Short Form Research Articles

The frequency and severity of urinary incontinence symptoms in the group of adult physically active women

Aim of the study. The aim of the study was to assess the epidemiology and severity of urinary incontinence (UI) in adult physically active women. Material and methods. In order to conduct the study, a total of 171 questionnaires have been collected from physically active women aged 18+. In order to follow UI diagnostic purposes the study was based on International Consultation on Incontinence Questionnaire– Urinary Incontinence Short Form. The gathered data was analysed with the use of Microsoft Excel and IBM SPSS Statistics 29 programs. Values of p < 0.05 were considered statistically significant. Results. After analysing the study group (n = 171, av. age 33 years) authors found a total of 42.1% women reporting UI incidents during their physical activity. Highest UI occurrence was observed by the patients during their anaerobic strength training with additional loads (14.1%), running (11%) and general fitness training (8.9%). In the study we did not find a significant relation between the UI occurrence, type of activity as well as the specificity of the training. Group of women with a UI in the questionnaire was however older (av. 5 years) than those without such incident being reported (p < 0.001). At the same time those with a higher number of labours were more likely to sustain a UI compared with those who have not experienced childbirth at all (p < 0.001). Conclusions. A high UI incidence in physically active women shows the need for proper education on the matter with the emphasis on those who train specific UI susceptible disciplines.

THE NEXUS BETWEEN AGGRESSION & ACADEMIC ACHIEVEMENT AMONG STUDENTS: A GENDER-BASED CORRELATIONAL STUDY

This research attempts to analyze the relationship between aggression and academic achievement among secondary school students, with a focus on gender differences. For this research, the purposive sample of 400 students (200 boys and 200 girls) was drawn from secondary schools across all five districts of Karachi, Pakistan. The aggression questionnaire short form was used to assess the participant’s overall aggression. The sample’s academic success was assessed by percentage of most recent school examination. Pearson product-moment correlation analysis revealed overall insignificant correlation between aggression and academic achievement for combined sample. The results provide significant information in reaching conclusion and making decision. However, significant negative correlation was found between the aggression and academic achievement in girls' sample. The t-test revealed a significant gender difference in academic achievement, with girls performing better than boys. No significant gender differences were observed in aggression levels. In this connection, this study highlights the diverse factors contributing to girls’ achievements and its relationship with aggression. Similarly, some limitations and future research directions are also offered.

The Impact of Obesity in the UAE: Real-world Physician and Patient Perspectives

Background: Limited evidence exists on the impacts of obesity in the United Arab Emirates (UAE). Real-world evidence is required to support obesity-related healthcare decision-making in the UAE. Materials and Methods: The Adelphi Real World Obesity Disease Specific ProgrammeTM is a multicountry , cross-sectional survey with retrospective data capture including physicians directly involved in chronic weight management and people living with obesity (PwO) presenting to them in a real-world clinical setting. UAE data were collected between April and August 2022. Physicians completed online questionnaires reporting demographics and clinical characteristics for eligible PwO (aged ≥18 years participating in a weight management plan and/or presenting with a body mass index [BMI] ≥30 kg/m2). PwO voluntarily completed questionnaires reporting out-of-pocket costs and patient-reported outcomes: Work Productivity and Activity Impairment Questionnaire (WPAI), Short Form 36 v2 Health Survey (SF-36v2), Jenkins Sleep Evaluation Questionnaire ( JSEQ). Analyses were descriptive. Results: 41 physicians identified 201 PwO; 49% were male and 65% were of Middle Eastern origin. Mean age, BMI, and median time since obesity diagnosis were 39.1 years, 33.7 kg/m2, and 11.5 months, respectively. PwO (n = 84) reported a mean of 7.4% monthly household income spent on medicine for weight and weight-related health conditions. Mean WPAI was 35.3% activity impairment and 37.5% overall work impairment due to obesity. Generally, SF-36v2 scores were <47, indicating impairment, and mean JSEQ score was 3.6. Conclusion: PwO in the UAE had a high level of complications and measurable negative obesity-related impacts. These data may contribute to improving obesity awareness and management in the UAE.

Effects of a combined aerobic and core stabilization exercise training program on functional capacity, pain, and health-related quality of life in hemodialysis and kidney transplant patients

Background Chronic kidney disease (CKD) poses a significant public health challenge globally while impacting patients’ physical function and quality of life. Addressing the issues of physical inactivity and pain management is essential during treatment to improve health-related quality of life. The present study investigated the effect of an aerobic training program with core stabilization exercises for hemodialysis (HD) patients on a transplant waiting list and renal transplant (RTx) patients. Methods A total of 45 patients with CKD were included in the 12-week study: 25 patients receiving HD (12 HD treatment group, 13 HD control group) and 20 patients with RTx (9 RTx treatment group, 11 RTx control group). Functional capacity was measured using the 6-min walk test, pain was measured using the visual analog scale, and health-related quality of life was measured using the Kidney Disease Quality of Life–Short Form 12 questionnaire. Nonparametric statistical tests were performed at a significance level of 0.05. Results Both the HD and RTx treatment groups showed significantly reduced times for the 6-min walking test (p = 0.002 and p = 0.008, respectively), significantly reduced pain severity (p = 0.002 and p = 0.008, respectively), and significantly improved quality of life scores (p = 0.006 and p = 0.041, respectively) by the end of the study compared with control groups. Conclusion Based on the results, structured exercise programs could be effective therapies in CKD management. Therefore, health providers should promote their integration into routine care practices to enhance patient outcomes and well-being.

IMPLEMENTATION OF A VIRTUAL FALL PREVENTION PROGRAM IN OLDER VETERANS

Abstract Though virtual platforms have increased in popularity few studies have explored the implementation and benefit of a virtually-based fall prevention program. MOVing FREEly (Multicomponent Otago Virtual Falls Reduction Exercise and Education program) is a VA-based fall prevention program delivered entirely over a virtual care platform. The MOVing FREEly program is six-weeks long and includes both education in fall-risk reduction and evidence-based fall prevention exercises. Process measures captured implementation considerations, feasibility and effectiveness of the program. 27 participants who were older (mean 75 years), mostly male (89.0%), white (85.2%) and moderate or high risk of falling completed the program. 70% were new to the virtual platform. Attendance for education and exercise classes was > 80% with little attrition. There was improvement in the Falls Efficacy Scale-International short form and statistically significant improvement in 30 second sit-to-stand and single leg balance tests. Process measures indicated that 40% of participants needed extra help at the start of each class to sign-on to the virtual visit, which was provided by program facilitators. By the fourth class, all participants were self-sufficient in their ability to navigate the virtual platform. Additional considerations such as electronic health record documentation and coding; clinic setup, referral management and virtual appointment scheduling; patient privacy and health emergency planning were necessary for the start-up and sustainability of the program. Virtual fall prevention programs are feasible and effective but require careful logistical planning and considerations. Implementation considerations from this program can guide future telerehabilitation research and clinical efforts.

Effectiveness of a Multicomponent Program for Fibromyalgia Patients in a Primary Care Setting (FIBROCARE Program): A Pragmatic Randomized Controlled Trial.

Background/Objectives: Multicomponent, non-pharmacological therapies are the preferred first-line treatments for fibromyalgia (FM), but little is known about them in primary care settings. Our study assessed the effectiveness of the FIBROCARE Program in improving the quality of life, functional impact, mood, and pain of people with FM. Methods: We conducted a pragmatic, randomized controlled trial that was not blinded for both patients and the professionals delivering the treatments in the study groups. We compared a group receiving non-pharmacological multicomponent group therapy (MT) based on health education, physical exercise, and cognitive-behavioral therapy with another group receiving the usual clinical care. The MT group was treated in the primary care context in Catalonia (Spain) through 12 consecutive weekly sessions. Both groups were followed up with at the end of the MT group sessions and 6 and 12 months after the group sessions with the Short-Form 36 (SF-36) v2 Health Survey questionnaire, the Hospital Anxiety and Depression Scale (HADS-A and HADS-D), the Visual Analog Scale, and the Revised Fibromyalgia Impact Questionnaire (ClinicalTrials.gov: NCT04049006). Results: Improvements in pain intensity, functional impact, physical health, fatigue, and emotional problems that affect daily activities in the MT group lasted up to 12 months. Benefits measured by the SF-36 Mental Health dimension and the HADS-A subscale were lost after 6 months. Effects on the SF-36 Social Functioning dimension and HADS-D present at 6 months persisted for up to 12 months. Generally, the longer the time since the FM diagnosis, the better was a patient's mood. Conclusions: The FIBROCARE Program effectively improves all the studied health outcomes except patient mood, since anxiety symptoms persist. The program should reinforce patient psychological support overall, focusing particularly on the years initially after diagnosis.

The Impact of Individual and Organizational Characteristics on Work Ethics- Cross-Cultural Comparison

This study aims to analyze the effect of individual (gender and education) and organizational (organizational sector) characteristics on work ethics in the United Kingdom, Serbia, and the United Arab Emirates. This research is centered around a survey conducted among managers, from the UK, the UAE, and Serbia. Their main task was to evaluate the aspects of the Multidimensional Work Ethic Profile (MWEP) short form. The MWEP was chosen for this study as it does not explicitly address work ethics with religion, making it a suitable tool for examining work ethics across three cultures with different religious practices. This study contributes to existing literature by exploring how organizational factors influence work ethics in three countries that share business interests and have cultural and economic ties. The findings indicate that these factors have an impact on work ethics in studied countries.

Determination of Factors Associated with Glycemic Control in Women with Type 2 Diabetes: Nutrition and Physical Activity Level

Aim: Effective diabetes management is achieved with adequate glycemic control. Nutrition and physical activity have an important role in glycemic control. This study was conducted to determine the relationship between glycemic control and nutrition attitude, Mediterranean diet adherence and physical activity levels of women with Type 2 diabetes aged 20-64 years who applied to a state hospital in Konya province. Material and Methods: This correlational study was conducted with 246 women aged 20-64 years with Type 2 diabetes who applied to the Internal Medicine and Endocrinology outpatient clinics of a hospital in Konya. Individuals were selected by random sampling method. Data were collected using a questionnaire form, Attitudes Toward Healthy Eating Scale, Mediterranean Diet Adherence Scale and International Physical Activity Questionnaire Short Form (IPAQ-SF). Descriptive statistics, Chi-Square, Fisher's exact test, Kruskal Wallis test, Spearman correlation analysis and logistic regression analysis were used to analyze the data collected by face-to-face interviews. Results: In the study, glycated hemoglobin A1c (HbA1c) and fasting blood glucose (FBG) were used to assess glycemic control. 55.3% and 56.9% of the individuals had poor glycemic control in terms of HbA1c and FBG, respectively. According to logistic regression analysis, for HbA1c; having diabetes for more than 10 years (OR=0.291, 95% Cl=0.095-0.894), high triglycerides (OR=0.440, 95% Cl=0.190-1.017) and low high density lipoprotein (HDL) (OR=0.293, 95% Cl=0.114-0.753); For FBG, increased frequency of skipping medication and insulin use (OR=2.431, 95% Cl=1.090-5.424) and low HDL level (OR=0.269, 95% Cl=0.110-0.653) were significant risk factors. Among the individuals, 73.2% had a moderate attitude towards healthy eating, 46.3% had a moderate adherence to the Mediterranean diet and 60.6% were physically inactive. In addition, there was a very weak negative significant correlation (p

A novel and alternative treatment method for moderate diabetic foot ulcer: tibial periosteal distraction

ObjectiveResearchers have proposed a novel surgical treatment for moderate diabetic foot ulcer: tibial periosteal distraction (TPD) which could improve affected limb microcirculation. We aimed to describe the method and therapeutic effects of this technique.MethodsWe provided a technical guide to perform TPD surgery for the treatment of moderate diabetic foot ulcer of who had been treated in our department. The demographic information had been collected at the time of their admission. The patients were followed up at 3, 6, and 12 months after the operation with the ulcer area, skin temperature of the medial malleolus, transcutaneous oxygen pressure of the medial malleolus, ankle brachial index, dorsalis pedis artery pulsation, 12 item short form survey quality of life scale score, and visual analogue scale.ResultsA total of 35 patients with type 2 diabetes were included in this study, including 19 males and 16 females, with an average age of 62.49 ± 10.34 years and a maximum age of 87 years. The ulcers of all patients were cured, and the average healing time of ulcers was 8.09 ± 2.28 weeks, with no associated complications. The microcirculation indexes of the affected foot were significantly improved (p < 0.05). Three cases showed new vessels regeneration in the affected limbs according to their computed tomography angiography (CTA) results.ConclusionTPD surgery technique is a simple procedure that significantly increases the efficacy and reduces the complications of moderate diabetic foot ulcer patients, which could accelerate the formation of collateral circulation.

The association Malnutrition-Inflammation Score with chronic kidney disease-associated pruritus and quality of life in hemodialysis patients: a multicenter cross-sectional study

Malnutrition is prevalent among hemodialysis patients, negatively impacting their quality of life (QoL) and chronic kidney disease-associated pruritus (CKD-aP). This study investigates the association between the Malnutrition-Inflammation Score (MIS) and CKD-aP, as well as QoL, in hemodialysis patients. This cross-sectional study was conducted on 479 HD patients (279 males and 200 females) referred to eight dialysis centers. A food frequency questionnaire (FFQ), Kidney Disease Quality of Life Short Form (KDQOL-SF™), and Yosipovitch Itch Questionnaire (YIQ) were used to assess nutritional status, QoL, and CKD-aP, respectively. Anthropometric indices, body mass index (BMI), biochemical parameters, and adequacy of dialysis (Kt/V) were also measured in all patients. Significant differences were observed across MIS quartiles in terms of age, dialysis vintage, dialysis time, and urine volume (p < 0.05 for all). QoL scores showed significant differences, with the physical component score and symptoms/problems score being lower in higher MIS quartiles (p < 0.05 for all). Multivariate analyses revealed that higher MIS quartiles were significantly associated with worse QoL scores, including symptoms/problems and physical component scores, even after adjusting for confounders (p < 0.05 for all). Moreover, the pruritus VAS score, as well as the burden of kidney disease and mental component, had a significant negative association with MIS after adjusting for confounders (p < 0.05 for all). This study demonstrates that higher MIS, indicating poorer nutritional status, is associated with impaired QoL, particularly in the symptoms/problems, physical, and mental components among hemodialysis patients. However, no significant association was found between MIS and CKD-aP.

Hubungan Anemia, Tingkat Stres, Aktivitas Fisik, dan Konsumsi Makanan Cepat Saji dengan Kejadian Dismenore Primer Pada Siswi SMA IT Putri Abu Hurairah Mataram

Dysmenorrhea is severe pain in the lower abdomen during menstruation. Dysmenorrhea is one of the health problems that has a high incidence rate worldwide. The purpose of this study was to determine the relationship between anemia, stress levels, physical activity and fast food consumption with the incidence of primary dysmenorrhea in SMA IT Putri Abu Hurairah Mataram. This research is an observational analytic quantitative research with a cross-sectional study design. The population of this study were all 374 students of SMA IT Putri Abu Hurairah Mataram. The research instruments used were questionnaires in the form of WaLLID score questionnaire, DASS questionnaire, International physical activity questionnaire short form (IFAQ-SF), and Food Frequency Questionnaire (FFQ). Data were analyzed using Spearman, univariate, and bivariate tests. The results showed that (1) there was no significant relationship between anemia and primary dysmenorrhea; (2) there was a significant relationship between stress level and primary dysmenorrhea; (3) there was a significant relationship between physical activity and primary dysmenorrhea; (4) there was a significant relationship between fast food consumption and primary dysmenorrhea.

Development of the Cultural Humility Scale—Short Form (CHS-SF)

Development of the Cultural Humility Scale—Short Form (CHS-SF)

Depression Among Elderly In A Rural Area Of Tamilnadu – A Cross Sectional Study

Background: Depression is a common problem in older adults but it is not a part of normal ageing process. According to Centre for Disease Control and Prevention (CDC), 1% to 5% of the general elderly population are affected by depression. It is often misdiagnosed as many of its symptoms mimic normal age related issues. Depression in older adults may affect their daily activities, reduces their quality of life and increases their suicidal risk. Hence this study is conducted to assess prevalence of depression among elderly people in a rural population. Methods: A community based cross sectional study was conducted in a rural area of Tamilnadu among elderly people aged 60 and above using a semi-structured questionnaire containing sociodemographic details and Geriatric Depression Scale(GDS)- Short Form after obtaining informed consent from the participants. Conclusion: Among 166 participants, 42.8% had depression. Depression was more prevalent in elderly who were 80 years and above, female participants, who were economically dependent on others, living alone and widowed/separated. Depression has to be diagnosed early and promptly treated to prevent adverse outcomes.

Comparison of Attitude, Fear, and Stigma towards Psychiatric Disorders in Medical Interns of Birjand University of Medical Sciences before and after Training in the Psychiatry Department of Imam Reza Hospital

Introduction: Work and activity in the psychiatry department affect the scope of people's thinking and judgment and their performance. Considering that similar studies in this field are limited in the country and there has been no study in this field in South Khorasan province, this study aimed to compare the state of attitude, fear, and stigma towards psychiatric disorders in medical interns before and after training. It was in the psychiatric ward. Method: The present study is descriptive and comparative. Our study population was the students of the psychiatry department in the academic year 1401-1402. In this study, the abbreviated form of the OMI questionnaire was used to evaluate students' attitudes regarding psychiatric disorders, the stigma questionnaire of health care providers (OMS_HC) was used to assess stigma, and the Lerary negative evaluation short form questionnaire was used to assess fear. Results: The average score of attitude, fear and stigma among students at the beginning and end of the study was not significantly different from each other (P&gt;0.05). The average changes in attitude, fear and stigma scores according to gender, educational level, marital status, place of residence of students did not differ significantly from each other (P&gt;0.05). Conclusion: The educational programs of the psychiatry department do not lead to the reduction of astigma, fear and increase of students' attitudes compared to the beginning of the study in medical students. The training program for medical interns in the psychiatry department should be revised.

A randomised controlled pilot trial protocol for patient led cognitive gamified training during haemodialysis

Disruptions in cognitive function have been reported in individuals undergoing haemodialysis and those with chronic kidney disease. This pilot study protocol primarily assesses the feasibility and acceptability of using mobile cognitive gaming apps for patient-led cognitive training during haemodialysis sessions. The protocol consists of three phases: (1) reviewing and evaluating available cognitive gaming apps, (2) conducting focus groups/interviews with people with kidney disease to determine app preferences, and (3) undertaking a quasi-experimental randomised controlled trial to compare cognitive outcomes between a patient-led app intervention group and a standard care control group over four months. Primary outcomes will include changes in cognitive test scores [Montreal Cognitive Assessment (MoCA), Modified Mini-Mental State Exam (3MSE), Rapid Objective Working Memory Assessment (ROWMA)], while secondary outcomes will encompass quality of life measures [Patient-Reported Outcomes Measurement (PROM) Kidney Disease Quality of Life Short Form (KDQoL-SF™) v 1.3, Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health Instrument, European Quality of Life Five Dimension (EQ-5D)]. If demonstrated to be effective, this novel method of utilising gamified cognitive training applications could potentially mitigate cognitive decline and improve the well-being of people receiving haemodialysis without necessitating significant clinical resources. The findings from this research will guide the development of a larger definitive randomised trial in the future.

Effect of enhanced external counterpulsation versus individual shear rate therapy on the peripheral artery functions

In this study, we aimed to assess the effects of enhanced external counterpulsation (EECP) and individual shear rate therapy (ISRT) on peripheral artery function in patients with lower extremity atherosclerotic disease (LEAD). We randomly assigned 45 LEAD patients to receive 35 sessions of 45 min of EECP (n = 15), ISRT (n = 15), or sham-control (n = 15). Flow-mediated dilation in the brachial artery (brachial-FMD); 6-min walk distance; blood flow in the popliteal, posterior tibial, anterior tibial, and dorsalis pedis arteries; and plasma levels were measured before and after the 7 weeks treatment. 36-item Short Form Health Survey [SF-36] was analyzed before, after 7 weeks, and 3-month follow-ups. EECP treatment significantly improved brachial-FMD and quality of life, increased walking distance, and increased blood flow and the diameters of the popliteal artery and posterior tibial artery (all P < 0.01). Conversely, ISRT markedly increased blood flow in the anterior tibial artery (P < 0.05). EECP and ISRT decreased the endothelin-1 and asymmetrical dimethylarginine levels in patients with LEAD (both P < 0.01). Additionally, sVCAM-1 was significantly reduced after EECP intervention (P = 0.004). Our findings demonstrate that EECP and ISRT have beneficial effects on walking distance, quality of life, flow-mediated dilation, endothelial-derived vasoactive agents, and inflammatory and oxidative stress in LEAD patients.Date of registration: 2021-06-21. Trial registration: ChiCTR2100048086.

Knee pain and function in retired male intercounty GAA players: an exploratory study.

Knee injuries are common among elite intercounty Gaelic games players (collectively GAA players). The primary aim was to examine knee pain, function, and quality of life in retired elite male GAA players. Secondary objectives were to (i) report the incidence of previous knee surgery and total knee replacement, (ii) assess medication usage, and (iii) investigate any associations between a history of knee injury and/or knee surgery and knee pain, function, and quality of life among retired elite male GAA players. One hundred retired male senior intercounty GAA players were surveyed on their history of severe knee injury and previous knee surgery (68 completed survey; 47 Gaelic football, 20 hurling, 1 dual player). The Knee Injury and Osteoarthritis Outcome Score Physical Function Short Form (KOOS-PS) and the Patient-Reported Outcomes Measurement Information System Global Health (PROMIS-GH) were used to assess level of function and pain. Forty-seven (69%) of the retired players described experiencing at least one severe knee injury during their intercounty career. Fourteen (21%) participants retired due to a significant knee injury. Mean KOOS-SP score was 75.5 (SD 17). The Global Physical Health and Global Mental Health mean scores were 44 and 51. There was a low negative correlation between KOOS-SP scores and a history of severe knee injury (r = -0.35, p = 0.001). Moderate negative correlation between Global Mental Health scores and a history of severe knee injuries (r = -0.36, p = 0.386) and a very weak negative correlation between the number of surgeries during a participant's intercounty career and Global Mental Health score (r = -0.089, p = 0.234). Severe knee injuries and knee surgery are common among male intercounty GAA players. These injuries lead to self-reported reduced performance and retirement and are potentially associated with worse health-related outcomes post-intercounty career. Further well-designed studies, including among retired women GAA players, are required to assess the relationship between knee injuries and long-term athlete outcomes. Improved injury prevention efforts, enhanced rehabilitation of knee injuries, and post-retirement care may mitigate the adverse effects associated with severe knee injuries among male GAA players.

Implementation of Function Focused Care for Acute Care Using the Evidence Integration Triangle.

The purpose of this study was to test the impact of Function Focused Care for Acute Care Using the Evidence Integration Triangle (FFC-AC-EIT) on hospitalized patients living with dementia. This was a clustered randomized clinical trial including 12 hospitals from two states and 455 patients living with dementia. Hospitals were randomized to FFC-AC-EIT versus FFC Education Only. The mean age of the participants was 82.5 (SD = 8.5), the majority were women (62.6%), White (65.3%), married (64.4%), and had 3.0 (SD = 2.4) comorbidities. Outcome measures included the Barthel Index; the Physical Activity Survey, the Confusion Assessment Method Short Form (CAM-S), the Neuropsychiatric Inventory (NPI), and the Pain Assessment in Advanced Dementia. At discharge, both groups improved in function and physical activity, patients in the intervention group had less increase in pain than those in the control group (β = -0.58, 95% confidence interval [95% CI] (-0.89, -0.26), p < 0.001). There were no group differences in behavioral symptoms or delirium. At 1 month post-discharge there was a significant improvement in function (β = 5.55, 95% CI [0.36, 10.75], p = 0.036) and physical activity (β = 3.07, 95% CI [1.87, 4.28], p < 0.001). Exposure to information about function focused care may help staff in acute care settings maintain and increase function and physical activity for older patients living with dementia during the hospital stay and help facilitate an increase in function and physical activity after discharge.

Information and Access for Safe Narcotic Disposal: A Cluster-Randomized Trial Among Pediatric Orthopaedic Surgical Patients in Los Angeles County

Introduction: Greater than two-thirds of individuals report unused opioids following surgical procedures. The need for improved prescribing practices notwithstanding, efforts to improve safe narcotic disposal are requisite to decreasing aberrant narcotic availability and opioid-related hospitalizations. This study aimed to evaluate the additive efficacy of education and access to DEA-compliant narcotic return receptacles on narcotic disposal rates among pediatric orthopaedic surgical patients. Methods: From July 2021 to July 2023, patients aged 5 to 17 years at two disparate sites were recruited for enrollment. Cluster randomization was done weekly to determine whether education was given on safe narcotic disposal versus standard discharge instructions. Halfway through the study, narcotic disposal receptacles were introduced as an additive intervention. Postoperatively, participants were asked to self-report opioid disposal rates and complete the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference Short Form to gauge pain control. Two sample z test of proportions and Fisher exact tests were used to compare disposal rates from both the isolated and combined interventions. Results: Analysis was restricted to 131 of 576 total patients: 44 (33.6%) disposed of unused narcotic medications and 87 (66.4%) did not. No notable difference was observed in disposal rates between those who received education or not (28/70 [40.0%] vs. 16/61 [26.2%], P &gt; 0.05) and those who had bin access or not (18/59 [30.5%] vs. 26/72 [36.1%], P &gt; 0.05). Furthermore, no notable difference was found between the control group and combination intervention group receptacles (6/25 [24.0%] vs. 8/23 [34.8%], P &gt; 0.05) or the education only and combination intervention group (20/47 [42.5%] vs. 8/23 [34.8%], P &gt; 0.05). Discussion: Neither preoperative education alone nor the addition of convenient disposal bins improved narcotic disposal rates following surgery. Conclusion: Retention rates remained high despite either intervention. Therefore, efforts to decrease narcotic availability must be nuanced and multimodal. Further studies may investigate the role of longitudinal patient education to better influence risk perception and subsequent behavioral changes.

The Chronic Headache Self-Efficacy Scale: Development and assessment of measurement properties.

To develop and assess the psychometrics of the Chronic Headache Self-Efficacy Scale (CHASE). Existing scales assess self-efficacy in coping strategies and management of symptoms and triggers but do not measure other important self-efficacy domains, such as performing daily activities and socializing in patients with chronic daily headache (CDH). The study had two phases: (i) Development of the 14-item CHASE, with items derived from patients with CDH and a multidisciplinary healthcare team; (ii) longitudinal observational study for psychometric evaluation. Participants with CDH (N = 79) completed the CHASE, Headache Management Self-Efficacy Scale (HMSE), six-item Headache Impact Test-6 (HIT-6), and 12-item Short Form Health Survey (SF-12) at baseline, 24-72 h after baseline, and 12 weeks after baseline. The Global Rating of Change (GROC) assessed perceived change in symptoms. We assessed internal consistency, day-to-day reliability, convergent and known group discriminant validity, dimensionality, and responsiveness via minimal clinical important difference (MCID). For day-to-day reliability, the CHASE intraclass correlation coefficient was 0.68 (95% confidence interval 0.49-0.81), with standard error of measurement and minimal detectable change of 10.3% and 24%, respectively. The CHASE had two independent factors (total R2 = 54.5%) that can be combined into a single score (Cronbach's alpha internal consistency 0.88). For convergent validity, the CHASE score was related to the HIT-6, HMSE, and SF-12 (R2: 0.17-0.29, all p < 0.001). For known group discriminant validity, individuals with an active headache had a lower CHASE score than those without (mean [standard deviation] 47.7 [17.3]% vs. 57.2 [19.8]%, p < 0.001). Classification and regression tree analysis showed the MCID for meaningful positive symptom change on the GROC was a CHASE change of >8% or CHASE change of 8% with baseline CHASE >67%. The CHASE is a reliable and valid questionnaire for assessing self-efficacy in performing daily activities, socializing, managing headache symptoms and triggers, and guiding treatment plans for patients with CDH.