Activity Domains Research Articles

Development of a weighted scoring model for social activities to predict disability incidents among older Japanese adults

BackgroundSocial activities contribute to health improvements in older adults, but methods for evaluating these activities are not yet established. We developed a scoring model for social activity, weighted by specific activities, to assess the association between disability incidence in older adults and social activities. MethodsData were obtained from Japan's National Center for Geriatrics and Gerontology Study of Geriatric Syndromes (NCGG-SGS). Social activity was evaluated across 16 domains. Disability was determined using data extracted from Japan's long-term care insurance system. ResultsData from 4998 older adults were analyzed; among them, 422 (8.4 %) developed a disability within 35 months (Interquartile range: 32-39). The Cox proportional hazards model was used to assess 16 domains of social activity. The results yielded risk factors for disability incidence in six social activity domains: work, travel, hobbies, babysitting, family caregiving, and events. The coefficients for these activities were assigned weights of 3, 3, 2, 1, 1, and 1, respectively. The weighted social activity scoring model significantly improved the ability to predict disability incidence when the number of social activities in which individuals participated was considered (social activity score: area under the curve [AUC] 0.691, 95 % confidence interval [CI] 0.664–0.717; number of social activities: AUC 0.681, 95 % CI 0.654–0.707, P = 0.042). ConclusionsThe composite score derived from the weighted social activity scoring model serves as a valuable tool due to its enhanced predictability, which complements established background factors associated with the incidence of disability in older adults.

The Creative Space Theory as a map to explore the mind

Despite significant transformations in most domains of activities, there might still be some constancies in the creative spaces explored throughout history. This paper introduces the Creative Space Theory (CST), a conceptual framework delineating 10 distinct creative spaces, analogous to creative landscapes. These creative spaces are proposed as navigational terrains for an array of media, tools, activities, and domains. The 10 spaces of the theory are movement, sound, image, sensation, emotion, strategy, story, symbol, network, and system. Notably, these creative spaces transcend specific media, and cover artistic as well as intellectual domains. For example, the sound space would be relevant to music, poetry, filmmaking, and acting among others, whereas the system space may be relevant to engineering, medicine, science, and design among others. The proposed theory holds potential utility in three key areas: (1) nurturing individual’s creative potential, (2) helping creators adapt to continuously changing circumstances, and (3) fostering positive creative self-beliefs in overlooked domains of creation. The current paper is a theoretical elaboration. We describe the creative spaces and discuss the implications of the theory towards individuals, educational practices, and research within the fields of cognition and Artificial Intelligence.

Bone Deformities through the Prism of the International Classification of Functioning, Disability and Health in Ambulant Children with Cerebral Palsy: A Systematic Review.

(1) Aim: The aim of this study was to determine the relationship between lower limb bone deformities and body functions, activity, and participation in ambulant children with CP and whether changing bone morphology affects outcomes in these domains. (2) Methods: A systematic literature search (PROSPERO CRD42020208416) of studies reporting correlations between measures of lower limb bone deformities and measures of body function, activity or participation, or post-surgical outcomes in these domains was conducted from 1990 to 2023 in Medline, Scopus, and Cochrane Library. We assessed study quality with the Checklist for Case Series (CCS) and a quality assessment developed by Quebec University Hospital. Meta-analysis was not possible; therefore, descriptive synthesis was performed. (3) Results: A total of 12 of 3373 screened articles were included. No studies evaluated the relationships between bone deformities and activity or participation, or the effect of isolated bone surgery on these domains. Correlations between bone deformities and body functions were poor-to-moderate. Internal hip rotation during gait improved after femoral derotation osteotomy. (4) Conclusions: A shift in paradigm is urgently required for the research and management of bone deformities in children with CP to include the activity and participation domains of the ICF, as well as consider more psychological aspects such as self-image.

Exploring the Association Between Physical Activity and Cognitive Function Among People Living with Dementia.

Physical activity preserves cognitive function in people without dementia, but the relationship between physical activity and cognitive domains among people living with dementia is unclear. The objective of this study was to explore the association between physical activity and cognition domains among people living with dementia. Participants living with dementia in residential care facilities (complete case analysis: n = 24/42) completed a battery of cognitive tests (global cognition: Montreal Cognitive Assessment; executive function: Trail-Making Test, Digit Span Forward Test; perception and orientation: Benton Judgement of Line Orientation Test; language: Boston Naming Test; learning and memory: Rey Auditory Verbal Learning Test; complex attention: Digit Symbol Substitution Test). Participants wore an actigraphy monitor on their non-dominant wrist over seven days. We conducted a linear regression for total physical activity (independent variable) with race (white/black), fall risk (Morse Fall Scale), and the number of comorbidities (Functional Comorbidities Index) as covariates, and cognitive tests as variables of interest. Participants were primarily male (75%), white (87.5%), and 50%had unspecified dementia (Alzheimer's disease: 33%). Greater physical activity was associated with poorer global cognition, better executive function, and better learning and memory (ps < 0.05). Physical activity was not related to visuospatial perception, language, or complex attention. Physical activity may preserve executive function and learning and memory among people living with dementia. Wandering is more common in later stages of dementia, which may explain greater physical activity observed with lower global cognition. Regularly assessing physical activity may be useful in screening and monitoring cognitive changes.

Changes in physical activity and sedentary behavior during the first COVID-19 pandemic- restrictions in Germany: a nationwide survey

BackgroundThe COVID-19 pandemic restrictions posed challenges to maintaining healthy lifestyles and physical well-being. During the first mobility restrictions from March to mid-July 2020, the German population was advised to stay home, except for work, exercise, and essential shopping. Our objective was to comprehensively assess the impact of these restrictions on changes in physical activity and sedentary behavior to identify the most affected groups.MethodsBetween April 30, 2020, and May 12, 2020, we distributed a COVID-19-specific questionnaire to participants of the German National Cohort (NAKO). This questionnaire gathered information about participants’ physical activity and sedentary behavior currently compared to the time before the restrictions. We integrated this new data with existing information on anxiety, depressive symptoms, and physical activity. The analyses focused on sociodemographic factors, social relationships, physical health, and working conditions.ResultsOut of 152,421 respondents, a significant proportion reported altered physical activity and sedentary behavioral patterns due to COVID-19 restrictions. Over a third of the participants initially meeting the WHO’s physical activity recommendation could no longer meet the guidelines during the restrictions. Participants reported substantial declines in sports activities (mean change (M) = -0.38; 95% CI: -.390; -.378; range from -2 to + 2) and reduced active transportation (M = -0.12; 95% CI: -.126; -.117). However, they also increased recreational physical activities (M = 0.12; 95% CI: .117; .126) while engaging in more sedentary behavior (M = 0.24; 95% CI: .240; .247) compared to pre-restriction levels. Multivariable linear and log-binomial regression models indicated that younger adults were more affected by the restrictions than older adults. The shift to remote work, self-rated health, and depressive symptoms were the factors most strongly associated with changes in all physical activity domains, including sedentary behavior, and the likelihood to continue following the physical activity guidelines.ConclusionsMobility patterns shifted towards inactivity or low-intensity activities during the nationwide restrictions in the spring of 2020, potentially leading to considerable and lasting health risks.

The Relationship of Exercise, Psychosocial Factors, and Social Participation Among Adults Aging With Long-Term Physical Disability: A Cross-Sectional Study.

This study investigated the relationships among exercise engagement, psychosocial factors, and social participation for adults aging with physical disabilities (AAwPD). A cross-sectional study within a community-based cohort study of participation among AAwPD was conducted. A comprehensive survey was administered online or via telephone. Participants were 474 individuals between the ages of 45-65, primarily living in the Midwestern United States, who reported living with a physical disability for at least 5years. Survey questions created based on prior consolidation of activity domains assessed exercise engagement. Psychosocial health and social participation were measured using the Patient Reported Outcomes Measurement Information System. Chi-square tests, t-tests, and a general linear model were used to examine differences between exercisers and non-exercisers. Participants who exercised reported less pain (P < .001), fatigue (P < .001), and depression (P < .001) and greater self-efficacy for management of chronic conditions (P = .002), satisfaction with participation in social roles and activities (P < .001), and ability to participate in social roles and activities (P < .001) compared with non-exercising participants. AAwPD who exercised reported fewer secondary conditions and greater social participation. Although causal relationships cannot be drawn, and the frequency, duration, and intensity of exercise were not examined, this study lays important groundwork for future research to determine the health and participation benefits of exercise for AAwPD. Future studies should also focus on the development of exercise interventions to support successful aging with disability.

Exploring basic psychological needs within and across domains of physical activity

ABSTRACT Purpose This study explored variations in adults’ experience of satisfaction, unfulfilment and frustration of basic psychological needs within and across four domains of physical activity: Transport, household, occupation, and recreation. Methods We utilized a qualitative approach, conducting semi-structured interviews with a diverse group of 42 Danish adults. The participants ranged in age from 16 to 79 years (mean age 49 years, SD 21 years), gender (45% men, 55% women), and physical activity levels (38% low, 33% average, 29% high). Data were analysed using a thematic analysis, applying Self-Determination Theory as the guiding framework. Results In the Transport domain, while most activities were seen as utilitarian necessities, autonomy satisfaction emerged for some through control over their means of transport. In Household domain, tasks were generally viewed as obligatory; however, activities with personal significance led to autonomy satisfaction and skill development. Occupation-wise, physical activity satisfaction varied, with the nature of the job impacting feelings of autonomy and competence. For Recreation domain, personal choice dictated autonomy satisfaction, with competence and relatedness varying according to goal achievement and social interactions. Conclusion The variations in the findings across domains indicate the effectiveness of applying strategies tailored to specific domains for enhancing need satisfaction.

Diminished hedonic capacity in social activities as a mediator of the link between dysfunctional behavioral activation system and depressive symptoms.

Adolescence is a crucial period for the development of depression, and previous studies have suggested that the Behavioral Activation System (BAS) plays a significant role. However, little is known about the underlying mechanisms. This study aimed to explore the mediating role of anhedonia in the relationship between BAS and depressive symptoms among Chinese adolescents. A total of 1,023 high-school students aged 15-18 years participated in the study, with 916 continuing their participation three months later. All participants completed the Behavioral Inhibition System/Activation System (BIS/BAS) scale, Dimensional Anhedonia Rating Scale (DARS), Children's Depression Inventory (CDI), and the State-Trait Anxiety Inventory (STAI-S/T). Pathway model analysis was performed to examine the concurrent and prospective mediating effects of anhedonia and the potential moderating effect of sex. Anhedonia in the domains of social activities, hobbies and sensory experiences significantly mediated the cross-sectional relationship between BAS and depressive level three months later. Furthermore, the beta-value of the mediating effect of social activities was significantly higher than that of the other domains of hedonic capacity cross-sectionally and longitudinally. However, sex showed no significant moderating effect. Our findings underscore the importance of hedonic capacity, especially within the social domain, in the development of depressive symptoms. These findings contribute to the early diagnosis and prevention of depressive disorders.

Validation of a Dyspnea Visual Analogue Scale in Fibrotic Interstitial Lung Disease.

A visual analogue scale (VAS) is a simple and easily administered tool for measuring impact of disease; however, little is known about the use of a Dyspnea VAS in interstitial lung disease (ILD). To validate the use of a Dyspnea VAS in a large and heterogenous cohort of patients with fibrotic ILD, including its minimal clinically important difference (MCID), responsiveness to change, and prognostic significance. Patients with fibrotic ILD were identified from a large prospective registry. Validity of a 100mm Dyspnea VAS was assessed by testing its correlation in change score with other measures of ILD severity, including the University of California San Diego Shortness of Breath Questionnaire (UCSDSOBQ), King's Brief Interstitial Lung Disease quality of life questionnaire Breathlessness and Activities Domain (KBILD-B), European Quality of Life visual analogue scale (EQ-VAS), forced vital capacity (FVC), and diffusion capacity of the lung for carbon monoxide (DLCO). Responsiveness of the Dyspnea VAS was qualitatively confirmed based on there being an observable difference in the change in Dyspnea VAS across tertiles of change in anchor variables. The minimum clinically important difference (MCID) in Dyspnea VAS was calculated using both anchor (linear regression) and distribution (one-half standard deviation) approaches, with anchors including the above variables that had a correlation with Dyspnea VAS (|r|0.30). The association of Dyspnea VAS with time to death or transplant was determined. The cohort included 826 patients with fibrotic ILD, including 127 patients with follow-up measurements at 6 months. Mean baseline Dyspnea VAS was 5324mm. Dyspnea VAS change scores were moderately correlated with UCSDSOBQ (|r|=0.55) and KBILD-B (|r|=0.44), and weakly correlated with EQ-VAS (|r|=0.19), FVC% (|r|=0.21) and DLCO% (|r|=0.05). MCID was 2.7 to 4.5 using the more reliable anchor-based methods and 12.0 based on distribution-based methods. Dyspnea VAS was associated with time to death or transplant in unadjusted models and after adjustment for age and sex (hazard ratio 1.16 and 1.15 respectively, p<0.05 for both). This study provides support for the use of Dyspnea VAS in patients with fibrotic ILD, with an estimated anchor-based MCID of 5mm.

Level of adherence to diet and physical activity among menopausal women and influencing factors in Jordan: a descriptive cross-sectional study.

During menopause, a woman's lifestyle may change significantly, which will have implications on her quality of life. Women will experience menopause for more than a third of their life; therefore, maintaining good health during this period is crucial. A healthy diet and physical activity can help women maintain their health during menopause. Hence, assessing adherence to a healthy diet and physical activity among menopausal women is important. This study aims to assess the degree of adherence to a healthy diet and physical activity of menopausal women in Jordan and determine the most influential factors. A descriptive cross-sectional design was used in this study, and an online self-administered questionnaire was sent to 299 menopausal women selected through simple random sampling. A valid and reliable questionnaire was used to assess the menopausal women's adherence to a healthy diet and physical activity. The questionnaire consisted of 14 items covering two domains: 12 questions for the diet domain and two questions for the physical activity domain. Descriptive statistics were obtained, mean weight and body mass index (BMI) were calculated, and stepwise regression was conducted for the data analysis. The overall degree of adherence to a healthy diet and physical activity of the women was moderate (49.25, SD = 7.17). Most of the participants reported eating refined food items once a month or less (n = 188, 62.9%) and not exercising weekly (n = 119, 39.8%), and only a few reported eating refined food items at least once a day (n = 5, 1.7%) and exercising 5-6 times a week (n = 15, 5%). The regression analysis showed that age (B = 0.145, p = 0.014), having two children (B = 0.123, p = 0.034) and completing primary or secondary education (B = 0.120, p = 0.038) were statistically significant and the strongest predictors of adherence. The predictors accounted for 68% of the variance in adherence to a healthy diet and physical activity (R2 = 0.068, F [343.54] = 7.123, p = 0.000). The majority of the middle-aged menopausal women in this study showed moderate adherence to a healthy diet and physical activity. Age, having two children and completing primary or secondary education were associated with degree of adherence to a healthy diet and physical activity. Therefore, healthcare intervention, such as physical activity and dietary control programs, should target women in this age group and stage in life.

Acceptability of built environment interventions to improve healthy eating and physical activity among city dwellers in Saskatchewan, Canada: THEPA findings from a local context

ABSTRACT Obesity and related chronic conditions present significant challenges in both national and global public health. Modifying the built environment stands as a population-level strategy to foster healthier behaviours and alleviate the burden of chronic diseases. The success of such interventions, however, hinges on their public acceptability, an aspect often overlooked. This study aimed to evaluate the level of public acceptability concerning diverse built environment interventions promoting healthy eating and physical activity within two major Canadian cities. We conducted an analysis of data gathered from 2,133 participants through a pan-Canadian survey, employing multilevel logistic regression. Interventions were categorized using the Nuffield Council on Bioethics’ ‘intervention ladder’, graded by their level of intrusiveness. Overall, individuals were more agreeable to implementing the least intrusive interventions in both food and physical activity domains. However, public support varied based on the type of intervention within and across different levels of intrusiveness. Notably, individuals self-identifying as women, Indigenous, or born outside of Canada demonstrated a higher likelihood of accepting interventions across all levels. The connection between neighborhood attributes and acceptability remained inconclusive. These locally pertinent findings carry practical implications for selecting, designing and implementing built environment interventions.

Factors associated with satisfaction with social roles and activities among people with systemic sclerosis: a Scleroderma Patient-centered Intervention Network (SPIN) cohort cross-sectional study

ObjectiveThe objectives were to (1) compare satisfaction with social roles and activities in a large multinational systemic sclerosis (SSc) cohort to general population normative data and (2) identify sociodemographic, lifestyle...

Functional long-term outcome following endovascular thrombectomy in patients with acute ischemic stroke

Endovascular thrombectomy (EVT) is the most effective treatment for acute ischemic stroke caused by large vessel occlusion (LVO). Yet, long-term outcome (LTO) and health-related quality of life (HRQoL) in these patients have rarely been addressed, as opposed to modified Rankin scale (mRS) recordings. We analysed demographic data, treatment and neuroimaging parameters in 694 consecutive stroke patients in a maximum care hospital. In 138 of these patients with respect on receipt of written informed consent, LTO and HRQoL were collected over a period of 48 months after EVT using a standardised telephone survey (median 2.1 years after EVT). Age < 70 years (OR 4.82), lower NIHSS on admission (OR 1.11), NIHSS ≤ 10 after 24 h (OR 11.23) and complete recanalisation (mTICI3) (OR 7.79) were identified as independent predictors of favourable LTO. Occurrence of an infection requiring treatment within the first 72 h was recognised as a negative predictor for good long-term outcome (OR 0.22). Patients with mRS > 2 according to the telephone survey more often had complaints regarding mobility, self‐care, and usual activity domains of the HRQoL. Our results underline a sustainable positive effect of effective EVT on the quality of life in LVO stroke. Additionally, predictive parameters of outcome were identified, that may support clinical decision making in LVO stroke.

From combat boots to running shoes: The role of military service in shaping masculine identity in Israeli long-distance running groups

This study examines the social construction of masculinity within the Israeli society, focusing on the associations between masculine identity, prior military service, and current involvement in long-distance running. A 2-year ethnographic research design was utilized, involving two running groups, which incorporated participant observation, semi-structured interviews, and running websites. The findings shed light on the significance of military service experience and the utilization of military discourse as strategies employed by runners to navigate the challenges of long-distance running and to reinforce their masculine identity. Through an analysis of the runners’ military discourse and behavior, it becomes evident that the integration of women into traditionally masculine domains of intense physical activity poses a threat to masculine dominance, eliciting various responses from men, such as intensified sports training and the use of sexist and aggressive language. These coping mechanisms contribute to the perpetuation of male dominance within the long-distance running sphere while simultaneously providing male runners with a pseudo-corrective experience associated with their personal history of non-combat military involvement.

Long-term medication for ADHD (LMA) trial: 2-year prospective observational study in children and adolescents. Core symptoms, daily functioning, and comorbidity outcomes

More knowledge is needed about long-term ADHD medication and symptom, daily functioning, comorbidity, and tolerability outcomes. This “Long-term Medication for ADHD (LMA) trial” was a prospective observational 2-year trial in children and adolescents aged 6–18 years (extension of 1-year trial). Participants met criteria for DSM-5 ADHD (inattentive or combined), with complex comorbidities; autism spectrum disorder (31%), autistic traits (24%), oppositional symptoms (59%), anxiety (32%), dyslexia/language disorder (16%), borderline intellectual functioning (17%). Medication was individually tailored and followed-up at clinical visits (1, 2, 3, 6, 12, 18, 24 months). Primary outcome: Clinical Global Impression-Severity and Improvement scales (CGI-S, CGI-I). Secondary outcomes: Investigator-rated ADHD-Rating Scale, Weiss Functional Impairment Rating Scale-Parent report (WFIRS-P; Family, School Learning and Behavior, Life Skills, Self-Concept, Social Activities, and Risky Activities domains), comorbidity symptoms and adverse events (AEs). One hundred twenty-eight participants were enrolled (1-year trial only n = 27, LMA trial n = 101). Of these 29 (23%) discontinued, mainly due to AEs (n = 7), moving (n = 7), or no longer needing medication (n = 6). Main AEs were poor appetite, low mood, anxiety, irritability, fatigue. Improvements from baseline to 2 years were large in CGI-S (effect size (ES) 2.28), ADHD-RS (ES 2.06), and moderate to large in WFIRS-P (ES total 0.73, learning 0.4, family 0.67). Overall, the trial showed robust and sustained improvements in ADHD symptom severity and daily functioning over a period of 2 years of ADHD medication in children and adolescents with ADHD and complex comorbidities. Most AEs were mild. Comorbidity symptoms were improved after 1 year, particularly oppositional symptoms, depression, and anxiety.

Challenges in the adoption of sustainability information systems: A study on green IS in organizations

Economic, social and ecological sustainability presents one of the greatest challenges of our society. As a result, there is growing pressure on a variety of organizations to implement sustainability programs, such as inclusion training related to social sustainability, cost management programs related to economic sustainability, and perhaps most importantly, green (information) systems related to environmental sustainability. Not only is multi-faceted sustainability most beneficial to organizations at large, but also there are several categorical thresholds that organizations must meet in order to be certified. For these reasons, companies are increasingly adopting information systems (IS) for sustainability in their operations. Specifically, programs designed to influence employee motivation, attitudes, beliefs, and behaviors are gaining attention. While there is a long tradition of research on technology adoption, such sustainability systems harbor several new phenomena, both with respect to individual and organizational adoption. Therefore, in this study, we explore the challenges of adopting sustainability systems in organizational contexts. Using activity theory and innovation diffusion theory, and with technology adoption theory as the backdrop of our investigation, we conduct a qualitative field study in four small- and medium- sized companies. Using both theory-guided deductive and inductive interpretation phases, we illuminate adoption challenges through combined intersections of adoption stages (knowledge, persuasion, decision, implementation, and confirmation) and activity domains (subject, instrument, object, community, rules). We then shed light on the severity and importance of these challenges through an expert validation study with green IS experts. In discussing the challenges in light of motivational and green IS design, we posit four dilemmas in green IS adoption that arise from tensions in the specific context of sustainability in organizations. Our findings expand existing knowledge in research on green IS, motivational IS design and sustainable behavior change interventions and yield several theoretical and practical avenues for future inquiry and endeavour.

P619 Sleep disruption is associated with reduced quality of life in inflammatory bowel disease through its interaction with pain

Abstract Background Quality of life is reduced in people with inflammatory bowel disease. Poor sleep is prevalent in people with inflammatory bowel disease. This study aimed to investigate the influence of sleep on quality of life in people with inflammatory bowel disease. Methods An online questionnaire was administered through three tertiary IBD centres, social media and through Crohn’s Colitis Australia. The questionnaire included the EQ-5D-5L measures of health-related quality of including EQ-5D utility score, EQVAS – visual analogue scale from 0-100 of quality of life and domains mobility, selfcare, activities, pain and depression and anxiety. Measures of sleep included the insomnia severity index (ISI), and the Pittsburgh sleep quality index (PSQI). IBD activity was assessed using validated patient reported scores. Demographic data and mental health scores were also obtained. Results Quality of life was lower in people IBD than the general South Australian population (utility score mean (SD) 0.79 (0.15) v 0.91(0.14)). Poor sleep and clinically significant insomnia were associated with lower quality of life (utility score 0.77 (0.15) and 0.71 (0.16) respectively, cohort 0.79 (0.15), p&amp;lt;0.0001). Sleep quality scores moderately correlated with EQ-5D domains pain (Ro=0.35), usual activities (Ro=0.32), and depression-anxiety (Ro=0.37) but not domains self-care or mobility. After adjusting for demographic variables, IBD anxiety, depression, and anxiety the pain domain continued to be influenced by sleep quality, sleep disturbance and sleep duration, and the usual activities domain continued to be influenced by daytime dysfunction (see table 1). Clinically significant insomnia was associated with a reduction of 13.6 (10.42-16.91) (univariate regression) in quality of life measured by EQVAS. Following introduction of demographic and IBD activity the reduction in EQVAS for clinically significant insomnia remained significant (10.11 (6.96-13.27)). Health related quality of life scores (EQVAS) were significantly worse in those with clinically significant insomnia and active IBD than with active IBD alone (see Figure 1). Conclusion Health related quality of life in IBD is influenced by aspects of sleep quality irrespective of IBD activity and mental health conditions. The presence of insomnia is associated with a significant decline health related quality of life. Consideration should be given to sleep targeting interventional studies in an IBD population.

Concurrent validity study of QuickDASH with respect to DASH in patients with traumatic upper extremity amputation

BackgroundThe Disability of the Arm, Shoulder and Hand Outcome Measure (DASH) is a validated patient-reported outcome measure (PROM) for many upper extremity musculoskeletal disorders. In patients with severe traumatic conditions, limited evidence exists regarding the equivalence between DASH and its shortened version, QuickDASH, which is more feasible in clinical practice. The rationale of this study was to analyze the concurrent validity of QuickDASH with respect to DASH in patients with traumatic upper extremity amputation.MethodsThis study is based on a consecutive cohort of traumatic upper extremity amputation patients treated with replantation or revision (completion) amputation at Tampere University Hospital between 2009 and 2019. We estimated the concurrent validity of QuickDASH with respect to DASH by correlation coefficients, mean score differences, Bland–Altman plots, and distribution density. Additionally, we assessed internal reliability with Cronbach’s alpha coefficients and item-total correlations.ResultsWe found a very strong linear correlation between DASH and QuickDASH scores (r = 0.97 [CI 95% 0.97–0.98], p < 0.001). The mean difference between DASH and QuickDASH was minor (MD = -1, SD 4 [CI95% from -1 to 0] p = 0.02). The mean sub-score for the activity domain was higher for QuickDASH than DASH (MD = -3 [CI95% from -4 to -3] p < 0.000) and lower for the symptom domain (MD = 7 [CI95% from 6 to 9] p < 0.000). The Bland and Altman plot showed good agreement between DASH and QuickDASH scores, but there was measurement error in QuickDASH with high scores (r = -0.20, [CI95% from -0.31 to -0.09], p = 0.001).ConclusionQuickDASH demonstrates higher total scores than the full DASH and emphasizes rating of activity over symptoms. Still, on average the differences in total scores are likely less than the MCID of DASH, and consequently, this study shows that QuickDASH can be recommended instead of the full DASH when assessing a traumatic condition.Trial registrationRetrospectively registered.

Sex disparities in physical activity domains and hypertension prevalence

BackgroundThis study aimed to examine the associations of leisure time physical activity (LTPA) and occupational physical activity (OPA) with the prevalence of hypertension, while exploring the sex disparities in these associations.MethodsA cross-sectional study was conducted using data from the Korea National Health and Nutrition Examination Survey between 2014 and 2019 (n = 26,534). Hypertension was defined as the use of antihypertensive drugs or systolic and diastolic blood pressure ≥ 140/90 mm Hg. Self-reported physical activity (PA), assessed by the global PA questionnaire, was categorized into three domains: total PA, LTPA and OPA. Each PA domain was classified based on METs-min/wk and intensity.ResultsIn a multivariable adjusted model, the odds ratio (OR) with 95% confidence intervals (CIs) for the prevalence of hypertension in the active versus inactive group, based on METs, was 0.92 (95% CI 0.85–0.99) for total PA, 0.90 (95% CI 0.83–0.98) for LTPA and 1.21 (95% CI 1.05–1.38) for OPA. Compared to the inactive group, moderate to vigorous intensity was associated with a lower odds of hypertension for total PA and LTPA (total PA: OR 0.95, 95% CI 0.89-1.00 and LTPA: OR 0.92, 95% CI 0.86–0.98), but a higher odd for OPA (OR 1.17, 95% CI 1.05–1.30). Subgroup analyses showed significant evidence of effect modification by sex on the associations of total PA and LTPA (METs and intensity) with hypertension prevalence (p-values for interaction < 0.01); the associations were generally stronger for women. OPA was associated with a higher prevalence of hypertension in women, but not in men (p-value for interaction > 0.05).ConclusionsHigher levels of total PA and LTPA were associated with lower prevalence of hypertension in both men and women, with slightly stronger associations for women. However, higher OPA was associated with a higher prevalence of hypertension in women. These findings support the PA health paradox hypothesis and highlight the sex disparities in the association between OPA and hypertension prevalence.

Unmet Needs and Barriers to Assistive Technology in the Coastal Districts of Karnataka, India.

Assistive Technologies (AT), such as hearing aids, walking aids, prostheses, spectacles, can improve the quality of life and enable many to lead dignified lives. The rapid Assistive Technology Assessment (rATA) tool developed by World Health Organization (WHO) can measure the needs of AT and the barriers to accessing them. This study aimed to measure the unmet needs and the usage of AT via the rATA tool in the coastal state of Karnataka in India. A population-based survey was conducted among a total of 500 households - 250 from Mangalore and 250 from Udupi of Coastal Karnataka. The need for AT was assessed under six domains of activities, including mobility, seeing, hearing, communication, remembering, and self-care. The mean age of study participants was 34.3 years with standard deviation of 21.2 years. 30.6% of the study participants reported the use of assistive products out of which 27.3% used one product and 2% used two products. 89.5% of assistive products were procured from private sector and only 4.1% was obtained from public sector. The level of difficulty in doing any activity increased with age. 301 participants reported out of pocket expenditure for assistive products with mean expenditure of Rs 2226.05 (S. D. 2204) per year. Spectacles, orthoses (spinal) and therapeutic footwear were most common assistive products with unmet need. Our findings highlight the urgent need to mainstream geriatric care policies which address functional difficulties among older people, resolve out-of-pocket spending through public private partnership for assistive technologies.