Difficulty Subscale Research Articles

HIV-Related Stigma and Psychological Adjustment Among Perinatally HIV-Infected Youth in Cape Town, South Africa.

The effect of chronic HIV-infection on psychological adjustment, including the impact of HIV-related stigma in perinatally HIV-infected (PHIV+) youth across Africa is largely unknown. This study examined psychological adjustment and HIV-related stigma using the Strengths and Difficulties Questionnaire (SDQ) and a 10-item stigma questionnaire in a cohort of PHIV+ youth in Cape Town, South Africa. The relationships between SDQ scores, elevated viral load, and suboptimal antiretroviral therapy (ART) adherence were also explored. Among 473 PHIV+ youth (aged 9-14years, on ART > 6months at enrollment), higher perceived HIV-related stigma was associated with higher scores across all adolescent and caregiver-reported SDQ difficulty subscales. Higher socioeconomic status (SES) was associated with lower scores on adolescent self- and caregiver-reported hyperactivity subscales. Higher adolescent-reported prosocial scores were associated with lower odds of self-reported suboptimal ART adherence, and higher caregiver-reported conduct scores were associated with higher odds of elevated viral load. No associations were observed between perceived HIV-related stigma and treatment outcomes. These findings highlight the potentially detrimental impact of perceived stigma on psychological adjustment in PHIV+ youth. The use of psychosocial metrics and interventions aimed at reducing illness related stigma in PHIV+ youth is also considered.

The Predictive Role of Schema Modes and Difficulties in Emotion Regulation in Corona Disease Anxiety

Introduction: The aim of this study was to predict corona disease anxiety based on difficulies in difficulties in emotion regulation and schema mode. Method: The design of the present research was correlational.The statistical population of the study included all students in Mashhad who were members of virtual social networks. Among the community, 238 volunteered to answer the questionnaires. For data collection the Corona Disease Anxiety Scale (CDAS), the Graz and Roemer difficulties in emotion regulation scale (DERS), the Schema Mode Questionnaire (SMQ) was used, and data was analysed by Pearson correlation test and multiple linear regression analysis Results: The results of this research indicate that the combination of difficulties in emotion regulation and schema mode components predicit corona disease anxiety. The components of impulse control and emotional uncertainty from the subscales of difficulties in emotion regulation were significantly associated with corona disease anxiety. Conclusion: In sum, according to the findings of the present study, it is possible to make effective interventions in emotion regulation and schema mode for prevention of coron disease anxiety.

Secondary Quality-of-Life Domains in Patients with Relapsed and Refractory Multiple Myeloma Treated with the Bcma-Directed CAR T Cell Therapy Idecabtagene Vicleucel (ide-cel; bb2121): Results from the Karmma Clinical Trial

Secondary Quality-of-Life Domains in Patients with Relapsed and Refractory Multiple Myeloma Treated with the Bcma-Directed CAR T Cell Therapy Idecabtagene Vicleucel (ide-cel; bb2121): Results from the Karmma Clinical Trial

Evaluación de la Adaptación al Divorcio-Separación: Propiedades Psicométricas del CAD-S en el Contexto Chileno

El divorcio-separación supone un proceso de adaptación al nuevo estatus, dada la serie de cambios que deben afrontarse en distintos ámbitos de la vida. En tal sentido, contar con instrumentos adaptados a la realidad chilena que permitan evaluar la adaptación al divorcio y la separación es un paso necesario para comprender este proceso. El presente estudio tuvo como objetivo examinar las propiedades psicométricas de la versión chilena del Cuestionario de Ajuste al Divorcio y la Separación (CAD-S, Yárnoz Yaben & Comino González, 2010). La muestra, no probabilística de conveniencia, estuvo compuesta por 348 progenitores, divorciados/as-separados/as provenientes de 4 ciudades de Chile. Los análisis dan cuenta de la idoneidad de un instrumento de 18 ítems y un análisis factorial confirmatorio apoya la estructura de 4 factores correlacionados, al igual que la versión desarrollada en España. Los coeficientes de consistencia interna de los factores, evaluados con el coeficiente Omega, fueron aceptables para las subescalas de dificultades psicológicas, conflictos con la expareja y disposición a la coparentalidad, con valores de 0,92, 0,74 y 0,83 respectivamente; mientras que para consecuencias negativas en los hijos fue 0,65, siendo un valor menos aceptable. Respecto de la evidencia de validez basada en la relación con otras variables, se obtuvieron correlaciones entre el ajuste al divorcio-separación y medidas de salud mental: depresión, ansiedad y estrés (DASS-21), y satisfacción con la vida (SWLS). La escala presenta evidencia de validez para su uso en la población estudiada.

The combined self- and parent-rated SDQ score profile predicts care use and psychiatric diagnoses

The Strengths and Difficulties Questionnaire (SDQ) is widely used, based on evidence of its value for screening. This evidence primarily regards the single informant total difficulties scale and separate difficulties subscales. We assessed to what degree adolescents’ SDQ profiles that combined all self- and parent-rated subscales were associated with use of care and psychiatric diagnoses, and examined the added value thereof over using only a single informant and the total scale. Cluster analysis was used to identify common SDQ profiles based on self- and parent-reports among adolescents aged 12–17 in mental healthcare (n = 4282), social care (n = 124), and the general population (n = 1293). We investigated associations of the profiles with ‘care use’ and ‘DSM-IV diagnoses’, depending on gender. We identified six common SDQ profiles: five profiles with varying types and severities of reported difficulties, pertaining to 95% of adolescents in care, and one without difficulties, pertaining to 55% of adolescents not in care. The types of reported difficulties in the profiles matched DSM-IV diagnoses for 88% of the diagnosed adolescents. The SDQ profiles were found to be more useful for predicting care use and diagnoses than SDQ scores reported by the adolescent as single informant and the total difficulties scale. The latter indicated the presence of problems among 42–63% of the adolescents in care, missing a substantial number of adolescents with reported emotional difficulties and borderline problem severity. These findings advocate the use of combined self- and parent-rated SDQ score profiles for screening.

Esansiyel trombositoz ve polisitemi vera hastalarında depresyon ve anksiyete düzeyleri ile yaşam kalitesi arasındaki ilişki

Aim: This study was conducted to assess the correlation between depression and anxiety and quality of life in ET and PV patients. Methods: The study was conducted in the Hematology Clinic of a training and research hospital in the Aegean region of Turkey between July 2016 and May 2017. A total of 60 patients (30 ET patients, 30 PV patients) were included in the study. Eastern Cooperative Oncology Group (ECOG), Karnofsky scale, EORTC QLQ-C30, and Hospital Anxiety and Depression Scale (HADS) were used to collect the data. The data was analyzed using SPSS 20.0 packaged software. The results were assessed at the confidence interval of 95% and significance level of p<0.05. Results: The age average of ET and PV patients were 60.3±11.2/ years and 58.7±11.7/ years, respectively. ECOG and Karnofsky performance scores were similiar in two group. There was no significant difference between the groups in terms of EORTC QLQ-C30 overall quality of life and HADS-D scores. HADS-A score mean rank was higher in PV patients (p=0.000) (ET: 22.1 in, PV:38.9). Score mean rank of EORTC QLQ-C30 fatigue, dyspnea and financial difficulty subscales (41.5, 38.2, 38.1) in ET patients and score mean rank of EORTC QLQ-C30 cognitive functioning, pain and diarrhea subscales (43.8, 38.9, 41.1) in PV patients were higher (p=0.000). There was a significant correlation between HADS-A and HADS-D scores and EORTC QLQ-C30 overall quality of life score (p<0.01) in ET patients. Conclusions: As depression and anxiety levels of ET and PV patients increased, their quality of life impaired.

Burden and Preparedness amongst Informal Caregivers of Adults with Moderate to Severe Traumatic Brain Injury.

This study examined the patterns of informal (unpaid) caregiving provided to people after moderate to severe traumatic brain injury (TBI), explore the self-reported burden and preparedness for the caregiving role, and identify factors predictive of caregiver burden and preparedness. A cross-sectional cohort design was used. Informal caregivers completed the Demand and Difficulty subscales of the Caregiving Burden Scale; and the Mutuality, Preparedness, and Global Strain subscales of the Family Care Inventory. Chi-square tests and logistic regression were used to examine the relationships between caregiver and care recipient variables and preparedness for caregiving. Twenty-nine informal caregivers who reported data on themselves and people with a moderate to severe TBI were recruited (referred to as a dyad). Most caregivers were female (n = 21, 72%), lived with the care recipient (n = 20, 69%), and reported high levels of burden on both scales. While most caregivers (n = 21, 72%) felt “pretty well” or “very well” prepared for caregiving, they were least prepared to get help or information from the health system, and to deal with the stress of caregiving. No significant relationships or predictors for caregiver burden or preparedness were identified. While caregivers reported the provision of care as both highly difficult and demanding, further research is required to better understand the reasons for the variability in caregiver experience, and ultimately how to best prepare caregivers for this long-term role.

Maternal and childhood urinary phenol concentrations, neonatal thyroid function, and behavioral problems at 10 years of age: The SMBCS study

BackgroundEnvironmental phenols, bisphenol A (BPA), triclosan (TCS), and benzophenone-3 (BP-3), are known as emerging endocrine-disrupting chemicals; however, their impacts on thyroid hormones and children's neurobehaviors are still unclear. ObjectivesWe aimed to examine the associations of prenatal and childhood exposure to phenols with neonatal thyroid function and childhood behavioral problems aged 10 years. MethodsA total of 386 mother-singleton pairs were included from Sheyang Mini Birth Cohort Study (SMBCS), a longitudinal birth cohort in China. We quantified urinary BPA, TCS and BP-3 concentrations in maternal and 10-year-old children's urine samples using gas chromatography tandem mass spectrometry and thyroid function parameters in cord serum samples. Caregivers completed the Strength and Difficulties Questionnaire (SDQ) for their children at 10 years of age. Multivariable linear regression models and logistic regression models were applied to estimate associations of urinary phenol concentrations with thyroid hormones and risks of children's behavioral problems, respectively. ResultsThe median values of urinary BPA, TCS and BP-3 concentrations for pregnant women were 1.75 μg/L, 0.54 μg/L and 0.37 μg/L, while 1.29 μg/L, 6.64 μg/L and 1.39 μg/L for children, respectively. Maternal urinary BPA concentrations were in associations with 1.00% [95% confidence interval (CI): 0.20%, 1.92%] increases in cord serum FT4 concentrations and significantly associated with increased risks of total difficulties [odds ratio (OR): 1.45, 95% CI: 1.07, 1.97], while maternal urinary levels of BP-3 were significantly related to poorer prosocial behaviors (OR: 1.58, 95% CI: 1.04, 2.39) of children at 10 years of age. In sex-stratified analyses, maternal urinary BPA concentrations were related to increased total difficulty subscales only in boys. ConclusionsThe findings indicated that higher prenatal urinary BPA concentrations were associated with increased risks of total difficulties, especially in boys and maternal urinary BP-3 concentrations were related to poorer prosocial behaviors at 10 years.

Predictors of the burden on family carers of patients on haemodialysis in Jordan.

Family caregivers of patients on haemodialysis can experience life changes and depression. This study assessed the self-perceived burden on their family caregivers of haemodialysis patients in Jordan, and the caregivers' perceived burden of caregiving and depression. The predictors of caregiver outcomes were determined. This cross-sectional study included 190 patients on haemodialysis and their caregivers in Jordan. Patients' self-perceived burden on their caregivers was assessed using the self-perceived burden scale. For caregivers, burden was assessed using the Oberst caregiving burden scale and Bakas caregiving outcomes scale - difficulty subscale. Caregivers' depression was assessed using the patient health questionnaire-9. Mean scores and standard deviations (SD) were calculated. Multiple regression analysis was done to determine the predictors of caregiver outcomes. Patients thought that they were a moderate to severe burden on their caregivers (mean score 36.31, SD 3.48). Caregivers perceived themselves as moderately burdened, and thought that their lives had changed for the worse because of caregiving (mean score 2.82, SD = 0.98). Caregivers were moderately depressed (mean score 1.80, SD 0.42). Multiple regression analysis showed that the perceived difficulty of caregiving tasks and patients' self-perceived burden predicted the caregiver outcomes. The difficulty of caregiver tasks explained 38% of the overall variance in the caregiver outcomes. Patient's self-perceived burden on their caregivers explained 16.4% of the variance. Factors that affect the burden on caregivers of dialysis patients should be identified and interventions considered to support caregivers and reduce this burden.

Geriatrik Bireylerin Aktivite-Rol Katılımlarının Yaşam Kalitesi Üzerine Etkisi

Amaç:Bu çalışmanın amacı, geriatrik bireylerin aktivite-rol katılımlarının yaşam kalitesi üzerine etkisini incelemektir. Gereç ve Yöntem:Çalışmaya Ankara Üniversitesi İbni Sina Hastanesi Geriatri Bölümünde yatan, 65 yaş ve üzerinde olan bireyler dahil edildi. Tüm bireylere sosyodemografik form, İnsan Aktivite Rol Tarama Aracı olan MOHOST ve Yaşam Kalitesi Kısa Form-36 ölçeği uyguladık. Bulgular:Çalışmamıza 40’ı kadın (yaş ort:76,75±7,41 yıl ), 30’u erkek (yaş ort:78,33±7,07 yıl ) olmak üzere 70 birey dahil edildi. Bireylerin İnsan-aktivite-rol anketinden aldıkları genel toplam puan ortalaması 60,24±13,25 olarak tespit edildi.Yaşlı bireylerin aktivite-rol için motivasyonları “engelli’’, aktivite-rol paterni, süreç becerileri, motor becerileri ve çevre parametresinde “destekli katılım”, iletişim etkileşim becerilerinde ise “sağlar” düzeyde olduğu tespit edildi. Kısa Form-36 özet puanlarından, fiziksel fonksiyon puan ortalaması 45,93 ± 29,13 ve ruhsal sağlık bileşenleri puan ortalaması 54,31 ± 26,22 idi. Alt ölçeklerde en düşük puan ortalaması 9,64 ± 25,99 ile fiziksel rol güçlüğü alt ölçeğinde, en yüksek puan ortalaması ise 54,31 ± 26,22 ile ruhsal sağlık alt ölçeğinde tespit edildi. MOHOST toplam puan ortalaması ile Yaşam Kalitesi (Kısa Form-36) ölçeğinin alt grupları arasında istatistiksel olarak iyi düzeyde pozitif ilişki bulundu (r=0.515 p&amp;lt;0.00). Sonuç:Elde ettiğimiz sonuçlar yaşlı bireylerin aktivite-rol katılımlarının yeterli düzeyde olmadığını göstermektedir.Yaşlı bireylerin aktivite-rol katılımında desteğe ihtiyaç duyulduğu tespit edildi.Aktivite-rol katılım düzeylerinin yeterli olmamasının, yaşam kalitesini negatif yönde etkilediği belirlendi. Yaşlı bireylerin yaşam kalitelerinin ve bunu etkileyecek tüm parametrelerin incelenmesi bu alandaki ergoterapi müdahalelerine ışık tutacaktır.

The effect of ventilation tube insertion on quality of life in children with persistent otitis media with effusion.

To determine the effect of ventilation tube (VT) surgery on quality of life (QoL) in children with persistent otitis media with effusion (OME). Secondary analysis of trial data (oral steroids versus placebo for persistent OME), comparing QoL by history of VT surgery performed between 5weeks and 12months post-randomisation. Multilevel regression models were used to identify the association between VT surgery and QoL scores at 12months, controlling for pre-exposure risk factors associated with surgery, including pre-surgery hearing level. Ear, nose and throat (ENT), paediatric audiology and audiovestibular medicine (AVM) departments in Wales and England. A total of 327 children aged 2-8years with OME symptoms for at least three months and audiometry-proven bilateral hearing loss with VT surgery status. Otitis Media questionnaire (OM8-30) and Paediatric Quality of Life Inventory (PedsQL) total and subscale scores, and the Health Utilities Index Mark 3 (HUI3) at 12months post-randomisation. Participants who had VT surgery had no significant difference in OM8-30, PedsQL or HUI total scores. OM8-30 hearing difficulty (HD) subscale scores at 12months were better in those who had VT surgery (adjusted mean difference (aMD)=-0.46 (95% confidence interval: -0.69 to -0.23), P<.001), and this varied by when the surgery occurred (aMD for surgery between 5weeks and 6months=-0.4 [-0.67 to -0.13], P=.004 and between 6 and 12months=-0.54, [-0.87 to -0.22], P=.001). Ventilation tube surgery was associated with an improvement in HD-related functional health status but no change in overall QoL.

Responsiveness and Predictive Validity of the Participation Measure–3 Domains, 4 Dimensions in Survivors of Stroke

ObjectivesTo examine the responsiveness and predictive validity of the Participation Measure–3 Domains, 4 Dimensions (PM-3D4D) in people receiving outpatient rehabilitation following stroke. DesignProspective cohort observational study. SettingOutpatient rehabilitation settings. ParticipantsVolunteer patients (N=269) with stroke (mean age ± SD [y], 55.36±12.46; 70.26% male). InterventionsNot applicable. Main Outcome MeasuresThe PM-3D4D was designed to measure 3 domains (Productivity, Social, and Community) and 4 dimensions (Diversity, Frequency, Desire for change, and Difficulty) of participation in individuals with rehabilitation needs. All participants completed the PM-3D4D, the Participation Assessment with Recombined Tools-Objective (PART-O), the Participation Measure for Post-Acute Care (PM-PAC), and the EuroQol-5-Dimension (EQ-5D) at the baseline assessment and again following 3 months of outpatient rehabilitation. ResultsSignificant mean changes in scores were observed for most of the PM-3D4D subscales, with the largest score change observed in the Difficulty subscale (standardized response mean=0.57∼0.88). The minimal detectable change and meaningful clinically important differences were calculated for each subscale. The Frequency and Difficulty dimensions of the PM-3D4D demonstrated significantly greater responsiveness than the PART-O and PM-PAC, respectively. The baseline PM-3D4D scores, except for Desire for change subscales, were significantly correlated with the PART-O, PM-PAC, and EQ-5D scores after 3 months of rehabilitation. ConclusionsThis study provides evidence supporting the responsiveness and predictive validity of the PM-3D4D in survivors of stroke. Among all subscales of the PM-3D4D, the Difficulty dimensional scale demonstrated the greatest responsiveness. The Desire for change dimension of the PM-3D4D showed less responsiveness, and we recommend that it be used as a goal-setting tool rather than an outcome measure. The PM-3D4D can potentially be used to predict participation outcomes and the health-related quality of life following rehabilitation interventions.

A comparative study of cortico-cancellous iliac bone graft with or without the combination of vascularized greater trochanter flap for the management of femoral head osteonecrosis: a minimum 6\u2009years follow-up

BackgroundTo compare the mid-long-term clinical and radiological outcomes between a combination of cortico-cancellous iliac bone graft with vascularized greater trochanter flap (Group A) and isolate iliac bone graft (Group B) in the treatment of Osteonecrosis of the Femoral Head (ONFH).MethodsFrom January 2006 to December 2012, 123 patients (135 hips) who underwent abovementioned hip-preserving surgeries were included for analysis. Clinical outcomes were assessed based on Harris Hip Score (HHS) System and The Western Ontario and McMaster University Index (WOMAC) scores between the preoperative and the last follow-up. A series of postoperative X-rays were compared to preoperative images for radiological evaluation.ResultsThe HHS in Group A and B were enhanced from 50.57 ± 3.39 to 87.60 ± 4.15 and from 50.24 ± 3.30 to 85.18 ± 6.45, respectively, which both showed significance between preoperative and postoperative latest follow-up (p < 0.001). Group A revealed better improvement in terms of HHS (p = 0.017). The WOMAC total, postoperative stiffness, difficulty subscale scores in Group A showed better outcomes when compared to Group B (p < 0.01), while pain improvement between these two groups revealed no significance (p = 0.402). Besides, Group A suggested better necrotic region repair (p = 0.020), but no femoral head collapse difference in terms of Association Research Circulation Osseous classification change was found (p > 0.05).ConclusionsA combination of cortico-cancellous iliac bone graft and concurrent vascularized greater trochanter flap with the lateral femoral circumflex transverse branch has been proved can obtain better functional and radiological results than isolate iliac bone grafting, which is attributed to blood reconstruction of the femoral head.

Depression and risky alcohol use: an examination of the role of difficulties regulating positive emotions in trauma-exposed individuals

ABSTRACTBackground: The co-occurrence of depression and risky alcohol use is clinically relevant given their high rates of comorbidity and reciprocal negative impact on outcomes. Emotion dysregulation is one factor that has been shown to underlie this association. However, literature in this area has been limited in its exclusive focus on emotion dysregulation stemming from negative emotions.Objectives: The goal of the current study was to extend research by exploring the role of difficulties regulating positive emotions in depression symptom severity, risky alcohol use, and their association.Methods: Participants were 395 trauma-exposed adults recruited from Amazon’s Mechanical Turk (MTurk) platform (56.20% female, Mage = 35.55) who completed self-report questionnaires.Results: Zero-order correlations among depression symptom severity, the three subscales of difficulties regulating positive emotions, and risky alcohol use were positive. Two subscales of difficulties regulating positive emotions—nonacceptance of positive emotions and difficulties controlling impulsive behavior when experiencing positive emotions—accounted for the relationship between depression symptom severity and risky alcohol use.Conclusion: Results suggest the importance of incorporating techniques focused on improving positive emotion regulation skills in interventions for risky alcohol use among individuals with depression.

The Effectiveness of Cognitive-Behavioral Education on Students' Communication Problems and Perfectionism

In the present study, the effectiveness of cognitive-behavioral education on the communication difficulties and perfectionism of students was studied. The research design was pre-test and post-test method with control group. The statistical population of this study included all students in district 2 of Tehran in the academic year of 2017-2018. The sample size consisted of 30 members of this community, which was first selected by simple random sampling method. And divided into two groups of 15 patients. The questionnaire of perfectionism and multidimensional perfectionism were used to measure the communication difficulties of the questionnaire and perfectionism. After selecting the test group and the test, experimental intervention (cognitive-behavioral training) was performed on the experimental group for 8 sessions of 90 minutes and one session per week, and after completing the training program from each of the two post-test groups action, it came to analyze the collected data, in addition to descriptive statistics, one-way covariance analysis was used. Results showed that cognitive-behavioral education improves the subscales of communication difficulties, explicitly and publicly, In terms of others, aggression, support and participation, and perfectionism, and under the subcategory of democratship (concern about mistakes-individual measures-parents expectations-doubts about things), the test group has been compared with the group. But under the scales (openness-dependence) and (parental critique-the tendency to order and organization) was not affected. The conclusion is that cognitive-behavioral learning can improve the interpersonal difficulties and perfectionism of students. Keyword : Cognitive-Behavioral Education, Communication Problems-Perfectionism. DOI : 10.7176/RHSS/9-3-10

&lt;p&gt;Clinical factors influencing resilience in patients with anorexia nervosa&lt;/p&gt;

PurposeThis study was to elucidate clinical factors influencing resilience in anorexia nervosa (AN) patients.Patients and methodsTwenty female patients with AN (median age =30.0 years, quartile deviation =6.8) and 40 female healthy controls (HCs) (median age =30.0 years, quartile deviation =8.6) participated in the present study. Resilience was assessed with the Connor– Davidson resilience scale (CD-RISC). Clinical symptoms were evaluated with the structured interview guide for the Hamilton depression rating scale (SIGH-D) and the eating disorder inventory-2 (EDI-2).ResultsScores of the CD-RISC in the AN group were lower than those in the HC group, and the SIGH-D score in the AN group was higher than that in the HC group. Scores of interoceptive confusion, interpersonal difficulty and negative self-image subscales of the EDI-2 negatively correlated with the CD-RISC score. Moreover, stepwise regression analysis showed that negative self-image score was an independent predictor of the CD-RISC score.ConclusionThese results suggest that among these clinical factors including psychopathologies, self-dissatisfaction and feeling of being rejected by others are the most important influencing factors on an AN patients’ resilience.

Vision-related quality of life in children with treated retinopathy of prematurity.

Purpose:To evaluate vision-related quality of life in children treated for retinopathy of prematurity.Methods:Cross sectional observational study of 54 treated ROP babies 2–7 years of age. The study excluded babies with chronic pediatric conditions and babies of parents suffering from mental illness. Detailed examination including visual acuity was done for all. Two versions of CVFQ questionnaire for children under 3 and above 3 years of age were posed to parents in this study. CVFQ contains six subscales: General health, vision health, competence, personality, family impact, and treatment difficulty. The scores ranged from 0 (worst score) to 1 (best score).Results:The study included 54 children with mean birth weight was 1194 grams, mean gestation age 30 weeks. The age, gender, birth weight, and gestational age didn’t affect the overall quality of life (P > 0.05). The severity of ROP (stage 4 and 5) had poorer CVFQ scores (personality and family impact subscales). Competence and personality scores were significantly lower in zone I disease. The quality of life especially general vision, competence, personality, and treatment difficulty subscales had significantly lower values in ROP with higher clock hour involvement (P < 0.05). With myopia after ROP treatment, only personality subscale was significantly affected (P 0.02). Mean CVFQ score including the family impact and treatment difficulty subscale score was also significantly lower in amblyopic and anisometropic children (P value < 0.05). Family impact subscale and overall quality of life was significantly lower in children with strabismus than children without strabismus (P 0.001).Conclusion:ROP has negative effect on the vision-related quality of life of children and their parents. The overall quality of life worsened with the increase in the severity of disease and the occurrence of ocular sequelae of ROP. The vision of the baby may not be the only cause of low scores in the quality of life questionnaire in ROP.

Automated analysis of gait and modified timed up and go using the Microsoft Kinect in people with Parkinson's disease: associations with physical outcome measures.

Instrumenting physical assessments in people with Parkinson's disease can provide valuable and sensitive information. This study aimed to investigate whether variables derived from a Kinect-based system can provide incremental value over standard habitual gait speed (HGS) and timed up and go (TUG) variables by evaluating associations with (1) motor and (2) postural instability and gait difficulty (PIGD) subscales of the Unified Parkinson's Disease Rating Scale (UPDRS). Sixty-two individuals with Parkinson's disease (age 66 ± 7years; 74% male) undertook an instrumented HGS and modified TUG tests, in addition to the UPDRS. Multivariable regression models were used to evaluate the associations of the Kinect measures with UPDRS motor and PIGD scores. First step length during the TUG and average step length and vertical pelvic displacement during the HGS were significantly associated with the PIGD subscale (P < 0.05). The only Kinect-derived variable showing additive benefits over the standard measures for the PIGD association was HGS vertical pelvic displacement. The only standard or Kinect-derived variable significantly associated with the motor subscale was first step length during the TUG (P < 0.01). This study provides preliminary evidence to support the use of a low-cost, non-invasive method of instrumenting gait and TUG tests in people with Parkinson's disease. Graphical abstract ᅟ.

Adjustment difficulties of siblings of children with disabilities and typically developing children

ABSTRACTThe aim of the present study was to compare the adjustment difficulties of siblings of children with autism spectrum disorder, intellectual disability, and typically developing children. The statistical population of the present study included all siblings of children with autism spectrum disorder, intellectual disability, and typically developing children in Shiraz, Iran. The sample consisted of 141 siblings (49 siblings of children with autism spectrum disorder, 42 siblings of children with intellectual disability, and 50 siblings of typically developing children). The Strengths and Difficulties Questionnaire (SDQ) [Goodman, 1997. ‘The strengths and difficulties questionnaire.’ Journal of Child Psychology and Psychiatry 40: 791–799.] was used for measuring the adjustment difficulties. Analysis of variance (ANOVA) and multivariate analysis of variance (MANOVA) tests were used for data analysis. The results showed that adjustment difficulties and three subscales of adjustment difficulties (emotional symptoms, hyperactivity, and peer relationships) of siblings of children with autism spectrum disorder and intellectual disability were significantly higher than those of siblings of typically developing children. Furthermore, no significant difference was found between the study groups in terms of conduct problems. Therefore, it is essential to design and implement preventive and interventional programmes to improve the adjustment difficulties of siblings of children with disabilities.

Development and Evaluation of the Boston University Osteoarthritis Functional Pain Short Form (BU-OA-FPS).

Pragmatic studies have gained popularity, thus emphasizing the need for patient-reported outcomes (PRO) to be integrated into electronic health records. This study describes the development of a customized short form from the Boston University Osteoarthritis Functional Assessment PRO (BU-OA-PRO) for a specific pragmatic clinical trial. A Functional Pain Short Form was created from an existing item bank of deidentified data in the BU-OA-PRO. Item response theory (IRT) methods were used to select items. Reliability was measured with the Cronbach alpha, then with IRT simulation methods. To examine validity, ceiling and floor effects, correlations between the short-form scores and scores from the BU-OA-PRO and the Western Ontario McMasters University Osteoarthritis Index (WOMAC) Pain and Difficulty subscales, and the area under the curve (AUC) were calculated. A minimum detectable change at 90% confidence (MDC90) was calculated based on a calibration sample. The BU-OA-PRO was reduced from 126 items to 10 items to create the BU-OA Functional Pain Short Form (BU-OA-FPS). The Cronbach alpha indicated high internal consistency (0.91), and reliability distribution estimates were 0.96 (uniform) and 0.92 (normal). Low ceiling effects (4.57%) and floor effects (0%) were found. Moderate-to-high correlations between the BU-OA-PRO and BU-OA-FPS were found with WOMAC Pain (BU-OA-FPS = 0.67; BU-OA-PRO = 0.64) and Difficulty (BU-OA-FPS = 0.73; BU-OA-PRO = 0.69) subscales. The correlation between the BU-OA-PRO and BU-OA-FPS was 0.94. The AUC ranged from 0.80 to 0.88. The MDC90 was approximately 6 standardized points. The BU-OA-FPS provides reliable and valid measurement of functional pain. Pragmatic studies may consider the BU-OA-FPS for use in electronic health records to capture outcomes.