Screening Questionnaire Research Articles

Assessment of Carpal Tunnel Syndrome in Patients With Wrist Involvement During the Course of Inflammatory Arthritis. A Cross-Sectional Study.

The aim of the study was to evaluate the ultrasonographic (United States) alterations of the median nerve, the performance of the Kamath screening questionnaire and the clinical examination (Tinel and Phanel test) in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) with previous or present inflammatory involvement of the radio-ulno-carpal joint. A cross-sectional study was carried out. Patients with RA and PsA and clinical symptoms suggestive of CTS were consecutively recruited. The main clinical-demographic characteristics were collected in all patients. The Kamath questionnaire was administered to all patients during the clinic visit. The US examination was used as a 'gold-standard' for the diagnosis of CTS (transverse nerve area >12mm2 and morpho-structural alterations) and was used to assess the sensitivity and specificity of the Kamath questionnaire and the Tinel and Phanel clinical tests. 44 patients, 34 patients with RA and 10 patients with PsA were evaluated. 7 (16%) patients had a median nerve cross-sectional area >12mm2, associated with US abnormalities of the nerve. The Kamath questionnaire showed moderate sensitivity values (71.4%) but low specificity (56.7%) for ultrasonographic diagnosis of CTS with a negative predictive value of 91.3%. Clinical tests show low sensitivity but high specificity. No statistically significant correlations were found with the main clinical variables. The screening questionnaire showed moderate sensitivity but low specificity compared to the ultrasound 'gold standard'. Clinical tests may support the diagnosis of CTS in these conditions.

Voice Recordings from Short Mobile Sessions versus Clinical Interviews for Mental Illness Screening: A Comparative Study with Deep Transfer Learning

The prevalence of mental illness symptoms is increasing. While questionnaires are traditionally used, prior research applied machine learning to clinical interview recordings conducted by a virtual agent for depression screening. In this research, we compare their screening ability with brief mobile voice recordings. The latter reduces completion time while increasing access to screening. We collected 546 mobile voice recordings in response to four clinical interview questions from over 200 crowd-sourced adults reporting English fluency. We also collected responses to traditional screening questionnaires to use as labels in the classifiers. We extract textual transcripts from these voice recordings, facilitating both unimodal and multimodal classification. We compose acoustic and language representation models into deep learning architectures fine-tuned for mental illness screening. In our study, we compare the mental illness screening ability of four questions from mobile voice recordings and complete clinical interviews. When screening for depression, the brief mobile voice responses to individual questions proved as good or better for half of the interview questions. Overall, we achieved AUC of 0.76 for depression, 0.76 for anxiety, and 0.81 for suicidal ideation screening using our mobile voice recordings. Our findings can help guide the development of efficient and effective mental illness screening technologies.

Rehabilitation service utilization among individuals with long COVID in Laval, Canada.

(1) investigate utilization of rehabilitation services (Physical Therapy [PT], Occupational Therapy [OT], Speech Language Pathology [SLP], and Psychology [Psych]) among adults with long-COVID in Laval, Quebec; (2) determine unmet needs; (3) determine factors associated with receiving services; (4) examine satisfaction. Using an electronic survey, participants completed the Newcastle Post-COVID Syndrome Follow-Up Screening Questionnaire, COVID-19 Yorkshire Rehabilitation Scale, and the COVID-19 Rehabilitation Needs Questionnaire. Descriptive statistics were used to describe rehabilitation services received, reasons for unmet needs, and satisfaction. Bivariate analysis and multivariable logistic regression were used to determine factors associated with receiving services. Of 1031 persons with long-COVID, 37(3.6%) accessed OT, 80(7.8%) PT, 2(0.2%) SLP, and 63(6.1%) Psych. One quarter of participants who did not access rehabilitation services reported needing them. Factors associated with receiving services included hospitalization, vaccination, comorbidities, ≥1 year since COVID-19, female, ≥55 years, married/living together, and unemployed. Reasons for unmet needs were not knowing who to turn to, no referral, and financial. Most were satisfied with the services they received (70-84%). The majority of participants with long-COVID did not access rehabilitation services to address their impairments and disabilities. Accessible, multidisciplinary rehabilitation services to address the functional needs of people with long COVID is needed.

The effects of autistic traits in adolescents on the efficacy of paediatric Intensive Interdisciplinary Pain Treatment (IIPT).

Autistic adolescents are at greater risk of chronic pain, but it is unclear how autistic features may relate to individual aspects of chronic pain. As autism traits exist in the general population as well, it is important to know if autistic traits could impact how effective chronic pain management is for adolescents. Here we examined autistic traits in 112 patients (12-18yrs) recruited from a UK national specialist adolescent pain rehabilitation programme. Participants completed screening questionnaires for autistic traits upon entry to the programme, as well as clinically recognised pain measures before and after the 3-week treatment program. Autistic traits predicted greater psychological challenges at treatment onset. Critically, autistic traits were not related to the magnitude of improvement in pain measures during the pain management program. Our study suggests that adolescents with greater autistic traits may benefit from existing pain rehabilitation programs at similar rates to their peers. Additionally, these data suggest no reason for therapeutic pessimism for autistic pain patients. We do however acknowledge that these data may differ in populations with an autistic diagnosis, and that barriers may still exist for autistic people in treatment for pain. PERSPECTIVE: Autistic traits were explored in patients undergoing an Intensive Interdisciplinary Pain Treatment (IIPT). Higher autistic traits correlated with more pain related psychological difficulties at intake. Autistic traits were not related to the magnitude of improvement following IIPT. Our data therefore suggests that autism should not be a barrier to IIPT. DATA AVAILABILITY: Data is held in the PAIRED Pain Rehabilitation Database: Bath and Bristol, individual data used in the current analyses are therefore not available.

The association of polytherapy and psychiatric comorbidity in epilepsy.

Managing epilepsy may require using more than one anti-seizure medication (ASM). While combination therapy may help, risks, including psychiatric problems, are not fully explored in Africa. We examined the relationship between polytherapy and psychiatric comorbidities among attendees of an epilepsy community clinic. We prospectively assessed individuals attending an outpatient clinic in Kilifi, Kenya, for patterns of ASM prescribing (mono- or polytherapy) and reviewed psychiatric diagnoses. We used the Psychosis Screening Questionnaire and the Patient Health Questionnaire Version 9 to assess for psychosis and depression, and the Child Behavior Checklist to assess for emotional and behavioural problems. We conducted a cross-sectional logistic regression analysis to determine factors associated with polytherapy and examine the impact of polytherapy and specific medication on psychiatric comorbidities. Of 3,016 attendees, most were on older ASM (99.7%), with about a third (32.9%) on polytherapy. The most commonly co-administered drugs were phenobarbital and carbamazepine (13.0%). Children were less likely to be on multiple medications than adults, and there was no difference between the sexes. Polytherapy was associated with focal to bilateralised seizures (aOR 1.2 [95% confidence interval:1.0-1.4]) and frequent seizures (aOR=2.1 [1.5-2.9]). Combining drugs increased the likelihood of any psychiatric problems (aOR=1.3 [1.0-1.8]), with polytherapy associated with depression (aOR=2.9 [1.0-8.4]) and psychosis (aOR=1.9 (1.0-3.6)). Polytherapy, especially with older drugs, is associated with psychiatric comorbidities in this population. Resorting to polytherapy needs to be carefully considered. Prioritizing research into the long-term effects of ASM on psychiatric comorbidities is crucial for improving mental health outcomes in epilepsy, particularly in low-income settings.

The effect of obstructive sleep Asghari on hearing impairment: A Cross-Sectional Study among Noise-Exposed Workers

Purpose. The principal goal of this investigation was to assess how obstructive sleep apnea affects hearing impairments in workers who are regularly exposed to occupational noise. Materials and methods. In this investigation, we assessed 920 noise-exposure workers in one of the metal industries in Iran. Noise-induced, high-frequency, and low-frequency hearing loss were classified based on the mean hearing thresholds of more than 25 dB at 500–2000 Hz, 300–8000 Hz, and 4000 Hz, respectively. We used the STOP-Bang questionnaire for screening for sleep apnea, and a score of ≥3 indicated a high risk of obstructive sleep apnea. Multivariable logistic regression analyses were used to evaluate the correlation between hearing impairment and obstructive sleep apnea risk. Results. The mean hearing thresholds at 3000–8000 Hz and specifically at 4000 Hz were significantly higher among workers at high risk for obstructive sleep apnea compared to those at low risk (p-value <0.05). Following the multivariate logistic regression analysis and the confounding factor adjustment, individuals with high obstructive sleep apnea risk showed a higher incidence of noise-induced hearing loss (p = 0.002, OR = 1.85, 95% CI = 1.28–2.36) and high-frequency hearing loss (p = 0.02, OR = 2.05, 95% CI = 1.28–2.16) compared to those with low risk. Limitations. The cross-sectional design and use of a subjective screening method instead of objective methods such as polysomnography for evaluating obstructive sleep apnea are weaknesses of this study. Conclusion. The current study showed obstructive sleep apnea in noise-exposed workers increased the risk of developing high-frequency hearing loss and hearing impairment from noise. So, identifying and managing workers with obstructive sleep apnea risk, early hearing screening, and periodic audiometry can help to prevent hearing loss in the primary stage.

Towards person-centred maternal and newborn care in Ethiopia: a mixed method study of satisfaction and experiences of care.

Person-centred maternal care is associated with positive experiences in high-income countries. Little is known about the transferability of this concept to non-Western, low-income settings. We aimed to explore women's experiences of care and investigate satisfaction with antenatal care (ANC) in relation to person-centred care and unmet psychosocial needs in rural Ethiopia. Design: facility-based, convergent mixed-method study. A cross-sectional survey included 2079 consecutive women attending ANC at eight health centres. Service satisfaction was measured using a 21-item validated measure. [1] person-centred care (1A: receipt of information; 1B: perceived adequacy of health worker responses) and [2] unmet psychosocial needs (2A: Patient Health Questionnaire for depressive symptoms; 2B: screening questionnaire for intimate partner violence (IPV)). Linear mixed effect regression assessed hypothesized associations between person-centred care/unmet psychosocial needs and service satisfaction, accounting for clustering at the health centre level. A linked qualitative study comprised eight in-depth interviews with women accessing ANC. Structured observations of ANC consultations rated health worker competencies (n = 65) and adherence to guidance promoting person-centred care (n = 53). Qualitative data were analysed thematically and triangulated with quantitative and observational data. Women reported lowest satisfaction in relation to family involvement (71.5% dissatisfied) and continuity of care (65.7% dissatisfied). As hypothesised, satisfaction increased with more information received (adjusted regression coefficient (ARC) 0.96 95%CI 0.71,1.20) but reported adequacy of help from health workers did not show a dose-response relationship (test-for-trend p = 0.157). Undetected depressive symptoms (ARC - 0.21 95%CI -0.27,-0.15) and IPV (ARC - 1.52; 95%CI -2.43,-0.61) were associated with lower service satisfaction scores. Most observed consultations scored low on most indicators of person-centred care. In qualitative interviews, women valued respectful and responsive communication from health workers, which affected their willingness to disclose psychosocial problems. Triangulation of findings indicated a mismatch between what women valued about care, their reported satisfaction with care and the actual care they were observed to receive. Systems strengthening interventions to support person-centred maternal care appear contextually relevant but need to increase women's expectations of care and agency to demand change. Prioritization of person-centred care could improve women's experience of maternal care and better address psychosocial needs.

Intermittent theta burst stimulation for negative symptoms in schizophrenia patients with moderate to severe cognitive impairment: A randomized controlled trial.

This study aims to assess the therapeutic effects of intermittent theta burst stimulation (iTBS) targeting the bilateral dorsomedial prefrontal cortex (DMPFC) on negative symptoms in patients with schizophrenia, utilizing functional near-infrared spectroscopy for evaluation. Thirty-five schizophrenia patients with negative symptoms and moderate to severe cognitive impairment were randomly assigned to a treatment group (n = 18) or a control group (n = 17). The treatment group received iTBS via bilateral DMPFC. Negative symptoms, cognitive function, emotional state, and social function were assessed using Positive and Negative Syndrome Scale (PANSS), Scale for the Assessment of Negative Symptoms (SANS), Montreal Cognitive Assessment (MoCA), Calgary Depression Scale for Schizophrenia (CDSS), and Social Dysfunction Screening Questionnaire (SDSS) scales at pretreatment, posttreatment, and follow-up at 4, 8, and 12 weeks. Brain activation in regions of interest (ROIs) was evaluated through verbal fluency tasks. Prior to treatment there was no significant difference in the two groups. After 20 iTBS sessions, a significant difference was observed in SANS total score, its related subscales, PANSS total score, and PANSS-negative symptoms (all P < 0.05). The group-by-time interaction showed statistical significance, indicating improvements in negative symptoms and related dimensions over time, with therapeutic effects persisting for at least 8 weeks posttreatment. Prior to treatment, there were no significant differences in activation across all ROIs between the two groups. Posttreatment, the activation of right inferior frontal gyrus (t = 2.19, P = 0.036) and right frontal eye field (t = 2.14, P = 0.04) in the treatment group was significantly higher than in the control group. iTBS stimulation of bilateral DMPFC demonstrates therapeutic effects in improving negative symptoms in schizophrenia patients, and this treatment approach has the potential to enhance activation within the prefrontal cortex.

P-1440. Are Veterans Willing to Complete Sexual Health Screening In Primary Care?: Lessons Learned from a Population Level Sexual Health Questionnaire

Abstract Background The CDC recommends routine sexual histories (SH), yet they are rarely completed in primary care (PC) due to barriers ranging from patient discomfort to provider time constraints. We implemented a system wide nurse-led sexual health screening tool at a large VA hospital. Here we report on patient acceptability of sexual histories and sexual behaviors of Veterans at a population level.Table 1Demographics, Overall by Question 1 ResponseThis table describes demographics of those who agreed to discuss their sexual health, ie said Yes to Question 1 Methods We deployed a short SH screening questionnaire to be conducted during PC visits. Administered mostly by nurses, the questionnaire began with a consent question. Those with an affirmative response proceeded to answer additional questions. We queried the VA’s electronic database to ascertain patient demographics including age, birth sex, sexual orientation, gender identity, race/ethnicity, Rural-Urban Commuting Area codes. We describe the population as medians and proportions.Table 2Demographics, Overall by Question 2 ResponseThis table describes demographics of those who agreed to discuss about sexual health and have more than one sexual partner, ie said Yes to Question 2 Results Over 2-years (April 14, 2022-24) 130,986 SH screening questionnaires were offered to 95,490 unique Veterans, with 83,510 (87%) agreed at least once (Table 1). Birth sex females were more likely than males to agree to SH (91% vs. 87%). Most 65 and older agreed to the screening (85%). Supermajority of Veterans who have recorded a sexual identity as LGBQ+ agreed to SH (1688/1798, 94%). Similarly, 96% of those who have recorded self-identified gender as transgender man, transgender woman, or non-binary also agreed to SH. Racial or ethnic minority patients were more likely to agree to SH than Whites: 90% Black vs. 87% White; 91% vs. 87% non-Hispanic. Of 83,510 patients who agreed, 2754 (3%) had more than 1 sexual partner in the last 6 months, with younger age, LGBQ+ identity, Black race and Hispanic ethnicity associated with likelihood of more than 1 sexual partner (Table 2). Of these, 4% reported sexual partners of more than 1 gender, and 21% of this subset had a self-described sexual orientation as straight or heterosexual. Sexual Health Questions Conclusion A brief SH screening questionnaire administered by nurses in PC settings is feasible and highly acceptable to patients. Patients who identify as minority racial, ethnic, sexual or gender identity groups are very willing to provide SH, in some cases at much higher rates than non-minority peers. Other healthcare systems can implement similar nurse-led screening tools to improve SH taking in PC settings Age Breakdown for Question 1 This table describes the age breakdown for those who said Yes to Question 1, indicating both young and old population agree to discuss about sex. Disclosures All Authors: No reported disclosures

637. Stable bloodstream infection rates despite rising colonization: Insights from a hospital system using in-house PCR screening for Candida auris

Abstract Background Candida auris (C. auris) is spreading in the United States at a rapid pace. At our facilities, risk-based admission screening for colonization with C. auris using PCR has been a cost-effective tool for guiding infection prevention (IP) practices. We describe the observed trends in incidence of detection of colonization present on admission and hospital-onset cultures at our facilities since deploying in-house PCR testing.Figure 1:A. Candida auris 2-step screening process B: Sample Candida auris screening questionnaire Methods Study conducted at an integrated healthcare system in Miami, Florida, consisting of a large tertiary care center, three community hospitals and one inpatient rehabilitation hospital. The study period went from August 2021 to December 2023. In August 2021 we implemented admission screening for C. auris with PCR performed in-house. Screening criteria, testing and isolation protocols are presented in Figure 1A-B. Patients testing negative on admission were not routinely re-tested. Joinpoint regression was used to estimate changes in the incidence rates of C. auris newly present on admission surveillance (CA-POA), hospital-onset (HO) clinical cultures from any source and bloodstream infections (BSI). Definitions used are presented in Table 1. Results We identified 292 patients with CA-POA, for a crude rate of 9.1 per 10,000 patient-admissions. Between August 2021 and June 2023, the monthly percent change in the incidence rate of CA-POA significantly increased by 4.9% (95% CI 2.6-7.2; p&amp;lt; 0.01) and decreased by 17.4% (95% CI -30.8 to -1.5; p=0.03) between July 2023 and December 2023. There were 124 patients with HO clinical cultures, including 72 hospital-onset BSIs, for a crude BSI rate of 0.59 per 10,000 patient-days. There were no statistically significant changes in the trends of incidence of these infections during the study period. Incidence rates for the different outcomes of interest are displayed in Figure 2A-2D. Incidence rates for outcomes of interest Conclusion We found that despite rising rates of patients newly identified as already colonized with C. auris upon admission, the rates of HO cultures and most importantly of bloodstream infections have remained stable at our facilities. Admission screening using in-house PCR can lead to a more precise deployment of IP resources, mitigation of horizontal transmission and raising public health awareness on spread occurring outside hospitals. Disclosures All Authors: No reported disclosures

Exploring the Patients' Perspective on Digital Tools for Psychosocial Assessment in Dentistry.

Psychosocial screening is a valuable part of the assessment of patients with orofacial pain, as psychosocial factors will affect prognosis and treatment outcomes. Paper-based questionnaires are predominately used to assess the degree of psychosocial comorbidity; however, digital alternatives for screening questionnaires may be more cost-effective and resource-saving if patients are receptive to using them. To evaluate how patients perceive digital psychosocial screening in dentistry. Using a qualitative approach, individual semi-structured interviews were conducted with a purposive sample of adult patients with orofacial pain (n = 16) recruited from specialist dental clinics in Umeå and Gävle, Sweden. The interviews were transcribed verbatim and then analysed using Qualitative Content Analysis. Before the interviews, patients first completed the paper-based questionnaires and then the digital version. The analysis of patients' experiences resulted in an overarching theme: Patients appreciate a holistic approach, thus valuing psychosocial screening, and they particularly favour screening in a digital format. From this theme, two categories emerged: Perceptions about health shape patients' expectations of dental care, and with deeper understanding of the value of psychosocial assessment, patients appreciate a holistic approach that includes psychosocial factors. Digital screening is perceived by patients as a reliable, meaningful and environmentally sustainable method. In general, the patients appreciated a holistic approach in dentistry and understood the value of psychosocial screening as part of this. From the patients' perspective, digital psychosocial screening was both acceptable and beneficial. The findings support the introduction of digital psychosocial screening into daily dental practice.

Factors associated with post-traumatic stress symptoms in healthcare providers after performance of cardiopulmonary resuscitation: a mixed-methods study

The experience of performing cardiopulmonary resuscitation (CPR) can cause post-traumatic stress symptoms that negatively impact healthcare providers and reduced their clinical competency. This two-phase mixed-methods was conducted to investigate the factors that cause post-traumatic disorder (PTSD) in healthcare providers who perform CPR. Phase 1 included a survey with a trauma screening questionnaire (TSQ). Phase 2 included gathering interview data and applying conventional content analysis to identify themes. Of the 286 medical staff who completed the TSQ, 32 (11.2%) of respondents experienced PTSD after administering CPR. PTSD occurred significantly more frequently in nurses than in doctors. Among nurses, those with 2–5 years of experience were the most likely to experience PTSD. From the content analysis of the interview data, four themes with twelve subthemes emerged: Healthcare providers were not prepared for CPR, Difficulties faced during CPR administration, Negative emotions experienced after performing CPR, and Overcoming stress and moving forward. The occurrence of PTSD is associated with negative experiences in each stage of the event: before-, during-, and after-CPR. Therefore, to avoid or overcome PTSD caused by performing CPR, systematic and customized intervention strategies suitable for each stage of the process are needed.

Association Between Symptoms of Body Dysmorphia and Social Media Usage: A Cross-Generational Comparison.

Background: The rise of social media parallels a mental health epidemic. The effect of social media usage on rates and severity of body dysmorphic disorder is not well-understood. Objective: To determine if an association exists between social media engagement, body dysmorphia symptoms, and/or interest in cosmetic surgery in a demographically diverse cross-section of the U.S. adult population. Methods: In a Qualtrics platform-based survey study of the general U.S. adult population, responses to demographic information, social media activity questionnaire and the body dysmorphic disorder screening questionnaire, and interest in cosmetic surgery were collected. Descriptive statistics and a multivariate logistic regression model were carried out. Results: A total of 1,013 respondents completed the survey. The average age was 40.9 (SD, 14.8) years, 72% were women. Median time spent on social media (IQR) was 4 (2-7) h/day. Respondents who screened positive for symptoms of body dysmorphia had higher daily mean social media usage time (odds ratio [OR] 1.49), tend to be female (OR 2.17), younger (OR 0.97), identify as Caucasian (OR 1.65), and are more likely considering a cosmetic procedure in the next year (OR 2.98). Conclusion: This study demonstrates a positive association between daily social media usage, self-reported symptoms of body dysmorphia, and interest in cosmetic procedures.

Identifying ICU survivors and relatives with post-traumatic stress disorder using text mining: An explorative study.

A quarter of ICU-patients develop post-traumatic stress disorder (PTSD) after discharge. These patients could benefit from early detection of PTSD. Therefore, we explored the accuracy of text mining with self-narratives to identify intensive care unit (ICU) patients and surviving relatives at risk of PTSD in a pilot study. In this prospective cohort study with self-administered questionnaires, discharged ICU-patients and surviving relatives participated. In a single centre study at a 32-bed ICU of a large teaching hospital, we used an online screening tool with self-narratives, to identify ICU-patients and surviving relatives at risk of PTSD using text mining. Study variables were Trauma Screening Questionnaire (TSQ) and self-narratives, administered 3 to 6months after ICU discharge. Of the participants 15% had an indication of PTSD based on TSQ. The median length of the self-narratives was 101 words. Using self-narratives, PTSD was predictable with a reasonable performance (AUROC of 0.67), compared to TSQ as gold standard. The most important words of the prediction model were 'happen' 'again' and 'done'. These words are difficult to interpret without context. It is possible to predict risk of PTSD for ICU-patients and surviving relatives using text mining applied on self-narratives, 3 to 6months after ICU discharge. The model performance is reasonable and helps to identify patients and surviving relatives at risk. Based on the large proportion of participants with an indication for PTSD, it remains important to persuade patients and surviving relatives to seek help when experiencing mental health problems after discharge.

P0232 Increasing awareness of joint symptoms in Inflammatory Bowel Disease clinic using recognised clinical joint pain scoring symptoms may aid early diagnosis of spondyloarthropathy

Abstract Background Axial spondyloarthropathy(axSpA) is under-recognised and underdiagnosed in lnflammatory Bowel Disease (IBD) patients. The aim of our study is to assess the prevalence of subclinical axSpA in our IBD patient cohort, assess risk factors and improve patient health through early recognition and referral. Methods A prospective observational study assessing presence of clinical symptoms suggestive of spondyloarthropathy was performed. Patients with established IBD and no previous history of joint pain or documented rheumatological disease attending a specialist IBD clinic were screened over a 6 month period from January to July 2024. All patients reporting lower back pain were assessed with a screening questionnaire using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score. BASDAI score ≥ 4 suggests moderate activity of axial spondyloarthropathy. Radiographic imaging of the sacroiliac joints were performed. BASDAI scores were correlated with CRP and calprotectin levels. Other demographic factors were also recorded from patient records. Results 590 patient visits for IBD were recorded from January to July 2024. 320 patients were screened for the study. 34 (10.6%) patients reported symptoms suggestive of axial spondyloarthropathy when questioned. The mean age was 45 years of age (19-82). 55.9% of patients were female. 14.7% of patients had symptoms of other extra-intestinal manifestations (EIMs). 50% of patients had Ulcerative colitis, 44% of patients had Crohn’s disease and 6% had IBD-U. Mean CRP level was 2.36 (0.5–7). Mean calprotectin was 151 (13-1100). 21/34 (62%) of patients had a BASDAI score suggestive of moderately active clinical symptoms of arthropathy. Mean BASDAI score was 4.97. 2/21 (9.5%) of those with BASDAI ≥ 4 had radiographic evidence of sacroiliitis. Of those patients with radiographic axSpA, the mean BASDAI was 5.1. Patients with radiographic axSpA were referred to the rheumatology outpatient service. 84% females screened had BASDAI ≥ 4 compared to 40 % males (Fisher exact test, p=0.015). There was no correlation noted between reporting of joint symptoms and age, CRP or calprotectin nor did it correlate with disease type or behaviour. Conclusion The use of rheumatological screening tests in the IBD clinic could contribute to the early diagnosis of axial spondyloarthropathy in IBD patients. Raising awareness of musculoskeletal manifestations of IBD could improve diagnosis, early involvement of the multidisciplinary team and improve disease burden.

Prevalence of Breast Cancer-Related Lymphedema in Israeli Women Following Axillary Procedures

Background/Objectives: Breast cancer-related lymphedema (BCRL) is a chronic complication of breast cancer treatment, leading to physical and psychological morbidity. While widely studied globally, the prevalence and risk factors for BCRL in Israeli patients remain unexplored. This study’s objectives were to determine the prevalence of BCRL in Israeli women treated for breast cancer, validate the Hebrew-translated Norman Questionnaire (NQ) for BCRL screening, and identify risk factors associated with the condition. Methods: A single-center study was conducted at Tel Aviv Sourasky Medical Center, including 181 patients who underwent unilateral axillary lymph node interventions between 2015 and 2018. Participants completed the Hebrew-translated NQ, which was validated through clinical evaluation and circumference-based volume measurements in a subset of 20 patients. Prevalence rates and risk factors were analyzed using multivariate modeling. Results: The prevalence of BCRL was 20%, with rates varying by procedure: 8.9% for sentinel lymph node biopsy, 19.6% for lymph node sampling, and 37.5% for axillary lymph node dissection (ALND). Of the 35 patients with BCRL, only 14% had been previously diagnosed. Risk factors included ALND (OR = 97.31), a higher lymph node excision count (OR = 0.81), and referral to physiotherapy (OR = 133.50). The Hebrew NQ demonstrated strong validity (rs = 0.852; p &lt; 0.001). Conclusions: This is the first study to estimate BCRL prevalence in Israeli women, highlighting underdiagnosis and the need for improved early detection. The Hebrew NQ is a reliable screening tool, enabling timely referral and intervention. Early diagnosis is crucial for optimizing treatment outcomes and improving the quality of life of BCRL patients.

P0970 Associations between diet, faecal and flatulence odour perception and disease activity in patients with inflammatory bowel disease and healthy controls

Abstract Background Inflammatory bowel disease (IBD) affects gastrointestinal function and may alter faecal odour due to changes in the gut microbiome and metabolism. Given the relationship between diet, gut health and microbiome diversity, exploring the link between dietary habits and faecal odour in IBD seems crucial. This study investigates the associations between dietary behaviour, flatulence and faecal odour perception and disease activity in IBD patients compared to healthy controls (HC). Methods From October 2023 to October 2024, a total of 238 IBD (women: 51.3%; CD: 59.7%; remission: 33.5%) patients and 97 HC (women:70.1%) were enrolled at the IBD outpatient clinic of the Hannover Medical School. In addition to a short screening questionnaire for highly processed foods (sQ-HPF), dietary behaviour (Food Frequency Questionnaire (FFQ)), clinical (HBI, PMS) and biochemical (CRP, faecal calprotectin) parameters of disease activity were assessed as well as adherence to a mediterranean diet and changes in bowel movement odour (faecal and flatulence) were collected. Results Significant differences in flatulence (p&amp;lt;0.001) and faecal odour perception (p&amp;lt;0.001) were found between IBD patients and HC. Further associations with dietary habits revealed differences between HC and IBD individuals exhibiting strong flatulence odour demonstrating significant associations with the daily intake of carbohydrates (p = 0.007), sugar (p = 0.049), vegetables (p = 0.033), legumes (p = 0.010), and the daily energy intake (kJ) from highly- and ultra-processed foods (p = 0.002 and p = 0.007, respectively). However, the differences between HC and IBD individuals with strong faecal odour were only significant for the daily intake of legumes (p = 0.002). Further analyses revealed significant associations between flatulence and faecal odour perception and IBD activity (p &amp;lt; 0.001). Subgroup analyses showed significant differences between Crohn’s disease (CD) and ulcerative colitis (UC) patients with and without strong faecal odour, particularly in those with moderate disease activity (p = 0.006 and p = 0.017). Additionally, significant differences in flatulence odour were found between CD and UC patients with moderate (p = 0.008) and severe disease activity (p = 0.041). Conclusion In conclusion, significant differences in flatulence and faecal odour perception were found between IBD patients and healthy controls, with dietary associations noted for strong flatulence and faecal odour. Disease activity was strongly associated with both flatulence and faecal odour perception, with notable differences between CD and UC, particularly in moderate and severe disease activity.

Prevalence of epilepsy across 25 sub-counties in three districts of northern Uganda.

Epilepsy is one of the most common neurological conditions worldwide, with large variation in prevalence across Sub-Saharan Africa countries. Northern Uganda is one of the poorest areas of the country and has seen high density of pigs and prevalence of Taenia solium, a zoonotic tapeworm transmitted which cause neurocysticercosis in humans. The objective of this study was to estimate the population-level prevalence of active epilepsy in 25 sub-counties of northern Uganda. This cross-sectional study was conducted in 2010-2011 in 25 sub-counties of Moyo, Adjumani and Gulu districts, northern Uganda. Participants were sampled using a multistage cluster sampling strategy including sub-counties, parishes, villages, and households as sampling levels. Eligible individuals were interviewed using a previously validated screening questionnaire for epilepsy. Screen positive individuals were further examined by a team of neurologists for confirmation of active epilepsy. Sampling weights and post-stratification to account for sex distribution in each of the 25 sub-counties sampled based on projected 2010 population sizes were applied. A total of 38,303 individuals were sampled across 299 villages from 25 sub-counties. The overall weighted and post-stratified prevalence estimate of active epilepsy was 3.7% (95% Confidence Interval: 3.4%-3.9%). However, there were large variation across sex (4.6% (95%CI: 4.2%-5.0%) in men and 2.7% (95%CI: 2.4%-3.0%) in women) and across sub-counties ranging from 1.7% in Pece Division (Gulu District) and Moyo Town Council (Moyo District) to 6.6% in Awach (Gulu District). People aged between 10 and 19 were the most affected. In northern Uganda, active epilepsy was very prevalent but varied largely across sub-counties. Males were a lot more affected than women, making the use of weighted and post-stratified methods to estimate the prevalence of epilepsy essential. Implementing programs and interventions targeting the control of local risk factors of epilepsy such as neurocysticercosis and improving population health care access could help reduce the rather high prevalence of epilepsy in this area of the country.

Evening Alpha-Lactalbumin Supplementation Alters Sleep Architecture and Reduces Morning Reaction Time in an Athletically Trained Population With Sleep Difficulties.

Evening consumption of a whey protein rich in the amino acid tryptophan, alpha-lactalbumin (ALAC), has previously shown to benefit sleep-particularly among poor sleepers. Given trained populations often experience sleep difficulty, this study investigated whether evening supplementation of ALAC would influence sleep outcomes, mood, and next-day cognitive performance within a trained population with sleep difficulties. Nineteen trained participants (females, n = 11) with sleep difficulties (Athlete Sleep Screening Questionnaire: 8.1 ± 3.1; Pittsburgh Sleep Quality Index: 10.5 ± 4.1) completed this double-blinded, counterbalanced, randomized, crossover trial. Forty grams of ALAC or control were supplemented 2hr presleep for three consecutive nights in a controlled environment, with sleep measured using dry electroencephalography. Blood samples were taken on the first evening of each experimental trial, with mood, sleepiness, and recovery assessed across the evening and morning. A cognitive testing battery was also completed each morning. During the ALAC condition, the primary findings were that participants had raised plasma tryptophan levels (p < .01), increased nonrapid eye movement Stage 2 sleep duration (CON: 205.9 ± 33.3; ALAC: 216.5 ± 33.1min), reduced rapid eye movement duration (CON: 110.8 ± 27.9; ALAC: 99.7 ± 23.1min), and improved reaction time in cognitive tests involving sensory motor speed, spatial orientation, and vigilant attention (p < .05). Data suggestevening supplementation of 40g ALAC alters sleep architecture and improves next-morning reaction time in trained populations with sleep difficulties. Therefore, trained individuals experiencing sleep difficulty may benefit from acute ALAC supplementation to assist next-day performance. Future research should investigate this effect within habitual environments, outside of a tightly controlled setting.

Irregular sleep/wake patterns in student-athletes exposed to early morning training

ABSTRACT This study aimed to examine the sleep parameters and sleep/wake regularity of a cohort of student-athletes who start training between 06:30 and 07:00. Twenty-one male Rugby Union players, aged 21 ± 2 years and competing at a national level, were assessed using actigraphy over two weeks, and the Athlete Sleep Screening Questionnaire (ASSQ). Sleep/wake regularity was calculated using the Sleep Regularity Index (SRI). Wilcoxon signed-rank tests showed that nocturnal sleep preceding morning training had a significantly shorter sleep duration (1.8 hr, r = .67), and advanced sleep onset (0.9 hr, r = .50) and sleep offset times (3.2 hr, r = .85) compared to nocturnal sleep preceding free days. The variability of training demands resulted in an inconsistent sleep pattern between consecutive days, resulting in a median SRI score of 67.0 (interquartile range: 17.0). Pearson correlations revealed that lower SRI was significantly associated with a higher daily sleep duration including naps (r = -.62), delayed sleep onset (r = -.50) and sleep offset (r = -.60), and a later chronotype assessed using the ASSQ (r = .52). These findings indicate that early morning training is a factor contributing to irregular sleep/wake patterns in student-athletes, and where feasible should be scheduled at an alternative time.