Sex-specific differences in pain localization in female patients with endometriosis: A comparison of sexless and female human body outlines.

BACKGROUND: This study explores sex-specific differences in pain localization using pain drawings in female patients with endometriosis. Traditional human body outlines (HBOs) used for pain drawings are often viewed as male, making accurate pain assessment difficult. The study aims to compare pain localization and extent between patients presented with sexless and female HBOs. METHODS: A total of 49 female patients with endometriosis completed questionnaires and pain drawings (n = 24 and n = 26 with individually designed sexless and female HBOs, respectively). The Ruzika similarity index was used to investigate potential differences in pain drawings between sexless and female HBOs. Hypothesis testing was applied to compare the number of pixels marked in the pain extents and to investigate the suitability of the presented body outline. RESULTS: Sex of HBOs used in pain drawings had no effect on pain area, and no statistically significant differences were found in pain localization or area between female and sexless outlines. Most, but not all participants found the body outlines suitable. CONCLUSIONS: The findings suggest that differences in the resulting areas marked in the pain drawings were negligible and the preferences for sexless pain drawings were not significant, so that a sexless body outline for pain drawings could be a good choice, especially when a study does not focus on one specific sex.

Errorless learning and assistive technology did not improve the negative prognosis for severe dressing impairment after stroke if persisting for two weeks: A randomized controlled trial.

Following severe cerebrovascular accidents, patients are often unable to dress themselves. Little is known about the persistence and treatment of this impairment. Study 1 followed 23 patients who were (1) completely dependent on others for help with dressing (2) for two weeks continually until their discharge from the rehabilitation unit. Study 2, a randomized controlled trial of 24 patients, examined the effects of errorless learning and RehaGoal App-based dressing practice on recovery in dressing ability-impaired patients who also experienced visuospatial neglect and/or apraxia. The control and intervention groups both underwent a standard therapy in the rehab unit; the intervention group additionally received dressing training (seven sessions of 45 min). The primary outcome measure was the score on an adapted version of the Nottingham Stroke Dressing Assessment; secondary outcome measures were the Barthel Index and Functional Independence Measure. Less than one-third of the patients in Study1, showed improvement. In Study 2, the intervention produced no specific effect on patients' dressing ability. However, apraxia and neglect predicted improvement for both groups. If patients depend completely on assistance for dressing for two weeks, prospects for recovery are limited. Future studies should include additional intervention sessions and incorporate treatments for neglect or apraxia.

Guiding patients with traumatic brain injury through the instrumental activities of daily living with the RehaGoal App: a feasibility study.

PURPOSE: Individuals with traumatic brain injuries (TBI) often experience executive function impairments that impact activities of daily living. Assistive technologies can help overcome these disabilities and Goal Management Training (GMT) provides an effective therapeutic approach for treating such impairments. To capture the benefits of GMT with assistive technology we developed the RehaGoal App. In this study, we investigate whether combining a modified GMT (mGMT) with the RehaGoal App is feasible in terms of study design, and preliminary evaluation of the attainment of self-defined goals. We also examine if the app produces useful metrics data, tests its usability, and gauges its potential for improving goal attainment. METHODS: We used a case study design to evaluate four individuals with impairments in executive functions after TBI. They underwent an 8-week mGMT and RehaGoal App intervention to achieve a self-defined goal. To investigate the intervention's feasibility, we collected Goal Attainment Scale (GAS) scores at two-time points, neuropsychological data at study start, System Usability Scale (SUS) scores at study end, and metrics data throughout the study period. RESULTS: Participant retention and compliance rates were high. All participants improved on GAS. Metrics data was collected successfully and revealed different participant usage behaviours. Overall, the SUS scores of the participants indicated excellent app usability. CONCLUSIONS: The intervention was feasible but the study design should be modified. Preliminary evaluation of GAS, SUS, and metrics data provided useful insights on user behaviour, app usability, and its role in achieving self-defined goals. The app received overall positive participant ratings.IMPLICATION FOR REHABILITATIONMetric data can be useful as it can give therapists additional opportunities to gain more information about the realization of intervention tasks between the therapy sessions allowing them to use this information to adjust therapy elements.RehaGoal App in combination with a modified GMT may be able to support participants with impairment in executive functions in completing the task of daily living.The study shows that the RehaGoal App is feasible in rehabilitation for a small sample size and that it may be scaled up in the future larger randomized controlled trial.

[Balance between structured activities and individual leisure time : Perceptions of retirement by people with intellectual and mental disabilities]. / Balance zwischen strukturierten Aktivitäten und individuellen Freiräumen : Vorstellungen vom Ruhestand von Menschen mit intellektueller und psychischer Beeinträchtigung.

BACKGROUND: The number of people with intellectual disabilities reaching retirement age has risen by more than two thirds in the last decade. OBJECTIVE: Due to the high number of retirements in this group of persons, the facilities for integration assistance are required to provide appropriate offers, both in terms of the transition to retirement and the course of retirement. METHODS: Interviews on retirement planning were conducted with aspiring pensioners from several workshops for disabled people, which were mostly located in urban areas. RESULTS: These interviews showed that people with intellectual and mental disabilities wanted a balance between structured group offers and individual privacy. Sporting and creative offers were perceived as positive. Maintaining interpersonal contact is very important for the respondents. The upcoming retirement was seen as positive by the majority of the respondents because of the associated "new freedom". Only a few worried about the financial situation in old age.

Early detection of dementia in people with an intellectual disability - A German pilot study.

BACKGROUND: This study investigated the application of a newly developed neuropsychological assessment, the Wolfenbütteler Dementia Test for Individuals with Intellectual Disabilities (WDTIM) in combination with the Dementia Screening Questionnaire for Individuals with Intellectual Disabilities (DSQIID). METHODS: The instruments were evaluated in a prospective 2-year follow-up study. A total of 102 people with an intellectual disability were assessed at 6-month intervals. Data were analysed using qualitative and statistical analyses. RESULTS: Four groups of individuals emerged from the analysis: (1) confirmed suspicion, (2) no suspicion, (3) questionable suspicion and (4) early suspicion. Significant differences were found between groups 1 and 2. The WDTIM could be administered to 90%-100% of all participants exhibiting mild-to-moderate intellectual disability and to 50% with severe intellectual disability . CONCLUSIONS: The WDTIM was shown to have good applicability to people with mild-to-moderate intellectual disability and to be appropriate for detecting cognitive changes. Using the two instruments in combination achieved greater accuracy in reinforcing a dementia suspicion than did using the DSQIID alone.

Learning by doing: an fMRI study of feedback-related brain activations.

Extracting meaningful information from the positive and negative outcomes of actions is a key requirement for learning. To define the neural correlates of feedback processing, rapid event-related functional magnetic resonance imaging was used in an associative learning paradigm in normal human volunteers. Positive (compared with negative) feedback was associated with activations in the ventral striatum, midbrain and anterior and posterior cingulate cortex. No activations were seen for the comparison negative >positive feedback. Blood oxygenation level-dependent responses from the midbrain and the anterior cingulate cortex showed a phasic increase in response to positive feedback, whereas a decrease in response was seen for negative feedback. These results underscore the role of the reward system in feedback learning.

Disturbed monitoring and response inhibition in patients with Gilles de la Tourette syndrome and co-morbid obsessive compulsive disorder.

OBJECTIVE: Fronto-striatal dysfunction has been discussed as underlying symptoms of Tourette syndrome (TS) with co-morbid Obsessive Compulsive Disorder (OCD). This suggests possible impairments of executive functions in this disorder, which were therefore targeted in the present study. METHODS: A comprehensive series of neuropsychological tests examining attention, memory and executive functions was performed in a group of 14 TS/OCD in co-occurrence with OCD patients and a matched control group. RESULTS: While attentional and memory mechanisms were not altered, TS/OCS patients showed deficits in executive functions predominantly in the areas of response inhibition and action monitoring. CONCLUSIONS: These findings provide further evidence for a substantial impairment of the frontal-striatal-thalamic-frontal circuit. We propose that the deficits in monitoring, error detection and response inhibition constitute the major impairment of TS/OCD patients in the cognitive domain.