Level Of Impairment Research Articles

Investigating antioxidant effects of hamamelitannin-conjugated zinc oxide nanoparticles on oxidative stress-Induced neurotoxicity in zebrafish larvae model.

An excessive amount of reactive oxygen species triggers oxidative stress, leading to an imbalance in cellular homeostasis. Antioxidant therapy is an effective tool for lowering the oxidative stress and associated ailments. Recently, green nano-based drug formulations have demonstrated promising antioxidant activity and neutralizing oxidative stress. In this study, a tannin molecule Hamamelitannin (HAM), was utilized to synthesize zinc oxide nanoparticles HAM-ZnO NPs, to mitigate oxidative stress and associated ailments . The HAM-ZnO NPs were synthesized and characterized by XRD, SEM, and FTIR. The antioxidant potentials of HAM-ZnO NPs were analyzed by in vitro antioxidant assays. Zebrafish embryos and larvae were used as in-vivo models to assess the toxicity and antioxidant protective mechanism. Hydrogen peroxide (1mM) was employed to induce oxidative stress and treated with HAM-ZnO NPs to study the cognitive impairment and antioxidant enzyme levels. Levels of reactive oxygen species and cell death due to oxidative stress induction were studied by 2',7'-dichlorodihydrofluorescein diacetate and Acridine orange staining methods. Additionally, expression of Antioxidant genes such as SOD, CAT, GPx, and GSR were studied. . HAM-ZnO NPs exhibited a spherical morphology and size ranges between 48 and 53nm. In vitro antioxidant studies revealed the antioxidant properties of HAM-ZnO NPs. Furthermore, in vivo studies indicated that HAM-ZnO NPs don't possess any cytotoxic effects in zebrafish larvae at concentrations between (5-25µg/ml), The study also observed that HAM-ZnO NPs significantly reduced Hydrogen Peroxide-induced stress and increased antioxidant activity in zebrafish larvae. Also, the antioxidant gene expression was upregulated in the HAM-ZnO NPs zebrafish larvae. Findings in this study showed that HAM-ZnO NPs might be a potential intervention for diseases linked to oxidative stress.

Brain-movement relationship during upper-limb functional movements in chronic post-stroke patients

BackgroundFollowing a stroke, brain activation reorganisation, movement compensatory strategies, motor performance and their evolution through rehabilitation are matters of importance for clinicians. Two non-invasive neuroimaging methods allow for recording task-related brain activation: functional near-infrared spectroscopy (fNIRS) and electroencephalography (fEEG), respectively based on hemodynamic response and neuronal electrical activity. Their simultaneous measurement during movements could allow a better spatiotemporal mapping of brain activation, and when associated to kinematic parameters could unveil underlying mechanisms of functional upper limb (UL) recovery. This study aims to depict the motor cortical activity patterns using combined fNIRS-fEEG and their relationship to motor performance and strategies during UL functional tasks in chronic post-stroke patients.MethodsTwenty-one healthy old adults and 21 chronic post-stroke patients were recruited and completed two standardised functional tasks of the UL: a paced-reaching task where they had to reach a target in front of them and a circular steering task where they had to displace a target using a hand-held stylus, as fast as possible inside a circular track projected on a computer screen. The activity of the bilateral motor cortices and motor performance were recorded simultaneously utilizing a fNIRS-fEEG and kinematics platform.Results and conclusionsKinematic analysis revealed that post-stroke patients performed worse in the circular steering task and used more trunk compensation in both tasks. Brain analysis of bilateral motor cortices revealed that stroke individuals over-activated during the paretic UL reaching task, which was associated with more trunk usage and a higher level of impairment (clinical scores). This work opens up avenues for using such combined methods to better track and understand brain-movement evolution through stroke rehabilitation.

Symptom- and function-based trajectories of patients with dementia in hospital and community palliative care settings in the last two weeks of life: a retrospective cohort study

BackgroundThe prevalence of dementia is increasing worldwide and many people with the condition require some level of palliative care. However, the trajectories of function and symptom burden in palliative care services at the end of life remain unclear. This study aimed to describe and compare the longitudinal trajectories of function and symptom burden among patients with dementia between hospital versus palliative community care services in the last two weeks of life.MethodsA retrospective cohort study used data from the Australian Palliative Care Outcomes Collaboration. Patients with dementia who died between 1 January 2013 and 31 December 2020 from the Australian Palliative Care Outcomes Collaboration. Four validated clinical instruments were used to collect outcomes on each individual’s function and symptom distress and severity. Multilevel models were used to estimate the differences in clinical trajectories between hospital and community-based palliative care in the last two weeks of life.ResultsPatients with dementia tended to have low levels of distress for most symptoms but increasing levels of functional impairment. There were no or only marginally significant differences in the symptom trajectories between the community and hospital groups (OR ranged from 0.57 to 1.97). Although clinical trajectories of function were relatively similar between two groups, statistically higher functional indicators were observed for people when admitted to community palliative care services (OR = 0.42 and 2.27, respectively).ConclusionsOur findings suggest that community-based palliative care services can be as effective as hospital-based care for many patients with dementia nearing the end of life. With appropriate support for families, community-based care could serve as a viable alternative to hospital-based care for some patients in the final stages of dementia.

Socio-demographic, psychosocial, and suicidal behavior correlates of stigma among people with physical disabilities in Northwest Ethiopia

BackgroundPeople with physical disability may experience stigma in various ways, including social avoidance, negative attitudes and discrimination. Stigma among people with physical disability can vary based on study participants’ socio-demographic, behavioral and psychosocial factors. Therefore, identifying the socio-demographic, behavioral and psychosocial correlates of stigma is important because the findings of the study can help inform future interventions aimed at reducing stigma among individuals with a physical disability.ObjectiveThis study aimed to assess the psychosocial, suicidal behavior, and socio-demographic correlates of stigma among people with physical disabilities in the University of Gondar communities, northwest Ethiopia.MethodData collection was conducted among 269 participants who had a physical disability within University of Gondar communities in Northwest Ethiopia. The participants, who included students and employees at the University completed the stigma scale for chronic illness (SSCI-8), which was used to measure stigma. The participants also completed four other questionnaires, including the perceived social support, the Kessler − 10, and the WHODAS. We used independent sample t-tests and ANOVA to examine group differences in stigma, while Pearson correlation analysis identified the correlates of stigma with other continuous variables.ResultThe overall mean stigma score among people with a physical disability was 14.68 with 95% CI (13.98, 15.38). About 90.71% of people with physical disability had stigma. Stigma varied along socio-demographic variables, including marital status (single) with a mean (SD) score of 15.17 ± 5.64, educational level (diploma and above) with a mean (SD) score of 14.99 ± 5.89, and occupational status with a mean (SD) score of 15.54 ± 5.79 (p < 0.001). In addition, stigma varied among participants with suicidal ideation with a mean (SD) score of 16.93 ± 7.43 and attempt (18.74 ± 8.41), levels of psychological distress (severe) with a mean (SD) score of 20.88 ± 6.94 (p < 0.001), low perceived social support with a mean (SD) score of 18.60 ± 7.54 (p < 0.001), and moderate/severe level of functional impairment with a mean (SD) score of 21.76 ± 7.34 (p < 0.001). Moreover, stigma was positively correlated with psychological distress (r = 0.42, p < 0.001) and WHO Disability Assessment Schedule (r = 0.5, p < 0.001). Conversely, it was negatively correlated with perceived social support (r=-0.31, p < 0.001).ConclusionOur findings indicate that stigma is prevalent among people with physical disabilities, with variations observed based on marital status, occupation, and education level. Additionally, stigma showed significant correlations with functional impairment, psychological distress, perceived social support, and health related quality of life. Therefore, addressing stigma, promoting social support and providing appropriate interventions can help improve the psychological well-being and quality of life of individuals with physical disabilities.

Febuxostat in patients with hyperuricemia and gout: is the nephroprotective effect real?

Hyperuricemia (HU) and gout are independent risk factors for chronic kidney disease (CKD). Worldwide, the increasing prevalence of CKD leads to a deterioration in the quality and duration of life of patients and an increase in mortality. If HU plays a significant role in the development of renal failure, then lowering high uric acid (UA) levels should theoretically contribute to the improvement of kidney function. The main method of lowering UA levels is administration of a urate-lowering therapy – xanthine oxidase (XO) inhibitors. The nephroprotective effect of one of the XO inhibitors, febuxostat has been demonstrated in animal models.The article analyzes the currently available data on the use of febuxostat in patients with HU and gout and different levels of renal function impairment and discusses the possible mechanisms of the drug's nephroprotective effect.

Investigating the relationship between impairment and performance in goalball: A level playing field?

ABSTRACT Currently, all eligible goalball players compete together irrespective of their level of vision impairment, yet it remains unclear whether those with more impairment are disadvantaged during competition. Following the International Paralympic Committee’s requirement for evidence-based, sport-specific classification, this study assessed whether individual goalball performance relates to the level of visual impairment. Using results from the 2016 and 2020 Paralympic Games, players’ sport classes and in-competition key performance statistics (minutes played, throws per minute, goals per minute, penalties conceded per minute, blocks per minute, and goals per throw) were extracted. Players’ visual acuity and visual field results were obtained through the IBSA Sport Administration System. Results showed no statistically significant differences in performance between classes. Further, there were no significant relationships between vision and performance for all six variables for female players. A small but significant positive correlation was found between visual acuity and the number of penalties conceded for male players. Collectively, the results suggest that currently eligible players compete fairly against one another during competitive goalball matches. Results provide support for the existing system of classification whereby all eligible athletes compete against each other irrespective of their level of impairment.

Systematic Review and Meta-Analysis of Intervention Techniques in Occupational Therapy for Babies and Children with Obstetric Brachial Plexus Palsy.

(1) Background: Obstetric brachial plexus palsy (OBPP) is an unpredictable and unpreventable neurological injury, caused by shoulder dystocia during birth, that affects the brachial plexus and leads to motor and sensory deficits in the child's upper extremity. The limited literature on early therapeutic assessment of newborns with OBPP highlights a gap in specialized care that, if filled, could enhance decision-making and support timely treatment. The objective of this paper is to analyze the therapeutic intervention techniques used at an early stage and their functional impact, from the occupational therapy discipline in the treatment of the upper extremity in babies and children with OBPP. (2) Method: Systematic review design and meta-analysis. A systematic review is a comprehensive analysis of existing research on a specific topic, using rigorous methods to identify, evaluate, and synthesize studies. Meta-analysis, often part of a systematic review, combines results from multiple studies to identify overall trends and enhance reliability, providing a clearer summary of evidence. Articles that included pediatric patients (from birth to 12 years of age) with a diagnosis of OBPP were reviewed. The results of the techniques used were analyzed according to each study, with the scale or method of assessment considered by the study for the presentation of data. The articles were assessed for methodological quality using the "PEDro Validity Scale". (3) Results: A total of 2190 articles were found, with 108 analyzed and 22 fully meeting this study's standards. Fourteen had a quantitative design, while the others included clinical guidelines. The most statistically reliable intervention techniques were CIMT (constraint-induced movement therapy) and splinting (dynamic and static), with second-tier techniques like joint manipulation, NMES, early infant management education, and serial casting used when needed. This study focused on children from birth to eight years old, with assessment tools primarily measuring upper limb range of motion, external rotation, supination, and impairment levels, though bimanual activity assessment was less common. (4) Conclusions: The early implementation of the techniques that provide us with the most data are CIMT, splinting, NMES, and joint manipulation linked to health education for families. In second place, we have the use of TB infiltrations and serial casts, when the treatment of the previous techniques fails in some cases.

Objectively measured levels of moderate to vigorous intensity physical activity are associated with cognitive impairment in diabetic hemodialysis patients: a cross-sectional study.

The purpose of this study was to observe the relationship between objectively measured levels of physical activity and cognitive impairment (CI) in the presence or absence of diabetes in middle-aged and elderly hemodialysis patients. In this multicenter cross-sectional study, 339 clinically stable hemodialysis patients (210 males; mean age: 67.38 ± 8.07 years) aged ≥55 years were included from 7 dialysis units in Shanghai, China. The Chinese version of the Modified Mini-Mental State Examination (MMSE) was used to assess the CI. The duration of physical activity at different intensities, including moderate to vigorous physical activity (MVPA) as well as light physical activity (LPA), was measured using a triaxial accelerometer (ActiGraph GT3X+, Pensacola, FL, USA). Logistic regression and multiple linear regression were used for analyses. The prevalence of CI was higher in hemodialysis patients with comorbid diabetes (24.3%). In diabetic patients, MVPA (increase per 10 min/day) was negatively associated with CI after adjusting for covariates [(OR = 0.89, 95%CI = 0.79-0.99), p = 0.042]. However, no significant association between physical activity and CI was found in non-diabetic hemodialysis patients. Further analyses revealed that MVPA was positively associated with temporal orientation, attention and calculation and recall in diabetic hemodialysis patients. Physical activity was associated with CI in diabetic hemodialysis patients rather than the non-diabetes group. This study is important for early differential diagnosis of CI and improvement of cognitive status in hemodialysis patients.

Characterizing cognitive phenotypes and clinical correlates in type 2 diabetes using fuzzy clustering and decision tree analysis

Cognitive impairment is frequently seen in patients with type 2 diabetes (T2DM), ranging from mild impairment to dementia. However, our knowledge of the specific profiles and risk factors for these different levels of impairment is limited. In this study involving 152 patients with T2DM, cognitive function was assessed using the Montreal Cognitive Assessment test. The Fuzzy C-means clustering algorithm was utilized to group individuals with similar cognitive characteristics. The study evaluated how well clinical parameters could classify characteristics of clusters using the Classification and Regression Trees algorithm. ROC analysis was then used to assess the classification success. Three distinct cognitive clusters were identified. Cluster 1 had the poorest cognitive performance and was characterized by more women, lower education levels, and lower levels of iron, hemoglobin, and creatine. Cluster 3, the amnestic cluster, was distinguished by low TSH levels. The decision tree model highlighted several parameters, including education level, hemoglobin, duration of diabetes mellitus (DM), iron, TSH, gender, family history of diabetes, and microalbumin/creatinine ratio, as significantly affecting the distinction of cognitive clusters. Diabetes-associated cognitive impairment stems from multifaceted pathophysiological mechanisms influenced by complex risk factors, resulting in diverse types of cognitive deficits.

The Impact of Body Contouring Following Bariatric Surgery: A Prospective Examination of Psychosocial and Medical Impairment.

Body contouring surgery (BCS) to remove loose skin is often desired following bariatric surgery. This study prospectively examined psychosocial and medical functioning based on BCS status after bariatric surgery. N=56 adults who sought a BCS consultation following bariatric surgery completed measures of impairment, depression, and medical (e.g., rashes, infections) and psychosocial concerns due to loose skin. Assessments were repeated at 1- and 3-month follow-ups. Most did not undergo BCS due to insurance coverage denial/finances; n = 24 (42.9%) underwent BCS. The groups with and without BCS did not differ significantly in BMI, weight loss, impairment, or depression at any assessment; however, a significantly greater proportion of non-BCS patients reported several medical and psychosocial concerns due to loose skin relative to BCS patients at follow-up assessments. Greater loose skin concerns were associated significantly with greater impairment and depression at all assessments. Over half who sought BCS did not undergo BCS, mostly due to insurance/financial reasons. The BCS group had significantly fewer medical and psychosocial concerns related to loose skin at follow-ups. Greater loose skin concerns were associated with heightened levels of broad psychosocial impairments suggesting that loose skin and psychological concerns warrant greater clinical attention after bariatric surgery. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Exploring racial and ethnic disparities in the hidradenitis suppurativa patient disease journey: Results from a real-world study in Europe and the USA.

Hidradenitis suppurativa (HS) is an inflammatory skin disease associated with high morbidity and disability that has limited treatment options. People from racial and ethnic minority groups may experience greater disease severity and delay to diagnosis. This study assessed the impact of race/ethnicity on HS diagnosis and management in real-world clinical settings. Data were derived from the Adelphi Real World Hidradenitis Suppurativa Disease Specific Programme, a survey of dermatologists and their consulting HS patients in five European countries and the USA in 2020/2021. Dermatologists returned demographic and clinical data, and treatment goals and satisfaction for their next five to seven consulting patients. Patients completed a questionnaire on disease history and diagnosis, disease burden, and treatment satisfaction. Groups were compared with bivariate tests. In total, 312 physicians returned data on 1787 patients; 57.6% were female and 77.7% White. People from racial and ethnic minority groups were younger than White patients (32.9 ± 11.6 vs. 34.9 ± 12.4, mean ± standard deviation) and reported symptoms at a younger age (23.3 ± 10.8 vs. 26.2 ± 11.1), but their time to first consultation was longer than for White patients (2.6 ± 5.7 vs. 1.2 ± 2.5 years). People from racial and ethnic minority groups took longer to receive a correct diagnosis following first consultation (2.7 ± 5.3 vs. 1.5 ± 4.1 years) and were more likely to be misdiagnosed with boils (73.5% vs. 40.4%). People from racial and ethnic minority groups had a greater disease awareness at diagnosis and reported wanting greater support. People from racial and ethnic minority groups reported a greater impact on life, more severe pain, and a greater level of activity impairment in the Work Productivity and Activity Impairment: General Health (27.0 ± 25.2 vs. 20.0 ± 20.6). All P values were ≤0.05. These data show evidence of delayed diagnosis and higher HS symptom burden amongst people from racial and ethnic minority groups, highlighting health disparities in HS.

Effects of Boron on Learning and Behavioral Disorders in Rat Autism Model Induced by Intracerebroventricular Propionic Acid.

Autism spectrum disorder is a neurodevelopmental disorder in which learning, communication, and social interaction are impaired. Research has sought to minimize the neural impairments associated with autism spectrum disorder and improve the quality of life. Recent studies suggest that boron may benefit nerve cells, with effects varying depending on the dosage. This study explored the impact of boron, administered as boric acid, on behavioral, biochemical, and histopathological parameters in a rat model of autism induced by propionic acid (PPA). Thirty-two male Sprague-Dawley rats were divided into control, autism model, and boron-treated groups. Behavioral tests were conducted pre- and post-PPA induction, with brain tissue analyzed post-euthanasia. Proinflammatory cytokines (tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1β), interleukin 6 (IL-6)) and brain-derived neurotrophic factor (BDNF) levels were assessed in the hippocampus. Histopathological evaluations were conducted on the hippocampus and cerebellum. Autism model rats displayed impaired learning, elevated BDNF and cytokine levels, microglial and astrocytic activation, and decreased Purkinje cell count. The boron-treated groups showed improvements, particularly with the 4mg/kg dose. This dose enhanced learning and social interaction, reduced proinflammatory cytokine levels, prevented microglial and astrocytic activation, and increased Purkinje cell count. Boron treatment exhibited neuroprotective potential, ameliorating autism spectrum disorder deficits by modulating cytokines, BDNF, microglia, and astrocytes, with low doses yielding pronounced effects.

Patterns of abnormal activations in severe mental disorders a transdiagnostic data-driven meta-analysis of task-based fMRI studies.

Studies suggest severe mental disorders (SMDs), such as schizophrenia, major depressive disorder and bipolar disorder, are associated with common alterations in brain activity, albeit with a graded level of impairment. However, discrepancies between study findings likely to results from both small sample sizes and the use of different functional magnetic resonance imaging (fMRI) tasks. To address these issues, data-driven meta-analytic approach designed to identify homogeneous brain co-activity patterns across tasks was conducted to better characterize the common and distinct alterations between these disorders. A hierarchical clustering analysis was conducted to identify groups of studies reporting similar neuroimaging results, independent of task type and psychiatric diagnosis. A traditional meta-analysis (activation likelihood estimation) was then performed within each of these groups of studies to extract their aberrant activation maps. A total of 762 fMRI study contrasts were targeted, comprising 13 991 patients with SMDs. Hierarchical clustering analysis identified 5 groups of studies (meta-analytic groupings; MAGs) being characterized by distinct aberrant activation patterns across SMDs: (1) emotion processing; (2) cognitive processing; (3) motor processes, (4) reward processing, and (5) visual processing. While MAG1 was mostly commonly impaired, MAG2 was more impaired in schizophrenia, while MAG3 and MAG5 revealed no differences between disorder. MAG4 showed the strongest between-diagnoses differences, particularly in the striatum, posterior cingulate cortex, and ventromedial prefrontal cortex. SMDs are characterized mostly by common deficits in brain networks, although differences between disorders are also present. This study highlights the importance of studying SMDs simultaneously rather than independently.

Bidirectional effects of parenting and ADHD symptoms in young children: Effects of comorbid oppositional symptoms.

Psychosocial factors play an important role in the manifestation of attention-deficit/hyperactivity disorder (ADHD) symptoms and accompanying impairment levels in children. In a community sample of 796 children evaluated at 4, 5, and 6 years of age, bidirectional effects were examined for each of three components of parenting (parental support, hostility, scaffolding skills) and ADHD-specific symptoms that are not associated with symptoms of oppositional defiant disorder. Results indicated that (a) age 4 parenting factors were not associated with changes in ADHD-I (inattention) or ADHD-H (hyperactive-impulsive) symptoms in the subsequent year, (b) ADHD-I and ADHD-H symptoms at age 4 were not associated with changes in parenting factors at age 5, (c) age 5 ADHD-I and ADHD-H symptoms were associated with decreases in parental scaffolding skills and increases in parental hostility from ages 5 to 6 years, and (d) parental support at age 5 was associated with a decrease in ADHD-H symptoms at age 6. Findings suggest that ADHD symptoms can lead to poorer parenting attitudes and behavior, while parental support during kindergarten has a small effect on decreasing ADHD-H symptoms over time.

Mild to moderate cognitive impairment does not bias the Geriatric Depression Scale in a large US sample of older adults.

The Geriatric Depression Scale (GDS) is widely used to screen for depression in clinical practice and to assess symptoms of depression in research about older adults. To determine whether the 15-item GDS can be used in adults with dementia, this study investigated whether item- or test-level bias in the GDS-15 is associated with the respondent's level of cognitive impairment. Using a large U.S. sample of 24,674 adults, we first conducted sample matching procedures between the five groups defined by CDR® Dementia Staging Instrument scores to control for potential confounding effects of common demographic variables. Then, we employed confirmatory factor analysis (for single-group and configural-invariance models only) and item response theory models to test potential differential item/test functioning effects associated with the GDS-15 across the five CDR groups. Practical consequences of the identified biases were quantified using sample-based Cohen's d effect sizes and misclassification rates. In general, people with higher CDR scores were older and had fewer years of education. In comparison to the normal cognition group (CDR-0), negligible biases in GDS-15 scores were found for the groups with questionable, mild, or moderate cognitive impairment (CDR-0.5/1/2). For individuals with severe cognitive impairment (CDR-3), their responses were inconsistent with the normal cognition group and their depression scores were significantly biased with a small-to-medium effect size. The GDS-15 can be used to assess depression in individuals with mild or moderate cognitive impairment, but not in individuals with severe cognitive impairment.

Factors Affecting Level of Physical Activity among Stroke Survivors: A Scoping Review.

Physical activity (PA) is crucial for improving stroke survivors' health outcomes and quality of life (QoL). Impaired PA levels are common among stroke survivors, a significant portion of whom spend their days in sedentary occupations. Understanding the factors that influence physical inactivity and addressing the barriers to exercise participation can contribute significantly to improving stroke survivors' health outcomes and prognoses. Therefore, in the current review, we systematically searched five databases (PubMed/Medline, Scopus, SpringerLink, ScienceDirect and Google Scholar) for published studies reporting PA levels among stroke survivors, which yielded 301 potential articles. Based on the identification and screening processes recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR), 13 articles were finally included in the analysis. The results of these studies, covering 1,318 stroke survivors, revealed physical inactivity among most of the participants and significant heterogeneity among the outcome measures used. The factors affecting PA levels among stroke survivors were mainly categorised as physical, psychological, and sociodemographic, and all were significantly associated with PA levels after strokes.

Application and expansion of an algorithm predicting attention-deficit/hyperactivity disorder and impairment in a predominantly White sample.

Current assessment protocols for attention-deficit/hyperactivity disorder (ADHD) focus heavily on a set of highly overlapping symptoms, with well-validated factors like cognitive disengagement syndrome (CDS), executive function (EF), age, sex, and race and ethnicity generally being ignored. Using machine learning techniques, the current study aimed to validate recent findings proposing a subset of ADHD symptoms that, together, predict ADHD diagnosis, severity, and impairment level better than the full symptom list, while also testing whether the inclusion of the factors listed above could further increase accuracy. Parents of 1,922 children (50.1% male) aged 6-17 years completed rating scales of ADHD, CDS, EF, and impairment. Results suggested nine symptoms as most important in predicting outcomes: (a) has difficulty sustaining attention in tasks or play activities; (b) does not follow through on instructions and fails to finish work; (c) avoids tasks (e.g., schoolwork, homework) that require sustained mental effort; (d) is often easily distracted; (e) has difficulty organizing tasks and activities; (f) is often forgetful in daily activities; (g) fidgets with hands or feet or squirms in seat; (h) interrupts/intrudes on others; and (i) shifts around excessively or feels restless or hemmed in. The abbreviated algorithm achieved accuracy rates that did not significantly differ compared to an algorithm comprising all 18 symptoms in predicting impairment, while also demonstrating excellent discriminative ability in predicting ADHD diagnosis. Adding CDS and EF to the abbreviated algorithm further improved the prediction of global impairment. Continued refinement of screening tools will be key to ensuring access to clinical services for youth at risk for ADHD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Parents' Distress and Demands for Children With Cancer-Related Cognitive Impairment in Western China: A Qualitative Study.

Cancer-related cognitive impairment is one of the common complications in children with cancer, but our understanding of their experience with cognitive deficits remains limited. From the perspective of parents, this study aimed to explore the distress and demands faced by children with cancer-related cognitive impairment, to provide references for developing targeted intervention strategies for cancer children. We used a purposeful sampling method to conduct semi-structured interviews with the parents of 18 children with cancer-related cognitive impairment. The transcripts were analyzed using Colaizzi's method. Three categories and 11 subcategories were obtained from the data analysis, including diverse levels of cognitive impairment in children (speech communication difficulties, impaired executive function, attention deficit, and intellectual disability), persistent negative emotions (anxiety and worry, complaints and resentment, negative avoidance and positive experiences after psychological adjustment), multiple needs (need for disease information, need for professional management, and an urgent need for more external support). Parents of children with cancer-related cognitive impairment face a significant psychological burden, coupled with confusion and numerous inquiries regarding the symptoms and management of their children's cognitive impairment. It is imperative for medical professionals to strengthen the dissemination of information related to cancer-associated cognitive impairments, while promptly recognizing and intervening in related symptoms. Rational allocation of resources, establishment of targeted support systems, and enhancement of social acceptance may be the key points that policymakers could consider. These efforts hold immense significance, as they play a pivotal role in elevating cognitive capabilities and enhancing the overall quality of life for children with cancer.

Health Profile Transitions and the Association With Cognitive Impairment in Older Nursing Home Residents With Suicidal Ideation.

In older U.S. nursing home residents with suicidal ideation (SI), limited studies have longitudinally investigated their health changes as related to cognitive function. This study aimed to identify the health profiles and the transitions between profiles at admission and 90-days and examine the associations with cognitive impairment. Using Minimum Data Set 3.0 (2011-15), we identified 10,079 older residents without severe cognitive impairment who reported SI on Patient Health Questionnaire-9. Health profile indicators included at-admission and 90-day post-admission depressive symptoms, frailty, and pain frequency and intensity. Using latent transition analysis, we identified distinct health profiles, examined the transitions between profiles over time, and estimated their associations with cognitive impairment. One third of residents continued to report SI at 90days. The five health profiles identified at admission were distinctive with varying levels of frailty, depressive symptoms, and pain, from the most severe Profile 1 characterized by frailty, all depressive symptoms, and horrible or frequent pain, to the least severe Profile 5 characterized by pre-frailty, depressed mood, and no pain. The 90-day profiles were mostly consistent. Most residents remained in a similar profile over time. Relative to residents with intact cognition/mild cognitive impairment, those with moderate impairment were less likely to belong to profiles characterized by more depressive symptoms and pain. Residents with SI had heterogeneous health profiles, which varied by cognitive impairment levels, but showed minimal changes despite being in a medically supervised setting. Findings highlighted the critical need for adequate recognition and management of SI in nursing homes.

Chronic stroke survivors underestimate their upper limb motor ability in a simple 2D motor task

BackgroundStroke survivors can exhibit a mismatch between the actual motor ability of their affected upper limb and how much they use it in daily life. The resulting non-use of the affected upper limb has a negative impact on participation in neurorehabilitation and functional independence. The factors leading to non-use of the affected upper limb are poorly understood. One possibility is that non-use comes about through inappropriately low confidence in their own upper limb motor abilities.ObjectiveWe asked whether chronic stroke survivors underestimate the motor ability of their affected upper limb.Methods20 chronic stroke survivors (Mean FM: 28.2 ± 10.5) completed a 2D reaching task using an exoskeleton robot. Target sizes were individually altered to ensure success rates were similar for both upper limbs. Prior to each reaching movement, participants rated their confidence about successfully hitting the target (estimated upper limb motor ability).ResultsConfidence ratings were significantly lower for the affected upper limb (estimated ability), even though it was equally successful in the reaching task in comparison to the less affected upper limb (actual ability). Furthermore, confidence ratings did not correlate with level of impairment.ConclusionsOur results demonstrate that chronic stroke survivors can underestimate the actual motor abilities of their affected upper limb, independent of impairment level. Low confidence in affected upper limb motor abilities should be considered as a therapeutic target to increase the incorporation of the affected upper limb into activities of daily living.