Golfers are physically more active and have greater health associated quality of life than non-golfers following lower limb arthroplasty

Background

The health benefits of physical activity are well recognised. This study assessed whether golfers were more physically active after lower limb arthroplasty when compared to those that did not play golf (primary outcome). In addition pre and postoperative changes in health-associated quality of life (HAQoL) and joint specific outcomes between golfers and none golfers were assessed (secondary outcomes).

Methods

There were 304 patients [THA (n = 155) or TKA (n = 149)] prospectively registered during a 4-month period undergoing lower limb arthroplasty. The mean age was 70.0 (range 37-92, standard deviation 10.2) years and included 188 (61%) females and 120 (39%) males. They completed pre and postoperative questionnaires assessing recreational activity, physical activity, HAQoL (EuroQol [EQ]), joint specific health (Oxford scores), and satisfaction.

Results

Golfers (n = 33, 10.9%) were more likely to achieve longer than 3 hours of moderate activity during a week (48.5% vs 38.0%, odds ratio (OR) 3.4, p = 0.045) and achieved their recommended activity level (96.8% vs 77.7%, OR 8.6, p = 0.015) compared to non-golfers following arthroplasty. Postoperative EQ5D (p = 0.034) and EQVAS (p = 0.019) were significantly greater in golfers. The joint specific Oxford hip score was greater in golfers compared to non-golfers (mean difference 5.6, p = 0.022), however no difference was observed in the Oxford knee score following TKA (p = 0.495).

Conclusion

Golfers were more likely to achieve their weekly recommended level of physical activity and had a greater HAQoL relative to those that did not play golf following lower limb arthroplasty. More specifically after THA golfers also had a greater postoperative joint specific outcome, but no such advantage was observed in those following TKA.

Evidence Level

Level II, diagnostic study.

Effects of Aromatherapy on Physical and Mental Health of Cancer Patients Undergoing Radiotherapy and/or Chemotherapy: A Meta-Analysis

BACKGROUP

Currently, aromatherapy is being increasingly utilized in clinical practice, particularly in managing the side effects associated with radiotherapy and chemoradiotherapy. However, it remains to be established whether aromatherapy can effectively alleviate these symptoms.

OBJECTIVE

To investigate the effects of aromatherapy on the physical and mental health of patients with cancer undergoing radiotherapy and chemotherapy.

METHODS

Seven databases were researched from inception until September 29, 2023, including PubMed, Scopus, and Web of Science, Chinese National Knowledge Infrastructure, Wanfang database, China Biology Medicine disc and VIP Chinese Medical Journal Database. Review Manager version 5.3 was utilized for data analysis. The Cochrane Risk of Bias tool RoB2 was employed to evaluate the quality of the literature included in the study. Evidence quality rating was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach through the GRADEpro GDT online tool.

RESULTS

Nineteen studies involving 1,541 patients were included. Aromatherapy can alleviate nausea [relative risk (RR)=0.64, 95% confidence interval (CI): 0.53 to 0.78, P<0.05, I2=46%; standardized mean difference (SMD)=-0.86, 95% CI: -1.21 to -0.51, P<0.05, I2=64%] and vomiting (RR=0.54, 95% CI: 0.42 to 0.69, P<0.05, I2=35%; SMD=-1.28, 95% CI: -1.52 to -1.03, P<0.05, I2=92%), improve sleep disorders [mean difference (MD)=-3.39, 95% CI: -3.95 to -2.84, P<0.05, I2=0%], relieve pain (SMD=-1.58, 95% CI: -1.96 to -1.21, P<0.05, I2=0%), mitigate fatigue (SMD=-1.28, 95% CI: -2.44 to -0.11, P<0.05, I2=93%) and enhance quality of life (SMD=0.50, 95% CI: 0.22 to 0.79, P<0.05, I2=0%) in cancer patients after radiotherapy and chemotherapy, but it may not have a significant effect on anxiety. The risk of bias was high in the included studies using the Cochrane Risk of Bias tool RoB2, and no studies were considered to be of high grade according to the GRADE system.

CONCLUSIONS

Aromatherapy is an efficacious, safe and economic adjunctive therapy for cancer patients, which can mend the physical symptoms and mental health of cancer patients. However, more high-quality studies are needed to verify it. (PROSPERO registration No. CRD42023390171).

Development of a multidimensional military readiness assessment

There is a need to be able to accurately evaluate whether an injured service member is able to return to duty. An effective assessment would challenge and measures physical and cognitive performance in a military-relevant context. Current assessments are lacking in one or more of these aspects. The simulation and data capture abilities of virtual reality systems are promising for use as the basis of multidimensional assessments. The team has previously developed a military-specific assessment in the Computer Assisted Rehabilitation Environment (CAREN) called the Readiness Evaluation During simulated Dismounted Operations (REDOp). Due to notable limitations in the original assessment, we have developed the next iteration, REDOp2. The assessment is able to challenge and measure a broader range of physical and cognitive performance domains in a more streamlined fashion. While limited to facilities with a CAREN, REDOp2 has the potential to provide an effective tool for highly trained and experienced wounded service members that require thorough assessment prior to returning to duty to ensure the safety of the team and mission. This methods paper describes the specific limitations in REDOp, how they were addressed in REDOp2, and suggested next steps to prepare the assessment for implementation.

Physical, Chemical and Enzymatic Changes in Amla (Emblica officinalis) Fruit during Growth and Maturation

BACKGROUND

Amla (Emblica officinalis) is one of the most prominent fruits in terms of nutritional and medicinal properties and is utilized for the preparation of many traditional processed foods and in Ayurvedic formulations.

OBJECTIVE

This study aims to investigate the enzyme activity and physical and chemical quality parameters during the growth and development stages of amla fruit for the determination of proper harvesting time to get optimum nutrient contents of fruit.

METHODS

The amla fruits of the chakaiya variety were harvested at 135 to 270 days after fruit set (DAFS) in 2021 and 2022 to study the various physical, chemical and enzymatic changes during growth and maturation.

RESULTS

The geometrical and gravimetric attributes of the fruit, viz. diameter, height, weight, volume, surface area, sphericity, aspect ratio, and radius of curvature increased. However, density decreased with the growth and maturation of the fruit. Furthermore, the rolling resistance, yellowness index and firmness of the fruit increased during the entire harvesting period of 135 to 270 DAFS. Total soluble solids and titratable acidity of the fruits increased only up to 195 DAFS and after that, continuously decreased. In contrast, ascorbic acid concentration grew in the entire growth and development period. Tannic, phenolic compounds and naringin content of the fruit steadily dropped until the final stage of harvest. Pectin Methyl Esterase (PME) activity was detected very low, 0.009 unit/ml at 135 DAFS, but as the fruit grew and matured, activity increased to 0.307 unit/ml at 270 DAFS. Polygalactouronase (PG) activity was not detected until 210 DAFS and, thereforesignificantly increased with maturity.

CONCLUSION

Considering the optimal value of all studied physical, chemical and enzymatic attributes of the fruit during the entire harvesting period of 135 to 270 DAFS, the optimal harvesting time of the fruit was 210 DAFS.

Changing society, changing research: integrating gender to better understand physical and psychological treatments use in chronic pain management

ABSTRACT

Treatment of chronic pain should be multimodal and include pharmacological, physical, and psychological treatments. However, because various barriers to physical and psychological treatments (PPTs) exist, a better understanding of biopsychosocial factors leading to their use is relevant. This study aimed to explore the association between gender identity, gender-stereotyped personality traits, and the use of PPTs in chronic pain management. The ChrOnic Pain trEatment cohort, a self-reported data infrastructure resulting from a web-based recruitment of 1935 people living with chronic pain (Quebec, Canada) was analyzed. Gender identity was operationalized as women, men, and nonbinary. Gender-stereotyped personality traits were measured using the Bem Sex-Role Inventory (feminine, masculine, androgynous, undifferentiated). A checklist of 31 types of PPTs that can be used for chronic pain management was presented to participants (yes/no). From the 1433 participants, 85.5% reported using at least one PPT. Hot-cold therapies (43.4%), exercise (41.9%), and meditation (35.2%) were the most frequently used PPTs, but most popular PPTs were not the same among women and men. Women reported a significantly higher use of PPTs in general (87.2% vs 77.2%; P < 0.001). Multivariable and interaction analyses showed that identifying as a man decreased the odds of reporting the use of PPTs (odds ratio: 0.32, 95% confidence interval: 0.11-0.92) but only among participants who scored high on both masculine and feminine personality traits (those classified as androgynous). The high prevalence of PPTs use found in our study is positive. Our results are relevant for a more personalized promotion of PPTs for chronic pain management.

Palliation of Intractable Cancer-Related Pain With Low-Dose Epidural Bupivacaine

Introduction: Patients with advanced cancer nearing end of life often present with complex multifactorial pain. Although epidural analgesia is routinely used in inpatient hospital settings for targeted pain control, there is scant description in the literature of the use of low-dose epidural analgesia for relief of cancer-related pain at end of life. In this study, we present a case of difficult to control cancer-related rectal and pelvic pain in a patient who responded well in her last days of life to a low-dose bupivacaine epidural. Case Description: A 66-year-old woman presented for inpatient hospital admission for pain control from home hospice with intractable cancer-related pain from metastatic colorectal adenocarcinoma marked by extensive erosive lesions extending from the anterior perineum to the posterior rectum, with rectovaginal fistula. The patient reported poor tolerance of medications and described spiritual beliefs (based in Buddhism) that caused her and her family to prioritize maintaining a lucid, clear mind above nearly all else while seeking symptom management. The patient was so debilitated by pain at the time of presentation that she was bedbound in a quadruped position. Case Management and Outcome: After 2 weeks of poor pain control in the hospital with multiple failed attempts at palliation-including bilateral pudendal block, as well as opioids and other routine, but potentially sedating or deliriogenic, medications to treat her pain-the patient permitted administration of a low-dose bupivacaine epidural that significantly reduced her pain and allowed the patient to remain clear-headed up until the time of her death. Twenty-three days after admission, and 5 days after initiation of low-dose bupivacaine epidural for pain control, the patient died peacefully in the hospital. Conclusion: Low-dose epidural analgesia for cancer-related pain at end of life from malignancy involving the pelvis-perineum, rectum, or vagina-may be a viable option for patients, particularly those who wish to avoid the risk of somnolence or confusion from systemic opioids and other analgesics.

A Retrospective Study: Clinical Characteristics and Lifestyle Analysis of Chinese Senile Gluteal Dermatosis Patients

Purpose

To summarize the clinical, histopathological and therapeutic features of senile gluteal dermatosis.

Patients and Methods

Retrospective analysis of 230 cases who visited the outpatient clinic of Hangzhou No. 3 People's Hospital for skin lesions on the buttocks and hips from 2018.8-2023.8 were included in the study, basic clinical information was collected, and they were subjected to physical examination of the buttocks and hips, and 36 cases were senile gluteal dermatosis, of which 7 underwent histopathological biopsy.

Results

A total of 230 patients were included, of which 36 were diagnosed with geriatric buttock dermatosis, with a mean age of (84.2±12.6) years, mean body mass index of (21.7±3.8) kg/m2, and a male to female ratio of 2:1. There was a significant correlation between the occurrence of the disease and age, gender, body mass index, sedentary time, type of chair used, and hypertension (P<0.05). The severity of the lesions may be associated with longer sitting time and prolonged use of bamboo chairs (P<0.05). Histopathologic changes were not specific. The skin lesions could subside after general treatment such as improvement of lifestyle, use of pressure-reducing air mattresses, salicylic acid cream, and moisturizing creams.

Conclusion

Senile gluteal dermatosis is a common senile physical dermatosis, mainly manifested as brownish scaly plaques, erythema and crusted ulcers, which can often be cured under reasonable treatment.

Systematic Review and Meta-analysis of Exercise Interventions for Psychotic Disorders: The Impact of Exercise Intensity, Mindfulness Components, and Other Moderators on Symptoms, Functioning, and Cardiometabolic Health

BACKGROUND AND HYPOTHESIS

Exercise therapy has been shown to be an effective complementary treatment for patients with psychotic disorders. However, the specific impacts of different training modalities remain poorly understood. This article aims to quantitatively review the moderating influence of different exercise modalities, hypothesizing that higher exercise intensity as well as utilization of mindfulness-based exercise (MBE) components, will improve intervention outcomes.

STUDY DESIGN

PubMed, Web of Science, and PsycINFO were searched from 2010 to March 2022 for randomized controlled trials investigating exercise interventions in patients with psychotic disorders (preregistration: https://doi.org/10.17605/OSF.IO/J8QNS). Outcomes considered were positive/negative symptoms, Positive and Negative Syndrome Scale (PANSS) General Psychopathology/Total scores, depressive symptoms, psychosocial functioning, quality of life, cardiorespiratory fitness, and body mass index. Separate meta-analyses, including moderator analyses, were performed to evaluate the moderating influence of different training modalities.

STUDY RESULTS

Of 6653 studies, 40 (n = 2111 patients) were included in the meta-analysis. The effects of moderate-intensity exercise exceed low-intensity approaches for PANSS Total scores (P = .02) and depressive symptoms (P = .04). The presence of MBE components was associated with improvements in positive symptoms (P = .04) and PANSS General Psychopathology subscores (P = .04) but also with higher error and between-study heterogeneity. Our analysis also shows improved intervention effects on depression in younger patients (P = .012) and improved psychosocial functioning scores following more frequent sessions (P < .01).

CONCLUSIONS

A minimum of moderate intensity should be considered. More frequent training sessions per week also seem to be beneficial. While adding mindfulness elements is promising, it increases heterogeneity and requires caution in terms of generalization.

Development and validation of the low-cost pregnant female physical phantom for fetal dosimetry in MV photon radiotherapy

BACKGROUND

Monte Carlo (MC) simulations or measurements in anthropomorphic phantoms are recommended for estimating fetal dose in pregnant patients in radiotherapy. Among the many existing phantoms, there is no commercially available physical phantom representing the entire pregnant woman.

PURPOSE

In this study, the development of a low-cost, physical pregnant female phantom was demonstrated using commercially available materials. This phantom is based on the previously published computational phantom.

METHODS

Three tissue substitution materials (soft tissue, lung and bone tissue substitution) were developed. To verify Tena's substitution tissue materials, their radiation properties were assessed and compared to ICRP and ICRU materials using MC simulations in MV radiotherapy beams. Validation of the physical phantom was performed by comparing fetal doses obtained by measurements in the phantom with fetal doses obtained by MC simulations in computational phantom, during an MV photon breast radiotherapy treatment.

RESULTS

Materials used for building Tena phantom are matched to ICRU materials using physical density, radiation absorption properties and effective atomic number. MC simulations showed that percentage depth doses of Tena and ICRU material comply within 5% for soft and lung tissue, up to 25 cm depth. In the bone tissue, the discrepancy is higher, but again within 5% up to the depth of 5 cm. When the phantom was used for fetal dose measurements in MV photon breast radiotherapy, measured fetal doses complied with fetal doses calculated using MC simulation within 15%.

CONCLUSIONS

Physical anthropomorphic phantom of pregnant patient can be manufactured using commercial materials and with low expenses. The files needed for 3D printing are now freely available. This enables further studies and comparison of numerical and physical experiments in diagnostic radiology or radiotherapy.

The relationship between physical function and psychological symptoms in Parkinson's disease: A systematic review and meta-regression analysis

AIMS

This systematic review and meta-regression aimed to examine available literature reporting measures of physical function, anxiety, and/or depression and whether any relationships exist between these measures in individuals with Parkinson's disease.

METHODS

MEDLINE, CINAHL, AMED, and APA PsychInfo databases were systematically searched. Screening, quality assessment, and data extraction were completed alongside meta-regression analysis.

RESULTS

Of 1175 studies retrieved, 40 were selected for analysis with only one study assessing the relationship between physical and psychological outcomes within their cohort. A total of 27 studies were also eligible for meta-regression analysis-a total sample of 1211 participants. Meta-regressions of five combinations of paired physical and psychological outcomes showed a significant moderating effect of symptoms of depression (Beck Depression Inventory) on mobility (Timed-Up-and-Go test; coefficient = 0.37, 95% CI 0.09 to 0.65, p = 0.012) and balance (Berg Balance Score) scores (coefficient = -1.25, 95% CI -1.77 to -0.73, p < 0.001).

CONCLUSION

Although physical and psychological outcomes of interest were used in all included studies, only one examined their relationship. Our analysis suggests that symptoms of depression may influence measures of mobility and balance. Specifically, as the severity of symptoms of depression increases, performance on measures of mobility and balance worsens.

The impact of coworking spaces on workers' performance, mental and physical health: A scoping review

BACKGROUND

Utilisation of coworking spaces (CWS) was rising sharply prior to the COVID-19 pandemic. The transition to new work arrangements which involve a hybrid, work and home model, is likely to involve the use of alternative workspaces. Understanding the impacts of CWS on employees is timely to examine the benefits of utilisation and how these might be incorporated into new ways of working. This scoping review aims to explore the relationship between CWS, mental and physical health, and workers' performance, and provide insights into future considerations for design.

OBJECTIVE

The main objective was to map the current literature on CWS, focusing on identification of relevant modifiable factors to improve worker's mental and physical health, and performance.

METHOD

Three databases, Embase, PsycInfo, and Proquest, were systematically reviewed, to identify studies from 2005 onwards. Data was extracted and analysed using diagrammatic mapping. Only studies published in English were included.

RESULTS

Eleven relevant papers were included which covered the three outcomes of interest: worker's performance (5), mental health (4) and physical health (2). Environmental factors influencing the three outcomes were categorised into physical environment (12 factors) and the psychosocial environment (6 factors). Overall, CWS environmental factors had a positive influence on workers (23 positive relationships and 11 negative relationships).

CONCLUSION

Coworking spaces offer potential benefits for tele-workers, including opportunities for collaboration/networking and productivity gains. However, attention to the CWS physical design is important to optimise the experience for workers and mitigate risk of adverse mental and physical health effects.

Volunteering on Heritage at Risk sites and wellbeing: A qualitative interview study

INTRODUCTION

We explored experiences of volunteering in Heritage at Risk (HAR) projects, intended to mitigate the deterioration to historic assets, and the relationship with wellbeing. We aimed to understand the value of HAR to volunteers' wellbeing and relationships between HAR programme characteristics such as location, asset type and type of activity.

METHODS

We used a qualitative design with semi-structured interviews of a purposive sample of volunteers recruited via Historic England (HE), employing Systematic Grounded Theory involving open, axial and selective coding.

FINDINGS

We interviewed 35 volunteers (18 male and 17 female) participating in 10 HAR projects. We identified six themes from the data analysis. (1) Purpose-was associated with volunteering motivations; there were some barriers to volunteering and many types of facilitators, including accessibility to local heritage sites. (2) Being-volunteers showed an appreciation and attachment to their place of residence. (3) Capacity-to learn heritage-specific skills and diversify experiences in learning new skills (life, technical and personal). (4) Sharing-community engagement, connectedness, and inclusivity captured diversity and inclusion within volunteers across age, ethnicity, ability, and gender. (5) Self-nurture-HAR volunteering created physical, psychological, and social benefits with limited risks and adverse outcomes. (6) Self-actualisation-described volunteers reflecting on their experiences.

CONCLUSION

HAR volunteering was associated with positive physical, social and psychological wellbeing outcomes. The study provides an evidence base for specific wellbeing benefits of volunteering at Heritage at Risk sites, although we could not conclude that HAR project activity was the cause of increased wellbeing.

PUBLIC CONTRIBUTION

Staff from HE were involved in designing the project brief. In selecting the HAR project sites, we took advice and recommendations from HE staff across all their six regional offices.

Violence Against Iraqi Doctors: A Sample from the Baghdad City

Physicians have recently become a target of workplace-violence, with rates four times higher than other workers studied. This study aimed to investigate the enormity and nature of violence directed against Iraqi doctors as well as to determine doctors' experiences in dealing with post-violence exposure and their plans to leave country for good. In this cross-sectional study, 397-medical staff surveyed online using reproducible, validated, and piloted questionnaire over a period of four weeks. Chi-square test used to assess the association between the typology of doctors'-violence exposure and their socio-demographic and workplace characteristics. Verbal-violence is the dominant-type experienced by Iraqi physicians (84.1%) followed by threats and physical-violence (50.4% and 31.2%). Resident-doctors are most affected among work-placements for all types of violence. Significant-associations have been observed between these three types of violent attacks and many of the doctors' demographic-characteristics (P < 0.05). Violence against Iraqi doctors has become common with a steady increase since 2003. Verbal-violence is the most constantly repeated aggression, usually resulting in either threats or a physical assault, which is commonly settled by paying a large amount of money as is invariably the tribal custom for a malpractice-claim, instead of having recourse to more formal and well-established legal action.

Values and preferences of health care professionals, policy-makers, patients and family members regarding recommendations of adapted physical restraint guidelines in critical care: A survey research

BACKGROUND

The values and preferences of stakeholders are crucial in the development of guidelines.

AIM

The aim of this study was to investigate stakeholders' values and preferences regarding draft recommendations for adapted physical restraint guidelines in China.

STUDY DESIGN

This survey research was carried out at four university-affiliated comprehensive hospitals based in the eastern, central, western, and north eastern zones of China from January 5-30, 2022. A 48-item self-report questionnaire was distributed, and values and preferences were assessed on a 10-point Likert scale. One-way ANOVA was used to compare values and preference scores among stakeholders. As effect-size measures, partial η2 and Cohen's f values are reported for ANOVA results.

RESULTS

A total of 1155 stakeholders were enrolled in the study. The mean value and preference scores were higher than seven for 46 draft recommendations. There was either no significant difference in the values and preferences of the stakeholders for the draft recommendations or there was a significant difference (p values ranged from <0.001 ∼ .048), but the effect size was small or very small (partial η2 value ranged from 0.011 ∼ .044; Cohen's f value ranged from 0.101 ∼ .214). The mean scores of patients for items related to cyber therapy and early tracheotomy were 6.84 and 6.60, respectively, which were lower than those of family members, policy-makers, and health care professionals and were statistically significant (p < 0.001). The partial η2 and Cohen's f values of the effect size were 0.083/0.062 and 0.302/0.256, respectively, which indicated that the differences were moderate.

CONCLUSION

These recommendations were in line with the values and preferences of stakeholders. Patients were more supportive of implementing cyber therapy or hypnosis for pain management but did not support early tracheotomy to reduce the duration of mechanical ventilation. Guideline panels could use value and preference information to revise and endorse recommendations of adapted physical restraint guidelines in critical care.

RELEVANCE TO CLINICAL PRACTICE

Practitioners should implement recommendations based on the values and preferences of stakeholders.

Evaluation of Primary Allied Health Care in Patients Recovering From COVID-19 at 6-Month Follow-up: Dutch Nationwide Prospective Cohort Study

BACKGROUND

Patients recovering from COVID-19 often experience persistent problems in their daily activities related to limitations in physical, nutritional, cognitive, and mental functioning. To date, it is unknown what treatment is needed to support patients in their recovery from COVID-19.

OBJECTIVE

This study aimed to evaluate the primary allied health care of patients recovering from COVID-19 at 6-month follow-up and to explore which baseline characteristics are associated with changes in the scores of outcomes between baseline and 6-month follow-up.

METHODS

This Dutch nationwide prospective cohort study evaluated the recovery of patients receiving primary allied health care (ie, dietitians, exercise therapists, occupational therapists, physical therapists, and speech and language therapists) after COVID-19. All treatments offered by primary allied health professionals in daily practice were part of usual care. Patient-reported outcome measures on participation, health-related quality of life, fatigue, physical functioning, and psychological well-being were assessed at baseline and at 3- and 6-month follow-up. Linear mixed model analyses were used to evaluate recovery over time, and uni- and multivariable linear regression analyses were used to examine the association between baseline characteristics and recovery.

RESULTS

A total of 1451 adult patients recovering from COVID-19 and receiving treatment from 1 or more primary allied health professionals were included. For participation (Utrecht Scale for Evaluation of Rehabilitation-Participation range 0-100), estimated mean differences of at least 2.3 points were observed at all time points. For the health-related quality of life (EuroQol Visual Analog Scale, range 0-100), the mean increase was 12.3 (95% CI 11.1-13.6) points at 6 months. Significant improvements were found for fatigue (Fatigue Severity Scale, range 1-7): the mean decrease was -0.7 (95% CI -0.8 to -0.6) points at 6 months. However, severe fatigue was reported by 742/929 (79.9%) patients after 6 months. For physical functioning (Patient-Reported Outcomes Measurement Information System-Physical Function Short Form 10b, range 13.8-61.3), the mean increase was 5.9 (95% CI 5.9-6.4) points at 6 months. Mean differences of -0.8 (95% CI -1.0 to -0.5) points for anxiety (Hospital Anxiety and Depression Scale range 0-21) and -1.6 (95% CI -1.8 to -1.3) points for depression were found after 6 months. A worse baseline score, hospital admission, and male sex were associated with greater improvement between baseline and 6-month follow-up, whereas age, the BMI, comorbidities, and smoking status were not associated with mean changes in any outcome measures.

CONCLUSIONS

Patients recovering from COVID-19 who receive primary allied health care make progress in recovery but still experience many limitations in their daily activities after 6 months. Our findings provide reference values to health care providers and health care policy makers regarding what to expect from the recovery of patients who receive health care from 1 or more primary allied health professionals.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04735744; https://tinyurl.com/3vf337pn.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2340/jrm.v54.2506.

The prevalence, risk factors and lifestyle patterns of Jordanian females with premenstrual syndrome: a cross-sectional study

Aim

The study aims to assess factors associated with premenstrual syndrome (PMS) and the frequency of using painkillers to relieve premenstrual pain.

Methods

This is a cross-sectional study of 1580 premenopausal women. An online self-administered questionnaire consists of sociodemographics, and the diagnostic criteria using the Arabic Premenstrual Syndrome Scale (A-PMS).

Results

The prevalence of PMS among Jordanian females was 94%. Moreover, a significant correlation was found between several factors, including BMI, family history of PMS, smoking, and herbal tea consumption and the psychological, physical and behavioral symptoms of PMS. Furthermore, analgesic use for pain relief and food cravings were significantly associated with psychological, physical and behavioral PMS symptoms.

Conclusion

PMS is highly prevalent and affects women in different life aspects.

Effects of yoga on physical and psychological health among community-dwelling older adults: A systematic review and meta-analysis

OBJECTIVES

To synthesise and critically appraise the quality of existing evidence about the effects of yoga on physical and psychological outcomes among older adults.

DESIGN

A systematic review and meta-analysis.

PARTICIPANTS

Participants aged 60 and above.

MEASUREMENTS

Nine English and two Chinese electronic bibliographic databases, including MEDLINE OvidSP, PsycINFO, AMED, EMBASE, Global Health, PubMed, Scopus, CINAHL, Cochrane Library, Hyread and WanFang databases, were searched. Randomised controlled trials (RCT) of yoga on physical and psychological outcomes among older adults were included. Meta-analysis was conducted for outcomes studied in three or more studies, otherwise narrative synthesis was performed.

RESULTS

Fifteen studies were included for review. The results of meta-analysis after sensitivity analysis showed that yoga significantly improved balance (SMD = 0.81, 95% CI: 0.48-1.14, p < .001, II2  = 59%), flexibility (SMD = 0.38, 95% CI: 0.07-0.68, p = .020, II2 34%), muscle strength (SMD = 0.49, 95% CI: 0.18-0.79, p = .002, I2 43%) and depressive symptoms (SMD = 0.50, 95% CI = 0.09-0.91, p = .01, I2 0%). There was insufficient data for meta-analysis on gait and other psychological outcomes. Narrative synthesis suggested that yoga has positive effects on reducing anxiety, but its effects on improving gait and reducing stress among older adults were inconclusive.

CONCLUSION

The results of this review supported the beneficial effects of yoga on physical outcomes among older adults, but the heterogeneity across studies was relatively high. Evidence related to the effect on psychological outcomes was limited.

3D-printed iodine-ink CT phantom for radiomics feature extraction - advantages and challenges

BACKGROUND

To test and validate novel CT techniques, such as texture analysis in radiomics, repeat measurements are required. Current anthropomorphic phantoms lack fine texture and true anatomic representation. 3D-printing of iodinated ink on paper is a promising phantom manufacturing technique. Previously acquired or artificially created CT data can be used to generate realistic phantoms.

PURPOSE

To present the design process of an anthropomorphic 3D-printed iodine ink phantom, highlighting the different advantages and pitfalls in its use. To analyze the phantom's X-ray attenuation properties, and the influences of the printing process on the imaging characteristics, by comparing it to the original input dataset.

METHODS

Two patient CT scans and artificially generated test patterns were combined in a single dataset for phantom printing and cropped to a size of 26 × 19 × 30 cm3 . This DICOM dataset was printed on paper using iodinated ink. The phantom was CT-scanned and compared to the original image dataset used for printing the phantom. The water-equivalent diameter of the phantom was compared to that of a patient cohort (N = 104). Iodine concentrations in the phantom were measured using dual-energy CT. 86 radiomics features were extracted from 10 repeat phantom scans and the input dataset. Features were compared using a histogram analysis and a PCA individually and overall, respectively. The frequency content was compared using the normalized spectrum modulus.

RESULTS

Low density structures are depicted incorrectly, while soft tissue structures show excellent visual accordance with the input dataset. Maximum deviations of around 30 HU between the original dataset and phantom HU values were observed. The phantom has X-ray attenuation properties comparable to a lightweight adult patient (∼54 kg, BMI 19 kg/m2 ). Iodine concentrations in the phantom varied between 0 and 50 mg/ml. PCA of radiomics features shows different tissue types separate in similar areas of PCA representation in the phantom scans as in the input dataset. Individual feature analysis revealed systematic shift of first order radiomics features compared to the original dataset, while some higher order radiomics features did not. The normalized frequency modulus |f(ω)| of the phantom data agrees well with the original data. However, all frequencies systematically occur more frequently in the phantom compared to the maximum of the spectrum modulus than in the original data set, especially for mid-frequencies (e.g., for ω = 0.3942 mm-1 , |f(ω)|original  = 0.09 * |fmax |original and |f(ω)|phantom  = 0.12 * |fmax |phantom ).

CONCLUSIONS

3D-iodine-ink-printing technology can be used to print anthropomorphic phantoms with a water-equivalent diameter of a lightweight adult patient. Challenges include small residual air enclosures and the fidelity of HU values. For soft tissue, there is a good agreement between the HU values of the phantom and input data set. Radiomics texture features of the phantom scans are similar to the input data set, but systematic shifts of radiomics features in first order features, due to differences in HU values, need to be considered. The paper substrate influences the spatial frequency distribution of the phantom scans. This phantom type is of very limited use for dual-energy CT analyses.

Physical Activity and Self-Perception of Mental and Physical Quality of Life during Pregnancy: A Systematic Review and Meta-Analysis

Self-perception of health status (quality of life) is considered one of the best indicators of health and well-being. However, during pregnancy, it could be impacted not only by physiological and anatomical changes, but by poor lifestyle habits like high sedentary behaviour or bad nutrition. This study assesses the effects of physical activity RCT interventions during pregnancy on both mental and physical components of quality of life. A systematic review and two meta-analyses were performed (PROSPERO registration number: CRD42022370467). Of the 207 articles captured both in English and Spanish, seven articles were deemed eligible for inclusion. The two analyses performed found that physically active pregnant women had better scores of mental self-perception of quality of life (z = 2.08, p = 0.04; SMD = 0.34, 95% CI = 0.02, 0.67, I2 = 76%, Pheterogeneity = 0.0004) and in physical self-perceived health status (z = 2.19, p = 0.03; SMD = 0.33, 95% CI = 0.03, 0.63, I2 = 71%, Pheterogeneity = 0.002) compared to control group pregnant women. Physical activity interventions could potentially increase mental and physical self-perception of quality of life during pregnancy.

Coding for Physical Restraint Status Among Hospitalized Patients: a 2019 National Inpatient Sample Analysis

BACKGROUND

The reduction of physical restraint utilization in the hospital setting is a key goal of high-quality care, but little is known about the rate of restraint use in general hospitals in the USA.

OBJECTIVE

This study reports the rate of physical restraint coding among acute care hospital discharges in the USA and explores associated demographic and diagnostic factors.

DESIGN

The National Inpatient Sample, a de-identified all-payors database of acute care hospital discharges in the USA, was queried for patients aged 18 and older with a diagnosis code for physical restraint status in 2019.

PARTICIPANTS

Hospitalized patients aged 18 and older.

MAIN MEASURES

Demographics, discharge diagnoses, in-hospital mortality, length of stay, total hospital charges.

KEY RESULTS

In total, 220,470 (95% CI: 208,114 to 232,826) hospitalizations, or 0.7% of overall hospitalizations, included a discharge code for physical restraint status. There was a 700-fold difference in coding for restraint utilization based on diagnosis, with 7.4% of patients with encephalitis receiving restraint diagnosis codes compared to < 0.01% of patients with uncomplicated diabetes. In an adjusted model, male sex was associated with an odds ratio of 1.4 (95% CI: 1.4 to 1.5) for restraint utilization coding, and Black race was associated with an odds ratio of 1.3 (95% CI: 1.2 to 1.4) relative to white race.

CONCLUSIONS

In the general hospital setting, there is variability in physical restraint coding by sex, race, and clinical diagnosis. More research is needed into the appropriate utilization of restraints in the hospital setting and possible inequities in restraint utilization.

Physical restraint use in children with mental and behavioral health emergencies in the prehospital setting

Objective

Emergency medical services (EMS) transport for mental and behavioral health (MBH) emergencies occurs frequently in children, yet little is understood regarding prehospital physical restraint use despite the potential for serious adverse events. We aim to describe restraint use prevalence and primary impressions among children with MBH emergencies.

Methods

This is a retrospective cross-sectional study of children with MBH emergencies evaluated by Alameda County (ALCO), California EMS from January 1, 2012 to December 31, 2018. Patient demographics and clinical variables were collected from the EMS records including sex, age at time of encounter, year of encounter, transport destination, medication use, and primary impression(s). The primary outcome was the use of physical restraints. Descriptive statistics were used to characterize the primary outcome and associated demographic and diagnostic features, as well as temporal use patterns. Sex and age were compared between restrained and non-restrained youth using chi-square analysis.

Results

Over the 7-year study period, ALCO EMS transported 9775 children with MBH emergencies. Of these transports, 1205 (12.3%) were physically restrained. Most children restrained had the primary impression of "behavioral/psychiatric crisis" (51.1%), "psychiatric crisis" (27.4%), and "behavioral-other" (12.4%) and the remaining children (9.1%) had a non-psychiatric/behavioral health primary impression. Over time, there was no statistically significant change in either number of children with MBH emergencies transported or physical restraint rate.

Conclusions

More than 1 in 8 children with MBH emergencies are being physically restrained during EMS transport. Restraint rate did not substantially change over time. Further studies to understand existing restraint rates and EMS resources available to address acute agitation in children are needed to inform quality and care enhancing initiatives.

An overview of the resilience world: Proceedings of the American Geriatrics Society and National Institute on Aging State of Resilience Science Conference

Resilience, which relates to one's ability to respond to stressors, typically declines with age and the development of comorbid conditions in older organisms. Although progress has been made to improve our understanding of resilience in older adults, disciplines have employed different frameworks and definitions to study various aspects of older adults' response to acute or chronic stressors. "Overview of the Resilience World: State of the Science," a bench-to-bedside conference on October 12-13, 2022, was sponsored by the American Geriatrics Society and National Institute on Aging. This conference, summarized in this report, explored commonalities and differences among the frameworks of resilience most commonly used in aging research in the three domains of resilience: physical, cognitive, and psychosocial. These three main domains are intertwined, and stressors in one domain can lead to effects in other domains. The themes of the conference sessions included underlying contributors to resilience, the dynamic nature of resilience throughout the life span, and the role of resilience in health equity. Although participants did not agree on a single definition of "resilience(s)," they identified common core elements of a definition that can be applied to all domains and noted unique features that are domain specific. The presentations and discussions led to recommendations for new longitudinal studies of the impact of exposures to stressors on resilience in older adults, the use of new and existing cohort study data, natural experiments (including the COVID-19 pandemic), and preclinical models for resilience research, as well as translational research to bring findings on resilience to patient care.

Psychological, social, and physical ecologies for child resilience: a South African perspective

Children live in a complex world surrounded by global concerns such as climate change, economic instability, threats of terrorism and war. However, in South Africa, one may note that children face several additional challenges including high unemployment rates in families, exposure to violence, living in conditions of poverty, exposure to HIV/AIDS, and high levels of orphanhood. Compounding these problems is the economic situation in the country where the government is unable to provide adequate support for children in various domains. Understanding the mechanisms through which children successfully adapt to their environments and transition into adulthood are important to understand. Resilience research seeks to understand these mechanisms and underlying processes that enable some individuals to recover from adversity against all odds. Therefore, there is an increased movement not only toward understanding resilience processes in children, which enable them to develop into fully functional and upstanding citizens of society despite the adversities they face, but also how resilience research can be translated into practice to be used by service professionals such as psychologists, school counselors, social workers, and teachers. Adopting a socioecological understanding of resilience, the author reviews literature on the psychological, social, and physical ecologies for child resilience globally. Special emphasis is placed on the ecologies of child resilience within the African context and South Africa in particular. A socioecological perspective positions child resilience within four important levels, namely individual, relationships, community, and society. The salient features of child resilience within a South African context are discussed within the four levels highlighting the implications for interventions to promote child resilience. The implications have global value because child resilience is a phenomenon that needs global attention.

Designing criterion measures for physically demanding jobs

The Bureau of Labor Statistics reported that 39.1% of the civilian workforce in the United States performs physically demanding jobs that require lifting, carrying, pushing/pulling, kneeling, stooping, crawling, and climbing activities in varied environmental conditions. United States military occupations are similar to those in the civilian sector involving equipment installation, emergency rescues, and maintenance, along with combat arms occupations. This article provides an overview of the types of criterion measures used to assess the physical domain and approaches for designing and evaluating the criteria. It also includes a method for generating criterion measures that are applicable across multiple jobs.

Can Non-Virtual Reality Simulation Improve Surgical Training in Endoscopic Sinus Surgery? A Literature Review

Simulation in endoscopic sinus surgery allows residents to learn anatomy, to achieve the correct handling of various rhinological instruments, and to practice different surgical procedures. Physically or non-virtual reality models are the main items in endoscopic sinus surgery simulation. The objective of this review is to identify and make a descriptive analysis of non-virtual endoscopic sinus surgery simulators which have been proposed for training. As a new state of the art, surgical simulators are developed continuously, so they can be used to learn basic endoscopic surgery skills by repetitive maneuvers, permitting detection of surgical error and incidents without risk for the patient. Of all training physical models, the ovine model stands out because of the similarities of the sinonasal pathways, the wide availability, and the low costs. Considering the similar nature of the tissues involved, the techniques and surgical instruments can be used almost interchangeably with minimal differences. Every surgical technique studied until now has a degree of risk and the only aspects that consistently reduced the number of complications are training, repetition, and hands-on experience.

Factors Influencing Participation in Physical Activity, Sports, and Exercise in Children and Adolescents with Spinal Pain or Spinal Conditions: A Systematic Review and Meta-Ethnography

BACKGROUND

Physical activity is an effective treatment for paediatric spinal pain. However, participation rates remain low and review evidence is needed to establish why. This review identifies factors influencing participation in sports, exercise, and physical activity in those aged 18 or under with spinal pain or spinal conditions. Trends or differences between discrete sub-populations are identified.

METHODS

A meta-ethnographic review was undertaken. Qualitative papers were identified and appraised using the JBI checklist. Thematic trends were mapped onto the biopsychosocial model and subthemes identified. Uniqueness was calculated and the confidence in the evidence was evaluated using the GRADE-CERQual tool.

RESULTS

Data were gathered from nine qualitative papers (384 participants). Three themes were identified: (1) biological: physical challenges and bladder and bowel care; (2) psychological: perceptions of differences to peers, struggle, anger, sadness, adjustment, and acceptance; and (3) sociological: influence of friends, social acceptance, negative attitudes from others, and the influence of their disability on family routine.

CONCLUSIONS

Sociological factors were most influential on exercise participation alongside related psychological and biological factors. Adolescents over 14 years offered greater critical insight compared to the younger children. Results are best applied to neuromuscular conditions with further robust evidence required in paediatric musculoskeletal spinal pain.

Association of adverse childhood experiences with adulthood multiple sclerosis: A systematic review of observational studies

INTRODUCTION

Adverse childhood experiences (ACEs) are proposed to increase the risk of developing multiple sclerosis (MS) later in life. This systematic review aimed to explore the correlation between ACEs and MS development, age of onset, quality of life in MS patients and MS relapse rates.

METHODS

We searched a total of six databases in June 2022 and retrieved the relevant studies. The population included adult (18+) individuals who either had been diagnosed or were at risk for developing MS and also had exposure to ACEs. Our primary outcomes include the risks of MS development, age of MS onset, and MS relapse rate in patients who were exposed to different types of ACEs.

RESULTS

A total of 11 studies were included in our review. A study reported that among 300 women diagnosed with MS, 71 (24%) reported a history of childhood abuse; moreover, with further research, it was concluded that ACEs were associated with the development of MS. Abuse that occurred 2-3 times per week was associated with an 18.81-fold increased risk of having MS when compared to the unexposed sample. The relapse rate of MS was found to be substantially greater in severe cases of ACEs compared to individuals who did not report any ACEs.

CONCLUSIONS

Results support a significant association between ACEs and the development of MS; individuals with a positive history of ACEs develop MS symptoms earlier. Moreover, the severity of ACEs is also linked with increased relapse rates of MS.

Feasibility of a pilot dyadic randomized controlled trial testing the effects of three behavioral interventions on older adults' cognitive, physical and everyday function

Introduction: Maintaining functional abilities is critical for optimizing older adults' well-being and independence. This randomized controlled trial (RCT) pilot examined the feasibility of testing the effects of three commercially available interventions on function-related outcomes in older adults. Methods: Pairs of community-dwelling older adults (N=55, Mage=71.4) were randomized to a 10-week intervention (cognitive-COG, physical-EX, combined exergame-EXCOG, or control-CON). Cognitive, physical, and everyday function were assessed at baseline, immediately post-intervention, and 6-months post-intervention. Feasibility was evaluated using recruitment, enrollment, training adherence, and retention metrics. Variability and patterns of change in functional outcomes were examined descriptively. Results: A total of 208 individuals were screened, with 26% subsequently randomized. Across training arms, 95% of training sessions were completed and 89% of participants were retained at immediate post-test. Variability in functional outcomes and patterns of change differed across study arms. Discussion: Results support a fully powered RCT, with several modifications to the pilot study design, to investigate short- and long-term training impacts.

Presence of Leptospira spp. in a Mosaic of Wetlands Used for Livestock Raising under Differing Hydroclimatic Conditions

Knowledge about the life cycle and survival mechanisms of leptospires in the environment is scarce, particularly regarding the environmental factors associated with their presence in ecosystems subject to livestock farming, where precipitation, seasonal floods, and river overflows could act as facilitators of leptospire dispersion. This study aimed to identify and study the presence of Leptospira spp. in the Lower Delta of the Paraná River and describe the physical, chemical, and hydrometeorological conditions associated with their presence in wetland ecosystems impaired by livestock raising intensification. Here, we show that the presence of Leptospira was determined mainly by water availability. We detected the species Leptospira kmetyi, L. mayottensis, and L. fainei and successfully cultured the saprophytic species L. meyeri from bottom sediment, suggesting the association of leptospires with microbial communities of the sediment's biofilm to enhance its survival and persistence in aquatic environments and adapt to changing environmental conditions. Knowledge of Leptospira sp. diversity in wetlands and the impact of climate variability on the transmission of these organisms is crucial for predicting and preventing leptospirosis outbreaks in the context of human health. IMPORTANCE Wetlands are environments that are often conducive to the survival and transmission of Leptospira because they provide a suitable habitat for the bacteria and are often home to many animal species that can act as reservoirs for leptospirosis. Bringing humans and animals into closer contact with contaminated water and soil and increased frequency and intensity of extreme weather events may further exacerbate the risk of leptospirosis outbreaks, which is mostly relevant in the context of climate change and a widespread intensification of productive activities, particularly in the Lower Delta of the Paraná River. The detection of leptospiral species in wetland ecosystems impaired by livestock raising intensification can help to identify propitious environmental factors and potential sources of infection, develop preventive measures, and plan for appropriate responses to outbreaks, ultimately improving public health outcomes.

Prevalence and Influencing Factors of Physical Restraints in Intensive Care Units: A Retrospective Cohort Study

Purpose

Physical restraints are used routinely in intensive care units (ICUs) and have negative effects. It is critical to identify the impact factors of physical restraints on critically ill patients. The present study investigated the prevalence of physical restraints and impact factors associated with their use in a large cohort of critically ill patients over one year.

Patients and Methods

A retrospective cohort study was performed in multiple ICUs at a tertiary hospital in China in 2019 using observational data from electronic medical records. The data consisted of demographics and clinical variables. Logistic regression was used to assess the independent impact factors for the use of physical restraint.

Results

The analysis consisted of 3776 critically ill patients with a prevalence of physical restraint use of 48.8%. The logistic regression analysis indicated that physical restraint use was associated with independent risk factors, including surgical ICU admission, pain, tracheal tube placement, and abdominal drainage tube placement. Physical restraint use was associated with independent protective factors, including male sex, light sedation, muscle strength, and ICU length of stay.

Conclusion

The prevalence of physical restraint use in critically ill patients was high. Tracheal tubes, surgical ICU, pain, abdominal drainage tubes, light sedation, and muscle strength were independent variables associated with the use of physical restraint. These results will assist health professionals in identifying high-risk physical restraint patients based on their impact factors. Early removal of the tracheal tube and abdominal drainage tube, pain relief, light sedation, and improvements in muscle strength may help reduce the use of physical restraints.

Paediatric palliative care for the generalist

Palliative care has been defined as 'the active holistic care of individuals across all ages with serious health-related suffering due to severe illness, and especially of those near the end of life'. Unfortunately, palliative care and especially paediatric palliative care remain a neglected area of medicine and are widely misunderstood, with few healthcare providers having any formal training in South Africa. To relieve health-related suffering, healthcare providers must understand that the field is not limited to end-of-life care for the terminally ill, and holistic care (physical, emotional, social and spiritual) should commence at the time of diagnosis of a serious illness. It is imperative that all healthcare providers develop the knowledge and skills to provide this essential care across all levels of care and disciplines. The article aims to raise awareness and show how to practically implement palliative care through case studies.

Molecular and physiochemical evaluation of buck semen cryopreserved with antioxidants

The current study evaluated the physiochemical quality and gene expression profile of post-thawed buck semen after supplementation with antioxidants [melatonin (M), L-carnitine (LC), cysteine (Cys), LC+M, M+Cys, LC+Cys, LC+Cys+M] in comparison with the non-treated control group. Physical as well as biochemical characteristics of semen were evaluated following freezing and thawing. Transcript abundance of six selected candidate gens was profile using quantitative real-time PCR. The data demonstrated significant enhancement of post-freezing total motility, progressive motility, percentage of live sperm, CASA parameters, plasma membrane and acrosome integrity in all groups supplemented with Cys, LC, M+Cys, and LC+Cys compared with the control group. The biochemical analysis of semen indicated that semen groups supplemented with LC and LC+Cys, recorded increased levels of GPX and SOD that were coupled with up-regulation of antioxidant genes (SOD1, GPX1, and NRF2) and mitochondrial transcripts (CPT2 and ATP5F1A). Moreover, H2O2 level and DNA fragmentation percentage were reduced compared to other groups. In conclusion, supplementation of Cys alone or in combination with LC positively improved the post-thaw physiochemical properties of rabbit semen through activation of bioenergetics-related mitochondrial genes and cellular antioxidant defense mechanism.

Mothers' perspectives of physical and psychological issues associated with caring for Ghanaian children living with tuberculosis: A qualitative study

AIM

The aim of the study was to explore and describe the mothers' perspectives on issues associated with caring for Ghanaian children aged 0-14 years living with tuberculosis.

DESIGN

Exploratory descriptive qualitative design.

METHODS

Semi-structured individual interviews were conducted face to face with 15 purposively sampled mothers from two health facilities in the Greater Accra area. Transcribed data were analysed using computer-enhanced thematic analysis.

RESULTS

Findings were grouped into (1) physical burden on the mothers and (2) psychological burden on mothers. The eight subthemes indicate that mothers of children living with tuberculosis experienced tiredness, sleeplessness, body pains, weight loss and sicknesses as they cared for their children. In addition to worrying, mothers experienced stigma and negative emotions such as sadness, guilt, fear and loneliness.

CONCLUSION

Mothers of children diagnosed with tuberculosis in Ghana experience physical and psychological health problems related to their caregiving roles. Nurses and other healthcare providers should identify specific problems and offer broad-based emotional and other support for these women.

Effects of exercise interventions on physical and psychological outcomes in frail older adults: Protocol for an overview of systematic reviews

AIMS

To systematically summarize the existing evidence regarding the effects of exercise interventions on physical and psychological outcomes in frail older adults and appraise the quality and strength of the evidence.

DESIGN

An overview protocol.

METHODS

A literature search of PubMed, Embase, Web of Science, CINAHL and Cochrane Database of Systematic Reviews will be conducted to identify relevant systematic reviews with or without meta-analysis on exercise interventions for frail older adults. Two independent reviewers will select articles, extract data and appraise the quality of included reviews. Physical and psychological outcomes will be synthesized using narrative summaries. The methodological quality of included reviews and the quality of evidence will also be assessed.

RESULTS

This overview will present the evidence on the effects of exercise interventions on physical and psychological outcomes for frail older adults, contributing to the implementation of exercise interventions to improve health outcomes for this population.

Assessment of functional capacity of the elderly

INTRODUCTION AND OBJECTIVE

Ageing is a continuous, progressive process of functional reserve loss. Physical fitness and mental state have a significant impact on the functionality level of the elderly population. Assessing the degree elderly people's of independence regarding self-care is an important aspect of the Comprehensive Geriatric Assessment (CGA). The aim of the study was to assess the functional capacity of people over 65 years of age.

MATERIAL AND METHODS

The study involved 312 patients in hospital wards across Lower Silesia, south-west Poland. The criteria for participation were as follows: providing informed consent to participate in the study, intellectual capacity to be interviewed, and age over 65. The study applied the diagnostic survey method, together with the use of the VAS, Barthel, IADL and GDS scales.

RESULTS

Among the respondents, 59.94% were in a moderately severe condition according to the Barthel scale, average IADL score - 20.56 points; according to the GDS scale, 58.97% had no symptoms of depression. Respondents suffered from multiple chronic diseases, the most common of which were hypertension (71.47%); they also reported some medical issues, mainly back pain (47.44). Assessment of the correlation of the Barthel and GDS scales, as well as the IADL and GDS, revealed a significant and negative correlation at -0.49 and -0.50. Assessment of the correlation between the number of diseases and the Barthel scale was -0.49, the number of symptoms and the Barthel scale -0.4; pain severity and the Barthel scale -0.41, number of diseases and IADL -0.58, and number of symptoms and IADL -0.52.

CONCLUSIONS

The greater the seniors' independence regarding instrumental activities of daily living, the weaker the symptoms of depression. Multimorbidity and experiencing pain impaired independence among the elderly.

Sulfate and acid-base balance

It has been acknowledged for years that compounds containing sulfur (S) are an important source of endogenous acid production. In the metabolism, S is oxidized to sulfate, and therefore the mEq sulfate excreted in the urine is counted as acid retained in the body. In this study we show that pH in fluids with constant [Na] and [HEPES] declines as sulfate ions are added, and we show that titratable acidity increases exactly with the equivalents of sulfate. Therefore, sulfate excretion in urine is also acid excretion per se. This is in accordance with the down-regulation of proximal sulfate reabsorption under acidosis and the observation that children with distal renal tubular acidosis may be sulfate depleted. These results are well explained using charge-balance modeling, which is based only on the three fundamental principles of electroneutrality, conservation of mass, and rules of dissociation as devised from physical chemistry. In contrast, the findings are in contrast to expectations from conventional narratives. These are unable to understand the decreasing pH as sulfate is added since no conventional acid is present. The results may undermine the traditional notion of endogenous acid production since in the case of sulfur balance, S oxidation and its excretion as sulfate exactly balance each other. Possible clinical correlates with these findings are discussed.

The Effects of Exergaming on Executive and Physical Functions in Older Adults With Dementia: Randomized Controlled Trial

BACKGROUND

Despite increasing interest in the effects of exergaming on cognitive function, little is known about its effects on older adults with dementia.

OBJECTIVE

The purpose of this is to investigate the effects of exergaming on executive and physical functions in older adults with dementia compared to regular aerobic exercise.

METHODS

In total, 24 older adults with moderate dementia participated in the study. Participants were randomized into either the exergame group (EXG, n=13, 54%) or the aerobic exercise group (AEG, n=11, 46%). For 12 weeks, EXG engaged in a running-based exergame and AEG performed a cycling exercise. At baseline and postintervention, participants underwent the Ericksen flanker test (accuracy % and response time [RT]) while recording event-related potentials (ERPs) that included the N2 and P3b potentials. Participants also underwent the senior fitness test (SFT) and the body composition test pre- and postintervention. Repeated-measures ANOVA was performed to assess the effects of time (pre- vs postintervention), group (EXG vs AEG), and group×time interactions.

RESULTS

Compared to AEG, EXG demonstrated greater improvements in the SFT (F_1.22=7.434, P=.01), reduction in body fat (F_1.22=6.476, P=.02), and increase in skeletal mass (F_1.22=4.525, P=.05), fat-free mass (F_1.22=6.103, P=.02), and muscle mass (F_1.22=6.636, P=.02). Although there was a significantly shorter RT in EXG postintervention (congruent P=.03, 95% CI 13.581-260.419, incongruent P=.04, 95% CI 14.621-408.917), no changes occurred in AEG. EXG also yielded a shorter N2 latency for central (Cz) cortices during both congruent conditions compared to AEG (F_1.22=4.281, P=.05). Lastly, EXG presented a significantly increased P3b amplitude compared to AEG during the Ericksen flanker test (congruent: frontal [Fz] F_1.22=6.546, P=.02; Cz F_1.22=5.963, P=.23; parietal [Pz] F_1.22=4.302, P=.05; incongruent: Fz F_1.22=8.302, P=.01; Cz F_1.22=15.199, P=.001; Pz F_1.22=13.774, P=.001).

CONCLUSIONS

Our results suggest that exergaming may be associated with greater improvements in brain neuronal activity and enhanced executive function task performance than regular aerobic exercise. Exergaming characterized by both aerobic exercise and cognitive stimulation can be used as an effective intervention to improve cognitive and physical functions in older adults with dementia.

TRIAL REGISTRATION

Clinical Research Information Service KCT0008238; https://cris.nih.go.kr/cris/search/detailSearch.do/24170.

Strong ions and charge-balance

It has been shown that the ability to predict the pH in any chemically characterized fluid, together with its buffer-capacity and acid content can be based on the requirement of electroneutrality, conservation of mass, and rules of dissociation as provided by physical chemistry. More is not required, and less is not enough. The charge in most biological fluids is dominated by the constant charge on the completely dissociated strong ions but, nonetheless, a persistent narrative in physiology has problematized the notion that these have any role at all in acid-base homeostasis. While skepticism is always to be welcomed, some common arguments against the importance of strong ions are examined and refuted here. We find that the rejection of the importance of strong ions comes with the prize that even very simple systems such as fluids containing nothing else, or solutions of sodium bicarbonate in equilibrium with known tensions of CO₂ become incomprehensible. Importantly, there is nothing fundamentally wrong with the Henderson-Hasselbalch equation but the idea that it is sufficient to understand even simple systems is unfounded. What it lacks for a complete description is a statement of charge-balance including strong ions, total buffer concentrations, and water dissociation.

Cost-Effectiveness of Prolonged Physical Activity on Prescription in Previously Non-Complying Patients: Impact of Physical Activity Mediators

In Sweden, physical activity on prescription (PAP) is used to support patients in increasing their levels of physical activity (PA). The role of healthcare professionals in supporting PA behavior change requires optimization in terms of knowledge, quality and organization. This study aims to evaluate the cost-effectiveness of support from a physiotherapist (PT) compared to continued PAP at a healthcare center (HCC) for patients who remained insufficiently active after 6-month PAP treatment at the HCC. The PT strategy was constituted by a higher follow-up frequency as well as by aerobic physical fitness tests. The analysis was based on an RCT with a three-year time horizon, including 190 patients aged 27-77 with metabolic risk factors. The cost per QALY for the PT strategy compared to the HCC strategy was USD 16,771 with a societal perspective (including individual PA expenses, production loss and time cost for exercise, as well as healthcare resource use) and USD 33,450 with a healthcare perspective (including only costs related to healthcare resource use). Assuming a willingness-to-pay of USD 57,000 for a QALY, the probability of cost-effectiveness for the PT strategy was 0.5 for the societal perspective and 0.6 for the healthcare perspective. Subgroup analyses on cost-effectiveness based on individual characteristics regarding enjoyment, expectations and confidence indicated potential in identifying cost-effective strategies based on mediating factors. However, this needs to be further explored. In conclusion, both PT and HCC interventions are similar from a cost-effectiveness perspective, indicating that both strategies are equally valuable in healthcare's range of treatments.

Prevalence and predictors of gender-based violence among Wolkite University female students, southwest Ethiopia, 2021: Cross-sectional study

Background

Gender-based violence is an important topic that needs to be taken into account when identifying gender-related gaps and disadvantages that a person might face because of their gender. Violence against women could result in psychological and physical adverse outcomes. Therefore, this study aims to assess the prevalence and predictors of gender-based violence among female students at Wolkite University, southwest Ethiopia, 2021.

Method

An institutional-based cross-sectional study was conducted among 393 female students and the students were selected by using a systematic sampling method. Data were checked for completeness and entered into EpiData version 3.1 and then exported to SPSS version 23 for further analysis. Binary and multivariable logistic regressions were employed to determine the prevalence and predictors of gender-based violence. The adjusted odds ratio (AOR) with its 95% confidence interval (CI) at a p-value of ≤0.05 was used to check statistical association.

Result

In this study, the overall prevalence of gender-based violence among female students was 46.2%. The prevalence of physical violence and sexual violence was 56.1% and 47.0%, respectively. Factors that were significantly associated with gender-based violence among female university students were: being a 2nd-year student or having a lower educational level [AOR = 2.56 (95% CI, 1.06-6.17)], being married or living with a male partner [AOR = 3.35 (95% CI, 1.07-10.5], having a father with no formal education [AOR = 15.46 (95% CI, 5.204-45.39)], having a drinking habit [AOR = 2.53 (95% CI, 1.21-6.30)] and not being able to freely discuss issues with their families [AOR = 2.48 (95% CI, 1.27-4.84)].

Conclusions and recommendations

The result of this study showed that more than one-third of the participants were exposed to gender-based violence. Thus, gender-based violence is an important topic deserving of more consideration; further investigations are important to decrease gender-based violence among university students.

A holistic analysis of collective behaviour and team performance in Australian Football via structural equation modelling

Despite awareness of the importance of quantifying technical, tactical, and physical characteristics of match play, few studies have examined the structural relationship of these aspects in professional sport. Accordingly, this study concurrently examined these components in relation to quarter outcome (n = 272) in Australian Football. The study followed a retrospective longitudinal case study design where one teams' cooperative passing network, skill counts, physical loads, and spatiotemporal behaviours during official Australian Football League games were collected from a period spanning four seasons (2016-2019). A principal components analysis (PCA) and structural equation modelling were used to explore the structural relationships between components and examine the influence on quarter outcome as determined by the point differential (quarter margin). Scoring opportunity and ball movement had direct associations with quarter margin, while unpredictability, uncontested behaviour and physical behaviour did not. Negative associations between uncontested behaviour and scoring opportunity suggest that elevated high-pressure success and a lack of synchrony may positively influence scoring opportunity, a determinant of quarter margin. Further, negative associations between physical behaviour and ball movement suggest that with less physical work, a team's collective ability to transfer possession between teammates is facilitated, offering an interesting dichotomy between skill and physical demands of Australian Football. While hundreds of different metrics are available, the present study was the first to concurrently examine the influence of a variety of match play components on performance outcomes in Australian Football. These results may provide direction for coaches and practitioners when contemplating practice design, tactical strategies, or the development of behaviour through specific training exercises. Game plans and training drills that focus on optimising attacking and low-pressure ball movement coupled with high levels of mutual interaction between teammates may be beneficial for performance.

Do environmental temperatures and altitudes affect physical outputs of elite football athletes in match conditions? A systematic review of the 'real world' studies

Players involved in the various football codes compete throughout the calendar year around the world. Therefore, environmental stressors such as temperature and altitude should be considered in preparation for, and during, matches. We aimed to systematically review the observational and quasi-experimental studies that have been specifically designed to quantify the effects of temperature (hot or cold) high altitude on in-match physical performance indicators. A search of electronic databases (Web of Science, Scopus, SPORTDiscus, PubMed/MEDLINE) was conducted, with 19,424 papers identified as relevant. Following sifting in relation to the eligibility criteria, 12 papers were deemed directly relevant. The reviewed studies scored 6-9 (on a 0-9 scale) for quality assessment using a previously used scale. The major outcome variables relevant to the current review were total distance (m), high-speed running (m) and high-speed runs (count) measured during matches. Standardized effect sizes (ES) were heterogeneous across studies for total distance (ES: -0.96 to -0.14) and high-speed running (ES: -0.69 to 0.12) for >1000 m vs sea-level, time spent at the given altitude being a putative factor for this heterogeneity. Heat had mainly detrimental effects on performance, but ES were, again, heterogeneous across studies (ES: -1.25 to 0.26), dependent on temperature. Given the small number of studies that involved mostly male athletes, and large heterogeneity across studies, more research needs be conducted on physical performance in these environmental conditions, with attention paid to standardizing outcomes and broadening the approaches of studies to guide future decision-making in professional sporting environments.

Effect of relative humidity, storage days, and packaging on pecan kernel texture: Analyses and modeling

The studies expounding on the effects of storage conditions on texture changes are limited. The researchers have been proposing methods to measure pecan texture instrumentally. But current protocols and/or attributes fail to address huge variability during experimentation. Additionally, there are no predictive models to estimate changes in pecan texture during storage. This study addresses all the above concerns and investigates the effects of different relative humidity (RH, 30-90%) and packaging material (Polyethylene-Nylon [PEN], polypropylene [PP], low density polyethylene [LDPE], and metallic laminates [ML]) on pecan texture, introducing a rift ratio (F/H or fracturability to hardness ratio) to address variability in the data and predictive model to estimate changes in the textural attribute of pecans during storage. The textural analysis was conducted on pecan cores and intact pecans to measure the area under curve, fracturability, hardness, cohesiveness, chewiness, springiness, and rift ratio. It was observed that values for the rift ratio obtained using the intact pecan method had high R² (0.72) as compared to the rest of the textural attributes. A three-parameter logistic model was employed to predict pecan texture during storage. The pecans stored at 75, 80, and 90% reached the rift ratio (F/H) of 0.5 at approx. 115, 3, and 0.15 days (~ 4 hr), respectively. Similarly, pecans stored in LDPE, PP, and PEN packs at 80% reached rift ratio (F/H) of 0.5 at approx. 26, 57, and 78 days, respectively. The presence of any kind of package delayed fracturability loss by at least eight folds at 80% RH. The pecans stored in ML did not experience a significant change in textural attributes.

PVH-Peri5 Pathway for Stress-Coping Oromotor and Anxious Behaviors in Mice

Stressful stimuli can activate the hypothalamic-pituitary-adrenal (HPA) axis. Clinically, it has been widely reported that stressful events are often accompanied by teeth clenching and bruxism, while mastication (chewing) can promote coping with stress. Trigeminal motoneurons in the trigeminal motor nucleus supplying the chewing muscles receive direct inputs from interneurons within the peritrigeminal premotor area (Peri5). Previous studies found that the paraventricular hypothalamic nucleus (PVH) participates in trigeminal activities during stressful events. However, the neural pathway by which the stress-induced oral movements alleviate stress is largely unknown. We hypothesized that paraventricular-trigeminal circuits might be associated with the stress-induced chewing movements and anxiety levels. First, we observed the stress-coping effect of wood gnawing on stress-induced anxiety, with less anxiety-like behaviors seen in the open field test and elevated plus maze, as well as decreased corticosterone and blood glucose levels, in response to stress in mice. We then found that excitotoxic lesions of PVH reduced the effect of gnawing on stress, reflected in more anxiety-like behaviors; this emphasizes the importance of the PVH in stress responses. Anterograde, retrograde, transsynaptic, and nontranssynaptic tracing through central and peripheral injections confirmed monosynaptic projections from PVH to Peri5. We discovered that PVH receives proprioceptive sensory inputs from the jaw muscle and periodontal ligaments, as well as provides motor outputs via the mesencephalic trigeminal nucleus (Me5) and Peri5. Next, pathway-specific functional manipulation by chemogenetic inhibition was conducted to further explore the role of PVH-Peri5 monosynaptic projections. Remarkably, PVH-Peri5 inhibition decreased gnawing but did not necessarily reduce stress-induced anxiety. Moreover, neuropeptide B (NPB) was expressed in Peri5-projecting PVH neurons, indicating that NPB signaling may mediate the effects of PVH-Peri5. In conclusion, our data revealed a PVH-Peri5 circuit that plays a role in the stress response via its associations with oromotor movements and relative anxiety-like behaviors.

High-Intensity Interval Training Versus Moderate-Intensity Continuous Training for Improving Physical Health in Elderly Women

In elderly women, a lack of regular physical exercise may result in faster decreases in general health and functional performance. Although high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) have been effectively applied in young and clinical groups, there is no evidence to support their use in elderly women to achieve health benefits. Thus, the major goal of this study was to investigate how HIIT affected health-related outcomes in elderly women. Twenty-four inactive elderly women agreed to participate in the 16-week HIIT and MICT intervention. Body composition, insulin resistance, blood lipids, functional capacity, cardiorespiratory fitness, and quality of life were all measured before and after the intervention. The number of differences between groups was determined using Cohen's effect sizes, and the pre-post intra-group changes were compared using paired t-tests. Using 2 × 2 ANOVA, the time × group interaction effects between HIIT and MICT were evaluated. Body fat percentage, sagittal abdominal diameter, waist circumference, and hip circumference all were improved significantly in the 2 groups. HIIT substantially improved fasting plasma glucose and cardiorespiratory fitness as compared to the MICT. HIIT improved the lipid profile and functional ability more significantly compared to the MICT group. These findings show that HIIT is a useful exercise for improving elderly women's physical health.

The Factors Affecting Frailty among the Elderly in Korea: A Study Using the Frailty Cohort

In this study, the effects of health-related factors such as cognitive, mental, and physical functions on frailty among the elderly in Korea were analyzed, and basic data were provided to prevent frailty. Based on the frailty cohort, this study classified 11 independent variables into physical, mental, cognitive, social, and activities of daily living. Multiple regression analysis was conducted using the Korean frailty index as the dependent variable. Consequently, the following regression equation was derived: The Korean frailty index = 8.412 + 0.148 × (SGDS-K) - 0.000095 × (K-ABC) - 0.122 × PF + 0.327 × (K-ADL) - 0.049 × (K-IADL) - 0.047(MNA) + e. Among the 11 factors, one mental (SGDS-K) and two activities of daily living were health-related factors affecting the frailty of the elderly. The results of this study will help in establishing plans for the prevention and intervention of aging and can provide basic data for government-level community care for the prevention of aging in the future.

Seven cardinal questions for the patient with ear, nose or throat complaints: Review

The incidence of otolaryngological problems in general medicine practice is highly seasonal and approaches 25% in some months of the year. Accurate diagnosis in the otolaryngology office often requires the use of binocular microscopy, nasal endoscopy, and flexible laryngoscopy, none of which are available in a general medicine office. Therefore, history taking and physical examination techniques available in the non-otolaryngology office are of utmost importance. Using evidence-based history taking for ear, nose, and throat (ENT) problems facilitates dealing with patients who present with otolaryngologic complaints. In this paper, I present 7 cardinal questions to be asked when taking the history of a patient with ENT complaints.

A Sustainable Alternative for Green Structural Lightweight Concrete: Performance Evaluation

The use of structural lightweight concrete in the construction industry is on the rise in the last few decades mainly because of the higher strength per unit density, as it reduces the total deal load of the structural elements as compared with normal strength concrete. In addition, the environmental concerns of the concrete industry have gained supreme importance in recent times, demanding vital and effectual steps. In this regard, the current study was carried out to formulate an alternative approach for producing a sustainable lightweight structural concrete. The study followed two stages: initially, the selection of optimized manmade plastic aggregates based on trial concrete mixes, and finally, to gauge the physical-, mechanical- and durability related properties of the concretes integrating optimized manmade aggregate series at different replacement fractions. As a result of the first phase: two aggregate series out of eight were selected based on the compressive strength and durability properties of their concretes. In the next stage, all the properties for the optimized aggregate concrete were analyzed in terms of compressive strength. It was noted that the physical, mechanical and chloride penetration resistances have generally displayed a decreasing trend, with an increase in the manmade plastic aggregate replacement fractions as compared with reference lightweight concrete. However, the two aggregates, i.e., 70% DS-30% LLDPE and 50% QF-50% PET at the replacement fractions of 25% and 100%, were found to be the best two contenders that fulfilled the criteria for structural lightweight concrete, i.e., ASTMC330/C330M-14, and were proposed for structural lightweight purposes with low and relatively high strength and chloride resistance-based durability requirements, respectively. In addition, the brittleness ratios and structural efficiency parameters for the concretes of the 70% DS-30% LLDPE and 50% QF-50% PET also supplemented the aforementioned findings. Overall, this study presents a sustainable approach for the effective utilization of plastic waste for producing structural lightweight concrete.

Overlap of Physical, Cognitive, and Social Frailty Affects Ikigai in Community-Dwelling Japanese Older Adults

This study aimed to investigate whether the overlap of physical, cognitive, and social frailty affects Ikigai in community-dwelling Japanese older adults. Participants were 116 community-dwelling older adult Japanese men and women. Associations of physical, cognitive, and social frailty with falls, daily living assessment, and Ikigai were analyzed by group comparisons and multivariate analyses. Physical, cognitive, and social frailty were associated with the risk of falls and Ikigai. An increase in the number of frailty category overlaps was associated with an increased risk of falls and decrease in Ikigai. Multivariate analyses adjusted for confounding factors showed that physical and cognitive frailty were related to Ikigai. In conclusion Two or more overlapping numbers of physical, cognitive, and social frailty had adverse effects on Ikigai in community-dwelling Japanese older adults.