Search

• We recruited residents from 27 nursing home in China. • Fear of falling directly and indirectly contributed to poor quality of life and depression. • We studied the mediating role using generalized structural equation modeling, activity restriction mediated the effect of the fear of falling on health outcomes. This study investigates the mediating role of activity restriction in the relationship between the fear of falling and health outcomes. This was a cross-sectional study with convenience sampling of 316 nursing home residents. Generalized structural equation modeling was conducted to test the mediating role. The results showed that residents with fear of falling were more likely to restrict their activities and residents who often or always restricted activities reported lower levels of quality of life and higher levels of depression. Severe activity restriction accounted for 75 % of the total effect of fear of falling on quality of life and 69 % of the total effect of fear of falling on depression. Fall prevention efforts should focus on strategies or interventions to reduce residents' excessive fear of falling and promote activity engagement. Physical and social activities will not only prevent future falls but also improve residents' quality of life and mental health. [ABSTRACT FROM AUTHOR]

• This study focuses on the phenomenon of fear of falling related activity restrictions in older adults. • A predictive model was constructed based on risk factors. • Internal and external validation the reproducibility and generalizability of the model. • Visual assessment tools are easily accessible to community health workers. • Early identification of older adults at risk and interventions for prevention. Fear of falling related activity restrictions are widespread among older adults, leading to several adverse effects. Given these consequences, there is an urgent need for a comprehensive assessment tool that integrates various risk factors to predict the likelihood of older adults experiencing such activity restrictions. This cross-sectional study investigated fear of falling related activity restrictions and its influencing factors, simultaneously constructed and validated a nomogram among older adults residing in the communities in China. The model includes variables like age, gender, self-rated health, past year injurious falls, gait stability, anxiety, and cognitive impairment. It showed an AUC of 0.892. Internal validation had an AUC of 0.893, and external validation had an AUC of 0.939. Calibration curve showed good fit, and decision curve showed high clinical benefits. It's an intuitive tool for medical professionals to identify older adults at high risk of activity restrictions due to fear of falling. [ABSTRACT FROM AUTHOR]

Objectives: Assess the influence of physical function on balance and future falls in older adults with fear of falling (FOF) and whether activity restriction modifies the contribution to falls. Methods: Analyses utilized data from Baltimore Longitudinal Study of Aging (n = 680) and National Health and Aging Trends Study (n = 4376) community-dwelling older adults. The role of physical function was examined by comparing balance performance and future fall odds before/after controlling for function in older adults with/without FOF. Fall likelihood analyses were repeated with FOF stratified by activity restriction. Results: When controlling for physical function, differences in balance and fall odds secondary to FOF/activity restricting FOF reduced but remained significant. Fall odds secondary to non-activity restricting FOF only slightly decreased. Discussion: Physical function contributes to balance and falls in older adults with FOF, more so in those restricting activity. Reduced balance and increased fall risk persists independent of function suggesting additional contributing factors. [ABSTRACT FROM AUTHOR]

Background and Objectives: The older members of a population might experience unmet medical needs, despite desiring medical care due to activity limitations driven by their perception of aging. This study conducted a cross-sectional analysis of the association between perceived activity restriction (PAR) due to people's own perception of aging and unmet medical needs (UMN) in late middle-aged and older Koreans based on the Korean National Health and Nutrition Examination Survey (KNHANES). Materials and Methods: The 2016–2020 KNHANES was used to analyze a total of 2008 participants among groups aged 45 years or older by applying individual weights imposed from the raw data. The independent variable of PAR was assessed using self-reported questionnaires based on the global activity limitation indicator. Also, the dependent variable of UMN, referring to the state in which a patient's medical care or service was insufficient, inadequate, or lacking, was assessed using a single question. After excluding missing values, the data on 2008 individuals were analyzed using a chi-square test, weighted logistic regression, and a stratified analysis of gender, age, and the presence of chronic illnesses. Results: The group that experienced PAR had an OR 2.13 higher (odds ratio [OR]: 2.13; 95% confidence interval [CI]: 1.27–3.56) to present UMN than the group that did not experience PAR. Furthermore, the results of the stratified analysis indicated that, in the group of female participants with chronic illness and in the group of elderly people, experiencing PAR was associated with a higher experience of UMN. Conclusions: There was a close association between PAR and UMN. In particular, when PAR occurred in the group of female participants with chronic illness and in the group of elderly people, the incidence rate of UMN was also found to be high. This finding highlights the need for policies and institutional measures to reduce UMN within vulnerable groups with an increased risk of medical inaccessibility due to activity restriction. [ABSTRACT FROM AUTHOR]

The vulnerability of biodiversity to climate change and habitat alterations is a growing global concern. In the case of reptiles, it has been widely documented that relatively small changes in temperature can have drastic effects on biological processes with significant ecological consequences. This study used biophysical models to investigate how climate change and levels of shade influence the activity period of a vulnerable tropical tortoise (Gopherus evgoodei). The results revealed that reduced shading, serving as an indicator of decreased vegetation cover, has a significant and negative impact on the activity time of this species. Furthermore, it is projected that a 1.8°C increase in ambient temperature due to climate change would lead to an even further reduction in its activity time. This finding highlights the critical importance of shade, vegetation, and thermal limitations in the physiology of this tortoise, emphasizing the challenges that tropical reptiles face due to climate change and habitat alteration. The study also emphasizes the utility of mechanistic niche models in understanding how climate change and habitat modification can affect organisms. In conclusion, this study provides valuable eco-physiological information for the conservation of vulnerable species in tropical environments, highlighting the importance of preserving vegetation cover in tortoise habitats and carefully considering the implications of climate change in an ever-changing world amidst the biodiversity crisis.

The occurrence pattern of stereotypic behavior in high-parity confined sows is still unclear. We continually observed the behavioral changes in activity-restricted sows from the first mating to the end of the third parity. The results showed that the second- or third-parity weaned sows exhibited more vacuum chewing and total oral behavior than the first-parity sows. The vacuum chewing of sows in the second and third pregnancies was significantly more than that of the first-pregnancy sows at each stage of pregnancy, and the total oral behavior changed similarly. The sitting of sows in the second and third pregnancies was significantly more than that of the first-pregnancy sows in the early stage of pregnancy, whereas sitting behavior in the third pregnancy was significantly more than that in the middle stages of the first and second pregnancies. Vacuum chewing or sitting was positively correlated with confinement duration. In summary, vacuum chewing and sitting behaviors in sows confined from the first mating were significantly affected by parity. From the late stage of the first pregnancy to the middle stage of the second pregnancy is the key period of stereotypic behavior development for low-parity sows.

Objectives: Self-reported activity restriction is an established correlate of depression in dementia caregivers (dCGs). It is plausible that the daily distribution of objectively measured activity is also altered in dCGs with depression symptoms; if so, such activity characteristics could provide a passively measurable marker of depression or specific times to target preventive interventions. We therefore investigated how levels of activity throughout the day differed in dCGs with and without depression symptoms, then tested whether any such differences predicted changes in symptoms 6 months later. Design, setting, participants, and measurements: We examined 56 dCGs (mean age = 71, standard deviation (SD) = 6.7; 68% female) and used clustering to identify subgroups which had distinct depression symptom levels, leveraging baseline Center for Epidemiologic Studies of Depression Scale–Revised Edition and Patient Health Questionnaire-9 (PHQ-9) measures, as well as a PHQ-9 score from 6 months later. Using wrist activity (mean recording length = 12.9 days, minimum = 6 days), we calculated average hourly activity levels and then assessed when activity levels relate to depression symptoms and changes in symptoms 6 months later. Results: Clustering identified subgroups characterized by: (1) no/minimal symptoms (36%) and (2) depression symptoms (64%). After multiple comparison correction, the group of dCGs with depression symptoms was less active from 8 to 10 AM (Cohen's d ≤ −0.9). These morning activity levels predicted the degree of symptom change on the PHQ-9 6 months later (per SD unit β = −0.8, 95% confidence interval: −1.6, −0.1, p = 0.03) independent of self-reported activity restriction and other key factors. Conclusions: These novel findings suggest that morning activity may protect dCGs from depression symptoms. Future studies should test whether helping dCGs get active in the morning influences the other features of depression in this population (i.e. insomnia, intrusive thoughts, and perceived activity restriction). [ABSTRACT FROM AUTHOR]

Environmental temperatures potentially influence reproductive performance and sexual selection by restricting opportunities for activity. However, explicit tests of the behavioral mechanisms linking thermal variation to mating and reproductive performance are rare. We address this gap in a temperate lizard by combining social network analysis with molecular pedigree reconstruction in a large-scale thermal manipulation experiment. Populations exposed to cool thermal regimes presented fewer high-activity days compared with populations exposed to a warmer regime. While plasticity in thermal activity responses in males masked overall differences in activity levels, prolonged restriction nevertheless affected the timing and consistency of male-female interactions. Females were less capable than males of compensating for lost activity time under cold stress, and less active females in this group were significantly less likely to reproduce. While sex-biased activity suppression appeared to limit male mating rates, this did not correspond to a heightened intensity of sexual selection or shifts in the targets of sexual selection. In many populations facing thermal activity restriction, sexual selection on males may play a limited role relative to other thermal performance traits in facilitating adaptation. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the relationship between psychological factors (depression, anxiety, and catastrophizing) and fear of falling avoidance behavior (FFAB) among individuals with Parkinson's disease (PD). Methods: A secondary analysis of cross-sectional data from 59 individuals with PD using hierarchical multiple regression. Results: Disease severity (Movement Disorder Society - Unified PD Rating Scale) and catastrophizing (Consequences of Falling Questionnaire (CoF)) explained approximately 48.2% of the variance in the FFAB Questionnaire scores (P <.001). Catastrophizing was the only significant psychological variable (P <.001). The damage to identity subscale of the CoF was significant in the final model (P <.001). Conclusions: Catastrophizing about the consequences of falls explained the largest portion of variability in FFAB after controlling for disease severity. Catastrophizing about the immediate consequences of falling may play a prominent role in FFAB and may be a potential treatment target for mitigating FFAB. [ABSTRACT FROM AUTHOR]

Background and Objectives: The older members of a population might experience unmet medical needs, despite desiring medical care due to activity limitations driven by their perception of aging. This study conducted a cross-sectional analysis of the association between perceived activity restriction (PAR) due to people’s own perception of aging and unmet medical needs (UMN) in late middle-aged and older Koreans based on the Korean National Health and Nutrition Examination Survey (KNHANES). Materials and Methods: The 2016–2020 KNHANES was used to analyze a total of 2008 participants among groups aged 45 years or older by applying individual weights imposed from the raw data. The independent variable of PAR was assessed using self-reported questionnaires based on the global activity limitation indicator. Also, the dependent variable of UMN, referring to the state in which a patient’s medical care or service was insufficient, inadequate, or lacking, was assessed using a single question. After excluding missing values, the data on 2008 individuals were analyzed using a chi-square test, weighted logistic regression, and a stratified analysis of gender, age, and the presence of chronic illnesses. Results: The group that experienced PAR had an OR 2.13 higher (odds ratio [OR]: 2.13; 95% confidence interval [CI]: 1.27–3.56) to present UMN than the group that did not experience PAR. Furthermore, the results of the stratified analysis indicated that, in the group of female participants with chronic illness and in the group of elderly people, experiencing PAR was associated with a higher experience of UMN. Conclusions: There was a close association between PAR and UMN. In particular, when PAR occurred in the group of female participants with chronic illness and in the group of elderly people, the incidence rate of UMN was also found to be high. This finding highlights the need for policies and institutional measures to reduce UMN within vulnerable groups with an increased risk of medical inaccessibility due to activity restriction.

Abstract Background The high prevalence of falling among older adults constitutes a major public and clinical health concern. Many elderly persons may develop activities-specific restriction due to the risk of falling. This highlights the need for relevant evaluative tools. Methods This cross-sectional study used activities-specific performance frequency indicators to quantify activity restrictions in elderly participants, with all measures based on items from the Activities-Specific Balance Confidence (ABC) scale. Specifically, we tested for correlations between activities-specific performance frequency and balance confidence, functional balance/mobility, and fall history. There were 88 elderly participants, including 28 with stroke, 30 with Parkinson’s disease, and 30 with no neurological diseases. In addition to their activities-specific performance frequency measures, we collected a series of demographic and health-related characteristics from each participant. We analyzed between-group differences in activities-specific performance frequency and other demographic and health-related characteristics via the one-way analysis of variance and Kruskal-Wallis test. Next, we used the Spearman’s rank correlation test and binary logistic regression to investigate the correlations between activities-specific performance frequency and demographic/other health-related characteristics. Results There were significant group differences in performance frequency for all ABC activity items except for walking around the house, average ABC scores, and functional balance/mobility among normal older adults, participants with strokes and those with Parkinson's disease. Activities-specific performance frequency showed stronger correlations with activities-relevant functional mobility (r=0.250-0.713 for 15 items with significant correlations, 13 activity items with r≧0.4) than with balance confidence (r=0.279-0.668 for 13 items with significant correlations, 10 activity items with r≧0.4). The performance frequency of walking in crowds/bumped was the most sensitive measure for predicting fallers (odd ratio=3.310, p

Background: According to the Organization for Economic Co-operation and Development, the unemployment rate of the middle-aged and elderly population is increasing worldwide. Moreover, 15.7% of middle-aged and elderly people in Korea are unable to engage in economic activities despite their desire for economic activities. Under these circumstances, various studies have been conducted to determine the relationship between unemployment and unhealthy status. Purpose: The purpose of this study was to identify the association between restrictions on economic activities due to health conditions and all-cause mortality rates in those aged 45 and older in Korea and to lower the mortality rates of these groups. Results: The study found that the mortality rate of those who responded "very probable" to experience of economic activity restrictions due to health conditions was 2.376 times (hazard ratio [HR] 2.376, 95% confidence interval [CI]: 1.933-2.920, p-value < .0001) higher than those who responded "not at all". Moreover, in a group with current non-economic activity, the mortality rate of those who responded "very probable" to experience of economic activity restrictions due to health conditions was 2.345 times (HR: 2.345, 95% CI: 1.856-2.963, p-value < .0001) higher than those who responded "not at all." Conclusion: This study found that the death rate of groups with economic activity restrictions due to health conditions was higher than that of other groups, particularly those with current non-economic activities due to restrictions on economic activities. Thus, if a policy related to social participation, such as economic activities, is provided to a group of individuals with non-economic activities, the mortality rate for these groups is expected to be lower. [ABSTRACT FROM AUTHOR]

Abstract Global climate change is already contributing to the extirpation of numerous species worldwide, and sensitive species will continue to face challenges associated with rising temperatures throughout this century and beyond. It is especially important to evaluate the thermal ecology of endangered ectotherm species now so that mitigation measures can be taken as early as possible. A recent study of the thermal ecology of the federally endangered Blunt‐nosed Leopard Lizard (Gambelia sila) suggested that they face major activity restrictions due to thermal constraints in their desert habitat, but that large shade‐providing shrubs act as thermal buffers to allow them to maintain surface activity without overheating. We replicated this study and also included a population of G. sila with no access to large shrubs to facilitate comparison of the thermal ecology of G. sila populations in shrubless and shrubbed sites. We found that G. sila without access to shrubs spent more time sheltering inside rodent burrows than lizards with access to shrubs, especially during the hot summer months. Lizards from a shrubbed site had higher midday body temperatures and therefore poorer thermoregulatory accuracy than G. sila from a shrubless site, suggesting that greater surface activity may represent a thermoregulatory trade‐off for G. sila. Lizards at both sites are currently constrained from using open, sunny microhabitats for much of the day during their short active seasons, and our projections suggest that climate change will exacerbate these restrictions and force G. sila to use rodent burrows for shelter even more than they do now, especially at sites without access to shrubs. The continued management of shrubs and of burrowing rodents at G. sila sites is therefore essential to the survival of this endangered species.

Objectives: To clarify whether enuresis treatment was more effective during the stay‐home period for the coronavirus disease 2019 pandemic, when restrictions on activities enabled patients to concentrate on treatment. Methods: We performed a retrospective, nonrandomized cohort study for monosymptomatic enuresis during the coronavirus disease 2019 pandemic (March–June 2020) and a 2‐year comparator period (March–June 2018 and March–June 2019). Primary outcome was treatment response, defined as a change in the number of wet nights per week within 6 months following enrollment. The time‐dependent occurrence of treatment response was evaluated with the Kaplan–Meier method and the log‐rank test. The Cox proportional hazards regression model was used to identify risk factors for treatment response. The range of appropriate sample sizes for this primary outcome was 39–48. Results: Of our 41 enrolled patients, 28 (68%) were male and mean age was 8.8 years. The complete response rate was 73% during the coronavirus disease 2019 pandemic period and 27% during the comparator period. Log‐rank tests showed a higher cumulative incidence of complete response in the pandemic period (P = 0.020). Cox regression analysis identified treatment during the coronavirus disease 2019 pandemic (hazard ratio 2.533; 95% confidence interval 1.069–6.006) and dinner before 19:00 (hazard ratio 4.184; 95% confidence interval 1.56–11.252) as significantly associated with treatment response. Conclusions: The rate of enuresis treatment response was uncommonly high during the stay‐home period for the coronavirus disease 2019 pandemic. Restrictions on daily life may provide opportunities to concentrate on treatments for chronic illnesses, leading to more success. [ABSTRACT FROM AUTHOR]

Objective: Fear of falling (FOF) is one of the important risk factors for falling, is higher in patients with Parkinson’s disease (PD). The Survey of Activities and Fear of Falling in the Elderly (SAFFE) differs from other scales in terms of considering the accompanying activity limitation. The aim of the study was to show the psychometric properties of the Turkish version of SAFFE (SAFFE-T) in PD, and to correlate SAFFE FOF subscale scores with age, disease duration, and the Turkish version of Movement Disorder Society Unified Parkinson’s Disease Rating Scale-III (MDS-UPDRS-TR-III) motor score. Materials and Methods: A total of 93 patients with PD were evaluated. Seventy patients who met the inclusion criteria were included. Responders received a second survey after about 5 to 7 days. The internal consistency was examined by means of Cronbach’s alpha. The construct validity was evaluated using the Falls Efficacy Scale International (FES-I) and with Spearman’s test. The test-retest reliability was studied in terms of intraclass correlation coefficient (ICC2.1), the standard error of measurement (SEM), and the minimal detectable difference (MDC95). The correlation between SAFFE FOF subscale scores and age, duration of disease, and MDS-UPDRS-TR-III score was evaluated using Spearman’s test. Results: The mean age of the patients was 60.99 (range: 33-84), mean duration of the disease was 7.27 years (range: 1-22), and mean MDS-UPDRS-TR-III score was 28.40 (range: 6-69). The test had excellent internal consistency (α: 0.854) and test-retest reliability (ICC2.1: 0.98/SEM: 0.36/MDC95: 1.00 for activity levels, ICC2.1: 0.86/SEM: 0.22/MDC95: 0.61 for FOF, ICC2.1: 0.99/SEM: 0.36/MDC95: 1.00 for activity restriction subscales). All subscales were moderately correlated with the FES-I (rS=0.51, p

Background: The high prevalence of falling among older adults constitutes a major public and clinical health concern. Many elderly persons may develop activities-specific restriction due to the risk of falling. This highlights the need for relevant evaluative tools.Methods: This cross-sectional study used activities-specific performance frequency indicators to quantify activity restrictions in elderly participants, with all measures based on items from the Activities-Specific Balance Confidence (ABC) scale. Specifically, we tested for correlations between activities-specific performance frequency and balance confidence, functional balance/mobility, and fall history. There were 88 elderly participants, including 28 with stroke, 30 with Parkinson's disease, and 30 with no neurological diseases. In addition to their activities-specific performance frequency measures, we collected a series of demographic and health-related characteristics from each participant. We analyzed between-group differences in activities-specific performance frequency and other demographic and health-related characteristics via the one-way analysis of variance and Kruskal-Wallis test. Next, we used the Spearman's rank correlation test and binary logistic regression to investigate the correlations between activities-specific performance frequency and demographic/other health-related characteristics.Results: There were significant group differences in performance frequency for all ABC activity items except for walking around the house, average ABC scores, and functional balance/mobility among normal older adults, participants with strokes and those with Parkinson's disease. Activities-specific performance frequency showed stronger correlations with activities-relevant functional mobility (r=0.250-0.713 for 15 items with significant correlations, 13 activity items with r≧0.4) than with balance confidence (r=0.279-0.668 for 13 items with significant correlations, 10 activity items with r≧0.4). The performance frequency of walking in crowds/bumped was the most sensitive measure for predicting fallers (odd ratio=3.310, p<0.05).Conclusions: This study proposed and validated the usage of activities-specific performance frequency as an alternative method for quantifying activity restrictions among older adults. [ABSTRACT FROM AUTHOR]

Introduction: Menstruation, a physiological phenomenon, till date is associated with myths, taboos, and malpractices. These interfere with the emotional, physical, and mental health of adolescent girls. This study attempts to draft a validated questionnaire to measure menstruation-related activity restriction. Objective: The objective was to study activities restricted during menstruation among adolescent girls residing in urban resettlement colonies of Delhi and to develop and validate a questionnaire for menstruation-related activity restriction. Materials and Methods: A community-based cross-sectional study was conducted among adolescent girls residing in urban resettlement colonies of Delhi during 2019. A multistage random sampling technique was used to select 1100 girls across four districts of Delhi. A 15-item questionnaire was developed by an expert committee and validated with principal component analysis (PCA). Results: In total, 1100 adolescent girls were included in the study whose mean age was 15.8 (±2.1) years. School/college/work was missed due to menstruation in 60% of the adolescent girls, 66% were not comfortable during menstruation, and 92% were restricted from entering religious places. In exploratory factor analysis using PCA, 6 principal components were identified which had eigenvalues more than 1. Conclusion: Religious restrictions during menstruation (94%) were highly prevalent among adolescent girls, followed by restriction of routine activity (69%) and work/academically related activity (60%). Construct validity has identified a six-factor structure for the menstruation-related activity restriction questionnaire. This was identified as a valid and internally consistent tool to assess activities restricted during menstruation among Indian adolescent girls.

Aim: To analyze the correlation between activity restriction due to fear of falling and mortality among Koreans aged ≥45 years. Methods: After excluding missing values, the data of 411 participants from the first to sixth waves of the Korean Longitudinal Study of Aging were analyzed using the χ2‐test, log‐rank tests and Cox proportional hazards model. Results: In model 1, which did not include activity restriction due to fear of falling as an independent variable, the death rate increased by 1.024‐fold (hazard ratio 1.024, 95% confidence interval 1.000–1.050, P = 0.0498) as the number of falls increased by one. In model 2, which included activity restriction due to fear of falling as an independent variable, participants with experience of activity restriction showed 1.993‐fold higher mortality (hazard ratio 1.993, 95% confidence interval 1.112–3.572, P = 0.0205) than those without such experience. In addition, as the number of falls in the group with chronic diseases increased by one, the mortality rate increased by 1.028‐fold (hazard ratio 1.028, 95% confidence interval 1.001–1.057, P = 0.043). Conclusions: There was a close relationship between activity restriction due to fear of falling and mortality. Therefore, this study can serve as the foundation for policies and institutional measures to reduce the mortality rate of groups with activity restrictions due to fear of falling. Geriatr Gerontol Int 2022; 22: 168–174. [ABSTRACT FROM AUTHOR]

Objective  Despite lack of evidence to support efficacy, activity restriction is one of the most commonly prescribed interventions used for the prevention of preterm birth. We have a departmental policy against the use of activity restriction but many practitioners still prescribe it in an effort to prevent preterm birth. We sought to evaluate the rate and compliance of women who are prescribed activity restriction during pregnancy to prevent preterm birth. Study Design  This was a single-site retrospective questionnaire study at a tertiary care, academic affiliated medical center. Women with a history of preterm delivery or short cervix were included. Once patients were identified, each patient was contacted and administered a questionnaire. We assessed the rates of activity restriction prescription and compliance. Secondary outcomes included details regarding activity restriction and treatment in pregnancy. Continuous variables were compared with t -test and categorical variables with Chi-square test. The value p  < 0.05 was considered significant. Results  Among the 52 women who responded to the questionnaire, 18 reported being placed on activity restriction by a physician, with 1 self-prescribing activity restriction, giving a rate of our primary outcome of 19 of 52 (36.5%). All women reported compliance with prescribed activity restriction (100%). Gestational age at delivery was not different in women placed on activity restriction. Conclusion  This questionnaire suggests that approximately one in three high-risk women were placed on activity restriction during their pregnancy despite a departmental policy against its use. The 100% compliance rate in patients placed on activity restriction is a strong reminder of the impact prescribing patterns of physicians can have on patients. Key Points One in three women are placed on activity restriction in pregnancy. Women are compliant with prescribed activity restriction. Activity restriction does not reduce rates of preterm birth. [ABSTRACT FROM AUTHOR]

Background: Artificial Neural Network (ANN) is relatively crude electronic model based on the neural structure of human brain which was used in the field of medicine in different purposes. It can be used for many medical branches especially for estimating the course of a certain disorder or treatment procedure. The aim of this study is to use ANN in maxillofacial surgery to estimate the postoperative symptoms after third molar surgery.Methods:The pre and post-operative information of 175 consecutive patients who needed extraction of impacted third molar teeth were employed to train an ANN. After the training process, the information of 26 cases was used in order to verify the network's ability to predict the post-operative symptoms such as swelling, pain, decrease of mouth opening, bleeding, number of days to return to normal activities and duration of activity restriction. The results obtained from ANN were compared with the results of patients self-reported information. The correlation between the postoperative symptoms of the patients and outcomes obtained from the ANN were analyzed statistically.Results: Close association was found between the patients’ reports and ANN results on post-operative pain, swelling, bleeding, number of days to return to normal activities and duration of activity restriction.Conclusions: The proposed ANN approach is easy to implement and adapted to predict the response of the postoperative outcomes. The model can be further extended to include more variables and experimental data to increase reliability.Keywords:Activity restriction, artificial neural network, postoperative discomfort, third molar surgery.

Introduction: Socioeconomic inequalities have been considered as an important factor for disparity in the prevalence of disabilities among geriatric population belonging to different socioeconomic strata with significantly increased of disability in elderly population belonging to lower socioeconomic status. The impact of socioeconomic status on the morbidity and disability profile of elderly in India is very scarce. This study would help in planning geriatric health care services for different communities depending upon their socioeconomic status. Aim: The aim of this study was to compare the morbidity profile, disability profile, and perceived health care needs in Indian elderly population belonging to two different socioeconomic strata residing in city of western India. Methodology: This was a cross sectional qualitative comparative study done in Aug 2016 to Dec 2016. In this study two geriatric cohorts one belonging to high income group staying in a gated community and other belonging to low income group staying in a urban slum were compared. House to house survey was done based on prevalidated WHO DAS scale predesigned questionnaire to assess the activity limitation and participation restriction of the elderly population in city dwellers in Western India. After initial sensitisation workshops to sensitise and train the medical students, paramedics and the social workers, the house to house survey was on holidays. Results: Total 406 elderly patients were interviewed in HIG and 409 were interviewed in LIG. Females outnumbered the males in both the cohorts with 53.7% in HIG and 63.8% in LIG. It was noted that 14.5% of the elderly were staying alone in HIG where as against 10.2% in LIG. It was also noted that 14.5% of elderly in HIG required help of outside caregiver from doing the activities of daily living (ADLs) where as 28.9% in LIG required outside help to do ADLs. It was noted that there was a significant difference in the activity limitation score in both the cohorts with 64% of elderly in HIG having a good score (0-18) as against 13.9 % in LIG. in participation restriction score with 77% of elderly belonging to HIG having a good participation score as against 40.6% in the elderly belonging to LIG. Conclusion: The morbidity profile, disability profile, and perceived health care needs in Indian elderly population belonging to two different socioeconomic strata residing in city of western India are different. Public health care penetration was poor in the elderly living in LIG as most of them visited the doctor only during emergencies and that too majority of them had access to alternative medicine system. Dedicated geriatric services along with provision of medicines, ambulance and geriatric helpline was the most felt needs in the society.

Global climate change is already contributing to the extirpation of numerous species worldwide, and sensitive species will continue to face challenges associated with rising temperatures throughout this century and beyond. It is especially important to evaluate the thermal ecology of endangered ectotherm species now so that mitigation measures can be taken as early as possible. A recent study of the thermal ecology of the federally endangered Blunt‐nosed Leopard Lizard (Gambelia sila) suggested that they face major activity restrictions due to thermal constraints in their desert habitat, but that large shade‐providing shrubs act as thermal buffers to allow them to maintain surface activity without overheating. We replicated this study and also included a population of G. sila with no access to large shrubs to facilitate comparison of the thermal ecology of G. sila populations in shrubless and shrubbed sites. We found that G. sila without access to shrubs spent more time sheltering inside rodent burrows than lizards with access to shrubs, especially during the hot summer months. Lizards from a shrubbed site had higher midday body temperatures and therefore poorer thermoregulatory accuracy than G. sila from a shrubless site, suggesting that greater surface activity may represent a thermoregulatory trade‐off for G. sila. Lizards at both sites are currently constrained from using open, sunny microhabitats for much of the day during their short active seasons, and our projections suggest that climate change will exacerbate these restrictions and force G. sila to use rodent burrows for shelter even more than they do now, especially at sites without access to shrubs. The continued management of shrubs and of burrowing rodents at G. sila sites is therefore essential to the survival of this endangered species. [ABSTRACT FROM AUTHOR]

Caregiving for individuals with Alzheimer's disease is associated with chronic stress and elevated symptoms of depression. Placement of the care receiver (CR) into a long-term care setting may be associated with improved caregiver well-being; however, the psychological mechanisms underlying this relationship are unclear. This study evaluated whether decreases in activity restriction and increases in personal mastery mediated placement-related reductions in caregiver depressive symptoms. In a 5-year longitudinal study of 126 spousal Alzheimer's disease caregivers, we used multilevel models to evaluate placement-related changes in depressive symptoms (short form of the Center for Epidemiologic Studies Depression scale), activity restriction (Activity Restriction Scale), and personal mastery (Pearlin Mastery Scale) in 44 caregivers who placed their spouses into long-term care relative to caregivers who never placed their CRs. The Monte Carlo method for assessing mediation was used to evaluate the significance of the indirect effect of activity restriction and personal mastery on postplacement changes in depressive symptoms. Placement of the CR was associated with significant reductions in depressive symptoms and activity restriction and was also associated with increased personal mastery. Lower activity restriction and higher personal mastery were associated with reduced depressive symptoms. Furthermore, both variables significantly mediated the effect of placement on depressive symptoms. Placement-related reductions in activity restriction and increases in personal mastery are important psychological factors that help explain postplacement reductions in depressive symptoms. The implications for clinical care provided to caregivers are discussed.

BackgroundsWith the rapid spread of COVID-19, strict home confinement has been implemented in most parts of Chinese regions. Millions of people were not allowed to leave their homes except for special reasons. Home confinement plays an essential role in curbing pandemic and promoting preventive behaviors, but it may affect individuals’ mental health as well.ObjectsThe objective of this study was to explore the psychological impacts of home confinement.Materials and MethodsWe collected more than 150,360 Weibo messages from 5,370 Chinese active users, and then extracted psycho-linguistic features from these messages. Psycho-linguistic analysis was carried out using the 2 (confinement vs. non-confinement) × 2 (before vs. after confinement) repeated measure analysis of variance (RM ANOVA).ResultsThe results showed that the frequency of positive emotion words was remarkably decreased during home confinement [F(1,5368) = 7.926, p = 0.005, η2 = 0.001]. In high-endemic subgroup, home confinement also reduced the frequency of exclusion words [F(1,3445) = 4.518, p = 0.034, η2 = 0.001] and inhibition words [F(1,3445) = 10.154, p = 0.001, η2 = 0.003].ConclusionHome confinement caused a decline in the use of positive emotion words. This indicates that home confinement can increase the frequency of negative emotions. The changes of exclusion words and inhibition words in high-endemic areas may be related to the high epidemic threat and the urgent need for social distancing in these areas.

Backgrounds: With the rapid spread of COVID-19, strict home confinement has been implemented in most parts of Chinese regions. Millions of people were not allowed to leave their homes except for special reasons. Home confinement plays an essential role in curbing pandemic and promoting preventive behaviors, but it may affect individuals' mental health as well. Objects: The objective of this study was to explore the psychological impacts of home confinement. Materials and Methods: We collected more than 150,360 Weibo messages from 5,370 Chinese active users, and then extracted psycho-linguistic features from these messages. Psycho-linguistic analysis was carried out using the 2 (confinement vs. non-confinement) × 2 (before vs. after confinement) repeated measure analysis of variance (RM ANOVA). Results: The results showed that the frequency of positive emotion words was remarkably decreased during home confinement [ F (1,5368) = 7.926, p = 0.005, η2 = 0.001]. In high-endemic subgroup, home confinement also reduced the frequency of exclusion words [ F (1,3445) = 4.518, p = 0.034, η2 = 0.001] and inhibition words [ F (1,3445) = 10.154, p = 0.001, η2 = 0.003]. Conclusion: Home confinement caused a decline in the use of positive emotion words. This indicates that home confinement can increase the frequency of negative emotions. The changes of exclusion words and inhibition words in high-endemic areas may be related to the high epidemic threat and the urgent need for social distancing in these areas. [ABSTRACT FROM AUTHOR]

Objective Physical activity restriction in sows may lead to behavioral abnormalities and affective disorders. However, the psychophysiological state of these sows is still unclear. As miRNAs can be used as effective markers of psychopathy, the present study aimed to assess the difference in microRNA expression between the long-term activity restricted sows and activity free sows, thus contributing to the understanding of abnormal sow behavior. Methods Four dry sows (sixth parity, Large×White genetic line) were selected from activity restricted crates (RC) or activity free pens (FP) separately. microRNAs in the ventromedial prefrontal cortex (vMPFC) and serum were examined using real-time polymerase chain reaction, and the correlation between the miRNAs expressed in the vMPFC and serum was evaluated. Results miR-134 (1.11 vs 0.84) and miR-1202 (1.09 vs 0.85) levels were higher in the vMPFC of the RC sows than in the FP sows (p0.05). The relative expression of serum miR-1202 was higher in the RC sows than in the FP sows (1.04 vs 0.54) (p0.05). Conclusion This pilot study demonstrates that long-term activity restriction in sows likely results in autism or other complex psychopathies with depression-like behaviors. These observations may provide new insights for future studies on abnormal behavior in sows and contribute to research on human psychopathy.

Supplemental Digital Content is Available in the Text. Background and Purpose: The Survey of Activities and Fear of Falling in the Elderly (SAFE) was originally developed in English to determine the level of fear of falling and its interactions with activities of daily living. The purpose of this study was to translate and cross-culturally adapt the SAFE instrument into Turkish and investigate its psychometric properties. Participants: One hundred eleven older adults (72 females) with a mean age of 69 years (SD = 7.22; range, 60-87) were included. Methods: For cross-cultural adaptation, 2 bilingual translators used the back-translation procedure. Within a 5- to 7-day period after the first assessment, the participants completed the Turkish version of the SAFE (SAFE-T) to evaluate test-retest reliability. Cronbach's α was used to assess internal consistency. The correlation with the Turkish version of the Falls Efficacy Scale-International (FES-T) was determined to check the validity. Results: The SAFE-T had excellent internal consistency (α = 0.96) and test-retest reliability (intraclass correlation coefficient [ICC2,1] = 0.96 for activity level, ICC2,1 = 0.95 for fear of falling, and ICC2,1 = 0.86 for activity restriction subscales). The SAFE-T activity level and SAFE-T activity restriction subscales were moderately correlated with the FES-I (ρ = −0.51, P <.001; ρ = 0.55, P <.001, respectively). A strong positive correlation was found between the SAFE-T fear of falling subscale and the FES-I (ρ = 0.75, P <.001), indicating good concurrent validity. Conclusions: The results show that the SAFE-T is semantically and linguistically adequate to assess the fear of falling in adults older than 60 years. Excellent internal validity and test-retest reliability of the SAFE-T were defined to evaluate the fear of falling among Turkish speaking older adults. [ABSTRACT FROM AUTHOR]

Objective: Fear of falling (FOF) is one of the important risk factors for falling, is higher in patients with Parkinson's disease (PD). The Survey of Activities and Fear of Falling in the Elderly (SAFFE) differs from other scales in terms of considering the accompanying activity limitation. The aim of the study was to show the psychometric properties of the Turkish version of SAFFE (SAFFE-T) in PD, and to correlate SAFFE FOF subscale scores with age, disease duration, and the Turkish version of Movement Disorder Society Unified Parkinson's Disease Rating Scale-III (MDS-UPDRS-TR-III) motor score. Materials and Methods: A total of 93 patients with PD were evaluated. Seventy patients who met the inclusion criteria were included. Responders received a second survey after about 5 to 7 days. The internal consistency was examined by means of Cronbach's alpha. The construct validity was evaluated using the Falls Efficacy Scale International (FES-I) and with Spearman's test. The test-retest reliability was studied in terms of intraclass correlation coefficient (ICC2.1), the standard error of measurement (SEM), and the minimal detectable difference (MDC95). The correlation between SAFFE FOF subscale scores and age, duration of disease, and MDS-UPDRS-TR-III score was evaluated using Spearman's test. Results: The mean age of the patients was 60.99 (range: 33-84), mean duration of the disease was 7.27 years (range: 1-22), and mean MDS-UPDRS-TR-III score was 28.40 (range: 6-69). The test had excellent internal consistency (α: 0.854) and test-retest reliability (ICC2.1: 0.98/SEM: 0.36/MDC95: 1.00 for activity levels, ICC2.1: 0.86/SEM: 0.22/MDC95: 0.61 for FOF, ICC2.1: 0.99/SEM: 0.36/MDC95: 1.00 for activity restriction subscales). All subscales were moderately correlated with the FES-I (S=0.51, p<0.001; S=0.59, p<0.001; S=0.56, p<0.001, respectively). The SAFFE-FOF subscale score was correlated with MDS-UPDRS-TR-III score (S=0.31, p=0.009), but it was not correlated with age and duration of disease (S=0.22, p=0.85; S=0.11, p=0.38, respectively). Conclusion: The SAFFE-T, which has excellent internal consistency and reliability, appears to be an appropriate survey for measuring FOF in PD and correlates with disease severity. [ABSTRACT FROM AUTHOR]

Introduction: Menstruation, a physiological phenomenon, till date is associated with myths, taboos, and malpractices. These interfere with the emotional, physical, and mental health of adolescent girls. This study attempts to draft a validated questionnaire to measure menstruation-related activity restriction. Objective: The objective was to study activities restricted during menstruation among adolescent girls residing in urban resettlement colonies of Delhi and to develop and validate a questionnaire for menstruation-related activity restriction. Materials and Methods: A community-based cross-sectional study was conducted among adolescent girls residing in urban resettlement colonies of Delhi during 2019. A multistage random sampling technique was used to select 1100 girls across four districts of Delhi. A 15-item questionnaire was developed by an expert committee and validated with principal component analysis (PCA). Results: In total, 1100 adolescent girls were included in the study whose mean age was 15.8 (±2.1) years. School/college/work was missed due to menstruation in 60% of the adolescent girls, 66% were not comfortable during menstruation, and 92% were restricted from entering religious places. In exploratory factor analysis using PCA, 6 principal components were identified which had eigenvalues more than 1. Conclusion: Religious restrictions during menstruation (94%) were highly prevalent among adolescent girls, followed by restriction of routine activity (69%) and work/academically related activity (60%). Construct validity has identified a six-factor structure for the menstruation-related activity restriction questionnaire. This was identified as a valid and internally consistent tool to assess activities restricted during menstruation among Indian adolescent girls. [ABSTRACT FROM AUTHOR]

Despite current recommendations against its use, activity restriction remains a common intervention used to prevent preterm birth in multiple clinical settings. Hypertensive disorders of pregnancy, preterm premature rupture of membranes, multiple gestations, vaginal bleeding, short cervical length, placenta previa, and fetal growth restriction are also common reasons for antepartum hospital admission and frequently lead to a recommendation for activity restriction. However, numerous reports have shown that activity restriction does not prevent adverse obstetrical outcomes but does confer significant physical and psychosocial risks. This consult reviews the current literature on activity restriction and examines the evidence regarding its use in obstetrical management. The recommendations by the Society for Maternal-Fetal Medicine are as follows: (1) we recommend against the routine use of any type of activity restriction in pregnant women at risk of preterm birth based on preterm labor symptoms, arrested preterm labor, or shortened cervix (GRADE 1B); (2) we recommend against the use of routine inpatient hospitalization and activity restriction for the prevention of preterm birth in women with multiple gestations (GRADE 1A); and (3) given the lack of data definitively demonstrating that activity restriction improves perinatal outcome in pregnancies complicated by fetal growth restriction, preterm premature rupture of membranes, or hypertensive diseases of pregnancy, coupled with evidence of adverse effects of activity restriction, we suggest that activity restriction not be prescribed for the treatment of pregnancies complicated by fetal growth restriction, preterm premature rupture of membranes, or hypertensive disease (GRADE 2B). [ABSTRACT FROM AUTHOR]

Purpose: Several studies have explored factors causing depression in cancer survivors, including perceived physical symptoms. Another critical factor in the depression symptomatology of cancer survivors is activity restriction (AR). We investigated how AR mediate the effects of perceived pain and fatigue on depression in cancer survivors.Methods: Cancer survivors (n = 61; mean age 56.16 years) that were recruited through cancer support groups in Japan participated in this study. Participants completed a battery of questionnaires comprising demographic and clinical information, the Pain Catastrophizing Scale, the Cancer Fatigue Scale, the Activity Restriction Scale for Cancer Patients, and the Hospital Anxiety and Depression Scale.Results: Mediation analysis indicated that AR partially mediates the effect of pain on depression. Direct paths from pain to AR, AR to depression, and pain to depression were significant (P < .005). Moreover, indirect paths from pain to AR, AR to depression, and pain to depression were also significant at the 95% level [0.04-0.13]. However, AR did not mediate the effect of fatigue on depression, and fatigue had a significant direct path to both AR and depression (P < .005).Conclusion: This study aimed to explore the mediating effect of AR in the relationships of perceived pain and fatigue and depression in cancer survivors. We found that AR mediates perceived pain to depression, however not for perceived fatigue. In addition, because AR was experienced in the face of any survivorship period, AR may need to be treated as a long-term effect of the cancer diagnosis. [ABSTRACT FROM AUTHOR]

Objective: We examined predictors of clinically significant levels of psychological distress among individuals with upper limb loss (ULL).Design: A multisite, cross-sectional study completed at six prosthetic rehabilitation centres throughout the United States.Methods: Oral administration of a brief assessment battery to 307 participants with ULL including demographic variables, injury information, screening instruments for PTSD and depression, pain interference, and activity restriction measures. Hierarchical multinomial logit models were conducted. Outcome groups were created using recommended cut-off scores on brief screening measures of depression and PTSD. Final models were assessed including relative risk ratios and marginal effects.Results: Over half of the sample screened positive for depression, PTSD, or both. Eight individuals exceeded the recommended cut-off score indicative of PTSD only (2.6%), and 106 participants (34.5%) screened positive for depression only. Moreover, 64 participants (20.8%) reported co-occurring PTSD and depression. Subsequent models revealed women and ethnic minority participants were more likely to have clinically significant levels of depression and PTSD. Greater restriction in activity and increased pain interference also predicted psychological distress.Conclusions: These findings indicate a significant number of individuals with ULL experience clinically significant levels of psychological distress, and routine clinical assessment of depression and PTSD is warranted. Women and individuals from ethnic minorities may be particularly at risk, regardless of the severity and cause of ULL. Restrictions in preferred and goal-directed activities and persistent pain are also contributing factors. Psychological interventions that address these issues are indicated. Statement of contribution What is already known on this subject? Research investigating psychological reactions and adjustment after limb loss has primarily focused on lower limb loss. Little research has investigated psychological adjustment or distress following upper extremity loss. Lower extremity limb loss is more likely to be from a disease process while upper extremity limb loss is more likely to be due to traumatic injuries. Upper extremity limb loss possesses a qualitatively different experience as upper limb amputation is more readily apparent to others, impacts activities of daily living, and limits instrumental function in social and non-verbal communication. What does this study add? A significant percentage of individuals with upper limb loss report significant levels of depression, PTSD, and mixed depression and PTSD. Moreover, women and minority clients were more likely to report clinically significant levels of depression and mixed PTSD and depression. Activity restriction and pain interference's contributions in the final model helped to elucidate the clinical picture of psychological distress for persons with upper extremity limb loss. Greater activity restriction and limitations from pain interference increased the likelihood of reporting clinically significant levels of psychological distress. [ABSTRACT FROM AUTHOR]

Objective: To assess the impact of bed rest on maternal and neonatal outcomes in pregnancies complicated by preterm premature rupture of the membranes (PPROM), enabling proper sample size calculation for a powered randomized controlled trial (RCT).Study Design: We conducted a pilot unblinded randomized controlled trial with a 1:1 allocation ratio (complete bed rest vs activity restriction groups) on singleton pregnancies complicated by PPROM at 24 + 0-33 + 6 weeks. Maternal and neonatal data were compared between groups with an intent-to-treat analysis. The primary outcomes were the latency time to delivery and the incidence of chorioamnionitis. The trial was conducted in a tertiary center of the Portuguese national healthcare system. Patients received standard antibiotic prophylaxis. Delivery was planned for the 34th week of gestation, except in cases of spontaneous labor or another complication.Results: Thirty-two cases were randomized and analyzed, 14 in the complete bed rest group and 18 in the activity restriction group. The median gestational age at PPROM was 30 vs 29 weeks (p = 0.82). In the complete bed rest group, the incidence of chorioamnionitis was nonsignificantly lower (14% vs 28%, p = 0.43). Median latency time was 11.5 days (95% CI, 2-20) in the complete bed rest group and 7.5 days (95% CI, 3-11) in the activity restriction group, lacking statistical significance on univariate (p = 0.6) and survival analyses (log-rank test, p = 0.75). No difference was found between groups regarding indication or type of delivery and maternal or neonatal morbidity. The median gestational age at delivery was 32 weeks for both groups (p = 0.94). A sample size of 2052 participants was calculated for a powered RCT, considering latency as the primary outcome.Conclusion: In this pilot trial, bed rest did not increase latency to delivery and did not improve maternal or neonatal morbidity in the setting of PPROM at 24 + 0-33 + 6 weeks. A sample size calculation is now available for a powered RCT. [ABSTRACT FROM AUTHOR]

When a child is diagnosed with epilepsy, counseling regarding the same is done by the treating doctor. Most parents are frightened and have poor knowledge about epilepsy. Therapeutic advice including drug dosage, administration and side effects takes up the major part of physician's time, thereby neglecting important issues like home seizure management, follow up and others. These lacunae in knowledge require systematic patient and family education. To address these issues, an expert group meeting of pediatric neurologists and epileptologists in India along with social workers/epilepsy educators, legal experts, parents, and teachers was held. The various aspects regarding parental counseling in children with epilepsy were discussed and a consensus document was formulated. Here authors present the group consensus statement on counseling parents and caregivers of children with epilepsy. This document is intended to help physicians and pediatricians counsel the families when a child is diagnosed with epilepsy. [ABSTRACT FROM AUTHOR]

A substantial body of research has reported negative outcomes due to caregiving, however, little is known about how caring for a young person with mental ill-health impacts on parents and carers. This study aims to examine whether, like carers of older people, they experience elevated levels of caregiver burden and stress. It expands on earlier studies by examining potential mediators of burden and stress, with a specific focus on how activity restriction affects this association. There were 226 Australian parents and carers of young people (12-25 years) experiencing mental ill-health who voluntarily completed a self-report questionnaire reflecting how their young person's ill-health had affected them over the past month. Hierarchical regression and multiple mediation analyses were conducted to examine the relationship between caregiver burden and stress, and whether adaptive coping, self-efficacy and activity restriction mediated this relationship. Caregiver burden and stress were strongly related, and both activity restriction and self-efficacy mediated their association, with activity restriction having the stronger effect. Strategies aimed at increasing awareness of the impact of activity restriction and encouraging parents and carers to find ways to maintain essential activity may reduce stress, improving mental health and well-being in parents and carers. [ABSTRACT FROM AUTHOR]

Mechanistic forecasts of how species will respond to climate change are highly desired but difficult to achieve. Because processes at different scales are explicit in such models, careful assessments of their predictive abilities can provide valuable insights that will be relevant to functionally similar species. However, there are surprisingly few comprehensive field tests of mechanistic niche models in the literature. We applied a general, thermodynamically grounded modeling framework to determine the fundamental niche of an extremely well‐studied herbivorous ectotherm, the sleepy lizard Tiliqua rugosa. We then compared the model predictions with detailed long‐term field observations that included sub‐hourly data on microclimate, activity levels, home ranges, and body temperatures as well as annual to decadal patterns of body condition and growth. Body temperature predictions inferred from gridded climatic data were within 10% of empirically observed values and explained >70% of observed daytime activity patterns across all lizards. However, some periods of activity restriction were explained by predicted desiccation level rather than by temperature, and metabolically driven activity requirements were much lower than potential activity time. Decadal trajectories of field growth and body condition could also be explained to within 10% of observed values, with the variance in trajectories being attributable to whether individuals had access to permanent water. Continent‐wide applications of the model partly captured the inland distribution limit, but only after accounting for water limitations. Predicted changes in habitat suitability under six climate change scenarios were generally positive within the species' current range, but varied strongly with predicted rainfall. Temperature is regarded as the major factor that will restrict the distribution and abundance of lizards and other terrestrial ectotherms under climate change. Yet our findings show how water can be more important than temperature in constraining the activity, habitat requirements, and distribution limits of terrestrial ectotherms. Our results demonstrate the feasibility of first‐principles computation of the climatic limits on terrestrial animals from gridded environmental data, providing a coherent picture for how species will respond to climate change at different scales of space and time. [ABSTRACT FROM AUTHOR]

Purpose: We sought to determine whether activity restriction (AR) in a cohort of women at high risk for preterm delivery is associated with the risk of preterm delivery.Materials and Methods: This is a secondary analysis of the Maternal-Fetal Medicine Units MFMU's Preterm Prediction Study; a multicenter prospective cohort study designed to identify risk factors of preterm birth (PTB). The study group consisted of women with a singleton gestation that at their first study visit (23-24 weeks) had at least one of the following criteria: patient reported contractions, severe back pain, a cervical length <15 mm, spotting, protruding membranes, or positive fetal fibronectin. Women were assessed for AR at a 27- to 29-week study visit. Associations between AR and preterm delivery (<37 weeks) were examined through logistic regression models before and after adjustment for confounders.Results: Of the 1086 women that met the inclusion criteria, 16.5% (n = 179) delivered preterm. In this cohort, 9.7% (n = 105) of women were recommended AR, with 37.1% (n = 39) having a PTB. In the group not recommended AR (n = 981), 14.3% (n = 140) delivered preterm.Conclusion: In this cohort of women at high risk for PTB, activity restriction was associated with an increased risk of PTB. The use of AR in this population should be discouraged. [ABSTRACT FROM AUTHOR]

Purpose: We sought to determine whether activity restriction (AR) in a cohort of women at high risk for preterm delivery is associated with the risk of preterm delivery.Materials and Methods: This is a secondary analysis of the Maternal-Fetal Medicine Units MFMU's Preterm Prediction Study; a multicenter prospective cohort study designed to identify risk factors of preterm birth (PTB). The study group consisted of women with a singleton gestation that at their first study visit (23-24 weeks) had at least one of the following criteria: patient reported contractions, severe back pain, a cervical length <15 mm, spotting, protruding membranes, or positive fetal fibronectin. Women were assessed for AR at a 27- to 29-week study visit. Associations between AR and preterm delivery (<37 weeks) were examined through logistic regression models before and after adjustment for confounders.Results: Of the 1086 women that met the inclusion criteria, 16.5% (n = 179) delivered preterm. In this cohort, 9.7% (n = 105) of women were recommended AR, with 37.1% (n = 39) having a PTB. In the group not recommended AR (n = 981), 14.3% (n = 140) delivered preterm.Conclusion: In this cohort of women at high risk for PTB, activity restriction was associated with an increased risk of PTB. The use of AR in this population should be discouraged. [ABSTRACT FROM AUTHOR]

Objectives: To test the efficacy of maternal activity restriction for reducing peripheral vascular resistance in normotensive pregnant women with raised total vascular resistance (TVR) and to evaluate its effect on fetal growth.Methods: This was a prospective case-control study of 30 women enrolled between 27 and 29 weeks' gestation. All patients met the following criteria: normal blood pressure before and during pregnancy, TVR between 1300 and 1400 dynes × s/cm5 at enrolment, normal fetal Doppler parameters at enrolment and abdominal circumference between the 10th and 25th centiles. Patients were assigned to activity restriction (activity-restriction group; n = 15) or no treatment (control group; n = 15) and were assessed after 4 weeks for TVR and fetal growth.Results: TVR at enrolment and estimated fetal weight centile were similar in the activity-restriction group vs controls (1358 ± 26 vs 1353 ± 30 dynes × s/cm5 ; 18th  ± 4 vs 19th  ± 4 centile; P = NS). After 4 weeks, the activity-restriction group compared with controls showed significantly lower TVR (1165 ± 159 vs 1314 ± 190 dynes × s/cm5 ; P < 0.05), which was associated with higher estimated fetal weight centile (25th  ± 5 vs 20th  ± 5 centile; P < 0.05). TVR was lower and estimated fetal weight centile higher for the activity-restriction group after 4 weeks compared with at enrolment.Conclusions: In normotensive pregnant women with raised TVR, maternal activity restriction appears to be effective in reducing TVR and therefore enhancing fetal growth. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

The current study extends the Activity Restriction Model of Depressed Affect by exploring the relationship between parental caregiving burden, activity restriction, and depressive symptoms. It investigated the mediating role of restriction in three types of activities (daily routine, personal control, and social) in the relationship between parental caregiving burden and carer depression. Respondents ( n = 203, Meanage = 45.45 years, standard deviation = 7.81, females = 84.7%) were parent carers of a young person with mental illness and based in Australia. They completed a set of measures assessing caregiving burden, participation in daily routine, personal control and social activities, and depressive symptoms. A multiple mediation analysis revealed that restriction of daily routine, personal control, and social activities indirectly mediated the relationship between parental caregiving burden and parent carers' symptoms of depression. A latent profile analysis suggested an optimal three-profile solution. As predicted, profile membership distinguished parent carers on depressive symptoms ranging from normal to severe levels based on participation in the specific activities. Our results suggest a typology of parent carers perceiving differential levels of caregiving burden and activity restriction. Strategies addressing these specific areas provide preventative and promotion measures to optimize carer mental health and well-being. [ABSTRACT FROM AUTHOR]

Objective A sedentary lifestyle has been associated with mental health disorders. Many medical conditions result in the cessation of exercise, which may increase the risk of developing mental health problems. The purpose of this article is to systematically review the literature examining the effects of exercise withdrawal on mental health. Method Literature was searched using PubMed, PsycINFO, and SPORTdiscus for studies that experimentally manipulated the withdrawal of exercise and included mental health as outcome measure. Results A total of 19 studies met inclusion criteria (total N = 689 with 385 individuals participating in an exercise withdrawal condition). Exercise withdrawal consistently resulted in increases in depressive symptoms and anxiety. Other mental health outcomes were investigated infrequently. Severe mental health issues requiring clinical intervention after experimentally controlled exercise withdrawal was rare. Heterogeneity in methods and outcomes was observed, especially in terms of the duration of exercise withdrawal (range 1 to 42 days, median = 7 days), with stronger effects if exercise withdrawal exceeded 2 weeks. Conclusion Experimentally controlled exercise withdrawal has adverse consequences for mental health. These observations in healthy individuals may help to understand the onset of mental health problems in response to acute and chronic medical conditions associated with reduced physical activity. Future research is needed to investigate potential mechanisms explaining the adverse mental health consequences of cessation of exercise that will provide new targets for clinical interventions. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to clarify the circumstances under which activity restriction (AR) is associated with depressive symptoms among patients with osteoarthritis (OA) and their spouses. Method: A total of 220 older adults with OA and their caregiving spouses participated in the study. The actor-partner interdependence model (APIM) was used to examine the associations between AR stemming from patients' OA and the depressive symptoms of patients and spouses. The potential moderating role of marital satisfaction also was examined. Results: After accounting for pain severity, health, and life stress of both patients with OA and spouses, higher AR was associated with more depressive symptoms for both patients and spouses. In regard to partner effects, patients whose spouse had higher AR reported more depressive symptoms. In addition, the association of spouses' and patients' AR and their own depressive symptoms was moderated by their marital satisfaction. For both patients and spouses, the associations between their own AR and depressive symptoms were weaker for those with higher levels of marital satisfaction compared with those with lower levels of marital satisfaction. Discussion: This pattern of findings highlights the dyadic implications of AR and the vital role of marital satisfaction in the context of chronic illness. [ABSTRACT FROM AUTHOR]

Background and Objective: Improvement in self-care and self-efficacy behaviors has proved to be a vital factor in a successful management of asthma. This study was carried out to determine the relationship of patients self-efficacy with control of asthma symptoms. Materials and Methods: This correlation study was carried out on 257 asthmatic patients (133 men and 124 women) aged 18-35, who referred to Sheykholrayis clinic of Tabriz, Iran, during 2011. Data collection tools included a questionnaire of social-personal specifications, asthma self-efficacy scale questionnaire and asthma control questionnaire as well as patients’ spirometer parameters. Data were analyzed using SPSS-17 and Pearson Correlation Coefficient test. Results: Among aspects of self efficacy, the regular use of medicine and patient relation with physician were demonstrated to be 4±0.6 and 2.7±0.7, respectively. Among aspects of asthma control, the level of activity restriction resulted by the disease during the past week and the number of spray puffs used during past week were 3±1.1 and 1.5±1.2, respectively. There was a significant relation between self-efficacy and asthma control (P