2020. The mean Total Delay Interval (Type 1–3) reported was 39.3 ± 32.3hours. Notably, 18 cases in this cohort resulted in a neonatal (n = 16) or maternal death (n = 2). Sub-analysis indicates significant delay interval reductions associated with involvement of a "Health Navigator" in emergency care coordination for Type 2 Delay Intervals (0.5 ± 0.3 vs. 1.2 ± 1.1 hrs., p = 0.002) and Type 3 Delay Intervals (17.9 ± 14.1 vs. 32.9 ± 33.7 hrs., p = 0.030). Prolonged delays, complex barriers, and high mortality highlight the fraught nature of maternal emergencies in this remote setting. We discuss practical considerations for application of the Three Delays model, and avenues for further investigation. [ABSTRACT FROM AUTHOR]

To analyse the clinical practice of Italian physiotherapists within the framework of postoperative rehabilitation of rotator cuff (RC) surgery patients, and to compare it with similar studies carried out in other countries. A web-based, voluntary, cross-sectional survey with 27 closed multiple-choice questions was developed and submitted to Italian-based physiotherapists in order to assess their clinical practice. Data from 1160 questionnaires were then analysed. Thirty-five percent of respondents (n = 413/1160) reported that they commence passive range of motion from the first postoperative week, while 49.2% (n = 571/1160) start during the second or third week. The majority of respondents (n = 603/1160, 52.0%) introduce active mobilisation between the fourth and the sixth week after surgery and 41.1% (n = 477/1160) introduce overhead movements between the fourth and the sixth week after surgery. When managing the postoperative rehabilitation of RC surgery patients, Italian physiotherapists' practice is congruent with the guidelines published by American Society of Shoulder and Elbow Therapists (ASSET) and also with other UK surveys. However, while Italian physiotherapists manage immobilisation periods, active and passive mobilisation and the return to sport activities, according to evidence-based best practice guidelines, there is less consistency with respect to physical exercise, patient follow-up and referral. Italian physiotherapists' practice with patients following rotator cuff (RC) repair complies with evidence-based practice guidelines regarding immobilisation periods, passive and active mobilisation, and return to sport activities. There is less consistency between reported/declared practice and available evidence concerning physical exercise, patient follow-up, and referral. Physiotherapist with Orthopaedic Manipulative Physical Therapy (OMPT) training is more aligned with the current literature compared to physiotherapists without specific training, in terms of managing rehabilitation programmes, period of immobilisation and therapeutic exercise. More careful adherence to the international guidelines is recommended, in order to manage patients following RC repair in accordance with the evidence and to achieve the best possible outcomes. [ABSTRACT FROM AUTHOR]

Despite a series of high-profile media reports of sexual abuse in sport over the past few years, little research has been done to explore the scope of the problem in the United States. The current article reports on prevalence of child sexual assault in elite athletes in the United States. Using a retrospective web survey, adults answered questions on their experiences in sport. Of the 473 elite athletes surveyed, 3.8% (n = 18) reported being sexual assaulted as a minor in the sporting context. Of those reporting assault, most (61%) reported being abused by an adult authority figure (usually a coach) and 44% reported being assaulted by a peer. Abused athletes were significantly more likely to report having been diagnosed with a mental disorder (Fisher's exact test; p <.001). The findings can be utilized to improve prevention and child protection measures and other safeguarding initiatives in sport. [ABSTRACT FROM AUTHOR]

To evaluate the relationship between nursing assessment findings at discharge and acute ischaemic stroke (AIS) patient prognosis after mechanical thrombectomy (MT). We analysed the characteristics of 144 AIS patients with MT treatment admitted to a university affiliated teaching hospital in Chengdu, Sichuan Province China, from January 2020 to December 2020. The modified Rankin Scale (mRS) score was used to assess outcomes 90-days after discharge. Exploratory analyses were undertaken using IBM SPSS Statistics (Version 26.0). At 90-days, 47.9% (n = 69) had a good prognosis (mRS ≤ 2) including 22.2% (n = 32) fully recovered patients. There were 5 (3.5%) deceased patients and 48.6% (n = 70) of patients had a poor prognosis (mRS ≥ 3). In univariate analysis, clinical prognosis correlated with the need for inpatient endotracheal intubation (p = 0.02), nasogastric tube (p < 0.001), indwelling urinary catheter (p < 0.001), central venous catheter (p = 0.03), health knowledge needs of pressure injury prevention (p = 0.03), National Institute of Health Stroke Scale (NIHSS) score (p < 0.001) and Activities of Daily Living (ADL) score (p < 0.001) at the time of discharge from hospital. The average hospitalization time of the 144 patients was 12[IQR, 9–25] days, and the average cost of hospitalization was $Y$21291.93 (SD 9165.01). Almost half of the surviving patients had a poor prognosis. In our country, this surgery and rehabilitation impose a significant financial burden that needs to be addressed. However, the longer length of hospital stay and higher costs at discharge may be contributing factors to worse outcomes. The outcomes of comprehensive nursing assessment of the patients, including nursing needs, activities of daily living, and neurological function, can predict their outcome. We recommend a comprehensive nursing assessment at discharge that predicts patient outcomes and can be used for subsequent targeted interventions. The prognosis of patients with acute ischaemic stroke after mechanical thrombectomy is poor, and the financial burden needs to be considered. [ABSTRACT FROM AUTHOR]

This study aimed to determine if implementing a clinically pragmatic behavior management approach for challenging behaviors during acute TBI reduces use of restraints, security incidences, acute length of stay admission and cost, thereby improving progress to rehabilitation. This pilot study involved a behavior management group (n = 27), compared with a historical control group (n = 74). The behavior management group received care following the implementation of a behavior management approach for challenging behaviors during acute TBI at two hospitals in South Australia. Fidelity results demonstrated high level of adherence to the implemented behavior management approach. The behavior management group had significant lower use of mechanical restraints (p = 0.03), and significantly lower acute admission costs (p = 0.034). Trends in lower pharmacological restraint usage, lower acute hospital length of stay and time from admission to rehabilitation acceptance were recorded. These pilot results contribute to improving quality of health care but methodological limitations make outcomes difficult to interpret as a direct result of the intervention. Future studies are required to investigate evidence-based behavior management interventions for acute TBI patients using more rigorous knowledge translation implementation designs. [ABSTRACT FROM AUTHOR]

Some students have negative perceptions of group work common in several active learning (AL) pedagogies. This study documented the potential change in student beliefs (epistemology) of learning biomechanical concepts over an introductory biomechanics course implementing low-tech AL exercises. Fifty-eight students in two biomechanics courses agreed to participate and completed a pre- and post-test consisting of the Biomechanics Concept Inventory (BCI3) version 3 and additional questions on their perceptions about group work and the nature of learning in biomechanics. Low-tech AL exercises resulted in a large (d > 0.8) mean improvement in student learning compared previous data on lecture alone. This improvement in learning of biomechanical concepts with AL may be unrelated to student perceptions of working with other students, the nature of biomechanical knowledge or learning. There was inconsistent evidence that student perceptions can be changed over a biomechanics course implementing low-tech AL exercises, with significant reductions in positive attitudes on one question and no difference on another from pre- to post-test. While the majority of students had positive perceptions about working with other students, some had negative perceptions, and how these perceptions changed over the term was not systematic with addition of low-tech AL exercises. [ABSTRACT FROM AUTHOR]

Previous research has found that major depressive disorder (MDD) commonly occurs in hypothyroid populations. The purpose of this study was to use the biopsychosocial model to investigate factors associated with MDD and hypothyroidism by comparing hypothyroid patients with MDD and without MDD. A sample of 386 participants with hypothyroidism completed both cognitive and psychosocial self-reported assessments along with a questionnaire rating the severity of common hypothyroid symptoms. Participants were divided into two groups (MDD and no MDD) using the diagnostic criteria of the Patient Health Questionnaire. Univariate comparisons were used to assess differences in the severity of physical, psychological, and social correlates in participants with and without MDD. Participants with MDD reported significantly worse symptom severity, increased stress, and disruptions of cognitive functioning. Compared to individuals without MDD, they also indicated poorer quality of life, doctor–patient relationships, and treatment adherence. Individuals with comorbid depression and hypothyroidism reported worse outcomes across physical symptoms, social factors, and psychological and cognitive states than individuals without MDD. Integrating depression screeners and independent treatment for MDD, in addition to the patient's hypothyroid treatment plan, may result in hypothyroid symptom relief and greater quality of life. [ABSTRACT FROM AUTHOR]

Patients who adhere to their disease-modifying therapies (DMTs) have a lower rate of MS-related relapses and disability. We sought to determine the adherence rate to DMTs and the association between adherence to DMTs and employment in patients with multiple sclerosis (MS). One hundred and forty-two patients with MS who were periodically followed in our clinic between January 2000 and January 2020. We compared three groups of patients, defined according to their adherence to DMTs (non-adherent; poorly adherent; adherent), on their obtaining paid employment. Forty-seven MS patients (33.1%) were non-adherent to any DMT medication, while 88 MS patients (62.0%) demonstrated good and 7 (4.9%) poor adherences. More patients in the good-adherence group were in paid employment 42.0% compared to 23.4% in the non-adherent group (p = 0.587) after controlling for potential co-founders. In this study veterans who adhered to their DMTs were 2.4 times more likely to be in paid-employment compared to non- or poorly-adherent patients. The clinical significance of this study is to encourage MS patients to adhere to their DMTs as a motivating factor of being in paid-employment. What is known about this subject? In the setting of a randomized controlled trial adherence rates reported for different injectable DMTs vary from 79–85% for once a week interferon beta-1a (IM IFNb-1a) to 49–78% for other injectable DMTs. •What are the new findings and/or impact on clinical practice? •Paid employment was more common among veterans whose adherence to DMTs was good (42.0% employed) or poor (42.9%) than among those who were non-adherent (23.4%). Veterans who adhered to DMTs were also younger, had less severe MS, and displayed less cognitive and physically impairment than those who did not adhere. •Being employed can act as a motivating factor to encourage adherence to treatment aimed at preventing accumulation of mental and physical disabilities. [ABSTRACT FROM AUTHOR]

Robot assisted upper limb (UL) therapy has been identified as an intervention with the potential to help improve the amount of practice performed by stroke survivors. This study aimed to measure the amount of UL practice (i.e., repetitions, duration, intensity) performed by subacute stroke survivors, in particular those with severe UL impairment, pre and post implementation of robot assisted upper limb therapy (RT-UL) into an inpatient rehabilitation setting. Two observational study phases (pre-RT-UL and post-RT-UL) were undertaken of occupational therapy and physiotherapy sessions performed by subacute stroke survivors. Upper limb tasks observed and recorded in therapy were classified as either impairment-related therapy or activity-related. In the pre-RT-UL observational phase, 7 subacute stroke survivors were observed across 11 days involving 25 therapy sessions. Post-RT-UL, 12 subacute stroke survivors were observed across 12 days involving 29 therapy sessions. There were no significant differences in characteristics of patients observed in each phase (p >.05). The mean difference (95% CI) between pre and post RT-UL for repetitions (reps) (569 (1 to 1136) and intensity (7 (4–11)) reps/min of practice increased for all patients, including those with severe UL impairment (337 (37–638)) reps and 8 (2–14) reps/minute, with the duration of therapy unchanged. This is the first study to have observed an increase in UL practice with the inclusion of RT-UL as part of routine clinical practice. This increase in practice is considered to be due to RT-UL providing highly supportive and expeditious semi-supervised practice. Notably, RT-UL was able to be implemented within the existing organisational structures with only basic training of therapy staff. Robotics presents as a viable intervention to increase the amount and intensity of upper limb practice performed by stroke survivors in routine clinical practice Robotics were able to be implemented within the existing organisational structures with only basic training of therapy staff [ABSTRACT FROM AUTHOR]