Self-assessment Of Symptoms Research Articles

Racial and regional disparities in the risk of noncommunicable disease between sub-Saharan black and European white patients.

Greater vulnerability of Black vs. White individuals to cardiovascular disease (CVD) and chronic kidney disease (CKD) is well charted in the United States, but studies involving sub-Saharan blacks are scarce. Baseline data (2021-2024) were collected in 168 sub-Saharan Blacks and 93 European Whites in an ongoing clinical trial (NCT04299529), using standardized patient selection criteria. Data included clinical and biochemical risk factors, ECG and echocardiographic traits, Framingham CVD risk, CKD grades (KDIGO 2024), self-assessed symptoms (WHO questionnaire), and urinary proteomic profiles predictive of left ventricular dysfunction (LVD) and CKD, HF1, and CKD273, respectively. Racial comparisons rested on unadjusted and multivariable-adjusted analyses. Despite being younger (60.4 vs. 68.3 years), blacks had a worse risk profile, as evidenced by higher diabetes prevalence, higher BMI, faster heart rate, unfavourable serum cholesterol fractions, lower estimated glomerular filtration rate, microalbuminuria, and sedentary lifestyle. This resulted in blacks having higher 10-year CVD risk, higher heart age (index of vascular ageing with chronological age as reference), and a worse CKD grades. In both races, CKD273 increased with CKD grade, but CKD273 and HF1 were not different by race. These observations were robust in subgroup and adjusted analyses. This study did not differentiate host (genetic, molecular, and pathogenic) from environmental drivers of disease. Nonetheless, the findings call for a multipronged and comprehensive implementation of innovative health policies in sub-Saharan countries. Education, research, empowerment of stakeholders, and international learned societies connecting experts from a wide array of disciplines should vigorously sustain this effort.

Value of preparticipation cardiovascular evaluation of master athletes by self-reported symptoms and cardiovascular risk-score

Purpose The risk of sudden cardiac death (SCD) is increased during endurance competitive sports. Coronary artery disease (CAD) is the most common cause of SCD in master athletes ≥ 35 years old (MAs). To reduce the risk of SCD self-assessment of symptoms by questionnaire, and evaluation of cardiovascular risk-score, are recommended as pre-participation cardiovascular evaluation (PCVE). We aimed to examine whether PCVE predicts CVD in MAs with or without increased risk as measured by validated score instruments. Methods We performed a single-site observational cohort study of healthy MAs based on findings at PCVE. They were allocated in two different groups: those MAs with reported symptoms on the questionnaire and/or with elevated cardiovascular risk score were allocated to a symptom group (SG), while MAs with no symptoms, nor raised risk score were defined as control group (CG). Thereafter, all were examined with extended examinations: resting-ECG, cardiorespiratory exercise testing and echocardiography. Results Total, 81 (18 women) MAs participated in the study. There were no differences at baseline between SG (n = 39) and CG (n = 42); sex (p = 0.11), age (55.0 ± 9.8 vs. 51.9 ± 11.1 years; p = 0.18), maximal oxygen uptake (49.8 ± 7.6 vs. 51.6 ± 7.0 ml/kg/min; p = 0.26), resting heart rate (61.4 ± 12.8 vs. 60.2 ± 11.0/min; p = 0.66), training hours/week (7.0 ± 3.2 vs. 7.1 ± 3.1; p = 0.88). After further examination, sixteen (20%) MAs were found with CVD: 12 in SG, 4 in CG (p = 0.024). The negative predictive value and specificity of the PCVE were 90% and 58%, respectively. Conclusion Negative findings on PCVE by questionnaire and cardiovascular risk-score may be a strategy to exclude subjects from preparticipation screening, thus saving resources.

The Translation, Cross-Cultural Adaptation and Validation of the Italian Version of the Hip and Groin Outcome Score Questionnaire for a Young and Active Population.

The HAGOS (Hip and Groin Outcome Score) questionnaire is a valid and reliable measure of the self-assessment of symptoms, activity limitation, participation restriction, and quality of life (Qol) of subjects with hip and/or groin pain. The aims of this study are to translate and transculturally adapt the HAGOS into Italian (HAGOS-I) and to assess its internal consistency, validity, and reliability in physically active, young, and middle-aged subjects. The translation and transcultural adaptation of (HAGOS-I) was carried out according to international guidelines. Eight-one subjects (mean age 28.19) were included in this study. All the participants completed the HAGOS-I, the Lower Extremity Functional Scale (LEFS-I), the Oxford Hip Score (OHS-I), and the Short Form 36 Health Surveys (SF-36-I). The Cronbach's α for the six HAGOS subscales ranged from 0.63 to 0.87. Statistically significant correlations were obtained between the six HAGOS-I subscales and the LEFS-I (rs = 0.44-0.68; p < 0.01). Only one HAGOS-I subscale (Participation in Physical Activities) did not reach statistical significance with the OHS-I, while the remaining five had a moderate correlation (rs = 0.40-0.60; p < 0.01). The test-retest reliability (Intraclass Correlation Coefficient) ranged from 0.57 to 0.86 for the six HAGOS-I subscales. The HAGOS-I is a valid and reliable instrument that can be used in clinical settings with young and middle-aged subjects with hip and/or groin pathologies.

Research on Mental Health of Foreign Language Teachers in a Private University of China

Foreign language teachers encounter a number of unique challenges, including cultural differences, language barriers and other stressors, in addition to a lack of promotion opportunities. In order to enhance their mental health and work efficiency, it is essential to examine the current state of mental health among foreign language teachers in private universities, identify the primary factors influencing their mental health and implement effective intervention measures. A questionnaire, individual interviews and a symptom self-assessment scale (SCL-90) were employed to investigate and research the mental health status and influencing factors of foreign language teachers in private universities. The aim was to explore effective intervention techniques, methods and paths, and to improve the dimension of mental health intervention system. SPSS.26.0 was used to analyses the data obtained from the questionnaire survey. The study aims to provide theoretical foundations and decision-making guidance for the management departments of private universities, particularly the human resources department. This will involve the development of a scientific, reasonable and efficient qualitative and quantitative assessment and management system for college English teachers. Additionally, the study will provide reasonable suggestions for private college teachers to improve their own mental health, with the ultimate goal of improving the mental health level of private universities’ foreign language teachers in China and promoting the sustainable development of education.

The moderating effect of physical activity on the relationship between neutrophil count and depressive symptoms

Variations in immune cell counts can trigger depressive symptoms, while physical activity effectively reduces the risk and severity of depressive symptoms. This study, based on the NHANES database, analyzes the relationship between neutrophil count and depressive symptoms and explores the moderating effect of physical activity on this relationship. Cross-sectional data from the NHANES database were extracted, including immune cell counts, PHQ-9 scores for self-assessment of depressive symptoms, and Global Physical Activity Questionnaire (GPAQ) scores (PA). The interrelations among physical activity, neutrophil count, and depressive symptoms were analyzed. After controlling for confounding factors, neutrophil count was found to have a significant role in identifying depressive symptoms with an odds ratio (OR) [95% Confidence Interval (CI)] = 1.13 [1.02, 1.251]; the moderating effect of physical activity on the impact of neutrophil count on depressive symptoms was statistically significant (coefficient = -0.0028, P < 0.05). Neutrophil count may be a significant factor in identifying depressive symptoms in adults. As an effective moderating factor, physical activity can mitigate the impact of neutrophil count on depressive symptoms to a certain extent.

Mental health in nursing homes: The role of immigration in the long-term care workforce

One-fourth of nursing home residents are diagnosed with anxiety disorders and approximately half live with depression. Nursing homes have long struggled with staffing shortages, and the lack of care has further heightened the risk of poor mental health. A key solution to both problems could be immigration. Prior studies have documented how immigrant labor could strengthen the long-term care workforce. We add to this picture by exploring the impact of immigrant inflows on the mental health outcomes of nursing home residents. Using a nationally representative dataset and a shift-share instrumental variable approach, we find empirical evidence that immigration reduces diagnoses of depression and anxiety, the use of antidepressant and antianxiety drugs, and self-assessed symptoms of depression. The results are robust to several sensitivity tests. We further find that the effect is more substantial in facilities with lower direct care staff hours per resident and with likely more immigrants without citizenship. Language barriers tend to be a minor issue when providing essential care. The findings suggest that creating a policy framework that directs immigrant labor to the long-term care sector can mutually benefit job-seeking immigrants and nursing home residents.

Hodnocení traumatických symptomů u dětí a adolescentů ve školských zařízeních pro výkon ústavní a ochranné výchovy

The paper focuses on the self-assessment of traumatic symptoms in children from 8 to 16 years of age who, as part of institutional or protective education, are placed in substitute educational care facilities. The research was conducted using the standardized questionnaire Assessment of Traumatic Symptoms in Children and Adolescents TSCC-A (Briere, 2022). The aim of the research investigation was to determine, find and compare differences in the self-assessment of traumatic symptoms in the selected group on a sample of 101 children and adolescents. The article reflects the key aspects related to this research.

Initiating and Maintaining Complete Decongestive Therapy Self-Management of Lymphedema Among Breast Cancer Survivors: Descriptive Qualitative Study.

This study aimed to identify determinants that promote the initiation and maintenance of complete decongestive therapy (CDT) as well as effective strategies for mitigating barriers to self-management of lymphedema among breast cancer survivors. A descriptive and qualitative design was used. In-depth interviews were conducted with 13 breast cancer survivors who were managing breast cancer-related lymphedema. Interviews were transcribed verbatim. An iterative descriptive data analysis method was employed to examine the data, compare codes, challenge interpretations, and inductively identify themes. A realization that lymphedema requires daily self-management was the primary determinant leading breast cancer survivors to initiate CDT self-management. The determinants for maintaining daily CDT self-management included the perceived effectiveness of CDT, being willing to assume accountability, and perceived efficacy to undertake CDT. Developing strategies to integrate CDT regimens into daily life is key to maintaining CDT self-management of lymphedema. Three core concepts mediate initiation and maintenance of CDT self-management: understanding lymphedema as a chronic condition that can be managed with CDT self-management, being worried about lymphedema exacerbation, and having support from patient peers and family. Interventions should be tailored to promote the initiation and maintenance of CDT self-management. While clinicians provided knowledge-based and clinical skills-based information, patient peers provided daily life examples, and real-life implementation strategies for CDT self-management. Ongoing patient-provider and patient-peer communication functioned as effective support for maintaining CDT self-management. Reliable and realistic methods of symptom self-assessment are important for maintaining CDT at home.

The Promoting Effect of Organic Integration of Sports and Aesthetic Education on College Students’ Mental Health in the New Era

Abstract College sports is an important part of college education, has the important function of fitness and heart health, and is an important way to cultivate the mental health of college students. This paper selects a representative number of colleges and universities from a certain region as the object of investigation, measures the organic integration of college sports and aesthetic education, and proposes the whole-process teaching design for the organic integration of college sports and aesthetic education after digging into the implementation of aesthetic education in college sports courses. On this basis, two natural classes in a college are taken as experimental objects to carry out intervention experiments on the integration of physical education and aesthetic education, diagnose the mental health level of college students by using the symptom self-assessment scale, and compare the mental health level of college students before and after the experiment by using the mathematical statistics method. The current teaching methods of physical education and aesthetic education are relatively traditional, focusing on the lecture-question-and-answer method (84.8%), the movement demonstration method (77.6%), and the movement decomposition and overall practice method (64.8%). After the teaching experiment, the mental health of the students in the two classes showed significant differences in each factor item (p &lt; 0.05). The mental health level of the students in the class that used the integration of sports and aesthetic education for teaching was reduced by 16.83% and 13.77% compared with the pre experimentation and the control class, respectively. The organic integration of sports and aesthetic education has a certain promotion effect on the mental health of college students.

Динамика депрессивных и психосоматических симптомов при гипербарической оксигенации в терапии пациентов с long-covid инфекцией

Purpose: To examine the dynamics of depressive and psychosomatic symptoms with hyperbaric oxygenation in therapy of patients with long COVID-19. Material and Methods: Patients with long COVID-19 (n = 52) who underwent 15 sessions of hyperbaric oxygenation in the Polyclinic No. 2 of the Federal State Budgetary Institution Federal Medical and Biological Center of Russia completed the Giessen questionnaire for self-assessment of psychosomatic symptoms before and after therapy. The patient depressive symptoms were also assessed before and after therapy by psychiatrists using the Hamilton Rating Scale for Depression. Results: The results showed a decrease in depressive symptoms, exhaustion, gastric and cardiac complaints, and overall symptom pressure after hyperbaric oxygen therapy. Rheumatic factor appeared to be the only psychosomatic symptom that did not decrease after therapy. Conclusion: Overall, depressive and psychosomatic symptoms are persistent with long COVID-19, and hyperbaric oxygenation may be effective in treating this symptomatology.

Attention-deficit/hyperactivity disorder symptoms and subsequent cardiometabolic disorders in adults: investigating underlying mechanisms using a longitudinal twin study

BackgroundEmerging research suggests that attention-deficit/hyperactivity disorder (ADHD) increases the risk for cardiovascular (CVDs) and metabolic disorders (i.e., cardiometabolic disorders) in adulthood. Yet, available studies are scarce and have mainly been focused on individuals receiving clinical ADHD diagnoses. We aimed to investigate the prospective associations of ADHD symptoms in young and mid-adulthood with subsequent cardiometabolic disorders and the underlying mechanisms.MethodsWe studied 10,394 twins from the Swedish Twin Registry (STR), born between 1958 and 1985 without previous medical history of cardiometabolic disorders. They provided self-assessment of ADHD symptoms (score range 0–36) via a validated, DSM-IV-based scale in a web-based questionnaire/telephone interview within the Study of Twin Adults: Genes and Environment (STAGE), in 2005–2006 (aged 19–47 years), and were followed until the end of 2018 (33–59 years) to identify incident clinical diagnoses/medication prescriptions for cardiometabolic disorders acquired from Swedish national registers. We used Cox regression models to investigate the associations between ADHD symptoms score and cardiometabolic outcomes, with and without adjustment for relevant covariates, and a co-twin control design to study familial confounding.ResultsA one-unit increase in the level of ADHD symptoms was associated with a 2% increase in the rate of CVDs (hazard ratio [HR] = 1.02, 95% confidence interval 1.01–1.04) and a 3% increase in the rate of metabolic disorders (HR = 1.03, 1.02–1.05), after adjusting for birth year and sex. The associations were no longer significant after adjusting for educational attainment, lifestyle factors, and comorbid psychiatric disorders. The associations remained significant after adjusting for familial factors shared by dizygotic twin pairs but became nonsignificant after adjusting for factors shared by monozygotic twin pairs. However, the strength of the associations attenuated significantly in monozygotic twins compared to dizygotic twins for CVDs only, suggesting genetic confounding.ConclusionsADHD symptom score is associated with a higher risk for cardiometabolic disorders, which may be explained by lower educational attainment, adverse lifestyle factors, and psychiatric comorbidities. Moreover, the associations appear to be partly confounded by shared genetic factors, especially for CVDs. Further research is needed to investigate the identified associations at the level of individual cardiometabolic disorders and to follow-up participants until a more advanced older age.

Individual tailored physical training in patients with postural orthostatic tachycardia syndrome after COVID-19 - a feasibility study

Abstract Background A significant proportion of patients with COVID-19 have developed persistent symptoms, described as post-acute COVID-19 syndrome (PACS ). A specific PACS variant is the postural orthostatic tachycardia syndrome (POTS). POTS is a cardiovascular autonomic dysfunction characterized by an excessive increase in heart rate in standing, deconditioning and low quality of life. Studies that have evaluated the effect and feasibility of individual tailored physical training in POTS associated with COVID-19 are sparse. Purpose To evaluate the effects and feasibility of individualized exercise on physical and psychological function in patients with POTS after COVID-19. Method Patients with POTS + PACS were enrolled between Dec 2021 and Dec 2022. The intervention consisted of individually tailored training, including endurance and muscle-strengthening exercises with a gradual progression of time, dose and position. The training was based on the study subject's heart rate and/or self-estimated exertion using BORG RPE. The intervention lasted 12 weeks. Progression of the exercise was halted if the study subject described increased symptoms &amp;gt;24h after the last exercise session. Measurements were carried out at baseline and after intervention: 6-minute walking test (6MWT), Active Standing Test (AST) and self-assessment of symptoms through forms; Malmö POTS scale (MaPS), Vanderbilt Orthostaic Symptom Score (VOSS), Fatigue Severity Scale (FSS) health-related quality of life (EQ-5D-5L), anxiety (GAD) and depression (PHQ-9). Physical activity and time in different positions (lying, sitting, standing and walking) were measured using accelerometers (ActivPAL). Recruitment rate, compliance and adverse events was registered as feasibility. Results A total of 24 patients were enrolled and 23 patients completed the intervention (19 women; mean age, 40.9 years (SD 10.7). No severe adverse events occurred however some of the patients described symptoms as post exertion malaise (PEM). After the intervention, patients demonstrated improvement in physical (6MWT, p&amp;lt;0.005) and psychological functions (PHQ-9, p&amp;lt;0.001), less symptoms related to POTS (MaPS p&amp;lt;0.01, VOSS p&amp;lt;0.02, FSS p&amp;lt;0.045) and improved HrQoL (EQ-5D p&amp;lt;0.001) (Table 1). The primary outcome, time spent in upright position increased by 1.5h/day i.e. by 49% (Figure 1). Conclusion In patients with COVID-19-related POTS, an individually tailored training seem to contribute to increased time in upright position, reduction of POTS-specific symptoms and improved functions. The intervention seems to be feasible in terms of recruitment, compliance and safety. Further studies are needed to verify these results and compare disease progression with and without intervention.Table 1Figure 1

Innovative and entrepreneurial thinking training combined with psychological nursing intervention on the relief of Graduate’s employment anxiety

BackgroundSevere employment competition and pressure have triggered students in higher vocational school to develop negative emotions of anxiety. They show intense, excessive as well as persistent worries and fears, and even somatic anxiety symptoms. In order to alleviate the anxiety triggered by the employment pressure of graduates of higher vocational school, the study introduces psychological care to intervene in graduation innovation and entrepreneurial thinking training and analyzes its ability to alleviate anxiety.Subjects and Methods48 graduates suffering from anxiety disorders in a higher vocational school were used as experimental research subjects, and the experimental group received a training program combining psychological nursing intervention and innovative entrepreneurial thinking; the control group received traditional innovation and entrepreneurship training courses. The Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Symptom Self-assessment Scale SCL90, and Self-Acceptance Questionnaire (SAQ) were evaluated before the experiment, and after the 2nd, 4th, and 8th weeks of the experiment, respectively.Results Graduates who participated in the training on the integration of psychological care into innovative and entrepreneurial thinking showed a significant decrease in the scores of all scales compared to the pre-experimental period (P&lt;0.05), and the relief of anxiety was more pronounced compared to the control group (P&lt;0.05).ConclusionsPsychological care integrated with innovative and entrepreneurial thinking training had a significant effect on the anxiety of graduates. They had a more rational and accurate control of the employment situation and restored their confidence in their future work and life.AcknowledgementThe project of higher education research in 2022 approved by Inner Mongolia Higher Education Society (No.NMGJXH-2022XZ006).

The intervention effect of using the scaffolding teaching model in middle school English on students’ social anxiety disorder

BackgroundA common psychological problem, social anxiety disorder, is prevalent among primary and secondary school students. Social anxiety disorder mainly manifests itself in the form of intense fear and apprehension in social situations, and excessive worry and fear make the patients gradually avoid socializing. In order to provide timely intervention for students with social anxiety disorder, the study introduced a scaffolding teaching model for middle school English in the middle school classroom.Subjects and Methods80 students with social anxiety disorder in a junior high school were randomly divided into an experimental group and a control group. The experimental group was taught using the junior high school English scaffolding teaching mode, while the control group was taught using the traditional English teaching mode, and the Symptom Self-assessment Scale (SCL-90) and Liebowitz Social Anxiety Scale (LSAS) were used to assess the patient’s social anxiety before and after the treatment.ResultsMiddle school English scaffolding teaching model has positive guidance effect on social fear (P&lt;0.05), students in the experimental group had a significant decrease in the scores of all scales after the experiment (P&lt;0.05), compared with the control group the intervention on social fear was more obvious (P&lt;0.05).ConclusionsThe scaffolding teaching model of middle school English has a positive impact on students’ anxiety and phobia, and the self-confidence of students with anxiety disorders was gradually built up and their social scope was gradually expanded.AcknowledgementThe stage achievement of the 14th 5-year plan of educational science foundation in Jiangsu Province (No. E-c/2021/05).

Work stress and psychological conditions: a survey study of anxiety disorders among investment banking practitioners

BackgroundThe work stress and psychological condition of financial investment bankers is a hot issue widely concerned by society. Excessive work pressure is a major risk factor for triggering anxiety disorder episodes. Anxiety disorders are often accompanied by symptoms such as nervousness, worry, muscle tension, panic, sweating, and avoidance of work or emotional instability. In order to reduce the level of anxiety among the practitioners of this industry, the study investigated the current status of anxiety disorders among the practitioners of investment banking.Subjects and MethodsA total of 1456 investment banking practitioners in a certain area were interviewed using the Composite International Diagnostic Interview Schedule-3.0 (CIDI-3.0), and anxiety disorders were diagnosed according to the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Symptom Self-assessment Scale SCL90, and Self-Acceptance Questionnaire (SAQ).ResultsThere were significant differences in the scores on HAMA, HAMD, SCL90, and SAQ among investment banking practitioners with different distributions of age, gender, years of working experience, marital status, and income level (P&lt;0.01), and the differences in the detection rate of anxiety disorders distributed by education level were not statistically significant (P&gt;0.05).ConclusionsThe possibility of anxiety disorders among investment banking practitioners is high, and psychological guidance and proper guidance need to be strengthened. This survey study provides a theoretical basis for the development of targeted interventions for anxiety disorders in the future.AcknowledgementNational Social Science Foundation Project (No. 10BJY106).

Usefulness of self-assessment of gastrointestinal symptoms: a web-based study in Anhui, China.

Gastrointestinal symptoms (GISs) are highly prevalent worldwide caused by a combination of biopsychosocial factors. Given the complex nature coupled with ineffective communication of diagnosis by physicians, patients with intimate GISs often feel stigmatized which in turn can inhibit their ability to express their thoughts and feelings adequately and lead to either over or underreport of their symptoms. And selective service seeking for and reporting of GISs have direct bearing on the stage of disease at presentation, and consequently, on the overall prognosis. The study aimed to investigate the usefulness of a web-based self-assessment of GISs as a supplementary means to cope with potential over/under reporting during routine consultations. The study used data about GISs collected using a novel web-based self-assessment tool (n=475) and that from non-participative observation of doctor-patient consultations (n=447) and household survey (n=10552) in Anhui, China. The data analysis focused primarily on description of composition of respondents and occurrence rates of GISs by socio-demographics and by methods and settings of symptom solicitation. Chi-square power tests were used, when necessary, to compare the differences in the occurrence rates between relevant groups and the significance level of the two-sided test was set at α<0.05. Both the average occurrence rates of upper and lower GISs derived from the web-based self-assessment were higher than that from the observation, being 20.9% vs 14.2% (p<0.001) and 12.9% vs 10.8% (p=0.02) respectively. The differences in six out of the nine upper GISs and three out of the eleven lower GISs studied were tested with statistical significance (p<0.05), and all these symptoms witnessed higher self-assessed than observed frequency rates. For upper GISs, the self-assessed versus observed differences ranged from 17.1% for bloating to 100% for bad mood after meal; while for lower GISs, the differences ranged from -50.5% for hematochezia/melena to 100% for uncontrollable stool. Stomachache, regurgitation, and dysphagia displayed higher occurrence rates among participants of the self-assessment than those of the household survey, being 20% vs 13%, 14% vs 11% and 3% vs 2% respectively; while the opposite was observed for constipation (5% vs 11%), hematochezia or melena (4% vs 5%) and anorexia (4% vs 5%). All the differences in the self-assessed occurrence rates of specific persistent GISs between socio-graphic groups were tested non-significant (P>0.05); while the same rate of any of the six persistent GISs studied among the respondents aged 51-60 was statistically higher than that among other age groups (P=0.03). The web-based self-assessment tool piloted in this study is useful and acceptable. It helps in soliciting more comprehensive GISs, especially symptoms with concerns about stigmatization, privacy, shame etc. Further studies are needed to integrate the web-based self-assessment with routine consultations and evaluate its efficacy.

Study protocol: effects of treatment expectation toward repetitive transcranial magnetic stimulation (rTMS) in major depressive disorder—a randomized controlled clinical trial

BackgroundPatients’ expectations toward any given treatment are highly important for the effectiveness of such treatment, as has been demonstrated for several disorders. In particular, in major depressive disorder (MDD), one of the most frequent and most serious mental disorders with severe consequences for the affected, the augmentation of available treatment options could mean a ground-breaking success. Repetitive transcranial magnetic stimulation (rTMS), a new, non-invasive, and well-tolerated intervention with proven effects in the treatment of MDD, appears particularly suitable in this context as it is assumed to exert its effect via structures implicated in networks relevant for both expectation and depression.MethodsAll patients will receive rTMS according to its approval. Half of the patients will be randomized to a psychological intervention, which is a comprehensive medical consultation aiming to improve positive treatment expectations; the control group will receive a conventional informed consent discussion (in the sense of a treatment-as-usual condition). As outcome parameters, instruments for both self-assessment and external assessment of depression symptoms will be applied. Furthermore, psycho-immunological parameters such as inflammation markers and the cortisol awakening response in saliva will be investigated. Resting-state functional magnetic resonance imaging (rs fMRI) will be performed to analyze functional connectivity, including the cerebellum, and to identify neuronal predictors of expectation effects. In addition, possible cerebellar involvement will be assessed based on a cerebellar-dependent motor learning paradigm (i.e., eyeblink conditioning).DiscussionIn this study, the effects of treatment expectations towards rTMS are investigated in patients with MDD. The aim of this study is to identify the mechanisms underlying the expectation effects and, beyond that, to expand the potential of non-invasive and well-tolerated treatments of MDD.Trial registrationGerman Registry of Clinical Studies (DRKS DRKS00028017. Registered on 2022/03/07. URL: https://www.drks.de/drks_web/.

Validation of the Polish Version of Knee Outcome Survey Activities of the Daily Living Scale in a Group of Patients after Arthroscopic Anterior Cruciate Ligament Reconstruction.

The study aimed to assess the reliability, validity, and responsiveness of the Polish version of Knee Outcome Survey Activities of the Daily Living Scale (KOS-ADLS) in a group of patients after arthroscopic reconstruction of the anterior cruciate ligament (ACL). The study was a longitudinal study with repeated measures. One hundred and twelve subjects who qualified for arthroscopic ACL reconstruction (mean age = 31.8 years) were initially enrolled in this study. The Polish version of KOS-ADLS and Short Form-36 v. 2.0 (SF-36) were used. The Polish version of KOS-ADLS in subjects after ACL rupture demonstrated excellent internal consistency (Cronbach's alpha for KOS-ADLS- total = 0.91), and test-retest reliability using the intraclass correlation coefficient (ICC-total = 0.98). The standard error of measurement (SEM) value was 0.81 and the minimal detectable change (MDC) was 2.23 for KOS-ADLS-total. The validity analysis showed a moderate and low correlation between KOS-ADLS and different domains of SF-36 from r = 0.354 between KOS-ADLS activity and the physical component scale (PCS) of SF-36: to r = 0.206 between KOS-ADLS activity and the mental component scale (MCS) of SF-36. The Polish version of KOS-ADLS turned out to be a reliable, valid and responsive self-reported outcome measure, allowing for the self-assessment of symptoms and function related to the knee joint impairment after ACL reconstruction. Therefore, the scale can be applied in clinical practice and research.

Individual tailored physical training in patients with postural orthostatic tachycardia syndrome associated with post-acute COVID-19 syndrome - a feasibility study

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Hjärt-Lungfonden Vetenskapsrådet Background The number of people that has been affected by COVID-19 is high and has continued to increase throughout the pandemic. A significant proportion of patients with COVID-19 have developed persistent symptoms, described as post-acute COVID-19 syndrome (PACS). A specific PACS variant is the postural orthostatic tachycardia syndrome (POTS). POTS is a cardiovascular dysautonomia characterized by an excessive increase in heart rate in standing and deconditioning. Studies evaluating effect and feasibility of individual tailored physical exercises in POTS associated with PACS are sparse. Purpose To evaluate the effects and feasibility of a individually tailored exercise on physical and psychological function in patients with POTS associated with PACS. Method Patients with POTS + PACS and diagnosed between Dec 2021-Sep 2022 were enrolled. Measurements were carried out at baseline and after intervention: 6-minute walking test (6MWT), Active Standing Test (AST) and self-assessment of symptoms through forms; Malmö POTS scale (MaPs), Vanderbilt Orthostatic Symptom Score (VOSS), health-related quality of life (EQ-5D-5L), anxiety (GAD) and depression (PHQ-9). Physical activity and time in different positions (lying, sitting, standing and walking) were measured using accelerometers (ActivPAL). The intervention consisted of 12 weeks individually tailored training, including both endurance and muscle-strengthening exercises with a gradual progression of time, dose, and position (supine-upright). The training was adapted based on the study subject's heart rate and/or self-estimated exertion using BORG reported perceived excertion. Progression of the exercise was halted if the study subject described increased symptoms &amp;gt;24h after the last exercise session indicating post exertional malaise (PEM). Recruitment rate, compliance and adverse events was registered. Results A total of 15 patients were enrolled and 14 patients completed the intervention (9 women; mean age, 41.6 years (SD 12.3). No severe adverse events occurred however some of the patients’ described PEM. After completing the intervention period, patients demonstrated improvement in physical (6MWT p&amp;lt;0.004) and psychological functions (PHQ-9 p&amp;lt;0.001) and less symptoms related to POTS (MaPS p&amp;lt;0.03) (Table 1). The primary outcome, time spent in upright position increased by 1.5h/day (Figure 1). Conclusion In patients with COVID-19-related POTS, individually tailored exercise was associated with increased time in upright position, reduction of POTS-specific symptoms and improved function. The intervention seems to be feasible in terms of recruitment, compliance and safety. Further studies are needed to verify these results and compare disease progression with and without intervention.

Low awareness of venous thromboembolism among neurosurgical hospitalized patients: a cross-sectional study

BackgroundVenous thromboembolism (VTE) including Deep Venous Thrombosis (DVT) and Pulmonary Embolism (PE), is a serious cause of patient morbidity and mortality in hospitals. Neurosurgical hospitalized patients have higher rates of immobility and bed rest, thus increasing their risk of developing VTE. This highlights the need for their thromboprophylaxis regimens. Patients’ awareness of VTE is essential for promoting strategies such as early ambulation and encouraging self-assessment and self-reporting of VTE signs and symptoms. This study evaluated neurosurgical hospitalized patients’ awareness of VTE and explored the influencing factors to provide a theoretical basis for nursing intervention.MethodsWe selected one tertiary level hospital in Hunan Province and randomly sampled eligible patients from each five neurosurgical units. We conducted a cross-sectional survey of the hospitalized patients of neurosurgery using the self-designed and validated VTE knowledge questionnaire, and the influencing factors were analyzed using SPSS 26.0.ResultsA total of 386 neurosurgical hospitalized patients completed the survey. The score of VTE knowledge in neurosurgical hospitalized patients was 13.22 (SD = 11.52). 36.0% and 21.2% of participants reported they had heard of DVT and PE, respectively. 38.9% of participants were unable to correctly identify any symptoms of VTE. The most frequently identified risk factor was ‘immobility or bed rest for more than three days’ (50.0% of participants), and 38.1% of patients agreed that PE could cause death. 29.5% of participants were unable to identify any prophylactic measures of VTE. The results of Negative Binomial Regression showed that the influencing factors of VTE knowledge in neurosurgical hospitalized patients were education level (P < 0.004) and sources of information related to VTE, including nurses (95% CI = 2.201–4.374, P < 0.001), and family member/friend (95% CI = 2.038–4.331, P < 0.001), Internet/TV (95% CI = 1.382–2.834, P < 0.001). Other sources included patient /pamphlet/poster /professional books (95% CI = 1.492–3.350, P < 0.001).ConclusionsThis study demonstrates the lack of awareness of VTE among neurosurgical hospitalized patients. More attention must be paid to carrying out training on VTE knowledge according to different characteristics of neurosurgical hospitalized patients, so as to ensure safe and high-quality patient care.