Disability Days Research Articles

Relationships between personality factors and DC/TMD Axis II scores of psychosocial impairment among patients with pain related temporomandibular disorders

This cross-sectional analytical study aimed to assess the relationship between personality factors and the DC/TMD Axis II scores of psychosocial impairment among patients with pain related temporomandibular disorders (TMD). 120 participants (60 females and 60 males) who were diagnosed with pain related TMD according to the Axis I DC/TMD protocol were recruited. The participants were requested to complete four tests including the NEO Five Factor Inventory (NEO-FFI) to assess personality factors and three Axis II DC/TMD tools; the Graded Chronic Pain Scale (GCPS) Version 2.0 to assess TMD pain intensity and pain-related disability, Patient Health Questionnaire-4 (PHQ-4) to assess psychological distress due to TMD pain, and Generalized Anxiety Disorder-7 (GAD-7) to assess patients’ stress reactivity. Results showed that 49.2% of the participants experienced high intensity of characteristic pain, 14.2% reported pain related disability more than 30 days (grade 3 disability days) and had disability scores of 70 or above (grade 3 disability scores), 16.7% demonstrated severe distress, and 18.3% reported severe anxiety due to TMD pain. Females scored higher on all these variables than males (P < .05). Multiple regression analyses indicated that higher extraversion scores, higher agreeableness scores and being a female were associated with higher intensity of characteristic pain (p < .05). Also, higher neuroticism and agreeableness scores were associated with more disability days (p < .05). In addition, higher agreeableness scores were associated with higher disability scores and disability point values (p < .05). Furthermore, lower neuroticism scores and being a female were associated with higher PHQ total scores, while being a female and having a lower level of education were associated with higher GAD total scores (p < .05). In conclusion, personality profiles and gender significantly impact the DC/TMD Axis II scores of psychosocial impairment among patients with pain related TMD.

Antihypertensive Medication Adherence and Medical Costs, Health Care Use, and Labor Productivity Among People With Hypertension.

Hypertension affects nearly half of US adults yet remains inadequately controlled in over three-quarters of these cases. This study aimed to assess the association between adherence to antihypertensive medications and total medical costs, health care use, and productivity-related outcomes. We conducted cross-sectional analyses using MarketScan databases, which included individuals aged 18 to 64 years with noncapitated health insurance plans in 2019. Adherence was defined as ≥80% medication possession ratio for prescribed antihypertensive medications. We used a generalized linear model to estimate total medical costs, a negative binomial model to estimate health care use (emergency department visits and inpatient admissions), an exponential hurdle model to estimate productivity-related outcomes (number of sick absences, short-term disability, long-term disability), and a 2-part model to estimate productivity-related costs in 2019 US dollars. All models were adjusted for age, sex, urbanicity, census region, and comorbidities. We reported average marginal effects for outcomes related to antihypertensive medication adherence. Among 379 503 individuals with hypertension in 2019, 54.4% adhered to antihypertensives. Per person, antihypertensive medication adherence was associated with $1441 lower total medical costs, $11 lower sick absence costs, $291 lower short-term disability costs, and $69 lower long-term disability costs. Per 1000 individuals, medication adherence was associated with lower health care use, including 200 fewer emergency department visits and 90 fewer inpatient admissions, and productivity-related outcomes, including 20 fewer sick absence days and 442 fewer short-term disability days. Adherence to antihypertensives was consistently associated with lower total medical costs, reduced health care use, and improved productivity-related outcomes.

Health shocks and households’ welfare in Ghana: does social assistance mitigate the effects?

PurposeHealth shocks are among the factors that have impeded households from experiencing better welfare. To mitigate the consequences of these shocks, individuals have sought to enrol in a formal insurance scheme or borrow from banks. This study estimates the effects of health shocks on households' welfare while examining the mitigating role of social assistance in Ghana.Design/methodology/approachThe study utilized the three-stage least squares and feasible generalized least squares to estimate the impact of health shocks on households' welfare.FindingsThe authors find that health shocks put households at risk, particularly disability and severe illness, which significantly limits individuals’ ability to smooth consumption to increase welfare. We further find that hospitalization due to illness significantly allows households to increase welfare through consumption. Finally, we find that social assistance has the potential to reduce these adverse effects of shocks conditioned on the type of shock and the outcome variable in question.Research limitations/implicationsFirst, we only used cross-sectional data for the two waves and therefore lacked panel data across time for analyses. Second, the data do not provide information on the exact amount of cash received by beneficiaries, so it was quite impossible to measure the exact effect of social assistance on welfare. We could only track whether or not having such assistance could mitigate the effect of a health shock.Practical implicationsThe practical implication of the findings is that Ghana needs to build a resilient health system in order to withstand the health shocks of individuals.Originality/valueNo study has attempted to investigate the differential effect of health shocks – hospitalization, disability and labour days lost due to illness in Ghana. Our choice is dependent on the fact that these shocks have been an issue for many households in Ghana, thus the need to examine their impact on individual well-being. Second, social assistance has been Ghana’s flagship social protection programme, but what is missing in the literature is whether this programme is capable of reducing the effect of health shocks faced by beneficiaries’ households in Ghana.

Preventing Pilonidal Sinus Recurrence With Laser Hair Epilation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Pilonidal sinus disease (PSD) is a common condition associated with significant morbidity and healthcare costs. High recurrence rates still pose a considerable challenge in managing PSD, with no universally accepted guideline inplace to guide management. Laser hair epilation offers a way to reduce recurrence rates with reports within the current literature demonstrating positive outcomes compared to alternative approaches. This review was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement standards. The primary outcome measure was the recurrence rate of PSD at a minimum of one year following laser hair epilation. The electronic databases of MEDLINE, EMBASE, CINAHL, Google Scholar, PubMed, and Cochrane Central Register of Controlled Trials (CENTRAL)were searched. OpenMeta Analyst (Brown University School of Public Health, Providence, RI) software was used for data synthesis. Three randomized controlled trials met the inclusion criteria with laser hair epilation treatments offering a significant reduction in PSD recurrence rateson odds ratio analysis: 0.319 ( 0.160, 0.636), P-value = 0.0001. Secondary outcomes involving patient disability days, caregiver disability days, health-related quality-of-life (HRQOL) scores, healthcare satisfaction scores, and perceived stigma were discussed qualitatively. The authors offer a decisive recommendation in favor of laser hair epilation in PSD; however, they recommend further high-quality trials to investigate the ideal timing and frequency of laser hair epilation sessions.

Auricular Therapy for Migraine.

Migraine brings hours or even days of disability, affecting 15% of the US population and one billion people worldwide. Migraine treatments have improved over the years and there is now a range of non-pharmacologic therapies that can be administered as monotherapy, combined with pharmacologic therapy or combined with other non-pharmacologic therapies to give greater options for those who do not tolerate, do not respond to, or who wish to reduce or avoid pharmacologic treatments. We conducted a review of the literature on auricular therapy as acute or preventive treatment for migraine, searching the databases of MEDLINE and ClinicalTrials.gov from 2013 to 2023. A total of 43 articles contained at least one search term, with three studies specific to acute or prevention of migraine (one for acute only, one for prevention only and one for both acute and prevention). The population was limited to, adults with migraine ages 18 or older, with the administration of auricular therapy as the intervention. While there have been studies on the use of auricular therapy for pain on two specific standardized auricular therapies, Battlefield Acupuncture (BFA) and National Acupuncture Detoxification Association (NADA), neither of these protocols were utilized in any of the studies specific to migraine management. Each of the three studies used different techniques, with one using acupuncture needles and five specific points and two using semi-permanent needles (remained in for a few days) that were placed in areas that showed high activity. Each of these studies showed auricular therapy to have benefit for the management of migraine. However, the authors of each of the studies recommended further studies. Auricular therapy may be a helpful adjunctive treatment to abort a current migraine attack or aid in reducing the frequency or severity of migraine attacks.

Implementation of remote MRI scanning

The present shortage of MRI technologists continues to interfere with the delivery of care of patients. In addition, there have been limited solutions to cover disability, sickness, vacation, and personal days of that limited workforce. Our practice decided that the best way to address these coverage problems was to implement a virtual remote scanning solution. We explain the IT infrastructure, training and policies needed to implement this innovative solution safely and successfully to the MRI technologist shortage.

ОСОБЕННОСТИ ЗАБОЛЕВАЕМОСТИ С ВРЕМЕННОЙ УТРАТОЙ ТРУДОСПОСОБНОСТИ РАБОТНИКОВ, ЗАНЯТЫХ В ПЕРЕРАБОТКЕ КАЛИЙНОЙ РУДЫ

The data on cases and days of temporary disability of employees at the mine of the sylvinite pro-cessing plant were analyzed. An assessment of morbidity rates was carried out and the features of morbidity were identified

Disability day programs for people with intellectual disability: Characteristics and long-term perspectives.

There is limited knowledge regarding people with intellectual disability and their occupations in Sweden. The aim of the study was to examine young adults with intellectual disability who after secondary school participate in disability day programs (daily activity), with a focus on characteristics and longitudinal analyses of movements between occupations. The study used a national register of 26,908 people with intellectual disability, of which 13,128 individuals (48.8%) participated in daily activity. The group had slightly more men than women, many had attended individual programs in school, and significant associations were found between background factors and participating in daily activity. Proportions in daily activity remained stable over time; however, some individuals transitioned to employment or no known occupation. The study presents national and longitudinal understanding, highlighting the dominance of daily activity as an occupation. Further research is needed to increase knowledge on meaningful occupations for people with intellectual disability.

"I'm pulling through because of you": injured workers' perspective of workplace factors supporting return to work under the Saskatchewan Workers' Compensation Board scheme.

Research demonstrates sustained return to work (RTW) by individuals on medical leave is influenced by personal and job resources and job demands. Relatively few studies have been conducted in the workers' compensation context that is known to have longer absence durations for RTW. This study sought to illuminate workers' experience as they returned to work following a work injury that was either psychological in nature or involved more than 50 days of disability, with a focus on the co-worker, supervisor, and employer actions that supported their return. Workers in Saskatchewan, Canada, with a work-related psychological or musculoskeletal injury, subsequent disability, and who returned to work in the last three years, were invited to complete an online survey comprising of free-text questions. Thematic analysis was used to explore participants' experiences. Responses from 93 individuals were analysed. These revealed that persistent pain, emotional distress, and loss of normal abilities were present during and beyond returning to work. Almost two-thirds indicated that the supervisors' and co-workers' support was critical to a sustained return to work: their needs were recognized and they received autonomy and support to manage work demands. By contrast, one-third indicated that the support they expected and needed from supervisors and employers was lacking. Workers returning to work lacked personal resources but co-workers' and supervisors' support helped improve confidence in their ability to RTW. Supervisors and employers should acknowledge workers' experiences and offer support and autonomy. Likewise, workers can expect challenges when returning to work and may benefit from cultivating supportive relationships with co-workers and supervisors.

Cost-effectiveness and cost-utility study of a psychoeducational group intervention for people with depression and physical comorbidity in primary care

ObjectiveTo evaluate the cost-effectiveness and cost-utility of a psychoeducational group intervention led by primary care (PC) nurses in relation to customary care to prevent the depression and improve quality of life in patients with physical comorbidity. DesignEconomic evaluation based on data from randomized, multicenter clinical trial with blind response variables and a one-year follow-up, carried in the context of the PSICODEP study. Location7 PC teams from Catalonia. Participants>50 year-old patients with depression and some physical comorbidity: diabetes mellitus type 2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma. Intervention12 psychoeducational group sessions, 1 per week, led by 2 PC nurses with prior training. MeasurementsEffectiveness: depression-free days (DFD) calculated from the BDI-II and quality-adjusted life years (QALYs) from the Euroqol-5D. Direct costs: PC visits, mental health, emergencies and hospitalizations, drugs. Indirect costs: days of temporary disability (TD). The incremental cost-effectiveness ratios (ICER), cost-effectiveness (ΔCost/ΔDLD) and cost-utility (ΔCost/ΔQALY) were estimated. ResultsThe study includes 380 patients (intervention group [IG] = 204; control group [CG] = 176). 81.6% women; mean age 68.4 (SD = 8.8). The IG had a higher mean cost of visits, less of hospitalizations and less TD than the CG. The difference in costs between the IG and the CG was −357.95€ (95% CI: −2026.96 to 1311.06) at one year of follow-up. There was a mean of 11.95 (95% CI: −15.98 to 39.88) more DFD in the IG than in the CG. QALYs were similar (difference −0.01, 95% CI −0.04 to 0.05). The ICERs were 29.95€/DLD and 35,795€/QALY. ConclusionsPsychoeducational intervention is associated with an improvement in DFD, as well as a reduction in costs at 12 months, although not significantly. QALYs were very similar between groups.

Climacteric status at age 46 is associated with poorer work ability, lower 2-year participation in working life, and a higher 7-year disability retirement rate: a Northern Finland Birth Cohort 1966 study.

To study the association between an advanced climacteric status at 46 years of age and current perceived work ability, the consequent 2-year accumulation of disability and unemployment days, and the 7-year incidence of disability pensions. Study participants (n = 2,661) were recruited from the Northern Finland Birth Cohort 1966 study's 46-year follow-up in 2012. The participants' perceived work ability was investigated using the Work Ability Score (0-7 = poor vs 8-10 = good), along with potential covariates. Data concerning their consequent disability days, unemployment days, and disability pensions were collected from national registers. The association between their climacteric status at age 46 years, work ability, and working life participation was assessed using regression models. The climacteric women were more often smokers and more often had a lower level of education. The odds ratio for poor perceived work ability was 1.41 (95% CI, 1.06-1.87), and the incidence rate ratios for disability and unemployment days during the 2-year follow-up were 1.09 (95% CI, 1.07-1.11) and 1.16 (95% CI, 1.14-1.18), respectively, for the climacteric women compared with the preclimacteric women in models adjusted for smoking and education. The 7-year hazard ratio for disability pensions was 1.72 (95% CI, 1.02-2.91) for the climacteric women. An earlier menopausal transition is associated with poorer perceived work ability, and it predicts lower recorded work participation and a higher disability pension rate in subsequent years.

Work absenteeism, disability, and lost wages among patients with acute myeloid leukemia and their caregivers: a cohort study using US administrative claims and productivity data

ABSTRACT Objective We describe the impact of acute myeloid leukemia (AML) diagnosis on workplace absenteeism and disability days among patients and their caregivers. Methods This retrospective study included adults with newly diagnosed AML (2009–2019) and adult caregivers of patients with newly diagnosed AML, identified from the US Merative™ MarketScan® Commercial Database. The Merative MarketScan Health and Productivity Management Database provided linked patient-level records of workplace absence and short-term (STD) and long-term disability (LTD) data. Endpoints included workplace absence, STD and LTD for patients and caregivers during 12 months pre-AML (baseline) and ≤3 years’ follow-up, and corresponding cost of work loss. Results Patient workplace absence decreased in the months post-AML diagnosis, but the number of STD and LTD leave days claimed increased significantly by sixfold and fourfold, respectively. The proportion of patients making STD leave claims increased within 4–5 months of diagnosis, while the proportion making LTD leave claims increased significantly starting from month 5. Caregiver workplace absence peaked in the first 2 months post-diagnosis and remained elevated versus baseline throughout the study. Conclusion AML diagnosis leads to workplace absenteeism and increased economic burden for patients with AML and their caregivers.

History of World AIDS Day

World AIDS day is observed on December 1 each year. World AIDS Day was first observed in 1988, making it one of the earliest international health days. Its primary purpose has been to raise awareness about HIV/AIDS. In the 1980s, when the HIV/AIDS epidemic emerged, there was widespread fear, stigma, and misinformation about the virus. The first World Health Assembly (WHA) met in 1948 at Geneva. Members of the assembly felt people all over the World suffered in World war. Members discussed global health issues, and felt the need of medical facility for everyone, when they are in need. Hence WHA stressed the importance of awareness of good health and wellbeing. To achieve this awareness about global health, all the members of World Health Organization (WHO), should devote 1 day to talk about good health and wellbeing, and also should provide the necessary medical help. Government organizations and non-governmental organizations of all nations joined hands with WHO. WHO decided to observe “World Health Day (WHD)” every year all over the World. The first WHD was observed on April 7 1950.1 Mahatma Gandhi, father of the Nation deeply sympathized towards the leprosy patients in India. On 30th January 1948, Mahatma Gandhi was assassinated, Government of India decided to observe “Martyrs day 30th January 1948” as “Anti-Leprosy Day in India”. Every year, in India January 30th is observed as anti-leprosy day and entire January month, survey of all villages to detect leprosy cases, school health programme and leprosy awareness programme for common man are conducted. In 1954 French journalist Raoul Follereau saw the success of anti-leprosy awareness activities in India, and he wanted WHA to observe last Sunday of January as World Leprosy Day (WLD)”. Since 1954, every year “Last Sunday of every year is observed as World Leprosy Day”. In 1982, 24th March is observed as “World Tuberculosis Day (WTD)”. Dr. Jonathan Mann made WHA to devote one day in a year to know the increasing menace of HIV/AIDS in 1988. WHA decided to observe 1st December as “World Aids Day (WAD)” since 1988. In 1991, November 14th “World Diabetes Day (WDD)” is observed. In 1992, December 3rd “World Disability Day (WDD)” is observed. In 2007, April 25th “World Malaria Day (WMD)” is observed. Keywords WHA, WHO, WHD, WLD, WAD, WTD

Access to quality care after injury in Northern Malawi: results of a household survey

BackgroundMost injury care research in low-income contexts such as Malawi is facility centric. Community-derived data is needed to better understand actual injury incidence, health system utilisation and barriers to seeking care following injury.MethodsWe administered a household survey to 2200 households in Karonga, Malawi. The primary outcome was injury incidence, with non-fatal injuries classified as major or minor (> 30 or 1–29 disability days respectively). Those seeking medical treatment were asked about time delays to seeking, reaching and receiving care at a facility, where they sought care, and whether they attended a second facility. We performed analysis for associations between injury severity and whether the patient sought care, stayed overnight in a facility, attended a second facility, or received care within 1 or 2 h. The reason for those not seeking care was asked.ResultsMost households (82.7%) completed the survey, with 29.2% reporting an injury. Overall, 611 non-fatal and four fatal injuries were reported from 531 households: an incidence of 6900 per 100,000. Major injuries accounted for 26.6%. Three quarters, 76.1% (465/611), sought medical attention. Almost all, 96.3% (448/465), seeking care attended a primary facility first. Only 29.7% (138/465), attended a second place of care. Only 32.0% (142/444), received care within one hour. A further 19.1% (85/444) received care within 2 h. Major injury was associated with being more likely to have; sought care (94.4% vs 69.8% p < 0.001), stayed overnight at a facility (22.9% vs 15.4% P = 0.047), attended a second place of care (50.3% vs 19.9%, P < 0.001). For those not seeking care the most important reason was the injury not being serious enough for 52.1% (74/142), followed by transport difficulties 13.4% (19/142) and financial costs 5.6% (8/142).ConclusionInjuries in Northern Malawi are substantial. Community-derived details are necessary to fully understand injury burden and barriers to seeking and reaching care.

Work Disability Duration Among Mobile Workers: Does Intraprovincial Mobility Matter as Much as Interprovincial Mobility?

The aim of the study is to compare work disability duration of intraprovincially and interprovincially mobile workers with nonmobile workers in British Columbia, Canada. Workers' compensation claims were extracted for workers injured between 2010 and 2019. Employer and residential postal codes were converted to economic regions to define nonmobile, intraprovincially, and interprovincially mobile workers. Quantile regression models using matched cohorts were used to estimate differences in work disability days at different percentiles of the distribution. Compared with nonmobile workers, both mobile worker groups had longer work disability durations, particularly interprovincially mobile workers. Differences persisted in injury-stratified models and were partially or fully attenuated in some industry-stratified models. Workers' compensation systems, employers, and healthcare providers may need to tailor specific interventions for mobile workers who are from out-of-province as well as traveling between regions in the province.

Importance of World AIDS Day

HIVAIDS is not just a pandemic disease but a prosodemic disease. HIVAIDS had rapidly spread reaching every village of the world neither wind nor water has a role in spreading the disease. The first World Health Assembly WHA met in 1948 at Geneva. Members of the assembly agreed that people all over the world suffered due to World War. Members discussed global health issues and felt the need for medical facility to serve everyone when in need. Hence WHA stressed the importance of awareness of good health and wellbeing. To achieve this awareness about global health all the members of World Health Organization WHO should devote one day to talk about good health and wellbeing and also should provide necessary medical help. Government organizations and non-governmental organizations of all the nations joined hands with WHO. WHO decided to observe ldquoWorld Health Day WHDrdquo every year all over the world. The first WHD was observed on April 7 1950. Mahatma Gandhi Father of our Nation deeply sympathized towards leprosy patients in India. On 30th January 1948 Mahatma Gandhi was assassinated. Government of India decided to observe ldquoMartyrs day 30th January 1948rdquo as ldquoAnti-Leprosy Day in Indiardquo. Every year in India January 30th is observed as anti-leprosy day and during the entire January month survey of all villages is conducted to detect leprosy cases school health programs and leprosy awareness programs for common man are also conducted. In 1954 French journalist Raoul Follereau noticed the success of anti-leprosy awareness activities in India and wanted WHA to observe last Sunday of January as World Leprosy Day WLD. Since 1954 every year Last Sunday of January is observed as lsquoWorld Leprosy Dayrsquo. In 1982 24th March was observed as ldquoWorld Tuberculosis Day WTDrdquo. Dr. Jonathan Mann in 1988 made WHA to devote one day in a year to remember the increasing menace of HIVAIDS. WHA decided to observe 1st of December as ldquoWorld AIDS Day WADrdquo. In 1991 ldquoWorld Diabetes Day WDDrdquo was observed on November 14th. In 1992 December 3rd was observed as ldquoWorld Disability Day WDDrdquo. In 2007 April 25th was observed as ldquoWorld Malaria Day WMDrdquo.

Clinicoepidemiological Profile of Agricultural Work Related Injuries in Rural Agrarian Community of Nepal: A Cross Sectional Study

Introduction Injuries have a significant proportion in the global burden of diseases and are in increasing trend. Nepal being an agrarian country had frequent reporting of injuries among rural communities whose major occupation is agriculture. So, we had this study with the objective to assess clinico epidemiological profile of agricultural work related injuries in the rural agrarian community of Nepal. Methods A community based cross sectional study was conducted among 362 farmers of rural agrarian communities of Budhiganga Rural Municipality of Nepal from 20 December 2022 to 20 June 2023 after getting ethical clearance from institutional review committee (IRC-PA 254/2022). A specially designed pro forma was used to collect data through convenient sampling techniques. Collected data was entered in Microsoft Excel and analyzed by SPSS version 23. Results The annual prevalence of agricultural work related injury was 48.6%. The most common primary causes were Sickle cut injury 43(24.4%), followed by Oxen/Cow hit injury 33 (18.8%), Traditional Plough cut injury 15 (8.5%), Spade cut injury 15 (8.5%) etc. Injury typically occurs in lower extremities 71 (40.3%). Among them 102 (58%), 82 (46.6%), 28 (15.9%) and 147 (83.5%) had a disability, bedridden, hospitalized and received some sort of treatment. Twenty two (12.5%), 36 (20.5%) and 32 (18.2%) reported stress, self reported decreased vision and self reported hearing loss at the time of injury respectively. Only 9 (5.1%) had used personal protective equipment (PPE) during agricultural work and about 36 (20.5%) had helping hands at the time of injury. Conclusions About half of farmers experienced agricultural work related injury with significant days of disability from daily activities and regular work. Use of personal protective equipment during work is miserable.

Building with Butterflies: The Role of Design and Art in Co-creating New Identities for Services

The workshop will build upon and explore the design approach that was developed through a collaboration between Trindlemoss Day Opportunities for people with learning disabilities and two interns from the Glasgow School of Art (GSA). It will involve the interns and the service delivery team sharing their process and learnings and demonstrating some of the key engagement methods from their work, and encourage reflection on the role of art and design in reshaping services.&#x0D; In North Ayrshire, our learning disability day services underwent a situational change, involving a merging of 2 separate building-based services within a new site. Along with this physical change, we recognised a need for a change in practice and ethos, moving away from a rigid, building based, model of provision, to a much more community oriented/distributed model, integrated with a variety of service and third sector partners. For individuals and staff who had been accessing and working within the services for a long time, this presented a profound shift in thinking and practice. &#x0D; Engaging customers, their families, and staff in an ongoing conversation about this process was critical but we tended to default to traditional methods of doing this. Working with interns from GSA provided an opportunity to take a creative, design led co-creation approach to engage with customers and staff. The brief was to deliver artefacts which captured the journey so far and hopes for the future, in a form shaped by the conversations they had, and thereby create a foundation for change. Recognising the need for flexibility to support engagement with customers with a wide range of abilities and communication preferences, the interns developed a variety of approaches including gamifying conversations through the use of physical board games. These are approaches which are best experienced, rather than described.&#x0D; The work led to a variety of outputs, including a visual identity for the centre to be used in branding; on-site art installations which reflected themes of growth and empowerment; and value and vision statements which underpin all aspects of the work, and which will be core to the identity of the service going forward.&#x0D; As a hands-on exploration of design-led approaches to co-creation, the workshop will have relevance for anyone seeking to engage service users from marginalised (and other) communities in ways that amplify their voice in an authentic and joyful manner. The theme of integration will be central to the workshop: pursuing integration with new collaborators; integrating customers and staff in shared conversations; integrating notions of external community identity, reversing the frequently inward facing service discussions; and integrating the personal and collective resources of individuals within creative activity.&#x0D; Workshop structure:&#x0D; Presentation: Introduction to Trindlemoss Day Opportunities: our change journey – 5 minutes&#x0D; Presentation: The work of the GSA interns: new perspectives, new tools – 15 minutes&#x0D; Activity: Using design based tools – small group activity for workshop participants – 20/30 minutes&#x0D; Open discussion: Design based thinking and practice as a lever for equity and integration – 15 minutes&#x0D; Summary and close – 5 minutes&#x0D;

Performance of the Physical Functioning Activities of Daily Living Scale in the 2020 Medicare Health Outcomes Survey

ObjectiveAssessing functional limitations for adults at high risk of frailty yields valuable information for identifying those in need of therapy. We evaluate a self-report measure used to assess physical function among Medicare recipients in the United States. DesignSecondary analysis of the 2020 Medicare Health Outcomes Survey. SettingA random sample of adult enrollees of 510 managed care plans. Participants287,476 adults (37% completion rate): 58% women; 16% were <65 years old (entitled via disability), 50% 65-74, and 34% 75 or older; 77% White, 14% Black, and 8% another race; 19% had <high school education. InterventionsNot applicable. Main Outcome MeasureWe evaluate item distributions, dimensionality, monotonicity of response options, reliability, and validity of the 8-item Physical Functioning Activities of Daily Living (PFADL) scale. ResultsMost reported they could do 6 basic activities of daily living without difficulty. More limitations were reported for the other 2 PFADL items: 32% were not limited at all in climbing several flights of stairs and 40% in moderate activities. Product-moment correlations among the 8 items ranged from r=0.19 between the easiest-to-do (eating) and most difficult-to-do (climbing several flights of stairs) items to r=0.73 between bathing and dressing. The coefficient alpha and omega for the 8-item scale were both 0.86. Item slopes ranged from 2.6 (climbing several flights of stairs and eating) to 4.8 (dressing). Item characteristic curves revealed that response options were most likely to be selected in the appropriate order along the physical functioning continuum. The PFADL had at least 0.80 reliability between about -3 SDs below the mean to the mean. It was negatively correlated with comorbid condition count, disability days, problems with balance or walking, falling, and obesity. ConclusionsThe PFADL is useful for assessing average or below physical function in Medicare recipients.

The risk and development of work disability among individuals with gambling disorder: a longitudinal case-cohort study in Sweden.

This longitudinal register study aimed to investigate the association between gambling disorder (GD) and work disability and to map work disability in subgroups of individuals with GD, three years before and three years after diagnosis. We included individuals aged 19-62 with GD between 2005 and 2018 (n = 2830; 71.1% men, mean age: 35.1) and a matched comparison cohort (n = 28 300). Work disability was operationalized as the aggregated net days of sickness absence and disability pension. Generalized estimating equation models were used to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the risk of long-term work disability (>90 days of work disability/year). Secondly, we conducted Group-based Trajectory Models on days of work disability. Individuals with GD showed a four-year increased risk of long-term work disability compared to the matched cohort, peaking at the time of diagnosis (AOR = 1.89; CI 1.67-2.13). Four trajectory groups of work disability days were identified: constant low (60.3%, 5.6-11.2 days), low and increasing (11.4%, 11.8-152.5 days), medium-high and decreasing (11.1%, 65.1-110 days), and constant high (17.1%, 264-331 days). Individuals who were females, older, with prior psychiatric diagnosis, and had been dispensed a psychotropic medication, particularly antidepressants, were more likely to be assigned to groups other than the constant low. Individuals with GD have an increased risk of work disability which may add financial and social pressure and is an additional incentive for earlier detection and prevention of GD.