Mobility Issues Research Articles

Determinants of psychological distress during the COVID-19 pandemic among people who use drugs in Montreal, Canada.

Limited data exists on psychological impacts of the COVID-19 pandemic among people who use drugs (PWUD). This study aimed to determine the prevalence and correlates of severe psychological distress (PD) among PWUD in Montreal around the beginning of the pandemic. We conducted a rapid assessment study from May to December 2020 among PWUD recruited via a community-based cohort of people who inject drugs in Montreal (Hepatitis C cohort [HEPCO], N = 128) and community organisations (N = 98). We analysed self-reported data on changes in drug use behaviours and social determinants since the declaration of COVID-19 as a public health emergency, and assessed past-month PD using the Kessler K6 scale. Multivariable logistic regression was conducted to examine correlates of PD distress (score ≥13). Of 226 survey participants, a quarter (n = 56) were screened positive for severe PD. In multivariable analyses, age (1-year increment) (adjusted odds ratio = 0.94, 95% confidence interval [0.90, 0.98]) and a decrease in non-injection drug use versus no change (0.26 [0.07, 0.92]) were protective against severe PD, while positive associations were found for any alcohol use in the past 6 months (3.73 [1.42, 9.78]), increased food insecurity (2.88 [1.19, 6.93]) and both moving around between neighbourhoods more (8.71 [2.63, 28.88]) and less (3.03 [1.18, 7.74]) often compared to no change. This study documented a high prevalence of severe PD among PWUD during the COVID-19 pandemic compared with pre-COVID-19 data. Social determinants such as food insecurity and mobility issues, alongside demographic and substance use-related factors, were linked to distress. Evidence-based risk mitigation strategies for this population could reduce negative consequences in future pandemics or disruptions.

Dialogue in the Dark Malaysia: reimagining an inclusive society through social innovation

Research methodology This case was developed via primary data collected from personal (one to one) interview with the CEO and founder of Dialogue in the Dark Malaysia (Dialogue Malaysia), Stevens Chan. With Stevens’ contact, the authors also conducted personal interviews with Kaye Chan (co-founder and wife of Stevens Chan), Lynn Foo (project manager since inception until early 2022) and Dr Foo Yin Fah (academic researcher in social entrepreneurship and advisor for Dialogue Malaysia). Secondary data included reports on visually impaired context in Malaysia, Dialogue Malaysia’s annual reports and online articles. Prior to the primary data collection, the authors obtained ethics approval from the University Human Ethics Committee (Project ID: 35461). Case overview/synopsis This case narrative focuses on Stevens Chan, a blind social entrepreneur who champions the empowerment of the disabled and marginalised community. Through a social franchising model, Stevens founded Dialogue in the Dark Malaysia in 2012. As a social start-up, Stevens showcases the strengths of blind and visually impaired individuals through transformative experiential encounters and reimagining future possibilities. Although there are constant challenges in securing financial and human capital, Stevens never lacks psychological capital, characterised by hope, self-efficacy, optimism and resilience. His vision is to educate society on the power of empathy (and not sympathy) and to create a holistic experience of celebrating diversity and inclusion through an innovative discovery centre, where the elderly and the disabled community (including the deaf, mute and those with mobility issues) share their lives with the public through fun activities. However, the future of this social enterprise is uncertain, and this case invites participants to embark on this journey with Stevens to uncover future pathways for growth and social impact. Complexity academic level The case is tailored for higher level undergraduates and entry-level and mid-level managers of executive education programs.

Health-related quality of life among people with diabetes: A cross-sectional study in Hail region, Saudi Arabia ​.

Diabetes Mellitus is a serious and expanding health problem, together with the issues of health- related quality of life (HRQoL). This further puts pressure on the government to allocate more funds for public healthcare. This study was devised to evaluate the health-related quality of life of people living with diabetes in Hail region of Saudi Arabia. This cross-sectional research was carried out at eight locations in the Hail region of Saudi Arabia between 21st March-20th May 2022 using the adapted version of the Euro QoL-5 dimension (EQ-5D-3L) questionnaire. A multistage random sample approach was used to choose the diabetes clinics, and data collectors approached the participants in the waiting areas to collect the information. The data were analyzed using logistic regression analysis, Mann-Whitney test, and Kruskal-Wallis tests in IBM SPSS statistics 21.0. The mean HRQoL score was 0.71±0.21 with a visual analog score of 68.4±16.2. Despite having much higher levels of quality of life in terms of self-care (85.8%), regular activity (73.8%) and anxiety (71.8%), nearly one half of the people reported moderate pain or discomfort, and more than one third reported having moderate mobility issues. In general, the quality of life for women was poorer than for men. Individuals with diabetes who were unmarried, young, educated, financially secure, and taking only oral medication had much improved HRQoL. The Euro QoL of people with diabetes patients were significantly influenced by gender, marital status, age, education, employment and treatment modality (p-values < 0.05), whereas only treatment modality had a significant impact on the patients' visual analogue measures (p-values < 0.05). The HRQoL of people with diabetes in Hail region was moderate in general, with pain and mobility issues being particularly prevalent. Gender, marital status, age, education, employment and type of medication therapy are significant predictors of HRQoL of patients with diabetes. Hence, planning and programs to enhance the HRQoL of people with diabetes, especially women is recommended.

SOCIAL POLICY REGARDING VETERANS, PEOPLE WITH DISABILITIES AND OTHER VULNERABLE POPULATION GROUPS

The article analyzes the issue of migration as a complex social phenomenon. International population migration in the conditions of growing globalization occupies an important place in the development of modern society and, accordingly, affects young people who, for various reasons, decided to study abroad (in Slovakia). The article reflects knowledge at the theoretical and empirical levels. One of the main tasks of modern higher education is the modernization and efficiency of the professional mobility of future specialists. Student migration is considered as educational migration. We point out that the Slovak Republic is one of the most economically successful countries in Central-Eastern Europe. Economic reforms and accession to the EU, combined with significant inflows of foreign direct investment, have led to sustained economic growth and job creation. Economic development and demographic changes have also created an additional need for skilled labor. At the same time, greater integration into the EU, open borders and a common educational space led to the migration of Slovak students to the neighboring Czech Republic and other EU countries. As a result, Slovakia gradually began to ease migration restrictions and allowed an increasing number of third-country nationals to enter the territory of the Slovak Republic. The integration policy of Slovakia is consistent with the migration policy, and among its priorities is the effective integration of foreigners in the labor market. The purpose of the article is to analyze Ukrainian student migration in Slovakia, focusing on the analysis of personal and social benefits. We analyze the issue of academic mobility as an integral component of the European educational space, which also undoubtedly has a positive effect on the national education system and the national economy. We highlight the issue of effective ethnic-national policy formation, development of theory and practice of social work with ethnic groups, find out directions and forms of social service work with migrants. In the empirical part, we present a quantitative study at all stages of the research process. The content of the study is to find out the reasons that motivate future Ukrainian students to migrate to Slovakia, as well as to find out how the initial decision about migration and arrival to Slovakia takes place. Part of the quantitative research is the analysis of the personal and social benefits of the migration of Ukrainian students to Slovakia.

Transport policies and their everyday impact on mobilities of older adults in Bengaluru

Background and objectives: Cities in the Global South are simultaneously witnessing wide-scale population ageing and rapid urbanisation. There is overwhelming pressure on policy makers to rapidly envision and provision age-friendly transport environments. In Indian cities, later-age mobilities face unique risks due to traffic congestion and inequities. However, the policy and transport research has treated congestion, equity and age-friendly mobilities as unrelated issues. This article goes a step ahead to understand how the policies to mitigate congestion can impact the provisioning of age-friendly infrastructure. Research design and methods: Bengaluru, once termed the ‘pensioners’ paradise’, is known for its ‘alarming’ levels of traffic congestion (Pucher et al, 2005; Pojani and Stead, 2017). We review Bengaluru’s transport policies and peer-reviewed articles concerning these policies to understand the positioning of age-friendly transport within this context. Results: Our findings recognise a shift from sufficientarianism to utilitarian orientations in Bengaluru’s policy making on easing congestion, which narrows the options for later-age transport users in terms of access and affordability. Some of the features not unique to Bengaluru – such as top-down planning, institutional fragmentation and distancing of users from policy making – have resulted in buses being inaccessible for passengers with mobility issues, metro rail being unaffordable for those on low incomes, lack of safe modes of transport and safe access to streets. Discussion and implications: The article is an initial foray into the ambiguity in the philosophical underpinning of transport policy making, which prioritises solving congestion ahead of providing age-friendly transport. We highlight specific challenges the cities of the Global South experience as they envision age-friendly transport policies amid the ascendance of congestion-solving policies.

Urban communist politics of the everyday in Graz, Austria

The everyday communist politics of local politicians in Graz offers a potential way forward for the left more broadly In September 2021, the Communist Party of Austria (KPÖ) won the municipal elections in Austria’s second-largest city, Graz, and Elke Kahr became the city’s mayor. Kahr has governed in a coalition with the Green Party and the Social Democrats, replacing the former conservative and far-right coalition that had lasted for eighteen years. A different kind of local politics has since then proved possible, even in conservative Austria. Graz local communists practise a politics that is sensitive to class injustice and engaged in the local community. Its slogan for the last thirty years has been ‘A party for everyday life’. The party’s success is based on its focus on everyday concerns such as housing, tenants’ rights, public health, education and mobility issues, as well as its battles against austerity and neoliberal privatisation. Its community-oriented approach, strongly committed to social infrastructure at the scale of people’s everyday experiences is explicitly critical of top-down state solutions ‐ and thus stands in stark contrast both to the previous neoliberal and profit-oriented policies in Graz, and to the centralist ways of governing of the socialist states. KPÖ politicians voluntarily cap their salaries at the level of the average worker, with the surplus going into a social fund for emergency help for those on low incomes. This has been criticised by some as a charity commitment rather structural change, but it can also be read as an attempt at lived solidarity. Drawing from local media coverage as well as interviews with politicians and local residents, the article discusses the everyday politics of Graz communists through the lens of relational care ethics, and discusses the potential international movements that could be built on this approach to communist municipal politics. The focus is on alternative social norms in urban cultures of care: solidarity among all members of society, and a recognition of people’s everyday practices and needs.

Unraveling the root causes of faults in mobile communications: A comparative analysis of different model explainability techniques

The escalating demand and complexity of monitoring services handled by Network Operations Centers (NOCs) have led Mobile Network Operators (MNOs) to prioritize automated solutions for network fault detection and diagnosis. Consequently, various Machine Learning (ML)-based Root Cause Analysis (RCA) systems have been developed, however their lack of explainability poses a challenge due to the predominantly black-box nature of ML models. This paper addresses this issue by presenting a supervised clustering methodology capable of integrating both glass-box and black-box models, the latter complemented by post-hoc explainability techniques. While black-box models excel in predictive capabilities, necessitating post-hoc techniques for explainability, glass-box models prioritize transparent decision-making, fostering a clearer understanding of the model’s behavior. This work delineates a methodology for performing RCA of faults in the User Downlink (DL) Average Throughput Key Performance Indicator (KPI), simultaneously comparing the performance of black-box models (Light Gradient-Boosting Machine (LightGBM) and Extreme Gradient Boosting (XGBoost)) with glass-box models (Logistic Regression (LR) and Explainable Boosting Machine (EBM)). Results revealed that the LightGBM black-box algorithm coupled with the SHapley Additive exPlanations (SHAP) method demonstrated superior performance in fault detection and diagnosis, without compromising the overall explainability. Consequently, it was possible to identify faults related to radio conditions, low network usage in specific user groups, low network capacity, and mobility issues. The paper concludes with practical mitigation strategies for each identified fault cluster.

Exploring the Impact of Fibroblast Growth Factor 17 on Functional Recovery and Neuroinflammation in Spinal Cord Injury

Spinal cord injury (SCI) affects more than 300,000 people in the United States, making it a significant and widespread problem. This includes injuries at the cervical level, which pose greater challenges due to respiratory in addition to mobility issues. Though there is a large societal impact there is still standard of care following spinal cord injury. While previous preclinical research has shown benefits from FGF1 and FGF2, there is weak data to suggest their clinical effcacy. A related compound, Fibroblast Growth Factor 17 (FGF17), has recently been described as a component within the CSF of young animals that when delivered to aged animals improved cognitive function. These improvements were associated with oligodendrogenesis. Spinal cord injury results in secondary demyelination, which may be mitigated by increasing oligodendrogenesis; this led us to examine how FGF17 may be used as a therapeutic agent following SCI. We used a rat C2 hemisection injury model to evaluate the effects of FGF17 at 4 hours, 2 and 6 weeks after injury. FGF17 was administered via intrathecal infusion at 25 μg/μl for 14 days at 0.5 μL/hour or a single application of 20 μL (4-hour timepoint). Following treatment, whole body plethysmography was performed weekly. Tissues were collected at endpoint to assess brainstem neuroinflammation via immunohistochemistry and molecular signaling pathways via western blotting. As anticipated, animals that were not treated with FGF17 had reduced tidal volume following spinal cord injury. Treatment with FGF17 partially preserved tidal volume as early as 3 days post injury. 6 weeks following spinal cord injury we observed a reduction in GFAP+ and IBA1+ staining in the brainstem near regions associated with respiratory control in animals treated with FGF17. Further, when we quantified the protein content in the spinal cord near the lesion epicenter we saw an increase in p-ERK 1/2 in all injured animals. However, in FGF17 treated animals we saw an increase in downstream transcription factors, STAT6 and Serum Response Factor. Serum Response Factor was implicated in oligodendrogenesis, ongoing studies will directly address this. These data suggest that FGF17 may be a viable alternative to the traditional fibroblast growth factor family members when treating spinal cord injury. R21NS121966, R01NS116068. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Smart Trolley - Human Following Trolley

Abstract: This abstract provides an overview of a novel IoT-based system designed to enhance the shopping experience by introducing a "Human-Following Shopping Trolley" Traditional shopping trolleys have remained relatively unchanged for decades, but this innovation leverages IoT technology and a mobile app to bring convenience and efficiency to the shopping process. The system comprises a smart shopping trolley equipped with sensors and actuators, allowing it to autonomouslyfollow a shopper as they navigate the store. This eliminates the need for physical pushing and pulling, making shopping more accessible, especially for the elderly and those with mobility issues. The trolleycommunicates with a mobile app installed on the shopper's smartphone or device

Impact Of Walking And The OTAGO Exercise Program On Improving Balance Parameters In The Elderly

There will likely be a rise in fall rates as the population ages. This will impact our society and put more strain on healthcare systems by increasing the number of unintentional injuries and injury-related deaths. According to Zijlstra et al. (2007), falls have a significant psychological impact on individuals, frequently leading to diminished confidence, decreased functional activity, deconditioning, and an elevated risk of falls. Estimated costs of fall-related damage to older adults owing to demographic changes in Australia (2003) predict that by 2051, fall-related injuries, which currently account for 5% of the country's overall health budget, would triple and cost the Australian health system about $1,375 million annually. Exercise and other modifications in lifestyle can potentially reduce the risk of many physical falls (Gregg et al., 2000; Sherrington et al., 2011). The current recommendations for physical exercise among older persons, which include elements of aerobic, resistance, and balance training, are not met by many of them. According to Chodzko-Zajko et al. (2009), the American College of Sports Medicine (ASCM) advises older persons to engage in aerobic, muscle-strengthening, and flexibility exercises. People who have mobility issues or are at risk of falling should also engage in certain activities designed to enhance their balance. We determined that the study's subjects would be third-age individuals (over 65) who reside in assisted living facilities located in Tirana's district and city due to the issues that this demographic faces. Keywords: falls prevention, ageing, nursing home support services, quality of life, older people, walking, OTAGO exercise program, balance, preventive care.

Predicting osteoporosis from kidney-ureter-bladder radiographs utilizing deep convolutional neural networks

Osteoporosis is a common condition that can lead to fractures, mobility issues, and death. Although dual-energy X-ray absorptiometry (DXA) is the gold standard for osteoporosis, it is expensive and not widely available. In contrast, kidney-ureter-bladder (KUB) radiographs are inexpensive and frequently ordered in clinical practice. Thus, it is a potential screening tool for osteoporosis. In this study, we explored the possibility of predicting the bone mineral density (BMD) and classifying high-risk patient groups using KUB radiographs. We proposed DeepDXA-KUB, a deep learning model that predicts the BMD values of the left hip and lumbar vertebrae from an input KUB image. The datasets were obtained from Taiwanese medical centers between 2006 and 2019, using 8913 pairs of KUB radiographs and DXA examinations performed within 6 months. The images were randomly divided into training and validation sets in a 4:1 ratio. To evaluate the model's performance, we computed a confusion matrix and evaluated the sensitivity, specificity, accuracy, precision, positive predictive value, negative predictive value, F1 score, and area under the receiver operating curve (AUROC). Moderate correlations were observed between the predicted and DXA-measured BMD values, with a correlation coefficient of 0.858 for the lumbar vertebrae and 0.87 for the left hip. The model demonstrated an osteoporosis detection accuracy, sensitivity, and specificity of 84.7 %, 81.6 %, and 86.6 % for the lumbar vertebrae and 84.2 %, 91.2 %, and 81 % for the left hip, respectively. The AUROC was 0.939 for the lumbar vertebrae and 0.947 for the left hip, indicating a satisfactory performance in osteoporosis screening. The present study is the first to develop a deep learning model based on KUB radiographs to predict lumbar spine and femoral BMD. Our model demonstrated a promising correlation between the predicted and DXA-measured BMD in both the lumbar vertebrae and hip, showing great potential for the opportunistic screening of osteoporosis.

Controlled Stiffness of Direct-Write, Near-Field Electrospun Gelatin Fibers Generates Differences in Tenocyte Morphology and Gene Expression.

Tendinopathy is a leading cause of mobility issues. Currently, the cell-matrix interactions involved in the development of tendinopathy are not fully understood. In vitro tendon models provide a unique tool for addressing this knowledge gap as they permit fine control over biochemical, micromechanical, and structural aspects of the local environment to explore cell-matrix interactions. In this study, direct-write, near-field electrospinning of gelatin solution was implemented to fabricate micron-scale fibrous scaffolds that mimic native collagen fiber size and orientation. The stiffness of these fibrous scaffolds was found to be controllable between 1 MPa and 8 MPa using different crosslinking methods (EDC, DHT, DHT+EDC) or through altering the duration of crosslinking with EDC (1 h to 24 h). EDC crosslinking provided the greatest fiber stability, surviving up to 3 weeks in vitro. Differences in stiffness resulted in phenotypic changes for equine tenocytes with low stiffness fibers (∼1 MPa) promoting an elongated nuclear aspect ratio while those on high stiffness fibers (∼8 MPa) were rounded. High stiffness fibers resulted in the upregulation of matrix metalloproteinase (MMPs) and proteoglycans (possible indicators for tendinopathy) relative to low stiffness fibers. These results demonstrate the feasibility of direct-written gelatin scaffolds as tendon in vitro models and provide evidence that matrix mechanical properties may be crucial factors in cell-matrix interactions during tendinopathy formation.

Global Cognition, Gender, and Level of Education Predict Dual-Task Gait Speed Variability Metrics in Older Adults

Introduction: The purpose of this study was to determine if demographic variables and measures of cognitive function, functional mobility, self-reported balance self-efficacy, and self-reported physical activity can predict gait speed variability during single-task walking (STGSCV), during cognitive-motor dual-tasking (DTGSCV), and dual-task effect on gait speed variability (DTEGSCV) in older adults. Methods: In 62 older adults, demographics were recorded and cognitive function (including the Montreal Cognitive Assessment, MoCA), functional mobility, balance self-efficacy (Activities-specific Balance Confidence Scale, ABC), and self-reported physical activity (Physical Activity Scale for the Elderly, PASE) were assessed. Three linear regression models were used to determine whether the functional mobility tests, PASE score, ABC score, and tests of cognitive function predicted gait speed variability outcomes (STGSCV, DTGSCV, DTEGSCV), with demographics included as covariates. Results: MoCA score (p = 0.003), gender (p = 0.040), and years of education (p = 0.010) significantly predicted DTGSCV (R2 = 0.297, p = 0.002). MoCA score (p = 0.008) and years of education (p < 0.001) also significantly predicted DTEGSCV. Despite a significant regression model (R2 = 0.316, p = 0.001), there were no significant individual predictors of STGSCV. Conclusion: Older adults with lower cognitive function scores, according to the MoCA, and higher levels of education demonstrate larger gait speed variability during dual-tasking and may be at increased risk of real-world mobility issues or falling.

The Relationship between Urinary Incontinence, Osteoarthritis, and Musculoskeletal System Disorders.

Background/Objectives: Urinary incontinence diminishes quality of life, and its severity can be worsened by mobility impairments. This study explored the link between urinary incontinence, osteoarthritis, and back musculoskeletal system disorders, considering pain, mobility issues, and daily activity difficulties. Methods: This cross-sectional study included respondents aged ≥ 15 years from the 2008 Turkish Health Studies Survey (n = 13,976). We assessed self-reported urinary incontinence, daily activity, mobility impairment, pain, osteoarthritis, and musculoskeletal disorders to explore their association with urinary incontinence. Gender-specific logistic regression models included chronic conditions related to urinary incontinence. Results: The prevalence of urinary incontinence was higher in the participants with osteoarthritis and back musculoskeletal system problems. Among the patients with osteoarthritis, the prevalence was 25.84% in the mobility-impaired group and 10.03% in the non-impaired group. Similarly, 33.02% of those with activities of daily living (ADL) difficulties and 12.93% of those without difficulties had incontinence. The frequency of urinary incontinence increased with pain severity. According to the multivariable logistic regression analyses, the adjusted odds ratio (95% confidence interval) of urinary incontinence for osteoarthritis was 1.58 (95% CI 1.23-2.02, p < 0.01) for females and 2.38 (95% CI 1.62-3.49, p < 0.01) for males. Conclusions: Urinary incontinence was more common in females, increased with age, and was found to be associated with osteoarthritis and back musculoskeletal system disorders. Among the patients with osteoarthritis and back musculoskeletal system disorders, those with mobility impairment and daily activity difficulties had a higher prevalence of urinary incontinence. The patients with more severe pain had a higher frequency of urinary incontinence.

Gait Analysis—A Tool for Medical Inferences

Gait analysis is a valuable tool for making medical inferences and improving the diagnosis and treatment of mobility issues. This project aims to leverage gait analysis in addressing two important challenges: detecting knock knees and monitoring patients with Parkinson’s disease for falls. The project proposes the integration of gait analysis with yoga therapy to provide a unique and effective approach for correcting knock knees. A web user interface is developed to enable individuals to access the system, receive accurate feedback on their gait, and access yoga postures tailored to target knock knees. Additionally, a fall detection system is designed to monitor patients with Parkinson’s disease and notify caregivers or guardians in case of a fall. The implementation involves utilizing deep learning models, such as OpenPose model, a widely adopted deep learning framework for pose estimation and MediaPipe, another recognized framework used for building multimodal applied machine learning pipelines, to analyze gait patterns and detect knock knees and falls. The project aims to empower individuals in improving their gait, correcting knock knees, and enhancing their physical health, ultimately improving their quality of life and well-being.

Mobile Technology Use in Clinical Research Examining Challenges and Implications for Health Promotion in South Africa: Mixed Methods Study.

The use of mobile technologies in fostering health promotion and healthy behaviors is becoming an increasingly common phenomenon in global health programs. Although mobile technologies have been effective in health promotion initiatives and follow-up research in higher-income countries and concerns have been raised within clinical practice and research in low- and middle-income settings, there is a lack of literature that has qualitatively explored the challenges that participants experience in terms of being contactable through mobile technologies. This study aims to explore the challenges that participants experience in terms of being contactable through mobile technologies in a trial conducted in Soweto, South Africa. A convergent parallel mixed methods research design was used. In the quantitative phase, 363 young women in the age cohorts 18 to 28 years were contacted telephonically between August 2019 and January 2022 to have a session delivered to them or to be booked for a session. Call attempts initiated by the study team were restricted to only 1 call attempt, and participants who were reached at the first call attempt were classified as contactable (189/363, 52.1%), whereas those whom the study team failed to contact were classified as hard to reach (174/363, 47.9%). Two outcomes of interest in the quantitative phase were "contactability of the participants" and "participants' mobile number changes," and these outcomes were analyzed at a univariate and bivariate level using descriptive statistics and a 2-way contingency table. In the qualitative phase, a subsample of young women (20 who were part of the trial for ≥12 months) participated in in-depth interviews and were recruited using a convenience sampling method. A reflexive thematic analysis approach was used to analyze the data using MAXQDA software (version 20; VERBI GmbH). Of the 363 trial participants, 174 (47.9%) were hard to reach telephonically, whereas approximately 189 (52.1%) were easy to reach telephonically. Most participants (133/243, 54.7%) who were contactable did not change their mobile number. The highest percentage of mobile number changes was observed among participants who were hard to reach, with three-quarters of the participants (12/16, 75%) being reported to have changed their mobile number ≥2 times. Eight themes were generated following the analysis of the transcripts, which provided an in-depth account of the reasons why some participants were hard to reach. These included mobile technical issues, coverage issues, lack of ownership of personal cell phones, and unregistered number. Remote data collection remains an important tool in public health research. It could, thus, serve as a hugely beneficial mechanism in connecting with participants while actively leveraging the established relationships with participants or community-based organizations to deliver health promotion and practice.

BREAST CANCER ASSISTANCE JOURNEY FROM THE PERSPECTIVE OF THE PUBLIC HEALTHCARE SERVICE OF RIO GRANDE DO SUL

Objective: This study aims to characterize the breast cancer (BC) patient journey in Rio Grande do Sul (RS), Brazil, through the perspectives of the High Complexity Oncology Assistance Centers (CACONs) and High Complexity Oncology Assistance Units (UNACONs). Methods: Conducted between March and May 2023 across 17 RS Oncology public healthcare services, the cross-sectional study utilized a 54-question questionnaire administered to healthcare professionals. The survey covered various aspects, including diagnosis, treatment, funding, and multidisciplinary teamwork. Results: Descriptive analysis revealed that BC patients undergo screening tests upon treatment entry (88.2%), with immunohistochemistry commonly performed externally (64.7%) and PCR often requested (82.4%) for adjuvant therapy initiation, taking an average of 90 to 250 days for all procedures. Patients encounter challenges such as lengthy hospital stays, extensive travel to treatment centers, treatment side effects, and high transportation expenses, often leading to treatment discontinuation. The most time-consuming stage is treatment, with subcutaneous infusion proving more time-efficient than intravenous administration. Physical limitations, mobility issues, late diagnosis (90-day average), and limited access to care significantly impact patients' quality of life. Healthcare teams face difficulties with outdated guidelines, lack of intravenous treatment facilities, and extended administration durations. Institutions confront barriers like drug shortages, guideline disparities, and logistical challenges. Conclusion: The study concludes by emphasizing the identified hurdles in BC patients' public healthcare journey, underscoring the need to address delays in screening, resource constraints, and disparities in access to care based on geographical, socioeconomic, and racial/ethnic factors to enhance overall quality of care and equity within the system.

A Comparison of Post-Operative Patient Reported Outcome Measurements Following Bunion Surgery: Modified Lapidus vs Minimally Invasive Techniques

Introduction/Purpose: The modified Lapidus procedure (MLP) or a minimally invasive surgery distal transverse osteotomy (MISDTO) are acceptable surgical treatment options for hallux valgus. The current literature is evolving when comparing the effects of each procedure on patient reported outcomes and post-operative complications. The purpose of this study is to compare postoperative outcomes, time to weight bear, and patient reported outcomes using the Patient Reported Outcome Instrumentation System (PROMIS) for the MLP and MISDTO. Methods: This study retrospectively reviewed patients who underwent a MLP or MISDTO for hallux valgus correction at Prisma Health Midlands between February 2020 – February 2022. Data collected included: demographic data, postoperative outcomes, time to weight bear, and PROMIS scores, including Pain Interference (PI), Physical Function (PF), and Mobility scores. Paired Student’s T-Test and Wilcoxon Rank Sum test were used to compare continuous variables and Chi-Squared test for categorical variables. Results: A total of 81 patients undergoing MLP and 78 undergoing MISDTO were included in the study. Average follow-up for MLP and MISDTO patients was 53.7 and 43.4 weeks, respectively. MLP demonstrated significant improvement in PI (52.5 vs 56.8, P&lt; 0.001) and Mobility (46.3 vs 43.4, P=0.044) scores, while MISDTO demonstrated a significant improvement in PI (48.8 vs 57.1, P&lt; 0.001), PF (50.2 vs 44.9, P&lt; 0.001), and Mobility (49 vs 42.8, P&lt; 0.001) scores. MISDTO patients had significantly larger improvements in PI (7.6 vs 4.5, P=0.008), PF (5.3 vs 2.2, P=0.026), and Mobility (5.5 vs 2.9, P=0.02) compared to MLP patients. MISDTO patients had a significantly lower non-union rate (13.6% vs 2.6%, P=0.025), hardware failure rate (0% vs 9.9%, P=0.007), and time to weight-bear (2.2 vs 7.8 weeks, P&lt; 0.001). Conclusion: Both MLP and MISDTO procedures are effective treatments for improving the pain and mobility issues associated with hallux valgus while maintaining patients’ function. MISDTO was found to improve patient reported outcomes significantly more than MLP, with a lower non-union rate, lower hardware failure rate, and shorter time to weight-bear. These findings suggest MISDTO is superior to MLP in improving patient reported outcomes and postoperative outcomes in the treatment of hallux valgus. Further study multicenter and long term outcome studies could be useful further evaluate these short term findings.

Physical Therapy Strategies for Osteogenesis Imperfecta

Osteogenesis Imperfecta (OI) is known to affect about 1/15,000–20,000 individuals in the world [1]. OI is rare congenital disorder characterised by bone fragility. Mutation in collagen related genes results in deficiency of collagen, which forms the bone matrix. This can result in fractures, deformities of the spine, and effects on other organs. A child's perception of pain can be influenced by a variety of circumstances, including repetitive fractures, bone deformities, muscle atrophy, mobility issues, and psychological concerns. Based on clinical characteristics and the course of the disease, OI subtypes are categorised; types I, II, III, and IV. OI Type I is considered the mildest form of the condition, with normal growth patterns and a low incidence of fractures during the perinatal period. Type II OI is more severe and causes death during the prenatal period. In contrast, OI Type III is a more serious presentation of the disorder. People with type III OI have significant bone deformities, and have fractures often even after birth. The most clinically heterogeneous type of OI is Type IV, with members displaying mild to severe symptoms. OI is diagnosed by using ultrasonography, radiography, bone densitometry, and serum electrolytes(calcium and phosphorous). Bone and skin biopsy also helps in diagnosis by studying collagen tissue. Individual differences in treatment response and outcome are due to genetic complexity in each kind of OI. Medicinal treatment(bisphosphonates) is the most common approach used to manage pain but these treatments' primary drawbacks include their comparatively low efficacy, their lack of benefits, the emergence of treatment resistance in certain individuals, or their cytotoxic adverse effects. The multidisciplinary approach to manage OI involves occupational therapy, physical therapy, orthotics and by other health care professionals including orthopaedic surgeon, dieticians, and speech therapists. Ongoing studies have provide new avenues for the management of OI, including medical, rehabilitation, and surgical treatments. Physical therapy maximise mobility and independence while lowering the risk of fracture and bone loss. The physiotherapists play a crucial role by providing counselling to the parents of OI infants based on disease severity and help the children with OI reach adult independence and maintain optimal musculoskeletal health. Parents are advised to handle and position the baby safely, with the ultimate goal of enabling the child to gain mobility on their own, whether that means utilising a wheelchair in the future or walking aids. Observational studies have shown evidence that supervised exercise regimes can enhance physical capacity and muscle strength.

Exploring the Relationship of SARS-CoV-2 and Uric Acid Levels With a Focus on Gout Patients: A Scoping Review.

Rheumatic diseases are a group of conditions including arthritis and various other conditions that can lead to chronic inflammation within the musculoskeletal system, which can have negative effects on soft tissues, bones, muscles, joints, and connective tissue. One form of arthritis is gout, which is an inflammatory condition in which urate acid crystals build up in joints. Gout is associated with joint swelling, pain, redness, and joint mobility issues. Early diagnosis and treatment are essential to prevent joint degradation and other adverse complications. The condition has been shown to increase the incidence of diseases outside the musculoskeletal system, including the renal and cardiovascular systems. Comorbid conditions associated with gout include but are not limited to type 2 diabetes mellitus (T2DM), hypertension, hyperlipidemia, chronic kidney disease, cardiovascular disease, and heart failure. This systematic review aims to provide insight into the relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, uric acid levels, and gout.