Difficulty In Activities Of Daily Research Articles

Effect of early weight bearing program with conventional physiotherapy on functional outcomes in surgically treated proximal tibia fracture: a pilot randomized controlled trial.

Patients are often instructed to avoid weight bearing on the proximal tibia for 6 - 12 weeks post-surgery to avoid fracture fixation failure. However, delayed weight bearing leads to delayed mobility, causing difficulties in daily activities; problems such as pain, limited knee ROM, reduced quadriceps muscle strength, and impaired functional outcomes are reported in long-term follow-up. This study primarily aimed to evaluate the feasibility and explore the effect size. The secondary aim was to determine the effectiveness of early weight bearing along with conventional physiotherapy on functional outcomes. A single-blinded pilot randomized controlled trial with 30 participants with proximal tibia type I, II, and III fractures were included; they were randomized using computer-based software. Seven patients were lost to follow-up. Group I received early weight bearing along with conventional physiotherapy whereas Group II received restricted weight bearing along with conventional physiotherapy. Assessments were made on post-operative day 3 (POD-03), at discharge, at 6 weeks, and at 12 weeks. Radiographs were recorded immediately after the operation, at discharge, and at 12 weeks. A full-scale RCT is feasible with an effect size between 0.3 - 0.7. A statistically significant difference (p < 0.05) was found within both groups 12 weeks post-surgery in all outcome measures; the difference was more prominent in the intervention group. A statistically significant difference (p < 0.05) was found between both the groups post-12 weeks in all outcome measures except quadriceps isometric muscle strength. A full-scale RCT for early weight bearing along with conventional physiotherapy for patients operated for Type I, II, and III proximal tibia fracture is feasible. Early weight bearing along with conventional physiotherapy could have a positive effect on reducing patient's pain perception and increasing knee joint mobility, quadriceps isometric muscle strength, knee function, and quality of life without any adverse effects. ClinicalTrialsRegistry.gov (CTRI/2022/10/046797).

Reliability and validity of a graphical computerized adaptive test Longshi scale for rapid assessment of activities of daily living in stroke survivors

Stroke survivors frequently experience difficulties in daily activities, such as bathing, feeding, and mobility. This study aimed to evaluate the reliability and validity of a computer-adaptive test-Longshi scale (CAT-LS) for assessing activities of daily living (ADL) in stroke survivors. This cross-sectional study collected data using an electronic application. The ADL function of stroke survivors in rehabilitation departments of hospitals was assessed using both the CAT-LS and BI. Correlations between the CAT-LS and Barthel index (BI) and concurrent validity were evaluated using Pearson’s correlation test and multiple linear regression. Interrater reliability was evaluated using the intraclass correlation coefficient based on a two-way random effect. The internal consistency of the CAT-LS was assessed using Cronbach’s coefficient (α) and corrected item-total correlations. Overall, 103 medical institutions in China were used in this study. In total, 7151 patients with stroke were included in this study. The CAT-LS classified patients into three ADL groups (bedridden, domestic, and community) with significantly different BI scores (P < 0.05). The CAT-LS results obtained using the decision-tree scoring model were consistent with the scores for each BI item. A strong correlation was observed between CAT-LS and BI (Pearson’s r: 0.6–0.894, P < 0.001). The CAT-LS demonstrated good internal consistency (Cronbach’s α, 0.803–0.894) and interrater reliability (ICC, 0.928–0.979). CAT-LS is time-efficient and requires < 1 min to administer. The CAT-LS is a reliable and valid tool for assessing ADL function in stroke survivors and can provide rapid and accurate assessments that reduce the burden on healthcare professionals. Further validation of this tool in other populations and settings is necessary.Study registration number: No.: ChiCTR2000034067; http://www.chictr.org.cn/showproj.aspx?proj=54770.

Customized Prosthetic Management for Post Orbital Exenteration Patient: A Case Report

Introduction : Orbital exenterations are performed to treat malignancies, orbital injury or other chronic conditions unresponsive to conservative therapy. Exenteration can result in depression, difficulties in daily activities, and aesthetic problems. Orbital prosthetic is an alternative therapy for aesthetic rehabilitation and protection of the orbital cavity.&#x0D; Case Illustration : A 46-year-old woman came with a chief complain of a black mass on the left lower eyelid ten years ago. Patient was diagnosed with basal cell carcinoma and underwent extirpation of the mass with skin graft reconstruction. On histopathological examination, it was discovered that the incision base was not free of tumor. Patient came two years later with recurrent black mass invaded cornea and sclera, and then underwent exenteration of the left eye (Figure 1). Patient completed 40 cycles of radiotherapy and then used spectacle retained orbital prosthetic (Figure 2 &amp; 3).&#x0D; Discussion : Orbital prosthetics are synthetic replacement after exenteration that can restores orbit, eyelid, eye and periorbita anatomy. Orbital prosthetic retention can be aided by attachment to spectacle, use of magnets, adhesives or osseointegrated implants. Spectacle retained orbital prosthetic is the easiest and the most affordable prosthetic to construct.&#x0D; Conclusion : Orbital defects rehabilitation improves physical and psychological well-being. Due to the complexity of prosthetic fabrication and production cost, retention of the orbital prosthetic with spectacles is the most suitable alternative treatment option in some cases, it is also the easiest prosthetic to construct and inexpensive.

Conservative Physiotherapy for Grade 4 Osteoarthritis Secondary to Genu Varum Deformity: A Case Report

Osteoarthritis (OA) is a prevalent form of degenerative joint disease that primarily affects the knees, leading to a gradual loss of function, severe pain, joint stiffness, and reduced quality of life. Despite its severity, exercise treatment offers promising results and proves beneficial for a wide range of patients. Preoperative rehabilitation for OA patients often involves therapeutic approaches such as exercise treatment, electrotherapy, and manual therapy. The present case revolves around a 58-year-old male diagnosed with OA in both knees, with the presence of genu varum deformity. A personalised preoperative rehabilitation protocol was designed based on his specific symptoms of pain, stiffness, and difficulties in daily activities. The case study highlights the effectiveness of the preoperative physical therapy approach for managing bilateral osteoarthritic knees with genu varum deformity.

Порушення соціального функціонування у хворих з депресивними розладами в умовах стресу війни

The psychotraumatic factors that occurred during the war of 2022-2023 significantly affect the exacerbation / onset and manifestations of depressive syndrome (DS) in schizophrenia spectrum disorders (SSD) and neurotic depressive disorders (NDD), as well as worsen the level of social functioning (SF) of patients. Objective. To study the SF impairment in patients with DS in patients with SSD and NDD, and the relationship between the stress factors and the exacerbation of psychopathological symptoms and their severity in these patients. Methods and materials. There was conducted psychopathological examination of 92 patients with SSD (schizophrenia, Sch and schizoaffective disorder, SchAD) and neurotic DR (recurrent depression, RD and depressive reaction as adjustment disorders, AD) who experienced severe stress during the war. Results. In the research the largest number of patients were women (60.9% of cases). Among patients aged 18 - 25 years, majority of cases was the patients with AD (46.2%), in the group of 26 - 35 years - with SSD (50,0% with Sch and with SchAD). The vast majority of RD cases were presented among patients aged 36-50 years. Depressive syndrome significantly prevailed in patients with RD, and depressive-phobic syndrome in patients with AD. Whereas, depressive-delusional syndrome was most often diagnosed in patients with SSD. Among all examined patient’s reactive exacerbation of the main disease (in case of SSD and RD), as well as the development of RA occurred as a result of a significant impact of stress factors of different content, but related to the war in all cases.The most frequent of these were the feeling of "war fatigue", uncertainty and/or hopelessness about the future (in general 82% of patients with RD and RA); difficulties during evacuation, caused a strong increase in family conflicts, especially in patients with SSD (57.9% of cases in general) and RA; significant reduction of money for life. The impairment of SF in patients with various mental disorders and DS as a result of war-related stressors was mainly manifested in significant difficulty in daily professional and household duties (91.3% of all patients); the feeling of social support lacks and loneliness; frequent and/or prolonged interpersonal conflicts; as well as a strong financial problem. Other psychopathological features associated with DS that develop under the war stress influence and worsened the level of patients' SF were sleep disturbances (97.8% of cases) with a significant direct correlation with a significant difficulty in daily activities; self-disbelief and hopelessness, as well as the emergence or strong increasing of suicidal thoughts were noted by more than 80% of the examined patients (36.0% of patients with NDDs had suicide attempts or self-injurirs - most often in AD); constant fatigue (80.0% of patients with NDDs). Conclusion. Understanding the impact of war-related stressors on the manifestations of DS, and the features and level of SF impairment need the use of treatment and rehabilitation complex for patients with DS (with SSD and NDD) who have experienced a severe psychotraumatic situation. It will allow timely and effective treatment of reactive states (relapses of psychotic episodes), take to account into the severity and characteristics of DS, and the content and severity of stressful effects in order to achieve remission, restore social adaptation of patients, and reduce the risk of self-destructive or aggressive behavior of them.

Порушення соціального функціонування у хворих з депресиівними розладами в умовах стресу війни

Abstract The psychotraumatic factors that occurred during the war of 2022-2023 significantly affect the exacerbation / onset and manifestations of depressive syndrome (DS) in schizophrenia spectrum disorders (SSD) and neurotic depressive disorders (NDD), as well as worsen the level of social functioning (SF) of patients. Objective. To study the SF impairment in patients with DS in patients with SSD and NDD, and the relationship between the stress factors and the exacerbation of psychopathological symptoms and their severity in these patients. Methods and materials. There was conducted psychopathological examination of 92 patients with SSD (schizophrenia, Sch and schizoaffective disorder, SchAD) and neurotic DR (recurrent depression, RD and depressive reaction as adjustment disorders, AD) who experienced severe stress during the war. Results. In the research the largest number of patients were women (60.9% of cases). Among patients aged 18 - 25 years, majority of cases was the patients with AD (46.2%), in the group of 26 - 35 years - with SSD (50,0% with Sch and with SchAD). The vast majority of RD cases were presented among patients aged 36-50 years. Depressive syndrome significantly prevailed in patients with RD, and depressive-phobic syndrome in patients with AD. Whereas, depressive-delusional syndrome was most often diagnosed in patients with SSD. Among all examined patient’s reactive exacerbation of the main disease (in case of SSD and RD), as well as the development of RA occurred as a result of a significant impact of stress factors of different content, but related to the war in all cases.The most frequent of these were the feeling of "war fatigue", uncertainty and/or hopelessness about the future (in general 82% of patients with RD and RA); difficulties during evacuation, caused a strong increase in family conflicts, especially in patients with SSD (57.9% of cases in general) and RA; significant reduction of money for life. The impairment of SF in patients with various mental disorders and DS as a result of war-related stressors was mainly manifested in significant difficulty in daily professional and household duties (91.3% of all patients); the feeling of social support lacks and loneliness; frequent and/or prolonged interpersonal conflicts; as well as a strong financial problem. Other psychopathological features associated with DS that develop under the war stress influence and worsened the level of patients' SF were sleep disturbances (97.8% of cases) with a significant direct correlation with a significant difficulty in daily activities; self-disbelief and hopelessness, as well as the emergence or strong increasing of suicidal thoughts were noted by more than 80% of the examined patients (36.0% of patients with NDDs had suicide attempts or self-injurirs - most often in AD); constant fatigue (80.0% of patients with NDDs). Conclusion. Understanding the impact of war-related stressors on the manifestations of DS, and the features and level of SF impairment need the use of treatment and rehabilitation complex for patients with DS (with SSD and NDD) who have experienced a severe psychotraumatic situation. It will allow timely and effective treatment of reactive states (relapses of psychotic episodes), take to account into the severity and characteristics of DS, and the content and severity of stressful effects in order to achieve remission, restore social adaptation of patients, and reduce the risk of self-destructive or aggressive behavior of them.

Perancangan Aplikasi Naviku untuk Memberikan Informasi Navigasi Kepada Tunanetra Menggunakan Metode Test Driven Development

Visually impaired is a term for someone who has lost or reduced the function of vision. People with visual disabilities often experience difficulties in daily activities, for example when walking or navigating. They need the help of others to help them go to a room or move from one place to another. Currently, existing navigation aids do not fully meet the needs of the blind. They still need the help of others to get detailed information about visual objects such as the layout of rooms in buildings, traffic signs, and vehicles. Based on these problems, an Android-based navigation application needed that utilizes Text-to-Speech (TTS) technology to help blind people navigate independently by utilizing navigation information provided by voice. In order to help the development process, applications are developed by adopting Agile Software Development principles using the Test Driven Development (TDD) method. The features developed begin with a test fail phase where the developer creates unit test code before the production code is implemented, then refactor the code, and tests afterward (test passes). The success status of the features being tested gets success status with a rate of 100% for all features. Then in the TTS test, testing was carried out with 2 TTS engines, namely Google TTS and Samsung TTS, the results showed that the Word Error Rate (WRE) of Google TTS was 2,86, lower than Samsung TTS which got 4,06.

코로나19 시기, 성인 장애인의 일상생활활동 어려움 비교 분석 : 국가 단위 실증 조사 자료 기반으로

Objectives: This study purposed to analyzed of safety awareness, quarantine, and difficulties in daily life activities experienced by people with disabilities in the COVID-19 situation by type of disability. It is an empirical analysis study to derive what the country needs to improve in the COVID-19 pandemic by type of disability. Methods: The 2020 Survey on the Status of Persons with Disabilities a large-scale sample data at the national level was used. 4,590 external physical disabilities, 1,191 internal organ disabilities, and 879 mental disabilities were studied. Using the SPSS 26.0 program, frequency analysis and chi-square test were used to analyze. Results: First, there was a statistically significant difference in safety awareness from disasters and accidents by disability type. It was recognized that external physical functional disabilities and mental disabilities were relatively dangerous compared to internal organ disabilities. Second, people with mental disabilities had relatively greater difficulties in obtaining information and purchasing and using quarantine equipment than other types of disabilities. Third, due to COVID-19, it was found that people with disabilities have great difficulties in daily activities such as going out, medical use, and emotional difficulties. Fourth, during the COVID-19 period, the people with disabilities had the largest support for quarantine products. Fifth, the demand for facilities and equipment in preparation for disasters considering the characteristics of disabilities was the highest as a national improvement to resolve the difficulties of people with disabilities. Conclusion: People with disabilities are suffering from difficulties in their daily lives activity such as going out, medical use, and emotional difficulties during the COVID-19 period, and more support for mental health-related health education programs is required.

Postpartum Depression; A Survey of Mothers Attending Paediatric Outpatient Department in A Tertiary Care Centre

Postpartum maternal depression (PPD) prevalence is around 15-20% in low- and middle-income group countries, and it harms the mother and child unit The aim of the study was to find the prevalence of Postpartum maternal depression in mothers attending Paediatric Out Patient Department OPD and to find if there is any correlation with Socio-Economic-Status SES, maternal health condition, pregnancy or obstetric complication, gender of the child, etc. with postpartum depression. A total of 200 mothers attending the pediatric OPD of a tertiary care hospital in a sub-urban area of South India were enrolled. They were interviewed with a semi-structured questionnaire. Details regarding demographic details, education level, employment, marital status, type of family, availability of help to look after the child and to do household chores, substance use in the family members, mental and physical abuse experienced by the mother, if any. Details of psychiatric illness in the family or history of previous postpartum depression were also collected. Screening for postpartum depression was done using Edinburgh postnatal depression scale. The prevalence of PPD was 9%, and interference with child rearing and perception of difficulty in daily activities were significantly associated with PPD. PPD is an underdiagnosed condition. Mothers can be easily screened for pediatric OPD, and treatment can be offered, leading to healthy mothers and children.

Association Between Insomnia and Healthcare Utilization: A Scoping Review of the Literature

Insomnia is a sleep disorder that affects significant portion of the population. It can result in adverse health outcomes and increased healthcare utilization. The purpose of this review was to identify existing research on the association between insomnia and healthcare utilization. A five-stage scoping review process was conducted guided by the Joanna Briggs Institute process. Data sources searched through 2022 were PubMed, HINARI, Google Scholar and Cochrane, with additional studies identified through hand searching. Descriptive and exploratory analyses were conducted from the findings of the selected studies. After reviewing 124 references, 23 studies were selected. A strong and positive association between insomnia and healthcare utilization and healthcare costs was identified. We also found that insomnia was associated with absenteeism from work, lower work performance ratings, disability, difficulties in daily activities, and life dissatisfaction. An unexpected theme that emerged from the included studies is that there is a large population with persistent insomnia who do not seek help that could benefit from improved management. Findings suggest that identifying and managing insomnia could result in a decrease in healthcare utilization and costs. Further research is needed to determine the most effective methods of identifying and managing insomnia.

Age-Related Trajectories of General Fluid Cognition and Functional Decline in the Health and Retirement Study: A Bivariate Latent Growth Analysis.

There have been few studies on associations between age-related declines in fluid cognition and functional ability in population-representative samples of middle-aged and older adults. We used a two-stage process (longitudinal factor analysis followed by structural growth modeling) to estimate bivariate trajectories of age-related changes in general fluid cognition (numeracy, category fluency, executive functioning, and recall memory) and functional limitation (difficulties in daily activities, instrumental activities, and mobility). Data came from the Health and Retirement Study (Waves 2010-2016; N = 14,489; ages 50-85 years). Cognitive ability declined on average by -0.05 SD between ages 50-70 years, then -0.28 SD from 70-85 years. Functional limitation increased on average by +0.22 SD between ages 50-70 years, then +0.68 SD from 70-85 years. Significant individual variation in cognitive and functional changes was observed across age windows. Importantly, cognitive decline in middle age (pre-age 70 years) was strongly correlated with increasing functional limitation (r = -.49, p < .001). After middle age, cognition declined independently of change in functional limitation. To our knowledge, this is the first study to estimate age-related changes in fluid cognitive measures introduced in the HRS between 2010-2016.

Effect of a video-assisted fall prevention program on fall incidence in community-dwelling older adults during COVID.

The study evaluated the effectiveness of a video-assisted exercise intervention program on fall incidence, activities of daily living, and fear of falling in community-dwelling older adults. A video-assisted 16-week exercise intervention consisting of stretching, strengthening, balance, and dual-task training was delivered to randomly selected 95 older adults with a high risk of falls. The fidelity of implementation was assessed for three areas; exercise program delivery, participant receipt, and enactment. The fall incidence reduced significantly by 45% (IRR 0.55, (95% CI, 0.13-0.86) and difficulty in daily activities decreased (OR: 0.74, 95% CI, 0.16 - 0.96) among participants in the intervention group. Fear of falls did not show any significant difference in the groups at the 12-month follow-up. The video-assisted exercise program was found to be effective in reducing fall incidence among older adults at a higher risk of falls.

Utility of Opportunistic Infections, Joints’ Involvement and Accuracy of Various Screening Tests to Diagnose Rheumatoid Arthritis Patients

Background and Objectives: Rheumatoid Arthritis (RA) is an auto-immune disease in which the body mistakenly considers some parts of its own system as pathogens and attacks them. Prevalence is approximately 0.75% in India. About 40% of the diseased become work disabled within 5 years from the onset of symptoms. The objective of this paper is to assess the sign/symptoms, joints' involvement, difficulties in daily activities and screening accuracy of serology tests of clinically suspected RA patients. Material and Methods: A cross-sectional cohort study design was conducted on two hundred ninety clinically suspected subjects who were referred by different OPDs of hospitals for screening. The profiles of study subjects were carried through a semi-structured, pre-tested schedule method. About 2 mL of blood samples were collected in a plain vial from each patient and tested for diagnostic tests RF, CRP and AntiCCP by using RF-Latex, CRP Latex and ELISA method, respectively, by the laboratory persons. Results: Joint pain shows to be a leading problem in RA as compared to other signs and symptoms. The majority of the study subjects suffer from knee problems (62%). Approximately equal numbers of RA-positive cases were screened by RF and AntiCCP tests. The CRP test screened about one-third of cases. CRP+ AntiCCP, RF+ AntiCCP and RF + CRP all have good sensitivity, and RF+ AntiCCP + CRP has a very high sensitivity for diagnosing RA. Conclusions: This study found that a substantiation of a major proportion of clinically suspected RA patients were suffering from knee pain. Predication of AntiCCP increased the possibility for the diagnosis of RA. However, RF was also moderately related to the diagnosis of RA, and the combination of both tests was more valuable.

Walking on inclines alters the gait characteristics in patients with acute stroke

BackgroundStroke leads to severe difficulties in daily activities, even when performing a simple task, such as walking from one point to another. The first apparent compensatory strategy in stroke survivors during walking is to slow down the walking speed. Slowing down the walking speed directly reduces the step length and cadence and further increases the stance phase, double, and support time. These alterations are to develop a compensatory strategy; however, this strategy generally leads to joint injuries and increases the potential risks of falls. Research QuestionA review strongly suggests that walking on the inclines may enhance this compensatory strategy. Therefore, this study attempted to extend the current knowledge to understand the fundamental gait control in patients with acute stroke during walking on inclines. ResultsThese results showed that (1) compared to healthy control, patients with acute stroke demonstrated different gait controls during walking on inclines, (2) the gait performance was enhanced when stroke patients were instructed on different inclines, and (3) the asymmetric gait pattern was reduced by walking on inclines. SignificanceThis study concluded that walking on inclines enhances gait performance (greater spatial but smaller temporal gait characteristics) and reduces spatial gait asymmetry.

Implications of refrigerator management on subjective memory complaints among Japanese community-dwelling older adults.

Older adults with subjective memory complaints (SMC) may experience very minor difficulties in daily activities. Although caregivers and occupational therapists who support community-dwelling older adults are aware of the existence of characteristic behaviours related to refrigerator management, no specific studies have been conducted. This study aimed to examine the implications of refrigerator management for older adults with SMC. A self-administered questionnaire was sent to 3000 randomly selected members of Consumer's Co-operative Kagoshima. Of the returned responses, a total of 282 older adults were analyzed. Analyzed subjects were divided into two groups: SMC (+) group (n=74) and SMC (-) group (n=192). A questionnaire was created by four occupational therapists and used to assess the characteristics of analyzed subjects and their abilities to manage the refrigerator. The observation list for early signs of dementia was also utilised. A multiple logistic analysis was performed to examine the association between SMC and refrigerator management. The SMC (+) group had a significantly higher number of refrigerator management errors than the SMC (-) group (P=0.008). The SMC (+) group had more errors than the SMC (-) group in the following four items regarding refrigerator management; the refrigerator has a lot of the same foods / expired food, the person does not know what's in the refrigerator, the person cannot find what he/she needs in the refrigerator. Moreover, SMC was associated with the item 'the person does not know what is in the refrigerator' (odds ratio 7.44, 95% CI 1.51-43.8, P=0.02). Our results showed that older adults with SMC had several problems regarding refrigerator management. Evaluating refrigerator management among older adults with SMC may help consider multifaceted support.

Epicranial Direct Current Stimulation Suppresses Harmaline Tremor in Rats

IntroductionEssential tremor (ET) is the most common neurologic movement disorder worldwide. It is characterized by a postural tremor, mostly in the upper extremities, causing difficulties in daily activities that may lead to social exclusion. Some patients with ET do not respond well to or do not tolerate medication. Thus, deep brain stimulation can be offered. In a recent study, we proposed a novel neuromodulation technique called epicranial current stimulation (ECS) that works in a minimally invasive way by placing the electrodes subcutaneously under the skin and directly over the skull. In this study, we investigated the feasibility of using epicranial direct current stimulation (EDCS) to suppress tremor in a rat harmaline ET model. Materials and MethodsIn experiment 1, seven Sprague Dawley rats were implanted with ECS electrodes placed over the motor cortex (MC) and the cerebellum to investigate whether stimulating between them could suppress tremor. In experiments 2 and 3, eight rats were implanted with ECS electrodes placed over the MC, cerebellum, and the rostral skull to separate the effects on tremor caused by stimulating each target. During each experiment, the rats were injected with harmaline, which induced tremor that was quantified using an accelerometer. EDCS was then applied through the different electrode configurations to evaluate their tremor suppression effectiveness. ResultsResults from experiment 1 showed that MCcathode-Cerebellaranode suppressed tremor compared with stimulation-OFF but MCanode-Cerebellarcathode did not. Furthermore, experiments 2 and 3 showed that it was the cerebellar anodal electrode that was driving tremor suppression. ConclusionCerebellar EDCS suppressed harmaline tremor in rats in a polarity-dependent manner. EDCS could be a promising neuromodulation method for patients with ET.

Satisfaction and Functional Outcome of Surgical Treatment in Patients with Brachial Plexus Injury: A Decade of Retrospective Comparative Study.

Brachial plexus injury (BPI) is a severe peripheral nerve injury resulting in physical disability. Few studies have investigated the postoperative functional status. We aimed to evaluate the satisfaction with surgical treatment in patients with BPI referred to the Panzdah-e Khordad Hospital, Tehran, Iran from 2011 to 2021. In this descriptive-analytical retrospective comparative study, physical examination, along with BrAT, and DASH questionnaires were used to evaluate the patients' status. Then the collected data on the patients' functional status and movements were collected. To compare the mean of quantitative variables before and after the surgery, the dependent t-student was used. Generally, the patients stated that they still had considerable difficulty doing most of the items of the questionnaires. Nevertheless, there was a significant difference between the following variables before and after surgery; shoulder abduction goniometry (0-150) and force (M0:M5), shoulder external rotation goniometry (0-90) and force (M0:M5)), shoulder forward flexion goniometry (0-180) and force (M0:M5)), elbow flexion goniometry (0- 150), elbow extension force (M0:M5), and wrist and finger muscle force (M0:M5) (P<0.001). Posterior approach in BPI surgery was associated with good outcomes in terms of shoulder external rotation and abduction. However, patients still suffered from difficulties in daily activities.

Assessment of cognitive impairment in psychosis spectrum disorders through self-reported and interview-based measures.

Self-reported and interview-based measures can be considered coprimary measures of cognitive performance. We aimed to ascertain to what extent cognitive impairment in psychotic disorders, as assessed with a neuropsychological battery, is associated with subjective cognitive complaints compared to difficulties in daily activities caused by cognitive impairment. We assessed 114 patients who had a psychotic disorder with a set of neuropsychological tests and two additional measures: the Cognitive Assessment Interview-Spanish version (CAI-Sp) and the Frankfurt Complaint Questionnaire (FCQ). Patients also underwent a clinical assessment. The CAI-Sp correlated significantly with all the clinical dimensions, while the FCQ correlated only with positive and depressive symptoms. The CAI-Sp correlated significantly with all cognitive domains, except for verbal memory and social cognition. The FCQ was associated with attention, processing speed and working memory. The combination of manic and depressive symptoms and attention, processing speed, working memory and explained 38-46% of the variance in the patients' CAI-Sp. Education and negative symptoms, in combination with attention, processing speed, and executive functions, explained 54-59% of the CAI-Sp rater's variance. Only negative symptoms explained the variance in the CAI-Sp informant scores (37-42%). Depressive symptoms with attention and working memory explained 15% of the FCQ variance. The ability to detect cognitive impairment with the CAI-Sp and the FCQ opens the possibility to consider these instruments to approximate cognitive impairment in clinical settings due to their ease of application and because they are less time-consuming for clinicians.

Insufficient Sleep and Health Care Utilization: A Scoping Review

The purpose of this study was to examine healthcare costs of older adults in relation to demographic characteristics, individual health personality traits, and resilience. Data included 3,907 participants, 65 and older, collected by a large provider of Medicare Supplemental Health Insurance. The Health Personality Assessment*, Brief Resilience Scale, total healthcare cost, and demographic information were used. In our sample, the average healthcare cost was $13,283.69 (SD=30,784.87), ranging from $0–$989,084, and higher healthcare costs were found among older, male, and less health-neurotic (i.e., lower health-related anxiety) adults. Configural frequency analyses were conducted to identify “types” and patterns of healthcare costs by age and gender. The following significant patterns emerged: Women in the oldest group with high healthcare costs and women in the young-old age group who had low healthcare costs occurred significantly more than expected by chance, p<.01. Next, we hypothesized configuration patterns for resilience, health personality, and healthcare costs. Results confirmed the following “types” or patterns occurring more often than expected by chance: less-resilient individuals with high health neuroticism and high healthcare costs, p<.001, and less-resilient, less-health-conscientious adults with high healthcare costs, p<.001. The results suggest higher healthcare costs for individuals who are less resilient, more neurotic about their health, and less disciplined in their health practices. Future intervention programs may benefit from promoting resilience, reducing health neuroticism, and increasing health conscientiousness. *The Health Personality Assessment (HPA) is © 2021 United HealthCare Services, Inc. All rights reserved.

Insufficient Sleep and Health Care Utilization: A Scoping Review

Insufficient sleep is a common problem among older adults with 26% over the age of 65 reporting less than seven hours sleep in a 24 hour time period. Evidence indicates that untreated sleep disorders are associated with osteoarthritis, heart disease, hypertension, diabetes, obesity, falls, decreased cognitive performance, and decreased health related quality of life in older adults. A scoping review was undertaken to determine what is known about the association between insufficient sleep or insomnia and health care utilization. The Joanna Briggs Institute, Methodology for JBI Scoping Reviews was used to guide the review. Searches were conducted in PubMed, HINARI, Google Scholar and Cochrane databases. Twenty nine studies were included. Overall, the review indicates that reduced sleep is associated with a greater odds of difficulties in daily activities, higher rates of health care utilization and costs, and poly pharmacy. Findings also reveal sociodemographic and geographic variations in prevalence of healthy sleep duration. Although the majority of studies focused on the causes and consequences of insomnia and recommended clinical and behavioral health promotion interventions, there is a gap in studies related to the public health or economic impact of insufficient sleep. Research in this area will provide perspectives on the need to raise awareness of the importance of sleep and to incorporate the awareness into policies that improve sleep health.