Item Functioning Research Articles

Evaluation of the test–retest and inter-mode comparability of the Impact of Vision Impairment questionnaire in people with chronic eye diseases

PurposeThe main objective of this study is to assess the test–retest and inter-administration mode reliability of the Impact of Vision Impairment profile (IVI), a common patient-reported outcome measure (PROM) for people with chronic eye diseases.MethodsThe IVI was administered to adult patients with stable, chronic eye diseases two to four times per participant (average intervals between administrations 12 to 20 days; maximum two phone interviews, paper administration, electronic administration) by two trained interviewers. Rasch models were fit to the data. Intra-class correlation coefficients (ICCs), mean differences and Cronbach’s alpha between test–retest administrations (two phone interviews) and inter-mode comparisons were calculated.ResultsTwo hundred-sixteen patients (mean age 67 ± 12 years, 40% male) were included in the study. The IVI met all psychometric requirements of the Rasch model, and the division into the domains of functional items (IVI_F) and emotional items (IVI_E) corresponded to the German validation study. ICCs (all for IVI_F and IVI_E, respectively) for the retest administrations were 0.938 and 0.912, and 0.853 and 0.893 for inter-mode comparisons phone/paper, 0.939 and 0.930 for phone/electronic, and 0.937 and 0.920 for paper/electronic (all p < 0.01). Mean differences (all for IVI_F and IVI_E, respectively) for the retest administrations were 2.8% and 0.7% and ranged from 2.0% to 6.2% and from 0.4 % to 4.9% between administration modes. Cronbach’s alpha ranged from 0.886 to 0.944 for retest and inter-mode comparisons.ConclusionDue to the high test–retest reliability and the almost equally high comparability of different modes of administration of the IVI, the study endorses its use as a robust PROM to capture vision-related quality of life. Our results further support the use of the IVI as an endpoint in clinical trials and may simplify implementing it in both clinical trials or real-world evidence generation by offering multiple administration modes with high reliability.

Identification and Analysis of Genes Related to Testicular Size in 14-Day-Old Piglets.

The RNA-Seq technology was used to screen the key genes that affect the early development of the testes of Duroc × Landrace × Yorkshire piglets, to determine the regulatory pathway and provide reference for subsequent reproductive performance research, breeding, and other production practices. This study selected 14-day-old Duroc × Landrace × Yorkshire piglets as the trial animals. Testes from piglets with similar weights and no pathological changes were divided into small testis (ST) and large testis (LT) groups, and the RNA-Seq screening of differentially expressed genes (DEGs) was performed to find candidate genes and regulatory pathways related to early testicular development. The results show that 570 DEGs were found in the ST and LT groups, with 281 upregulated and 289 downregulated. The DEGs were mainly enriched on 47 gene ontology (GO) functional items. The Kyoto encyclopedia of genes and genotypes (KEGG) enrichment analysis found that there were 44 significantly enriched KEGG signal pathways, and the regulation of testicular development mainly focused on the arachidonic acid metabolism, Wnt signaling pathway and GnRH secretion pathways. The PTGES, SFRP1, SPP1, PLA2G4E, KCNJ5, PTGS2, and HCN1 genes were found to be as closely related to the testicular development of these Duroc × Landrace × Yorkshire piglets, and the differential gene expression was consistent with the real-time quantitative reverse transcription PCR (real-time qRT-PCR) validation results. This study was validated by high-throughput sequencing analysis and real-time qRT-PCR, and showed that the PTGES, SFRP1, SPP1, PLA2G4E, KCNJ5, PTGS2, and HCN1 genes may be involved in the regulation of germ cell development, spermatogenesis and semen traits. These should be further studied as candidate genes for early testicular development and reproductive trait regulation in boars.

Physical Activity Participation Decreases the Risk of Depression in Older Adults: The ATHLOS Population-Based Cohort Study

BackgroundTo which extent physical activity is associated with depression independent of older adults’ physical and cognitive functioning is largely unknown. This cohort study using harmonised data by the EU Ageing Trajectories of Health: Longitudinal Opportunities and Synergies consortium, including over 20 countries, to evaluate the longitudinal association of physical activity (light-to-moderate or vigorous intensity) with depression in older adults (aged ≥ 50 years).ResultsWe evaluated 56,818 participants (light-to-moderate models; 52.7% females, age 50–102 years) and 62,656 participants (vigorous models; 52.7% females, age 50–105 years). Compared to never, light-to-moderate or vigorous physical activity was associated with a lower incidence rate ratio (IRR) of depression (light-to-moderate model: once/week: 0.632, 95% CI 0.602–0.663; twice or more/week: 0.488, 95% CI 0.468–0.510; vigorous model: once/week: 0.652, 95% CI 0.623–0.683; twice or more/week: 0.591, 95% CI 0.566–0.616). Physical activity remained associated with depression after adjustment for the healthy ageing scale, which is a scale that incorporated 41 items of physical and cognitive functioning (light-to-moderate model: once/week: 0.787, 95% CI 0.752–0.824; twice or more/week: 0.711, 95% CI 0.682–0.742; vigorous model: once/week: 0.828, 95% CI 0.792–0.866; twice or more/week: 0.820, 95% CI 0.786–0.856).ConclusionsPhysical activity, of any intensity and weekly frequency, was a strong protective factor against depression, independent of physical and mental functioning. Health policies could stimulate the incorporation of lower physical activity intensity to protect against depression, which might be more feasible at the population level.

Índice de fragilidade modificado de 11 itens (mFI-11) como instrumento para prever mortalidade em pacientes idosos em hemodiálise crônica

Abstract Objective To analyze the 11-item modified frailty index (mFI-11) as a predictor of mortality among older adults on chronic hemodialysis. Method A prospective observational study conducted in dialysis units in the municipality of Niterói (RJ, Brazil). A total of 124 patients on hemodialysis (HD) for at least 3 months, who began renal replacement therapy at the age of 65 or older, were followed for 24 months. Frailty was measured using the mFI-11, which comprises 9 comorbidities, 1 functional item, and 1 cognitive item. The comorbidities were obtained through anamnesis and medical record review. Functional dependency was determined by the presence of 2 or more dependencies on the Katz scale, and cognitive deficit was measured by the Mini-Mental State Examination (MMSE). The cutoff point for frailty was defined as mFI-11 ≥3. Results The mean age at the start of the study was 76 years, and 55.6% were men. Of the 124 participants, 56.5% had diabetes, 21% had functional dependency, and 52.9% had cognitive deficits. The prevalence of frailty was 67.7%, and an mFI-11 score of ≥3 was significantly associated with an increased risk of death (HR 2.39, 95% CI 1.21-4.72). Conclusion The mFI-11 demonstrated good performance in predicting mortality in older adults on HD. Its simplicity and feasibility make it a valuable tool for clinical practice, aiding in advanced care planning.

Relationship between independence in activities of daily living at discharge and physical activity at admission of older postoperative hip fracture rehabilitation inpatients: A retrospective case-control study.

Hip fractures are associated with a reduction in activities of daily living (ADL) and require long-term care. The physical activity of patients with hip fractures is temporarily impaired immediately after surgery, causing difficulty in the measurement of physical activities at the time of rehabilitation admission. This study examined the relationship between ADL at discharge and light- and moderate-intensity physical activity at the time of rehabilitation admission by determining a cut-off value predicting ADL independence. This retrospective case control study analyzed 43 postoperative hip fracture patients aged ≥65years admitting into inpatient rehabilitation. ADL at discharge was assessed using the Functional Independent Measure motor items (FIM-m). The duration of physical activity at the time of rehabilitation admission was measured using an activity tracker equipped with an accelerometer. Prehospital frailty was evaluated using Clinical Frailty Scale. The relationship between these variables was examined using Spearman's product-moment correlation coefficient. Differences in physical activity between patients requiring and not requiring assistance with ADLs were examined using the analysis of covariance. A receiver operating characteristic curve of the need for ADL assistance at discharge was constructed from the duration of physical activity. The duration of physical activity at the time of rehabilitation admission was related to FIM-m at discharge. The cut-off value of the duration of physical activity for predicting the need for ADL assistance at discharge was 135s, with a sensitivity of 83.3% and specificity of 68.4% (area under the curve: 0.76). The duration of physical activity at the time of rehabilitation admission may be a factor that can quantitatively predict the risk of requiring assistance with ADLs at discharge in older hip fracture patients. The duration of light-and-moderate intensity physical activity may be a component of multidisciplinary inpatient rehabilitation to improve patients' ADL.

Risk factors of thyroid dysfunction in patients with rheumatoid arthritis.

The study aimed to investigate the complicating thyroid dysfunction situation in patients with rheumatoid arthritis (RA) and to analyze the related risk factors of thyroid dysfunction in RA patients. The retrospective analysis of the clinical data and laboratory examinations of 290 cases of RA and 200 healthy individuals undergoing the physical examination was carried out. The thyroid function, anti-thyroid antibodies, and routine laboratory test items were measured. The RA disease activity score (DAS28) was determined in RA patients. Logistic analysis was used to identify risk factors associated with thyroid dysfunction in RA patients. The detection rate of RA combined with thyroid dysfunction was 30.0%, which was higher than in the control group (7%, 14 cases). In the thyroid function test, levels of total triiodothyronine (T3) and free triiodothyronine (FT3) were lower, while thyrotropin (TSH), antithyroid peroxidase antibody (TPOAb), and antithyroglobulin antibody (TgAb) were higher in the RA group. There was a difference in hemoglobin (HGB) and total cholesterol (TC) in RA patients with and without abnormal thyroid function. Rheumatoid arthritis patients are more prone to develop thyroid dysfunction than healthy individuals, especially hypothyroidism. HGB and TC were correlated with thyroid hormones and antibodies and were risk factors correlated with thyroid dysfunction in RA patients. Clinical work should pay full attention to changes in thyroid function in patients with RA.

Changes in caregiving risk and motor function among older adults participating in community gatherings in Koshigaya city.

[Purpose] This study investigated the changes in caregiving risk and motor function among older adults participating in community gatherings ("Kayoinoba") in Koshigaya. [Participants and Methods] A total of 257 older participants who engaged in the Kayoinoba program for 6 months from its inception were included in the analysis. Caregiving risk and motor function were assessed twice-once at the beginning of the Kayoinoba (first assessment) and again 6 months later (second assessment). The Kihon Checklist was used to evaluate caregiving risk, and the timed up-and-go, one-leg standing, and 30-s chair-stand tests were done to evaluate motor functioning. Participants were divided into pre-frail and healthy groups, and the first and second assessments were compared. [Results] The Kihon Checklist score of the pre-frail group significantly improved from the first to the second assessment. The pre-frail group had lower composite scores for physical function, outdoor activities, and depression mood items based on the Kihon Checklist; the healthy group showed no such differences. Performance on the 30-s chair-stand test was significantly better in the second assessment than in the first assessment in both groups. [Conclusion] The findings of this study emphasize the benefits of participating in Kayoinoba among high-risk older adults and provide the knowledge for developing a healthier community-based symbiotic society.

A Study on the Relationship between Digital Presentation of Intangible Cultural Heritage in Libraries and Visitors’ Interactive Experience

Abstract Under the guidance of the theory related to the KANO demand model, this paper constructs the user demand hierarchy of the digital display of intangible cultural heritage and carries out the division of functional demand item categories through classification experiments. A questionnaire survey was set up to evaluate the satisfaction of the virtual reality technology of intangible cultural heritage crafts, and 30 participants’ interactive behaviors were coded so as to analyze the data results and explore the relationship between digital display and interactive behaviors. The findings indicate that both social and gamified interaction are charismatic needs of users when it comes to the digital display of NRM. In the practical case of virtual technology combined with non-heritage skills, the satisfaction level of design, content, and other aspects exceeded 60%. Non-heritage digital displays have 115 more interactive behaviors than traditional display methods. The interactive experience of participants can be enhanced and their needs can be satisfied by the digital display of NRLs.

응급구조(학)과 학생들의 신경학적 검진 역량 교육요구도 조사

Objectives This study aims to identify educational needs for neurological examination capabilities for department of paramedicine students, and to provide basic data on the development and application of educational programs to improve neurological capabilities, as well as implications for finding strategies to efficiently cope with neurological emergencies in practice.&#x0D; Methods To develop an education program to strengthen neurological examination capabilities, the survey on educational needs for strengthening neurological examination capabilities among paramedicine students was designed as a cross-sectional descriptive research survey using importance and performance analysis, and was designed to determine the importance of neurological examination and Paired t-test was used to determine differences in performance, and Importance-Performance Analysis (IPA) was used to select priorities for training needs.&#x0D; Results First, the neurological screening capability measurement tool developed in this study can also be seen as a meaningful attempt to improve the neurological capabilities of department of paramedicine students. Second, the exercise function item was the highest in the neurological examination competency item that the department of paramedicine students considered important. Third, as a result of analyzing the educational needs for enhancing neurological screening capabilities recognized by department of paramedicine students using IPA techniques, the items recognized by this study subjects as priorities were pathological reflexes, cerebral function, and brain neurological examination, and the items that should be maintained and managed continuously were motor function, symptoms and signs, overall neurological evaluation, records and reports.&#x0D; Conclusions It is also very important to provide education to new medical staff or health care personnel in the medical field for neurological emergencies, but before that, it is necessary to develop subjects and conduct regular education by organizing various contents, including coping protocols for neurological emergencies and overall understanding of neurological emergencies, to meet students'needs.&#x0D;

Upcycling of solid waste for furniture production: an environmentally sustainable solution for waste disposal

Purpose. This study aimed to demonstrate, using studio research approaches, how solid waste in Kumasi Metropolis, Ghana, can be innovatively recycled into aesthetically pleasing and functional furniture pieces as a waste management strategy to achieve environmental sustainability. Results. Environmental sustainability and the economic profitability of solid waste generated during furniture production go hand in hand. By using recycled or reclaimed materials, implementing sustainable production practices and responding to the demand for environmentally friendly products, furniture manufacturers can contribute to a more sustainable future while receiving financial benefits. The study showed that upcycling is an excellent waste management strategy that creative persons and other innovators could use to help in the management of solid waste that have become an environmental nuisance. Also, the study revealed that creative persons could potentially train others in their locality to be more creative-centered so as to innovatively transform solid waste materials into more aesthetically relevant and functional items for environmental sustainability. Scientific novelty. The discarded solid wastes were repurposed to create new, functional and aesthetically pleasing furniture. The process of upcycling not only reduces solid waste but also minimizes the need for raw materials and energy consumption in furniture production. This is a new and an innovative concept in the field of furniture in Ghana. Practical value. Upcycling of solid waste for furniture production in the Kumasi Metropolis offers usable relevance by reducing waste, conserving physical resources, and creating economic opportunities which is mutually beneficial for both the environment and the community. Applying sustainable practices in furniture production can improve the brand image and attract public or consumer attention to environmentally conscious people.

Effect of papaya leaf (Carica papaya) boiled water and honey to reduce menstrual pain in teenage girls in Indonesia

Premenstrual or menstrual cramping can cause pain or discomfort in the lower abdomen. Although it can range from minor to severe, menstrual discomfort can be disruptive to daily life. Both pharmaceutical and non-pharmacological therapies can be used to alleviate menstrual discomfort. Papaya leaves (Carica papaya) and honey are two natural components that are thought to be used in one of the ancient remedies to lessen menstruation pain. Vitamin E, which is found in papaya leaves, can lessen menstruation pain. Because honey includes glucose and fructose, which regulate the smooth muscles of the uterus, there is less pain associated with menstruation because the uterine muscles can relax. This research aimed to determine the effect of boiled papaya leaf water and honey on reducing menstrual pain in adolescent girls at Ngawen II Public Health Center Gunungkidul. With a single group pretest-posttest design, this study employs a quasiexperimental methodology. A total of 184 teenage females with menstruation discomfort at the Ngawen II Public Health Center in Gunungkidul participated in this study. The tpaired test was used to process the data. According to the findings, adolescent menstruation pain levels decreased on average from -2.65 to 2.29. The results of statistical testing revealed a p-value of 0.000, indicating that there is a difference between giving teenagers functional drink items made from boiled papaya leaves, water, and honey in reducing menstruation pain. Therefore, boiled papaya leaf water and honey can be an alternative to lessen adolescent girls' menstrual pain.

NETWORK ANALYSIS OF OBJECTIVE AND SUBJECTIVE INDICATORS OF SOCIAL ISOLATION AND FUNCTIONAL LIMITATIONS

Abstract Functional limitations, including decreased physical performance and increased limitations in daily activities, are common among older adults and associated with both objective and subjective social isolation. However, the dynamic interactions between and within different indicators of functional limitations and social isolation are unclear. This study employed network analysis to graphically depict and explore the relationships between various objective and subjective indicators of functional limitations and social isolation. Data came from the 2014/2016 waves of the Health and Retirement Study (n=9,076, mean age =67.25,52.32% female, 80.17% non-Hispanic White). Functional limitations were measured by objective physical performance (grip strength, tandem balance test) and self-reported limitations in daily activities. Objective social isolation was based on marital status, living arrangement, and network composition (children, other family members, and friends); subjective social isolation was indicated by the UCLA loneliness scale. Separate networks were constructed for men and women. Centrality indices, including strength, betweenness centrality, and eigenvector centrality, were computed to quantify the influence of each item. Subjective functioning and isolation items were strongly correlated but had weaker interconnections with one another. Strength and eigenvector centrality indicated that subjective functioning items had high degrees of influential interactions. Subjective social isolation items had high values of betweenness centrality, suggesting important bridging roles of these constructs. Subjective social isolation items had a more influential role in the network of women than men. Findings suggest opportunities for interdisciplinary interventions to address the multifactorial relationship between functional limitations and social isolation among older adults.

Body Image and its Relation with Coping Strategies in Breast Cancer Patients: A Descriptive Study in Sulaimaniyah, Iraq

Background: Breast cancer is several of the worst severe illnesses for women, which influences their physical and mental quality of life and acceptance of their bodies. It affects patients' views of their bodies; thus, finding effective coping mechanisms is essential. &#x0D; &#x0D; Objective: This study aimed to discover body image and its relation with coping mechanisms in breast cancer patients admitted to Hiwa Hematology/Oncology Hospital in Sulaimaniyah, Iraq.&#x0D; &#x0D; Materials &amp; Methods: This Cross-sectional study was conducted on women diagnosed with breast cancer admitted to the Hiwa Hematology/Oncology Hospital Sulaimaniyah, Iraq. A three-part questionnaire was utilized to gather information to determine body image and coping mechanisms that were demographic and clinical form, body image scale and Coping Orientation to coping or regulating cognitions in response to stressors (Brief-COPE).&#x0D; &#x0D; Results: The mean score for the body image was reported as 7.86±7.73, the mean score for coping strategies, including problem-focused /active coping strategies items was reported as 2.74±0.67, and functional items as 2.82±0.43. Considering the calculated mean scores, the distress or concerns of the participants about their body image were lower. The most frequent coping strategies were religious coping (3.88±0.32), while the least active coping approach was humor (1.96±1.08). Self-distraction (3.13±1.03) was the least avoidant coping strategy. A significant positive relationship between the coping strategies with body image was reported as (p=0.032, r=0.200).&#x0D; &#x0D; Conclusions: Good body image in women was associated with increased usage of practical acceptance. Therefore, it is advised to promote a positive view of physical appearance and having skilled nurses assess all breast cancer patients' capacity for coping following surgery. Nurses and patients can effectively communicate about body image and coping techniques through these assessments.

Cortical activity associated with focal muscle vibration applied directly to the affected forearm flexor muscle in post-stroke patients: an fNIRS study.

The purpose of this study was to utilize functional near-infrared spectroscopy (fNIRS) to identify changes in cortical activity caused by focal muscle vibration (FMV), which was directly administered to the affected forearm flexor muscles of hemiplegic stroke patients. Additionally, the study aimed to investigate the correlation between these changes and the clinical characteristics of the patients, thereby expanding the understanding of potential neurophysiological mechanisms linked to these effects. Twenty-two stroke patients with right hemiplegia who were admitted to our ward for rehabilitation were selected for this study. The fNIRS data were collected from subjects using a block-design paradigm. Subsequently, the collected data were analyzed using the NirSpark software to determine the mean Oxyhemoglobin (Hbo) concentrations for each cortical region of interest (ROI) in the task and rest states for every subject. The stimulation task was FMV (frequency 60 Hz, amplitude 6 mm) directly applied to belly of the flexor carpi radialis muscle (FCR) on the affected side. Hbo was measured in six regions of interest (ROIs) in the cerebral cortex, which included the bilateral prefrontal cortex (PFC), sensorimotor cortex (SMC), and occipital cortex (OC). The clinical characteristics of the patients were assessed concurrently, including Lovett's 6-level muscle strength assessment, clinical muscle tone assessment, the upper extremity function items of the Fugl-Meyer Assessment (FMA-UE), Bruunstrom staging scale (BRS), and Modified Barthel index (MBI). Statistical analyses were conducted to determine the activation in the ROIs and to comprehend its correlation with the clinical characteristics of the patients. Statistical analysis revealed that, except for right OC, there were statistically significant differences between the mean Hbo in the task state and rest state for bilateral SMC, PFC, and left OC. A positive correlation was observed between the muscle strength of the affected wrist flexor group and the change values of Hbo (Hbo-CV), as well as the beta values in the left SMC, PFC, and OC. However, no statistical correlation was found between muscle strength and Hbo-CV or beta values in the right SMC, PFC, and OC. The BRS of the affected upper limb exhibited a positive correlation with the Hbo-CV or beta values in the left SMC and PFC. In contrast, no statistical correlation was observed in the right SMC, PFC, and bilateral OC. No significant correlation was found between the muscle tone of the affected wrist flexor group, FMA-UE, MBI, and Hbo-CV or beta values of cortical ROIs. FMV-evoked sensory stimulation applied directly to the FCR belly on the paralyzed side activated additional brain cortices, including bilateral PFC and ipsilesional OC, along with bilateral SMC in stroke patients. However, the clinical characteristics of the patients were only correlated with the intensity of ipsilesional SMC and PFC activation. The results of this study provide neurophysiological theoretical support for the expanded clinical application of FMV.

Is communication key in stroke rehabilitation and recovery? National linked stroke data study

ABSTRACT Background Information on the characteristics or long-term outcomes of people with communication support needs post-stroke is limited. We investigated associations between communication gains in rehabilitation and long-term outcomes (quality-of-life [EuroQOL-ED-3 L], mortality) by post-stroke communication support need status. Methods Retrospective cohort study using person-level linked data from the Australian Stroke Clinical Registry and the Australasian Rehabilitation Outcomes Centre (2014–2017). Communication support needs were assessed using the Functional Independence Measure™ comprehension and expression items recorded on admission indicated by scores one (total assistance) to five (standby prompting). Multivariable multilevel and Cox regression models were used to determine associations with long-term outcomes. Results Of 8,394 patients who received in-patient rehabilitation after stroke (42% female, median age 75.6 years), two-thirds had post-stroke communication support needs. Having aphasia (odds ratio [OR] 4.34, 95% CI 3.67–5.14), being aged ≥65 years (OR 1.21, 95% CI 1.08–1.36), greater stroke severity (unable to walk on admission; OR 1.48, 95% CI 1.32–1.68) and previous stroke (OR 1.25, 95% CI 1.11–1.41) were associated with increased likelihoods of having communication support needs. One-point improvement in FIM™ expression was associated with reduced likelihood of self-reporting problems related to mobility (OR 0.85, 95% CI: 0.80–0.90), self-care (OR 0.79, 95% CI: 0.74–0.86) or usual activities (OR 0.84, 95% CI: 0.75–0.94) at 90–180 days. Patients with communication support needs had greater mortality rates within one-year post-stroke (adjusted hazard ratio 1.99, 95% CI: 1.65–2.39). Conclusions Two-thirds of patients with stroke require communication support to participate in healthcare activities. Establishing communication-accessible stroke care environments is a priority.

Mind the gap: Bridging knowledge and action in e-waste management

Electronic waste (e-waste) is a growing global problem of WEEE (waste electrical and electronic equipment), including both functional and damaged items. The study aimed to assess the university's electronic waste production and the level of awareness among respondents. The data gathered from the survey paints a detailed picture of respondents' demographics, awareness, and practices related to electronic devices and e-Waste management. Daily electronic device usage patterns reveal the ubiquitous nature of cell phones and laptops in respondents' lives, showcasing the indispensable role of these technologies. Moreover, the collective acknowledgment of the hazardous nature of electronic waste and recognition of specific electronic devices as potential sources of environmental harm are noteworthy. The survey's findings underscore the collective responsibility to safeguard the environment by making informed choices in the realm of electronics. It also calls for ongoing efforts to raise awareness and educate individuals from diverse demographics and educational backgrounds about sustainable electronic device use and disposal.

Effectiveness of Motor Relearning Programme on Sit to Stand Performance Among Right and Left Hemiparesis Patients

OBJECTIVE: To compare the effectiveness of Motor Relearning Program (MRP) on sit to stand performance among right and left hemi paresis patients. Study design: Quasi experimental study design with two groups pre-test and post test. Participants: A total of 16 male right and left hemi paretic patients in the age group of 45 to 65 years participated in the study. The participants recruited were diagnosed with middle cerebral artery lesion with duration less than 3 weeks and a score of 1 on the Motor Assessment Scale for sitting to standing up item. The patients who satisfied inclusion criteria were conveniently assigned into 2 groups. Group A- right hemiparesis and Group B- left hemi paresis. Interventions: Motor Relearning Programme for sitting to standing for duration of 2 weeks (40 minutes/session, 5session/week, total 10 sessions). Outcome Measures: Measurements were taken using Sitting to standing functional item of Motor Assessment Scale (MAS) following 2 weeks of the training program. Results: Statistical analysis was done using the ‘t’ test, which showed a significant improvement in Motor Assessment Scale (MAS) for sitting to standing up item for both groups. But GROUP-A (Right hemi paresis) showed a more significant improvement than GROUP – B(Left hemi paresis) in Motor Assessment Scale (MAS) for sitting to standing up item. Conclusions: The findings of this study suggest Motor Relearning Programme improves sit to stand performance. And there was a significant difference in sit to stand performance between right and left hemi paresis patients following 2 weeks of Motor Relearning Programme. Keywords: Motor Relearning Programme, Sit to stand, Motor Assessment Scale, Hemi paresis.

Uncovering Differential Item Functioning effects using MIMIC and mediated MIMIC models.

The aim of this study was twofold: first, to examine the presence of bias across gender in a scholastic achievement test named the Academic Achievement Test (AAT) for the Science Track. Second, to understand the underlying mechanism that causes these bias effects by examining the effect of general cognitive ability as a mediator. The sample consisted of 1,300 Saudi high school students randomly selected from a larger pool of 173,133 participants to reduce the effects of excessive power. To examine both goals, the Multiple Indicators Multiple Causes (MIMIC) approach for detecting Differential Item Functioning (DIF) items was used. The results showed that 13 AAT items exhibited DIF effects for different gender groups. In most of these items, male participants were more likely to answer them correctly than their female counterparts. Next, the mediated MIMIC approach was applied to explore possible underlying mechanisms that explain these DIF effects. The results from this study showed that general cognitive ability (i.e., General Aptitude Test - GAT) seems to be a factor that could explain why an AAT item exhibits DIF across gender. It was found that GAT scores fully explain the DIF effect in two AAT items (full mediation). In most other cases, GAT helps account for only a proportion of the DIF effect (partial mediation). The results from this study will help experts improve the quality of their instruments by identifying DIF items and deciding how to revise them, considering the mediator's effect on participants' responses.

P056 Improvements in Daytime Function Items of the Insomnia Severity Index Are Correlated with a Positive Impact of Treatment on the Patient Global Impression Insomnia Scale

Abstract Introduction Items 4-7 (daytime function [DF]) of the 7-item Insomnia Severity Index (ISI) can assess daytime impairment. In Study E2006-G000-303 (Study 303; NCT02952820), lemborexant (LEM), a dual-orexin receptor antagonist, was associated at 6 months (6mo) with both significant improvement in ISI-DF items and significantly more subjects reporting positive effects on sleep, as assessed by the Patient Global Impression–Insomnia version (PGI-I), versus placebo (PBO). This analysis looked at the correlation between ISI-DF improvement and patient ratings on the PGI-I. Methods Study 303 was a 12-month, randomized, double-blind PBO-controlled (first 6mo) phase-3 study in adults with insomnia disorder. Subjects were randomized to PBO, LEM 5mg or 10mg for 6mo (2nd 6mo not reported here). ISI items are rated from 0 (no problem) to 4 (very severe problem). ISI-DF includes sleep satisfaction, extent symptoms are noticeable to others, cause worry/distress, and interfere with daily function. On the PGI-I, subjects assess positive, neutral or negative treatment impact on falling asleep, overall benefit on sleep, and total sleep time. Results A total of 739 subjects completed the ISI and PGI-I and were included in these analyses. At 6mo in all treatment groups, there were significant correlations (all P&amp;lt;0.001) between improvement in both ISI-DF items and PGI-I ratings regarding falling asleep, overall benefit on sleep, and total sleep time. Discussion These data suggest that the PGI-I may be a useful, quick tool to use in clinical practice, since an improvement in its score reflects improvements in daytime function. Sponsor Funded by Eisai Inc.

There as a discourse-pragmatic marker in Irish English

The upper ranks of corpus word frequency lists are primarily populated by functional items, as well as by other small words characterised by their polysemy that reward focussed attention and research. Exploring these items has resulted in rich and fruitful insights from a corpus pragmatic perspective. This paper focuses on the nature and value of there as a discourse-pragmatic marker in Irish English (IrE). We focus on intimate discourse (i.e., the language used between family and friends), and use corpora of IrE to trace and investigate the varietal nuances of there in this context. Our analysis acknowledges the expected existential and locative functions and illustrates that there has specific discourse–pragmatic properties in the intimate sphere in IrE. We argue that there has acquired additional pragmatic dimensions and is used in the language of family and friends as, for example, an involvement marker or mitigator. In the discussion of the development of there as a discourse-pragmatic marker, we consult historical data that matches our focal context, and discuss the processes by which there has come to fulfil a range of discourse-pragmatic functions in IrE.