Higher Prevalence Of Disability Research Articles

The Role of High-Density Lipoprotein, C-reactive Protein, and Serum Ferritin in Ischemic and Hemorrhagic Stroke: An Observational Cross-Sectional Comparative Study.

Background Stroke is a significant global health issue, with a high prevalence of morbidity, mortality, and disability. We can classify strokes into two types: ischemic and hemorrhagic, with ischemic strokes being more common. This study aims to investigate the role of high-density lipoprotein (HDL), C-reactive protein (CRP), and serum ferritin levels in people who have had ischemic and hemorrhagic strokes in order to identify possible biomarkers for diagnosis and treatment. Materials and methods This observational cross-sectional comparative study included 100 stroke patients (50 ischemic and 50 hemorrhagic) from Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune. We collected data through clinical evaluations, laboratory tests, and imaging studies. We measured and analyzed HDL, CRP, and serum ferritin levels using appropriate statistical tests, such as the chi-square test and Student t-test, with a 95% confidence interval (CI) and a 5% p-value for significance. Results The mean age for ischemic stroke patients was 55.92 years, whereas for hemorrhagic stroke patients, it was 58.68 years. The study found significant differences in HDL, CRP, and ferritin levels between the two groups. The mean HDL level for ischemic stroke patients was significantly lower at 25.10 mg/dL, compared to 40.57 mg/dL in hemorrhagic stroke patients, with a p-value of <0.001. The mean CRP level was higher in ischemic stroke patients (28.90 mg/L) compared to hemorrhagic stroke patients (22.80 mg/L), with a p-value of <0.001. Ferritin levels were also higher in hemorrhagic stroke patients (587.98 ng/mL) compared to ischemic stroke patients (473.16 ng/mL), with a statistically significant p-value of <0.001. Conclusion This study highlights the significant role of HDL, CRP, and serum ferritin levels in distinguishing between ischemic and hemorrhagic stroke patients. Elevated HDL levels may protect against ischemic strokes due to their anti-inflammatory properties, while higher CRP levels in ischemic strokes indicate a strong inflammatory response. Elevated ferritin levels in hemorrhagic strokes suggest increased oxidative stress and inflammation.

Application of a comprehensive disability measure: Disability prevalence among US Veterans and non-veterans from the National Health Interview Survey Data from 2015 to 2018

BackgroundCurrent measures of condition-specific disabilities or those capturing only severe limitations may underestimate disability prevalence, including among Veterans. ObjectivesTo develop a comprehensive measure to characterize and compare disabilities among US Veterans and non-Veterans. MethodsUsing 2015–2018 pooled cross-sectional National Health Interview Survey data, we compared the frequency and survey-weighted prevalence of non-mutually exclusive sensory, social, and physical disabilities by Veteran status. We developed a measure for and examined the frequency and survey-weighted prevalence of eight mutually exclusive disability categories—sensory only; physical only; social only; sensory and physical; social and sensory; physical and social; and sensory, social, and physical. ResultsAmong 118,818 NHIS respondents, 11,943 were Veterans. Veterans had a greater prevalence than non-Veterans of non-mutually exclusive physical [52.01% vs. 34.68% (p < 0.001)], sensory [44.47% vs. 21.79% (p < 0.001)], and social [17.20% vs. 11.61% (p < 0.001)] disabilities (after survey-weighting). The most frequently reported mutually exclusive disability categories for both Veterans and non-Veterans were sensory and physical (19.20% and 8.02%, p < 0.001) and physical only (16.24% and 15.69%, p = 0.216) (after survey-weighting). The least frequently reported mutually exclusive disability categories for both Veterans and non-Veterans were social only (0.31% and 0.44%, p = 0.136) and sensory and social (0.32% and 0.20%, respectively, 0.026) (after survey-weighting). ConclusionsOur disability metric demonstrates that Veterans have a higher disability prevalence than non-Veterans, and a higher prevalence than previously reported. Public policy and future research should consider this broader definition of disability to more fully account for the variable needs of people with disabilities.

Prevalence of Upper Extremity Pain among Tabla Players working in Islamabad/Rawalpindi

Background: Upper extremity pain is a significant concern among musicians, particularly those involved in repetitive and high-stress activities such as playing the tabla. This study aims to assess the prevalence and risk factors of upper extremity pain and associated functional disabilities in tabla players based in Islamabad and Rawalpindi. Objective: To determine the prevalence of upper extremity pain and functional disability among tabla players and to identify associated risk factors. Methods: A cross-sectional descriptive survey was conducted at music schools, academies, and churches in Islamabad and Rawalpindi. The study spanned five months from June 23, 2023, following the approval of the synopsis. A sample size of 100 male tabla players aged 19-38 years, with at least two years of playing experience and a minimum of two practice sessions per week, was selected using a non-probability convenient sampling technique. Data collection tools included the Visual Analogue Scale (VAS) for pain assessment and the Disabilities of Arm, Shoulder, and Hand (DASH) questionnaire for evaluating functional limitations. Participants with a history of upper extremity diseases, surgical history, trauma, or congenital deformities were excluded. Descriptive analysis was performed using SPSS version 25, with frequencies, percentages, and p-values calculated to determine statistical significance. Results: Among the participants, 40% were aged 19-23 years, 26% were aged 24-28 years, 31% were aged 29-33 years, and 3% were aged 34-38 years. The prevalence of upper extremity pain was 89%, and functional disability was 88%. Pain levels varied with playing hours per week: 11% reported no pain, 16% had mild pain, 67% experienced moderate pain, and 6% had severe pain. Functional disability scores were similarly distributed across playing hours, with 11% reporting no disability, 16% mild disability, 67% moderate disability, and 6% severe disability. The relationship between playing hours and both VAS and DASH scores was statistically significant (p-values 0.045 and 0.032, respectively). Conclusion: The study revealed a high prevalence of upper extremity pain and functional disability among tabla players, significantly impacting their quality of life. Key risk factors included repetitive movements, abnormal posture, prolonged practice hours, poor technique, age, and gender. These findings underscore the need for preventive strategies and targeted interventions to reduce musculoskeletal disorders in this population.

TRPM2 and CaMKII Signaling Drives Excessive GABAergic Synaptic Inhibition Following Ischemia.

Excitotoxicity and the concurrent loss of inhibition are well-defined mechanisms driving acute elevation in excitatory/inhibitory (E/I) balance and neuronal cell death following an ischemic insult to the brain. Despite the high prevalence of long-term disability in survivors of global cerebral ischemia (GCI) as a consequence of cardiac arrest, it remains unclear whether E/I imbalance persists beyond the acute phase and negatively affects functional recovery. We previously demonstrated sustained impairment of long-term potentiation (LTP) in hippocampal CA1 neurons correlating with deficits in learning and memory tasks in a murine model of cardiac arrest/cardiopulmonary resuscitation (CA/CPR). Here, we use CA/CPR and an in vitro ischemia model to elucidate mechanisms by which E/I imbalance contributes to ongoing hippocampal dysfunction in male mice. We reveal increased postsynaptic GABAA receptor (GABAAR) clustering and function in the CA1 region of the hippocampus that reduces the E/I ratio. Importantly, reduced GABAAR clustering observed in the first 24 h rebounds to an elevation of GABAergic clustering by 3 d postischemia. This increase in GABAergic inhibition required activation of the Ca2+-permeable ion channel transient receptor potential melastatin-2 (TRPM2), previously implicated in persistent LTP and memory deficits following CA/CPR. Furthermore, we find Ca2+-signaling, likely downstream of TRPM2 activation, upregulates Ca2+/calmodulin-dependent protein kinase II (CaMKII) activity, thereby driving the elevation of postsynaptic inhibitory function. Thus, we propose a novel mechanism by which inhibitory synaptic strength is upregulated in the context of ischemia and identify TRPM2 and CaMKII as potential pharmacological targets to restore perturbed synaptic plasticity and ameliorate cognitive function.

Assessment of Dependency in Activities of Daily Living (ADL) and its Predictors: A Cross-Sectional Study among the Elderly Rural Population in a Sub-Himalayan UT of India.

With an increase in life expectancy over the last few decades, there has been a parallel increase in the prevalence of disabilities among the elderly population. To estimate the prevalence of dependency in activities of daily living (ADL) and its predictors among the rural elderly population. This was a cross-sectional study carried out in the community among the rural geriatric population in the field practice area of PG Department of Community Medicine, Government Medical College Jammu. The Barthel Scale Index was used to measure ADL dependency. PSPP software was used to analyze the data. The mean age of study participants was 68.31 ± 7.9 years. ADL dependency was observed in 46.3% of the subjects, with the majority demonstrating mild to moderate dependence. Only 2.5% of the respondents reported a severe degree of ADL dependence. The mean ADL score was 94.47 ± 8.98. On multivariate logistic regression analysis, age, educational status, the presence of stress in the family, personal history, and the presence of co-morbidities emerged to be independent predictors of ADL dependence. High prevalence of physical disability in the geriatric population is now an area of major concern. This emphasizes the significance of setting up geriatric care centers especially in rural areas preferably integrating with health and wellness centers.

Cognitive frailty and its association with disability among Chinese community-dwelling older adults: a cross-sectional study

BackgroundThere are a variety of determinants that are key to functional disability of older adults. However, little is known regarding the relationship between cognitive frailty and disability among older people. The aims of this study were to examine the associations between cognitive frailty and its six components with instrumental activities of daily living (IADL) functioning in community-dwelling older adults.MethodsA total of 313 community-dwelling older adults (aged ≥ 65 years) were recruited from eight community centers in central China. Cognitive frailty was operationalized using the Mini-Mental State Examination for the evaluation of cognitive status and the Fried criteria for the evaluation of physical frailty. The outcome was functional disability assessed by the IADL scale. The association between cognitive frailty, as well as its components, and IADL limitations was identified by conducting binary logistic regression analysis.ResultsThe prevalence of cognitive frailty was 8.9% in this study. The results showed that cognitive frailty (OR = 22.86) and frailty without cognitive impairment (OR = 8.15) were associated with IADL limitations. Subdimensions of cognitive frailty, exhaustion, weakness, low physical activity and cognitive impairment components were independently associated with IADL limitations.ConclusionCognitive frailty was associated with a higher prevalence of disability. Interventions for improving cognitive frailty should be developed to prevent IADL disability among community-dwelling older adults in China.

Prevalence of low back pain and disability among secondary school teacher in the eastern province of the Kingdom of Saudi Arabia: a cross-sectional analytical study.

Lower back pain is common worldwide and affects over 600,000 people annually, including teachers. The study aimed to investigate the prevalence of low back pain and disability among secondary school teachers in the Eastern Province of the Kingdom of Saudi Arabia. This cross-sectional study included secondary school teachers in the eastern province of Saudi Arabia. 34 schools were selected using a multistage stratified sampling approach. Teachers were allotted randomly and proportionally to each school. Data was collected by anonymous questionnaire having three elements: sociodemographic and health-related questions, the Standardized Nordic Questionnaire, and the Oswestry Low Back Pain Disability Questionnaire. The anthropometric data was also included. Both unadjusted and adjusted logistic regression analyses were performed. A total of 601 teachers participated in the study with 62.56% reported low back pain. The overall mean age was 40.31 ± 8.13 years. The male-to-female ratio was similar. Back pain was significantly higher among females than males (73.36 and 51.52%, respectively). Additionally, back pain will significantly increase when stress levels and the number of classes increases. A positive correlation was found between age with low back pain (p = 0.001).There was minimal disability in 64.63% of the 376 teachers who reported low back pain, moderate disability in 29.79%, and severe disability in 4.79%, and only three (0.8%) were considered crippled. Females were more frequently seen in moderate and crippled categories, and perceived stress levels generally increased mean disability scores. Age and female gender were revealed to be significant predictors of low back pain by logistic regression (adjusted odds ratio [OR] = 1.04, 95% confidence interval [CI] = 1.02-1.07) and (adjusted OR = 2.11, 95% CI = 1.45-3.05), respectively. The number of classes per week was also a significant predictor. This study adds to the epidemiological evidence that reveals a high prevalence of low back pain and disability among teachers. Identified risk factors in this study may also reinforce the importance of setting different interventions and preventive measures to reduce lower back pain risk.

Disability provokes poverty and vice versa, a review of the relationship

Abstract: Millions of people all over the world are affected by disability arising out of accident, disease, or congenital. This is a crucial health issue for mankind and needs structured treatment and rehabilitation plans. Prevalence and management capacity of disability have wide cross-cultural and geographical variations. Despite the lack of specific data there are reasons to believe that third-world countries have more disabilities and fewer resources and capacity for rehabilitation. So, there is a strong relationship between poverty and disability. Marginalized populations, disadvantaged or at-risk populations such as women, older people, and people who are poor are inappropriately affected by disability. Children from poverty-stricken families, indigenous populations, and ethnic minority groups are significantly at higher risk of experiencing disability. There is a higher prevalence of disability in lower-income countries than in higher-income countries. Poor people from lower-income countries are usually involved in high-risk jobs which make them vulnerable to injury and disability. Because of exaggerated life stress, poor health status, and poor living conditions due to poverty, people at low resource outset are more vulnerable to disease and disability. Of inadequate support from affluent persons as well as from the government, they spend their last savings to meet the treatment costs and get poorer. They are also common victims of road traffic accidents when they travel on risky roads and vehicles. There are many other shreds of evidence for a link between disability and poverty in low and middle-income countries and there is an urgent need for further research and policy action to break the cycle. This review article intends to find out the relationship between poverty and disability and reveals how poverty influences suffering disability and vice versa. J Bangladesh Coll Phys Surg 2024; 42: 63-67

Personal protective equipment utilization and its association with educational status among industry workers in Ethiopia: A systematic review and meta-analysis protocol.

Ethiopia is experiencing high prevalence of occupational morbidity and disability. One of the main contributing reasons is a low utilization of personal protective equipment (PPE). Previous studies on PPE utilization and association with educational status among industry workers were largely inconsistent. Therefore, this meta-analysis is aimed to pool the magnitude of PPE utilization and its association with educational status among industry workers in Ethiopia. A compressive search of international databases and libraries including Scopus, PubMed, MedNar, Embase, MEDLINE, the web of science, Google Scholar, the JBI Library, African Journals Online, and Science direct will be carried out to locate published reports. Two independent reviewers will screen the records for inclusion using standardized JBI tools. Before extracting and synthesizing data, the selected studies will undergo a rigorous critical appraisal. If appropriate, a meta-analysis will be conducted. Cochrane Q-test and I2-test statistics will be used to assess the heterogeneity between studies. If necessary, meta-regression and subgroup analyses will be conducted to explore potential reasons for any inconsistency and heterogeneity. Sensitivity analysis will be performed to assess the effect of a single study on the pooled magnitude estimates. Funnel plots, along with Egger's and Begg's tests, will be used to assess the presence of publication bias. PROSPERO registration number: PROSPERO, CRD42022364562.

CUMULATIVE EFFECTS OF COGNITIVE IMPAIRMENT AND FRAILTY ON GERIATRIC SYNDROMES IN A GERIATRIC OUTPATIENT SETTING

Abstract Aim With underlying geriatric syndromes, only few studies emphasized on the aspect of co-occurrence of frailty and cognitive impairment, though they are independently associated with several geriatric syndromes. Methods The participants were recruited from the outpatient clinic of geriatric department in a medical center. Frailty was assessed by a modified version of Fried’s criteria, while cognitive impairment was defined by cutoff scores of the Mini Mental State Examination. Demographic characteristics, self-assessed health status, and geriatric assessment were collected. Polytomous logistic regression model was used to evaluate factors correlated with frailty alone, cognitive impairment alone, and co-occurrence of frailty and cognitive impairment. Results The mean age of the 323 participants (60.1% women) was 80.4 ± 7.3 years. The prevalence of non-frailty, frailty alone, cognitive impairment alone and co-occurrence were 34.4%, 16.7%, 23.8% and 25.1%, respectively. When compared to the not-frail group, the odds ratios (OR) of having activity of daily living impairment (aOR 1.44, 95% CI 1.28-1.63), instrumental activities of daily living impairment (aOR 1.61, 95% CI 1.45-1.81), urinary incontinence (aOR 1.61, 95% CI 1.45-1.81) and with lower mini-nutritional assessment score (aOR 148, 95% CI 1.30-1.69) were significantly higher in the co-occurrence group after adjusted with demographic variables and Charlson comorbidity index. Conclusions Co-occurrence of frailty and cognitive impairment was associated with higher prevalence of disability, incontinence and malnutrition. It is crucial to approach frailty and cognitive impairment simultaneously in daily geriatric clinical practice due to the correlations of several geriatric syndromes to the co-occurrence of physical frailty and cognitive impairment.

A culturally and linguistically tailored Community-Engaged Dementia Education Program (CEDEP) for the Houston Vietnamese American community.

Data from the Vietnamese Aging and Care Survey (VACS) showed the high prevalence of disability, depressive symptoms, and cognitive impairment in older Vietnamese immigrants and refugees. We proposed a Community-Engaged Dementia Education Program to examine the Houston Vietnamese American community's literacy on dementia and develop a one-pager educational material. This is a cross-sectional, qualitative study (interviews and focus groups) using the Cultural Exchange Model as a conceptual framework. We interviewed fourteen Vietnamese key informants and assessed the community's knowledge of dementia based on Edwards' 9-stage Community Readiness Model. The community's low literacy on dementia (Stages 2-3: Denial/resistance to vague awareness) was revealed. Approaches to introducing dementia conversations to the community and what to include in the one-pager were discussed. Based on the key informants' insight, we developed a dementia one-pager tailored to the community by using lay language with a representative image of the target population, indicating warning signs of dementia, and encouraging them to see their doctors for cognitive check-ups. The plan for the next steps includes utilizing the local ethnic media, collaborating with the existing pillars of the Cultural Exchange model, leveraging the university students' learning opportunities, and disseminating the culturally and linguistically tailored one-pager.

Determinants of Labor Participation and Wages toward People with Disabilities in Indonesia

Reductions in the supply of labor and wages occur to people with disabilities. Disability conditions cause a decline in productivity so that the probability of being a labor is small, risk of unemployment and loss of income. The high prevalence of disabilities in Indonesia causes inequality of labor participation and wages for disabilities in Indonesia based on the type of disabilities. The data used is Indonesia Family Life Survey (IFLS) waves 4 and 5 by pooled cross-section. The analysis methods are logit and tobit models. The results showed that communicative disabilities have a higher chance of labor participation and wages. Factors of the degree of severity, age, male, head of household, education, urban, chronic disease, ownership of insurance, and ownership of assets also affect labor participation and wages for disabilities. The labor activation program for disabilities is a succession and initiative as welfare reform, poverty alleviation and an indicator of inclusive development.

Functional capacity and its associated factors in older adults in the rural area in Brazil

Background &amp; Aim: Aging leads to bodily changes and impairment of functional capacity in older adults. The objective was to analyze the association between socio-demographic and health data, cognitive impairment, and risk of sarcopenia with functional capacity in older adults enrolled in the Family Health Strategies in the rural area of the municipality of Picos, Piauí, Brazil.&#x0D; Methods &amp; Materials: This is a quantitative and cross-sectional study that was developed with 320 older adults attending the Family Health Strategies located in the rural area of Picos, Piauí, Brazil. The participants were people 60 years old, registered in the Family Health Strategies, and living in a rural area. Data was collected in the older adults’ homes using the following instruments: Demographic profile, Self-reported illnesses, Mini-Mental State Examination, Barthel Index, Lawton and Brody Scale, and SARC-F.&#x0D; Results: It was found that 70% had cognitive impairment, 53.8% were at risk of sarcopenia, with a mean of 93.72 (SD=11.84) points for basic activities daily living, and 77.8% with partial dependence for instrumental activities daily living with a mean of 16.79 (SD=3.79) points. In the multivariate multiple regression, it was identified that there was an association between Basic Activities of Daily Living and Instrumental Activities of Daily Living with age (p&lt;0.001), number of children (p=0,025), education (p=0.003), monthly income (p=0.018), number of diseases (p&lt;0.001), sarcopenia (p&lt;0.001) and cognitive status (p&lt;0.001).&#x0D; Conclusion: A high prevalence of functional disability was identified in elderly people living in the rural area of ​​Picos, Piauí, Brazil. Therefore, it is important to pay attention to factors associated with dependence on daily activities.

Prevalence and risk factors of disabilities among Egyptian preschool children: a community-based population study

BackgroundChild disability has significant implications on their well-being and healthcare systems. Aim: This survey aimed to assess the magnitude of seven types of disability among Egyptian children aged 1 < 6 years and their socio-demographic, epidemiological, and perinatal predictors.MethodsA national population-based cross-sectional household survey targeting 21,316 children from eight governorates was conducted. The screening questionnaire was derived from the WHO ten-question survey tool validated for identifying seven disability categories.ResultsThe percentage of children with at least one disability was 8.1% as follows: speech/communication (4.4%), Mobility/physical (2.5%), Seizures (2.2%), Comprehension (1.7%), Intellectual impairment (1.4%), Visual (0.3%) and Hearing (0.2%). Age was not found to affect the odds of disability except for visual disability (significantly increased with age (AOR = 1.4, 95% CI:1.1–1.7). Male sex also increased the odds of all disabilities except visual, hearing, and seizures. Convulsions after birth significantly increased the odds of disability as follows: hearing (AOR = 8.1, 95% CI: 2.2–30.5), intellectual impairment (AOR = 4.2, 95% CI: 2.5–6.9), and mobility/physical (AOR = 3.4, 95% CI: 2.3–5.0). Preterm delivery and being kept in an incubator for more than two days after birth increased the odds for visual disability (AOR = 3.7, 95% CI: 1.1–12.1 & AOR = 3.7, 95% CI: 1.7–7.9 respectively). Cyanosis increased the odds of seizures (AOR = 4.7, 95% CI: 2.2–10.3). Low birth weight also increased the odds for all disability domains except for visual and hearing. Maternal health problems during pregnancy increased the odds for all types of disability except hearing and seizures. Higher paternal education decreased the odds for all disabilities by at least 30% except for vision and hearing.ConclusionThe study found a high prevalence of disability among Egyptian children aged 1–6 years. It identified a number of modifiable risk factors for disability. The practice of early screening for disability is encouraged to provide early interventions when needed.

A national screening for the prevalence and profile of disability types among Egyptian children aged 6–12 years: a community-based population study

AimThis study aimed to determine the prevalence of disability domains among Egyptian children in the age group of 6–12 years as well as assess their socio-demographic, epidemiological, and perinatal predictors.MethodsA national population-based cross-sectional household survey targeting 20,324 children from eight governorates was conducted. The screening questionnaire was derived from the WHO ten-question survey tool validated for the identification of disabilities.ResultsThe prevalence of children with at least one type of disability was 9.2%. Learning/ comprehension was the most prevalent type (4.2%), followed by speech/communication (3.7%), physical/ mobility and seizures (2.2% for each), intellectual impairment (1.5%), visual (0.7%), and hearing (0.4%). The commonest predictors for disabilities were children who suffered from convulsions or cyanosis after birth and maternal history of any health problem during pregnancy. However, preterm and low birth weight (LBW) babies or being admitted to incubators for more than two days were strong predictors for all disabilities except hearing disability. A history of jaundice after birth significantly carried nearly twice the odds for seizures (AOR = 2.2, 95% CI:1.5–3.4). History of difficult labor was a predictor of intellectual impairment (AOR = 1.5, 95% CI:1.1–2.0). A disabled mother was a strong predictor for all disabilities except seizures, while a disabled father was a predictor for visual and learning/ comprehension disabilities (AOR = 3.9, 95% CI:2.2–7.1 & AOR = 1.6, 95% CI:1.1–2.4 respectively). Meanwhile, both higher maternal and paternal education decreased significantly the odds to have, physical/ mobility and Learning/ comprehension by at least 30%.ConclusionThe study found a high prevalence of disability among Egyptian children aged 6–12 years. It spotted many modifiable determinants of disability domains. The practice of early screening for disability is encouraged to provide early interventions.

Claims-Based Frailty Index as a Measure of Dementia Severity in Medicare Claims Data.

Dementia severity is unavailable in administrative claims data. We examined whether a claims-based frailty index (CFI) can measure dementia severity in Medicare claims. This cross-sectional study included the National Health and Aging Trends Study Round 5 participants with possible or probable dementia whose Medicare claims were available. We estimated the Functional Assessment Staging Test (FAST) scale (range: 3 [mild cognitive impairment] to 7 [severe dementia]) using information from the survey. We calculated CFI (range: 0-1, higher scores indicating greater frailty) using Medicare claims 12 months prior to the participants' interview date. We examined C-statistics to evaluate the ability of the CFI in identifying moderate-to-severe dementia (FAST stage 5-7) and determined the optimal CFI cut-point that maximized both sensitivity and specificity. Of the 814 participants with possible or probable dementia and measurable CFI, 686 (72.2%) patients were ≥75 years old, 448 (50.8%) were female, and 244 (25.9%) had FAST stage 5-7. The C-statistic of CFI to identify FAST stage 5-7 was 0.78 (95% confidence interval: 0.72-0.83), with a CFI cut-point of 0.280, achieving the maximum sensitivity of 76.9% and specificity of 62.8%. Participants with CFI ≥0.280 had a higher prevalence of disability (19.4% vs 58.3%) and dementia medication use (6.0% vs 22.8%) and higher risk of mortality (10.7% vs 26.3%) and nursing home admission (4.5% vs 10.6%) over 2 years than those with CFI <0.280. Our study suggests that CFI can be useful in identifying moderate-to-severe dementia from administrative claims among older adults with dementia.

Determinación de intersecciones probabilísticas relacionadas con daño cerebral adquirido a partir de la determinación de probabilidades a priori y a posteriori.

The acquired brain damage is a common neurological disorder. Determine the probabilistic intersections of variables related to acquired brain damage from the determination of a priori and a posteriori probabilities. Analytical retrospective study. A descriptive analysis was carried out, confidence intervals were calculated to obtain the mean and the proportion with α = 0.05 considering the age of the patient and the diagnosis. An analysis of probabilistic intersection, a priori and a posteriori probability was performed considering diagnosis, sex and age decade; finally, chi squared was calculated. 736 patients were analyzed. The most frequent diagnosis was language disorder. The patients diagnosed with memory disorder were the youngest and those diagnosed with degenerative cognitive disorder the oldest. The probability that a patient with sequelae due to acquired brain damage arrives at the hospital, at the language pathology service, to be diagnosed with a language disorder and that this patient is also a man is 29.06%. The high prevalence of short and long-term disability generated by acquired brain damage highlights the importance of an early and timely detection and diagnosis so that it favors prompt and efficient specialized care.

Factors influencing home care workers’ loyalty in long-term nursing services

Given the high prevalence of clinical disease and disability among elderly individuals, there is an ever-greater demand for social care services. Despite this demand, the elder care sector has the largest labor shortage levels among all front-line providers of long-term care services. Strategies to reduce turnover and improve employee loyalty have therefore become an important issue. The purpose of this study is to identify the factors that affect the loyalty of home care workers. Following a literature review, wedetermined four independent variables—job satisfaction, work engagement, organizational citizenship behavior (OCB) and transformational leadership—and investigated their relevance to, and ability to predict, home care workers’ employee loyalty. A total of 455 home care workers participated in the anonymous survey. The results of multiple regression analysis indicate that the adjusted coefficient of determination (R2) of the model explained 65.6% of the variance of the dependent variable, showing high explanatory capacity. The influences of the four independent variables on employee loyalty were all significant and positive, with the greatest impact on employee loyalty being exerted by OCB (Adjusted ß = 0.400), followed by job satisfaction and then transformational leadership. The three hierarchical regression models provided evidence for the partial mediating effect of job satisfaction, work engagement and OCB between transformational leadership and employee loyalty. Our findings suggest that managers of home care institutions should adopt a transformational leadership style to motivate home care workers’ job satisfaction, work engagement and OCB. Such an environment not only help retain employee but also attract more young people to join the ranks of the home care profession, which will help solve fundamental short-staffing problems.

The Digital Twin: A Potential Solution for the Personalized Diagnosis and Treatment of Musculoskeletal System Diseases.

Due to the high prevalence and rates of disability associated with musculoskeletal system diseases, more thorough research into diagnosis, pathogenesis, and treatments is required. One of the key contributors to the emergence of diseases of the musculoskeletal system is thought to be changes in the biomechanics of the human musculoskeletal system. However, there are some defects concerning personal analysis or dynamic responses in current biomechanical research methodologies. Digital twin (DT) was initially an engineering concept that reflected the mirror image of a physical entity. With the application of medical image analysis and artificial intelligence (AI), it entered our lives and showed its potential to be further applied in the medical field. Consequently, we believe that DT can take a step towards personalized healthcare by guiding the design of industrial personalized healthcare systems. In this perspective article, we discuss the limitations of traditional biomechanical methods and the initial exploration of DT in musculoskeletal system diseases. We provide a new opinion that DT could be an effective solution for musculoskeletal system diseases in the future, which will help us analyze the real-time biomechanical properties of the musculoskeletal system and achieve personalized medicine.

Work participation in adults with rare genetic diseases - a scoping review

BackgroundWork participation is a crucial aspect of health outcome and an important part of life for most people with rare genetic diseases. Despite that work participation is a social determinant of health and seems necessary for understanding health behaviours and quality of life, it is an under-researched and under-recognized aspect in many rare diseases. The objectives of this study was to map and describe existing research on work participation, identify research gaps, and point to research agendas in a selection of rare genetic diseases.MethodsA scoping review was performed by searching relevant literature in bibliographic databases and other sources. Studies addressing work participation in people with rare genetic diseases published in peer reviewed journals were assessed using EndNote and Rayyan. Data were mapped and extracted based on the research questions concerning the characteristics of the research.ResultsOf 19,867 search results, 571 articles were read in full text, and 141 satisfied the eligibility criteria covering 33 different rare genetic diseases; 7 were reviews and 134 primary research articles. In 21% of the articles the primary aim was to investigate work participation. The extent of studies varied between the different diseases. Two diseases had more than 20 articles, but most had only one or two articles. Cross-sectional quantitative studies were predominant, with few utilizing prospective or qualitative design. Nearly all articles (96%) reported information about work participation rate, and 45% also included information about factors associated with work participation and work disability. Due to differences in methodologies, cultures and respondents, comparison between and within diseases are difficult. Nevertheless, studies indicated that many people with different rare genetic diseases experience challenges related to work, closely associated to the symptoms of the disease.ConclusionWhile studies indicate high prevalence of work disability in many patients with rare diseases, the research is scarce and fragmented. More research is warranted. Information about the unique challenges of living with different rare diseases is crucial for health and welfare systems to better facilitate work participation. In addition, the changing nature of work in the digital age, may also open up new possibilities for people with rare genetic diseases and should be explored.