Changes In Health Status Research Articles

Association between opioid utilization and patient-reported outcome measures following lumbar spine surgery

BACKGROUND CONTEXTThe patient-reported outcomes measurement information system (PROMIS), created by the National institute of Health, is a reliable and valid survey for patients with lumbar spine pathology. Preoperative opioid use has been shown to be an important predictor variable of self-reported health status in legacy patient-reported outcome measures. PURPOSETo investigate the impact of chronic preoperative opiate use on PROMIS survey scores. STUDY DESIGNRetrospective database analysis. PATIENT SAMPLEBetween March 2019 and November 2021, 227 patients underwent lumbar decompression ± ≤ 2 level fusion. Fifty-seven patients (25.11%) had chronic preoperative opioid use. OUTCOME MEASURESOswestry disability index (ODI) and PROMIS survey scores. METHODSA retrospective analysis of a prospectively maintained single center patient-reported outcome database was performed with a minimum of 2 year follow-up. PROMIS Anxiety, Depression, Fatigue, Pain Interference (PI), Physical Function (PF), Sleep disturbance (SD), and Social Roles (SR) surveys were recorded at preoperative intake with subsequent follow-up at 6, 12, and 24 months postoperatively. Patients were grouped into chronic opioid users as defined by >6-month duration of use. Differences in mean survey scores were evaluated using Welch t-tests. RESULTSTwo hundred and twenty-seven patients met our inclusion criteria of completed PROMIS surveys at the designated timepoints. A total of 57 (25.11%) were chronic opioid users (COU) prior to surgery. Analysis of patient-reported health outcomes shows that long term opioid use correlated with worse ODI and PROMIS scores at baseline compared to nonchronic users (NOU). At 1 and 2 year follow-up, the COU cohort continued to have significantly worse ODI, PROMIS Fatigue, PF, PI, SD, and SR scores. There is a statistical difference in the magnitude of change in health status between the 2 cohorts at 1 year follow-up in PROMIS Depression (-5.04±7.88 vs -2.49±8.73, p=.042), PF (6.25±7.11 vs 9.03±9.04, p=.019), and PI (-7.40±7.37 vs -10.58±9.87, p=.011) and 2 year follow-up in PROMIS PF (5.58±6.84 vs 7.99±9.64, p=.041) and PI (-6.71±8.32 vs -9.62±10.06, p=.032). Mean improvement in PROMIS scores for the COU cohort at 2 year follow-up exceeded minimal clinically important difference (MCID) in all domains except PROMIS Depression, SR and SD. CONCLUSIONPatients with chronic opioid use status have worse baseline PROMIS scores compared with patients who had nonchronic use. However, patients in the COU cohort displayed clinically significant postoperative improvement in multiple PROMIS domains. These results show that patients with chronic opioid use can benefit greatly from surgical intervention and will allow physicians to better set expectations with their patients.

The impact of income level on skeletal muscle health in rural Chinese older residents: a study of mediating effects based on dietary knowledge.

China's rural residents have basically solved the problem of subsistence, but due to aging, the prevalence of sarcopenia (abbreviated as sarcopenia) has been increasing year by year, especially the skeletal muscle health of the rural older residents has not been sufficiently paid attention to, so analyses of the impact of income level on the skeletal muscle health of the older people in rural areas of China are of great practical significance. Based on the annual data of the China Health and Nutrition Survey (CHNS) in 2006, 2009, and 2011, we introduced the mediator variable of dietary knowledge and used the Probit model regression, mediation effect model, and instrumental variable regression to assess the skeletal muscle health status of the rural older people in China and explore the mechanism of the influence of the income level on the skeletal muscle health of the rural older residents in China. The primary objectives of this study were to evaluate the impact of income level on the skeletal muscle health status of older adults living in rural areas of China and to investigate the underlying mechanisms. By analyzing the findings of this study, our aim is to establish a correlation between the economic status and skeletal muscle health of older adults in rural communities, as well as elucidate the influence of income level and dietary knowledge on their skeletal muscle health. Through the attainment of these objectives, we hope to provide valuable insights and recommendations for enhancing skeletal muscle health among the rural older population in China. Based on our research findings, it can be inferred that there was a significant association between the financial status of rural older adults and their skeletal muscle health. Additionally, the prevalence of sarcopenia was lower among individuals with higher income levels, and there was a negative correlation between the prevalence of sarcopenia and the level of dietary knowledge among rural older individuals. The knowledge of dietary knowledge level of rural older people plays a mediating role in the income level and the prevalence of sarcopenia. Moreover, with the change in income level and the increase in age, the change in skeletal muscle health status showed obvious heterogeneity, in which the effect on the relatively younger (65-70 years old) samples was greater. Therefore, sustained income growth remains an effective way to improve the skeletal muscle health of older rural residents. At the same time, improving dietary knowledge and dietary quality among the older people is important in preventing a decline in muscle strength and physical function and in preventing the onset of sarcopenia.

Prevalence and correlates of depressive symptoms among matriculated university students in Singapore during Covid-19 pandemic: findings from a repeated cross-sectional analysis

BackgroundDepression is a common issue among university students and has been particularly exacerbated during the COVID-19 pandemic. However, limited research has specifically focused on depression among university entrants.ObjectivesThis study aimed to determine the prevalence of depression severity and identify associated factors during different phases of the COVID-19 pandemic using health screening questionnaires completed by matriculated university students in Singapore.MethodsA repeated cross-sectional study was conducted at a public university in Singapore. Data from health screening questionnaires administered in 2020 and 2021, involving 15,630 newly enrolled university students, were analyzed. The questionnaires covered students’ sociodemographic information, physical health status, own and family medical history, lifestyle behaviours, and the Patient Health Questionnaire (PHQ-9). The PHQ-9 was used to measure the severity of depressive symptoms, categorizing into moderate to severe depressive symptoms (MSDS), mild depressive symptoms (MDS), or no depressive symptom (NDS). Multinomial logistic regression was used to assess the sociodemographic, physical and behavioural correlates of depression.ResultsThe prevalence of MSDS was 1% in both 2020 and 2021, while the rates for MDS were 1.93% in 2020 and 1.64% in 2021. In the 2020 cohort, male freshmen who reported better health had a lower likelihood of experiencing depression. Conversely, students of Malay ethnicity, those majoring in Engineering, those with multiple chronic diseases, monthly alcohol consumers, current smokers, and those with a family history of mental disorder had a higher likelihood of experiencing depression. Moreover, students who lived on-campus in the 2021 cohort were less likely to experience depression than those living off-campus. However, the associations between academic majors, alcohol consumption, and smoking with depression were not significant in the 2021 cohort.ConclusionsThis study reported a low prevalence of both MSDS and MDS among university entrants in Singapore. The study further identified three categories of factors associated with depression: sociodemographic, physical, and behavioural. This study suggests policy interventions to enhance targeted social support that address each student group’s specific requirements and susceptibilities. A more extensive and comprehensive study is warranted to assess the changes in student mental health status post-COVID-19 pandemic.

Decadal Descriptive Analysis of Health Status, Hospitalization, Intensive Care Admissions, and Mortality Rates Among the Elderly Population in Turkey (2012-2022)

Objective: This study aimed to analyse decadal changes in health status, hospitalisation, intensive care admissions, and mortality rates among the Turkish elderly population from 2012 to 2022, focusing on the impact of the COVID-19 pandemic. Material and Methods: A retrospective study obtained data from the Turkish Statistical Institute (TÜİK) and Health Statistics Yearbooks. Descriptive statistics were used to elucidate healthcare utilisation patterns and mortality profiles among individuals aged ≥ 65 years. Results: Analysis showed that self-reported "Very good/Good" health status peaked at 70.7% in 2012, decreased to 60.9% in 2019, and rebounded to 63.4% in 2022. The hospitalisation rates for the 65-74 age group increased from 17.5% in 2012 to 20.2% in 2021, with males (20.2%) having higher rates than females (16.0%) in 2021. ICU admission rates escalated during the pandemic, reaching 3.7% in 2021 for ages 65-74 and 4.7% for 75+ years, before declining in 2022 to 3.0% and 4.0%, respectively. The annual population growth rate has significantly decreased from 21.7 per thousand in 2012 to 5.5 per thousand in 2022, whereas the crude death rate has remained stable, dropping from 7.1 per thousand in 2012 to 5.1 per thousand in 2022. Conclusion: This study highlights fluctuating health perceptions among the elderly exacerbated by the pandemic. The enduring gender disparities in health status and healthcare utilisation underscore the need for gender-sensitive policies. The consistent yet stable mortality rates amidst demographic shifts emphasise the resilience of Turkey's healthcare system. These findings provide critical insights into geriatric care policies and post-pandemic health care strategies.

Patient-reported outcome, clinician-reported outcome, and patient satisfaction with treatment by crisis resolution teams: a multicenter pre-post study of outcome and associated factors in Norway

BackgroundCrisis resolution teams (CRTs) have become a part of mental health services in many high-income countries. Many studies have investigated the impact of CRTs on acute admissions to inpatient units, but very few studies have investigated patient-reported and clinician-reported outcomes for CRT service users. Our aims were to study patient-reported and clinician-reported outcomes of CRT treatment, how the outcomes were associated with characteristics of the service user and the treatment, and whether outcomes were different across CRTs.MethodsThe study was a pre-post observational multicenter study of 475 patients receiving treatment from 25 CRTs in urban and rural areas in Norway. There was no control group. Outcomes were change in mental health status reported by service users using CORE-10 and by clinicians using HoNOS. Patient satisfaction was measured using CSQ-8 at the end of the treatment. Components of CRT accessibility and interventions were measured by clinicians reporting details on each session with the service user. CRT model fidelity was measured using the CORE CRT Fidelity Scale version 2. We used paired t-tests to analyze outcomes and linear mixed modeling to analyze associations of the outcomes with the characteristics of service users and the treatment provided. Using independent t-tests, we analyzed differences in outcomes and patient satisfaction between two clusters of CRTs with differences in accessibility.ResultsThe patient-reported outcomes and the clinician-reported outcomes were significantly positive and with a large effect size. Both were significantly positively associated with practical support and medication management and negatively associated with collaboration with mental health inpatient units. Patient satisfaction was high at the end of the treatment. CRTs with higher accessibility had a significantly better clinician-reported outcome, but no significant differences were reported for patient-reported outcomes or patient satisfaction.ConclusionsCRT treatment led to improved symptom status as reported by patients and clinicians, as well as high patient satisfaction. Practical support and medication management were the interventions most strongly associated with positive outcomes. Some of the variations in outcomes were at the team level. Patient- and clinician-reported outcomes should be used more in studies on the effect of treatment provided by crisis resolution teams.

Proteins in scalp hair of preschool children.

(1)Early childhood experiences have long-lasting effects on subsequent mental and physical health, education, and employment. Measurement of these effects relies on insensitive behavioral signs, subjective assessments by adult observers, neuroimaging or neurophysiological studies, or retrospective epidemiologic outcomes. Despite intensive search, the underlying mechanisms for these long-term changes in development and health status remain unknown. (2)We analyzed scalp hair from healthy children and their mothers using an unbiased proteomics platform using tandem mass spectrometry, ultra-performance liquid chromatography, and collision induced dissociation to reveal commonly observed hair proteins with spectral count of 3 or higher. (3)We observed 1368 non-structural hair proteins in children, 1438 non-structural hair proteins in mothers, with 1288 proteins showing individual variability. Mothers showed higher numbers of peptide spectral matches and hair proteins compared to children, with important age-related differences between mothers and children. Age-related differences were also observed in children, with differential protein expression patterns between younger (2 years and below) and older children (3-5 years). We observed greater similarity in hair protein patterns between mothers and their biological children as compared to mothers and unrelated children. The top 5% proteins driving population variability represent biological pathways associated with brain development, immune signaling, and stress response regulation. (4)Non-structural proteins observed in scalp hair include promising biomarkers to investigate the long-term developmental changes and health status associated with early childhood experiences.

The association between post-injury chronic physical health conditions, health status, and survival time in people with serious orthopaedic injuries

Background A better understanding of how chronic physical health conditions affect long-term outcomes following injury is essential for quantifying the burden of serious orthopaedic injuries. We aimed to describe the association between the presence of post-injury chronic physical health conditions and (i) the change in health status from before injury to six different follow-up time points after injury; and (ii) survival time. Methods A cohort study was conducted using linked data from the REcovery after Serious Trauma: Outcomes, Resource Use, and Patient Experiences study, the Victorian Registry of Births, Deaths and Marriages (BDM) (2009–2017), the victorian admitted episodes dataset (2009–2017) and the victorian emergency minimum dataset (2009–2017). Adults (≥ 18 years old) with serious orthopaedic injuries who survived to discharge from their trauma admission were included. Multivariable linear regression analysis was conducted to evaluate the association between post-injury chronic physical health conditions and the mean change in health status (EuroQol-Visual Analogue Scale) from before injury to six follow-up time points post-injury. Survival analysis was conducted to estimate the probability of survival for people with and without chronic physical health conditions following injury. Results Out of 894 participants, 177 (19.8%) had at least one chronic physical health condition recorded up to five years post-injury. People with post-injury conditions reported a greater mean decline in health status than people without post-injury conditions (difference, (95% CI): −6.9 (−9.7, −4.2), p = 0.01). Over the study period, almost six times as many people with chronic physical health conditions post-injury died as people without these conditions (AHR (95% CI): 5.7 (2.9, 11.3), p < 0.01). Conclusions Chronic physical conditions after serious orthopaedic injuries were associated with a lower survival probability and a deteriorating health status. Orthopaedic injury survivors may benefit from early detection and treatment of chronic conditions.

Quality of Life in Locally Advanced Carcinoma Rectum Patients During Various Phases of NACRT: An Indian Perspective.

In low- and middle-income countries (LMICs) including India, cancer patients have a poor prognosis because of late diagnosis and cases already grown to advanced stages, low cancer awareness and skewed cancer care facilities. In India, the incidence of colorectal cancer (CRC) is ranked the 4th most common (6.4%) in males and the 5th most common (3.4%) in females. The improvement in the cure rate of rectal cancer has increased life expectancy, and assessment of the quality of life (QoL) in these patients has become a fundamental requirement. Little is known about how the patients perceive these adverse effects during curatively intended radiotherapy. Although studies have investigated the various adverse effects that can occur with radiotherapy and chemotherapy in carcinoma rectum patients, these have not yet been critically appraised and synopsized to form a comprehensive review of their prevalence and effects on QoL. The study was designed to explore the QoL issues in locally advanced carcinoma rectum patients during various phases of neoadjuvant concurrent chemo-radiotherapy (NACCRT). The study was performed over a period of 2years at a single super speciality cancer hospital in North India. Patients were selected as per the inclusion criteria and followed up with a standard questionnaire incorporating various aspects depicting QoL. The interview technique was used for collecting QoL data at four points, at baseline, midway during treatment, at the end of treatment and 4weeks after completion of NACCRT, using EORTC QLQ C30, for QLQ CR29. Special care was taken to avoid observer bias in cases of language issues, and interpreters' services were utilised, and compared with the baseline pre-treatment scores, patients reported a statistically significant and large clinically meaningful change in the global health status, social functioning, fatigue (FACIT-F), appetite loss, anxiety, sore skin and male and female sexual function at the post-treatment time point. Statistically significant changes with moderate clinically meaningful changes were reported for the functional scales-physical, role and emotional functioning of the QLQ C30 questionnaire and body image and weight of the CR29 questionnaire. Similar moderate clinical changes were found in the symptom scales-fatigue, nausea and vomiting, insomnia, constipation and diarrhoea of QLQ C30 and stool frequency, embarrassment with bowel function, impotence and dyspareunia. These parameters returned to almost the pre-treatment values after 4weeks of completion of NACRT. Since QoL is a relatively subjective variable, differences in human race, culture, education and social environment will have impacts on the results. International cooperation is needed to study the QoL in patients with multiple cultural backgrounds. The existing QoL questionnaire tools have been designed with Western countries in mind, and we did face multiple social issues. We suggest that many similar multicentre studies shall be required to essentially tap the accurate QoL-related issues keeping in mind the diverse social, economic, racial and educational backgrounds. As we deal with the ever-increasing cancer menace and better life expectancy, QoL issues shall be a major determinant of treatment success besides primary treatment. These factors should form an integral part of treatment modality, and adequate counselling must be performed prior to initiation of care.

Comparing surgeries to restore upper extremity function in tetraplegia: Impact on function during the perioperative period

Context/Objective To assess short-term changes in health outcomes in people with cervical-level spinal cord injury (SCI) who underwent upper extremity (UE) reconstruction via either novel nerve transfer (NT) or traditional tendon transfer (TT) surgery with individuals who did not undergo UE surgical reconstruction. Design Prospective, comparative cohort pilot study. Participants 34 participants with cervical SCI met the following inclusion criteria: age 18 or older, greater than 6 months post-injury, and mid-cervical level SCI American Spinal Injury Association Impairment Scale (AIS) A, B or C. Setting Two tertiary academic hospitals and their affiliated veterans’ hospitals. Methods Health outcomes were assessed using two previously validated measures, the Spinal Cord Independence Measure (SCIM) and Short-Form Health Survey (SF-36). Demographic, surgical, and survey data were collected at the initial evaluation and one month postoperatively/post-baseline. Results 34 participants with cervical SCI were recruited across three cohorts: no surgery (n = 16), NT (n = 10), and TT (n = 8). The TT group had a decline in SCIM and SF-36 scores whereas the NT and no surgery groups experienced little change in independence or health status in the immediate perioperative period. Conclusions Surgeons and rehabilitation providers must recognize differences in the perioperative needs of people with cervical SCI who chose to have restorative UE surgery. Future work should focus on further investigation of health outcomes, change in function, and improving preoperative counseling and cross-disciplinary management.

Protocol for a scoping review to map health outcomes in individuals with inducible laryngeal obstruction.

Inducible laryngeal obstruction causes narrowing of the laryngeal aperture in response to external triggers. Outcomes are measured in inducible laryngeal obstruction to monitor changes in health status over time. This study is a scoping review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. The review will be guided by the following research question: 'What health outcomes are measured in studies including people with inducible laryngeal obstruction?' The research question was validated using the Population-Concept-Context framework according to the methodology for Joanna Briggs Institution Scoping Reviews. Relevant peer-reviewed studies and grey literature conducted over the last 40 years will be identified from electronic databases including AMED, CINAHL, Embase, EMCARE, MEDLINE, OVID, PubMed and PsycINFO. The search strings 'inducible laryngeal obstruction', 'ILO', 'vocal cord dysfunction', 'VCD', 'paradoxical vocal fold motion', 'PVFM', 'outcome', 'measure', 'measurement instrument', 'assessment', 'scale', 'questionnaire' will be combined using Boolean logic. An independent reviewer will conduct title screening; two independent reviewers will conduct abstract and full article screening, followed by data extraction by two reviewers. Analyses will be conducted appropriate to the findings. The review will document evidence of health outcomes measured in inducible laryngeal obstruction, identifying measurement characteristics and potential utility. Collating studies may identify gaps in coverage, the need for novel tools, and for standardisation for clinical and research purposes. What is already known on the subject Inducible laryngeal obstruction causes narrowing of the laryngeal aperture in response to external triggers. Outcomes are measured in inducible laryngeal obstruction to monitor changes in health status over time. Currently, there are no standardised outcome measures for measuring the effects of interventions in inducible laryngeal obstruction (ILO). What this paper adds to existing knowledge Assessment of health can be measured in a variety of ways. Physiological, radiological and biochemical measurements of impairment are more common historically but there are a lot of outcomes of other factors now including subjective measures of functional status and health-related quality of life, with data collected directly from patients. This study will allow us to scope the literature to see the health outcomes being measured in ILO to attempt to standardise and develop future health outcomes. What are the potential or actual clinical implications of this work? The review will document evidence of health outcomes measured in inducible laryngeal obstruction, identifying measurement characteristics and potential utility. Collating studies may identify gaps in coverage, the need for novel tools and for standardisation for clinical and research purposes.

Neuro Receptor Signal Detecting and Monitoring Smart Devices for Biological Changes in Cognitive Health Conditions.

Currently, wearable sensors significantly impact health care through continuous monitoring and event prediction. The types and clinical applications of wearable technology for the prevention of mental illnesses, as well as associated health authority rules, are covered in the current review. The technologies behind wearable ECG monitors, biosensors, electronic skin patches, neural interfaces, retinal prosthesis, and smart contact lenses were discussed. We described how sensors will examine neuronal impulses using verified machine-learning algorithms running in real-time. These sensors will closely monitor body signals and demonstrate continuous sensing with wireless functionality. The wearable applications in the following medical fields were covered in our review: sleep, neurology, mental health, anxiety, depression, Parkinson's disease, epilepsy, seizures, and schizophrenia. These mental health conditions can cause serious issues, even death. Inflammation brought on by mental health problems can worsen hypothalamic-pituitary-adrenal axis dysfunction and interfere with certain neuroregulatory systems such as the neural peptide Y, serotonergic, and cholinergic systems. Severe depressive disorder symptoms are correlated with elevated Interleukin (IL-6) levels. On the basis of previous and present data collected utilizing a variety of sensory modalities, researchers are currently investigating ways to identify or detect the current mental state. This review explores the potential of various mental health monitoring technologies. The types and clinical uses of wearable technology, such as ECG monitors, biosensors, electronic skin patches, brain interfaces, retinal prostheses, and smart contact lenses, were covered in the current review will be beneficial for patients with mental health problems like Alzheimer, epilepsy, dementia. The sensors will closely monitor bodily signals with wireless functionality while using machine learning algorithms to analyse neural impulses in real time.

Adaptive Care Planning: A paradigm shift.

A key challenge of implementing advance care planning lies in the fact that decisions made in advance require patients and their family members to imagine what their clinical picture will look like rather than knowing or experiencing the clinical circumstances as they unfold. Even more important is the acknowledgment of the unpredictability of a given clinical course. This type of situation requires adaptiveness and flexibility in decision-making that frequently occurs in the moment(s) triggered by changes in health state(s). We describe an alternative frameshifting approach called "Adaptive Care Planning (AdaptCP)," which features an evolving communication between physicians and patients/families with ongoing incorporation of the patient's/family's perspective. This process continues iteratively until each decision can be reached in a way that is both harmonious with the patient's/family's perspective and is consistent with medical treatment options that are actionable for the healthcare team. We include a table of tools drawn from the literature that can help clinicians when implementing AdaptCP.

ACCESS: an empirically-based framework developed by the International Nursing CASCADE Consortium to address genomic disparities through the nursing workforce.

Introduction: Efforts are needed across disciplines to close disparities in genomic healthcare. Nurses are the most numerous trained healthcare professionals worldwide and can play a key role in addressing disparities across the continuum of care. ACCESS is an empirically-based theoretical framework to guide clinical practice in order to ameliorate genomic disparities. Methods: The framework was developed by the International Nursing CASCADE Consortium based on evidence collected between 2005 and 2023 from individuals and families of various ethnic backgrounds, with diverse hereditary conditions, and in different healthcare systems, i.e., Israel, Korea, Switzerland, and several U.S. States. The components of the framework were validated against published scientific literature. Results: ACCESS stands for Advocating, Coping, Communication, cascadE Screening, and Surveillance. Each component is demonstrated in concrete examples of clinical practice within the scope of the nursing profession related to genomic healthcare. Key outcomes include advocacy, active coping, intrafamilial communication, cascade screening, and lifelong surveillance. Advocacy entails timely identification of at-risk individuals, facilitating referrals to specialized services, and informed decision-making for testing. Active coping enhances lifelong adaptation and management of disease risk. Effective intrafamilial communication of predisposition to hereditary disease supports cascade testing of unaffected at-risk relatives. Lifelong surveillance is essential for identifying recurrence, changes in health status, and disease trajectory for life-threatening and for life-altering conditions. Discussion: ACCESS provides a standardized, systematic, situational, and unifying guide to practice and is applicable for nursing and for other healthcare professions. When appropriately enacted it will contribute towards equitable access to genomic resources and services.

Potentialities of the combined use of underwater fluorescence imagery and photogrammetry for the detection of fine-scale changes in marine bioconstructors

Marine communities are facing both natural disturbances and anthropogenic stressors. Bioconstructor species are endangered by multiple large-scale and local pressures and the early identification of impacts and damages is a primary goal for preserving coral reefs. Taking advantage of the recent development in underwater photogrammetry, the use of photogrammetry and fluorimetry was coupled to design, test and validate in laboratory a multi-sensor measuring system that could be potentially exploited in open water by SCUBA divers for assessing the health status of corals and detecting relevant biometric parameters with high accuracy and resolution. The approach was tested with fragments of the endemic coral Cladocora caespitosa, the sole zooxanthellate scleractinian reef-builder in the Mediterranean. The most significant results contributing to the scientific advancement of knowledge were: 1) the development of a cost-effective, flexible and easy-to-use approach based on emerging technologies; 2) the achievement of a sub-centimetric resolution for measuring relevant biometric parameters (polyp counting, colony surface areas and volumes); 3) set up of a reliable and repeatable strategy for multi-temporal analyses capable of quantifying changes in coral morphology with sub-centimeter accuracy; 4) detect changes in coral health status at a fine scale and under natural lighting through autofluorescence analysis. The novelty of the present research lies in the coupling of emerging techniques that could be applied to a wide range of 3D morphometrics, different habitats and species, thus paving the way to innovative opportunities in ecological research and more effective results than traditional in-situ measurements. Moreover, the possibility to easily modify the developed system to be installed on an underwater remotely operated vehicle further highlights the possible concrete impact of the research for ecological monitoring and protection purposes.

Deteksi Risiko Jatuh Dan Pendampingan Latihan Keseimbangan Sebagai Upaya Pencegahan Risiko Jatuh Pada Lansia Di Panti Wredha Semarang

Falls occur due to an unintentional loss of balance resulting in a failure of postural stability, or an unexpected and sudden change in position resulting in landing on the floor. Associated risk factors include current health status (living in the community, nursing home, hospital, frail or active state), existing illness (diabetes, hip fracture, stroke) and general changes associated with aging (decreased balance, coordination, muscle strength, visual impairment, etc.). The elderly are an age group that is vulnerable to falls. The purpose of this service is to detect the risk of falls in the elderly and provide assistance in balance training as an effort to prevent the risk of falls in the elderly. The output targets to be achieved are in the form of accredited national journal publications and Copyright for videos of community service activities. The method used is a fall risk detection examination using the Time Up and Go Test and continued with the provision of balance training, so that the elderly who have a risk of falling can be recognized as early as possible so that the provision of balance training can maintain and improve the balance of the elderly body.

Unraveling the "golden ratio": a pilot study investigating acute-to-chronic workload ratio in breast cancer patients undergoing active treatment.

Training load monitoring is a common practice in sports medicine for supporting athletes' health and performance. Despite progress in exercise oncology research for breast cancer patients, training load monitoring is underutilized. This study retrospectively investigated the relationship between maintained training load within a defined range and physical and health outcomes of ten breast cancer patients during active anticancer treatment who underwent a 12-week exercise program. Intervention consisted of endurance and resistance training, three times a week, with each session lasting 30-45min. Assessments were conducted at baseline, 6 and 12 weeks after enrollment, evaluating physical function (6-min walk test-6MWT, and sit-to-stand), muscle strength, body composition, sleep quality (Pittsburgh Sleep Quality Index-Pittsburgh Sleep Quality Index), quality of life (EORTC-QLQ-C30), heart rate variability and physical activity levels (International Physical Activity Questionnaire-International Physical Activity Questionnaire). The Physiological Cost Index/Energy Expenditure Index (PCI/EEI) was estimated using the 6MWT and Heart rate. Training load monitoring was performed by session rating of perceived exertion (sRPE, relative intensity multiplying with session duration). Acute-to-Chronic Workload Ratio (ACWR) (7:28, rolling average) was calculated accordingly. Analyses were performed within-subjects across time points and between-subjects, comparing those who maintained from weeks 6-12 an ACWR of 0.8-1.3 with those who did not. Adherence rates were similar between groups. Physical function improved in the total sample with large effect sizes (Δ6MWT = 56.5m [95%CI: 6-100m], effect size [w] = 0.52, p = 0.006; ΔSit-to-Stand = 1.5 [95%CI: 1-5], effect size [w] = 0.681, p < 0.001), demonstrating greater changes in patients with higher ACWR. Sleep quality improvements were higher in the appropriate ACWR group (p = 0.016). A positive correlation was demonstrated between global health status and 6MWT change from baseline to 12 weeks (ρ = 0.689, p = 0.04). Despite a small sample size, patients maintaining sufficient relative training load presented greater physical fitness and sleep quality improvements. Thus, training load monitoring may enhance exercise program benefits in breast cancer patients under active treatment.

Evaluation of comorbid psychological disorders in functional gastrointestinal disorders patients by vibraimage technology: protocol of a prospective, single-center trial.

Functional gastrointestinal disorders (FGIDs) affect over 40% of individuals globally, and impact the quality of life. A significant portion of FGIDs patients comorbids with anxiety and depression. Traditional screening tools for psychological disorders may lack comprehensiveness. Vibraimage technology currently enables non-contact, objective analysis of psychological indicators through high-frame-rate cameras and computer analysis of micro-movements. Therefore, this study aims to (1) explore the use of vibraimage technology as a non-contact objective method to assess the psychological status of FGIDs patients, comparing this technology with the Hospital Anxiety and Depression Scale (HADS) to evaluate its screening efficacy, and (2) observe the therapeutic outcomes of FGIDs patients with or without comorbid psychological disorders after the same conventional treatment. This is a prospective, single-center observational trial. 276 FGIDs outpatients who visit Peking Union Medical College Hospital will be evaluated simultaneously by HADS and vibraimage technology, then to evaluate the screen efficacy of this technology. The patients will be allocated into two groups (those with or without psychological disorders). The primary endpoint is the overall rate of improvement, specifically referring to the proportion of patients who achieved Likert scores greater than or equal to 4. The secondary endpoints encompass evaluating whether there is a reduction of more than 50% in symptom evaluation scores such as IBS-SSS. Additionally, the study will assess changes in health status and quality of life using SF-36 questionnaires and the patients' satisfaction with treatment. Furthermore, psychological status will be reassessed by vibraimage technology and HADS after treatment to evaluate the effect of combined psychological factors on FGIDs treatment.

Oral Bioavailability, Tissue Distribution, Metabolism, and Excretion of Panduratin A from Boesenbergia rotunda Extract in Healthy Rats.

Our previous studies in vitro and in vivo have shown anti-severe acute respiratory syndrome coronavirus 2 activity of fingerroot extract (Boesenbergia rotunda) and its phytochemical panduratin A. Therefore, the objective of this study was to determine the pharmacokinetic profiles of panduratin A, as a pure compound and in fingerroot extract, in rats. Male rats were randomly divided into four groups. Rats underwent intravenous administration of 4.5 mg/kg panduratin A, a single oral administration of 45 mg/kg panduratin A, or a multiple oral administration of 45 mg/kg panduratin A-consisted fingerroot extract for 7 consecutive days. The concentrations of panduratin A in plasma, tissues, and excreta were measured by using LCMS with a validated method. The rats showed no change in health status after receiving all test preparations. The absolute oral bioavailability of panduratin A administered as pure panduratin A and fingerroot extract were approximately 9% and 6%, respectively. The peak concentrations for the single oral doses of 45 mg/kg panduratin A and fingerroot extract, were 4833 ± 659 and 3269 ± 819 µg/L, respectively. Panduratin A was mostly distributed in gastrointestinal organs, with the highest tissue-to-plasma ratio in the stomach. Approximately 20-30% of unchanged panduratin A from the administered dose was detected in feces while a negligible amount was found in urine. The major metabolites of administered panduratin A were identified in feces as oxidation and dioxidation products. Panduratin A from fingerroot extract showed low oral bioavailability, good tissue distribution, and partially biotransformed before excretion via feces. These findings will assist in developing fingerroot extract as a phytopharmaceutical product for COVID-19 treatment.

Trajectory Patterns of Three Lifestyle Behaviors and Subsequent Health Conditions in Japanese Adults: A Retrospective Longitudinal Study Using a Health Checkup Database.

Although the associations between lifestyle behavioral changes over time and the risks of cancer and cardiovascular diseases are documented worldwide, evidence specific to the Japanese population remains limited. This study aimed to elucidate the trajectories of lifestyle behaviors and their associations with health conditions. We analyzed health checkup data from the Japan Medical Data Center Claims Database from 2005 to 2019, specifically those of individuals who underwent 10 consecutive annual checkups. We focused on smoking, frequency of drinking alcohol, and regular exercise habits as the exposure factors. A group-based trajectory model was employed to estimate the patterns of single and multiple trajectories for three exposures. Furthermore, a linear mixed-effects model was used to assess the association between trajectory patterns and longitudinal changes in health conditions (body mass index, systolic blood pressure [sBP], LDL-cholesterol, and HbA1c). This study included 51,064 Japanese subjects aged 20-59 years at their initial health checkup. We identified seven trajectory groups (Groups 1-7) that represented a high percentage of subjects in the following order: Group 3 (inactive, 31.0%), Group 5 (long-term smoking, 26.9%), and Group 2 (daily drinkers, 11.0%). The only lifestyle behavioral change observed was smoking cessation. Groups 3 and 5 exhibited higher sBP (Group 3: β = 1.18, standard error [SE] = 0.60, p = 0.05; Group 5: β = 1.33, SE = 0.61, p < 0.05) and LDL-cholesterol levels (Group 3: β = 3.80, SE = 1.36, p < 0.05; Group 5: β = 3.04, SE = 1.37, p < 0.05) than the nonsmoking, nondrinking, and regular exercise groups. Group 2 exhibited significantly high sBP (β = 2.43, SE = 0.62, p < 0.001), with an observed interaction effect over time (p < 0.05). Regular exercise and abstinence from smoking and drinking may be essential to avoid deterioration of health conditions.

“Application of Transitions Nursing Theory among Patients with Cardiac Arrests to Assess the Impact of Cardiopulmonary Resuscitation Duration on Functional Outcome—A Conceptual Framework”

Background: Change is the only constant in life, and humans continuously strive to cope and adapt based on the changes in their health (physical and mental) status. Cardiovascular diseases (CVD’s) are the leading cause of cardiac emergencies that cause enormous impact on patients, families, and health systems prompting processes and strategies for coping with their health status changes and their aftermath effect. Aim: A discussion of the conceptual framework of transition theory applicable to the study to assess the impact of the cardiopulmonary resuscitation (CPR) duration on the functional outcome among patients with in-hospital cardiac arrest (IHCA). Methodology: The transition theory, a middle-range and situation specific theory is applied to the prospective study conducted at a tertiary care hospital in South India. The outcomes were measured using the cerebral performance category (CPC). Results: The theory identifies that cardiac arrest is a situational transition affected by the chronicity of the disease as described with unfavorable outcome with CPC score of 3–5. The fear of death, dependency state of the patient in an unfavorable outcome based on CPC, and caregiver burden on family due to the prolonged duration of acuity of the disease or death of the patient are identified as properties in this theory. Based on the study, the personal meaning includes lifestyle modifications, the impact of spiritualism, financial stability, and the educational qualifications of the patient and family identified as personal meanings that play a major role as facilitators and inhibitors. The patterns and responses in this study identified with follow-up appointments, confidence in caring for themselves, and coping for themselves among the survived cardiac arrest patients. The nursing therapeutics identified from the study are risks identified from the comprehensive assessment, readiness to intervene and implement nursing actions, educating the patient and family based on the transition, and enhancing the creation of a healthy environment. Conclusions: The transition theory is holistically applicable for patients with cardiac arrest, identifying the process and changes adapted by the patient and family with the progression of the disease and the roles adapted by the family members in the event of the patient’s death.