Limitations In Social Activities Research Articles

Quality-of-Life Assessment in Children with Mild to Moderate Bronchial Asthma.

Background and Objectives: Assess the quality of life of children aged 2-10 with mild to moderate bronchial asthma. To evaluate the general health condition of children with mild and moderate severity bronchial asthma. To determine health changes in children with mild- and moderate-severity bronchial asthma as they grow older. To evaluate the impact of mild- and moderate-severity bronchial asthma on children's daily and social activities, physical health, emotional state, and general well-being. Materials and Methods: A comparative cross-sectional study was conducted in March-June 2020. Parents or guardians of 2-10-year-old children without bronchial asthma and children with mild to moderate bronchial asthma were interviewed after receiving their written informed consent. The questionnaire was based on the standardized quality-of-life quiz SF-36. A total of 248 questionnaires were collected-106 from the parents or guardians of children with bronchial asthma and 142 from parents/guardians of children without bronchial asthma. For further analysis, 106 children without bronchial asthma and with no chronic conditions were selected. Quantitative variables were compared using the Mann-Whitney U test and qualitative data using the chi-square (χ2) criteria. Quantitative data were described by giving means, medians, and standard deviations (SD); qualitative features by giving relative frequencies. Statistical data were analyzed using SPSS and Excel 2020. Results: Children with mild and moderate asthma exhibit poorer health compared to their healthy counterparts. Only 20.7% of respondents with asthma reported excellent or very good health, contrasting with 64.1% of healthy children (p < 0.001). As children with asthma age, their general condition improves, with 46.2% showing improvement in the past year, while 42.5% of healthy children had a stable condition (p < 0.05). In various activities, children with asthma face more constraints than healthy children (p < 0.05), including energetic activities (sick-59.5%; healthy-10.3%), moderate activities (sick-24.5%; healthy-4.7%), climbing stairs (sick-22.7%; healthy-3.8%), and walking over 100 m (sick-9.4%; healthy-0%). Children with asthma are more likely to experience exhaustion, anxiety, tiredness, lack of energy, and restraint in public activities (p < 0.05). Conclusions: Parents/caregivers of children with mild to moderate bronchial asthma rate their health worse than those of healthy children do. As children with mild to moderate bronchial asthma grow, the disease impact on their overall well-being decreases. Children with mild to moderate bronchial asthma, compared to healthy children, experience more limitations in vigorous or moderate activities; face more difficulties climbing stairs or walking more than 100 m; frequently feel exhaustion, anxiety, fatigue, or lack of energy; and encounter restrictions in social activities.

Four modeling approaches to study restrictions on everyday life and social activities due to chronic diseases with consequences of suicidal behavior

The purpose of this study was to discover the association between disability in everyday life and social activities due to chronic diseases and suicidal ideation (SI), suicidal plan (SP), and suicidal attempt (SA) from the Korea National Health and Nutrition Examination Survey (KNHANES), considering the cross-sectional design of this study, 2016–2018 dataset. Variables for finding the associated factors of SI, SP, and SA were confirmed through random forest (RF), decision tree, generalized linear model (GLM), and support vector machine (SVM), and the performance of each model is listed. A total of 17,323 (males: 7,530, females: 9793) responders from the KNHANES from 2016 to 2018 were employed for the study. The relationship between restrictions on daily life, social activities, and three stages of suicidal behaviors due to diseases were analyzed using the R function (R version 4.2.0), randomForest, ctree, glm, and ksvm. The F1-score is a measure used to evaluate the accuracy of the performance of a model, in the binary classification. The score of 1 indicates good performance, whereas a score of 0 signifies poor performance. Due to chronic diseases, disability in everyday life and social activities lead to suicide behaviors. In our study, we examined the impact of limitations in daily living and social activities on suicidal behaviors among participants. Our findings revealed that for those experiencing such limitations, the odds ratios (ORs) for SIs were 6.10 (95% CI: 3.99–9.34) for males and 2.61 (1.79–3.81) for females. SPs were 3.69 (2.36–5.78) for males and 3.94 (2.70–5.75) for females. Similarly, the odds ratios for SAs were 5.04 (2.51–10.13) for males and 2.71 (1.48–4.98) for females, indicating a significant association between these limitations and increased suicidal behaviors, with variances observed between genders. These results underscore the necessity of addressing daily living and social activity restrictions when considering mental health interventions and suicide prevention strategies. In RF, GLM, and SVM, F1-score were 0.8192, 0.6887, and 0.9687 in SA, respectively. Among the patients with chronic disease, those with sequelae, low incomes, and low levels of education had limitations in daily activities and social activities, which increased the likelihood of suicidal thoughts, planning, and attempts.

Factors Affecting The Incidence of Anemia in Pregnancy During The COVID-19 Pandemic

Anemia during pregnancy carries the risk of premature birth, low birth weight, and fetus malformations and can impose additional costs on society and families. The prevalence of anemia would be the best indicator to monitor pregnant women’s health and prevent pregnancy complications. The COVID-19 pandemic has impacted pregnant women. The prevalence of anemia in pregnancy increased from 38.33% in 2019 to 49.21% in 2020. In the COVID-19 pandemic situation with social activity restrictions, decreasing family income, and limited access to health services, suffering from COVID-19 are risk factors for increasing the incidence of anemia in pregnancy. This study aimed to determine factors affecting the incidence of anemia in pregnancy during the COVID-19 pandemic in Karangrejo District, Magetan Regency. This study was an observational analytic study with a cross-sectional study design. The sample was selected by purposive sampling with a sample size of 52 study subjects. Data were analyzed using logistic regression analysis with SPSS. Factors that increased the incidence of anemia in pregnancy during the COVID-19 pandemic were pregnancy interval (OR=17.67; CI 95%= 1.01 to 116.00; p=0.049), gestational age (OR=11.39; CI 95% 1.12-116.00; p= 0,040), animal protein intake (OR= 0.25; CI 95% 0.03 – 2.38; p= 0,044), iron supplementation (OR= 108.47; CI 95% 2.36 – 4978.68; p= 0,016), consumption of tea (OR=36,89; CI95% 1.57 to 868.41; p=0.025). Mothers’ education, family income, parity, frequency of ANC visits, and COVID-19 morbidity do not significantly affect the incidence of anemia in pregnancy. There were effects of pregnancy interval, gestational age, animal protein intake, iron supplementation, and consumption of tea on the incidence of anemia in pregnancy during the COVID-19 in Karangrejo District, Magetan Regency. Keywords: anemia;pregnancy;COVID-19

Health-Related Quality of Life of Asthmatic Patients in Al-Baha City, Saudi Arabia.

Introduction According to disability-adjusted life years (DALY), bronchial asthma (BA) is rated 28th among the top causes of disease burden globally and among the most significant reasons for years lived with disability. Internationally, 300 million people have asthma, and another 100 million individuals may develop it by 2025. In Al-Baha City, where environmental factors such as dust and pollen levels can exacerbate asthma symptoms, understanding and addressing the health-related quality of life of asthmatic patients is crucial. Understanding the health-related quality of life of asthmatic patients can inform public health policies and initiatives aimed at reducing environmental triggers and promoting better asthma management in the city. Objectives The study aims to assess the impact of asthma regarding physical, emotional, and social activities that affect health-related quality of life. Subjects and methods A cross-sectional study was conducted from January 2023 to May 2023 at King Fahad Hospital in Al-Baha City, Saudi Arabia. The study used a Mini Asthma Quality of Life Questionnaire that measures physical, emotional, and social activities that affect health-related quality of life. Results One hundred and fifty-one out of 185 participants responded, yielding a response rate of 81.6%. The average age of the participants was 52, with a standard deviation of 15.4 years. Participants' responses regarding symptoms related to the environment during the last two weeks indicated "all the time" experiencing feeling bothered by or having to avoid cigarette smoke (n=104, 69%) and dust (n=92, 61%) in the environment. Moreover, considering emotion-related symptoms, 54% reported they did not feel afraid of not having their asthma medication available. Similarly, 46% reported never feeling frustrated because of asthma, whereas 3.3% of the participants documented hardly ever feeling frustrated. Regarding social activity limitations, 44 individuals (29%) reported no limits in these activities, while 43 (28%) reported being completely limited. While there were limitations in work-related activities, 42 participants (28%) reported no restrictions, whereas 34 (23%) reported being completely limited. Conclusion The study findings highlight a concern about suboptimal asthma control and the need to attain more satisfactory levels of asthma management.

Development and validation of a Chinese version chronic wound health-related quality of life instrument: A methodological study.

To develop a Chinese version of a chronic wound health-related quality of life (QoL) instrument and to examine the psychometric properties of this instrument. Existing QoL instruments are not tailored to the linguistic and cultural characteristics of Chinese-speaking patients; a version addressing this gap will increase clinical understanding of their healthcare experience and may help guide chronic wound care. A methodological study. The method advanced by DeVellis (2017) was used to develop the instrument. An initial pool of 38 items was created. To optimize scale length and test reliability and validity, exploratory and confirmatory factor analyses were conducted. A total of 23 items formed the final pool. After two rounds of expert discussions, the average content validity index of the final 23 items was .89. A total of 226 patients completed the instrument and were divided into two groups for further analysis. Exploratory factor analysis revealed that 15 items remained in four factors (social activity restrictions, physical and psychological disturbance, wound burden and daily life limitation), which accounted for 64.87% of the variance. Confirmatory factor analysis revealed an acceptable fit of the hypothesized factor structure and the convergent and discriminant validities were achieved. Cronbach's α coefficients for each factor were .807, .773, .799 and .713, respectively. The Chinese version of a chronic wound health-related QoL instrument consists of 15 items in four subscales and demonstrates good reliability and validity. This instrument can be used intermittently or continuously to evaluate the treatment effect of chronic wounds by assessing health-related QoL. Scholars in Chinese-speaking regions may find this culturally compatible instrument useful when conducting studies related to chronic wounds. Two hundred twenty-six participants provided their perspectives on health-related QoL.

Facing Pediatric Rheumatic Diseases: The Role of Disease Activity and Parental Emotion Regulation Strategy in Parents' and Children's Psychological Adjustment.

Pediatric rheumatic diseases (PRDs) are a group of chronic disorders that start in childhood and are characterized by periodic exacerbations and remissions of symptoms, with limitations in family, school, and social activities. The aim of this study was to detect differences in parents' psychological adjustment and emotion regulation strategies, and parent-reported children's adjustments in families of children with active and inactive PRDs. Fifty-four parents (38 mothers and 16 fathers) of children with PRD were recruited from a pediatric unit. Disease activity was evaluated by their pediatric rheumatologist, while parents' depressive and anxiety symptoms, emotion regulation strategies, and children's emotional difficulties and hyperactivity-inattention symptoms were assessed through a web-based survey. Parents of children with active PRDs reported higher levels of their child's emotional difficulties and hyperactivity-inattention symptoms. Linear regression analysis demonstrated that having a child in the active phases of PRD and lower use of cognitive reappraisal lead to higher children's emotional symptoms, while active disease, low use of cognitive reappraisal, and greater expressive suppression were associated with higher hyperactivity-inattention symptoms. Our study highlights that children with PRDs and their parents may be at increased risk for psychological problems, especially during the active disease phase, highlighting the importance of a multidisciplinary approach.

Social Activity Restriction and Psychological Health Among Caregivers of Older Adults With and Without Dementia.

We examined associations between social activity restriction and psychological distress and well-being for caregivers of older adults with and without dementia, and if the identified associations are different for the two groups. Using data from the 2017 National Study of Caregiving, we identified caregivers of older adults with (N = 541) and without (N = 1701) dementia. Linear regression models were estimated, adjusting for caregivers' age, gender, race, education, relationship to care recipient, and self-rated health. Restriction in visiting friends and family and attending religious services were associated with higher distress in dementia caregivers. Restriction in visiting friends and family was associated with higher distress and lower well-being in non-dementia caregivers. Any activity restriction had stronger association with distress for caregivers of older adults with versus without dementia. Findings highlight the need for tailored interventions based on caregivers' perceptions of meaningful social activities and dementia-friendly communities to promote social participation.

Magnetic separation and concentration of Aβ 1–42 molecules dispersed at the threshold concentration for Alzheimer’s disease diagnosis in clinically-relevant volumes of sample

BackgroundAlzheimer’s disease (AD) is the leading cause of dementia and loss of autonomy in the elderly, implying a progressive cognitive decline and limitation of social activities. The progressive aging of the population is expected to exacerbate this problem in the next decades. Therefore, there is an urgent need to develop quantitative diagnostic methodologies to assess the onset the disease and its progression especially in the initial phases.ResultsHere we describe a novel technology to extract one of the most important molecular biomarkers of AD (Aβ1−42) from a clinically-relevant volume − 100 µl – therein dispersed in a range of concentrations critical for AD early diagnosis. We demonstrate that it is possible to immunocapture Aβ1−42 on 20 nm wide magnetic nanoparticles functionalized with hyperbranced KVLFF aptamers. Then, it is possible to transport them through microfluidic environments to a detection system where virtually all (~ 90%) the Aβ1−42 molecules are concentrated in a dense plug of ca.50 nl. The technology is based on magnetic actuation by permanent magnets, specifically designed to generate high gradient magnetic fields. These fields, applied through submillimeter-wide channels, can concentrate, and confine magnetic nanoparticles (MNPs) into a droplet with an optimized shape that maximizes the probability of capturing highly diluted molecular biomarkers. These advancements are expected to provide efficient protocols for the concentration and manipulation of molecular biomarkers from clinical samples, enhancing the accuracy and the sensitivity of diagnostic technologies.ConclusionsThis easy to automate technology allows an efficient separation of AD molecular biomarkers from volumes of biological solutions complying with the current clinical protocols and, ultimately, leads to accurate measurements of biomarkers. The technology paves a new way for a quantitative AD diagnosis at the earliest stage and it is also adaptable for the biomarker analysis of other pathologies.

The relationship between unmet medical needs awareness and health care utilization in Korean adults with social activity restriction: a secondary analysis study using propensity score matching

The relationship between unmet medical needs awareness and health care utilization in Korean adults with social activity restriction: a secondary analysis study using propensity score matching

Differential use of postoperative psychosocial and physical services among older adults with head and neck cancer

IntroductionOlder adults undergoing head and neck cancer (HNC) surgery often have significant functional and mental health impairments. We examined use of postoperative physical, nutritional, and psychosocial services among a cohort of older adults with HNC comanaged by geriatricians and surgeons. Materials and MethodsOur sample consisted of older adults who were referred to the Geriatrics Service at Memorial Sloan Kettering Cancer Center between 2015 and 2019 and took a geriatric assessment (GA) prior to undergoing HNC surgery. Physical, nutritional, and psychosocial service utilization was assessed. Physical services included a physical, occupational, or rehabilitation consult during the patient's stay. Nutritional services consisted of speech and swallow or nutritional consult. Psychosocial services consisted of psychiatry, psychology, or a social work consult. Relationships between each service use, geriatric deficits, demographic, and surgical characteristics were assessed using Wilcoxon rank-sum test or Chi-square test. ResultsIn total, 157 patients were included, with median age of 80 and length of stay of six days. The most common GA impairments were major distress (61%), depression (59%), social activity limitation (SAL) (54%), and deficits in activities of daily living (ADL) (44%). Nutritional and physical services were used much more frequently than psychosocial services (80% and 85% vs 31%, respectively). Receipt of services was associated with longer median length of hospital stay, operation time, and greater deficits in ADLs. SAL was associated with physical and psychosocial consult and lower Timed Up and Go (TUG) score; instrumental ADL (iADL) deficits were associated with physical services; and depression and distress were associated with psychosocial services. DiscussionThe burden of psychosocial deficits is high among older adults with HNC. Future work is needed to understand the limited utilization of psychosocial services in this population as well as whether referral to psychosocial services can reduce the burden of these deficits.

The role of Digital Marketing as an Online marketing strategy for Micro, Small, and Medium Enterprises (UMKM) based on Islamic Sharia in Teluk Pinang Village, Ciawi District

Digital marketing is a combination of all marketing activities carried out through electronic media and the internet. Some of the digital marketing activities include SEO, SEM, social media marketing, email marketing, content marketing and more. Facebook Instagram with the advent of the Internet in the 1990s, digital marketing has become widespread on the internet through marketplaces or social networks such as Facebook, Tiktok and Instagram. The purpose of this study is to explain the impact of digital marketing and digital marketing expertise, especially with social media access, to increase sales and profits for small and medium enterprises (MSMEs) in Telukpinang Village. The research approach used consisted of a qualitative method using a triangulation model that combined in-depth interviews and observations with the chairman of the Teluk Pinang village MSME Forum, Bunda Wilis Sugiarti, and several MSME stakeholders in the forum discussing the economic situation of MSME stakeholders after the COVID-19 pandemic and several MSME marketing strategies in Teluk Pinang village: based on the results of the study, one of the challenges experienced by some MSME business actors is Product Marketing. After the implementation of extensive social restrictions (PSBB) and community activity restrictions (PPKM) in 2021 is still ongoing, agents are trying various ways to market their products to keep their business running. Therefore, these MSMEs need to be educated about the importance of using digital marketing to improve their marketing system. Thus, MSMEs can expand the scope of their business objectives and show better sales activity. Digital marketing makes it easy for MSME players to provide information, interact directly with consumers, increase understanding of digital marketing strategies, and increase MSME awareness.

Characteristics of older patients with postmenopausal osteoporosis who developed loss of muscle mass during the COVID-19 pandemic – a case–control study

BackgroundUnder the restriction of social activities during the coronavirus disease 2019 (COVID-19) pandemic, there was concern about the loss of muscle mass due to a decrease in physical activity for the elderly. The purpose of this study was to investigate the characteristics of older patients with postmenopausal osteoporosis who developed loss of muscle mass during the COVID-19 pandemic in Japan.MethodsA total of 54 patients with postmenopausal osteoporosis were evaluated in this study. Whole-body dual-energy X-ray absorptiometry was performed pre- and post-COVID-19 pandemic to measure trunk and lower limb muscle mass. At the time of the post-COVID-19 pandemic, we conducted a survey to compare lifestyle before pandemic (the frequency of going out, the frequency of meeting acquaintances or families living apart, regular exercise habits, walking time, family structure), and comorbidities between the muscle mass loss (ML) group and the muscle mass maintenance (MM) group. The ML group consisted of patients with at least a 5% decrease in lower limb muscle mass or trunk muscle mass.ResultsA significant difference was found only for the family structure (P = 0.0279); in the ML group, those living alone were the largest group, while in the MM group they were the smallest group.ConclusionsThe ML group was significantly more likely to live alone than the MM group. The current study showed that loss of muscle mass was more common in patients living alone.

Re-learning mental representation of walking after a brain lesion. Effects of a cognitive-motor training with a robotic orthosis.

Stroke-related deficits often include motor impairments and gait dysfunction, leading to a limitation of social activities and consequently affecting the quality of life of stroke survivors. Neurorehabilitation takes advantage of the contribution of different techniques in order to achieve more benefits for patients. Robotic devices help to improve the outcomes of physical rehabilitation. Moreover, motor imagery seems to play a role in neurological rehabilitation since it leads to the activation of the same brain areas as actual movements. This study investigates the use of a combined physical and cognitive protocol for gait rehabilitation in stroke patients. Specifically, we tested the efficacy of a 5-week training program using a robotic orthosis (P.I.G.R.O.) in conjunction with motor imagery training. Twelve chronic stroke patients participated in the study. We evaluated balance and gait performance before and after the training. Six of them underwent fMRI examination before and after the training to assess the effects of the protocol on brain plasticity mechanisms in motor and imagery tasks. Our results show that the rehabilitation protocol can effectively improve gait performance and balance and reduce the risk of falls in stroke patients. Furthermore, the fMRI results suggest that rehabilitation is associated with cerebral plastic changes in motor networks. The present findings, if confirmed by future research, have the potential to advance the development of new, more effective rehabilitation approaches for stroke patients, improving their quality of life and reducing the burden of stroke-related disability.

Identifying domains of health-related quality of life: the perspective of individuals with low back pain

BackgroundIdentifying the most relevant HRQOL domains for LBP from the perspective of individuals with lived experience with LBP is necessary to prioritize domains that will be most informative for evaluating the impact of pain and interventions while overcoming the burden of using long-form assessment tools. This study aimed to identify which domains of HRQOL are most important from the perspective of individuals with chronic LBP.MethodsSemi-structured interviews were conducted with 26 individuals with LBP. Participants first responded to questions related to the impact of their LBP on their HRQOL. Then, using a card sorting method, they were asked to select and indicate HRQOL domains that were most relevant to them from a list of 18 cards that represented different HRQOL domains. Participants were asked to explain the reasoning for their selection.ResultsParticipants identified physical activity restriction (50%), severity of pain (31%), social activity restriction (23%), and work performance restriction (23%) as the most important domains. The most frequently selected HRQOL domains during card sorting were social function (69%), pain intensity (62%), physical function (58%), fatigue (58%), and pain interference (42%).ConclusionThe most important domains of HRQOL perceived by participants were pain intensity, social function, physical function, fatigue, and pain interference. Identifying these domains will inform clinical decision-making and guide treatment choices for health care providers.

Expression and Role of Toll-like Receptors in Facial Nerve Regeneration after Facial Nerve Injury.

Facial nerve palsy directly impacts the quality of life, with patients with facial nerve palsy showing increased rates of depression and limitations in social activities. Although facial nerve palsy is not life-threatening, it can devastate the emotional and social lives of affected individuals. Hence, improving the prognosis of patients with this condition is of vital importance. The prognosis of patients with facial nerve palsy is determined by the cause of the disease, the degree of damage, and the treatment provided. The facial nerve can be easily damaged by middle ear and temporal bone surgery, trauma or infection, and tumors of the peripheral facial nerve or tumors surrounding the nerve secondary to systemic disease. In addition, idiopathic, acquired immunodeficiency syndrome and autoimmune diseases may damage the facial nerve. The treatment used for facial paralysis depends on the cause. Treatment of facial nerve amputation injury varies depending on the degree of facial nerve damage, comorbidities, and duration of injury. Recently, interest has increased in Toll-like receptors (TLRs) related to innate immune responses, as these receptors are known to be related to nerve regeneration. In addition to innate immune cells, both neurons and glia of the central nervous system (CNS) and peripheral nervous system (PNS) express TLRs. A comprehensive literature review was conducted to assess the expression and role of TLRs in peripheral nerve injury and subsequent regeneration. Studies conducted on rats and mice have demonstrated the expression of TLR1-13. Among these, TLR2-5 and TLR7 have received the most research attention in relation to facial nerve degeneration and regeneration. TLR10, TLR11, and TLR13 increase during compression injury of the facial nerve, whereas during cutting injury, TLR1-5, TLR8, and TLR10-13 increase, indicating that these TLRs are involved in the degeneration and regeneration of the facial nerve following each type of injury. Inadequate TLR expression or absence of TLR responses can hinder regeneration after facial nerve damage. Animal studies suggest that TLRs play an important role in facial nerve degeneration and regeneration.

포스트 코로나 자치경찰의 치안활동 방향에 관한 연구

In 2020, the COVID-19 pandemic spread, and strong quarantine policies were implemented, which restricted social activities. As the lifestyle changed to a non-face-to-face-centered lifestyle, the crime pattern also changed. Crimes that could have occurred in daily life decreased, but non-face-to-face crimes and crimes committed at home showed an increasing trend. In the pandemic situation, not only the crime but also the police had a big change. In 2021, the autonomous police system was introduced and implemented, which led to various changes in the police's office area and activities. Since then, COVID-19 has changed to an Endemic of infectious diseases, and society is recovering from daily activities and the security environment is changing. In line with this situation, the police should develop policies and activities that reflect the changes in security activities.&#x0D; In this study, we analyze the changes in the public safety environment, focusing on Chungcheongnam-do, in the context of the COVID-19 pandemic and its transition to an endemic phase. Based on previous studies, we present the current issues within the police force and provide directions for public safety activities. Firstly, we propose strengthened responses and preventive measures against changes in crime and safety incidents resulting from the recovery of daily activities. Secondly, considering the continued economic downturn, we suggest preventive and responsive actions against financial and property crimes. Thirdly, we propose the formation of a security governance system, which includes welfare-oriented public safety activities tailored to specific crime types and targets.

Predictors of not maintaining regular medical follow-up after stroke

BackgroundRegular medical follow-up after stroke is important to reduce the risk of post-stroke complications and hospital readmission. Little is known about the factors associated with stroke survivors not maintaining regular medical follow-up. We sought to quantify the prevalence and predictors of stroke survivors not maintaining regular medical follow-up over time.MethodsWe conducted a retrospective cohort study of stroke survivors in the National Health and Aging Trends Study (2011–2018), a national longitudinal sample of United States Medicare beneficiaries. Our primary outcome was not maintaining regular medical follow-up. We performed a cox regression to estimate predictors of not maintaining regular medical follow-up.ResultsThere were 1330 stroke survivors included, 150 of whom (11.3%) did not maintain regular medical follow-up. Stroke survivor characteristics associated with not maintaining regular medical follow-up included not having restrictions in social activities (HR 0.64, 95% CI 0.41, 1.01 for having restrictions in social activities compared to not having restrictions in social activities), greater limitations in self-care activities (HR 1.13, 95% CI 1.03, 1.23), and probable dementia (HR 2.23, 95% CI 1.42, 3.49 compared to no dementia).ConclusionsThe majority of stroke survivors maintain regular medical follow-up over time. Strategies to retain stroke survivors in regular medical follow-up should be directed towards stroke survivors who do not have restrictions in social activity participation, those with greater limitations in self-care activities, and those with probable dementia.

The establishment, maintenance, and adaptation of high- and low-impact chronic pain: a framework for biopsychosocial pain research.

The establishment, maintenance, and adaptation of high- and low-impact chronic pain: a framework for biopsychosocial pain research.

Dapagliflozin and Physical and Social Activity Limitations in Heart Failure With Reduced Ejection Fraction

BackgroundHeart failure (HF) is associated with impaired physical function and poor quality of life and affects health status more profoundly than many other chronic diseases. ObjectivesThe authors examined the effects of dapagliflozin on specific physical and social limitations as reported by patients in the DAPA-HF (Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure) trial. MethodsThe effect of dapagliflozin on the change from baseline to 8 months in each of the individual physical and social activity limitation questions answered by patients completing the Kansas City Cardiomyopathy Questionnaire (KCCQ), and overall scores, were examined with mixed-effects models and responder analyses. ResultsIn total, 4,269 (90.0%) and 3,955 (83.4%) patients had complete data for both the physical and social activity limitation scores at baseline and 8 months, respectively. Compared with placebo, dapagliflozin significantly increased (improved) the mean KCCQ physical and social activity limitation scores at 8 months (placebo-corrected mean difference 1.94 [95% CI: 0.73-3.16] and 1.84 [95% CI: 0.43-3.25], respectively). Dapagliflozin also increased each of the individual components that comprise the physical and social activity limitations domains at 8 months, with the largest improvement seen in “hobbies or recreational activities” (placebo-corrected mean difference: 2.76 [95% CI: 1.06-4.46]) and “doing yardwork, housework, or carrying groceries” (placebo-corrected mean difference: 2.59 [95% CI: 0.76-4.42]). The proportion of patients with a 5-point improvement from baseline to 8 months in the KCCQ physical and social activity limitation scores was greater with dapagliflozin than with placebo (ORs: 1.23 [95% CI: 1.09-1.40] and 1.19 [95% CI: 1.05-1.35], respectively). ConclusionsIn patients with HFrEF, dapagliflozin, compared with placebo, improved physical and social activity limitations as measured by KCCQ. (Study to Evaluate the Effect of Dapagliflozin on the Incidence of Worsening Heart Failure or Cardiovascular Death in Patients with Chronic Heart Failure [DAPA-HF]; NCT03036124).

Ride-hailing app use for same-day delivery services of foods and groceries during the implementation of social activity restrictions in Indonesia

This study investigates e-shopping behavior change through ride-hailing applications (RHAs) for grocery and food as an alternative way to minimize out-of-home activities during the pandemic. Exploratory factor analysis and structural equation modeling were applied, which utilized data collected from a web-based questionnaire survey during the implementation of social activity restrictions in August 2021. The modeling results show a complementary effect between food and grocery delivery services, where an increase in food delivery is followed by an increase in grocery delivery, but not vice versa. Meanwhile, grocery delivery could substitute in-store grocery shopping. The frequency of food delivery before the pandemic also significantly affects food and grocery deliveries during the pandemic. The more individuals avail food delivery services before the pandemic, the more they avail grocery delivery services during the pandemic. In contrast, the less likely people are to avail food delivery services before the pandemic, the more likely they are to avail food delivery services during the pandemic. The study also found that RHA use for food delivery is influenced by the latent variable of e-shopping enjoyment, whereas the latent variable of e-shopping benefits affects RHA use for grocery delivery. Regarding the socio-demographic effect, females and well-educated people tend to increase RHA use for grocery delivery, and millennials are more likely to participate in grocery shopping and dining out. The findings provide valuable insights into the suppression of virus spread in the short term and travel demand management in the medium term.