Subscale Scores Research Articles

Effect of virtual-reality-based education program for managing behavioral and psychological symptoms of dementia: A randomized controlled trial

This study aims to evaluate the effect of the virtual-reality-based education program (VR-EduBPSD) for managing behavioral and psychological symptoms of dementia (BPSD). Sixty-six family caregivers of people with dementia were randomly assigned to either the experimental or control group following a 1:1 ratio. The experimental group received VR-EduBPSD while the control group received analogous paper-based educational materials. The outcome measures were competence in managing BPSD, dyadic relationship, caring self-efficacy, attitudes toward dementia, and behavior management skill. Only the ‘awareness of symptoms’ sub-scale score for competence in managing BPSD showed a significant group-by-time interaction. Significant time effects were also observed on the total and sub-scale scores for competence in managing BPSD, as well as on the dyadic relationship. This program, which utilizes high-immersion VR technology, offers a valuable learning experience for those new to the care of people with dementia. This study was registered at cris.nih.go.kr with number of KCT0006788.

Symptoms and atrial fibrillation burden measured by an insertable cardiac monitor in endurance athletes

Abstract Background Atrial fibrillation (AF) is the most common cardiac arrhythmia in athletes, but knowledge regarding AF burden, symptoms and quality of life (QoL) in endurance athletes with AF is limited. Purpose To study AF burden by continuous monitoring using insertable cardiac monitor (ICM), AF symptoms and QoL in endurance athletes with paroxysmal AF. Methods In endurance athletes diagnosed with paroxysmal AF who reported ≥2 episodes of AF, of which ≥1 during the past six months, we continuously monitored AF using ICM. Episodes recognized as AF by ICM were validated by a cardiologist. We defined AF burden as the cumulative duration of AF episodes lasting ≥30 secs divided by the total duration of monitoring. AF symptoms were assessed using the 21-item Atrial Fibrillation Effect on QualiTy-of-Life Questionnaire (AFEQT). AFEQT produces a summary score and three subscale scores (symptoms, daily activities, treatment concerns), ranging from 0 (complete AF-related disability) to 100 (no AF-related disability). We defined any score <80 as clinically relevant AF symptoms. We classified athletes according to the modified European Heart Rhythm Association (mEHRA) classification. Sport participation was obtained by questionnaires. Height and weight were measured and physical fitness was examined during cardiopulmonary exercise testing. Results A total of 38 athletes (3 female, 8%) were included. Table 1 shows their characteristics. Eight of the athletes (21%) had recurrent AF after previous AF ablation therapy. ICM recordings were available in 30 athletes who were monitored for an average of 53±21 days (mean±SD). Eighteen athletes (60%) had ≥1 AF episode, the median number of AF episodes was 2 (interquartile range 8.75), and the mean AF burden was 1.4±2.5%. The mean AFEQT summary score was 84±12 and 11 athletes (29%) had an AFEQT summary score <80. The mean AFEQT symptom subscale score was 78±18). While 21 athletes (55%) had a symptom subscale score <80, indicating clinically relevant symptomatic AF, 9 (24%) scored <60, indicating more severely symptomatic AF. Figure 1 shows ICM-detected AF burden across categories of mEHRA classes and categories of the AFEQT summary score. The AF burden corresponded to both AFEQT scores and mEHRA categories, with a higher AF burden associated with more symptomatic AF (Figure 1). AF burden was numerically lower in athletes with recurrent AF after previous AF ablation therapy, compared to athletes previously not treated with AF ablation (0.6% vs. 1.7%, p= 0.66), but previously ablated athletes were more symptomatic (AFEQT symptom subscale score 68 vs. 80, p= 0.04). Conclusions Despite a relatively low AF burden during continuous monitoring with ICM, a majority of the athletes had clinically relevant symptomatic AF. Athletes with recurrent AF after previous ablation therapy had a numerically lower AF burden, but were more symptomatic compared to athletes with paroxysmal AF not previously treated with AF ablation.

Special Series on the Wechsler Adult Intelligence Scale-IV Performances in Five Asian Countries: Summary of Findings, Clinical Implications, and Future Directions.

This special series of exploratory studies compared WAIS-IV performances in five Asian countries: Japan, South Korea, Taiwan, India, and Indonesia with the U.S. The studies examined cognitive profiles across age groups to develop hypotheses on how culture can impact cognition. This summary article integrates the findings from each study to determine similarities and differences across Asian countries and proposes possible underlying cultural factors impacting cognition. In each study, raw scores corresponding to a subscale score of 10 were scored with U.S. norms across all age groups. Index scores were calculated with the adjusted scale scores. The impact of education on test performances was determined by correlating WAIS-IV scores with a ratio of educational attainment for each country with the U.S. for each age group. Findings from each country were then integrated to develop hypotheses on cultural factors that impacted cognitive profiles. East Asian countries (Japan, South Korea, Taiwan) demonstrated weaker Verbal Comprehension Index scores and stronger Processing Speed Index scores than the U.S. sample, although the latter was moderated by age. East Asian countries demonstrated stronger performances on Perceptual Reasoning versus Verbal Comprehension tests. East Asians and the Java subset of the Indonesian sample demonstrated a pattern of stronger performances in younger versus older cohorts which was significantly correlated with educational attainment. Cultural factors impacting cognition were proposed. Clinical implications of the findings were discussed and directions for future studies to examine the relationship between culture and cognition were recommended.

The relationship between anxiety and diet quality in adolescent populations: a cross-sectional analysis.

Globally, more than 13 % of adolescents have clinically significant mental health problems, with anxiety and depression comprising over 40 % of cases. Despite the high prevalence of anxiety disorders among youth, dietary research has been focused on youth with depression, resulting in a significant knowledge gap regarding the impact of anxiety on adolescent diet quality. Adolescents with diagnosed anxiety disorders and healthy controls were included in this study. Anxiety symptoms were measured using the Screen for Child Anxiety-Related Disorders. Diagnosis of anxiety disorder was determined using the Kiddie Schedule for Affective Disorders and Schizophrenia interview. Five diet quality indices were scored from FFQ. Diet quality indices associated with anxiety symptoms in the correlation matrix were interrogated using multiple linear regression modelling. All models were adjusted for depression. One hundred and twenty-eight adolescents (mean age 14·8 years (sd: 2·1); 66·4 % female) were included in this cross-sectional analysis. Although healthy controls and outpatient participants had similar unhealthy dietary index subscale scores, outpatient participants had lower healthy index scores. Higher anxiety symptoms were associated with lower healthy dietary indices in univariate analysis; after adjusting for comorbid depression; however, anxiety symptoms were no longer associated with dietary indices following adjustment for multiple testing (P = 0·038 to P = 0·077). The association between anxiety symptoms and a poor diet is attenuated by depression. The results of this study support the need for an integrated approach to the assessment of mental and physical well-being and further research aimed at understanding the unique contribution of depression to healthy dietary patterns.

Impact of prior knee surgery on change in knee pain, quality of life, and walking speed following supervised education and exercise therapy: an analysis of 30,545 people with knee osteoarthritis.

To investigate the impact of prior knee surgery on changes in outcomes following an 8-week supervised patient education and exercise therapy program in patients with knee osteoarthritis. Patients were classified according to knee surgery in the most affected knee joint (yes/no) prior to enrolment in the Good Life with osteoArthritis in Denmark (GLA:D®) program. Between-group differences in outcome changes from baseline to 3 months follow-up were evaluated using linear regression stratified by sex. Outcomes were knee pain intensity (VAS, 0-100 mm), joint related quality of life (Knee Injury and Osteoarthritis Outcome Score Quality of Life subscale score (KOOS QOL, 0-100)) and walking speed (40-m fast-paced walk test). To evaluate clinically relevant between-group differences, proportions of patients reaching a threshold of minimal important change in the surgery and non-surgery groups were compared. Among 30,545 patients, 27% (n, 8254) had prior surgery in the most affected knee. The prior surgery and the non-surgery group experienced improvements in all outcomes with minor between-group differences in change in pain intensity (males, 0.03 95% CI - 0.9 to 1.0; females, 1.3 95% CI 0.6 to 2.1); KOOS QOL (males, 0.3 95% CI - 0.4 to 0.9; females 0.02 95% CI - 0.5 to 0.5); and walking speed (males, 0.01 95% CI - 0.01 to 0.02; females 0.01 95% CI 0.003 to 0.02). The responder analysis showed no clinically relevant between-group differences in improvements. Previous knee surgery does not seem to modify the clinical outcome following exercise therapy and patient education in patients with knee osteoarthritis.

Associations between genotype, phenotype and behaviours measured by the Rett syndrome behaviour questionnaire in Rett syndrome

IntroductionRett syndrome (RTT) is a rare neurodevelopmental disorder with developmental impairments, comorbidities, and abnormal behaviours such as hand stereotypies and emotional features. The Rett Syndrome Behaviour Questionnaire (RSBQ) was developed to describe the behavioural and emotional features of RTT. Little is known how RSBQ scores are associated with genetic and clinical characteristics in RTT. This study investigated relationships between genotype, age, walking, hand function, sleep, and RSBQ total and subscale scores in RTT.MethodsThis is a cross-sectional analysis of data collected in the Australian Rett Syndrome Database and the International Rett Syndrome Phenotype Database. Parent caregivers completed the RSBQ and Sleep Disturbance Scale for Children [subscales for disorders of initiating and maintaining sleep (DIMS), disorders of excessive somnolence (DOES)], and provided information on age, variant type, functional abilities (mobility, hand function), seizure frequency and gastrointestinal problems. Associations between the RSBQ scores and the independent variables were modelled using linear regression.ResultsData were available for 365 individuals with RTT [median (range) age 17.8 (2.9–51.9) years, 2 males]. Compared to adults, 2- to 12-year-old children had higher mean Total, Night-time Behaviour and Fear/Anxiety scores. Compared to individuals with a C-terminal deletion, individuals with the p.Arg255* variant had higher mean Total and Night-time Behaviours scores, whereas the p.Arg294* variant had higher mean Mood scores. Individuals with intermediate mobility and hand function abilities had a higher mean Total score. Total RSBQ and subscale scores were similar across categories for seizures, constipation, and reflux, but were higher with abnormal DIMS and abnormal DOES scores.ConclusionExcept for associations with sleep, the RSBQ measures the behavioural phenotype rather than clinical severity in RTT, as traditionally conceptualised in terms of functional abilities and comorbidities. When designing clinical trials, the RSBQ needs to be complemented by other outcome measures to assess specific core functions and associated comorbidities in RTT.

A long-term follow-up study of gastric peroral endoscopic myotomy (G-POEM) in a large cohort of patients with postsurgical gastroparesis.

Postoperative gastroparesis occurs after surgeries which affect the upper digestive tract. Gastric peroral endoscopic myotomy (G-POEM) is a treatment for postoperative gastroparesis. The present study boasts the long-term efficacy and safety of G-POEM in a large cohort of patients. Gastroparesis Cardinal Symptom Index (GCSI) and Gastroesophageal Reflux Disease Questionnaire (GERDQ) were utilized for the assessment of postsurgical gastroparesis symptoms. Gastroscope was used to observe the anastomotic site. Three-dimensional ultrasound was used to measure the morphological structure of the gastric antrum and pylorus tube. Gastric emptying time was calculated by analyzing the volume change of gastric antrum. Significant clinical effectiveness of G-POEM was observed. The GCSI score, including each subscale score, showed significant decrease after G-POEM. Before G-POEM, there was a negative correlation between GCSI score and the inner diameter of pylorus, as well as a positive correlation with the length of pyloric tube. The similar results were found in the scores of nausea/vomiting and postprandial fullness/early satiety subscales. No correlation was observed between GCSI score and the emptying time, nor between the emptying time and the parameters of antrum morphology. After G-POEM, no correlation was found between GCSI (including subscales) score, the emptying time, and the parameters of antrum morphology. Patients who exhibited as clinical non-responders often accompanied with GERD symptoms. After G-POEM, the score of GERDQ decreased significantly. Either before or after G-POEM, no correlation was noticed between GERDQ scores, the emptying time and the parameters of antrum morphology. The technique of G-POEM was demonstrated as a minimally invasive approach with the long-term efficacy and safety in therapying postoperative gastroparesis.

85 Improving children and families healthcare experiences through a Community Social Paediatrics model

Abstract Background The clinical presentation of children with referrals related for behavioral and school difficulties is often complex and involves environmental and psychosocial components in addition to medical considerations. Collaborative, team based, holistic and integrated approaches are standard of care for many medically complex conditions but less emphasized for what is considered more general presentations in Paediatrics. Given the complexity of patients presenting with challenging behaviors, an integrated approach should be considered as a patient centered and efficient model of care. Objectives The aim of this study was to determine if using a Community Social Paediatrics (CSP) model with an interdisciplinary team can improve experiences and outcomes for families of children being assessed for challenging behaviors who also have complex psychosocial considerations. Design/Methods This pre-post study recruited families with children who had received behaviour-related Paediatric referrals. Participants received the standard of care and additional resources typical to a CSP model, including support from a social worker, home visits, and referral/funding for clinically indicated therapeutic services such as occupational therapy. Three measures were used to evaluate the experience and outcomes of patients and families prior to intake and after 12 months of care: Paediatric Integrated Care Survey (PICS), Child Behaviour Checklist (CBCL), and Quality of Relationship Inventory (QRI). Descriptive analyses of demographics and subscale scores were conducted. Paired t-tests were conducted to detect significant changes in subscale scores across time points. Results In total, 31 caregivers completed the intake assessment and 26 of these completed the follow-up assessment for their children, who were between the ages of 5 to 14 at the time of intake. The QRI scores, which assessed the child-caregiver relationship, indicated a significant decrease in the conflict subscale between timepoints (M1=2.23, M2=1.87, p<0.005). Similarly, the CBCL scores indicated significant reductions in aggressive behaviour (M1= 68.65, M2= 64.77, p<0.05) and conduct problems (M1= 68.69, M2= 62.31, p<0.05). The PICS scores indicated families reported fewer access problems (M1= 3.35, M2= 1.19, p<0.005), and better communication with health care providers (M1= 14.53, M2= 16.92, p<0.05). Conclusion Findings indicate that aspects of the family experience and child outcomes were significantly improved after receiving care through the CSP model. In particular, the reduction of caregiver-child conflict, aggressive behaviour, and conduct problems may indicate that the child’s needs are being more effectively met, thus reducing conflict at home and school. Paediatricians should strongly consider an interdisciplinary model when seeing children for behavioral referrals. This may be especially true for those with complex psychosocial needs.

Assessing the utility of a telehealth autism spectrum disorder assessment battery including the TELE-ASD-PEDS and the BASC-3

Objectives The goal of this research was to examine aspects of utility of an autism diagnostic tool created for telehealth use: the TELE-ASD-PEDS. This research also assessed associated clinical characteristics related to other behavior scales commonly used to assess children. Three hypotheses were examined: (1) Children with different diagnoses will have different scores on the TELE-ASD-PEDS; (2) There will be a positive correlation between the TELE-ASD-PEDS total score and the clinical subscales of the Behavior Assessment System for Children, 3rd edition (BASC-3); and (3) There will be a negative correlation between the TELE-ASD-PEDS and other selected subscales of the BASC-3. Methods Participants included children referred to a rural, Appalachian, state-funded, autism diagnostic clinic. A one-way ANOVA was conducted to compare TELE-ASD-PEDS scores with diagnoses received. TELE-ASD-PEDS scores and BASC-3 subscale scores were compared through bivariate correlation. Results When compared to the Autism group, both the Rule Out and the No Autism groups had lower scores on the TELE-ASD-PEDS. The BASC-3 subscale Withdrawal had a positive correlation with the TELE-ASD-PEDS. Finally, the adaptive subscales in the BASC-3 Social Skills, Functional Communication, and Activities of Daily Living had negative correlations with the TELE-ASD-PEDS. Conclusions Current data provided partial support for all hypotheses.

A real-world study on the clinicopathological profile, treatment outcomes and health-related quality of life, anxiety and depression among patients with desmoid tumor at two tertiary care centers in India

BackgroundThe medical management of DT comprises tyrosine kinase inhibitors (TKIs), hormonal agents, anti-inflammatory drugs with the recently approved gamma secretase inhibitor nirogacestat being the current standard of care. Real-world data on evolving treatment landscapes of DT remains scarce.MethodsThis is a retrospective study of patients with DT registered between 1995 and 2020 at All India Institute of Medical Sciences, New Delhi and Tata Medical Center, Kolkata. Baseline characteristics were analyzed in form of median values and interquartile range. Categorical and continuous variables were compared by chi square and independent samples T- tests respectively. Anxiety, depression and QoL were prospectively measured among 30 patients using Hospital Anxiety and Depression (HADS) and Functional Assessment of Cancer Therapy-General (FACT-G) scales respectively between 2022 to 2023.Results200 patients were included with a male-predominant (n=111, 55.5%) population and median age 26.5 (2.5-75) years. Extremity (n=100, 50%) and abdomen (n=65, 32.5%) were commonest primary sites and median of 2 (1–4) lines of treatment were received. First-line included surgery (n=116, 58%), systemic therapy (n=67, 33.5%), radiotherapy (10, n=5%) and active surveillance (n=7, 3.5%). First-line systemic agents included tamoxifen (n=55, 27.5%), imatinib (n=7, 3.5%), sorafenib (n=1, 0.5%) and chemotherapy (n=4, 2%). 2019 onward, 3% and 63% underwent active surveillance and surgery respectively. Best radiological response obtained with tamoxifen was stable disease (SD) (n=76, 59%) and partial response (PR) (n=31, 24.2%). Best radiological response obtained with sorafenib was PR (n=17, 60.7%) and SD (n=9, 32.1%). Thirty patients underwent HADS and FACT-G scale assessment. Mean HADS-Anxiety subscale score was 3.6 (+/-3.9 SD) and HADS-Depression sub-scale score was 2.6 (+/-3.5 SD) with clinically significant anxiety and depression in 2 (6.7%) patients each. The overall mean FACT-G score was 87.5 (+/-12.6 SD) and lower mean physical well-being (p=0.006) and emotional well-being (0.017) scores were significantly associated with higher HADS-anxiety (>/=8) scores.ConclusionsAssessment of anxiety, depression and QoL are paramount to gauge the psychological impact of DT. This study gives an overview of clinical and management profile of patients with DT in India, with limitations of selection bias, heterogeneous population and small sample size for QoL assessment.

Trapeziometacarpal total joint arthroplasty, with or without supervised hand rehabilitation: A quasi-experimental trial

Introduction Aim of this study was to determine whether postoperative supervised rehabilitation improves functional outcomes after trapeziometacarpal (TMC) total joint arthroplasty (TJA), compared to education alone. Method A quasi-experimental before-after trial included 31 women (≥40 years) per group diagnosed with trapeziometacarpal osteoarthritis who underwent TJA. A cohort ( n = 31) who was given education alone was compared to a cohort ( n = 31) who were subjected to supervised rehabilitation. Primary outcome was the difference in hand function 3 months postoperatively, measured by the Michigan Hand Outcomes Questionnaire (MHOQ). Other outcomes were the MHOQ subscale scores, the active range of motion, strength, time to return to work, satisfaction and complications. Results Patients in the education group had a significantly higher median delta MHOQ score when compared to the rehabilitation group at 3 months; 28.5 (20.5-31.3) versus 15.8 (1.9-21.1), ( p = <0.01) and at 12 months 36.6 (26.8 - 47.2) versus 27.4 (14.5 - 33.0), ( p = 0.01). Only the secondary outcomes the MHOQ subscales hand function, ADL and satisfaction revealed significant differences in favor of the education group. The education method reduced the median number of hand therapy sessions with eight visits. Conclusion The present study does not show a significant or clinically relevant benefit from supervised rehabilitation in terms of functional outcomes following TJA compared to education alone. Based on this, it seems safe to leave patients unsupervised in their recovery following TJA and to suffice with just education, however further exploration of effectiveness and safety of this intervention is recommend in larger trials.

Validating scores from the short form of the Music Self-Perception Inventory (MUSPI-S) with seventh- to ninth-grade school students in Germany

The Music Self-Perception Inventory-Short (MUSPI-S) is a theoretically based instrument consisting of 28 items with subscales that assess music self-concept globally and in six specific areas. The present study sought to validate a German translation of the MUSPI-S using a sample of 444 secondary school students. In addition to participants’ scores from the German translation of the MUSPI-S, associated data included demographic background variables, self-reported school grades in various subjects, and interest in the school subject of music. Confirmatory factor analyses supported the hypothesized factor structure and measurement model for MUSPI-S scores. Latent factor correlations among MUSPI-S subscale scores and correlations of these scores with school grades and interest in the school subject of music aligned well with theoretical expectations and previous research. Findings also provided evidence for strict measurement invariance of scores in the German MUSPI-S across subgroups of gender, school year (i.e., grade level), and musical activity. MUSPI-S subscale factor-level means did not reliably differ among seventh-, eighth-, and ninth-grade students but favored females over males and musically active over non-active students on nearly all subscales. Overall, this evidence supports the use of the German translation of the MUSPI-S in assessing a wide range of important self-perceived musical abilities for research and practical assessment purposes.

Quality of Life After Microvascular Alveolar Ridge Reconstruction with Subsequent Dental Rehabilitation

Background/Objectives: Defects in maxillary and mandibular alveolar ridges are common in maxillofacial practice. Reconstruction with microvascular bone grafts and subsequent prosthetic rehabilitation is the gold standard treatment. This study investigated patients’ quality of life (QoL) after microvascular alveolar ridge reconstruction with subsequent dental rehabilitation. The effect of the underlying disease and success rates of the prosthetic treatment on QoL were analysed. Methods: OHIP-49 was used to evaluate oral health-related QoL (OHrQoL). The SF-36 was used to assess disease-nonspecific QoL. Results: Fifty-eight patients were enrolled and divided into four diagnostic (malignancy, osteoradionecrosis, benign disease, and cleft palate) and five prosthetic groups (no prosthetics, removable partial dentures, complete dentures, implant-supported removable dentures, and implant-supported fixed dentures). There was a significant difference between the diagnostic groups in the total score of their OHIP-49 (p = 0.008). Patients with malignant disease and osteoradionecrosis had worse QoL scores than those with benign diseases and cleft palate. Implant-supported prostheses had the best OHrQoL. Removable partial dentures and patients in whom dental rehabilitation was not possible had the worst OHrQoL (p = 0.042). The SF-36 subscale score showed no statistically significant differences between the diagnostic and prosthetic groups (p > 0.05). Conclusions: OHrQoL after microvascular alveolar ridge reconstruction differs significantly based on underlying diagnoses and prosthetic restorations. Benign diseases and implant-supported dentures have the highest scores.

Platelet-Rich Plasma Injections Do Not Improve the Recovery After Arthroscopic Partial Meniscectomy: A Double-Blind Randomized Controlled Trial.

Arthroscopic meniscectomy is one of the most performed surgical procedures in orthopaedics. Different approaches have been proposed to improve patient recovery but with unsatisfactory results. Platelet-rich plasma (PRP) augmentation has been proposed as a strategy to improve the recovery after meniscectomy. To investigate the clinical benefits of an intra-articular PRP injection after meniscectomy, in terms of faster and better patient recovery. Randomized controlled trial; Level of evidence, 1. Ninety patients were randomized into a treatment group, with arthroscopic partial meniscectomy immediately followed by a 5-mL injection of autologous conditioned plasma, and a control group with partial meniscectomy alone. Patients were evaluated at baseline and at 15, 30, 60, and 180 days of follow-up with the visual analog scale (VAS) score for pain (primary outcome), as well as with International Knee Documentation Committee subjective score, Knee injury and Osteoarthritis Outcome Score subscales, Tegner score, and EuroQol-Visual Analog Scale score. Objective evaluation was performed analyzing knee range of motion and circumference and the International Knee Documentation Committee objective score. Complications, patient judgment, and satisfaction were documented as well. No major complications and an overall significant improvement in the clinical scores were observed in both groups. Overall, the comparative analysis did not demonstrate significant between-group differences in absolute values or improvements of both subjective and objective scores, as well as activity level. The improvement in terms of VAS pain score for the treatment group was significant already at 15 days (from 4.3 ± 2.5 to 2.5 ± 2.5; P = .014), while in the control group it became significant at 30 days (from 3.7 ± 2.3 to 2.0 ± 2.4; P = .004). No significant differences were observed between the 2 groups in terms of judgment of treatment results and satisfaction. A single postoperative injection of PRP was not able to significantly improve patient recovery after arthroscopic partial meniscectomy. PRP augmentation did not provide overall benefits at a short-term follow-up (6 months) in terms of pain relief, function, objective parameters, and return-to-sport activities. NCT02872753 (ClinicalTrials.gov identifier).

THE EFFECT OF EXERCISES OF DIFFERENT INTENSITY APPLIED AFTER TOTAL KNEE ARTHROPLASTY ON POST-OPERATIVE PAIN: RANDOMIZED CONTROLLED TRIAL

Purpose: This study aimed to investigate the changes in pain following exercise sessions with different intensities in patients who underwent total knee arthroplasty (TKA). Methods: This is a repeated measure and single-blinded randomized controlled study. Thirty-six patients who underwent TKA (age, 64.9 ± 7.42 years) were randomly assigned to either low-intensity exercises (LIEs) group or high-intensity exercises (HIEs) group. Exercise programs lasted for five days during the hospitalization period. Pain intensity was assessed by visual analog scale (VAS) and pressure pain thresholds (PPTs) were measured over quadriceps and biceps brachii and muscles immediately before and after exercise. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) subscale (pain, stiffness, and physical function) scores were recorded at two points in baseline and discharge from the hospital. Results: The pain intensity decreased in patients in both groups after TKA. PPTs increased in both groups at all tested sites following the first, third, and fifth exercise bouts. HIE program had a greater positive effect on the pain intensity after the first exercise session than LIE program on the PPTs ([Formula: see text] < 0.05). HIE program was more effective in order to reduce pain severity immediately after the exercise sessions in patients ([Formula: see text]: 0.5, [Formula: see text] < 0.05). WOMAC scores significantly improved in both groups during the discharge from the hospital ([Formula: see text] = 0.001). Conclusion: Our results found that both LIE and HIE programs performed during hospitalization after TKA declined pain intensity. Particularly notable were the substantial improvements observed in managing post-operative pain, especially following the second exercise session. The HIE program proved more effective in improving stiffness, and enhancing physical function.

Differences in eating behaviours and mothers attitudes between baby-led weaning vs. traditional spoon-feeding approaches in Türkiye.

This study was aimed to examine the differences in eating behaviours and mothers attitudes between baby-led vs. traditional spoon-feeding approaches and its effect on eating behaviours in preschool children. The study was conducted with 150 mothers of children aged 2-6, who applied to the Pediatrics Polyclinic of Başkent University Ankara Hospital, between December 2022 and February 2023. Sociodemographics, biochemical parameters were recorded to form. Maternal attitudes and eating behaviours of children were evaluated with Mother's Attitudes Towards the Feeding Process Scale (MATFP) and Early Childhood Adaptive Eating Behaviour Scale (ECAEB), respectively. The mean age of the children was 43.80±11.04 months and 51.3% of them were girls. A weak negative correlation was found between the ECAEB total scores and the child age (r=-0.196, p<0.05). A moderate positive correlation was found between the total scores of the MATFP and ECAEB (r=0.699, p<0.001). There wasn't significant difference between the MATFP total scores who chose baby-led weaning or traditional feeding (p>0.05). According to the ECAEB; aggression and reaction to main meal order subgroup scores of children who consumed pureed vegetables until the ninth month were higher than those who didn't consume them (p<0.05). Mothers who prefer the TSF offer their babies more blenderized and pureed foods, while those who prefer the BLW serve fork-mashed, steamed and sliced foods (p<0,05). As the mothers' subscale scores for negative affect during meals, attitudes about insufficient/unbalanced feeding, negative feeding strategies, forced feeding, reaction to viewpoint of others increase, so did their subscale scores for child reluctance, eating refusal associated with sensory causes, aggression, reaction to main meal order increase. Consequently, it's believed that maternal attitudes and actions should be taken into account while evaluating the eating habits of toddlers.

Psychometric Properties of the German Version of the Benzodiazepine Dependence Self-Report Questionnaire

AbstractTo facilitate measurement and screening of benzodiazepine/Z-drug dependence, the Dutch “Benzodiazepine Dependence Self-Report Questionnaire” was translated into German (Bendep-SRQ-GV) and psychometrically evaluated. A cross-sectional online study with 343 benzodiazepine/Z-drug users was conducted. Structural validity and reliability were assessed using confirmatory factor analysis, while convergent validity was evaluated through correlation and receiver operating characteristic analyses with the “Severity of Dependence Scale” (SDS). Furthermore, the use of simple sum subscale and total scale scores was reviewed. A model with four first-order factors and one second-order factor fitted the data best. The questionnaire showed good to excellent reliability. The scores correlated satisfactorily with the model-based factor scores and the SDS, indicating good convergent validity and supporting the use of simple sum scores. The study provided strong evidence for the validity and reliability of the Bendep-SRQ-GV as a measure of benzodiazepine/Z-drug dependence, which represents a significant step towards developing a multidimensional screening tool.

Initial examination of use of the Brief Observation of Social‐Communication Change (BOSCC) across home and school contexts

AbstractThis study investigated the potential influences of administration context on the measurement of child skills. The Brief Observation of Social‐Communication Change (BOSCC) was administered at two time points to preschool‐aged children with autism in two contexts: (1) at school by trained research staff and (2) at home by the parent. Participants were of ages 3–5 years (M = 4.27 years) old with a confirmed diagnosis of Autism Spectrum Disorder. Of the 13 participants (nine male), eight were White, three Asian, one Black and one White/Black; all identified as non‐Hispanic. The social‐communication and Core total scores yield similar information in both contexts, but Restricted and Repetitive Behaviors and Other Abnormal Behavior subscales scores were not related. These results underscore the importance of purposeful selection of measures and their administration context.

Improved Pain, Morning Stiffness, and Fatigue With Bimekizumab in Axial Spondyloarthritis: Results From the Phase III BE MOBILE Studies.

To assess the effect of bimekizumab on pain, morning stiffness, and fatigue in patients with nonradiographic and radiographic axial spondyloarthritis (axSpA) in the phase III BE MOBILE studies (ClinicalTrials.gov: NCT03928704 and NCT03928743). Patients were randomized to bimekizumab 160 mg or placebo every 4 weeks; and all patients received bimekizumab from week 16. Patients reported spinal pain, peripheral pain, morning stiffness, and fatigue to week 52. Total and nocturnal spinal pain were each assessed on a 0-10 numerical rating scale (NRS). Individual Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) items (0-10-point NRS) assessed peripheral arthritis pain (question [Q] 3), enthesitis pain/discomfort (Q4), morning stiffness (mean of Q5 and Q6), and fatigue (Q1). Functional Assessment of Chronic Illness Therapy Fatigue subscale score (FACIT-Fatigue) is also reported. At week 16, bimekizumab-treated patients reported lower mean nocturnal spinal pain, total spinal pain, and BASDAI scores (nominal except for nocturnal spinal pain; all P ≤ 0.001), as well as higher FACIT-Fatigue scores (nominal P < 0.05) vs placebo, indicating improved symptom levels. Improvements continued to week 52 in continuous bimekizumab-treated patients and in placebo-bimekizumab switchers. A higher proportion of bimekizumab- vs placebo-randomized patients achieved increasingly stringent thresholds for low spinal and peripheral pain at week 16; this was sustained or improved at week 52. Results were similar for morning stiffness and fatigue. At week 52, over half of patients were considered FACIT-Fatigue responders (≥ 8-point increase in score). Bimekizumab treatment led to rapid improvements in levels of pain and morning stiffness. Substantial improvements were seen in all domains across the full disease spectrum of axSpA and continued to week 52.

Psychopathologic Evaluation in Patients With Nasal Bone Fractures.

Background: Nasal bone fractures are pretty common. The most common causes include interpersonal violence, traffic accidents, sports injuries, and falls. This study aimed to assess patients presenting with nasal bone fractures not only for nasal trauma but also for personality disorders, impulsivity, and attention-deficit/hyperactivity disorder (ADHD) using psychiatric questionnaires. Methods: The study included 41 patients, and the control group consisted of 43 volunteers without nasal bone fracture; neither the patients nor the volunteers had previously been diagnosed with or treated for psychiatric disorders. The psychiatric questionnaires administered were the Eysenck Personality Questionnaire Revised-Short Form (EPQR-S), the Barratt Impulsivity Scale-Short Form (BIS-11-SF), and Turgay's Adult ADD/ADHD DSM-IV-based Scale. Results: The most common cause of nasal bone fractures in our study was violence (41.5%), followed by traffic accidents (29.3%), falls (17%), and sports injuries (12.2%). In the EPQR-S assessment, the nasal bone fracture (NBF) group had significantly-higher total scores than the control group (CG) (P < .001). In the subscales of the questionnaire, extroversion, psychoticism, and lie subscale scores were higher in the NBF group than in the CG. In the BIS-11-SF assessment, the NBF group had higher total scores than the CG (P < .001). Assessment using Turgay's adult ADD/ADHD DSM IV-based diagnostic screening and rating scale revealed no statistically-significant difference between the NBF group and the CG in terms of attention deficit and hyperactivity. Conclusion: We found that psychoticism patterns and impulsivity were more prevalent in the patient group, whereas ADD/ADHD was not. The results of our study suggest that performing a psychiatric assessment may be the right decision in patients presenting with NBFs caused by violence, whether they are the aggressor or the victim.