Self-reported Impairment Research Articles

Physical Activity and the Association With Self-Reported Impairments, Walking Limitations, Fear of Falling, and Incidence of Falls in Persons With Late Effects of Polio

The purpose of this study was to determine the association between physical activity and self-reported disability in ambulatory persons with mild to moderate late effects of polio (N = 81, mean age 67 years). The outcome measures were: Physical Activity and Disability Survey (PADS), a pedometer, Self-Reported Impairments in Persons with Late Effects of Polio Scale (SIPP), Walking Impact Scale (Walk-12), Falls Efficacy Scale-International (FES-I), and self-reported incidence of falls. The participants were physically active on average 158 min per day and walked 6,212 steps daily. Significant associations were found between PADS and Walk-12 (r = -.31, p < .001), and between the number of steps and SIPP, Walk-12, and FES-I (r = -.22 to -.32, p < .05). Walk-12 and age explained 14% of the variance in PADS and FES-I explained 9% of the variance in number of steps per day. Thus, physical activity was only weakly to moderately associated with self-reported disability.

Methodological factors conducting research with incarcerated persons with diabetes

ObjectiveThe aim of this study was to describe methodological issues specific to conducting research with incarcerated vulnerable populations who have diabetes. BackgroundMuch has been written about the ethical and logistical challenges of conducting research with vulnerable incarcerated populations. However, conducting research with incarcerated persons with diabetes is associated with additional issues related to research design, measurement, sampling and recruitment, and data collection procedures. MethodA cross-sectional study examining the relationships of diabetes knowledge, illness representation and self-care behaviors with glycemic control in 124 incarcerated persons was conducted and serves as the basis for describing methodological factors for the conduct of research with an incarcerated population with diabetes. ResultsWithin this incarcerated population with diabetes, sampling bias due to gender inequity, recruitment of participants not using insulin, self-reported vision impairment, and a lack of standardized instruments especially for measuring diabetes self-care were methodological challenges. Clinical factors that serve as potential barriers for study conduct were identified as risk for hypoglycemia due to insulin timing and other activities. ConclusionConducting research with incarcerated persons diagnosed with diabetes requires attention to a set of methodological concerns above and beyond that of the ethical and legal regulations for protecting the rights of this vulnerable population. To increase opportunities for conducting rigorous as well as facility- and patient-friendly research, researchers need to blend their knowledge of diabetes with an understanding of prison rules and routines.

Trends in mammography over time for women with and without chronic disability.

Women with disabilities often receive mammograms at lower rates than do nondisabled women, although this disparity varies by disability type and severity. Given the implementation of disability civil rights laws in the early 1990s, we examined whether disability disparities in mammogram use have diminished over time. We analyzed National Health Interview Survey responses of civilian, noninstitutionalized United States female residents 50 to 74 years old from selected years between 1998 and 2010. We identified seven chronic disability types using self-reported functional impairments, activity/participation limitations, and expected duration. We conducted bivariable and multivariable logistic regression analyses examining associations of self-reported mammogram use within the previous two years with sociodemographic factors and disability. Most chronic disability rates rose over time. The most common disability was movement difficulties, with rates increasing from 35.6% (1998) to 39.8% (2010). Mammogram rates for all women remained relatively stable over time, ranging from 72% to 75%. Bivariable analyses generally found statistically significantly lower mammogram rates for women with disability versus nondisabled women. Over time, disparities grew significantly between women with any basic action difficulty or complex activity limitation and nondisabled women (p<0.01). In multivariable logistic analyses, having any difficulty with basic actions was significantly associated with lower adjusted odds of mammography; for example, adjusted odds [95% confidence interval]=0.5 [0.3-0.8], p=0.006, in the model involving movement disability. Little has changed since 1998 in mammogram rates for women with versus without disabilities. Women with certain disabilities continue to experience disparities in mammography testing.

Foot and ankle impairments affect balance and mobility in stroke (FAiMiS): the views and experiences of people with stroke

Purpose: To explore the nature and impact of foot and ankle impairments on mobility and balance in community-dwelling, chronic stroke survivors. Methods: A qualitative research design using face to face semi-structured, audio recorded interviews. Thirteen community-dwelling stroke survivors, all of whom had self-reported foot and ankle impairments, were interviewed (female n = 6, mean age = 67 years, SD = 12 years, mean time since stroke = 4 years, SD = 6 years, right stroke n = 7, left stroke n = 6). A framework analysis approach was used to analyse and interpret transcribed interviews. Results: Three themes emerged: (1) Impact. The influence of foot and ankle impairments on mobility and balance. (2) Standing out. How participants felt they “stood out” because of their impairments and wanted to be normal. (3) Help. The specific help and advice participants received in managing their problems. Conclusions: Foot and ankle impairments such as pain, altered somatosensory input and weakness significantly contribute to problems with community ambulation, balance and fear of falling in people with chronic stroke. Specific foot and ankle impairments may also negatively contribute to perceptions of physical appearance and self-esteem. Therapeutic management approaches within clinical practice appear to focus mostly on the gross performance of the lower limb with little emphasis on the specific assessment or treatment of the foot or ankle.Implications for RehabilitationFoot pain, sensory impairments and muscle weakness in the foot and ankle can impact on community ambulation, balance and fear of falling following stroke.Foot and ankle function post-stroke should be routinely assessed and monitored.Clinicians should be aware of the potentially distressing negative perceptions associated with altered gait patterns, footwear and orthotic use.

Tolerance, bioavailability, and potential cognitive health implications of a distinct aqueous spearmint extract

Background: Cognitive function can decline during the aging process and significantly reduce quality of life. Although a number of interventions have been investigated for cognitive dysfunction, including antioxidants, this prominent health concern emphasizes a need to explore methods to support cognitive health later in the life span. An aqueous extract from a proprietary spearmint line has been developed which contains a number of antioxidant compounds, including rosmarinic acid, at levels that are higher than found in commercially-bred spearmint. Therefore, this pilot trial assessed the tolerance, bioavailability, and potential cognitive health implications of a proprietary spearmint extract in men and women with self-reported memory impairment. Methods: Subjects consumed 900 mg/day spearmint extract for 30 days. The sample population (N = 11) was 73% female and 27% male with a mean age of 58.7 ± 1.6 y. Tolerability parameters were assessed at baseline and end of treatment visits. Computerized cognitive function tests were completed and blood was drawn at pre- and post-dose (0.5 to 4 h) timepoints during baseline and end of treatment visits. Subjective cognition was also assessed at end of treatment. Results: No serious adverse events or clinically relevant findings were observed in any tolerability parameters. Plasma vanillic, caffeic, and ferulic acid sulfates, rosmarinic acid, and methyl rosmarinic acid glucuronide were detected in plasma following acute administration of the spearmint extract. Computerized cognitive function scores improved in reasoning (P = 0.023) and attention/concentration (P = 0.002) after 30 days of supplementation. After acute administration, subjects had improved attention/concentration in two tests at 2 (P = 0.042 and P = 0.025) and 4 h (P = 0.001 and P = 0.002). Conclusions: The results from this pilot trial suggest that the spearmint extract, which contains higher rosmarinic acid content relative to extracts from typical commercial lines, was well￾tolerated at 900 mg/day. In addition, the extract was bioavailable and further investigation is warranted regarding its potential for supporting cognitive health

Self-reported Upper Extremity Function, Active Range Of Motion And Shoulder Isometric Strength In Breast Cancer Survivors

Post-surgical rehabilitation from mastectomy in breast cancer patients may be challenged by compromised range of motion range of motion and functional strength associated with disuse. The PENN Shoulder Scale (PSS) and the Disability of the Arm, Shoulder and Hand (DASH) questionnaires have been developed to assess and quantify self-reported upper limb impairment. PURPOSE: To examine the associations between self-reported upper extremity function reported with DASH and PSS, with active range of motion (AROM) and isometric strength (IS) of surgically affected limb in breast cancer survivors (BCS). METHODS: Thirty-one (52.4±9.4 years) BCS were recruited from LA County Hospital and Norris Comprehensive Cancer Center at USC as a part of a larger ongoing exercise study. Investigators measured AROM of the surgically affected limb, completed during external rotation (ER) at 90° abduction and shoulder forward flexion (SFF) using a standard goniometer. Scapular elevation (SE) and external rotation (ER) IS was measured using a hand-held dynamometer (Hoggan Health Industries) on the participants’ surgically affected arm. Participants then completed DASH and PSS questionnaires. Pearson correlations were used to determine associations between DASH, PSS, and AROM and IS. RESULTS: Mean PSS and DASH scores (±SD) were reported as 72.8±19.8 (out of 100 points) and 18.9±15.9 (out of 100 points). No statistically significant relationship was detected between PSS scores and AROM (ER, p=0.14, r=−0.26; SFF, p=0.08, r=−0.30) or IS(ER, p=0.46, r=−0.12; SE, p=0.39, r=−0.15). Pearson correlations revealed no statistically significant association between DASH scores and AROM (ER, p=0.28, r=0.17; SFF, p=0.50, r=0.10) or IS(ER, p=0.60, r=0.13; SE, p=0.76, r=−0.05). CONCLUSION: The PSS and DASH assessments of shoulder disability were not related to AROM or IS in BCS. These self-reported assessment tools may not be appropriate for predicting upper body strength or range of motion in BCS.

Association between falls and depressive symptoms or visual impairment among Japanese young‐old adults

To investigate the association between falls and self-reported depressive symptoms or visual impairment among young-old adults. A total of 1904 participants (986 men and 918 women) aged 64 years from the New Integrated Suburban Seniority Investigation Project from 1996 to 2005, an age-specific cohort study in Nisshin, Japan, took part in the present study. Depressive symptoms were evaluated using the Geriatric Depression Scale. Visual impairment was assessed using a self-administered questionnaire. The outcome variable was self-reported injurious falls at the age of 70 years. Multivariate odds ratios (OR) and 95% confidence intervals (CI) of depressive symptoms and visual impairment for the incidence of falls were calculated using logistic regression models and adjusted for possible confounding factors. Overall, 77 (7.8%) men and 126 (13.7%) women reported falls within the past 1 year at age 70 years. Among women, depressive symptoms and visual impairment were significantly associated with falls after adjusting for potential confounders (OR 1.70, 95% CI 1.09-2.62; OR 2.34, 95% CI 1.45-3.71, respectively), but not among men. Women with both conditions had a significantly increased risk of falls after adjusting for potential confounders (OR 3.50, 95% CI 1.65-7.13) compared with those with neither condition; the association was not significant among men. Depressive symptoms and visual impairment at age 64 years were significantly associated with an increased risk of falls at age 70 years in Japanese women but not in men. The combination of the two symptoms had an even greater association with fall risk.

Effectiveness of Powered Mobility Devices in Enabling Community Mobility-Related Participation: A Prospective Study Among People With Mobility Restrictions

ObjectiveTo investigate the effectiveness of powered mobility device (ie, powered wheelchair and scooter) interventions over a 1-year period in Nordic countries. DesignProspective design. SettingThe study involved community-dwelling participants from Denmark, Finland, and Norway. ParticipantsIn all, 180 participants with different self-reported impairments participated in the study. The mean age was 68.7 years (95% confidence interval [CI] = 39.9-97.5 years), and 47.8% of the participants were men. MethodsTwo face-to-face interviews about mobility and mobility-related participation were conducted with participants in their homes. The first interview took place shortly before the participants received their powered mobility device, and the second took place about 1 year later (mean, 386.9 days; standard deviation = 52.78). Main Outcome MeasuresChanges in frequency, ease/difficulty, and number of mobility-related aspects of participation in daily life were investigated in the total sample and in subgroups by means of the NOMO 1.0 instrument, applying a structured interview format. ResultsIn the total sample, the frequency of shopping for groceries (P < .001, effect size = 0.29, 95% CI = 0.08-0.50) and going for a walk/ride (P < .001, effect size = 0.62, 95% CI = 0.41-83) increased, whereas the number of aspects of participation performed (P < .001) increased only slightly. Going to a restaurant/café/pub, shopping for groceries, doing other shopping, posting letters, going to the bank or the chemist's, going for a walk/ride, and visiting family/friends became easier (P < .001 to P = .001); effect sizes varied between 0.50 (95% CI = 0.29-0.71) and 0.85 (95% CI = 0.63-1.07). Men, persons who used scooters, and persons with poor self-reported health seem to benefit the most from the intervention. ConclusionsPowered mobility device interventions mainly contribute to mobility-related participation by making participation easier for people with mobility restrictions and by increasing the frequency of aspects of participation such as shopping for groceries and going for a walk/ride. The effects varied with regard to the subgroups. The present study further strengthens the current evidence that powered mobility devices increase mobility-related participation in daily life among certain subgroups of adults with mobility restrictions.

Burnout Phenomenon in U.S. Plastic Surgeons

Recent studies by the American College of Surgeons reveal that nearly 40 percent of U.S. surgeons exhibit signs of burnout. The authors endeavored to quantify the incidence of burnout among U.S. plastic surgeons, determine identifiable risk factors, and evaluate its impact on quality of life. All U.S. residing members of the American Society of Plastic Surgeons were invited to complete an anonymous survey between September of 2010 and August of 2011. The survey contained a validated measure of burnout (Maslach Burnout Inventory) and evaluated surgeon demographics, professional and personal risk factors, career satisfaction, self-perceived medical errors, professional impairment, and family-home conflicts. Of the 5942 surgeons invited, 1691 actively practicing U.S. plastic surgeons (28.5 percent) completed the survey. The validated rate of burnout was 29.7 percent. Significant risk factors for burnout included subspecialty, number of hours worked and night calls per week, annual income, practice setting, and academic rank. Approximately one-fourth of plastic surgeons had significantly lower quality-of-life scores than the U.S. population norm, and this risk increases in burned out surgeons. In addition to having lower career satisfaction and more work-home conflicts, plastic surgeons with burnout also had a nearly two-fold increased risk of self-reported medical errors and self-reported impairment. Over one-fourth of plastic surgeons in the United States experience validated burnout, with concomitant attenuated career satisfaction and quality of life. Multivariate analysis identified predisposing factors that may aid in better understanding risk profiles that lead to burnout; therefore, efforts to understand and thereby avoid this burnout phenomenon are warranted.

How various self-reported impairments influence walking ability in persons with late effects of polio.

Many persons with late effects of polio experience new or increased impairments, which can lead to walking limitations in daily life. No study has comprehensively analyzed how various self-reported impairments are associated with different aspects of self-reported walking limitations. To determine the associations between self-reported impairments and self-reported walking limitations in persons with late effects of polio. Three hundred and twenty-five persons (175 women and 150 men) with verified late effects of polio responded to the Self-reported Impairments in Persons with late effects of Polio (SIPP; 13-items) and to the Walking Impact Scale (Walk-12; 12 items). The overall correlation (rho) between the total sum scores of the SIPP and the Walk-12 was 0.61 (p < 0.01). Of the 156 correlation coefficients (SIPP vs Walk-12), 151 (97% ) were significant at the 1% level. Self-reported muscle weakness, muscle fatigue, muscle and/or joint pain during physical activity and general fatigue had the strongest correlations (rho: 0.33 to 0.64) to the self-reported walking limitations, whereas memory difficulties, sleep disturbances and concentration difficulties had the weakest correlations (rho: 0.10 to 0.34). There are weak to moderate associations between self-reported impairments and walking limitations in persons with late effects of polio. By limiting the impact of those impairments that are strongest associated with walking, clinicians may improve walking ability. However, the strength of the associations implies that other rehabilitation interventions should be considered for improving overall performance in daily activities related to walking.

Disability identity predicts lower anxiety and depression in multiple sclerosis.

Disability identity involves affirming one's status as a person with a disability and incorporating this group membership into one's identity. It is associated with well-being in populations of people with disabilities, but its relationship with depression and anxiety in multiple sclerosis (MS) has yet to be examined. It was hypothesized that disability identity would predict lower depression and anxiety above and beyond the effects of demographic and disability variables. One hundred and six participants with MS completed a cross-sectional Internet survey measuring disability identity, depression and anxiety, activities of daily living performance, MS duration, and demographic variables. Inclusion criteria were as follows: self-reported diagnosis of MS, self-reported impairment in walking, age 18 or older, living in the United States, and English fluency. Hierarchical regressions revealed that disability identity was a unique predictor of lower depression and anxiety. Older age and higher activities of daily living performance also predicted lower depression and anxiety. Stronger disability identity predicts lower psychological distress in MS. Clinical implications include supporting patient disability identity by encouraging involvement in disability support and advocacy groups. Future research should examine psychosocial interventions to affirm identity.

Sex-Related Differences in Self-Reported Neurocognitive Impairment among High-Risk Cocaine Users in Methadone Maintenance Treatment Program.

BACKGROUNDPrevious research has suggested possible sex-related differences in executive functioning among cocaine users; however, no studies specifically explain sex-related differences in neurocognitive impairment (NCI) among cocaine users receiving clinical care. Knowledge about this association can aid in the development of targeted prevention strategies to reduce adverse health outcomes. This study was designed to examine the sex-related differences in NCI among high-risk cocaine users receiving substance-abuse treatment.METHODSThe Neuropsychological Impairment Scale (NIS) was administered to 199 cocaine users (98 men; 101 women), receiving methadone maintainance treatment, to assess self-reported NCI by identifying the patients’ awareness of neuropsychological symptoms. We used T-test comparison to find differences in NCI between men and women and multiple regression analysis to explore the relative contribution of sex to NCI.RESULTSConsistent with prior work, high NCI was evident within this sample, as indicated by high scores on most of the NIS subscales. Women reported greater impairment than men, as evidenced by significantly higher scores on several NIS subscales, after controlling for demographic and other confounding variables. Interestingly, cocaine craving significantly predicted NCI among men but not among women, as suggested by the significant association between cocaine craving and all except one of the NIS subscales.CONCLUSIONSThese findings suggest that cocaine users enter into treatment with a range of NCI – with women having significantly more neurocognitive deficits than men – that may contribute to differential treatment outcomes. This highlights the need to include additional services such as neuropsychological screening and sex-specific treatment programs to optimally reduce adverse health outcomes in these high-risk, cognitively impaired patients.

Factors associated with the accuracy of subjective assessments of hearing impairment.

Self-reported hearing impairment is often used to gauge objective hearing loss in both clinical settings and research studies. The aim of this study was to examine whether demographic factors affect the accuracy of subjective, self-reported hearing in older adults. We examined 3557 participants aged 50 and older in the National Health and Nutrition Examination Survey cycles 1999-2006 and 2009-2010. We examined the relationship between objective and subjective hearing impairment using percent correct classification and misclassification bias in analyses stratified by gender, age group, race/ethnicity, and education. We found that younger participants tended to overestimate and older participants underestimate their hearing impairment. Older women, blacks, and Hispanics were less accurate in self-reporting than their respective younger age groups. The association between subjective and objective hearing differs across gender, age, race/ethnicity, and education, and this observation should be considered by clinicians and researchers employing self-reported hearing.

The OPD structure questionnaire captures the general features of personality disorder

The alternative DSM-5 model of personality disorder (PD) links general criteria and severity of PD to impairments in self and interpersonal functioning. This approach is very similar to the Level of Structural Impairment Axis of the Operationalized Psychodynamic Diagnosis (OPD-2). In this study we investigate the relationship of these 2 approaches based on 2 new self-report questionnaires. 228 psychotherapeutic inpatients filled out the OPD Structure Questionnaire (OPD-SQ), the General Assessment of Personality Disorder (GAPD), and the Patient Health Questionnaire (PHQ-D). The correlation between the latent general factors of OPD-SQ and GAPD was 0,91. After controlling for depressive symptoms the correlation was 0,86. The general factors of the OPD-SQ and the GAPD are almost identical. The OPD-SQ captures the general features of PD in terms of self-reported impairments in self and interpersonal functioning.

Social and lifestyle characteristics and burden of ill-health associated with self-reported hearing and vision impairments in older men in the British community: a cross-sectional study

BackgroundSensory impairment is common in older adults and we need to understand more about its association with other health conditions. We explored sensory impairment in relation to demographic, lifestyle factors, and health conditions in older men. MethodsIn a cross-sectional study, 3981 men aged 63–85 years (82% of participants recruited to the British Regional Heart Study cohort in 1978–80 and still alive in 2003) were selected from general practices in 24 British towns. Data on hearing aid use and ability to follow television at a volume others find acceptable allowed for four categories of hearing: can hear (n=2851), can hear with an aid (n=482), cannot hear and no aid (n=424), and cannot hear despite an aid (n=168). Vision impairment was defined as not being able to recognise a friend across a road (n=124). Logistic regression was used to investigate associations of hearing impairment and vision impairment with self-reported doctor-diagnosed coronary heart disease, disability (difficulty taking the stairs, difficulty keeping balance), social interaction (attending few social activities), and quality of life (experiencing pain, feeling anxious or depressed). Findings1074 men (27%) reported hearing impairment and 124 (3%) reported vision impairment. Compared with those reporting no hearing problem, hearing impairment was associated with disability, poor social interaction, and poor quality of life. Poor quality of life remained significant after having adjusted for social class, smoking, obesity, and physical activity. Only men who could not hear despite having a hearing aid were more likely to report coronary heart disease (age-adjusted odds ratio 1·89, 95% CI 1·36–2·63) and falls (1·62, 1·05–2·48). Vision impairment was associated with symptoms of coronary heart disease including chest pain (1·58, 1·07–2·40) and breathlessness (2·06, 1·38–3·06), but not with diagnosed coronary heart disease (1·39, 0·93–2·07). Vision impairment was also significantly associated with falls, poor quality of life, poor social interaction, and disability, which remained significant after adjusting for social class, smoking, obesity, and physical activity. Men with a sensory impairment were more likely to be physically inactive, obese (hearing impairment only), and in a manual social class. InterpretationOlder men with hearing impairment and vision impairment have a high risk of disability, poor health, and poor social interaction. Policy efforts for early detection and treatment of sensory impairment could be crucial for independent living in old age. FundingThe British Regional Heart Study is funded by the British Heart Foundation. AEML is funded by the National Institute for Health Research School for Public Health Research. SER is funded by a UK Medical Research Council Fellowship.

Attachment Rate of the Inferior Alveolar Nerve to Buccal Plate During Bilateral Sagittal Split Osteotomy Influences Self-Reported Sensory Impairment

This study was aimed to investigate a modified buccal osteotomy technique and whether the integrity of the lingual part of the lower border influences the attachment of the neurovascular bundle to the proximal segment of the mandible during a sagittal split osteotomy without increasing the number of bad splits. The presence of self-reported sensibility disturbance in the lower lip at the last follow-up visit was assessed. This study included 220 and 133 patients with bilateral sagittal split osteotomy undergoing the classical and the new modified buccal osteotomy techniques, respectively. In the new technique, the lower border is divided into a lingual fragment that remains incorporated in the tooth-bearing fragment and a buccal fragment that comes with the proximal fragment (buccal plate). In the classical technique, the inferior alveolar nerve was attached to the proximal segment of the mandible in more than one third of operation sites (36.36% on the right and 40.91% on the left) compared with less than one fourth of the operation sites using the new technique (9.73% on the right and 23.01% on the left). The overall figure of self-reported changed sensibility was 09.40% (12/128) in the new technique compared to 15.12% in the classical technique. We present a suitable improvement to the classical buccal osteotomy technique that allows less manipulation and injury of the inferior alveolar nerve with consequent reduction in self-reported postoperative changes in lower lip sensation

Sensory function: insights from Wave 2 of the National Social Life, Health, and Aging Project.

Sensory function, a critical component of quality of life, generally declines with age and influences health, physical activity, and social function. Sensory measures collected in Wave 2 of the National Social Life, Health, and Aging Project (NSHAP) survey focused on the personal impact of sensory function in the home environment and included: subjective assessment of vision, hearing, and touch, information on relevant home conditions and social sequelae as well as an improved objective assessment of odor detection. Summary data were generated for each sensory category, stratified by age (62-90 years of age) and gender, with a focus on function in the home setting and the social consequences of sensory decrements in each modality. Among both men and women, older age was associated with self-reported impairment of vision, hearing, and pleasantness of light touch. Compared with women, men reported significantly worse hearing and found light touch less appealing. There were no gender differences for vision. Overall, hearing loss seemed to have a greater impact on social function than did visual impairment. Sensory function declines across age groups, with notable gender differences for hearing and light touch. Further analysis of sensory measures from NSHAP Wave 2 may provide important information on how sensory declines are related to health, social function, quality of life, morbidity, and mortality in this nationally representative sample of older adults.

Neurocognition, functional competence and self-reported functional impairment in psychometrically defined schizotypy

Introduction. Schizotypy is phenologically and genetically related to schizophrenia-spectrum illness. Previous studies find cognitive function to be mildly impaired, but specific impairments and their relationship to functioning are not well understood. In this study, we sought to examine how cognitive load affects performance in schizotypy and to examine whether impairments might manifest in functional capacity and quality of life.Methods. Undergraduate students were screened for abnormally high levels of schizotypy (N = 72) and compared to those without psychopathology (N = 80) on a standard battery of neuropsychological tests, cognitive tests with varying cognitive load, functional capacity measures and quality of life.Results. The high schizotypy group did not differ from controls on traditional measures of neuropsychological functioning, but an interaction of group by cognitive load was observed, where those with schizotypy manifested a greater decline in performance as information processing load was parametrically increased. Differences in functioning were observed and cognitive impairment was associated with impaired functioning.Conclusions. Cognitive and functional impairment can be observed in those with high schizotypal traits who are non-treatment seeking. The sensitivity of cognitive tests to impairment in this population might be a function of their ability to parametrically increase cognitive load.

Health effects of supplemental work from home in the European Union

Internationalization and technological developments have changed the work organization in developed and developing industrial economies. Information and communication technologies, such as computers and smartphones, are increasingly used, allowing more temporal and spatial flexibility of work. This may lead to an increase in supplemental work, i.e. constant availability or working in addition to contractually agreed work hours. This in turn extends work hours and leads to work hours in evenings and weekends, causing interferences of work hours with biological and social rhythms for sleep, recovery and social interaction. However, empirical findings on the effects of supplemental work and work hours on occupational health are rather scarce. Therefore, the aim of this study was to investigate the association between (1) work-related contacts outside of regular work hours and (2) working in the free time with self-reported work-related health impairments in the fourth and fifth European Working Conditions Surveys (EWCS 2005, EWCS 2010). Out of these cross-sectional, large-scale surveys, data on n = 22 836 and n = 34 399 employed workers were used for weighted logistic regression analyses. About half of the sample reported at least occasional supplemental work. The results showed an increased risk of reporting at least one health problem for employees who had been contacted by their employer (EWCS 2005), or worked in their free time to meet work demands (EWCS 2010) in the last 12 months, compared to those reporting no supplemental work or work-related contacts during free time. These results were controlled for demographic variables, physical and mental work load, worker autonomy, and several work hours characteristics (e.g. hours per week, unusual and variable hours). The risk of reporting health problems was increased by being contacted both sometimes (Odds Ratio [OR] 1.26, 95% Confidence Interval [CI] 1.14–1.39) and often (OR 1.13, 95% CI 1.02–1.25), whereas the frequency of working in the free time showed a clear dose-response effect (sometimes: OR 1.14, 95% CI 1.04–1.24; often: OR 1.60, 95% CI 1.47–1.75), both compared to the category “never”. The findings, thus, indicate that even a small amount of supplemental work beyond contractually agreed work hours may increase the risk of work-related health impairments. Working in the free time was associated with a substantial risk increase and might be a better indicator for actual work load than being contacted by the employer outside of contractually agreed work hours. Thus, in order to minimize negative health effects, availability requirements for employees outside their regular work hours should be minimized. While these effects definitely need further study, especially regarding a quantification of actual supplemental work and its temporal location, addressing the company culture and using incentives and policies might be options to reduce the amount of supplemental work and maintain the risks of health impairments in the working population at a lower level.

Association of Hearing Impairment and Frailty in Older Adults

Objectives:Frailty is a state characterized by decreased physiologic reserve and weakness that is associated with poor health outcomes. Whether hearing impairment, which is associated with physical and cognitive decline, is associated with frailty, is unknown.Methods:We analyzed 2109 individuals 70 years and older in the 1999‐2002 cycles of the National Health and Nutrition Examination Survey (NHANES). Hearing impairment was measured by self‐report (good, little trouble, lot of trouble). Frailty was defined as the presence of at least 3 of the following: 5% unintentional weight loss in the past year and/or body mass index &lt;18.5 kg/m2, slow walking speed, weakness, exhaustion, and low physical activity. Logistic regression models were adjusted for demographic characteristics, cardiovascular risk factors, hearing aid use, and health status.Results:Among all individuals, self‐reported hearing impairment was significantly associated with frailty in fully adjusted models (odds ratio [OR] 1.68 [95% confidence interval {CI} 1.00, 2.82]). Analyses stratified by sex demonstrated that this association was observed in women (OR 3.79 [95% CI 1.69, 8.51]) but not men (OR 0.85 [95% CI 0.44, 1.66]).Conclusions:In these cross‐sectional analyses, self‐reported hearing impairment was significantly associated with frailty in women. Further research using objective hearing measures and longitudinal assessment of frailty are needed.