Decrease In Daily Activity Research Articles

Pemberian Terapi Latihan dan Edukasi dalam Upaya Meningkatkan Kemampuan Aktivitas Fungsional pada Lansia dengan Osteoarthritis Knee di Puskesmas Rampal Celaket

Osteoarthritis is a joint disorder that develops degeneratively due to chronic inflammation in the joint. Symptoms involve the gradual breakdown of cartilage, osteophyte formation, and changes in the synovial membrane. Osteoarthritis sufferers often experience a decrease in daily activities. In particular, Knee Osteoarthritis is the most common type of Osteoarthritis that causes joint pain and limitation of motion in the knee, characterized by damage to the joint cartilage and Diarthrodial structures. In order for people to prevent Osteoarthritis Knee, it is important to identify the risk factors that can lead to the condition. With this understanding, it is hoped that people can avoid the risk factors as part of prevention efforts. By distributing leaflets and conducting Knee Osteoarthritis examinations and daily activity evaluations on patients, the results showed an increase in functional activity in the elderly after undergoing routine exercise therapy. In conclusion, through this counseling activity, increasing public awareness, especially among the elderly, about the importance of preventing Osteoarthritis Knee. Continuous preventive and curative efforts are needed to reduce the incidence rate of Osteoarthritis Knee in the community.

Characteristic of the quality of life in the young population with chronic disease

Introduction. The quality of life and health in the young population is the main component that determines the potential of the country. Study in this area is necessary to determine the adequacy of medical care, as well as the effectiveness of therapeutic and preventive measures. Purpose. Assessment of the quality of life in the young population of Astrakhan region suffering from chronic diseases. Materials and methods. The article presents the results of a study of the quality of life of the young population of the city of Astrakhan, suffering from chronic diseases. The study involved 18–44 year four hundred one resident of Astrakhan. Russian version of questionnaire SF-36 was used as the main method for assessing the quality of life in the study group. Results. In general, the quality of life in young residents of Astrakhan suffering from chronic diseases is average. The physical and social activity of respondents does not decrease, according to the results of the analysis of the physical and psychological components of health. There is a decrease in daily activity, depending on the physical condition in participants with pathologies of the genitourinary system, the hematopoietic system, the respiratory and the circulatory system. Analysis of life activity, daily activity, depending on the emotional background, social functioning, as well as the mental health of respondents, regardless of pathology, showed average values. Research limitations. The limiting factors in the study are the age composition of the study group, the set of factors studied, structure of the diseases, regional characteristics. The study did not involve patients with disabilities, as well as those suffering from severe diseases. Conclusion. The results of the study are applicable in practical healthcare to improve the quality of management and conduct of medical examinations, preventive medical examinations and dispensary observation of the population; training of personnel in the field of prevention of non-communicable diseases and the formation of a healthy lifestyle.

PENGALAMAN KUALITAS TIDUR PADA PASIEN HIPERTENSI : STUDI FENOMENOLOGI

Hypertension is one of the leading causes of death and one of the diseases with the highest incidence in the world. Hypertension can be caused by several factors such as age, gender, personality type, genetic factors, obesity, exercise, diet, lifestyle, stress, and sleep patterns. Poor sleep quality is a factor in the occurrence of physical, psychological, environmental and lifestyle problems. The physical problems caused include a decrease in daily activities, weakness, fatigue, decreased endurance, and instability of vital signs, while psychological factors impact depression, anxiety, and difficulty concentrating. Study was to determine the experience of sleep quality in hypertensive patients at the Karanganyar 1 Health Center. The design of this study was qualitative using a phenomenological approach by involving 3 hypertension participants who had poor sleep quality. Three themes that emerged were then used to reflect the objectives of the study, including: 1) perceptions of hypertensive patients about sleep quality 2) problems perceived by hypertensive patients with sleep quality 3) how hypertensive patients deal with sleep quality. All participants experienced poor sleep quality, such as difficulty sleeping, short sleep hours, frequent daytime sleepiness, waking up in the middle of the night, difficulty sleeping again. Participants felt complaints such as dizziness, neck pain, and participants experienced drug dependence.

The impact of covid-19 lockdown on the Quality of life, meaningful activities, and frailty in community-dwelling octogenarians: A study in Belgium

Objectives To investigate the impact of COVID-19 lockdown on quality of life (QoL), meaningful daily activities, and (pre)frailty in community-dwelling octogenarians. Methods Cross-sectional design with bivariate and multiple linear regression modeling using a stepwise approach examining the level of QoL during the COVID-19 lockdown in a group of 215 community-dwelling octogenarians (Mage = 86.49 ± 3.02). A comprehensive set of biopsychosocial variables (FRAIL scale, general health, engagement in meaningful activities survey, questions on loneliness, and feelings) were used as explaining variables. Results Particularly, a decrease in daily activities, social activities, and an increase in free times activities were observed, but the decrease in QoL could be explained by the meaningfulness in activities, together with experiencing emptiness in life, taking ≥ 4 medications a day and feeling down or depressed. Conclusions We tried to understand which components contribute to and might affect a person’s QoL caused by restrictions imposed by the governance and its influence on the lives of the community-dwelling octogenarians. As such, this output could be a baseline for the development of minimally impacting countermeasures during future lockdowns. Clinical implications Studying lifestyle changes and thus also variables related to QoL during a pandemic, may support policymakers and practitioners to develop relevant interventions.

Fear of Falling in Older Adults Treated at a Geriatric Day Hospital: Results from a Cross-Sectional Study.

(1) Background: The fear of falling (FOF) is a geriatric syndrome that causes a decrease in daily activities and personal autonomy. Its prevalence is highly variable as are the methodologies used to assess it. This study aimed at estimating the prevalence and describing the main determinants of FOF in older adults attending a geriatric day hospital. (2) Methods: Descriptive, cross-sectional study of individuals aged ≥70 years, who attended an ambulatory functional rehabilitation group in the metropolitan area of Barcelona. FOF was assessed using the Activities-Specific Balance Confidence (ABC) scale. Other recorded outcomes were: sex, age, marital status, living alone, level of education, degree of autonomy, pain, previous falls, visual acuity, and signs of depression. Prevalence was estimated overall and according to the possible determinants. (3) Results: The study included 62 individuals (66.1% women), with a prevalence of fear of falling of 38.7% (95% CI 26.2–51.2%). The identified determinants were pain (OR = 7.4, 95% CI 1.4–39.7), a history of falls (OR = 25.3, 95% CI 2.1–303.4), poor visual acuity (OR = 5.6, 95% CI 1.0–29.8), and signs of depression (OR = 19.3, 95% CI 1.4–264.3). (4) Conclusions: The prevalence and determinants of fear of falling in older adults attending geriatric day hospitals were similar to those described in those dwelling in the community.

A case report of inhibition and severe desnutrition: negative symptoms in resistant schizophrenia

IntroductionThe appearance of inhibitory symptoms encompassed in what are known as negative symptoms is part of the usual symptoms of schizophrenia. Sometimes this inhibition reaches a significant severity, so it is essential to know its approach.ObjectivesCase report and literature review regarding the treatment of resistant schizophrenia with a predominance of negative symptomsMethodsWe present the clinical case of a 28-year-old man diagnosed with schizophrenia at 23 years old, whose onset was characterized by delusional ideas of harm (poisoning) and delusions with a mystic-religious theme that lead him to reduce his intake until requiring a first admission for severe desnutrition. Subsequently, after two more admissions, the patient presents selective reduction in food intake, decrease in daily activity and apathy without positive symptoms.ResultsThroughout the treatment, several lines of antipsychotic treatments have been tried at the maximum tolerated dose (haloperidol, oral paliperidone and depot, aripiprazole and clozapine up to a dose of 600 mg). Clozapine resistance required testing various augmentation strategies (Venlafaxine, Lamotrigine and Electroconvulsive therapy) with low results. Finally, to complement the treatment, the patient was transferred to a mid-stay unit where psychosocial treatment with a multidisciplinary approach was started. This has allowed more continuous follow-up and thus a partial improvement of the clinic.ConclusionsNumerous studies describe numerous augmentation strategies for clozapine-resistant schizophrenia with negative symptoms. However, the results are still inconclusive, needing more research. Meanwhile, we want to highlight the importance of complementing the treatment with psychosocial approaches.DisclosureNo significant relationships.

How environmental conditions affect sleep? An investigation in domestic dogs (Canis lupus familiaris)

Studies with humans and some other animal species have shown that sleep is compromised when the presence of external factors such as light, sound, and temperature surpass normal levels. This study investigated the effects of these environmental conditions on 13 kennelled laboratory dogs, assessing whether each variable interfered with their sleep behaviour and/or increased stress responses, which could further compromise sleep quality. The behaviour of dogs was video recorded for eight months. Diurnal and nocturnal behaviour were recorded, along with naturally occurring levels of temperature, light and sound in the dogs’ kennel environment. Faecal cortisol metabolites (FCM), from samples collected every morning, were used to monitor the dogs’ adrenocortical activity. GLMM models and non-parametric tests were conducted to evaluate the relationship between sleeping patterns, environmental variables, and stress on the studied dogs. Nocturnal sleep decreased in response to increases in temperature and in day light duration. No effects of sound and FCM levels on dogs’ sleep were observed. However, diurnal sleep was affected by sound and FCM levels, decreasing when both factors increased. Additionally, noisier days increased stress responses, especially in male dogs. Increased FCM levels were associated with changes in the diurnal behaviour of dogs; for example, decreased activity. The decrease in daily activities and increased physiological stress responses could be associated with maladaptation to the environment, which could indicate poor welfare. Our study suggests that mitigating the impact of environmental conditions in the kennels could improve sleep quality and the overall quality of life of the dogs.

IDF21-0163 The usefulness of low-intensity physical activity management for malaise in type 2 diabetic patients after ablation

Background: The number of patients with type 2 diabetes mellitus with severe arrhythmias is increasing. The number of ablation procedures for these patients is increasing in Japan. Post-operative general malaise has been reported as a symptom of reduced daily activity. In this study, we applied the low-intensity physical activity management (PAM) technique to improve the symptoms of HIV and longCOVID. Aim: To report is the data and subjective evaluation of the progress of the application and appropriate use of low-intensity physical activity management techniques to improve the symptoms of daily inactivity due to general malaise experienced by myself. Method: The patient was 35 years old with type 2 diabetes mellitus. 19 years after the onset of the disease, A1C increased from 6.2% to 12%, SGLT2 was increased and lowered to 9.0%. Shortly afterwards he developed severe atrial fibrillation and underwent an ablation procedure in August at the age of 55. Postoperatively, the patient developed a right recurrent nerve palsy. Afterwards, the patient developed significant dyspnea, and oxygen was administered for 48 hours. Seventy-two hours after the operation, the patient was released from respiratory control and developed marked general malaise and fatigue immediately after movement. PAM was performed using a POLAR M430 active tracker with 24-hour pulse and postural recording and a SPO2 meter. General malaise and daily inactivity were assessed using a 10-point scale, and the number of times per day that the heart rate increase immediately after an ADL activity exceeded 100 beats per minute (the number of spikes) was monitored. When HR 100 and SPO2: 85% or lower for all activities, PAM was performed for 2 months with a measure of 10 minutes of complete rest (based on left lateral recumbency). Results: After discharge from the hospital, the general malaise (M) was 9, the decrease in daily activity (PA) was 8, and the rapidity frequency (T) was 20. This was followed by 2 months of measure B, estimating preoperative ADL physical activity and selecting priority activities using the so-called spoon technique (SPT). M8, PA7, T15. no reduction in beta-blockers. 6 months later, M8, PA7, T12. no improvement in subjective malaise. 15 for 40 kcal/day. After 9 months, marked dyspnoea and pulmonary edema due to recurrent nerve palsy, SPO2 dropped to 82%. Off beta-blockers. Resting heart rate averaged(rHR) 70 to 90 bpm; M7, PA6, T15; A1C 12%. After this, exercise is taken off. After 12 months, M6, PA5, T10, resting HR level of 80 bpm. A1C of 11.5%. 15 months later, SPT for 2 months. M5, PA4, T8, rHR level of 70 bpm. A1C of 10%. PAM completed at 18 months. M3, PA3, T2. rHR66 bpm, A1C of 9.0%. Anxiety about developing motor fatigue associated with activities of daily living disappeared. Discussion: Low-intensity physical activity management techniques, together with glycaemic control, were effective in treating symptoms of reduced daily activity due to general malaise, using active trackers and SPO2 meters. We present an example of the use of low-intensity physical activity management as a method of improving these symptoms.

Weather determines daily activity pattern of an endemic chipmunk with predictions for climate change

Environmental changes can affect an animal's activity pattern and influence fitness. Our goal was to understand the influence of weather on daily activity pattern and assess potential impacts of climate change on activity. We used the Organ Mountains Colorado chipmunk (Neotamias quadrivittatus australis) as a case study. To record activity, we deployed 19 remote cameras at locations occupied by the chipmunk for one year. First, we estimated seasonal variation in daily activity pattern using circular kernel density. Second, we tested if weather influenced activity in each season using Poisson regression in a model selection framework. Third, we predicted the impacts of future climate (RCP8.5 high-emissions scenario) on activity using the best weather model for each season. We found that times and modality of peak activity varied seasonally. Temperature influenced intensity of daily activity in late spring, early summer, monsoon, late fall, and winter, while precipitation influenced intensity of daily activity in early spring and early fall and relative humidity influenced intensity of daily activity in early and late fall. Intensity of daily activity was predicted to increase by 89% in winter and decrease by 51% in early summer under future (2050) climate. The predicted future increase in daily activity in winter may negatively affect fitness because small mammals have higher survival while hibernating. The predicted future decrease in daily activity in early summer may negatively affect fitness due to reduced reproductive output. Losing or gaining time for activity because of shifting climatic conditions could have severe consequences to fitness.

P231 Work productivity loss in perianal crohn’s disease

Abstract Background Few data exist on the socio-professional impact in patients with perianal Crohn’s disease, probably because the patient-doctor relationship is mainly focused on obtaining clinical, biological and endoscopic remission of the Crohn’s disease (CD). Our study aimed to evaluate the impacts of perianal Crohn’s disease on work productivity. Methods A prospective cross-sectional study including patients with CD followed in the Gastroenterology department between July and August 2020 was performed. Professional impact was assessed using Work Productivity and Activity Impairment questionnaire (WPAI) which is composed of 6 questions evaluating during the last seven days preceding the interview with the patient, the absenteeism, the presenteeism, the total decrease in productivity and the decrease in daily activities for health reasons. The results are multiplied by 100, expressed as a percentage of time lost. A higher percentage indicates greater depreciation and less productivity. Professional impact was compared in patients with perianal Crohn’s disease and controls without perianal symptoms. Results Thirty two patients were included. The mean age was 38.28 years [18–60] and the sex ratio was 1. Perianal manifestations were observed in 15 patients (44% of cases). Thirteen patients (41%) were in paid employment at the time of inclusion. CD was responsible for an average absenteeism of 30% ± 10.4% [0–80%] of the working time during the last seven days. An average percentage of work impairment defining the presenteeism was noted to be 52% ± 28% [0–80%] of working time. The overall average decline in productivity was estimated at 56% ± 22% [0–97%]. CD was responsible for an average restriction of 45% ± 33% [0–100%] of usual daily activities. By comparing the professional impact according to the presence or not of anoperineal lesions (APL), an association between the mean rate of activity restriction and the presence of APL (p = 0.04) was objectified. However, no significant association was noted in the other dimensions of the WPAI questionnaire. Conclusion According to our study, it appears that Crohn’s disease is a source of reduced work productivity especially in case of perianal manifestation. These results should be confirmed by larger studies.

Neuropathy of the peroneal nerve as a complication after total knee arthroplasty: characteristics of rehabilitation

Knee arthroplasty is recognized as the gold standard in the treatment of stage IIIIV degenerative diseases and the consequences of traumatic injuries. The number of surgeries is growing, and the number of complications after considered interventions is growing as well. Frequency of peripheral nerve neuropathies is not high, but damage to the peroneal nerve after total arthroplasty of the knee joint can lead to severe dysfunction of the lower limb, decrease in daily activity and the patients quality of life. The article analyzes the treatment results of 254 patients after primary and secondary knee arthroplasty. Signs of damage to the peroneal nerve upon admission to the second stage of rehabilitation were identified in 3.9% of cases. The clinical and functional examination performed in dynamics showed that the presence of neuropathy of the peroneal nerve aggravated the severity of the existing functional disorders in patients after knee arthroplasty. It has been established that complex intensive rehabilitation treatment, which should begin immediately after the diagnosis is made and be carried out intermittently for at least six months, restore the function of the affected nerve in 75% of cases.

The prognosis for post-stroke aphasia

To determine risk factors and factors of favorable prognosis for regression of post-stroke aphasia in the early recovery period of ischemic stroke (IS). A cohort study was undertaken with 40 patients with different clinical forms of aphasia. The duration of study was 3-4 months of the disease. The regression of speech and non-speech cognitive impairment was assessed by the Method of a 10-point evaluation of higher mental functions. The method involves a comprehensive assessment of all mental functions with more than 90 subtests at the beginning and at the end of rehabilitation course and the calculation of the difference in the scoring of each mental function as a measure of treatment efficacy. Using logistic regression and odds ratio estimation, significance of the influence and the prognostic relationship of symptoms related to IS, and a number of biological and social factors (sex, age, and education) were studied. An independent prognostic value for the aphasia regression on the third month of disease has the severity of neurologic symptomatology (NIHSS score) for the first day of stroke (OR 3,27 95% CI 1,02-9,77) and the third month of the disease (p=0,005, OR 4,6, 95% CI [1,39-15,11]) and the decrease in daily activity assessed by the total score of the Barthel index (p=0,004, OR 3,92, 95% CI [1,01-15,21]). A number of MRI signs (localization of post-stroke changes in the left angular gyrus, frontal-temporal region and focal volume) had a significant effect on the dynamics of non-verbal cognitive impairment. Neuropsychological examination revealed a significant improvement of speech in patients with initially severe forms of aphasias, in particular, sensory and sensorimotor. A direct relationship between age and certain clinical forms of aphasia as well as a significant positive effect of duration (β=1,91, p≤0,01) and level of education (β=1,68, p≤0,007) on aphasia regression were determined. The severity of neurologic symptoms, in particular motor and sensory deficits, both in the acute and in the recovery period of the disease is one of the pathogenetic factors worsening the processes of functional reorganization of neuronal speech networks. The positive dynamics of the recovery of speech function is associated with the initial severity and clinical form of aphasia. The level and duration of education are related to factors positively affecting post-stroke neuroplasticity.

LA METAMORFOSIS DE LA FE EN CREYENTES DE EDAD AVANZADA

This paper analyzes if the practice of faith has its foothold in social interaction and if it suffers changes on an advanced age group due vulnerability, illness, disability or retirement, or while the physical straightness, consumption requirements, social and economic interactions get reduced and therefore a decrease in daily activities that produce changes in the lifestyle and the social relationships. I argue that as the person's age grows, the less active and more passive faith becomes, which doesn’t imply that new public, private and mostly intimate expressions of faith aren’t being generated and followed with changes on the perceptions of the material and spiritual world.

Results of Functional Endoscopic Sinus Surgery in Patients with Mucosal Contact Points Suffering From Chronic Daily Headache Non-Responding to Medications

Summary Pain is a worldwide health disorder causing depression and decrease in daily activities, as well as cognitive, memory and attention impairments. In this regard, mucosal contact headache is a second type of headache disorder in the International Classification of Headache Disorders. Some studies have reported that contact points may work as triggers in the initiation of chronic daily headache. The aim of the paper was to evaluate the effects of surgical removal of contact points on relief of chronic daily headache. In this prospective study, thirty patients underwent functional endoscopic sinus surgery and the intensity of pain was examined by visual analogue scale (VAS) before and after a six-month follow-up. Study population included 13 (43.3%) males and 17 (56.6%) females aged from 14 to 54 years, with mean age of 30 years. After surgical removal of contact points, the mean headache (days/month) was decreased from 8.3±6.5 to 1.5±1.7 days (P< 0.005). The length of daily headache was reduced from 3.5±3.1 hour/day to 36±0.8 minute/day. Based on the VAS pain rating scale, the severity of pain decreased from 5.2±1.8 (preoperative) to 1.47±1.3 (postoperative) (P:0.013). Nasal septal deviation was the commonest anatomical variation identified in these patients (21 subjects-70 %). Surgical removal of contact points can improve the therapeutic outcomes in management of patients with chronic daily headache. These contact points may act as triggers for chronic daily headache.

Benefits of Oxygen on Exercise Performance in Patients with Chronic Lung Diseases

Chronic respiratory diseases limit exercise capacity, due to breathlessness and hypoxemia. A decrease in daily activity results in impairment of quality of life and higher mortality. Oxygen therapy improves exercise capacity. The main mechanism of this improvement in COPD patients is a reduction in dynamic hyperinflation. The benefits of oxygen therapy is present not only in patients with severe hypoxemia at rest (PaO2 < 60 mm Hg) requiring long-term oxygen therapy, but also in mild hypoxemic patients who develop desaturation during exercise. An improvement in exercise tolerance is proportional to the administered oxygen flow. Provision of oxygen flow from ambulatory source may be continuous or intermittent only during inspiration. Both methods seem to be comparable in terms of improving exercise tolerance and reducing hypoxemia. Ambulatory oxygen should be prescribed to all patients on long-term oxygen therapy who report outdoor activity. Moreover, normoxemic patients with severe exertional desaturation and low exercise tolerance should also be prescribed ambulatory oxygen. The flow of oxygen should be titrated to prevent desaturation during activities. The long-term effects of ambulatory oxygen such as improvement of quality of life and increasing daily activity have not been confirmed and require further investigation.

Sleep Restriction Decreases the Physical Activity of Adults at Risk for Type 2 Diabetes

To test the hypothesis that recurrent sleep curtailment will result in decreased physical activity in adults at risk for type 2 diabetes. Two-condition 2-period randomized crossover study. University General Clinical Research Center. Eighteen healthy patients with parental history of type 2 diabetes (9 females and 9 males, age 27 yr [standard deviation 3], body mass index 23.7 [2.3] kg/m²). Two week-long inpatient sessions with 8.5 or 5.5-hr nighttime sleep opportunity. Participants who exercised regularly (39%) could follow their usual exercise routines during both sessions. Sleep and total body movement were measured by wrist actigraphy and waist accelerometry. Subjective mood and vigor was assessed using visual analog scales. The main outcome was the comparison of total activity counts between sleep conditions. Ancillary endpoints included changes in sedentary, light, and moderate plus vigorous activity, and their association with changes in mood and vigor. Daily sleep was reduced by 2.3 hr (P < 0.001) and total activity counts were 31% lower (P = 0.020) during the 5.5-hr time-in-bed condition. This was accompanied by a 24% reduction in moderate-plus-vigorous activity time (P = 0.005) and more sedentary behavior (+21 min/day; P = 0.020). The decrease in daily activity during the 5.5-hr time-in-bed condition was seen mostly in participants who exercised regularly (-39 versus -4% in exercisers versus nonexercisers; P = 0.027). Sleep loss-related declines in physical activity correlated strongly with declines in subjective vigor (R = 0.90; P < 0.001). Experimental sleep restriction results in decreased amount and intensity of physical activity in adults at risk for type 2 diabetes.

Appropriate Referral Timing Based Upon MELD Score versus Portal Hypertension Complications for Cirrhotic Patients

Purpose: Referral for liver transplantation (LTx) is often not done until model for end stage liver disease (MELD) scores reach 10 to 15 points. However, various compensated cirrhotic patients with MELD scores less than 10 points suffer from a vast array of portal hypertension complications. The purpose of this review is to evaluate portal hypertension related complications in relation to MELD scores. Methods: The initial evaluation/consult notes were reviewed from January 2010 through May 2011. All patients with cirrhosis referred to two tertiary Hepatology and Transplant programs for the management of chronic liver disease and pretransplant evaluation. Only MELD scores less than 20 points were included. All patients were diagnosed with cirrhosis via histology and/or radiographic confirmation. The chart information included the following complaints or diagnosis; fatigue and/or significant muscle wasting, sleep wake cycle alteration, confusion events and memory loss (as reported by family), subclinical and/or overt hepatic encephalopathy, esophageal varices and/or bleed, hospitalizations related to portal hypertension, disability/loss of employment, and ascites. Additional information included; gender, age, ethnicity, chronic liver disease entity, and patient and family member review of symptoms, employment status, and activity. Results. There were 245 patients involved; 104 females, 141 males, age (range 19-74), ethnicity (79% Caucasian, 10% African American, 6% Hispanic, 5% other), and mean MELD (7 range 6-20). Disease entities; Chronic HCV (32%), alcoholic liver disease (29%), NAFLD (24%), autoimmune diseases (8%), chronic HBV (3%), other (4%). Results: Complication/MELD score 5-7 (%) (n=76) 8-10 (%) (n=68) 11-14 (%) (n=55) 15-20 (%) (n=46) Esophageal Varices 30 35 52 85 Sarcopenia 78 96 100 100 Fatigue 85 95 98 100 Subclinical HE 48 66 78 100 Ascites 10 18 55 78 Decrease in daily activity 45 65 75 95 Disability 32 38 45 55 OHE 15 18 22 38 Hospitalizations 15 38 55 78. Conclusion: The above results suggest that patients suffering from cirrhosis have significant frequency of portal hypertension complications with low MELD scores. The results suggest that referral for pretransplant evaluation should be considered individually and based upon the patient's present quality of health and related portal hypertension complications.Table: No Caption available.

Effects of circadian typology on sleep-wake behavior of air traffic controllers.

The effects of circadian typology on sleep-wake behavior in shiftworkers were investigated using wrist actigraph in 18 air traffic controllers (ATC), nine morning types and nine evening types, working in a backward 1-1-1 super rapid rotation shift schedule. The ATC wore a wrist actigraph continuously over 6 days (3 days on duty and 3 days off duty). Evening types presented more flexible sleep habits and slept significantly less than morning types. Regardless of circadian typology, the morning shift tended to reduce the amount of sleep whereas night shift produced a decrease in daily activity.

Psychosocial impact of the progress of chronic respiratory disease and long-term domiciliary oxygen therapy

Purpose : The psychosocial impact of the progress of chronic respiratory disease and long-term domiciliary oxygen therapy (LTOT) was examined to develop an appropriate intervention strategy for pulmonary rehabilitation programmes. Methods : Psychosocial factors were investigated using a self-administered questionnaire. A total of 144 patients receiving LTOT were compared with 100 chronic respiratory patients (RES) who were not yet suffering from respiratory failure and therefore not under LTOT, and a control group of 51 healthy subjects (HCS). Results : With the progress of the disease, there was a decrease in daily activities as well as in body mass index. Support of family members and others, life satisfaction, and morale decreased, while the tendency for depression increased significantly. These patterns appeared to begin before initiation of LTOT and worsened in the respiratory failure stage. The negative emotions ranged from 'feeling helpless', 'feeling being a burden and miserable', 'denying LTOT', and 'feeling dependent and anxious'. Conclusions : For pulmonary rehabilitation programmes, an effective intervention strategy that is suggested from this study should address these psychosocial issues at the initiation of LTOT, and follow through with continuous care throughout life under therapy to counter the development of negative attitudes.

Failure of periodic presentation of palatable diet to entrain feeding, drinking and activity rhythms under constant conditions

Feeding, drinking and activity of two groups of male laboratory rats were studied across three experimental stages: LD 12:12; LL; and LD 12:12. In the first group (Control), ordinary diet was availabel ad lib for the entire experiment. In the second group (Experimental), palatable diet was available for the first 12 hr of each day and ordinary diet for the remainder of the day in stages 2 and 3. It was found that in stage 1 all behaviors were highly nocturnal. The nocturnality of feeding was achieved by the ingestion of more meals in the D phase as compared to the L phase. Dark ingested meals were not significantly larger than meals in the L phase. In stage 2, circadian rhythms in all three variables were damped and meals became evenly spaced across the day in both groups. In the Control group, meal sizes were also of the same magnitude across the day. However, periodic presentation of palatable diet resulted in larger meals and, therefore, the ingestion of 60% of total daily food intake during the 12 hr period when palatable food was available. Total daily food intake in LL did not change compared to stage 1 and did not differ between the groups. The size and number of significant meal size/post-meal interval correlations increased over the duration of the experiment but remained relatively small. In stage 2, water intake and activity were similarly evenly distributed over the 24 hr period in both groups and were not influenced by periodic presentation of palatable diet. No marked decreases in total daily water intake, but a substantial decrease in daily activity, were found. Under LL, daily body weight increments in both groups were maintained, but subtle changes were observed. In stage 3 when the LD cycle was reinstated, both groups ate a greater number of meals in the D phase despite the availability of palatable food in the L phase for the Experimental group. These animals ate fewer but larger meals of palatable diet than ordinary food resulting in 50% of their daily intake being ingested during the L phase. Activity and water intake returned to stage 1 levels and the distributions of these behaviors were similar to those found in stage 1 in both groups. It was concluded that palatable diet influenced meal size only and that the timing of meals depended on the illumination conditions only. Further, periodic presentation of palatable diet failed to entrain the damped rhythms of feeding, drinking and activity in LL. These results do not rule out the possibility that such an entraining effect of periodic presentation of palatable diet might be found in conditions of DD.