Factors associated with vitamin D deficiency among patients with musculoskeletal disorders seeking physiotherapy intervention: a hospital-based observational study.

BACKGROUND: A considerable number of studies have suggested that there is a strong correlation between 25-hydroxyvitamin D or vitamin D levels and overall health, with reported impacts ranging from mental health and vital organ health to musculoskeletal health. This study aimed to determine the prevalence of 25-hydroxyvitamin D deficiency and identify its associated factors among patients with musculoskeletal disorders (MSDs) currently seeking medical attention. METHODS: A total of 143 patients with MSDs were randomly selected for blood sample collection to measure serum 25-hydroxyvitamin D levels. Descriptive statistics were used to describe the demographic and clinical characteristics of the study participants. Multiple logistic regression analyses were performed to compute the adjusted odds ratio. RESULTS: Overall, 53.1% of patients had vitamin D deficiency. Vitamin D deficiency was more prevalent among patients with higher body mass index, a bachelor's degree, lower sun exposure time, and lower serum calcium levels and those living in an urban setting. The multiple logistic regression model suggested that the duration of weekly sun exposure and living location were the independent predictors of vitamin D deficiency. CONCLUSION: It is recommended for patients with MSDs to participate in routine physical exercise, consume calcium- and vitamin D-enriched foods, and have regular sun exposure for minimizing the risk of vitamin D deficiency.

Electrochemical sensing: A prognostic tool in the fight against COVID-19.

The COVID-19 pandemic has devastated the world, despite all efforts in infection control and treatment/vaccine development. Hospitals are currently overcrowded, with health statuses of patients often being hard to gauge. Therefore, methods for determining infection severity need to be developed so that high-risk patients can be prioritized, resources can be efficiently distributed, and fatalities can be prevented. Electrochemical prognostic biosensing of various biomarkers may hold promise in solving these problems as they are low-cost and provide timely results. Therefore, we have reviewed the literature and extracted the most promising biomarkers along with their most favourable electrochemical sensors. The biomarkers discussed in this paper are C-reactive protein (CRP), interleukins (ILs), tumour necrosis factor alpha (TNFα), interferons (IFNs), glutamate, breath pH, lymphocytes, platelets, neutrophils and D-dimer. Metabolic syndrome is also discussed as comorbidity for COVID-19 patients, as it increases infection severity and raises chances of becoming infected. Cannabinoids, especially cannabidiol (CBD), are discussed as a potential adjunct therapy for COVID-19 as their medicinal properties may be desirable in minimizing the neurodegenerative or severe inflammatory damage caused by severe COVID-19 infection. Currently, hospitals are struggling to provide adequate care; thus, point-of-care electrochemical sensor development needs to be prioritized to provide an approximate prognosis for hospital patients. During and following the immediate aftermath of the pandemic, electrochemical sensors can also be integrated into wearable and portable devices to help patients monitor recovery while returning to their daily lives. Beyond the COVID-19 pandemic, these sensors will also prove useful for monitoring inflammation-based diseases such as cancer and cardiovascular disease.

A Cumulative Impact of Psychological and Sensitization Risk Factors on Pain-Related Outcomes.

OBJECTIVE: Risk constructs based on psychological risk factors (eg, pain catastrophizing, PC) and sensitization risk factors (eg, pressure pain threshold, PPT) are important in research and clinical practice. Most research looks at individual constructs but does not consider how different constructs might interact within the same individual. An evaluation of the cumulative impact of psychological and sensitization risk factors on pain-related outcomes may help guide us in the risk assessment of patients with pain conditions. The aim of this study is to evaluate the cumulative impact of these psychological (PC) and sensitization (PPT) risk factors on pain-related outcomes (activity avoidance, pain severity, and disability) considering covariates. METHODS: We included 109 participants (70.60% women; mean ± SD age 53.6 ± 12.3 years) with chronic musculoskeletal pain for data analysis, who completed all measures of this study. Participants completed a single testing session that included measures of risk factors (PC and PPT) and pain-related outcomes (self-reported avoidance, functional avoidance, disability, and pain severity). Subgroups were constructed by dichotomizing of PC and PPT scores, resulting in four groups: (1) low catastrophizing and low sensitivity (N = 26), (2) high catastrophizing and low sensitivity (N = 27), (3) low catastrophizing and high sensitivity (N = 25), and (4) high catastrophizing and high sensitivity (N = 31). RESULTS: One-way analysis of variance (ANOVA) revealed significant group differences (P < 0.05, η2  = 0.08 to 0.14) in all outcomes of this study (except functional avoidance), and post hoc analysis indicated the significant differences are between group 1 and 4. A cumulative impact is reflected by large effect sizes between group 1 and 4 (d = 0.8 to 1). The group 2 and 3 (one risk dimension groups: either high-PC or high-PPT) represent 47% of the total participants. CONCLUSIONS: The study suggests both higher level of PC and pressure sensitivity have a cumulative impact on risk screening for pain-related outcomes, considering gender in functional avoidance (task-related outcome). A clinical presentation with high-PC (one dimension of risk) is not associated with high-PPT (another dimension of risk). This finding has important clinical and theoretical implications.

Glutamate sensing in biofluids: recent advances and research challenges of electrochemical sensors.

Glutamate is a nonessential amino acid and a putative neurotransmitter. When its consumption exceeds its synthesis, it becomes necessary to monitor its levels. Hence, a low-cost, sensitive and real-time monitoring of glutamate to quantify pain and detect neurodegenerative diseases is imperative to improve pharmacotherapy and early diagnosis for health care. While enzymatic electrochemical sensors are promising to address issues in lab-based detection techniques, non-enzymatic sensors are better due to their higher stability and lower cost. In this review, we aim to discuss the recent advances and remaining challenges of sensing glutamate in biofluids. First, we discuss the metabolic routes of glutamate, followed by its transmission processes to the biofluids. Second, we identify the connection of glutamate to pathologies as a potential biomarker. Third, we emphasize electrochemical sensors instantaneously detect glutamate in biofluids in real-time, quantifying pain and monitoring neurodegenerative diseases. The literature shows the concentration of glutamate in biofluids, such as plasma, cerebral spinal fluid, urine, and saliva are in the range of 5-100 µM, 0.5-2 µM, 8.5 (3.3-18.4) µM mM-1 creatinine, and 0.232 ± 0.177 µM respectively. While these concentration levels are sometimes lower than the detection limit of electrochemical sensors, functionalization of the nanomaterials currently being used such as NiO and Co3O4 with carbon nanotubes or beta-cyclodextrin may improve the sensing performance. Another key challenge in the research is to develop relationships between glutamate and biofluids. Finally, we have to advance electrochemical sensors that are compatible to detect glutamate in physiological conditions for long durations of time.

Correction: Glutamate sensing in biofluids: recent advances and research challenges of electrochemical sensors.

Correction for 'Glutamate sensing in biofluids: recent advances and research challenges of electrochemical sensors' by Jessica Schultz et al., Analyst, 2020, 145, 321-347. DOI: 10.10.1039/C9AN01609K.

Quantitative Sensory Testing in Chronic Musculoskeletal Pain.

BACKGROUND: In recent years, several published articles have demonstrated that quantitative sensory testing (QST) is useful in the analysis of musculoskeletal pain disorders. Based on the evidence from these studies, it is assumed that QST might be a useful tool in the analysis of the pathogenesis, classification, differential diagnosis, and prognosis of chronic musculoskeletal pain. OBJECTIVES: The objective of this paper is to discuss measurement properties of QST and potentials research and clinical applications in musculoskeletal pain. METHODS: This is a review of the current knowledge base on QST as it relates to musculoskeletal pain disorders. We based our summary on articles retrieved from Ovid MEDLINE (1946 to present) including EMBASE, AMED, and PsycINFO databases to search for all published literature focused on QST and musculoskeletal pain. RESULTS: QST has been shown to be related to neural sensitivity in musculoskeletal pain. QST measurement properties have been evaluated for multiple sensory evaluation modalities and protocols with no clear superior instrument or test protocol. The research evidence is incomplete, but suggests potential clinical benefits for predicting outcomes and subtyping pain. Threshold detection testing is commonly used to quantify sensory loss or gain, in current practice and has shown moderate reliability. Intensity/magnitude rating can be assessed on a wide range of rating scales and may be more useful for pain rating in a clinical context. Threshold detection-based testing and intensity/magnitude rating-based testing can be combined to determine pain threshold in clinical evaluation. CONCLUSIONS: Musculoskeletal pain management may benefit from treatment algorithms that consider mechanism, pain quality, or neurophysiological correlates. Non-invasive QST may be helpful to find sensory array of altered nociceptive process. Due to the diverse etiopathogenetic basis of musculoskeletal pain disorders, a broad range of reliable and valid QST tests may be needed to analyze the various disease entities.

In vitro antimicrobial, antioxidant activity and phytochemical screening of Apium graveolens.

The present study evaluates the phytochemical screenings, antioxidant activity and antimicrobial assay of Apium graveolens L. The phytochemical screening showed the presence of flavonoids, tannins, saponins and steroids in Apium graveolens while terpenoids was absent. The total phenolic content was slightly higher in methanolic fraction (63.46 ± 12.00 mg GAE/g) followed by ethanol (36.60 ± 12.28 mg GAE/g) and hexane fractions (34.86 ± 6.96 mg GAE/g). The flavonoid content was high in methanolic extract (56.95 ± 7.14 mg Quorcetin/g) and low level of the content was found in methylated spirit extract (29.2 ± 3.15 mg Quercitin/g). Antioxidant activity assayed by FRAP was higher in methanolic fraction (12.48 ± 1.06 mmole of FeSO4equivalent/litre of extract) compared with other extracts. Likewise, good antimicrobial activity was measured by crude ethanol fraction against S. aureus (MIC=0.12 ± 0.03 µg/ml) and S. typhi (MIC= 0.5 ± 0.2 µg/ml). Results also that ethanolic fraction was effective against A. flavus (MIC= 05 ± 1.0 µg/ml).

Comparison of Structural Diagnosis and Management (SDM) approach and MyoFascial Release (MFR) for improving plantar heel pain, ankle range of motion and disability: A randomized clinical trial.

[Purpose] The purpose of this study was to compare the effectiveness of the Structural Diagnosis and Management (SDM) approach with Myofascial Release (MFR) in improving plantar heel pain, ankle range of motion, and disability. [Subjects] Sixty-four subjects, aged 30-60 years, with a diagnosis of plantar heel pain, plantar fasciitis, or calcaneal spur by a physician according to ICD-10, were equally allocated to the MFR (n = 32) and SDM (n = 32) groups by hospital randomization and concealed allocation. [Methods] In this assessor-blinded randomized clinical trial, the control group performed MFR to the plantar surface of the foot, triceps surae, and deep posterior compartment calf muscles, while the experimental group performed a multimodal approach utilizing the SDM concept for 12 sessions over 4 weeks. Both groups also received strengthening exercises, ice compression, and ultrasound therapy. Pain, activity limitations and disability were assessed as primary outcomes using the Foot Function Index (FFI) and Range of motion (ROM) assessment of the ankle dorsiflexors and plantar flexors using a universal goniometer. Secondary outcomes were measured using the Foot Ankle Disability Index (FADI) and a 10-point manual muscle testing process for the ankle dorsiflexors and plantar flexors. [Results] Both MFR and SDM groups exhibited significant improvements from baseline in all outcome variables, including pain, activity level, disability, range of motion, and function after the 12-week intervention period (p < .05). The SDM group showed more improvements than MFR for FFI pain (p < .01), FFI activity (p < .01), FFI (p < .01) and FADI (p = <.01). [Conclusion] Both MFR and SDM approaches are effective in reducing pain, improving function, ankle range of motion, and reducing disability in plantar heel pain, however, the SDM approach may be a preferred treatment option.

Knowledge, Attitude, Practice, and Fear of COVID-19: an Online-Based Cross-cultural Study.

The study aimed to measure Knowledge, Attitude, and Practice (KAP) and fear level towards COVID-19 and explore its cross-cultural variances in knowledge by sociodemographic factors among the general population of 8 different countries over 5 continents. It was a cross-sectional online survey. This survey was conducted in April 2020 among 1296 participants using the "Google Form" platform. Considering the social distancing formula and pandemic situation, we collect data using popular social media networks. Univariate and bivariate analyses were used to explore the collected data on KAP, fear, and sociodemographic factors. Overall knowledge score was 9.7 ± 1.7 (out of 12), and gender differences (female vs male: 9.8 ± 1.6 vs 9.5 ± 1.9) were significant (p = 0.008) in the bivariate analysis. Knowledge score variances were found significant in some regions by gender, marital status, and education qualification. The highest and lowest mean knowledge scores were recorded in the Middle East (10.0 ± 1.7) and Europe (9.3 ± 2.0). Despite having a high fear score (22.5 ± 5.6 out of 35), 78.35% of respondents were positively and 81.7% in a good practice level. Fear score rankings: Middle East (1st; 23.8 ± 5.5), Europe (2nd; 23.2 ± 5.8), Africa (3rd; 22.7 ± 5.0), South Asia (4th; 22.1 ± 5.7), Oceania (5th; 21.9 ± 5.8), and North America (6th; 21.7 ± 5.5). Fear and knowledge were not correlated. KAP and fear variation exist among geographical regions. Gender, marital status, and education qualification are factors in knowledge variances for some regions. KAP and fear measures can help health education programs consider some sociodemographic factors and regions during an outbreak of highly contagious disease and uplift a positive attitude and good practice. Supplementary Information: The online version contains supplementary material available at 10.1007/s11469-021-00638-4.

Depression, anxiety, stress, and suicidal behavior among Bangladeshi undergraduate rehabilitation students: An observational study amidst the COVID-19 pandemic.

Background and Aims: Common mental health symptoms (CMHS) like depressive moods, anxiety, and stress are the underlying causes of suicidal behavior. The incidence of suicide is higher among Bangladeshi students. Due to the pandemic, students of health/rehabilitation sciences are at the most significant risk. This study aimed to measure the prevalence rate and predicting factors for depression, anxiety and stress, suicidal ideation, and suicide attempts in Bangladeshi undergraduate rehabilitation students. Methods: This cross-sectional study included data from 731 participants. Descriptive analyses estimated prevalence, and multivariate logistic regression models identified the factors associated with CMHS and suicidal behavior after adjusting the confounders. Results: The result shows a high prevalence of moderate to very severe CMHS and a higher risk of suicidal ideation among rehabilitation students. Sociodemographic factors, illness, behavior, institution, and subject-related issues were identified as the predicting factors of CMHS and suicidal behavior. The students suffering from mental health symptoms reported suicidal ideation and attempted at a significantly higher rate. Conclusion: To deal with CHMS and suicide risk, a holistic, supportive approach from government and academic institutions are essential for minimizing the predicting factors identified by this study. The study is helpful for the government regulatory body and policymakers to take immediate steps for preventing CMHS and suicidal behavior among rehabilitation students in Bangladesh.

Combined Effect of Vitamin D Supplementation and Physiotherapy on Reducing Pain Among Adult Patients With Musculoskeletal Disorders: A Quasi-Experimental Clinical Trial.

Background: The prevalence of musculoskeletal disorders (MSD) and vitamin D insufficiency is high. Past research indicating vitamin D supplementation and physiotherapy are useful for the treatment of MSDs. However, to the best of our knowledge, the combined benefits of vitamin D and physiotherapy are not yet evaluated in MSD. We hypothesized that combined intervention of vitamin D supplementation and physiotherapy would be more effective in relieving the pain of MSD compared to only physiotherapy intervention. Objective: This study aimed to examine whether combined effect of vitamin D supplementation and physiotherapy was better than physiotherapy alone in reducing pain-related outcomes (e.g., pain severity, affective interference, and physical interference) in patients with MSD. Methods: A quasi-clinical experiment was conducted between May 2020 and April 2021. Vitamin D level in the blood was measured at the start of the study. Patients with vitamin D levels <20 ng/mL were assigned to the combined physiotherapy and vitamin D group. The physiotherapy group consisted of the patients with vitamin D levels more than 20 ng/mL. The Brief Pain Inventory scale was utilized to measure pain at baseline and after 12 weeks of interventions. We used the paired t-tests for unadjusted analysis. Further, a linear regression model was used to identify the combined effect of physiotherapy and vitamin D on reducing pain scores after adjusting potential confounders. Results: Combined intervention of vitamin D and physiotherapy showed significantly better results than only physiotherapy intervention in the reduction of three pain-related outcomes (p < 0.001). The multivariable analysis indicated that the combination of physiotherapy and vitamin D treatment reduced pain score by 1.126 (slope = -1.126, p = 0.035) compared to physiotherapy alone. Conclusion: Combined intervention (vitamin D with physiotherapy) had a better pain-relieving effect than physiotherapy alone. To confirm these findings, more research is needed with randomized control trials. Clinical Trial Registration: [http://ctri.nic.in/Clinicaltrials/advancesearchmain.php], identifier [CTRI/2020/04/024845].

Economic stressors and mental health symptoms among Bangladeshi rehabilitation professionals: A cross-sectional study amid COVID-19 pandemic.

BACKGROUND: Mental health symptoms are considered a public health concern by many professionals and are frequently impacted by factors related to occupation, employment opportunities, and economic stressors. This study investigated the relationship between economic stressors and mental health symptoms among Bangladeshi rehabilitation professionals. METHODS: We conducted a cross-sectional survey of 420 rehabilitation professionals between July 2020 and October 2020. Economic stressors were measured using Economic Hardship Questionnaire, Financial Threat Scale, and Financial Well-Being Scale. Mental health symptoms were measured using the Depression, Anxiety, and Stress Scale (DASS-21). Multivariable logistic regression analysis was performed to find associated factors on mental health problems after adjusting confounders. RESULTS: Among 420 rehabilitation professionals 62.1% were male, 38.6% were post-graduated and 75% were in practice. The overall prevalence of depression, anxiety, and stress was 51.0%, 58.6%, and 33.6%, respectively. The multivariable regression analysis indicated that without a high professional degree, lack of opportunity to practice, and loss of income were the associated factors for mental health symptoms. The modelling of the structural equation showed that financial threat is significantly associated with mental health symptoms. CONCLUSION: During the era of COVID-19, a high prevalence of mental health symptoms was observed among rehabilitation professionals. To minimize the burden of mental health, we recommend that all rehabilitation organizations and the government come together to create equal opportunities to practice and enable individuals to obtain high professional degrees.

Road traffic delays in commuting workplace and musculoskeletal health among sedentary workers: A cross-sectional study in Dhaka city.

OBJECTIVES: Despite previous research aimed at identifying factors linked to musculoskeletal health issues, there was no evidence about the relationship between road traffic delays (RTDs) and musculoskeletal health in sedentary employees. As a result, the aim of our research was to understand such a correlation among bank employees in Dhaka, Bangladesh. METHODS: A cross-sectional analysis was conducted with bank employees who worked in sedentary settings. The Eriksen subjective health complaints scale was used to measure the eight items of musculoskeletal health complaints (MHCs), and RTDs were measured using principal component analysis using variables commute time, distance, and traffic congestion experience to work. The association between RTDs and MHCs was identified using a multilevel model after adjusting potential confounders. RESULTS: A total of 628 employees (mean[SD] age, 36.1[7.0] years; 254[40.5%] women) participated in the study. Among the employees, the one-month prevalence of MHCs was 57.2%. The highest prevalence of MHCs was low-back pain (36.6%), followed by neck pain (22.9%) and upper-back pain (21.2%). Also, 136(21.7%) employees reported long-RTDs in commuting workplace and 81% of them had MHCs. The multilevel analysis identified that long-RTDs had a significant relationship with MHCs (adjusted odds ratio, AOR = 10.20, 95%CI = 5.41-16.91). Private transportation commuters reported 70% reduced odds of MHCs (AOR = 0.30, 95%CI = 0.15-0.59) and walking or bicycling commuters had 84% fewer MHCs (AOR = 0.16, 95%CI = 0.10-0.28) compared to public bus commuters. CONCLUSIONS: Sedentary employees with long-RTDs reported increased MHCs, emphasizing the importance of including musculoskeletal exercise in office facilities. Findings of this study also highlight the need for a sound public transportation system in Dhaka city.

Association between daily commute and subjective health complaints among the office workers in an urban community.

PURPOSE: To determine the prevalence of subjective health complaints (SHC) among metropolitan office commuters and to investigate the relationship between SHC and socio-demographic, commuting, and work-related factors. METHODS: The participants in this cross-sectional study were 628 full-time bank employees in Dhaka. One-month prevalence was determined using the SHC inventory scale. Internal consistency was determined using factor analysis. The discrepancy between socio-demographic and SHC was summarized using descriptive analysis. To discover factors related to SHC, random logistic regression intercept models were employed. RESULTS: Sadness (54.0 percent), low back pain (36.6 percent), anxiety (34.2 percent), pseudo-neurological disorders (26.6 percent), and musculoskeletal pains (20.2%) were the most common health complaints. The relationship between traffic congestion and SHCs was found to be statistically significant (p = 0.001) for the majority of complaints. According to multilevel analysis, long-distance office commuters were 7.29 times more likely than short-distance commuters to suffer from musculoskeletal pains (AOR = 7.29, 95% CI = 3.58-15.21). Furthermore, we discovered that long-distance commuters were 2.72 times more likely to complain about flu (AOR = 2.72, 95% CI = 1.22-6.27), 1.56 times more likely to complain about pseudo-neurological problems (AOR = 1.56, 95% CI = 0.84-2.92), and 1.88 times more likely to complain about gastrointestinal problems (AOR = 1.88, 95% CI = 0.69-5.41). CONCLUSION: In Dhaka, we found a high prevalence of health concerns among full-time bank personnel. A significant prevalence of health complaints was related to traffic congestion, long commutes, and use of public transportation. Reducing daily commuting time, switching modes of transportation, and avoiding traffic congestion could help to alleviate the burden of health concerns experienced by regular office commuters.

Prevalence of mental health symptoms and its effect on insomnia among healthcare workers who attended hospitals during COVID-19 pandemic: A survey in Dhaka city.

BACKGROUND: During the COVID-19 pandemic, the high workload, risk of infection, and safety issues for family members may pose a threat to the mental health of healthcare workers (HCWs) working in hospital settings. The study aimed to find out the prevalence of anxiety, depression, and insomnia symptoms were among HCWs, as well as the factors related to these mental health issues. METHODS: We conducted an online survey of HCWs employed in Dhaka city from June 6 to July 6, 2020. Symptoms of anxiety, depression, and insomnia were measured using the Generalized Anxiety Disorder, the depression module of the Patient Health Questionnaire, and the Insomnia Severity Index, respectively. The related factors of anxiety, depression, and insomnia symptoms were identified using three regression models. RESULTS: This research included responses from 294 HCWs (mean ± standard deviation age: 28.86 ± 5.5 years; 43.5% were female). Anxiety, depression, and insomnia symptoms were found in 20.7%, 26.5%, and 44.2% of HCWs, respectively. The variable financial difficulties was commonly found as an associated factor for anxiety, depression, and insomnia symptoms. Female HCWs were more prone to mental health symptoms and insomnia compared to male HCWs (Adjusted odds ratio- AOR = 2.20, 95% CI = 1.27-3.79). The depression symptoms among HCWs were found to be a factor for insomnia (AOR = 6.321, 95% CI = 3.158-12.650). CONCLUSION: In the current pandemic, the high prevalence of mental health symptoms among HCWs indicates that this occupational group being associated with increased mental distress. Increasing financial support for HCWs and providing support to female workers in care facilities could help to alleviate the burden of mental illness. Supportive, training, and educational strategies, particularly through knowledge and communication platforms, could be recommended to the care facilities, which can reduce the burden of mental health symptoms among HCWs.

Prevalence of Long COVID symptoms in Bangladesh: a prospective Inception Cohort Study of COVID-19 survivors.

BACKGROUND: The objective of this study was to identify the prevalence of long COVID symptoms in a large cohort of people living with and affected by long COVID and identify any potential associated risk factors. METHODS: A prospective survey was undertaken of an inception cohort of confirmed people living with and affected by long COVID (aged 18-87 years). 14392 participants were recruited from 24 testing facilities across Bangladesh between June and November 2020. All participants had a previously confirmed positive COVID-19 diagnosis, and reported persistent symptoms and difficulties in performing daily activities. Participants who consented were contacted by face-to-face interview, and were interviewed regarding long COVID, and restriction of activities of daily living using post COVID-19 functional status scale. Cardiorespiratory parameters measured at rest (heart rate, systolic blood pressure, diastolic blood pressure, oxygen saturation levels, maximal oxygen consumption, inspiratory and expiratory lung volume) were also measured. RESULTS: Among 2198 participants, the prevalence of long COVID symptoms at 12 weeks was 16.1%. Overall, eight long COVID symptoms were identified and in descending order of prominence are: fatigue, pain, dyspnoea, cough, anosmia, appetite loss, headache and chest pain. People living with and affected by long COVID experienced between 1 and 8 long COVID symptoms with an overall duration period of 21.8±5.2 weeks. Structural equation modelling predicted the length of long COVID to be related to younger age, female gender, rural residence, prior functional limitation and smoking. CONCLUSION: In this cohort, at 31 weeks post diagnosis, the prevalence of long COVID symptoms was 16.1%. The risk factors identified for presence and longer length of long COVID symptoms warrant further research and consideration to support public health initiatives.

Knowledge, Attitudes, Behavioural Practises, and Psychological Impact Relating to COVID-19 Among People Living With Spinal Cord Injury During In-Patient Rehabilitation in Bangladesh.

AIM: The aim of this research is to focus on gaining an insight into the knowledge, attitudes, behavioural practises (KAP), and psychological impact relating to COVID-19 among the people living with spinal cord injury receiving in-patient rehabilitation. METHODS: A prospective, cross-sectional survey of people with SCI (N = 207), who were in active in-patient rehabilitation from two tertiary SCI Rehabilitation Centres in Bangladesh. Data were collected via face-to-face interviews, after voluntary consent, using a pretested, language validated questionnaire on Knowledge, Attitude and Behavioural practises (KAP) and the Depression, Anxiety, Stress Scale (DASS-21). Ethical approval and trial registration were obtained prospectively. RESULTS: A total of 207 people with SCI responded, among which 87% were men and 13% were women, with a mean age of 34.18 ± 12.9 years. Within the sample group, people living with tetraplegia comprised 33.8%, and people living with paraplegia comprised 66.2%. Overall, 63.8% of the participants were diagnosed with an SCI categorised as ASIA-A. Overall, the "knowledge score" was 8.59 ± 2.3 out of 12, "depression" was 11.18 ± 8, "anxiety" was 7.72 ± 5.1, and "stress" was 9.32 ± 6.7 from a total of 21 scores each category. The strong correlation was between knowledge, DASS scores, and age (p < 0.05). In addition, there was a strong correlation between knowledge, gender (p < 0.05) and education (p < 0.01). Binary logistic regression found a stronger association of knowledge and DASS scores with gender, young age, illiteracy (p < 0.01), and rural residence (p < 0.05). A positive relationship was found between depression and anxiety scores (p < 0.01) and a moderate positive relationship was found between depression and stress scores (p < 0.01). A positive attitude was reported by the majority of participants (p < 0.05). In terms of behavioural practises, participants reported both self and caregiver had followed health advice with regard to consulting health professionals (65.7%), implementing isolation (63.8%), taking droplet precaution care (87.4%), and hygiene care (90.3%). CONCLUSION: Participants in this study reported high levels of knowledge, adoption of positive attitudes, and the practise of positive health advisory behaviours related to COVID-19 prevention procedures. However, high levels of depression, anxiety, and stress were also reported. Overall, women and younger participants were more likely to have high KAP, whereas those living in rural areas and with literacy challenges were less likely to report high knowledge scores.

A structured classification of the types of pain research studies accessed by different health professionals involved in pain management.

OBJECTIVES: The aim of this study was to describe the information access behaviours of clinicians involved in pain management with respect to their use of a pain evidence resource and to determine the areas of professional differences. METHODS: Users (n = 258) of a free pain evidence alerting service (PAIN+) were enrolled in this study. The users regularly received email alerts about newly published clinical articles about pain that were pre-appraised for scientific merit and clinical relevance. A sample of up to 10 abstracts retrieved by each user were retrieved and classified using a descriptive classification system to describe the types of research, pain subtypes, interventions and outcomes that were reported in the accessed studies. Frequencies and chi-square tests were performed to compare access behaviours across professions. RESULTS: A total of 258 participants viewed 2311 abstracts. More than 52% of abstracts viewed were primary clinical studies; the majority (87%) addressed treatment effectiveness and were quantitative research (99.8%). The most commonly accessed clinical topic (58%) related to musculoskeletal pain and the most accessed pain type was chronic pain (76%). Drugs, injections and rehabilitation therapy were most commonly addressed in accessed intervention studies. Differences in professional focus were reflected in access: physicians/nurses accessed studies on injections (23%) and drugs (26%) and nurses accessed surgical studies, whereas other professions rarely did. Physiotherapists (PTs) and occupational therapists (OTs) preferentially accessed studies on rehabilitation. OTs and psychologists preferentially accessed the available studies on cognitive interventions; OTs accessed more ergonomic studies. Psychologists most accessed educational and psychosocial intervention studies. There were no differences in access across professions to multidisciplinary interventions. CONCLUSION: While access partially reflects the content of the pain repository, professional differences in access were evident that related to the nature of the intervention, type of pain and the research design. Multidisciplinary evidence repositories may need to consider how to include and meet varied information needs.

Knowledge, attitudes, and fear of COVID-19 during the Rapid Rise Period in Bangladesh.

The study aims to determine the level of Knowledge, Attitude, and Practice (KAP) related to COVID-19 preventive health habits and perception of fear towards COVID-19 in subjects living in Bangladesh. DESIGN: Prospective, cross-sectional survey of (n = 2157) male and female subjects, 13-88 years of age, living in Bangladesh. METHODS: Ethical approval and trial registration were obtained before the commencement of the study. Subjects who volunteered to participate and signed the informed consent were enrolled in the study and completed the structured questionnaire on KAP and Fear of COVID-19 scale (FCV-19S). RESULTS: Twenty-eight percent (28.69%) of subjects reported one or more COVID-19 symptoms, and 21.4% of subjects reported one or more co-morbidities. Knowledge scores were slightly higher in males (8.75± 1.58) than females (8.66± 1.70). Knowledge was significantly correlated with age (p < .005), an education level (p < .001), attitude (p < .001), and urban location (p < .001). Knowledge scores showed an inverse correlation with fear scores (p < .001). Eighty-three percent (83.7%) of subjects with COVID-19 symptoms reported wearing a mask in public, and 75.4% of subjects reported staying away from crowded places. Subjects with one or more symptoms reported higher fear compared to subjects without (18.73± 4.6; 18.45± 5.1). CONCLUSION: Bangladeshis reported a high prevalence of self-isolation, positive preventive health behaviors related to COVID-19, and moderate to high fear levels. Higher knowledge and Practice were found in males, higher education levels, older age, and urban location. Fear of COVID-19 was more prevalent in female and elderly subjects. A positive attitude was reported for the majority of subjects, reflecting the belief that COVID-19 was controllable and containable.

Evaluating the novel added value of neurophysiological pain sensitivity within the fear-avoidance model of pain.

BACKGROUND: The fear-avoidance model (FAM) is a leading theoretical paradigm for explaining persistent pain following musculoskeletal injury. The model suggests that as injuries heal, pain-related outcomes are increasingly determined by psychological, rather than physiological factors. Increasing literature, however, suggests that neurophysiological processes related to pain sensitivity also play an important role in chronicity. To date, there has been limited research that has specifically explored the role of pain sensitivity within the FAM. This study addresses this gap by evaluating whether clinical measures of pain sensitivity help explain FAM-related outcomes, beyond model-relevant psychological predictors. METHODS: The study sample consisted of 80 adults with chronic and widespread musculoskeletal pain. Participants completed a single testing session that included measures of all of the major constructs of the FAM, including pain catastrophizing, pain-related fear, activity avoidance (self-report and functional measures), pain-related disability, depression and pain severity, as well as a battery of quantitative sensory testing that included measures of pressure pain threshold and temporal summation of mechanical pain across eight body sites. RESULTS: A series of hierarchical regression analyses revealed that after controlling for the psychological predictors of the FAM, indices of pain sensitivity significantly predicted 4 of the 5 FAM-related outcomes (p < 0.05). Depression was the only outcome not significantly predicted by pain sensitivity. Interestingly, measures of pain sensitivity, but not FAM psychological factors, predicted the functional measure of activity avoidance. CONCLUSIONS: These findings provide further evidence for the importance of neurophysiological factors within the FAM and have important clinical and theoretical implications. SIGNIFICANCE: This study provides evidence for the unique and added value of neurophysiological factors within the Fear Avoidance Model of pain and for the importance of integrating both sensory and psychological factors within both theoretical paradigms and clinical management strategies.