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ObjectiveTo investigate the psychometric properties of the Lift and Carry Test (LCT) time in people with stroke.DesignCross-sectional design.SettingUniversity based neurorehabilitation laboratory.ParticipantsTwenty-four people with stroke and 24 healthy controls.Outcome measuresLift and Carry Test (LCT), Fugl-Meyer Assessment of upper extremity and lower extremity, ankle dorsiflexor and plantarflexor muscle strength, Berg Balance Scale (BBS), Timed Up and Go (TUG) and Community Integration Measure.ResultsThe mean LCT time (29.70s) in people with stroke was more than double of that in healthy controls (13.70s). The LCT showed excellent intra-rater, inter-rater and test–retest reliability [intraclass correlation coefficient (ICC) = 0.943–1.000]. The LCT times demonstrated a significant negative correlation with the BBS score (rs = −0.771) and significant positive correlations with the TUG times (rs = 0.933). There was no significant correlation between LCT times and FMA score (p > 0.05). An optimal cut-off LCT time of 15.48 s (sensitivity = 95.8%, specificity = 87.5%) was identified to differentiate between people with stroke and healthy controls (area under the curve = 0.957).ConclusionLCT is an excellent clinical test for examining advanced functional ability in people with stroke and distinguishing people with stroke from healthy controls.

The sweetpotato whitefly, Bemisia tabaci MEAM1, is one of the most devastating pests of row-crop vegetables worldwide, damaging crops directly through feeding and indirectly through the transmission of many different viruses, including the geminivirus Tomato yellow leaf curl virus (TYLCV). Y-tube olfactometer tests were conducted at different stages of TYLCV infection in tomatoes to understand how TYLCV affects B. tabaci behavior. We also recorded changes in tomato hosts’ color and volatile profiles using color spectrophotometry and gas chromatography-mass spectrometry (GC-MS). We found that the infection status of B. tabaci and the infection stage of TYLCV influenced host selection, with uninfected whiteflies showing a preference for TYLCV-infected hosts, especially during the late stages of infection. Viruliferous B. tabaci attraction to visual targets significantly differed from non-viruliferous B. tabaci. Late-stage infected hosts had larger surface areas reflecting yellow-green wavelengths and higher emissions of methyl salicylate in their volatile profiles. These findings shed new light on several critical mechanisms involved in the viral manipulation of an insect vector and its economically important host.

Abstract Background There is increasing epidemiological evidence supporting the association between onchocerciasis and seizures, reinforcing the concept of onchocerciasis-associated epilepsy (OAE). The aim of this paper is to provide an update on the new knowledge about OAE and to propose recommendations to the World Health Organization how to address this public health problem. Main text During the 2nd International Workshop on OAE held on 19–21 September, 2023, in Antwerp, Belgium, participants recognised OAE as a substantial yet neglected public health problem, particularly in areas of sub-Saharan Africa where onchocerciasis remains hyperendemic. Evidence from prospective population-based studies suggest that strengthening onchocerciasis elimination efforts leads to a significant reduction of OAE incidence. There is a need to validate an OAE case definition to estimate the burden of disease and identify onchocerciasis-endemic areas requiring intensification of onchocerciasis elimination programmes and integration of epilepsy care. It is expected that raising awareness about OAE will boost the population uptake of ivermectin. The implementation of a community-based epilepsy treatment programme offering free anti-seizure medications (ASMs) has shown high effectiveness in reducing the frequency of seizures and improving the overall quality of life of people with epilepsy. Conclusions To reduce OAE burden, enhanced collaboration between onchocerciasis and mental health programmes at community, national, and international levels is required. Urgent efforts are needed to ensure the uninterrupted provision of free ASMs in onchocerciasis-endemic areas. Furthermore, OAE should be included in the quantification of the onchocerciasis disease burden. Graphical Abstract

Despite the numerous advantages of soil fertility management (SFM) practices and substantial investments to promote adoption, uptake of these technologies remains low across sub-Saharan Africa. We study the adoption and intensity of key SFM practices - improved fallow, animal manure, compost, crop residue retention, minimum tillage, inorganic fertilizer, and intercropping among rural farmers in Zambia. Data from 1234 rural farms and the multivariate probit (MVP) and generalized Poisson regression models are used. The MVP model highlights interconnections among practices, emphasizing the need for integrated interventions. Socio-demographics like gender, age, education, and household labor availability significantly influence adoption of SFM practices. Farm characteristics including experience, land ownership, livestock, and off-farm income also play pivotal roles. Accessibility of information via phones, radio, and farmer groups emerged as a crucial enabler, while extension services, credit, and proximity to markets and roads shape adoption decisions. Results indicate education, household labor, off-farm income, and group membership drive intensity of adoption. Extension contacts, training, and agro-ecological region location also affect intensity with regional variations. Key policy implications emerge. First, the complementarities among practices underscore the need for holistic strategies recognizing these synergies. Second, enhancing education specifically for younger farmers can promote adoption of SFM technologies by increasing knowledge. Third, spurring farmer groups facilitates knowledge exchange, input access, and collaborative adoption. Fourth, strategic extension services and training programs are vital to address knowledge gaps for sustained adoption. Overall, this study provides insights to guide policies for promoting SFM practices among rural farms.

ObjectivesThe potential impact of cumulative community-directed treatment with ivermectin (CDTI) on epilepsy epidemiology in Mvolo County, South Sudan, an onchocerciasis-endemic area with high epilepsy prevalence, was investigated. Annual CDTI was introduced in 2002 in Mvolo, with interruptions in 2016 and 2020.MethodsComprehensive house-to-house surveys in Mvolo (June 2020 and 2022) identified cases of epilepsy, including probable nodding syndrome (pNS). Community workers screened households in selected sites for suspected epilepsy, and medical doctors confirmed the diagnosis and determined the year of seizure onset. The incidence of epilepsy, including pNS, was analysed using 95% confidence intervals (CIs). Data on ivermectin intake and onchocerciasis-associated manifestations (itching and blindness) were collected.ResultsThe surveys covered 15,755 (2020) and 15,092 (2022) individuals, identifying 809 (5.2%, 95% CI: 4.8-5.5%) and 672 (4.5%, 95% CI: 4.1-4.8%) epilepsy cases, respectively. Each survey reported that a third of the surveyed population experienced skin itching, and 3% were blind. Epilepsy incidence per 100,000 person-years gradually declined, from 326.5 (95% CI: 266.8-399.1) in 2013-2015 to 96.6 (95% CI: 65.5-141.7) in 2019-2021. Similarly, pNS incidence per 100,000 person-years decreased from 151.7 (95% CI: 112.7-203.4) to 27.0 (95% CI: 12.5-55.5). Coverage of CDTI was suboptimal, reaching only 64.0% of participants in 2019 and falling to 24.1% in 2021 following an interruption in 2020 due to COVID-19 restrictions. Additionally, while 99.4% of cases had active epilepsy in 2022, less than a quarter of these had access to antiseizure medication.ConclusionsThe observed decrease in epilepsy incidence despite suboptimal CDTI coverage highlights the potential impact of onchocerciasis control efforts and underscores the need to strengthen these efforts in Mvolo County and across South Sudan. As a proactive measure, Mvolo and neighbouring counties are transitioning to biannual CDTI. Furthermore, the substantial epilepsy treatment gap in Mvolo should be addressed.

In Malawi, ethnobotanical surveys have been carried out on the plants used to treat or manage allergies and their symptoms. However, studies focusing on information analysis such as systematic reviews of anti-allergic plants and natural products are not yet published. This review highlighted and analysed data of potential anti-allergic medicinal plants used in Malawi in order to discover potential treatments for allergies through various approaches and improve well-being of people. Literature search strategy was used to collect data of medicinal plants. Chemoinformatics analysis was applied to compile associated natural products and to profile the physicochemical properties (drug-likeness and fingerprint diversity) with references to 60 antihistamine 1 drugs (H1R drugs) and 277 anti-H1 receptor inhibitors. Sixty (60) medicinal plants from 36 families out of 645 reported plant species had information of diseases or symptoms of allergies. The Malawian Natural Products (MNP) data set composed of 1757 unique compounds was compiled for the first time from 39 of 60 medicinal plants and approximately 48.9 % and 45.3 % of the compounds did not violate Lipinski and Veber drug-like rules respectively. Chemical space mapping revealed that compounds from Malawian medicinal plants are structurally diverse and share a small space with antihistamine compounds and drugs. This information is useful in exploring other anti-allergy biological mechanisms for natural products. Similarity screening identified usambarine (CID442121), which is structurally similar to 2,8-Dimethyl-5-(2-pyrazine-2-ylethyl)-gamma-carboline (CHEMBL1783970) and 29 other antihistamine compounds. The results will be used as a baseline for further studies which may eventually lead to the discovery of potential allergy treatments through various approaches. This could improve health and well-being of people which is in line with goal number 3 of Sustainable Development Goals, Africa's Union's Agenda 2063 and National Research Agenda for the Malawi 2063.

Stroke rehabilitation, which demands consistent, intensive, and adaptable intervention in the long term, faced significant challenges due to the COVID-19 pandemic. During this time, telerehabilitation emerged as a noteworthy complement to traditional rehabilitation services, offering the convenience of at-home care delivery and overcoming geographical and resource limitations. Self-help rehabilitation robots deliver repetitive and intensive physical assistance, thereby alleviating the labor burden. However, robots have rarely demonstrated long-term readiness for poststroke telerehabilitation services. The transition from research trials to general clinical services presents several challenges that may undermine the rehabilitative gains observed in these studies. This perspective discusses the technological readiness of personal use robots in the context of telerehabilitation and identifies the potential challenges for their clinical translation. The goal is to leverage technology to seamlessly integrate it into standard clinical workflows, ultimately enhancing the outcomes of stroke rehabilitation.

Objectives: To examine the association between falls and fear of falling in people with stroke and to evaluate the differences between patients with acute stroke and those with chronic stroke with regard to any such association. Methods: Articles were searched in Medline, CINAHL, AMED, Embase, PsycINFO, Cochrane Library of Reviews and PEDro from inception until March 2023. Experimental, observational or explorative studies investigating the association between fear of falling and falls in people with stroke were included. Articles were screened by 2 independent reviewers. Data were extracted by an independent reviewer. Results: A total of 26 reports were included in this review (n = 2863). Fear of falling, assessed by a single-question survey, was significantly associated with falls (relative risk = 1.44; 95% confidence interval (95% CI) = 1.22, 1.70; I2 = 0%) in people with acute stroke. Significant mean differences in fear of falling, based on the Falls Efficacy Scale (mean difference = 12.80; 95% CI = 1.81, 23.78; I² = 28%) and Activities-specific Balance Confidence Scale (mean difference = –9.99; 95% CI = –15.36, –4.62; I² = 57%), were also reported between fallers and non-fallers in people with chronic stroke. Conclusion: A small, but significant, association exists between falls and fear of falling in both acute and chronic stroke patients.

BackgroundStroke disrupts the functions carried out by the brain such as the control of movement, sensation, and cognition. Disruption of movement control results in hemiparesis that affects the function of the diaphragm. Impaired function of the diaphragm can in turn affect many outcomes such as respiratory, cognitive, and motor function. The aim of this study is to carry out a systematic review and meta-analysis to determine the efficacy of diaphragmatic breathing exercise on respiratory, cognitive, and motor outcomes after stroke.MethodThe study was registered in PROSPERO (CRD42023422293). PubMED, Embase, Web of Science (WoS), PEDro, Scopus, and CENTRAL databases were searched until September 2023. Only randomized controlled trials comparing diaphragmatic breathing exercise with a control were included. Information on the study authors, time since stroke, mean age, height, weight, sex, and the protocols of the experimental and control interventions including intensity, mean scores on the outcomes such as respiratory, cognitive, and motor functions were extracted. Cochrane risks of bias assessment tool and PEDro scale were used to assess the risks of bias and methodological quality of the studies. Narrative synthesis and meta-analysis were used to summarize the results, which were then presented in tables, risk-of-bias graph, and forest plots. The meta-analysis was carried out on respiratory function [forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow (PEF)] and motor function (trunk impairment, and internal and external oblique muscles activity).ResultsSix studies consisting of 151 participants were included. The results of the meta-analyses showed that diaphragmatic breathing exercise is only superior to the control at improving respiratory function, FVC (MD = 0.90, 95% CI = 0.76 to 1.04, P < 0.00001), FEV1 (MD = 0.32, 95% CI = 0.11 to 0.52, P = 0.002), and PEF (MD = 1.48, 95% CI = 1.15 to 1.81, P < 0.00001).ConclusionThere is limited evidence suggesting that diaphragmatic breathing exercise may help enhance respiratory function, which may help enhance recovery of function post stroke.Systematic Review RegistrationPROSPERO, identifier CRD42023422293.

Regular physical activity (PA) contributes to maintaining health and improving the quality of life among older people. This cross-sectional study investigates the associations between motivations derived from self-determination theory (SDT) and physical activity levels, as well as health-related fitness indices, in older Chinese women. We recruited 92 retired older women (range: 60–85 years; mean age ± SD: 71.74 ± 5.39 years) from Hong Kong, China. We assessed participants' motivations (autonomous motivation, controlled motivation, and amotivation) using the Treatment Self-Regulation Questionnaire, and measured their moderate-to-vigorous intensity physical activity (MVPA) and weekly walking using the International Physical Activity Questionnaire. We also evaluated body fat (fat mass, fat percentage, and visceral fat) using the Tanita SC240MA, flexibility with the Back Scratch Test and Chair Sit-and-Reach Test, and muscle strength using the Five-Times Sit-to-Stand Test and ''Timed Up and Go'' Test. We analyzed the data using partial-least squares structural equation modeling with Warp PLS 8.0 software. The results showed that autonomous motivation was significantly and positively related to walking (β = .24, p

Abstract Cancer is globally a disease of significant public health concern owing to its prevalence, and association with morbidity and mortality. Thus, cost‐effective treatments for cancer are important to help reduce its significant morbidity and mortality. However, the current therapeutic options for cancer such as chemotherapy, radiotherapy, and surgery may produce serious adverse events such as nausea, vomiting, fatigue, and peripheral neuropathy, especially in the long term. In addition, these therapeutic options may not be well tolerated by the elderly especially those who are frail. The current article is aimed at discussing an alternative therapeutic option, non‐invasive vagus nerve stimulation (VNS), and the roles it plays in cancer pathology and immunotherapy. The VNS does this by reducing oxidative stress via silent information regulator 1 (SIRT1); inhibiting inflammation via both hypothalamic–pituitary–axis (HPA) and the release of corticosteroid from the adrenal gland, and cholinergic anti‐inflammatory pathway (CAP), and increasing vagal activity which helps in the regulation of cell proliferation, differentiation, apoptosis, and metabolism, and increase chance of survival. Furthermore, it helps with reducing complications due to cancer or its treatments such as postoperative ileus and severity of peripheral neuropathy induced by chemotherapy, and improves cancer‐related fatigue, lymphopenia, and quality of life. These suggest that the importance of non‐invasive VNS in cancer pathology and immunotherapy cannot be overemphasized. Therefore, considering the safety of non‐invasive VNS and its cost‐effectiveness, it is a therapeutic option worth trying for these patients, especially in combination with other therapies.

Abstract Vagus nerve stimulation (VNS) is used to deliver electric current to stimulate the vagus nerve. The aim of this study is to carry out a systematic review and meta-analysis to determine its effects on motor function in patients with stroke. PubMED, Embase, Web of Science (WoS), and Scopus were searched. Data on time since stroke, and mean scores and standard deviation on outcomes such as level of impairment and motor function were extracted. The results showed that invasive (MD 2.66, 95% CI 1.19–4.13, P = 0.0004) and non-invasive (MD 24.16, 95% CI 23.56–24.75, P = 0.00001) VNS are superior at improving level of motor impairment than the control post intervention and at follow-up respectively. Similarly, VNS improved motor function post intervention (MD 0.28, 95% CI 0.15–0.41, P

In contrast to previous studies regarding the impact of minimum wages which only focused on total workers and the economic sector and the use of employment status to form formal workers, this study analyzed the effect of minimum wages on one of the demographic variables namely youth by comparing the formation of formal workers using cross tabulation of status and type of work and formation of formal workers by using job status only. The purpose of this research is to analyze the impact of the minimum wage on young formal workers in Indonesia. This study describes that the difference in the high percentage of young formal workers supports the research objective that it is important to compare the impact of the minimum wage on the two categories. Using the 2015 SAKERNAS cross section data and the OLS regression method the impact of the minimum wage on young formal workers using cross-tabulations is higher than the impact of the minimum wage on young formal workers using only employment status. The minimum wage reduces formal youth employment (either by cross-tabulation or by status alone) significantly. Ignoring the use of cross-tabulations between status and type of work can lead to underestimates in the percentage of young formal workers so that the use of cross-tabulations is more representative in showing the effect of minimum wages on young formal workers compared to using employment status alone

The development of sustainable catalytic processes is the requirement of the future to replace traditional protocols involving hazardous, non-green, non-benign reagents/solvents, and cost ineffectiveness. Metal and mixed metal oxides due to their redox properties make them potential substitutes for conventional homogeneous catalysts. The acidity can be enhanced further by the sulfation process to form sulfated oxides representing a new class of solid acid catalysts. This review is the revisiting of sulfated solid acid catalysts, with major emphasis on understanding, methods, applications, and their role in the syntheses of heterocycles of pharmaceutical importance. The present review also discusses factors affecting the acidity of the catalysts, possibilities of leaching in reaction media, methods of sulfation to arrest leaching, other challenges, and future prospects.

Giuliano Lo Bianco,1,2 Andrea Tinnirello,3 Alfonso Papa,4 Maurizio Marchesini,5 Miles Day,6 Gaetano Joseph Palumbo,7 Gaetano Terranova,8 Maria Teresa Di Dato,4 Simon J Thomson,9 Michael E Schatman10,11 1Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy; 2Anesthesiology and Pain Department, Fondazione Istituto G. Giglio, Cefalù, Italy; 3Anesthesiology and Pain Medicine Department, ASST Franciacorta, Ospedale di Iseo, Iseo, 25049, Italy; 4Pain Department, AO “Ospedali dei Colli”, Monaldi Hospital, Naples, Italy; 5Mininvasive Surgery Department, Unit of Pain Medicine IRCCS Maugeri Pavia, Pavia, 27100, Italy; 6Pain Research, The Pain Center at Grace Clinic, Texas Tech University HSC, Lubbock, TX, USA; 7Azienda Ospedale - Università Padova, Department of Anesthesia and Intensive Care, Padova, Italy; 8Anaesthesia and Intensive Care Department, Asst Gaetano Pini, Milano, Italy; 9Pain Management, Mid and South Essex University Hospitals NHSFT, Basildon, SS16 5NL, UK; 10Department of Anesthesiology, Perioperative Care, and Pain Medicine, NYU School of Medicine, New York, NY, USA; 11Department of Population Health – Division of Medical Ethics, NYU School of Medicine, New York, NY, USACorrespondence: Giuliano Lo Bianco, Email giulianolobianco@gmail.comAbstract: In patients where conservative approaches have failed to relieve from chronic pain, interventional procedures may be an option in well selected patients. In recent years there has been an increase in the use and development of invasive procedures. Concomitantly, there has also been an increase in the complications associated with these procedures. Taken this into consideration, it is important for healthcare providers to take a cautious and vigilant approach, with a focus on patient safety, in order to minimize the risk of adverse events and ensure the best possible outcome for the patient. This may include careful selection of patients for procedures, use of proper techniques and equipment, and close monitoring and follow-up after the procedure. The aim of this narrative review is to summarize the primary complications associated with commonly performed image-guided (fluoroscopy or ultrasound-guided) interventional procedures and provide strategies to reduce the risk of these complications. We conclude that although complications from interventional pain procedures can be mitigated to a certain degree, they cannot be eliminated altogether. In order to avoid adverse events, patient safety should be given considerable attention and physicians should be constantly aware of the possibility of developing complications.Keywords: chronic pain, pain management procedures, complications, spinal cord stimulation, intrathecal drug delivery, low back pain

Although there is easy accessibility of infection control measures and recommendation regarding the PPE, most of the dentists failed to practice appropriate infection control measures. The aim of the current survey was conducted to assess the knowledge, perception, and attitude regarding the role of PPE among the dental care professionals in COVID-19. This is cross-sectional web-based questionnaire survey conducted among dental care professionals in Tamil Nadu. The self-administered questions related to the PPE infection control measures were collected from 500 subjects. The statistical analysis was done using Statistical Package for Social Sciences SPSS (V 22.0). The frequency distribution was computed. This survey revealed that all the 500 (100%) respondents had awareness about the role of PPE in COVID-19 pandemic. Among the 500 study subjects, 93.2% had well-known knowledge about PPE, 60.4% of dentist strictly adheres to the use of PPE in routine dental practice, 80.2% of dentist mentioned PPE is safe and effective against spread of infection, and 93.4% of dentist had awareness about donning and doffing. Conclusion: From the beginning of this COVID-19, information provided by the health organization like CDC and WHO regarding the role of PPE had positive impact among the dental care professionals.

BackgroundStroke results in impairment of motor function of both the upper and lower limbs. However, although it is debatable, motor function of the lower limb is believed to recover faster than that of the upper limb. The aim of this paper is to propose some hypotheses to explain the reasons for that, and discuss their implications for research and practice.MethodWe searched PubMED, Web of Science, Scopus, Embase and CENTRAL using the key words, stroke, cerebrovascular accident, upper extremity, lower extremity, and motor recovery for relevant literature.ResultThe search generated a total of 2,551 hits. However, out of this number, 51 duplicates were removed. Following review of the relevant literature, we proposed four hypotheses: natural instinct for walking hypothesis, bipedal locomotion hypothesis, central pattern generators (CPGs) hypothesis and role of spasticity hypothesis on the subject matter.ConclusionWe opine that, what may eventually account for the difference, is the frequency of use of the affected limb or intensity of the rehabilitation intervention. This is because, from the above hypotheses, the lower limb seems to be used more frequently. When limbs are used frequently, this will result in use-dependent plasticity and eventual recovery. Thus, rehabilitation techniques that involve high repetitive tasks practice such as robotic rehabilitation, Wii gaming and constraint induced movement therapy should be used during upper limb rehabilitation.

Due to diagnostic improvements, medical diagnostics is demanding non-invasive or minimally invasive methods. Non-invasively obtained body fluids (eg., Urine, serum) can replace cerebral fluid, amniotic fluid, synovial fluid, bronchoalveolar lavage fluid, and others for diagnostic reasons. Many illnesses are induced by perturbations of cellular signaling pathways and associated pathway networks as a result of genetic abnormalities. These disturbances are represented by a shift in the protein composition of the fluids surrounding the tissues and organs that is, tissue interstitial fluid (TIF). These variant proteins may serve as diagnostic “signatures” for a variety of disorders. This review provides a concise summary of urine and serum biomarkers that may be used for the diagnosis and prognosis of a variety of disorders, including cancer, brain diseases, kidney diseases, and other system diseases. The studies reviewed in this article suggest that serum and urine biomarkers of various illnesses may be therapeutically useful for future diagnostics. Correct illness management is crucial for disease prognosis, hence non-invasive serum and urine biomarkers have been extensively studied for diagnosis, subclassification, monitoring disease activity, and predicting treatment results and consequences.

Soft wearable robotic hand can assist with hand function for the performance of activities of daily living (ADL). However, existing robotic hands lack a mathematical way to quantify the grip force generated for better controlling the grasp of objects during the performance of ADL. To address this issue, this article presents a soft wearable robotic hand with active control of finger flexion and extension through an elastomeric-based bi-directional soft actuator. This actuator bends and extends by pneumatic actuation at lower air pressure, and a flex sensor embedded inside the actuator measures the angles of the fingers in real-time. Analytical models are established to quantify the kinematic and tip force for gripping of the actuator in terms of the relationship between the input pressure and the bending angle, as well as the output force, and are validated experimentally and by the finite element method. Furthermore, the ability of the soft robotic hand to grasp objects is validated with and without being worn on a human hand. The robotic hand facilitates hand opening and closing by the wearer and successfully assists with grasping objects with sufficient force for ADL-related tasks, and the grip force provided by the actuator is further estimated by the analytical models on two healthy subjects. Results suggest the possibility of the soft robotic hand in providing controllable grip strength in rehabilitation and ADL assistance.

Abstract Social support has an important role in stroke rehabilitation. The Multidimensional Scale of Perceived Social Support (MSPSS) is an instrument examining the adequacy of perceived social support. However, the psychometric properties of the Chinese version of MSPSS (MSPSS-C) have not been examined in Chinese people with stroke. This study aimed at investigating the psychometric properties of the MSPSS-C, identifying the correlations between MSPSS-C scores and health-related measures of these people; and examining the differences in the levels of perceived social support between people with and without stroke in Hong Kong using a cohort of 57 community-dwelling people with stroke and 50 age-matched healthy controls. We found that the MSPSS-C subscales demonstrated excellent internal consistency, and a ceiling effect was observed for the family subscale of the MSPSS-C. The total MSPSS-C score had significant weak to moderate correlations with the scores of the concerned variables of interests. Exploratory factor analysis revealed a two-factor structure for the MSPSS-C. People with stroke had lower levels of perceived social support from friends and their significant other than those without stroke. The MSPSS-C is a valid tool for assessing perceived social support among chronic stroke survivors with moderate to very severe motor impairment.

Welma Lubbe,1 Hannakaisa Niela-Vilén,2 Gill Thomson,3 Elina Botha4 1School of Nursing Science/NuMIQ Research Focus Area, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa; 2University of Turku, Department of Nursing Science, Turku, Finland; 3School of Community Health and Midwifery, University of Central Lancashire, Preston, UK; 4School of Social Services and Health Care, Tampere University of Applied Sciences, Tampere, FinlandCorrespondence: Welma Lubbe, Email welma.lubbe@nwu.ac.zaObjective: The aim of this systematic review was to explore the impact of the COVID-19 pandemic on breastfeeding support services and continuation rates.Methods: Electronic searches were undertaken in seven databases: Academic Search Complete, Springer Nature Journals, CINAHL Medline, Health Source: Nursing/Academic Edition, Masterfile premier, and SocINDEX. Publications following the COVID-19 pandemic between January 2020 and March 2022 were searched for using the following keywords: impact or effect or influence and breastfeeding support and breastfeeding continuation and COVID-19 or coronavirus. Fifteen studies were included for investigation and extracted to identify seven themes related to breastfeeding support during COVID-19.Results: Factors which impacted breastfeeding support during the COVID-19 pandemic included separation, lack of skin-to-skin contact, insufficient support, online breastfeeding support, the impact of the pandemic on breastfeeding rates and experiences, fears of the pandemic, and the need for additional support. The pandemic mostly influenced breastfeeding support negatively, with a small exception occurring where some mothers experienced lockdown as positive since it protected the mother-infant dyad from unwanted visitors. Virtual breastfeeding support was introduced in many contexts; however, practitioners and mothers reported that this could not replace the need for face-to-face support.Conclusion: Breastfeeding is a lifesaving intervention, especially in the face of a disruption such as a pandemic. This work highlights the need for clear, consistent, and evidence-based information about risks, and for key practices to be maintained including not separating mothers and infants, promoting skin-to-skin contact, and ensuring availability of high-quality breastfeeding support.Keywords: breastfeeding support, COVID-19, coronavirus, pandemic, effect

Abstract Background and Aim Patients with inflammatory bowel disease (IBD) requiring infliximab frequently spend hours to attend treatment. Through quality improvement (QI) methodology, we aimed to shorten the time spent in the biologics infusion center using the accelerated infusion protocol and describe patient outcomes, safety, and associated cost savings. Methods From September 2018 through December 2019, eligible IBD patients receiving infliximab were recruited. We implemented interventions including the accelerated infusion protocol, and modifying collection location of infliximab. Statistical process control charts were created. Patients' clinical outcome and cost savings data were analyzed using descriptive statistics and Pearson's chi‐square. Results During the study period, a total of 60 patients with IBD receiving infliximab were recruited. A total of 315 infusions were administered—152 were under accelerated infusion protocol and 163 under standard protocol. The mean infliximab infusion time was reduced by 47%, from 2.4 h (142 ± 14 min) to 1.2 h (75 ± 10 min) (142 min vs 75 min, P