Attributional styles are associated with care burden in geriatric depression: older adults and their caregivers in Taiwan.

BACKGROUND: Given the rising prevalence of depression among older adults and the associated increase in caregiving responsibilities, understanding factors influencing caregiver burden is crucial. Previous research has not extensively explored the impact of caregivers' attributional styles, that is, how individuals interpret the causes of life events, on their care burden. AIM: This study examined the relationship between caregivers' attributional styles and their care burden for older patients with depression. METHODS: This cross-sectional study enrolled older adults aged ≥ 65 years diagnosed with depression and their caregivers. Depression was diagnosed according to the DSM-V criteria for Major Depressive Disorder or Persistent Depressive Disorder. Caregivers completed the Chinese Depression Caregiver Burden Scale (CDCBS) to assess care burden, the Hamilton Depression Rating Scale (HAM-D) to evaluate patient symptom severity, the Center for Epidemiological Studies Depression Scale (CES-D) for measuring caregivers' depression, and the Chinese Depression Patient Caregiver Attribution Style Scale (CDPCAS) to assess attributional styles. Hierarchical regression analysis was used to identify the factors independently associated with the caregiver's subjectively assessed care burden. RESULTS: The sample included 146 caregivers of geriatric patients with depression. Most depression patients were women (74.7%) with a mean age of 74.3 years, whereas the mean age of caregivers was 57.7 years. Hierarchical regression analysis identified that caregivers' gender (ß = - 0.14, p = .044), educational level (ß = 0.19, p = .008), caregivers' own depression assessed by the Center for Epidemiological Studies Depression Scale (ß = 0.41, p < .001), and attributional styles, particularly manipulation (ß = 0.29, p < .001) and illness/stress attributional style (ß = 0.23, p = .002) as independent factors associated with care burden. Patient symptom severity assessed using the Hamilton Depression Scale was not significantly correlated with care burden after controlling for attributional styles. CONCLUSIONS: Certain attributional styles, particularly the manipulation and illness/stress attributional styles, significantly increased self-reported care burden. These findings highlight the need for educational resources to change the attribution style, along with support systems and accessible mental health services for caregivers to potentially ease the care burden.

Magnetic Resonance Elastography in the Assessment of Acute Effects of Kinesio Taping on Lumbar Paraspinal Muscles.

BACKGROUND: Kinesio tape (KT) is an elastic therapeutic tape used for treating sports-related injuries and a number of other disorders. To date, the objective evidence to link pathophysiological effects and actual reactions triggered by KT is limited. PURPOSE: To explore the effect of KT on the lumbar paraspinal muscles by magnetic resonance (MR) elastography. STUDY TYPE: Prospective observational study. POPULATION: Sixty-six asymptomatic volunteers with 31 women and 35 men. FIELD STRENGTH/SEQUENCE: 3.0T MRI and elastography with vibration frequency of 120 Hz. ASSESSMENT: The 5-cm-width KT with full tension was placed on a single side of the lumbar paraspinal muscle. The taping side and adhering direction were randomly decided. Two rectangular regions of interest (ROIs) of 5- and 2.5-cm-width were positioned at the bilateral paraspinal regions from the L2 to L4 level on the confidence map of MR elastography before and after KT taping. The mean shear stiffness values of the ROIs at the superficial, middle, and deep depths were recorded; then the differences between the taping and reference sides were calculated. STATISTICAL TESTS: Paired t-test and Pearson correlations were used to evaluate the stiffness changes after KT application and intraoperator errors of the stiffness measures on the reference side, respectively. RESULTS: A significant decrease in the muscle stiffness value between taping and reference sides (-0.71 kPa ± 0.60 with KT and -0.25 kPa ± 0.78 without KT, P < 0.0001 for 5-cm ROI; -0.67 kPa ± 1.12 with KT and -0.16 kPa ± 1.17 without KT, P = 0.0004 for 2.5-cm ROI) was found in the superficial depth, but no significant differences in the middle and deep depths (P = 0.25 and P = 0.79 for 5-cm ROI; P = 0.09 and P = 0.67 for 2.5-cm ROI, respectively). There were no significant differences of muscle stiffness differences between gender (P = 0.11 for superficial, P = 0.37 for middle, P = 0.78 for deep) and taping direction (P = 0.18 for superficial, P = 0.13 for middle, P = 0.15 for deep). DATA CONCLUSION: Our results demonstrate that KT can reduce the MR elastography-derived shear stiffness in the superficial depth of paraspinal muscles. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1039-1045.

Estimated radiation risk of cancer from dental cone-beam computed tomography imaging in orthodontics patients.

BACKGROUND: Radiation dose evaluation is important to cone-beam computed tomography (CBCT) for routine orthodontic treatment planning, especially for a significant proportion of children in orthodontic patients. This study evaluated the patient radiation dose and estimated the radiation cancer risk on dental CBCT according to the calculations by the Monte Carlo simulation method. METHODS: The dental CBCT scanner evaluated in this project was the i- CAT® (Imaging Sciences International Inc., PA, U.S.A.) device. Organ doses and effective doses were calculated by using personal computer-based Monte Carlo simulation (PCXMC 2.0 Rotation) software. The cancer risk resulting from the exposure to ionizing radiation was estimated by using the BEIR VII (Biologic Effects of Ionizing Radiation VII) report model, and the risk of exposure-induced death (REID) was assessed by PCXMC 2.0 Rotation software. RESULTS: The largest contribution to the organ dose and effective dose at Zref 83 cm positioned in the dental CBCT x-ray beam centerline was from the salivary glands (738.29µGy, 7.38 µSv). The different organ doses showed the maximum values at the different Zref locations, and the largest contribution to the organ dose and effective dose of all simulated positions was from the thyroid (928.77µGy, 37.5 µSv). The REID values in the 10-year olds (22.6 × 10- 7, female; 19 × 10- 7, male) were approximately double than those in 30-year olds (10.4 × 10- 7, female; 8.88 × 10- 7, male) for all cancers. The highest change during age range from 10 to 30 was shown in breast cancer of females. CONCLUSIONS: Although individual cancer risk estimates as a function of gender and age are small, the concern about the risks from dental CBCT is related to the rapid increase in its use for orthodontic practice, especially in children patients.

Inter-rater reliability and validity of the stroke rehabilitation assessment of movement (stream) instrument.

The Stroke Rehabilitation Assessment of Movement (STREAM) instrument is used to measure motor and mobility problems in patients who have experienced a stroke. The purposes of the study were to examine the interrater reliability, concurrent and convergent validity of the STREAM instrument in stroke patients. Fifty-four stroke patients participated in the study. For the purpose of interrater reliability, the STREAM instrument was administered by two raters on each patient within a 2-day period. Validity was assessed by comparing the patients' scores on the STREAM instrument with those obtained from the other well-established measures. Weighted kappa statistics for inter-rater agreement on scores for individual items ranged from 0.55 to 0.94. The intraclass correlation coefficient for the total score was 0.96 indicating very high inter-rater reliability. The intraclass correlation coefficients were also very high in each of the subscales. The total STREAM score was moderately to highly associated with the score of the Barthel Index and Fugl-Meyer motor assessment scale, rho = 0.67, and 0.95, respectively. The STREAM subscale scores were closely associated with scores of the other well-validated measures. Our results demonstrate that consistent and valid information can be obtained from the STREAM instrument and support its use in the value of the STREAM evaluation of motor and mobility recovery in persons who have experienced a stroke.