Emotional Disability Research Articles

Clinical Profile, Trends, and Management in Pediatric Patients with Audiovestibular Disorders: Can We Predict Emotional Disability in Pediatric Patients with Episodes of Vertigo and Dizziness?

Audiovestibular disorders in childhood occur with considerable frequency. However, the difficulty of obtaining medical history, the nonspecificity of symptoms, and the lack of cooperation during complementary tests often contribute significantly to diagnostic biases, attributing clinical presentations to psychosomatic disorders. The objectives of this work are, firstly, to characterize, from an auditory and vestibular perspective, the most frequent causes of vertigo in childhood and a possible relationship with emotional symptoms. On the other hand, to propose the usefulness of the MSSQ-Short questionnaire as a predictive variable in the evolution of children diagnosed with recurrent vertigo of childhood (RVC). An observational cross-sectional study was designed with retrospective data collection at three tertiary hospitals. Among the 117 patients recruited between 2016 and 2024, 32 patients (27.35%) were diagnosed with an anxious-depressive syndrome prior to audiovestibular testing. The mean age was 11.19 ± 5.61 years and the most frequent final diagnoses were vestibular migraine (VM) with 41.03% and RVC with 23.93%. Patients with VM, compared with RVC, are approximately 1.12 times more likely to have psychosomatic pathology (CI 0.39 to 3.25). The most sensitive and frequently altered test was VEMPS (39.32%), with statistical significance in VM and otic capsule dehiscence, while regarding the MSSQ-Short questionnaire, the linear regression of 0.28 indicates an increase in clinical duration with high questionnaire scores. Vestibular disorders causing dizziness and vertigo are challenging to diagnose, often due to lack of cooperation and/or symptom nonspecificity. A thorough medical history and complementary tests, including audiovestibular and imaging studies, are advisable, thus avoiding systematically attributing children's complaints to other psychosomatic disorders.

Neuromodulation Treatments Targeting Pathological Synchrony for Tinnitus in Adults: A Systematic Review.

(1) Background: Tinnitus involves the conscious awareness of a tonal or composite noise for which there is no identifiable corresponding external acoustic source. For many people, tinnitus is a disorder associated with symptoms of emotional distress, cognitive dysfunction, autonomic arousal, behavioural changes, and functional disability. Many symptoms can be addressed effectively using education or cognitive behavioural therapy. However, there is no treatment that effectively reduces or alters tinnitus-related neurophysiological activity and thus the tinnitus percept. In this systematic review, we evaluated the effectiveness of neuromodulation therapies for tinnitus that explicitly target pathological synchronous neural activity. (2) Methods: Multiple databases were searched for randomised controlled trials of neuromodulation interventions for tinnitus in adults, with 24 trials included. The risk of bias was assessed, and where appropriate, meta-analyses were performed. (3) Results: Few trials used acoustic, vagal nerve, or transcranial alternating current stimulation, or bimodal stimulation techniques, with limited evidence of neuromodulation or clinical effectiveness. Multiple trials of transcranial direct current stimulation (tDCS) were identified, and a synthesis demonstrated a significant improvement in tinnitus symptom severity in favour of tDCS versus control, although heterogeneity was high. (4) Discussion: Neuromodulation for tinnitus is an emerging but promising field. Electrical stimulation techniques are particularly interesting, given recent advances in current flow modelling that can be applied to future studies.

Systematic Review of the Psychopathological Symptomatology and Neuropsychological Disorders of Chronic Primary Musculoskeletal Pain.

Chronic pain can develop without tissue damage, injury, or underlying illness. There are several intervening biological, psychological, and social factors involved in its appearance that significantly affect the activities of daily life. It is also associated with significant emotional anxiety and/or functional disability. This review systematically analyses works published in the last five years that evaluate the psychopathological symptomatology and neuropsychological disorders of chronic primary musculoskeletal pain (CPMP). A bibliographic search was carried out to identify articles published in English between January 2018 and March 2023 using the Medline, Scopus, PsycInfo, and Pubmed databases. Twenty articles were obtained using the PRISMA selection method. The main results of this study provided evidence of the presence of moderate and severe chronic pain in patients suffering from musculoskeletal pain. This increase in the intensity of pain correlates with greater psychopathological symptomatology, such as depression, anxiety, insomnia, lack of attention, and hyperactivity/impulsiveness, as well as the use of maladaptive coping strategies. Furthermore, there exists dysfunction in the cerebral structures related to attention and the processing of pain in patients with CPMP. This review may help to develop and optimise the multidisciplinary treatments adapted to the deficits caused by this illness.

Integrated Microfluidic-Transistor Sensing System for Multiplexed Detection of Traumatic Brain Injury Biomarkers.

Traumatic brain injury (TBI) is widely recognized as a global public health crisis, affecting millions of people each year, leading to permanent neurologic, emotional, and occupational disability, and highlighting the urgent need for rapid, sensitive, and early assessment. Here, we design a novel and simple lithography-free method for preparing dual-channel graphene-based field-effect transistors (G-FETs) and integrating them with microfluidic channels for simultaneously multiplexed detection of key blood TBI biomarkers: neurofilament light chain (NFL) and glial fibrillary acidic protein (GFAP). The G-FET utilizes an ingenious dual-channel electrode array design, where the source is shared between channels and the drains are independent of each other, which is the key to achieving simultaneous output of dual detection signals. At the same time, the microfluidic chip realizes microscale fluidic control and fast sample response time. This integrated detection system shows excellent sensitivity in biological fluids for the TBI biomarkers with detection limits as low as 55.63 fg/mL for NFL and 144.45 fg/mL for GFAP in phosphate-buffered saline (PBS) buffer, respectively. Finally, the clinical sample analysis shows promising performance for TBI detection, with an area under the curve (AUC) of 0.98 for the two biomarkers. And the combined dual-protein assay is also a good predictor of intracranial injury findings on computed tomography (CT) scans (AUC = 0.907). The integrated microfluidic G-FET device with a dual-signal output strategy has important potential for application in clinical practice, providing more comprehensive information for brain injury assessment.

Effectiveness of AI-driven Individualized Learning Approach for Children with Autism Spectrum Disorder (ASD)

IntroductionAutism Spectrum Disorder (ASD) is a condition with varying degrees of social, emotional and behavioural disability. These children require focused and individualised learning plan to facilitate social integration. Robots have been used for this purpose but are not routinely available in several parts of the world. Effective, point of care (POC) digital therapies that can be used anywhere by anyone is the need of the day.ObjectivesTo evaluate the effectiveness of Artificial Intelligence (AI) driven individualised learning plans delivered through POC digital platform (CognitiveBotics) for children with ASD.MethodsAfter Ethical approval and parental consent, children diagnosed with ASD (Childhood Autism Rating Scale CARS 2) aged 2 years and above were screened for study inclusion and exclusion criteria and enrolled. AI driven individualised learning plan was administered through CognitiveBotics software that could be used on either computer or a tablet. Initially, interactive questions were administered to parents by the AI tool to understand child’s functioning. Based on these, an individualised learning plan was assigned. Each task is delivered using either interactive videos, chatbot and/or animated/AI games. The child’s progress is captured for attention (attempted questions, retries and timeouts) and retention (first time corrects and corrects) continuously. The initial interactive questions administered to parents were repeated to assess child’s progress in real life. Paired ‘t’ test using SPSS version 26 was used to compare initial and final data.ResultsOut of 85 registered children, 41 regularly used the AI tool. Mean age was 43.93 months (range 26 to 72 months). 37 (90.24%) were boys. The baseline mean scores (ranges), were CARS 33.48 (30-39.5); Social quotient 53.4 (27.25-80.32), Developmental quotient 71.35 (45.90-93.33) and IQ 62.34 (36.58-86.83). The base line mean score of parents assessed child function was 115.24 (range 58 to 215). A mean of 15.54 tasks were given (range 5 to 48). At the time of analysis with a mean follow up of 3 months (range 2 to 5 months) the children completed a mean of 10.10 tasks (range 0 to 42). There was significant improvement in child’s learning captured by the AI software based on attention and retention parameters (p = <0.00001). This improvement was also reflected in parent assessed child function (mean 147.15, (59 to 231)) (p = <0.00001). The percentage of improvement in both software captured and parent assessed child function was directly related to the amount of time spent by the child on the software.ConclusionsAI driven individualised learning approach is effective in teaching skills and promote social integration for children with ASD. Such technology can capture the child’s progress on a day-to-day basis and deliver personalised training.Disclosure of InterestNone Declared

Reduction of Chronic Primary Low Back Pain by Spinal Manipulative Therapy is Accompanied by Decreases in Segmental Mechanical Hyperalgesia and Pain Catastrophizing: A Randomized Placebo-controlled Dual-blind Mixed Experimental Trial

Chronic primary low back pain (CPLBP) refers to low back pain that persists over 3 months, that cannot be explained by another chronic condition, and that is associated with emotional distress and disability. Previous studies have shown that spinal manipulative therapy (SMT) is effective in relieving CPLBP, but the underlying mechanisms remain elusive. This randomized placebo-controlled dual-blind mixed experimental trial (NCT05162924) aimed to investigate the efficacy of SMT to improve CPLBP and its underlying mechanisms. Ninety-eight individuals with CPLBP and 49 controls were recruited. Individuals with CPLBP received SMT (n = 49) or a control intervention (n = 49), 12 times over 4 weeks. The primary outcomes were CPLBP intensity (0–100 on a numerical rating scale) and disability (Oswestry Disability Index). Secondary outcomes included pressure pain thresholds in 4 body regions, pain catastrophizing, Central Sensitization Inventory, depressive symptoms, and anxiety scores. Individuals with CPLBP showed widespread mechanical hyperalgesia (P < .001) and higher scores for all questionnaires (P < .001). SMT reduced pain intensity compared with the control intervention (mean difference: −11.7 [95% confidence interval, −11.0 to −12.5], P = .01), but not disability (P = .5). Similar mild to moderate adverse events were reported in both groups. Mechanical hyperalgesia at the manipulated segment was reduced after SMT compared with the control intervention (P < .05). Pain catastrophizing was reduced after SMT compared with the control intervention (P < .05), but this effect was not significant after accounting for changes in clinical pain. Although the reduction of segmental mechanical hyperalgesia likely contributes to the clinical benefits of SMT, the role of pain catastrophizing remains to be clarified. PerspectiveThis randomized controlled trial found that 12 sessions of SMT yield greater relief of CPLBP than a control intervention. These clinical effects were independent of expectations, and accompanied by an attenuation of hyperalgesia in the targeted segment and a modulation of pain catastrophizing.

Ablated Sonic Hedgehog Signaling in the Dentate Gyrus of the Dorsal and Ventral Hippocampus Impairs Hippocampal-Dependent Memory Tasks and Emotion in a Rat Model of Depression.

Specific memory processes and emotional aberrations in depression can be attributed to the different dorsal-ventral regions of the hippocampus. However, the molecular mechanisms underlying the differential functions of the dorsal hippocampus (dHip) and ventral hippocampus (vHip) remain unclear. As Sonic Hedgehog (Shh) is involved in the dorsal-ventral patterning of the neural tube and its signaling is dysregulated by chronic unpredictable mild stress (CUMS), we investigated its role in influencing the differential functions of the dHip and vHip. Here, CUMS downregulated the expression of Shh signaling markers, including Shh and its downstream effectors GLI family zinc finger 12 (Gli1/2), Patched (Ptch), and smoothened (Smo), in both the dHip and vHip of rats, though more so in the vHip. Additionally, Shh knockdown in the dorsal or ventral dentate gyrus (DG) resulted in restrained neurogenic activity in newborn neurons, especially in immature neurons through decreased expression of Shh signaling markers. Furthermore, Shh knockdown in the DG of the dHip led to memory impairment by inhibiting experience-dependent activation of immature neurons, whereas its knockdown in the DG of the vHip led to an emotional handicap by delaying the maturation of immature neurons. Finally, Shh knockdown in either the dDG or vDG of hippocampus abolished the corresponding cognitive enhancement and emotional recovery of fluoxetine. In conclusion, Shh is essential to maintain the functional heterogeneity of dHip and vHip in depressed rat, which was mainly mediating by local changes of dependent activation and maturity of immature neurons, respectively.

Hybrid dizziness counseling with vestibular rehabilitation in participants with chronic dizziness: a comparison of dizziness handicap

IntroductionPatients with chronic dizziness often have an unremarkable laboratory vestibular examination and have medical clearance from other specialties. However, functional impairments are still significant and affect patients' quality of life. Recent diagnostic criteria and identification of persistent postural perceptual dizziness (PPPD) have helped us to better understand the psychological-somatic manifestations of organic disorders. As the literature suggests good efficacy using a combination of cognitive behavior therapy (CBT) and vestibular rehabilitation, we compared the efficacy of a hybrid protocol using dizziness handicap inventory (DHI) as an outcome measure amongst the different sub-types of chronic dizziness.MethodsThis was an observational study with 35 participants allocated to three different groups: those who strictly fulfilled the PPPD criteria, those with spontaneous episodic vestibular syndrome, and participants with non-specific dizziness. We compared the DHI total and sub-domain scores at baseline and 6 months post-intervention for differences. All participants undertook three sessions in 6 months.ResultsThe total DHI scores were reduced in all three groups. However, the DHI total on average was 11 points higher in the episodic vestibular syndrome group. The emotional sub-domain scores were also reduced in all three groups, but the functional and physical scores were significantly higher in the episodic vestibular group.ConclusionA hybrid protocol worked best for typical PPPD patients who strictly fulfilled the criteria followed by participants in the non-specific dizziness group. When symptoms were episodic in spontaneous vestibular syndrome, only emotional handicap was reduced at 6 months, but functional and physical handicap scores remained high. Regardless, the DHI total scores in all groups were significantly reduced, possibly due to CBT reducing the anxiety that results from a lack of understanding of the clinical diagnoses.

Investigating the effectiveness of oral ketamine on pain, mood and quality of life in treatment resistant chronic pain

IntroductionChronic pain is defined as pain lasting longer than 3 months. This often causes persistent emotional distress and functional disability that is refractory to conventional treatments. Emerging evidence suggests that oral Ketamine therapy may have a specific role in managing treatment-resistant chronic pain. This study aimed to assess the effectiveness of oral ketamine within a tertiary chronic pain management clinic.MethodsThis study was a clinic-based retrospective descriptive study of 79 patients with a broad range of chronic pain diagnoses and treated with oral ketamine over a period up to 12 years. Changes in pain, mood and quality of life (QoL) were assessed using a numerical pain severity score, the Brief Pain Inventory (BPI), the Public Health Questionnaire (PHQ-9) and American Chronic Pain Association Quality of Life (QoL) scale.Results73 patients were accessible for follow-up (mean daily dose and treatment duration were 193.84 mg and 22.6 months respectively). Pain scores decreased (p &amp;lt; 0.0001) on both numerical scores (41.6% decrease) and BPI scoring (mean decrease 2.61). Mood improved (p &amp;lt; 0.0001) across both PHQ-9 and BPI measurements. Patients also reported less difficulty with daily activities and improved QoL. The most common adverse reaction was drowsiness (21.9%), with 30.1% reporting no adverse reactions from Ketamine.DiscussionThis work adds to the growing body of evidence that under the supervision of a pain specialist, oral ketamine therapy may be a safe, tolerable and effective treatment for chronic pain conditions which have not responded to other management options. Further research is required to produce a more accurate understanding of its chronic use. Key messageThis real-world study shows that patients being treated with oral ketamine for chronic pain report decreased severity of pain, improved mood and increased quality of life across all conditions.

School distress and the school attendance crisis: a story dominated by neurodivergence and unmet need.

The Covid-19 pandemic has brought into sharp focus a school attendance crisis in many countries, although this likely pre-dates the pandemic. Children and young people (CYP) struggling to attend school often display extreme emotional distress before/during/after school. We term this School Distress. Here we sought to elucidate the characteristics of the CYP struggling to attend school in the United Kingdom. Using a case-control, concurrent embedded mixed-method research design, 947 parents of CYP with experience of School Distress completed a bespoke online questionnaire (February/March 2022), alongside an age-matched control group (n = 149) and a smaller group of parents who electively home-educate (n = 25). In 94.3% of cases, school attendance problems were underpinned by significant emotional distress, with often harrowing accounts of this distress provided by parents. While the mean age of the CYP in this sample was 11.6 years (StDev 3.1 years), their School Distress was evident to parents from a much younger age (7.9 years). Notably, 92.1% of CYP currently experiencing School Distress were described as neurodivergent (ND) and 83.4% as autistic. The Odds Ratio of autistic CYP experiencing School Distress was 46.61 [95% CI (24.67, 88.07)]. Autistic CYP displayed School Distress at a significantly earlier age, and it was significantly more enduring. Multi-modal sensory processing difficulties and ADHD (among other neurodivergent conditions) were also commonly associated with School Distress; with School Distress CYP having an average of 3.62 NDs (StDev 2.68). In addition, clinically significant anxiety symptomology (92.5%) and elevated demand avoidance were also pervasive. Mental health difficulties in the absence of a neurodivergent profile were, however, relatively rare (6.17%). Concerningly, despite the striking levels of emotional distress and disability reported by parents, parents also reported a dearth of meaningful support for their CYP at school. While not a story of exclusivity relating solely to autism, School Distress is a story dominated by complex neurodivergence and a seemingly systemic failure to meet the needs of these CYP. Given the disproportionate number of disabled CYP impacted, we ask whether the United Kingdom is upholding its responsibility to ensure the "right to an education" for all CYP (Human Rights Act 1998).

Reliability and validity of the Turkish voice handicap index-partner (VHI-P-TR)

ObjectiveThis study examines the Turkish validity, reliability and diagnostic performance of the Voice Handicap Index-Partner (VHI-P-TR), which is used to obtain the perceptions of communication partners of individuals with dysphonia about the functional, physical and emotional handicap resulting from the patient experiencing dysphonia. MethodThe study included 160 individuals with dysphonia and their communication partners. First, translation, back translation, expert validity and pilot study were performed in the scale adaptation process. Then, a confirmatory factor analysis (CFA) was conducted to assess the construct validity of the VHI-P-TR. Correlations between the VHI-P-TR and Voice Handicap Index (VHI-TR) scores of dysphonic individuals were examined to evaluate the concurrent validity of the VHI-P-TR. To assess the reliability of the VHI-P-TR, a test-retest analysis was performed, and internal consistency coefficients (α) were calculated. A receiver operating characteristic (ROC) analysis was conducted to determine the cut-off point for the VHI-P scores. ResultsA high positive correlation was found between the participants’ VHI-P-TR and VHI-TR total and subscales mean scores (r's > 0.782; p < 0.01). The VHI-P-TR had high internal consistency regarding for its subscales and total score (α's > 0.94; p < 0.01). Factor loadings of all VHI-P-TR items were higher than 0.30 and their error variances were lower than 0.90. In addition, factor loadings were statistically significant for all the items (p < 0.05). The data fit the model well according to all CFA indices except for GFI (scale = 0.69). An adequate sensitivity and specificity were achieved for the VHI-P-TR, and the cut-off point was found as 11.50 for the total score and ranged from 2.50 to 5.50 for the subscales. ConclusionThe VHI-P-TR is a valid and reliable measurement tool with high diagnostic performance in all subscales and total score, and has high levels of agreement with the VHI-TR.

‘Our Classes Are Like Mainstream School Now’: Implementing Universal Design for Learning at a Special School

AbstractStudents with emotional and behavioural disability who receive their education in special settings often do not have access to the curriculum through evidence-based pedagogies, such as direct instruction, and instead complete packets of worksheets or participate in distance education. The current study was a collaborative action research project involving a special school for students with emotional disability and a local university to examine the effects of replacing online distance education with in-person direct instruction underpinned by Universal Design for Learning. Researchers sought to discover teacher and student perceptions of Universal Design for Learning, enablers and barriers to its implementation, and its effect on attendance and behaviour. Results suggested satisfaction on the part of both students and teachers and a positive effect of Universal Design for Learning on both attendance and behaviour.

Is Biofeedback for Vertigo Effective in Ordinary Medical Centers? A Controlled Trial in Northern Italy

The aim of this study was to assess the therapeutic effectiveness of biofeedback, in a medical center’s routine for treating vestibular disorders, reducing emotional, functional, and physical disability at three-month follow-up. A total of 197 outpatients were recruited from a medical center to treat vestibular disorders. Patients in the control group received treatment as usual, consisting of one monthly visit with an otolaryngologist and pharmacological treatment specific for vertigo, while the experimental group attended biofeedback training. Patients in the experimental group received pharmacological therapy only in the phase before the start of biofeedback in order to stabilize the acute phase. During the three-month follow-up, the experimental group did not receive any booster sessions of biofeedback. At three-month follow-up there was a statistically significant difference between the groups, both in the mean total score of the dizziness handicap inventory and in the three subscales: physical, emotional, and functional. Moreover, the biofeedback group had reduced psycho-physiological parameters for all average values at three-month follow-up compared to the baseline. This is one of few studies assessing the effectiveness of biofeedback in a naturalistic setting for vestibular disorder treatment. The data confirmed that biofeedback can impact illness course, in terms of self-perceived disability reduction, assessed on emotional, functional, and physical aspects of daily living.

Techno Emotive Pedagogy: A Strategic Enabler for Catalyzing Sustainable Learning and Living in the Post-Pandemic Educational Landscape

In this era of digitalization, the imbibition of technology in all walks of life is immensely felt. In a fast-pacing world, a desirable demand for an easy life makes it necessary for the burgeoning of technological prospects. Moreover, technology would have acclimatized the education sector one day or the other, like Scandinavian countries, for sure: but this anticipation was met rapidly during the pandemic period. As a consequence, most educationists felt the necessity for an alternative to leverage the learning loss across the globe. Technology performed the role of a Godmother to forge our country as ‘Vishwa Guru’ and save pedagogical principles from the clutches of the devastating pandemic. Educational resources began flooding from various technological tools like water flowing from the reservoir while lifting the shutters of a dam. A serious concern that knocks this scenario is ‘will this amalgamation of technology and education remain harmonious, or this synchronization will be able to resolve all the ethical or ontological questions of Homo sapiens in the post-pandemic period’? At this juncture, there is the relevance of a shift from techno-pedagogy to techno-emotive pedagogy. Techno-emotive pedagogy is potentially sound to function as a sustainable approach in the field of education by embracing life skills to adapt to the fast-changing modern society. Undoubtedly, technology would be enthroned as the ultimate dependent variable of education, but without neglecting the emotional canvas. It relies on the strong footing that humans are essentially more emotional than intellectual. A single-track system of techno dependence neglecting the organismic emotional contour of individual and social tenets of humans will result in chaos. This paper intends to present techno-emotive pedagogy as a pedagogical experimentation and innovation in the teaching and learning process by utilizing an exploratory approach to the various emotional handicap that intruded on the learning and living system due to the single strategic path adopted during the covid period by analyzing the empirics from the education stakeholders. An attempt is also made to design and develop an instructional strategy that is synchronized with this paradigm. The findings showed that techno-emotive pedagogy plays as a strategic enabler in catalyzing sustainable learning and also the derivatives of this attempt are expected to contribute to a sustained strategic system for learning and living.

Relationship of serum estradiol and progesterone with symptoms and sex difference in schizophrenia: A cross-sectional study in Iran.

Schizophrenia is a devastating disease characterized by frequent relapses, cognitive decline, and emotional and functional disability, with unknown causes. The phenomenology and clinical course of schizophrenic disorders are different between the two genders, which is thought to be related mainly to the effects of steroid sex hormones on the nervous system. Regarding inconsistencies in the studies, we aimed to compare the levels of estradiol and progesterone between schizophrenia patients and healthy individuals. This cross-sectional study was conducted on 66 patients referred to the specialized clinical psychiatric ward of a teaching hospital in the north of Iran, for 5 months in 2021. Thirty-three schizophrenia patients confirmed by a psychiatrist based on DSM5 criteria were included in the case group, and 33 individuals without a psychiatric disease were included in the control group. We completed a demographic information checklist for each patient, along with the Simpson-Angus extrapyramidal side effect scale (SAS) for drug side effects and the positive and negative syndrome scale (PANSS) for the severity of the disease symptoms. Then, a 3-ml blood sample was taken from each participant to determine the serum levels of estradiol and progesterone. The data were analyzed by SPSS16 software. Thirty-four (51.5%) and 32 (48.5%) participants in this study were male and female, respectively. The mean serum level of estradiol was 22.33 ± 13.65 pm/dl in schizophrenia patients and 29.36 ± 21.32 pm/dl in the control group, showing no significant difference between the two groups (P = 0.4). However, the mean serum level of progesterone was significantly lower in schizophrenia patients (0.37 ± 1.39 pm/dl) than in control subjects (3.15 ± 5.73 pm/dl) (P < 0.001). The PANSS and SAS scores were not significantly correlated with the level of sex hormones (P > 0.05). Serum estradiol and progesterone levels based on sex significantly differed between the two groups (except for female estradiol). Considering the hormonal differences between schizophrenia patients and control subjects, determining hormonal levels in these patients and using complementary hormonal therapies with estradiol or similar compounds can be beneficial as the starting point of schizophrenia treatment, where therapeutic responses can draw the future developmental framework.

Sexual Dysfunction Evaluation in Candidal Balanoposthitis: A Single Centred Observational Study.

A common genito-urinary infection known as Balanoposthitis presents with mild symptoms like itching or severe complications such as phimosis, ulceration of glans, and foreskin. It can result in four types of sexual dysfunction including Disorder of sexual desire, Disorder of erectile dysfunction, Disorder of satisfaction/premature ejaculation, and Disorder of orgasm. An observational clinic study including 50 patients diagnosed with Candidal Balanoposthitis based on KOH and clinical findings were recruited and evaluated for sexual function using a standardised questionnaire. The results demonstrated that sexual dysfunction in patients with Candidal Balanoposthitis is a common entity encountered in STI clinics and should be addressed properly as any deficiency in any aspect of sexual health of a patient can lead to emotional and psychological disability impacting the overall quality of the life. The factors like advanced age, Diabetes Mellitus, and poor hygiene measures of genitalia can increase the incidence of candidal Balanoposthitis as well as sexual dysfunction. Candidal Balanoposthitis, a common cause of sexual dysfunction in elderly population takes a toll on emotional and psychological health and certain modifiable factors like diabetic control and hygiene can prevent recurrent fungal infections.

Psychosocial factors associated with workability after surgery in cancer survivors: An explorative study.

This study aimed to evaluate the work ability and its associated factors in patients with glioma (II, III) and breast cancer after 6 (T0) and 12 (T1) months from surgery. A total of 99 patients were evaluated with self-reported questionnaires at T0 and T1. Correlation and Mann-Whitney tests were used to investigate the association between work ability and sociodemographic, clinical, and psychosocial factors. The Wilcoxon test was used to investigate the longitudinal change in work ability. Our sample showed a decrease in work ability level between T0 and T1. Work ability was associated with emotional distress, disability, resilience, and social support in glioma III patients at T0, and with fatigue, disability, and clinical treatments in patients with breast cancer at T0 and T1. Work ability levels decreased in patients with glioma and breast cancer and were associated with different psychosocial factors after surgery. Their investigation is suggested to facilitate the return to work.

Comparative Short-Term and Long-Term Effects of Neck Massage and Self-Massage on Tension Type Headache

Background. Tension-type headache is a common complaint in modern society. Self-massage or massage can be prescribed to reduce it, but it is still unclear which of these techniques is more effective in reducing tension-type headaches. The aim of the study is to determine the short-term and long-term effects of neck massage and self-massage in tension-type headache. Methods. 30 people participated in the study, who were randomly divided into two groups: massage and self-massage, 15 people in each group. Outcome measures were subjects’ headache intensity, active head range of motion, fatigue, and functional and emotional disability index pre and post the nine-week interventions and long-term effect – one month after the interventions. Results. Both massage and self-massage after the 9-week interventions significantly reduced pain-related indicators. One month after the interventions, the headache intensity, fatigue, functional and emotional disability of subjects in the self-massage group were significantly (p &lt; 0.05) lower, and the active amplitudes of neck movements were significantly higher (p &lt; 0.05) than in the massage group. Conclusions. Both massage and self-massage significantly reduced subjects’ headaches, increased head range of motion, reduced fatigue, and functional and emotional disability. However, one month after the interventions, the long-lasting effect of self-massage was significantly superior to the massage group. Keywords: pain, functional disability, emotional disability, fatigue.

The impact of COVID‐19 on teachers' transition practices for students with disabilities in Illinois, USA

Transition services are central in preparing youth with disabilities for opportunities in postsecondary education, employment and independent living. The life skills education acquired in school may be the only resources they receive to help them with this transition. With COVID‐19, educational systems were interrupted, including the access of students with disabilities to service provision and transition services. This study aimed to investigate the impact of COVID‐19 on teachers' transition practices for students with disabilities in the State of Illinois, United States and to identify factors associated with the differences in teachers' practices across eight domains of transition. Results indicated statistical significant differences in transition practices before and during COVID‐19 in all eight domains. Gender, Race, School Closings &amp; Type of School did not show significant associations with any of the eight domains. Emotional Disability was found to have a significant association with all eight domains, whereas Intellectual Disability did not show significant association with any of the eight domains. Grade level and teachers' educational level showed significant associations with certain domains. Future investigations into how COVID‐19 changed teachers' transition practices for students with disabilities and the long‐term impact that these changes will have on students' post‐secondary outcomes are needed.

Emotional disability and strategies for supporting student outcomes: interviews with K–12 special education teachers

ABSTRACT This interview study with special education teachers in rural and urban school divisions within Virginia, USA, reports instructional strategies that support outcomes for students with social emotional mental health (SEMH) needs. Evidence-based strategies from the interviews are delineated for teachers who work with this highly vulnerable population. K–12 teacher–student relationships (TSRs) and four relational phases – appraisal, testing, agreement, and planning – were analyzed. Strategies for influencing students socially, academically, and behaviorally were also identified. Research questions probed (a) the role of TSRs for students with risk factors and (b) strategies for achieving desirable results in SEMH contexts. TSRs were examined relative to supports and risks associated with students’ development and success. A literature synthesis of strategies and models for advancing knowledge is included. The article offers insight into what teachers do in actual situations to foster student growth and outcomes.