Limitations In Activities Of Daily Research Articles

Revised definition of obesity in Asian Indians living in India.

The prevailing guidelines for obesity in Asian Indians, published in 2009, relied solely on body mass index (BMI) criteria. Recognizing the limitations of BMI in accurately diagnosing obesity and the emergence of new research revealing the association between generalized and abdominal adiposity in Asian Indians and early-onset co-morbid diseases, a comprehensive redefinition was needed. In a Delphi process focused on obesity in India, experts were invited via email to participate in five rounds. The survey questions were administered through Google Form to gather insights from the selected experts. In Stage 1 Obesity, individuals exhibit increased adiposity (BMI>23kg/m2) without discernible effects on organ functions or daily activities. Stage 2 Obesity denotes a more advanced state characterized by heightened adiposity (generalized and abdominal), impacting both physical and organ functions, resulting in functional limitations during day-to-day activities, and contributing to co-morbid diseases. The criteria for Stage 2 Obesity include a mandatory BMI exceeding 23kg/m2 and at least one of the following: excess waist circumference or waist-to-height ratio. Additionally, the presence of one or more symptoms indicative of limitations in daily activities or one or more obesity-related comorbid conditions/diseases are needed to support the stage 2 obesity. This refined framework seeks to enhance precision in identifying obesity and its associated health risks among Asian Indians living in India, and facilitation of rational management, and aligns with worldwide initiative of new definition of obesity.

Medication Adherence and Health related Quality of life among Patients with Chronic Obstructive Pulmonary Disease in Pokhara

Background: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable chronic disease. Patients have to consume medicine for longer duration which usually leads to non adherent to medicine in long term due to various socio-economic factors such as financial status, economical status of patients. This study focuses on nature of medicine adherence among COPD patients, factors affecting medicine adherence of the patients and influence of medicine adherence on Health related Quality Of Life.Methods: A descriptive analysis study was done among known case of COPD cases after obtaining approval from ethical review board of NHRC. A written consent was obtained from all the participants. Morrisky Medication adherence scale was used to access medication adherence among patient where as st. George ’s Respiratory Questionnaire for COPD was used to evaluate Health related Quality of life of the patients. Results: Among 350 cases analyzed, majority (n= 217; 63%) of the cases were poorly adherence to medicine. There was significant association between rural residence of patients, poor financial status, low education status, longer disease duration, lack of financial support, nuclear family type and poor adherent to medicine (p< 0.05). There was also significant association between poor medicine adherent and poor Health related Quality of Life. (P < 0.05).Conclusion: These patients experienced a severe impact on their symptoms, considerable limitations in daily activities, a higher burden of disease, and an overall reduction in their quality of life.

From joint to heart: Cardiovascular implications of rheumatoid arthritis

Rheumatoid arthritis is a commonly encountered autoimmune disease and a progressive chronic inflammatory condition that often leads to permanent joint damage. Systemic inflammation in rheumatoid arthritis is linked to various comorbid conditions such as interstitial lung disease, osteoporosis, metabolic syndrome, cardiovascular disease, infections, malignancies, cognitive dysfunction, depression, and fatigue, which can increase morbidity and mortality in rheumatoid arthritis patients. Approximately 36% of patients report worse health and limitations in daily activities, while nearly 30% require more assistance with personal care compared to individuals without rheumatoid arthritis. Epidemiological data from 1990 to 2017 show an incidence of rheumatoid arthritis of 246.6 per 100,000 people aged 33-54 years, with prevalence in women 2-3 times higher. In Southeast Asia, the incidence is 89 per 100,000 in individuals aged 13-22 years, while in Indonesia, it is estimated at around 5-7.5 per 100,000 population. Cardiovascular disease is the primary cause of mortality in rheumatoid arthritis patients, with myocardial infarction being the major contributor. The pathogenesis of rheumatoid arthritis is still complex and involves immunological processes that occur long before joint inflammation symptoms appear, including genetic modifications and environmental factors that lead to deimination and joint disturbances. Cardiovascular manifestations, particularly myocardial infarction, occur due to an atherosclerotic process triggered by rheumatoid antibody complexes. Given the higher cardiovascular risk in rheumatoid arthritis patients, early detection and awareness of these manifestations are crucial for better management.

Long-Term Determinants of Depression Mood: A 19-Year Follow Up of 2344 Middle-Aged and Older Adults.

Objectives: This study explores depression changes and influencing factors in middle-aged and older individuals, focusing on different cognitive function states. Methods: This cohort study uses panel data from seven waves of the nationally representative Taiwan Longitudinal Study on Aging (1996-2015) with 2344 participants aged 50 or above. Data analysis was conducted from 25 January 2023 to 4 May 2023. Results: Multivariate logistic regression analyzed three trajectories: maintained mood, progressive depression, and consistent depression. Protective factors for progressive depression included self-health perception, exercise, family satisfaction, and financial well being, while risk factors were chronic diseases, pain, substance use, and daily activity limitations. Cognitive function emerged as a significant protective factor, while pain exhibited the highest risk. In the cognitive dysfunction group, only social participation showed notable differences. Conclusion: Progressive and consistent depression in middle-aged and older people have aroused concern. In addition to necessary protection and risk factors, special attention should be paid to the risks posed by the level of pain. Addressing pain as a crucial risk factor is essential, particularly for middle-aged and older people with cognitive impairment and depression, necessitating targeted support.

The current situation and associated factors of preoperative frailty in elderly patients undergoing abdominal surgery

BackgroundThis study aimed to investigate the current preoperative frailty status of elderly patients undergoing abdominal surgery and identify its associated factors. The objective of this study was to provide clinicians with valuable insights for implementing frailty intervention strategies.MethodsA cross-sectional study was conducted with 375 elderly patients who underwent abdominal surgery at a tertiary hospital in Chengdu, Sichuan Province, between October 2021 and August 2022. The data were collected using various instruments, including a general information questionnaire, the FRAIL frailty assessment scale, the West China Mood Index, the Nutritional Risk Screening 2002, and the Barthel Index. Multivariate logistic regression analysis was conducted to investigate the factors influencing preoperative frailty in this patient population.ResultsAmong the 375 elderly patients who underwent abdominal surgery, 59 were identified as having preoperative frailty, resulting in a preoperative frailty rate of 15.7%. Multivariate analysis revealed that multiple chronic diseases, malnutrition risk, and limited ability to perform daily life activities were significant associated factors for preoperative frailty in these patients (P < 0.05).ConclusionClinical medical staff should prioritize the preoperative frailty assessment of elderly patients undergoing abdominal surgery, particularly those with multiple chronic diseases, malnutrition risk, and limited daily life activities.

Factors affecting pain experience after lower third molar germectomy in teenagers-a clinical study.

This study aimed to investigate the correlation between subjective pain threshold (SPT), daily pain recovery (PR) during the first postoperative week, and patient/surgical characteristics, while evaluating changes in SPT across multiple surgeries. Additionally, it assessed how perceived quality of life correlates with SPT and PR in adolescents undergoing lower third molar germectomy. A prospective clinical study was conducted at the Paediatric Surgery Unit, Sapienza University of Rome, involving 51 patients aged 10-16years undergoing lower third molar germectomy. SPT and daily PR were measured using the Visual Analogue Scale (VAS) during the first postoperative week, and quality of life was evaluated using the SF-12 questionnaire at 1-week follow-up. A total of 87 germectomies were performed, with 36 patients undergoing a second surgery. The mean age was 13.86 ± 1.81years. Mean VAS scores increased from 4.2 ± 1.5 for Intervention 1 to 4.8 ± 1.6 for Intervention 2. Longer operative times were associated with higher PR scores on postoperative day 3. Higher PR scores correlated with greater limitations in daily activities and emotional well-being, while lower PR scores were linked to better self-perceived health. SPT and PR are influenced by surgical duration and self-health perception. Shorter procedures and positive self-health perception contribute to faster recovery and improved postoperative quality of life in young patients.

Occupational Therapy Interventions and Their Impact on Work Performance and Activities of Daily Living in Persons with Multiple Sclerosis

Background. Multiple sclerosis (MS) is a chronic neurological disease that affects the central nervous system, leading to various physical, cognitive, and emotional challenges that significantly impact daily activities and work performance. Occupational therapy (OT) plays an important role in managing MS by providing interventions designed to improve functional performance, promote independence, and enhance overall well-being. Aim. To evaluate the impact of OT interventions on work performance and activities of daily living in individuals with MS. Methods. A total of 776 participants diagnosed with MS were included in this study. Data were collected through structured questions extracted from the MS Quality of Life-54 questionnaire. The study assessed the relationships between the type of MS, work performance, daily activities, and the effectiveness of OT interventions. Statistical analyses included Chi-Square tests, correlation analysis, calculations of standard deviation and variance, Box Plots, and ANOVA tests. Results. The study found that 65% of participants reported reduced working hours, 78% performed fewer activities than desired, and 66% experienced limitations in work tasks or daily activities due to MS. Emotional problems also impacted work performance and daily activities. The ANOVA test revealed significant differences in reduced working hours, fewer activities, and the impact of emotional problems among different types of MS. Specifically, the relapsing-remitting type of MS showed the highest impact on work performance and daily activities. Conclusions. OT plays a crucial role in addressing the functional and emotional challenges associated with MS. The interventions are particularly beneficial in improving work performance and daily activities, especially for individuals with the relapsing-remitting type of MS. Individualized OT strategies should be tailored to address the specific needs of individuals with different types of MS. Keywords: occupational therapy; multiple sclerosis; daily activities; work performance.

A case of apraxia of eyelid opening associated with benign essential blepharospasm in Bhutan

Apraxia of eyelid opening (AEO) is a non-paralytic motor abnormality characterized by difficulty in eyelid opening bilaterally. This is due to the inability of voluntary opening of the eyes in the absence of visible contraction of the orbicularis oculi despite sustained willful frontalis contraction. We present you a case of a 60-year-old woman with AEO associated with benign essential blepharospasm who suffered marked limitation in daily activities due to functional blindness. She was treated with botulinum toxin type A injections following which she had adequate eyelid opening in both eyes during 1 week follow up. It is essential for physicians and patients to be aware of this condition for proper diagnosis and treatment.

Living with Pyoderma Gangrenosum: A Qualitative Study.

Pyoderma gangrenosum is a rare, autoinflammatory disorder characterized by rapidly progressive painful ulcers that are challenging to diagnose and treat. This qualitative study aimed to explore the experiences of patients living with pyoderma gangrenosum. Using an inductive qualitative approach, semi-structured interviews were completed with a purposive sample of 21 patients with pyoderma gangrenosum recruited from a public dermatology outpatient clinic in Melbourne, Australia. A reflexive thematic analysis was performed, yielding 5 themes: pain, physical challenges, social functioning and relationships, mental health, and treatment. The impact of pyoderma gangrenosum on quality of life was multifaceted and varied throughout disease progression, remission, and recurrence. Experiences of delayed diagnosis and misdiagnosis were common, causing distress and resulting in unnecessary treatments including surgery. Severe pain disrupted sleep and limited daily activities, eroding patients' sense of self-control and perpetuating depressed mood and anxiety. Management should include early specialist referral, providing information sheets for managing pain and wound care, and communicating disease expectations. In conclusion, this study has deepened understanding and given personal perspectives on what it is like to live with a condition poorly understood by many health professionals. Increased efforts should be made to increase clinician awareness regarding pyoderma gangrenosum to facilitate early diagnosis.

Impact of lateral ankle sprains on physical function, range of motion, isometric strength and balance in professional soccer players

ObjectiveLateral ankle sprains (LASs) are prevalent in soccer and can affect long-term performance, injury recurrence and risk for chronic ankle instability. This case–control study examined functional impairments associated with LAS...

A Heat Sensitivity Scale for People with Parkinson's Disease.

People living with Parkinson's disease (PD) commonly experience heat sensitivity-worsening symptoms and restricted daily activities in heat. This study aimed to develop a scale of heat sensitivity for people with PD. Through a search of the scientific literature and online forums, we developed 41 items relating to experiences of heat for people with PD to assess heat sensitivity. A panel of experts was then consulted to review the scale items critically. After two rounds of review, the scale was refined to 36 items with an overall scale content validity index of 0.89. Via an online survey, 247 people with PD responded to the items. The items were examined with exploratory factor analysis to determine the underlying factors therein. After several iterations, a simple structure was achieved with 29 items loading uniquely onto one of four factors: daily activities, sweating and exercise, heat-related illness, and symptoms and medications. The model had acceptable to excellent fit statistics (root mean square error of approximation = 0.073 [90% confidence interval 0.067-0.081], root mean square of the residuals = 0.03, comparative fit index = 0.93, and Tucker-Lewis index = 0.91), and each factor showed high reliability (Cronbach's α ≥0.89). Factor and total scale scores were significantly higher among those reporting sensitivity to heat and poor health status. This new heat sensitivity scale for people living with PD can enable health professionals and clients to assess the severity and impact of heat sensitivity.

COMPLEX PHYSICAL THERAPY OF PATIENTS WITH ADHESIVE CAPSULITIS

Adhesive capsulitis is predominantly an idiopathic condition and is more common in patients with metabolic disorders. PS contracture can be of varying degrees of severity, depending on the pathology of the PS with which we are dealing. This condition greatly aff ects work capacity and quality of life due to the presence of pain, discomfort and limitation of daily life activities. Prolonged pain syndrome can provoke sleep disorders and depression. Disruption of normal sleep, pain and depression form a pathological closed circle and contribute to the maintenance of the pathological process in the locus morbi.The development of a comprehensive program of physical therapy for patients with adhesive capsulitis with the use of modern means of recovery, which will reduce the risk of the disease re-emerging, and will also contribute to the faster recovery of the functional capacity of the musculoskeletal system of the patients.The objective of the study. The develop and practically substantiate a comprehensive program of therapy for patients with adhesive capsulitis using physical therapy.Materials and Research Methods. The study is based on a comprehensive therapeutic approach for 36 patients diagnosed with adhesive capsulitis in the acute phase of the condition. The assessed parameters included X-ray and computed tomography results, evaluation of range of motion in the shoulder joint, joint- muscle apparatus, and analysis of pain intensity indicators.Conclusions. To improve the condition of patients and optimize the process of treatment and rehabilitation of patients with adhesive capsulitis of the shoulder joint in the acute period, it is advisable to use with the diff erentiation of means of therapeutic intervention according to the diagnosis of the international classifi cation of functioning, optimization of physiotherapeutic means and special means of physical therapy allowed to shorten the terms of treatment and recovery of patients with adhesive capsulitis. It was determined that the best combination of means of therapeutic intervention for patients with adhesive capsulitis is the use of a complex of ideomotor exercises to create the patient’s idea of correct movement; correct positioning of the limb during sleep, everyday and professional activity; passive exercises to increase the volume of painless movements (bending, external rotation); restorationof the pattern of typical motor actions and optimization of physiotherapeutic means due to the use of shock wave and TENS therapy signifi cantly improved the eff ectiveness of their recovery in the short-term and long-term stages of the acute period of rehabilitation.

Effects of Temporomandibular Joint Dysfunction Syndrome on the Quality of Life- A Cross-Sectional Study

Background: The patient with temporomandibular joint dysfunction syndrome TMDS may present with clicking and pain located in and around the TMJ and masticatory muscle complex. The joint dysfunction may be acute or chronic affecting quality of life. In chronic cases, the pain is of longer duration and usually not self-limiting.Objective: To determine the mean quality of life (QoL) score among patients presenting with temporomandibular joint syndrome (TMDS) using the SF-36 questionnaire.Materials and Methods: This was a cross-sectional study with a sample size of 60 patients (95% confidence level and 0.05 as a margin of error). The duration of the study was six months, done at the Department of Oral and Maxillofacial Surgery, Khyber College of Dentistry, Khyber Pakhtunkhwa. SF-36 questionnaire assessed nine domains related to QOL for the patients diagnosed with TMPDs. Variables like Age, duration of TMDs, and QOL score were calculated as Mean±SD. Qualitative variables such as gender, educational status were calculated in frequency and percentages. Results: Temporomandibular joint dysfunction syndrome (TMPD) was more common in females (66.67%) than males. Mean and SDs for age were 25.32+10.6. Eight patients (13.34%) had QoL scores below 50. Physical health was affected in 74.1% of the patients while the second most affected domain was the limitation of daily routine activities (71.6%). The majority of patients were depressed (58.3%) cases. Conclusion: Patients with TMPDS in our study with high scores (SF-36 questionnaire) showed better quality of life, compared to those having lowest scores with worst quality of life. Keywords: Emotions, General health, Pain, Quality of Life Score (QOLS), SF-36 Questionnaire, Social well-being, TMPDS.

Cross-cultural adaptation and validation of a revised Italian Anterior Knee Pain Scale version.

The study aimed to validate a revised Italian version of the Anterior Knee Pain Scale (AKPS) by addressing shortcomings in previous adaptations and following the COSMIN guidelines to ensure robust psychometric evaluation. One hundred thirty patients with anterior knee pain symptoms were recruited, with 65 undergoing a retest after 7 days to assess the scale's reliability. Structural validity was assessed through confirmatory factor analysis (CFA) to evaluate the scale's dimensionality. Internal consistency was measured using Cronbach's alpha, while test-retest reliability was assessed using the intraclass correlation coefficient (ICC). Measurement error was evaluated using the standard error of measurement (SEM) and the smallest detectable change (SDC). Construct validity was examined by correlating the AKPS with other established scales, including the Knee Injury and Osteoarthritis Outcome Score, Internal Knee Documentation Committee, Victorian Institute of Sport Assessment - Patella, Short-Form 36 Health Survey, and the Visual Analogue Scale. The CFA supported a three-factor model encompassing pain intensity and interference, functional limitations in daily activities, and knee structural and functional issues. The scale demonstrated good internal consistency (Cronbach's α=0.79) and excellent test-retest reliability (ICC=0.91), with low measurement error (SEM<5%). Construct validity was confirmed through moderate-to-strong correlations with related scales, particularly in domains related to pain intensity, symptoms, and daily functioning. The newly validated scale, demonstrating strong psychometric properties, meets international standards for clinical assessment tools, making it a reliable and effective instrument for assessing anterior knee pain in the Italian context.

Factors associated with the development, severity, and resolution of post COVID-19 condition in adults living in Canada, January 2020 to August 2022.

We aimed to characterize the burden of post COVID-19 condition (PCC) among adults in Canada and identify factors associated with its occurrence, severity, and resolution. We used self-report data from a population-based cross-sectional probability survey of adults in Canada conducted between April and August 2022. Incidence and prevalence of PCC were estimated using confirmed infections, as well as confirmed and suspected combined. Multivariable modeling using confirmed cases identified associated factors. As of August 2022, 17.2% (95% CI 15.7, 18.8) of adults with confirmed infections and 16.7% (95% CI 15.5, 18.0) of adults with confirmed or suspected infections experienced PCC, translating to 3.3% (95% CI 3.0, 3.6) and 4.4% (95% CI 4.1, 4.8) of all adults, respectively. Age less than 65years (aORs of 1.75 to 2.14), more pre-existing comorbidities (aORs of 1.75 to 3.57), and a more severe initial infection (aORs of 3.52 to 9.69) were all associated with higher odds of PCC, while male sex at birth (aOR = 0.54, 95% CI 0.41, 0.70), identifying as Black (aOR = 0.23, 95% CI 0.11, 0.51), and being infected after 2020 (aORs of 0.24 to 0.55) were associated with lower odds. Those residing in a rural area (aOR = 2.31, 95% CI 1.35, 3.93), or reporting a disability (aOR = 2.87, 95% CI 1.14, 7.25), pre-existing chronic lung condition (aOR = 5.47, 95% CI 1.85, 16.12) or back problem (aOR = 2.34, 95% CI 1.26, 4.36), or PCC headache (aOR = 2.47, 95% CI 1.60, 3.83) or weakness (aOR = 2.27, 95% CI 1.41, 3.68) had higher odds of greater limitations in daily activities, while males had lower odds (aOR = 0.54, 95% CI 0.34, 0.85). Two or more pre-existing chronic conditions (aHRs from 0.33 to 0.38), or PCC symptoms relating to the heart (aHR = 0.25, 95% CI 0.07, 0.90), brain fog (aHR = 0.44, 95% CI 0.23, 0.86), or stress/anxiety (aHR = 0.48, 95% CI 0.24, 0.96) were associated with a decreased rate of symptom resolution. Over the first two and a halfyears of the pandemic, a substantial proportion of infected adults in Canada reported PCC. Females and people with comorbidities were disproportionately impacted.

Relationship Between Morphofunctional Alterations of the Foot and Its Functionality in Patients with Fibromyalgia Syndrome: A Case-Control Study.

Objective: To evaluate the morphofunctional alterations in the foot and their association with functionality, considering aspects such as disability, pain, and limitations in daily activities in patients with fibromyalgia syndrome (FMS). Methods: A case-control study was conducted in patients with FMS (case group) and without FMS (control group), matched by age and sex. Foot posture was assessed using the foot posture index (FPI), along with the presence of hallux valgus (HV), trigger points, hyperkeratosis, and dorsiflexion of the first metatarsophalangeal joint and ankle. Foot functionality was evaluated using the foot function index (FFI) questionnaire. Results: A total of 100 women with FMS and 100 women without FMS, with a mean age of 61.97 ± 9.26 years, were recruited. HV (p < 0.001), hyperkeratosis (p < 0.001), pronated and supinated foot (p < 0.001), as well as limitations in dorsiflexion of the first metatarsophalangeal joint (p < 0.001) and the ankle with the knee flexed (p < 0.001) and extended (p < 0.001), along with the activity of the flexor hallucis brevis (p = 0.006), adductor hallucis (p = 0.006), and dorsal interosseous (p = 0.002) muscles, were significantly associated with the FFI, being higher in individuals with FMS, indicating greater impairment of foot functionality in these patients. Multivariate analysis revealed a statistical association between FMS and low educational level (OR = 2.57, 95% CI 1.05-5.72), the presence of another rheumatic disease (OR = 5.07, 95% CI 2.34-11), and the presence of any active trigger point (OR = 11.15, 95% CI 3.97-31.31). Conclusions: The study highlights the relationship between morphofunctional foot alterations, specifically the presence of active myofascial trigger points, and functionality in patients with FMS.

The connection between anemia and limitations in daily activities among older males: the critical role of dynapenia

AimThe aim of the present study was to examine the relationship between anemia and basic and instrumental activities of daily living in older male patients.MethodsA total of 223 older males attending one geriatric outpatient clinic were included in this cross-sectional study. Anemia was defined as a hemoglobin level below 13 g/dL. Patients’ demographic characteristics, comorbidities, and comprehensive geriatric assessment parameters were also recorded. Handgrip strength of < 27 kg for males was accepted as dynapenia. Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL) questionnaires were used to evaluate functional capacity.ResultsThe mean age (standard deviation) of the participants was 80.17 (7.69) years. The prevalence of patients with anemia was 43.9%. There was differences between anemic and non-anemic groups in terms of presence of diabetes mellitus (DM), congestive heart failure (CHF), chronic kidney disease (CKD), malnutrition, dynapenia, geriatric depression, BADL and IADL scores (all p < 0.05). In multivariate analysis, after adjusting for all confounding variables except for dynapenia, patients with anemia were associated with reduced BADL and IADL (all p < 0.05). After adjusting for all confounding variables including dynapenia, deterioration in total BADL and IADL scores did not remain significant in the anemic group compared to the non-anemic group (p > 0.05).ConclusionClose to one in two older outpatient men had anemia. Anemic men had a higher incidence of DM, CHF, CKD, malnutrition, geriatric depression and dynapenia. Anemia was associated with dependence in both BADL and IADL in older men. However, comorbidities, nutritional status, depressive mood and, specifically muscle strength, were important contributors to this association.

Depressive symptoms and associated socioeconomic and clinic factors: Three different years data from Türkiye.

Depression is one of the main diseases that cause disability. It is more common in various sociodemographic situations. This study investigated the risk factors associated with depressive symptoms and changes over the years based on data from a sample from the Republic of Türkiye. It was also intended to compare depressive symptoms and inflation rates by years. Data for 2016, 2019 and 2022 from the Turkish Health Survey performed by the Turkish Statistical Institute were used in the study. Data for age, sex, marital status, education level, employment status, accompanying chronic health problems, restrictions in daily activities associated with health problems and problems accessing psychological treatment due to difficulty in paying were evaluated in terms of depressive symptoms. Higher depressive symptoms were determined in women, the widowed and divorced, individuals with a low level of education, the unemployed, individuals with chronic health problems, those with restrictions in daily activities associated with chronic health problems and those with problems accessing psychological treatment due to difficulty in paying. Although inflation rates increased over the years, the severity of depressive symptoms decreased. A moderate positive correlation was observed between depressive symptoms and basic activities of daily living. Developing policies aimed at groups with high depressive symptoms may be important in combating depression.

Development and Validation of a Patient-Reported Outcome Measure of the Impact of Chronic Hand Eczema on Health-Related Quality of Life: the Hand Eczema Impact Scale (HEIS).

Chronic Hand Eczema (CHE) is an inflammatory skin disease that causes significant impact on health-related quality of life (HRQoL). The Hand Eczema Impact Scale (HEIS) is a new patient-reported outcome(PRO) measure designed to assess the impact of CHE on key domains of HRQoL. This study aimed to develop and evaluate content and psychometric validity of the HEIS. The HEIS was initially developed on the basis of a literature review and concept elicitation interviews. Qualitative cognitive debriefing interviews (n = 20) were conducted with patients with CHE to assess relevance and understanding of items, response options, and recall period. Psychometric properties (item performance, dimensionality, reliability, validity, responsiveness, and estimation of meaningful change thresholds) were then assessed using data (n = 258) from a phase 2b trial (NCT03683719). Cognitive debriefing confirmed all items were understood and relevant to patients. Inter-item correlations (all > 0.50) and confirmatory factor analysis (factor loadings ≥ 0.80) supported unidimensionality of the HEIS score, and mostly provided support for the HEIS Proximal Daily Activity Limitations (PDAL) score, with only one item loading below the prespecified threshold. Item properties and previous qualitative work supported retaining this item in the total score but removed from the HEIS PDAL domain. Internal consistency (Cronbach's alpha ≥ 0.89) and test-retest reliability (intra-class correlation coefficient ≥ 0.79) results were very strong. Strong correlations with concurrent measures (0.66-0.87) and significant differences between severity groups (p < 0.001) supported construct validity. Large effect sizes for mean change scores in participants that improved and significant differences between groups indicated ability to detect change. Anchor-based analyses supported within-individual responder definitions of ≥ 1.3 points for improvements in both HEIS score and HEIS PDAL score (covering three items) and of ≥ 1.5 points for HEIS embarrassment with the appearance of hands (Emb) score (covering two items). The 9-item HEIS is the first CHE-specific PROmeasure developed and validated according to regulatory guidance for assessment of the impact of CHE on key domains of HRQoL. This article provides evidence of strong content and psychometric validity and shows improvements of ≥ 1.3 points in HEIS score and HEIS PDAL score, and improvements of ≥ 1.5 points in HEIS Emb score represent clinically meaningful, important changes. NCT03683719.

Prevalence, Risk Factors, and Impact of Long COVID Among Adults in South Korea.

This study aimed to identify the prevalence, risk factors, and impact of long COVID in a community-based representative sample of patients with COVID-19 aged 19-64 years. A total of 975 participants completed online or telephone surveys at 1 and 3 months post-diagnosis, covering persistent symptoms, daily activity limitations, vaccination status, and underlying diseases. Long COVID, as defined by the WHO criteria, had a prevalence of 19.7-24.9% in females and 12.7% in males. Logistic regression revealed that the odds of having long COVID symptoms were higher among females compared to males (OR, 2.43; 95% CI, 1.53-3.87), and higher in those aged ≥ 30 years compared to those aged 19-29 years: 30-39 years (OR, 2.91; 95% CI, 1.59-5.33), 40-49 years (OR, 2.72; 95% CI, 1.51-4.89), and 50-64 years (OR, 1.96; 95% CI, 1.10-3.49). Additionally, patients with underlying diseases had higher odds of long COVID symptoms compared to those without underlying diseases (OR, 1.81; 95% CI, 1.24-2.64). Among those with long COVID, 54.2% experienced daily activity limitations, and 40.6% received treatment. Furthermore, lower income groups faced greater daily activity limitations but had similar treatment rates to higher income groups. These findings emphasize the need for interest in and the development of programs to support these low-income populations.