Impairment In Activities Of Daily Research Articles

Preservation of inferior mesenteric artery reduces short- and long-term defecatory dysfunction after laparoscopic colorectal resection for diverticular disease: An RCT.

The quality of life after surgery for diverticular disease is mainly linked to the presence and severity of postoperative defecatory disorders. These symptoms are frequently related to the sigmoid and rectal denervation following the arterial ligation. The preservation of Inferior Mesenteric Artery performing colorectal resections seems to reduce denervation, which led to a better defecatory function. This study aimed to assessing the efficacy of inferior mesenteric artery preservation following colonic resections for diverticular disease in terms of reduced defecatory disorders and improved quality of life. This is a prospective randomized controlled trial entirely conducted at St. Maria Goretti and St. Andrea Hospitals. Between January 2012 and January 2018 each patient scheduled for sigmoidectomy, left colonic or rectal resection for diverticular disease were included in the study and randomly divided in two groups. Colorectal resections were performed either preserving the inferior mesenteric artery or not. The incurrence of defecatory disorders and their impact on QoL of defecatory disorders were assessed with 6 questionnaires, administered at 6 and12months and after 6years from surgery and with an anorectal manometry performed after 6months and 5years. 219 patients were evaluated during the study showing a statistically lower incidence and severity of defecatory disorders in the group of patients whose inferior mesenteric artery was preserved. These defecatory disorders remained stable over the time. The study showed a statistically better quality of life in patients who experienced less defecatory disorders. Inferior Mesenteric Artery preserving in colonic resection for diverticular disease allows to improve defecatory function by reducing the denervated colonic tract. This led to better quality of life and less impairment of daily activities also after 6years from surgery. The study was registered in ClinicalTrials.gov with number NCT06506552.

Anxiety Contributes to Physical Health Among Older Adults Who Are Incarcerated in Prison

ABSTRACT This study explores links between anxiety and physical health among older adults (aged 45+) incarcerated in Kentucky state prisons. Using secondary data, independent sample t-tests, and hierarchical multiple linear regression, we identify disparities in anxiety and physical health among those with and without self-reported anxiety and the contribution of symptoms of anxiety to physical health in the sample. Findings show individuals with self-reported anxiety experienced increased impairment in daily activities, multimorbidity, and decreased physical health-related quality of life. Older adults are a large and growing proportion of prison populations, and addressing anxiety may improve physical health and reduce related costs.

Evaluating Digital Rehabilitation Outcomes in Chronic Musculoskeletal Conditions Across Non-Obesity, Obesity, and Severe Obesity.

Obesity is a known risk factor and aggravator of musculoskeletal (MSK) conditions. The rising prevalence of obesity calls for scalable solutions to address MSK conditions in this population, given their complex clinical profile and barriers to accessing care. To evaluate the engagement and clinical outcomes of a fully remote digital care program in patients with MSK conditions, focusing on those with and without comorbid obesity. A post-hoc analysis of a prospective, longitudinal, single-arm observational home-based study conducted between August, 2023, and August, 2024. Adults suffering from chronic MSK pain were categorized according to their body mass index (BMI) into non-obesity, obesity and severe obesity. Outcomes included completion rates, engagement, satisfaction, pain (minimal clinically important change: 30%), impairment in daily activities, and patient global impression of change (PGIC). Depending on the clinical outcomes, latent basis growth analysis and logistic regression were used. Completion rates were high across all groups (77.5-85.6%), although slightly lower in the obesity groups. Fairly similar engagement was observed with both exercise sessions and the educational content (1.9-2.2 exercise sessions per week; 8.10-9.31 educational content videos watched). Obesity groups interacted more with the physical therapists than the non-obesity group (severe obesity: 24.6 (SD 10.1); obesity: 23.2 (SD 10.46) vs non-obesity: 22.4 (SD 9.8), P < 0.001). Despite higher baseline risk and clinical impairment in the obesity groups, all groups showed significant pain reductions, with pain responder rates ranging from 56.6 to 63.6%, slightly lower in the severe obesity group. Improvements in daily activities were significant across groups, alongside a positive PGIC (50.4-53.6%). Satisfaction was very high (>9/10) in all BMI groups. Despite worse baseline clinical presentations, obesity groups achieved high completion rates, engagement, and significant clinical improvements comparable to the non-obesity group, highlighting the potential of a digital program for this population.

Prevalence and impact of vasomotor symptoms due to menopause among women in Canada: A subgroup analysis from an international cross-sectional survey of Women with Vasomotor Symptoms Associated with Menopause (WARM Study).

The aim of the study was to assess the prevalence of postmenopausal vasomotor symptoms (VMS) and the impact of VMS and related treatment patterns among perimenopausal and postmenopausal Canadian women. A subgroup analysis of data from a cross-sectional online survey of women aged 40-65 years conducted November 4, 2021, through January 17, 2022, evaluated the prevalence of moderate/severe VMS among postmenopausal Canadian women. The analysis also assessed survey responses from perimenopausal and postmenopausal Canadian women with moderate/severe VMS who completed the Menopause-Specific Quality of Life questionnaire, Work Productivity and Activity Impairment questionnaire, and the Patient-Reported Outcomes Measurement Information System Sleep Disturbances-Short Form 8b and answered questions about treatment patterns and attitudes toward treatments. Of 2,456 Canadian postmenopausal women, 360 (14.7%; primary analysis) reported moderate/severe VMS in the previous month. Perimenopausal and postmenopausal women with moderate/severe VMS (n = 400; secondary analysis) reported negative impact on overall quality of life (mean total Menopause-Specific Quality of Life questionnaire score: 4.3/8). VMS impaired overall work and daily activities by 30.2% and 35.7%, respectively. Overall mean (SD) Patient-Reported Outcomes Measurement Information System Sleep Disturbance-Short Form 8b score (scale 8-40) was 28.5 (6.9), confirming sleep disturbances in this population. The majority of women (88% of the total cohort) sought advice, but about half were never treated. Most women had positive or neutral attitudes toward menopause. In a survey conducted in Canada, moderate/severe VMS were reported by 14.7% of postmenopausal women and were associated with impairment in quality of life, work productivity, daily activities, and sleep in perimenopausal and postmenopausal women.

Comparative cross-sectional study of comorbid depression in patients with irritable bowel syndrome and chronic gastritis at an urban outpatient clinic

This comparative cross-sectional study evaluates the prevalence of comorbid depression in patients with Irritable Bowel Syndrome (IBS) and chronic gastritis (CG) at an urban outpatient clinic. A total of 178 patients—89 diagnosed with IBS and 89 with CG—were assessed for depressive symptoms using the Beck Depression Inventory-II (BDI-II) and the 21-item Hamilton Depression Rating Scale (HDRS-21). Our findings indicate a significantly higher prevalence of depression in IBS patients, with 71.9% meeting criteria for depression based on the BDI-II and 70.8% based on the HDRS-21, compared to 10.1% in CG patients. The study highlights that retardation symptoms, including depressed mood and loss of interest, are central to depression and contribute to substantial impairment in daily activities and quality of life. Additionally, anxiety and somatization were prominent in the IBS cohort. This study emphasizes the need for integrated care approaches that address both gastrointestinal and psychological symptoms, fostering improved patient management and outcomes. Our results underscore the importance of regular psychological assessments in IBS patients, particularly those without overt depressive symptoms, to enhance their overall well-being.

Exploring the Importance of Race and Gender Concordance Between Patients and Physical Therapists in Digital Rehabilitation for Musculoskeletal Conditions: Observational, Longitudinal Study.

Race/ethnicity and gender concordance between patients and providers is a potential strategy to improve health care interventions. In digital health, where human interactions occur both synchronously and asynchronously, the effect of concordance between patients and providers is unknown. This study aimed to evaluate the impact of race/ethnicity or gender concordance between patients and physical therapists (PTs) in engagement and the clinical outcomes following a digital care program (DCP) in patients with musculoskeletal (MSK) conditions. This secondary analysis of 2 prospective longitudinal studies (originally focused on assessing the acceptance, engagement, and clinical outcomes after a remote DCP) examined the impact of both race/ethnicity concordance and gender concordance between patients and PTs on outcomes for a digital intervention for MSK conditions. Outcomes included engagement (measured by the completion rate and communication, assessed by text interactions), satisfaction, and clinical outcomes (response rate, ie, percentage of patients achieving at least a minimal clinically important change in pain, measured by the Numerical Pain Rating Scale [NPRS]; anxiety, measured by the Generalized Anxiety Disorder 7-item scale [GAD-7]; depression, measured by the Patient Health Questionnaire 9-item [PHQ-9]; and daily activity impairment, measured by the Work Productivity and Activity Impairment [WPAI] questionnaire). Of 71,201 patients, 63.9% (n=45,507) were matched with their PT in terms of race/ethnicity, while 61.2% (n=43,560) were matched for gender. Concordant dyads showed a higher completion rate among White (adjusted odds ratio [aOR] 1.11, 95% CI 1.05-1.19, P<.001) and Hispanic (aOR 1.27, 95% CI 1.08-1.54, P=.009) groups, as well as women (aOR 1.10, 95% CI 1.06-1.18, P<.001), when compared to discordant dyads. High and similar levels of interaction between patients and PTs were observed across race/ethnicity and gender dyads, except for Asian concordant dyads (adjusted β coefficient 5.32, 95% CI 3.28-7.36, P<.001). Concordance did not affect satisfaction, with high values (>8.52, 95% CI 8.27-8.77) reported across all dyads. Response rates for pain, anxiety, and daily activity impairment were unaffected by race/ethnicity concordance. An exception was observed for depression, with White patients reporting a higher response rate when matched with PTs from other races/ethnicities (aOR 1.20, 95% CI 1.02-1.39, P=.02). In terms of gender, men had a slightly higher pain response rate in discordant dyads (aOR 1.08, 95% CI 1.01-1.15, P=.03) and a higher depression response rate in concordant dyads (aOR 1.23, 95% CI 1.05-1.47, P=.01). Race/ethnicity and gender concordance between patients and PTs does not translate into higher satisfaction or improvement for most clinical outcomes, aside from a positive effect on treatment completion. These results highlight the importance of other PT characteristics, in addition to race/ethnicity or gender concordance, suggesting the potential benefit of experience, languages spoken, and cultural safety training as ways to optimize care. ClinicalTrials.gov NCT04092946, NCT05417685; https://clinicaltrials.gov/study/NCT05417685, https://clinicaltrials.gov/study/NCT04092946.

Benign paroxysmal positional vertigo: diagnosis, treatment, rehabilitation. Current concepts on the role of betahistine in the complex treatment of patients with benign paroxysmal positional vertigo

The treatment of patients with benign paroxysmal positional vertigo (BPPV) is an urgent issue in modern medicine.Expert Council on the diagnosis and treatment of BPPV was held in Moscow on June 1, 2024. Timely diagnosis and effective treatment play a key role in the management of patients with BPPV, reduce the risk of falls and related injuries, prevent the development of emotional disorders and impairment of daily activities. Accurate patient routing and selection of appropriate treatment can significantly reduce the duration of disability and the burden on the healthcare system. Relatively simple positional tests aimed at detecting involvement of various semicircular canals have been found to be of paramount importance in the diagnosis of BPPV. Repositioning maneuvers are of paramount importance in the treatment of patients with BPPV. They vary depending on the canal affected and aim to move the otoliths out of the semicircular canals to the vestibule of the labyrinth. If repositioning maneuvers can not be performed, effective methods of vestibular gymnastics can be used. When discussing drug therapy, it was found that the use of betahistine in addition to repositioning maneuvers or vestibular gymnastics increases the efficacy of therapy, accelerates the recovery process and prevents the development of residual non-positional vertigo.

Efficacy and safety of guselkumab in European patients with palmoplantar pustulosis: A multi-center, single-arm clinical trial (GAP study)

BackgroundPalmoplantar pustulosis (PPP) is a chronic inflammatory skin disorder that affects palms and soles. Patients suffer significant pain, itching and daily activity impairment. Guselkumab, an interleukin-23 inhibitor, has been approved for PPP treatment in Japan. However, there is no effective therapy licensed for PPP in Europe and the USA. ObjectiveTo explore the efficacy and safety of guselkumab in patients with moderate-to-severe PPP in the Caucasian population. MethodsA multicenter, single-arm, phase II study involving 50 patients with moderate-to-severe PPP treated with 100 mg guselkumab subcutaneously for 24 weeks was conducted (GAP). Primary endpoint was the reduction of palmoplantar-pustulosis psoriasis area and severity index (PPPASI) at week 24 compared to baseline. Secondary endpoints included physician-assessed and patient-reported measures. Serum samples were taken for exploratory studies. ResultsThe primary endpoint was met with a significant median PPPASI reduction by 59.6% at week 24 compared to baseline (p<0.001). The proportions of patients achieving PPPASI-50 and PPPASI-75 at week 24 were 66.0% and 34.0%, respectively. Median DLQI dropped from 15 at baseline to 5 at week 24 (p<0.001). Week-4 changes in IL-19 serum levels predicted week-24 clinical response. ConclusionGuselkumab may be a promising therapeutic option for PPP in Caucasian patients.

Prevalence of Noise-Induced Hearing Loss Among Construction Workers in Puducherry, India.

Introduction Noise-induced hearing loss (NIHL) is one of the emerging health problems in today's world. NIHL results from multifactorial damage to auditory structures due to exposure to loud sounds from occupational, environmental, or recreational causes. The World Health Organisation (WHO) indicates that workplaceNIHL is second to accidental harm for years of healthy life lost. It causes significant impairment in patients' daily activities and quality of life. Aim This study aimed to find the prevalence of NIHL among construction site workers in Puducherry, a southern state of India, and to find the association between the degree of hearing loss and various demographic factors. Methods This cross-sectional study was conducted among construction workers in a tertiary care center in Puducherry. The study was conducted for 18 months, from January 2021 to June 2022. After the initial assessment, all the workers were subjected to pure tone audiometry, and findings were recorded. Results A total of 500 construction site workers participated in the study. The prevalence of the NIHL was found to be 13.2%. The study also showed that the majority of the patients (6.6%) had a mild-degreehearing loss. The study also showed a significant association exist between age (p = 0.002), gender (p = 0.001), work experience (p < 0.001), and the number of hours of work per day (p < 0.001) with the degree of hearing loss. Conclusion The prevalence of NIHL is growing day by day, so proper preventive measures should be taken by enhancing knowledge of the disease, adopting protective tactics, and creating therapies to prevent the disease.

A Cross-Sectional Analysis of American Insurance Coverage of Upper and Lower Lid Blepharoplasty.

Dermatochalasis is a common condition that can cause obstruction of peripheral visual fields and impairment of daily activities. These effects can be addressed with a blepharoplasty, which may be considered a cosmetic procedure by American health insurers. The authors assessed insurance coverage of all indications of blepharoplasty and their medical necessity criteria. A cross-sectional analysis was conducted of 70 insurance policies for blepharoplasty. The insurance companies were selected based on their state enrollment and market share. A web-based search and telephone interviews were utilized to identify the policies. Medically necessary criteria were extracted from the publicly available policies. Of the 70 insurance policies assessed, 67 (96%) provide coverage for blepharoplasty. There were 7 indications for coverage, the most common being dermatochalasis causing functional visual impairment (n = 56, 80%), prosthesis difficulties in an anophthalmic socket (n = 44, 63%), and congenital ptosis (n = 38, 54%). Of companies that indicated coverage for dermatochalasis, 95% required visual field loss testing to qualify for coverage. Significantly more companies required a 30% loss in the superior visual field for coverage versus the literature-recommended amount of 24% loss (n = 14 versus n = 3, 26% versus 6%, P = 0.0067). There is a great discrepancy in insurance policy criteria for coverage of blepharoplasty, especially regarding requirements for visual field testing. Unfortunately, this disparity does not reflect the current literature as to whom may gain significant functional benefit from blepharoplasty.

Burden of illness and treatment attitudes among participants meeting Rome IV criteria for irritable bowel syndrome: A nationwide survey in the United States.

Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction characterized by abdominal pain and altered bowel habits, with patient-perceived dissatisfaction of treatment symptom control. We assessed disease burden, satisfaction with medication use, and impact on activities, in participants with IBS with constipation (IBS-C) and diarrhea (IBS-D). This study assessed data from a large, United States survey of adults querying demographics, comorbid conditions, quality of life, medication use, satisfaction with symptom control, and work productivity. Participants were grouped into the IBS-C or IBS-D cohort if they met Rome IV criteria, with controls matched 1:1 according to age, sex, race, region, and Charlson Comorbidity Index score. All data were self-reported. Nine hundred and ten participants with IBS-C and 669 with IBS-D were matched to controls. The most reported symptoms were abdominal discomfort for IBS-C and abdominal pain and abdominal discomfort for IBS-D. Among the IBS-C and IBS-D cohorts, 74.2% and 65.9%, respectively, took prescription and/or over-the-counter medication for their symptoms. Respondents were more dissatisfied than satisfied with control of their symptoms. Respondents taking prescription medication(s) with or without over-the-counter medication(s) reported better symptom control than respondents only taking over-the-counter medications (p < 0.001). There was significantly higher mean presenteeism, work productivity loss, and daily activity impairment (p < 0.001 for all) in respondents with IBS compared with controls. This study provides insight into respondents' experiences of IBS symptoms, including the impact on daily activity, as well as satisfaction with control of symptoms and prescription and over-the-counter medications.

Caregiver Experience Survey of Anti-Vascular Endothelial Growth Factor Treatment for Diabetic Macular Edema and Neovascular Age-Related Macular Degeneration

Introduction: Diabetic macular edema (DME) and neovascular age-related macular degeneration (nAMD) require frequent anti-vascular endothelial growth factor (VEGF) treatment and monitoring visits. We aimed to understand the burden of treatment on caregivers. Methods: This multinational, noninterventional study used a cross-sectional survey of adult patients with DME or nAMD treated with anti-VEGF injections in the USA, Canada, France, Italy, Spain, and the UK. The survey assessed caregivers’ sociodemographic characteristics, patient relationships, patients’ clinical history and treatment experiences, caregivers’ experiences, and the Caregiver Reaction Assessment of caregiving burden. Results: Caregivers for patients with DME (n = 30) and nAMD (n = 95) completed surveys. Mean ± standard deviation (SD) age was 64.0 ± 13.4 years, and most were female (71.2%), white (70.4%), married (66.4%), and from Europe (67.2%). Most were caring for their mother/father or partner/spouse (85.6%). Mean ± SD length of time as a caregiver was 9.1 ± 10.0 years. Caregivers estimated they provided support for 4.2 ± 2.9 days/week and 6.0 ± 7.1 h/day on average. Nearly half of caregivers (45.6%) reported some impairment in daily activities, and more than two-thirds (70.5%) of working caregivers (n = 44) reported work absenteeism due to anti-VEGF treatment/monitoring appointments. At least one treatment barrier was reported by 66.7% and 50.5% of caregivers of patients with DME and nAMD, respectively, which were related to coronavirus disease 2019- (38.4%), clinic- (18.4%), social-/health- (13.6%), treatment- (10.4%), or financial-related factors (4.8%). Caregiver Reaction Assessment scores indicated mild-to-moderate burden, with higher caregiver schedule disruption scores associated with an increasing number of anti-VEGF treatment/monitoring visits among DME caregivers (r = 0.61). Conclusion: Caregivers devote substantial time to caregiving, leading to schedule disruptions and absenteeism for some working caregivers. Positive and negative impacts on caregiver mental health were reported.

The Impact of Inflammatory Bowel Diseases on Patients' Quality of Life and Work Functionality: An Observational Study.

This study aimed to assess the employment status, quality of life, and work functionality in patients affected by inflammatory bowel diseases (IBDs). Patients (N = 216) were enrolled between June 2020 and October 2021. Personal, clinical, and occupational features were investigated. The Short Inflammatory Bowel Disease Questionnaire and the Work Productivity and Activity Impairment questionnaire were administered. Among the enrolled patients, 114 (53%) were employed. The mean absenteeism and presenteeism percentages of 10% and 37% were determined, with 44% and 39% of daily and work activity impairment, respectively. A poor Health-Related Quality of Life (HRQoL) was retrieved (47 ± 12). Extraintestinal manifestations, disease activity, and HRQoL were associated with occupational outcomes. IBD can impact patients' work functionality. The association between clinical, psychological, and occupational issues suggests the relevance for a multidisciplinary management of the disease.

THE EFFECTIVENESS OF COGNITIVE-BEHAVIORAL THERAPY IN ADOLESCENTS WITH SOCIAL ANXIETY DISORDER

Social anxiety disorder (SAD) is a prevalent condition among adolescents, characterized by an intense and persistent fear of social situations or performance, which results in significant distress and impairment in daily activities. Adolescents with SAD often avoid social interactions, which can negatively affect their academic, social and emotional development. Cognitive-behavioral therapy (CBT) has been widely recognized as an effective approach to treating SAD, offering practical strategies to reduce anxiety symptoms and improve social functioning. This abstract will explore the effectiveness of CBT in adolescents with social anxiety disorder, highlighting the main techniques used and the clinical outcomes observed. The aim of this paper is to review and evaluate the effectiveness of cognitive-behavioral therapy in the treatment of adolescents with social anxiety disorder. The aim is to analyze the main techniques of CBT, the mechanisms by which it promotes anxiety reduction and the results of clinical studies that show its effectiveness. In addition, the challenges and specific considerations in applying CBT to this age group will be discussed. This literature review aims to analyze the effectiveness of Cognitive-Behavioral Therapy (CBT) in the treatment of social anxiety in adolescents. To this end, references from relevant studies and meta-analyses were selected and reviewed, covering various approaches and results related to the topic. The selection of references was based on the relevance and impact of the publications in the field of psychotherapy and social anxiety. CBT is a form of psychotherapy based on identifying and modifying dysfunctional patterns of thought and behavior. In the context of SAD in adolescents, CBT aims to help patients recognize and restructure irrational beliefs about themselves and social situations, develop appropriate social skills and reduce avoidance of social interactions. With this in mind, the main CBT techniques include cognitive restructuring, gradual exposure and social skills training. Cognitive restructuring involves helping adolescents to identify negative automatic thoughts and replace them with more realistic and balanced interpretations. Gradual exposure consists of exposing adolescents, in a controlled and progressive way, to feared social situations, allowing them to face their fears and reduce the associated anxiety response. Social skills training focuses on developing social competencies, such as initiating and maintaining conversations, asking and answering questions, and dealing with criticism and rejection in an assertive manner. Clinical studies have demonstrated the effectiveness of CBT in reducing SAD symptoms in adolescents. Research indicates that adolescents who receive CBT show a significant decrease in levels of social anxiety, improved quality of life and greater participation in social and school activities. For example, a study conducted by Masia Warner et al. (2005) showed that adolescents who participated in a group CBT program had a notable reduction in social anxiety symptoms compared to a control group. Another study by Beidel, Turner and Morris (2000) showed that individual CBT resulted in substantial improvements in adolescents’ social anxiety and social functioning. Despite the promising results, the application of CBT to adolescents with SAD presents specific challenges. Adherence to treatment can be hampered by adolescents’ resistance to engaging in therapy sessions and facing feared social situations. In addition, parental involvement and coordination with schools are important components for successful treatment, as social and environmental support is crucial for the generalization of therapeutic gains. Therefore, cognitive-behavioral therapy has proven to be an effective approach for treating adolescents with social anxiety disorder. Cognitive restructuring techniques, gradual exposure and social skills training are key to helping adolescents overcome their fears and improve their social functioning. Clinical studies provide robust evidence that CBT can significantly reduce SAD symptoms and improve quality of life for adolescents. However, it is essential to consider the challenges specific to this age group, including resistance to treatment and the need for support from parents and schools. With a careful and collaborative approach, CBT can provide lasting benefits for adolescents with social anxiety disorder, promoting their emotional and social well-being.

Therapeutic Potential of Indian Medicinal Herbs and Current Therapeutic Approach used to Mitigate the Symptoms of Chronic Fatigue Syndrome: A Review

Abstract: Chronic fatigue syndrome (CFS) is a complex condition marked by severe exhaustion that lasts at least 6 months. The global prevalence of CFS ranging between 0.4% and 2.5% is growing. Women are affected by CFS more often than men. It is considered a common condition in developed countries. There is no approved treatment for CFS but symptoms can be managed and controlled persistent exhaustion causes significant impairment in daily routine activities. Lowered ATP synthesis, mitochondrial impairment, decreased oxidative phosphorylation, disruption of the hypothalamic–pituitary–adrenal (HPA) axis, and an imbalance of brain neurotransmitters play a major role in the pathophysiology of CFS. The purpose of the present study is to figure out the several plants that are used as a source of medication in chronic fatigue syndrome (CFS) and its current therapeutic approach. The Indian medicinal herbs described in this article are very efficacious in the management of chronic fatigue syndrome symptoms due to the presence of phytochemicals. This review article also covers the current therapeutic approach for chronic fatigue syndrome in a concise form that comprises CBT (Cognitive based therapy), GET (Graded exercise therapy), usage of immunoglobins, psychodynamic counseling, and yoga therapy that includes isometric yoga and yoga nidra are very beneficial in alleviating the symptoms of chronic fatigue syndrome. Antidepressants, immunomodulatory agents, and corticosteroids come under conventional medication for CFS. This article explores different Indian medicinal herbs, their pharmacological properties, and their potential role and current treatments for reducing the severity of symptoms of chronic fatigue syndrome.

Transforming Veteran Rehabilitation Care: Learnings from a Remote Digital Approach for Musculoskeletal Pain.

While musculoskeletal pain (MSP) stands as the most prevalent health condition among Veterans, timely and high-quality care is often hindered due to access barriers. Team Red, White & Blue (Team RWB), a nonprofit organization dedicated to promoting a healthier lifestyle among Veterans, aimed to assess innovative approaches to veteran care. This is a single-arm pilot study investigating the feasibility, clinical outcomes, engagement, and satisfaction of a remote multimodal digital care program among Veterans with MSP. The impact of deployment experience on outcomes was explored as a secondary aim. From 75 eligible Veterans, 61 started the program, reporting baseline pain frequently comorbid with mental distress. Program acceptance was suggested by the high completion rate (82%) and engagement levels, alongside high satisfaction (9.5/10, SD 1.0). Significant improvements were reported in all clinical outcomes: pain (1.98 points, 95%CI 0.13; 3.84, p = 0.036); mental distress, with those reporting at least moderate baseline depression ending the program with mild symptoms (8.50 points, 95%CI: 6.49; 10.51, p = 0.012); daily activity impairment (13.33 points, 95%CI 1.31; 25.34, p = 0.030). Deployed Veterans recovered similarly to their counterparts. Overall, the above results underscore the potential of a remote digital intervention to expand Veterans' access to timely MSP care.

Physical Inactivity Increases Impairment of Daily Activities Due to Pain in Workers: An Ordinal Regression Logistic and Correspondence Analysis.

Background: The evidence for the health benefits of physical activity is growing; however, the prevalence of unhealthy lifestyles continues to contribute to the increase in chronic non-communicable diseases. We know that occupational-time physical activity does not provide the same benefits as leisure-time physical activity, which has been shown to reduce mortality and pain. We also know that multiple factors influence pain; however, there are no studies that specifically analyze the impact of type of working time and occupational-time physical activity on the impairment of daily activities due to pain. We aimed to study the influence of both personal and occupational factors on the impairment of daily activities due to pain, assessing whether leisure-time physical activity acts as a protective factor. Methods: A cross-sectional, population-based design was used based on the 2017 National Health Survey in Spain (ENSE). Sociodemographic, leisure-time physical activity, and work-related variables were collected. The outcome variable was the impairment of daily activities due to pain. Ordinal logistic regression was applied, and the analysis was complemented with simple correspondence analysis. Results: A total of 1,441 workers between 18 and 65 years of age were studied. Significant differences were found between sexes for all variables except age and leisure-time physical activity. Logistic regression revealed significant associations between sex, primary and secondary education levels, no leisure-time physical activity, and overweight with impairment of daily activities due to pain. Simple correspondence analysis showed that the categories doing leisure-time physical activity several times a week as well as several times a month are closer to the categories of little or no pain. Conclusion: Female gender, low educational level, overweight, and lack of leisure-time physical activity were associated with increases in impairment of daily activities due to pain. Occupational-time physical activity and work shift were not related to impairment of daily activities due to pain. Implications for Occupational Health Practice: Occupational Health Nursing interventions through education and counseling on the importance of leisure-time physical activity promotion programs potentially can reduce the impairment of daily activities due to pain in working populations.

The Effects of Neuropsychiatric Symptom Clusters in People with Dementia on Family Caregiver Burden.

Neuropsychiatric symptoms are a robust risk factor for caregiver burden in family dementia caregivers. By grouping these symptoms, clinical interpretations regarding neuropsychiatric symptoms may facilitated because different groups of symptoms may require a different approach for intervention, thereby reducing caregiver burden. As clustering of neuropsychiatric symptoms could be clinically relevant, we aimed to explore the effects of these clusters on burden in family dementia caregivers. 152 family dementia caregivers were included. Caregiver burden was measured using the Ervaren Druk door Informele Zorg (EDIZ)/Self-Perceived Pressure from Informal Care, a Dutch questionnaire. Caregivers also reported the neuropsychiatric symptoms and functional impairments in daily activities of the people with dementia they cared for. Multiple regression analyses were used in this cross-sectional study. Adjusted for functional impairments and sociodemographic variables, neuropsychiatric symptoms were associated with more caregiver burden (p < 0.001). However, this association did not differ between the three neuropsychiatric symptom clusters (p = 0.745). Neuropsychiatric symptoms were associated with more family caregiver burden, but no conclusive evidence was found that this association differed for the three clusters. Clustering of neuropsychiatric symptoms is, however, worth exploring further in future studies with more participants. If specific links are found, these could be targeted in clinical practice in order to prevent, reduce and/or postpone caregiver burden.

Quality of life and work productivity and activity impairment among online survey respondents with migraine across a range of headache frequency.

This study aimed to describe the migraine burden and healthcare utilization in the context of headache frequency using nationwide claims data linked to online survey data previously collected in Japan. It has been shown that increase in headache frequency can impose greater impact on individuals' daily and social functioning, but migraine burden in those with low-frequency headaches remains largely unknown in Japan. This post-hoc, observational study reported on 674 respondents who were working individuals and their family members aged 19-74 years, responded to an online questionnaire (response rate: 14.1% [21,704 responded/153,545 kencomⓇ registrants]), and were previously classified as having migraine. Disease burden in terms of Migraine-Specific Quality of Life (MSQ) and Work Productivity and Activity Impairment (WPAI) was compared across 0-3, 4-7, 8-14, and ≥ 15 monthly headache days (MHD). Among 674 respondents, 419 (62.2%), 148 (22.0%), 61 (9.1%), and 46 (6.8%) had 0-3, 4-7, 8-14, and ≥ 15 MHD, respectively. Of those, 55 (13.1%), 31 (20.9%), 19 (31.1%), and 20 (43.5%) respondents consulted physicians for headaches. Moderate-to-severe impairments in daily activities were reported by 298 (71.1%), 110 (74.3%), 46 (75.4%), and 38 (82.6%) respondents. The proportion of the respondents with WPAI >0% generally increased with increasing headache frequency (presenteeism: 41.7 and 67.5% in respondents with 0-3 and ≥ 15 MHD, respectively; overall work impairment: 44.8 and 72.5%, respectively; and activity impairment: 44.9 and 73.9%, respectively), except for absenteeism (12.4 and 22.5%, respectively). The mean MSQ score declined with increasing MHD (Role function-restrictive: 75.1 and 59.5 in those with 0-3 and ≥ 15 MHD, respectively; Role function-preventive: 85.8 and 75.0, respectively; and Emotional function: 81.9 and 63.6, respectively). Based on the Japanese nationwide claims data, quality of life and work productivity decreased with increasing numbers of headache days. Substantial disease burden paired with low levels of healthcare utilization highlights the need for medical or non-medical intervention.

Healthcare resource utilization and economic burden of multiple sclerosis in Chinese patients: results from a real-world survey

Multiple sclerosis (MS) is uncommon in China and the standard of care is underdeveloped, with limited utilization of disease-modifying treatment (DMT). An understanding of real-world disease burden (including direct medical, non-medical, and indirect costs, such as loss of productivity), is currently lacking in this population. To investigate the overall burden of managing patients with MS in China, a cross-sectional survey of physicians and their consulting patients with MS was conducted in 2021. Physicians provided information on healthcare resource utilization (HCRU; consultations, hospitalizations, tests, medication) and associated costs. Patients provided data on changes in their life, productivity, and impairment of daily activities due to MS. Results were stratified by disease severity using generalized linear models, with a p value < 0.05 considered statistically significant. Patients with more severe disease had greater HCRU, including hospitalizations, consultations and tests/scans, and incurred higher direct and indirect costs and productivity loss, compared with those with milder disease. However, the use of DMT was higher in patients with mild disease severity. With the low uptake and limited efficacy of non-DMT drugs, Chinese patients with MS experience a high disease burden and significant unmet needs. Therapeutic interventions could help save downstream costs and lessen societal burden.