Measures Of Function Research Articles

Measuring and Contextualizing School Refusal in Pediatric Chronic Pain: Establishing the Psychometric Properties of the School Refusal Evaluation (SCREEN) Measure for Youth with Chronic Pain.

School refusal is a longstanding difficulty for youth with chronic pain. Yet, research is hindered by lack of adequate measurement tools to assess and describe the complex interpersonal and systems-level factors contributing to school refusal. This study investigates the utility of the School Refusal Evaluation (SCREEN) measure and its psychometric properties in a sample of youth with chronic pain. and Methods: Youth undergoing multidisciplinary evaluation at outpatient pain clinics completed self and parent-report questionnaires. Descriptive data examined school refusal. Internal consistency and construct validity were tested. Multiple regressions examined parent and child factors related to school refusal. 698 youth with chronic pain participated. Two-thirds reported symptoms suggesting at-risk or clinically significant symptoms of school refusal. Cronbach alpha scores were in the acceptable to good range on the SCREEN. Convergent validity for the Interpersonal Discomfort subscale of the SCREEN was established. Child fear of pain, stress, peer relationships, and parent protective behaviors significantly correlated with SCREEN total scores. Participants enrolled in fully in-person school during the study period reported significantly higher scores on the interpersonal discomfort scale than those enrolled in remote learning. Our results provide evidence that youth with chronic pain experience significant challenges with school functioning and offer some support for the reliability and validity of the SCREEN in a sample of youth with chronic pain, a population for which few appropriate measures of school functioning have been established. The SCREEN measure may aid in assessing school refusal, with good clinical potential to quantify risk and identify modifiable factors.

Outcomes of Pediatric Patients with Excessive Postural Tachycardia After Attending an Intensive Interdisciplinary Pain Program: A Pilot Study

Background/Objectives: Adolescents with autonomic disorders who attend Intensive Interdisciplinary Pain Treatment (IIPT) programs report improvements in functioning. However, it is unclear whether they experience corresponding improvements in physiological measures. As such, the aim of this pilot study was to examine changes in physiological measures in youth attending an IIPT program who demonstrated excessive postural tachycardia on an active stand test. The secondary goal was to examine associations between physiological measurements and self-reported measures of chronic orthostatic intolerance (cOI) and functioning. Methods: At admission and discharge, eighteen adolescents and young adults (AYAs) attending IIPT (M age = 17.39 years; SD = 2.15 years) completed an active stand test, measures of breathing rate and muscle tension, as well as self-reported measures of cOI symptoms and functioning. Results: AYAs showed significant reduction in active stand test heart rate increase (p < 0.001; d = 1.07) and maximum heart rate (p = 0.002, d = 0.76) from admission to discharge. Improvements were also observed in resting respiration rate (p = 0.001, d = 89) and resting trapezoid tension (p = 0.03, d = 0.49). Although patients showed significant improvements on self-report measures of functioning (p < 0.001, d = 1.78), changes on subjective report of cOI symptoms did not reach significance. Exploratory analyses that only included patients with a POTS diagnosis were consistent with the overall results. Conclusions: Youth who demonstrated excessive postural tachycardia on active stand test at admission to an IIPT showed significant improvements from admission to discharge in their active stand maximum heart rate and heart rate increase, as well as respiration rate, muscle tension, and reports of their functioning. Future research is necessary to examine the mechanisms of change that contribute to symptom improvement.

Regional hippocampal thinning and gyrification abnormalities and associated cognition in children with prenatal alcohol exposure

Abstract Background Prenatal alcohol exposure (PAE) impacts hippocampal structure and function, contributing to deficits in memory and decision-making in affected individuals. Here, we evaluate hippocampal anomalies in children with PAE and an unexposed comparison group using advanced MRI methods that characterize hippocampal curvature and thickness. Methods Participants, ages 8 to 16 years, included children with PAE (n = 48) and an unexposed comparison group (n = 46) who underwent a dysmorphology exam, neuropsychological assessment, and an MRI scan. Height, weight, head circumference, and dysmorphic facial features were evaluated. Of those with PAE, 4.2% had fetal alcohol syndrome (FAS), 22.9% had partial FAS, and 72.9% had alcohol-related neurodevelopmental disorder. Neuropsychological testing included measures of intelligence and memory functioning. T1-weighted anatomical data were processed with the Hippunfold pipeline, which “unfolds” the complex hippocampal structure onto a template surface and provides measures of thickness and gyrification/curvature at each vertex. Permutation Analysis of Linear Models (PALM) was used to test for group differences (PAE vs. comparison) in hippocampal thickness and gyrification at each vertex and also to assess correlations with cognitive functioning. Results There were significant regional differences in thickness and gyrification across bilateral hippocampi, with the PAE group showing substantially thinner tissue and less curvature than the comparison group, especially in CA1 and subiculum regions. For those with PAE, thinner subicular tissue (bilateral) was associated with lower IQ. Also in the PAE group, lower episodic memory performance was associated with thinness in the right hippocampus, especially in the subiculum region. There were no significant regional hippocampal patterns that were associated with cognitive functioning for individuals in the unexposed comparison group. Conclusions We used a novel MRI method to evaluate hippocampal structure in children with PAE and an unexposed comparison group. The data suggest that PAE disrupts hippocampal development, impacting both the early-stage folding of the structure and its ultimate thickness. The data also demonstrate that these developmental anomalies have functional consequences in terms of core memory functions as well as global intellectual functioning in children with PAE.

Impact of nitroglycerin-induced vasodilation on stroke volume and diuretic response in acute heart failure: A protocol for a mechanistic trial.

Acute heart failure is a clinical syndrome characterized by cardiac dysfunction and neurohumoral activation, encompassing complex underlying pathophysiology which may vary across phenotypes. Nitroglycerine is a nitrate donor with vasodilatory effects on both venous capacitance vessels and arterial resistance vessels in higher doses, typically used with the aim of reducing congestion, preload, and afterload. A limited number of studies have proposed that nitroglycerin could promote diuresis and natriuresis. However, the exact hemodynamic effects of nitroglycerin remain uncertain in the clinical setting of acute decompensated heart failure. We hypothesize that intravenous nitroglycerin induces a significant increase in stroke volume and urinary output while lowering cardiac filling pressures. This will be a prospective single-center interventional clinical study of 21 patients hospitalized with a diagnosis of AHF. Patients are examined before and after administration of intravenous nitroglycerin. To characterize hemodynamic phenotypes of AHF, continuous estimates of stroke volume will be obtained, and total blood volume estimated. Vital signs and estimates of peripheral perfusion will be recorded continuously. Measures of cardiac function, renal function, volume status, and autonomic function will be assessed sequentially. This study will assess the acute effects of vasodilation on stroke volume and urinary output in hospitalized patients with AHF. Furthermore, characterizing the hemodynamic profile of the patient prior to vasodilation may help explore which patients will benefit from vasodilation.

Caregiver assessment of socioemotional functioning in people living with neurodegenerative disease (Part 2): Concurrent validity and test-retest reliability of a new measure.

Care recipients with neurodegenerative disease can have socioemotional impairments that are challenging for their caregivers. We examine the concurrent and incremental validity of a novel informant-rated measure of care recipient functioning, the Caregiver Assessment of Socioemotional Functioning (CASEF), by examining links with clinician-rated behavioral problems, neuropsychiatric symptoms, and disease severity, as well as caregivers' reported burden and relationship quality. We also examine test-retest reliability of the CASEF. Informal caregivers (N=177) of individuals with neurodegenerative disease reported on their care recipients' socioemotional functioning and completed structured interviews with clinicians to assess care recipients' disease severity and neuropsychiatric symptoms. Care recipients' behavioral symptoms were evaluated with clinician rating scales. Another sample of caregivers (N=61) repeated the CASEF four to six months following an initial administration. CASEF subscales evidenced concurrent validity with other measures of care recipients' socioemotional functioning, disease severity, neuropsychiatric symptoms, and behavioral symptoms. CASEF subscales also evidenced incremental validity by accounting for significant additional variance in caregiver burden and relationship quality after accounting for care recipients' neuropsychiatric and behavioral symptoms. Finally, CASEF subscales demonstrated adequate to excellent test-retest reliability. Findings highlight the validity and reliability of the CASEF. Coupled with findings from Part 1 of this series (which established CASEF's construct validity), these findings support using the CASEF in clinical and research settings to assess changes in care recipient socioemotional functioning over time and to examine links between care recipient socioemotional changes and caregiver burden, health, and well-being.

Cognitive Rehabilitation to Remediate Attention and Memory in Patients with Complicated Mild Traumatic Brain Injury: A Case Series

AbstractAttention and memory deficits are frequently observed in individuals suffering from mild traumatic brain injury (MTBI), particularly in those exhibiting neurostructural abnormalities, commonly referred to as complicated mild traumatic brain injury (C-MTBI). The present case series employed customized cognitive retraining interventions and compensatory techniques designed to enhance attention, memory, and activities of daily living (ADL) of C-MTBI patient. Scores on Glasgow Coma Scale (GCS) and neuroimaging abnormalities detected via computed tomography (CT) or magnetic resonance imaging (MRI) were used to categorize the cases as C-MTBI. All four cases in the present case series were selected using purposive sampling technique. Cognitive dysfunction of the cases was evaluated utilizing the PGI Battery of Brain Dysfunction (PGI-BBD), while assessment of ADL was measured through the Hindi version of the Cognitive Symptom Checklist (CSC). Patients with C-MTBI underwent cognitive rehabilitation (CR) specifically tailored to address the unique requirements and characteristics of their nature of cognitive deficits. Cognitive retraining sessions were systematically organized on a biweekly basis, complemented by an additional weekly session focused on compensatory strategies, which were conducted face to face or through telephonic/video conferencing. All four cases completed CR sessions and after competition of the CR sessions, cognitive functions and ADL were reassessed using the PGI-BBD and CSC, respectively. The present case series highlights the effectiveness of CR program combining cognitive retraining and compensatory strategies in improving attention, memory, and ADLs of C-MTBI patients. All four cases demonstrated significant improvements in cognitive functioning and ADL measures following the CR program, supporting its applicability and therapeutic value.

Requiring an Interpreter Influences Stroke Care and Outcomes for People With Aphasia During Inpatient Rehabilitation.

Communicative ability after stroke influences patient outcomes. Limited research has explored the impact of aphasia when it intersects with cultural or linguistic differences on receiving stroke care and patient outcomes. We investigated associations between requiring an interpreter and the provision of evidence-based stroke care and outcomes for people with aphasia in the inpatient rehabilitation setting. Retrospective patient-level data from people with aphasia were aggregated from the Australian Stroke Foundation National Stroke Audit-Rehabilitation Services (2016-2020). Multivariable regression models compared adherence to processes of care (eg, home assessment complete, type of aphasia management) and in-hospital outcomes (eg, length of stay, discharge destination) by the requirement of an interpreter. Outcome models were adjusted for sex, stroke type, hospital size, year, and stroke severity factors. Among 3160 people with aphasia (median age, 76 years; 56% male), 208 (7%) required an interpreter (median age, 77 years; 52% male). The interpreter group had a more severe disability on admission, reflected by reduced cognitive (6% versus 12%, P=0.009) and motor Functional Independence Measure scores (6% versus 12%, P=0.010). The interpreter group were less likely to have phonological and semantic interventions for their aphasia (odds ratio, 0.57 [95% CI, 0.40-0.80]) compared with people not requiring an interpreter. They more often had a carer (68% versus 48%, P<0.001) and were more likely to be discharged home with supports (odds ratio, 1.48 [95% CI, 1.08-2.04]). The interpreter group had longer lengths of stay (median 31 versus 26 days, P=0.005). Some processes of care and outcomes differed in inpatient rehabilitation for people with poststroke aphasia who required an interpreter compared with those who did not. Equitable access to therapy is imperative and greater support for cultural/linguistic minorities during rehabilitation is indicated.

Role of visual function and performance of activities of daily living in cognitive function in patients with mild cognitive impairment: a cross-sectional study

BackgroundMild cognitive impairment (MCI) is a precursor to dementia, with many patients showing early decline in activities of daily living (ADLs). However, the role of visual impairment in this process is underexplored despite evidence suggesting it may accelerate cognitive decline. Current research does not understand how visual dysfunction affects cognitive abilities and how ADLs might moderate this relationship. This gap is crucial because early interventions targeting visual impairments could potentially delay progression to dementia, offering new avenues for supporting MCI patients.ObjectiveThis study investigates the relationship between visual function and cognitive abilities in patients with MCI. Specifically, it seeks to determine how different aspects of visual function, such as visual field indices and visual acuity, correlate with various cognitive domains measured by standardized assessments. Additionally, the study aims to examine the role of ADLs as a potential moderating factor in this relationship. By analyzing how ADL performance influences the strength and direction of the association between visual impairments and cognitive function, this research intends to identify key areas where visual deficits may contribute to cognitive decline in MCI.MethodsThis is a cross-sectional study. Two hundred and seventy four elderly patients were diagnosed with MCI from various communities in Taicang City, Jiangsu Province, China. Most participants were women (68.6%), and the average age was 69 years. Notable comorbidities included hypertension (41.6%) and diabetes (33.2%), indicating a higher burden of health conditions than typical older adult populations. Visual function, Montreal Cognitive Assessment (MoCA), and the ADLs were measured. Pearson's correlation coefficients were used to examine the unadjusted associations between visual function measures and cognitive performance. Multivariable linear regression models were employed to further explore these relationships and to assess the moderating role of ADLs.ResultsSignificant positive correlations were found between visual function and cognitive performance, particularly with Visual Function Index (VFI) showing a strong initial correlation with the total MoCA score (r = 0.61, p &amp;lt; 0.001), which was attenuated after adjusting for ADL (β = 0.06, p = 0.23). Maximum Visual Field (Max VF) was positively correlated with language skills (r = 0.13, p &amp;lt; 0.05). The negative correlation of Minimum Visual Field (Min VF) with cognitive performance became positive after ADL adjustment (β = 0.12, p = 0.04).ConclusionsThese findings suggest that visual function plays a crucial role in the cognitive and functional abilities of patients with MCI. Early interventions targeting visual impairments may help mitigate cognitive decline and improve the quality of life for these patients.

FTIR Spectroscopic Analysis of Plant Proteins and Correlation with Functional Properties.

Development of plant-based products faces challenges like raw material standardization and time-consuming functionality measurements. Fourier Transform Infrared (FTIR) spectroscopy provides a quick, non-destructive way to analyze protein molecular characteristics. This study explored the classification capability of FTIR in analyzing five plant protein isolates-soy, mung bean, pea, fava bean, and lentil-and assessed its predictive ability for functional property measurement such as water absorption capacity (WAC), oil absorption capacity (OAC), Solubility (SOL), foaming, and emulsification. Functional properties were calculated using traditional methods of measurements. Principal Component Analysis (PCA) and Partial Least Square (PLS) Regression Analysis were used to study FTIR spectra and its correlation with functional properties. PCA revealed distinct clusters for each protein source based on their FTIR spectra, indicating molecular differences. WAC and OAC prediction models showed strong correlations, with prediction correlation coefficients (Rp) of more than 0.99 and cross-validation correlation coefficients (Rcv) ranging from 0.85 to 0.92. As sample size increases, SOL, emulsifying, and foaming properties display promising potential. Moreover, WAC and OAC predictions exhibited robust results with protein blends of various ratios. The expanded WAC model predicted with an Rp of 0.99 and an Rcv of 0.95, while the expanded OAC model had an Rp of 0.99 and an Rcv of 0.84. The results underscore FTIR has the potential to identify plant proteins aiding in raw material verification and quality control as well as being an alternative to analyzing functional properties of plant proteins.

A semantic strength and neural correlates in developmental dyslexia

IntroductionMost studies of dyslexia focus on domains of impairment (e.g., reading and phonology, among others), but few examine possible strengths. In the present study, we investigated semantic fluency as a cognitive strength in English-speaking children with dyslexia aged 8–13.MethodsNinety-seven children with dyslexia completed tests of letter and semantic verbal fluency, standardized measures of reading and cognitive functions, and task-free resting-state functional magnetic resonance imaging (rs-fMRI). First, we adjusted performance on semantic fluency by letter fluency and created a residual score that was used to separate participants into high (residual &amp;gt;0) or average (residual &amp;lt;0) semantic performance groups. We then employed a psycholinguistic clustering and switching approach to the semantic fluency task and performed dynamic task-free rs-fMRI connectivity analysis to reveal group differences in brain dynamics.ResultsHigh and average semantic fluency groups were well-matched on demographics and letter fluency but differed on their psycholinguistic patterns on the semantic fluency task. The high semantic fluency group, compared to the average semantic fluency group, produced a higher number of words within each cluster, a higher max cluster size, and a higher number of switches. Differential dynamic rs-fMRI connectivity (shorter average dwell time and greater brain state switches) was observed between the high and average groups in a large-scale bilateral frontal-temporal-occipital network.DiscussionThese data demonstrate that a subgroup of children with dyslexia perform above average on semantic fluency tasks and their performance is strongly linked to distinct psycholinguistic patterns and differences in a task-free resting-state brain network, which includes regions previously implicated in semantic processing. This work highlights that inter-individual differences should be taken into account in dyslexia and reveals a cognitive area of strength for some children with dyslexia that could be leveraged for reading interventions.

Volume Changes in Brain Subfields of Patients with Alzheimer’s Disease After Transcranial Ultrasound Stimulation

Background/Objectives: Alzheimer’s disease (AD) is characterized by progressive brain atrophy marked by cognitive decline and memory loss, which significantly affect patients’ quality of life. Transcranial ultrasound stimulation (TUS) is a potential physical treatment for AD patients. However, the specific brain regions stimulated by TUS and its therapeutic effects remain unclear. Methods: In this study, magnetic resonance imaging (MRI) and FreeSurfer segmentation were employed to assess alterations in the brain volume of AD patients after TUS. Results: Our findings revealed significant volume increases in the corpus callosum (CC) and lateral orbitofrontal cortex (lOFC) in the TUS group. Moreover, the volumetric changes in the CC were strongly correlated with improvements in the Mini-Mental State Examination score, which is a widely used measure of cognitive function of AD patients. Conclusions: TUS has the potential to alleviate disease progression and offers a non-invasive therapeutic approach to the improvement of cognitive function in AD patients.

Analysis of the short-term effect of three different level pedicle screws in the treatment of thoracolumbar type A fractures

ObjectiveThe effects of three short-segment vertebral fixation methods—short-segment fixation (4s group), short-segment fixation across the injured vertebra (6s group), and long-segment fixation (8s group)—on the surgical efficacy of patients with type A thoracolumbar fractures were compared to identify the optimal fixation method.MethodsData from 277 patients who underwent posterior pedicle screw fixation for thoracolumbar fractures between September 2018 and January 2023 were retrospectively analyzed. Surgery-related indicators, laboratory parameters, clinical functional measures (VAS and ODI), and postoperative imaging findings were compared among the three groups.ResultsBaseline data showed no significant differences among the three groups. The operation time in the 4s group (75.352 ± 15.458 min) and intraoperative blood loss (188.65 ± 42.728 ml) were significantly lower compared to the 8s group (operation time: 108.243 ± 19.529 min; intraoperative blood loss: 209.93 ± 50.542 ml), with statistically significant differences (p < 0.05). Postoperative hematocrit (33.277 ± 4.639) and albumin levels (34.971 ± 4.116) in the 6s group were significantly higher than those in the 8s group (hematocrit: 31.820 ± 4.323; albumin: 33.170 ± 3.553), with p < 0.05. Other outcome indicators did not show statistically significant differences (p > 0.05).ConclusionShort-segment fixation across the injured vertebra (6s) provides results comparable to short-segment fixation (4s) while causing less trauma. Furthermore, the 6s method demonstrates similar efficacy to long-segment fixation (8s) in maintaining long-term deformity correction. These findings offer valuable insights for clinicians in selecting surgical fixation methods, optimizing treatment strategies, and improving patient outcomes.

Screening Cognition, Sleep, and Physical Activity in Pediatric Oncology Long-Term Follow-Up Care.

Children treated for pediatric cancer are at risk for cognitive late effects, as well as impairments in sleep and physical activity. The aim of the present study was to examine the psychometric properties of clinical screening of child- and caregiver-reported cognitive functioning, sleep, and physical activity and the relationship between cognitive functioning and health behaviors within a pediatric oncology long-term follow-up clinic. The study included a retrospective chart review of 99 caregivers and 80 children (8-17years old) who completed the Conners Short Form (parent only) and PROMIS cognitive functioning, sleep-related impairment, sleep disturbance, and physical activity scales at the child's annual long-term follow-up visit. Test statistics and T-tests were used to assess psychometrics of the PROMIS scales. Bivariate correlations were used to examine the relationship between cognitive function and health behaviors. The child- and parent-report, short-version PROMIS cognitive functioning, sleep, and physical activity scales demonstrated high internal consistency and inter-rater reliability. High convergent validity was observed between PROMIS cognitive functioning and Conners Short Form. Caregiver- and child-reported cognitive functioning and health behaviors were significantly related (p ≤ 0.042). The PROMIS short-version scales are reliable and valid measures for screening cognitive function and health behaviors in pediatric oncology long-term follow-up care. Further research examining the predictive validity and longitudinal utility of the PROMIS scales in survivors is warranted. There was a positive association between cognitive functioning and health behaviors in survivors, warranting further investigation to inform potential targets of intervention in long-term follow-up care.

Differences in fatty infiltration in thigh muscles and physical function between people with and without knee osteoarthritis and similar body mass index: a cross-sectional study

BackgroundPeople with knee osteoarthritis (OA) may have more thigh intermuscular and intramuscular adipose tissue (interMAT and intraMAT, respectively) compared to those without knee OA. Literature has not considered differences in body mass index (BMI) in the context of comparing intraMAT and interMAT between individuals with and without knee OA, matched for BMI (± 1 kg/m²). This study aims to compare interMAT and intraMAT, along with physical function (including knee extension strength), between individuals with and without knee osteoarthritis, matched by BMI.MethodsParticipants aged ≥ 40 years with symptomatic and radiological knee OA group (grade 2 and 3 on the Kellgren and Lawrence (KL) scale) were included in the affected group, while those with no knee pain and no radiological knee OA changes were included in the unaffected group. No participants were lost to assessment, ensuring complete data analysis for all participants. We used independent t-test and mean difference (95% CI) to compare thigh intraMAT and interMAT volume, self-reported measures (WOMAC questionnaire), physical function measures, and knee extension strength between groups.ResultsForty-six participants were analyzed (23 in each group). The affected group had significantly higher intraMAT compared to the unaffected group (p < 0.05), but no differences were observed for interMAT. Self-reported outcomes and physical function measures were worse in the affected group, as was knee extension strength.ConclusionPeople with knee OA present higher levels of intraMAT and poorer physical function compared to those without knee OA. These findings highlight the need for further research to explore the clinical significance of intraMAT and its potential impact on physical function in this population.

Factors associated with impaired physical functionality in x-linked hypophosphatemia

Abstract X-linked hypophosphatemia (XLH) is a rare inherited disorder characterized by elevated levels of fibroblast growth factor-23 (FGF23), chronic hypophosphatemia, impaired bone mineralization and chronic long-term manifestations. Treatment for XLH has been mainly focused on normalizing its biochemical abnormalities. Despite treatment, patients with XLH often present impaired physical function and decreased quality of life (QoL). We hypothesize that physical functionality and QoL is more strongly associated with chronic pain and decreased muscle mass than persistent biochemical abnormalities or exposure to conventional treatment. We conducted an observational, cross-sectional study with patients with XLH. Clinical records and biochemical parameters were assessed. QoL surveys SF36v.2 and WOMAC were applied. Functional status was measured by a physiatrist and an occupational therapist. Appendicular lean mass (ALM) was measured and compared to age and sex-matched healthy controls. Enthesopathies and osteoarthritis were evaluated. Pain was assessed using the Brief Pain Inventory, the Visual Analog Scale and the Doleur Neuropathique-4 scales. Muscle strength was evaluated by the Quadriceps Muscle isometric Strength (QMS) and physical performance with the 6-minute walk test (6MWT) and the Functional Independence Measure (FIM) scale. A total of 30 patients were included: 21 females; median age of 32 years. All participants had significant functional deficits, chronic pain and reduced QoL. Limitations in daily activities were significantly associated with higher severity of pain, decreased ALM, lower QMS, and less distance in 6MWT (P&amp;lt;.05). Neither FIM scale, phosphate levels, FGF23, nor the lifetime exposure to conventional treatment were associated with these functional variables. In conclusion, impaired physical functionality in patients with XLH was associated with lower muscle mass, lower muscle strength and severe chronic pain. These findings highlight the importance of, in addition to optimizing the biochemical control of the disease, expanding patient care including pain prevention and management as well as comprehensive physical therapy and rehabilitation.

Depression and Its Effect on Geriatric Rehabilitation Outcomes in Switzerland’s Aging Population

Background and Objectives: Depression is a common mental problem in the older population and has a significant impact on recovery and general well-being. A comprehensive understanding of the prevalence of depressive symptoms and their effects on functional outcomes is essential for improving care strategies. The primary aim of this study was to determine the prevalence of depressive symptoms in older patients undergoing geriatric rehabilitation and to assess their specific impact on their functional abilities. Materials and Methods: A retrospective study was conducted at the Lucerne Cantonal Hospital in Wolhusen, Switzerland, spanning from 2015 to 2020 and including 1159 individuals aged 65 years and older. The presence of depressive symptoms was assessed using the Geriatric Depression Scale (GDS) Short Form, while functional abilities were evaluated using the Functional Independence Measure (FIM) and the Tinetti test. Data analysis was performed using TIBCO Statistica 13.3, with statistical significance set at p &lt; 0.05. Results: Of the participants, 22.9% (N = 266) exhibited depressive symptoms, with no notable differences between genders. Although all patients showed functional improvements, the duration of rehabilitation was prolonged by two days (p = 0.012, d = 0.34) in those with depressive symptoms. Alarmingly, 76% of participants were classified as at risk of falling based on the Tinetti score. However, no significant correlation was found between the GDS and Tinetti scores at admission (p = 0.835, r = 0.211) or discharge (p = 0.336, r = 0.184). The results from the non-parametric Wilcoxon matched-pairs test provide compelling evidence of significant changes in FIM scores when comparing admission scores to those at discharge across all FIM categories. Conclusions: Depressive symptoms are particularly common in geriatric rehabilitation patients, leading to prolonged recovery time and increased healthcare costs. While depressive symptoms showed no correlation with mobility impairments, improvements in functional status were directly associated with reduced GDS scores. Considering mental health during admission and planning is critical in optimizing rehabilitation outcomes.

Physical function estimates change in pain following IIPT among children with chronic pain.

Chronic pain can negatively impact a child's quality of life. Pediatric Intensive Interdisciplinary Pain Treatment (IIPT) programs aim to improve overall functioning despite pain through various rehabilitative strategies. It is, however, unclear whether improved function corresponds to self-reported decrease in pain levels. Hence, the purpose of this study is to examine the relationship between changes in physical function and perceived pain among children with chronic pain who have undergone inpatient IIPT. A secondary analysis of pre-existing databases of IIPT from two different inpatient acute rehabilitation programs was carried out. Children and adolescents (N = 309; age = 16.2 ± 2.6; 79% females) with chronic pain who attended on average 4-week inpatient IIPT from Nov 2011 to Jan 2023 were included. Participants completed pain intensity (Numerical Pain Rating Scale) and self-reported function measures (Lower Extremity Functional Scale [LEFS], Upper Extremity Functional Index [UEFI], Canadian Occupational Performance Measure [COPM]-Performance, and COPM-Satisfaction) at admission and discharge. Change in self-reported physical function was significantly associated with change in pain from admission to discharge. After covariate adjustment, self-reported physical function (per the LEFS, UEFI, COPM-Performance, and COPM-Satisfaction) explained 19.8%, 7.8%, 12.0%, and 8.6% of the variance in change in pain, respectively. These measures of self-reported physical function further distinguished between minimal (<30%) and moderate (≥30%) pain reduction. Self-reported functional gains during IIPT are associated with greater change in perceived pain. Moreover, measures of self-reported physical function can help identify children at risk of minimal pain reduction post-IIPT.

Emotional intelligence as a predictor of functional outcomes in psychotic disorders.

Psychotic disorders are associated with significant impairment in psychosocial functioning, yet mechanisms associated with this impairment remain poorly understood. Emotional intelligence, a component of social cognition, is associated with psychosocial functioning in this population. However, prior work has used relatively small samples, reported inconsistent relations between functioning domains and emotional intelligence, and inconsistently considered negative symptoms. To address these limitations, we examined the predictive ability of emotional intelligence on functional outcomes using a five-year longitudinal design. We used a large sample of individuals with and without psychotic disorder diagnoses (N=324), a performance-based measure of emotional intelligence, and three measures of functioning (i.e., social performance, assessor-rated social and occupational functioning, self-rated functioning in independent living). Results revealed individuals diagnosed with a psychotic disorder have lower emotional intelligence than those without a history of psychosis. Emotional intelligence was associated with social performance and social and occupational functioning in both those with and without a history of psychosis. In those diagnosed with a psychotic disorder, emotional intelligence and negative symptoms better predict social performance (βEmotional=0.36, R2delta=0.09) and social and occupational functioning (βEmotional=0.21, R2=0.03), but not self-rated functioning in independent living (βEmotional=-0.08, R2delta=0.00), as compared to negative symptoms alone. Overall, findings support the use of emotional intelligence as a longitudinal predictor of social and occupational outcomes above and beyond negative symptoms alone. This work highlights potential, specific intervention targets for individuals with psychotic disorders.

RELIABILITY OF POPLITEAL ARTERY FLOW-MEDIATED DILATION IN THE SEATED POSITION

https://youtu.be/4OD0OwXpzSw INTRODUCTION Flow-mediated dilation (FMD) is a noninvasive measure of endothelial function used to assess cardiovascular risks. The popliteal artery is commonly used for FMD measurement in different body positions, which may impact its reliability. This study aimed to examine the reliability of popliteal artery FMD in the seated position, as no previous studies have examined this. METHODS Popliteal artery FMD was measured in 20 healthy adults across two visits in seated and prone positions to assess visit-to-visit reliability, with two measurements taken for each body position at each visit for trial-retrial reliability. %FMD was calculated as the percent change from baseline diameter to peak diameter. The reliability of FMD was assessed via intraclass correlation coefficient (ICC). RESULTS Popliteal artery %FMD shows moderate-to-good reliability in the seated position (ICC: 0.67 to 0.89) and poor-to-moderate reliability in the prone position (ICC: 0.25 to 0.74) within and between visits. There were no significant differences in baseline diameter or minimum diameter between body positions, visits, or trials (p&amp;gt;0.05). %FMD and peak diameter following cuff deflation demonstrated no significant difference between body positions (p&amp;gt;0.05). CONCLUSION Popliteal artery FMD demonstrates good reliability in the seated position, supporting the development of a standardized measurement protocol.

Coprophenomena Associated With Worse Individual and Family Function for Youth With Tourette Syndrome: A Cross-Sectional Study.

Tourette syndrome (TS) is defined by multiple motor tics and one or more phonic tics with a symptom duration of >1 year. Coprophenomena are uncommon tics characterized by obscene sounds, words, or gestures. Youth with TS commonly have psychiatric co-occurring conditions such as attention-deficit hyperactivity disorder or obsessive-compulsive disorder and have reported lower scores on measures of individual and family functioning than youth without TS. This study aimed to determine associations among co-occurring condition symptoms, tic severity, and function in youth with TS and coprophenomena compared with those with TS without coprophenomena. Data were collected through a multicenter, cross-sectional study. Youth with TS were recruited from 2 referral centers, and data were collected from youth and their parents or caregivers. Tic severity was assessed using the Yale Global Tic Severity Scale, and individual function was measured with the Children's Global Assessment Scale. Family impact was measured using the Family Impact Module in domains of parent health-related quality of life (HRQOL), family functioning, and total family impact. We compared individual and family function in youth with TS with coprophenomena (TS+copro) and without coprophenomena (TS-copro). Wilcoxon rank-sum tests were used to compare scores on individual function and family function measures. Of 169 participants, 17 (10.1%) reported coprophenomena. Participants with TS and coprophenomena had higher tic severity scores than those without coprophenomena (TS+copro mean = 36.9, TS-copro = 20.8). Youth with coprophenomena had lower scores for global function (TS+copro median = 51, TS-copro = 60), family functioning (TS+copro = 43.8, TS-copro = 59.4), parent HRQOL (TS+copro = 57, TS-copro = 72), and total family QOL (TS+copro = 50.7, TS-copro = 65.3). Youth with TS and coprophenomena had lower individual function, family function, and parent HRQOL than youth without coprophenomena. Coprophenomena presence may indicate that youth have a more severe phenotype of TS, and youth with copropheneomena may benefit from additional caregiver or family supports.