Head and pelvis are the key segments recruited by adult spinal deformity patients during daily life activities.

Functional assessment is a key element in evaluating adult spinal deformity (ASD) patients. The multitude of 3D kinematic parameters provided by movement analysis can be confusing for spine surgeons. The aim was to investigate movement patterns of ASD based on key kinematic parameters. 115 primary ASD and 36 controls underwent biplanar radiographs and 3D movement analysis during walking, sit-to-stand and stair ascent to calculate joint and segment kinematics. Principal component analysis was applied to identify the most relevant kinematic parameters that define movement strategies adopted by ASD. Pelvis and head relative to pelvis kinematics were the most relevant parameters. ASD patients adopted four different movement strategies. Class 1: normative head and pelvis kinematics. Class 2: persistent pelvic backward tilt. Class 3: persistent forward shift of the head. Class 4: both pelvic backward tilt and forward shift of the head. Patients in class 3 and 4 presented sagittal malalignment on static radiographs with increased pelvic tilt, pelvic incidence-lumbar lordosis mismatch and sagittal vertical axis. Surprisingly, patients in class 3 had normal pelvic kinematics during movement, showing the importance of functional evaluation. In addition to being key segments in maintaining static global posture, head and pelvis were found to define movement patterns.

Ecological virtual reality-based cognitive remediation among inpatients with schizophrenia: A pilot study.

Schizophrenia presents a considerable clinical challenge due to limited progress in promoting daily-life functioning among diagnosed individuals. Although cognitive remediation (CR) has emerged as a promising approach to improving cognitive and functional outcomes in schizophrenia, its effectiveness among inpatients and within hospital environments-where opportunities to practice skills in real-world contexts are limited-remains unclear. Here, we aimed to establish the feasibility and initial efficacy of a short, ecological virtual reality-based CR training (CR-EVR) in acute mental health inpatient settings. Efficacy was assessed at four levels: training engagement, near transfer, far transfer, and ecological transfer. Twenty-three inpatients with schizophrenia (Male: 33.3 ± 8.5; 4 Female) completed 8, 20-min CR-EVR sessions, with exercises training the cognitive abilities of inhibition, planning, working memory, shifting, self-initiation, persistence, and attention. Their cognitive functioning, schizophrenia symptoms, functional capacity, and participation in occupations were evaluated pre- and post-training to address four levels of effectiveness. Of the recruited participants, 25.8 % dropped out. Inpatients who completed the full protocol reported high rates of satisfaction (1-not satisfied; 5-very satisfied)) from the intervention (Median = 4, IQR:3.5-5). Post-training, significant improvements were found in the trained cognitive components (intervention engagement: -6.58 < t/Z < 2.02, p < .05), general cognitive functioning (-2.59 < t/Z < 2.29, p < .05), functional capacity (t = -2.9, p < .05), and diversity of participation in everyday activities (t = -3.36, p < .05). This preliminary study suggests that CR-EVR may be a feasible and practical tool to enhance cognitive and ecological outcomes in short-stay acute inpatient settings. Subject to further research, such intervention may be considered an add-on to current practices that promote recovery and health among inpatient populations.

Getting stress-related disorders under control: the untapped potential of neurofeedback.

Stress-related disorders are among the biggest global health challenges. Despite significant progress in understanding their neurocognitive basis, the promise of applying insights from fundamental research to prevention and treatment remains largely unfulfilled. We argue that neurofeedback - a method for training voluntary control over brain activity - has the potential to fill this translational gap. We provide a contemporary perspective on neurofeedback as endogenous neuromodulation that can target complex brain network dynamics, is transferable to real-world scenarios outside a laboratory or treatment facility, can be trained prospectively, and is individually adaptable. This makes neurofeedback a prime candidate for a personalized preventive neuroscience-based intervention strategy that focuses on the ecological momentary neuromodulation of stress-related brain networks in response to actual stressors in real life.

Understanding the daily life needs of older public assistance recipient subgroups in Japan: A qualitative study.

Transition from individual-level treatment to social-level intervention should be made to improve peoples daily living conditions for reducing health inequality, which is a major global public health concern. Older public assistance recipients in Japan are socially vulnerable and require healthcare, long-term care, daily living, and social care support. Understanding the diverse daily living needs among public assistance recipient subgroups would prompt the development of novel support measures in the welfare sector. Therefore, this study aimed to understand the daily life needs of older recipient subgroups (segments) created quantitatively in our previous study. We interviewed four caseworkers at municipal welfare offices in 2021; the interview data were analyzed using a qualitative descriptive method to describe the daily life needs of the five older recipient segments for each sex. Five themes of daily life needs were demonstrated: i) housing, ii) financial, iii) welfare service, iv) healthcare, and v) no daily life needs. Consequently, we identified the daily life needs of some older recipient segments, indicating the necessity for support interventions. Future research would help interview other professionals from various backgrounds to further understand the daily life needs of older recipient segments.

Navigating Life With Parkinson's Disease: A Focus Group Study on Coping Strategies and Considerations for Self-Management Support.

AIM: To investigate the experiences of people with Parkinson's disease in coping with and adapting to their disease and to identify considerations for a tailored self-management support program. DESIGN: A descriptive phenomenological focus group study. METHODS: Five semi-structured focus groups were conducted between April 2023 and June 2023 in the Netherlands, with 12 people with Parkinson's disease. Two researchers independently performed an inductive content analysis. RESULTS: Three principal categories emerged: (1) Rational realisation versus emotional experience: the coping strategy transition. This category includes three main coping strategies: denial or avoidance coping, acknowledging with less active coping and proactive and task-oriented coping. (2) Factors that influence coping, including mindset and skills, social circles and communication and access to support and care. (3) Considerations for successful self-management of Parkinson's disease, highlighting key areas such as psycho-emotional guidance, nutrition and lifestyle, peer support and maintaining autonomy and sense of identity. CONCLUSION: Coping and adaptation strategies are individual and dynamic processes, with multiple key or turning points during the transition between strategies. Tailored self-management support can enhance coping abilities during these transitions, fostering adaptation to a life with Parkinson's disease. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: A patient-focused version of an existing blended self-management support program for family caregivers will be developed, which will be delivered by healthcare professionals. IMPACT: This study can help healthcare professionals tailor support for people with Parkinson's disease, emphasising their role in facilitating coping and adaptation. Enhancing self-management can improve self-efficacy, quality of life and potentially reduce healthcare utilisation in people with Parkinson's disease. REPORTING METHOD: Findings are reported according to the COREQ guidelines. PATIENT OR PUBLIC CONTRIBUTION: Patients and Parkinson's disease experts participated in the preparation and implications of the findings. All participants could contribute to the self-management support program, either through video interviews or content feedback.

Self-reported body function and daily life activities 18 months after Covid-19: A nationwide cohort study.

AIMS: This study aimed to investigate body function and daily life activities 18 months after Covid-19 infection, depending on the initial severity of disease and according to sex. METHODS: All 11,955 individuals on sick leave due to Covid-19 during the first wave of the pandemic in Sweden were invited to answer a questionnaire regarding experiencing negative changes in body function and daily life activities approximately 18 months after the start of sick leave. The analysis of data included descriptive statistics, group comparisons and multivariable binary logistic regressions (two groups). RESULTS: Of 5464 responders (45.7%), 4676 (85.6%) reported experiencing at least one problem with body function, and the reported prevalence of problems with daily life activities was 46%. The most frequently reported problems were fatigue (66.3%), cognition, sleep and movement. In general, women and those initially hospitalised reported more problems. In the regression analyses, problems with body function could partly explain whether individuals experienced problems with daily life activities. However, only fatigue and movement significantly contributed throughout all groups (p<0.001). Furthermore, the odds ratios for fatigue were larger in regressions for women than for men. CONCLUSIONS: In this nationwide study, more than 8 out of 10 individuals experienced problems with body function 18 months after being on sick leave due to Covid-19, with women and those initially hospitalised reporting more problems. Problems with body function, such as fatigue, could partly explain problems with daily life activities. However, the mechanisms behind the consequences are not yet clear and need to be further investigated.

One-year evaluation of people recovering from COVID-19 receiving allied primary healthcare: A nationwide prospective cohort study.

BACKGROUND: A Dutch nationwide prospective cohort study was initiated to investigate recovery trajectories of people recovering from coronavirus disease 2019 (COVID-19) and costs of treatment by primary care allied health professionals. OBJECTIVES: The study described recovery trajectories over a period of 12 months and associated baseline characteristics of participants recovering from COVID-19 who visited a primary care allied health professional. It also aimed to provide insight into the associated healthcare and societal costs. METHODS: Participants completed participant-reported standardized outcomes on participation, health-related quality of life, fatigue, physical functioning, and costs at baseline (ie, start of the treatment), 3, 6, 9 and 12 months. RESULTS: A total of 1451 participants (64 % women, 76 % mild/moderate severity) with a mean (SD) age of 49 (12) years were included. Linear mixed models showed significant and clinically relevant improvements over time in all outcome measures between baseline and 12 months. Between 6 and 12 months, we found significant but not clinically relevant improvements in most outcome measures. Having a worse baseline score was the only baseline factor that was consistently associated with greater improvement over time on that outcome. Total allied healthcare costs (mean €1921; SEM €48) made up about 3% of total societal costs (mean €64,584; SEM €3149) for the average participant in the cohort. CONCLUSIONS: The health status of participants recovering from COVID-19 who visited an allied health professional improved significantly over a 12-month follow-up period, but nearly the improvement occurred between baseline and 6 months. Most participants still reported severe impairments in their daily lives, and generated substantial societal costs. These issues, combined with the fact that baseline characteristics explained little of the variance in recovery over time, underscore the importance of continued attention for the management of people recovering from COVID-19. TRIAL REGISTRATION: clinicaltrials.gov (NCT04735744).

Resting vagally-mediated heart rate variability in the laboratory is associated with momentary negative affect and emotion regulation in daily life.

Vagally-mediated heart rate variability (vmHRV) is a physiological index reflecting parasympathetic activity that has been linked to emotion regulation (ER) capacity. However, very limited research has examined associations of physiological indices of regulation such as vmHRV with emotional functioning in daily life. The few studies that exist have small samples sizes and typically focus on only a narrow aspect of ER or emotional functioning. In this study, we examined associations between vmHRV assessed in the laboratory and emotional/mental health functioning in daily life using a 7-day ecological momentary assessment design in 303 adult community participants. We hypothesized that higher resting vmHRV would be associated with higher positive affect (PA), lower negative affect (NA), less affective variability, greater well-being, fewer dysphoria symptoms, greater use of engagement ER strategies, and less use of avoidance ER strategies, as assessed in daily life. Results revealed that higher resting vmHRV in the laboratory (as indexed by both high frequency heart rate variability, HF-HRV, and the root mean of successive square deviations between heart beats, RMSSD) was significantly associated with less frequent use of avoidance ER strategies in daily life. Theoretical and clinical implications are discussed, including the association of vmHRV with negatively valenced, rather than positively valenced, daily life experiences.

Improving outcome measures in late onset Pompe disease: Modified Rasch-Built Pompe-Specific Activity scale.

BACKGROUND AND PURPOSE: The Rasch-Built Pompe-Specific Activity (R-PAct) scale is a patient-reported outcome measure specifically designed to quantify the effects of Pompe disease on daily life activities, developed for use in Dutch- and English-speaking countries. This study aimed to validate the R-PAct for use in other countries. METHODS: Four other language versions (German, French, Italian, and Spanish) of the R-PAct were created and distributed among Pompe patients (≥16 years old) in Germany, France, Spain, Italy, and Switzerland and pooled with data of newly diagnosed patients from Australia, Belgium, Canada, the Netherlands, New Zealand, the USA, and the UK and the original validation cohort (n = 186). The psychometric properties of the scale were assessed by exploratory factor analysis and Rasch analysis. RESULTS: Data for 520 patients were eligible for analysis. Exploratory factor analysis suggested that the items separated into two domains: Activities of Daily Living and Mobility. Both domains independently displayed adequate Rasch model measurement properties, following the removal of one item ("Are you able to practice a sport?") from the Mobility domain, and can be added together to form a "higher order" factor as well. Differential item functioning (DIF)-by-language assessment indicated DIF for several items; however, the impact of accounting for DIF was negligible. We recalibrated the nomogram (raw score interval-level transformation) for the updated 17-item R-PAct scale. The minimal detectable change value was 13.85 for the overall R-PAct. CONCLUSIONS: After removing one item, the modified-R-PAct scale is a valid disease-specific patient-reported outcome measure for patients with Pompe disease across multiple countries.

Impact of dental caries and Self-perceived oral health on daily lives of children and mothers in rural Egypt: a household survey.

BACKGROUND: The present study assessed the impact of oral health on the daily lives of children and mothers living in a rural area in Northwestern Egypt. METHODS: A cross-sectional household survey including children between 6 and 12 years old and their mothers was conducted in rural Egypt, 2019-2020. Data were collected using clinical examination and interview-based questionnaires of children and mothers. Three binary logistic regression models were used to assess the relationship between the dependent variables (oral health impact (yes, no) on avoiding smiling, chewing problems, and missing school (children) and avoiding social events (mothers)), and the explanatory variables: oral health (clinically-assessed caries experience and self-reported oral health) controlling for sociodemographic profile (child age and sex, mother's education), daily toothbrushing and village of residence. RESULTS: A total of 211 households with 355 children and 211 mothers were included (91.5% response rate). About 54% of the children were girls, mean (SD) age = 8.7 (2.05) years and 82.3% did not brush their teeth daily. Mother's mean (SD) age was 31.70 (5.45) years. Because of dental problems, 31.3% of children reported chewing difficulties, 31% avoided smiling compared to 76.3% and 43.6% of mothers. Also, 30.4% of children missed school and 76.8% of mothers reported reduced participation in social activities. In children, the number of decayed anterior teeth was associated with significantly higher odds of avoiding smiling (AOR = 1.22, 95%CI: 1.03, 1.44). In mothers, a greater number of posterior missing teeth was associated with significantly higher odds of chewing difficulties (AOR = 1.21, 95%CI: 1.01, 1.45), and a greater number of all missing teeth was associated with significantly higher odds of reduced participation in social events (AOR = 1.30, 95%CI: 1.30, 1.57). Good/ very good reported oral health in children and mothers was associated with lower odds of avoiding smiling and chewing problems (p < 0.05). CONCLUSION: Decayed anterior teeth in children have a negative impact on smiling whereas missing teeth in mothers affect the ability to chew food and socialize. The psychological, functional, and social impacts of caries in this rural setting needs to be mitigated by improving oral health literacy and access to care.

The order characteristics of daily life space in Chinese urban communities--a case of Ningbo Green Axis Sports Park.

This paper explores the order characteristics of urban daily life spaces in China through ethnographic studies and field research data, with a focus on Ningbo Green Axis Sports Park. The study identifies four key characteristics of urban community daily life spaces: hierarchical "bounded space", rhythmic temporality, physical embodiment, and habitual occupation. In Chinese urban contexts, the delineation between work and life proves challenging, intertwining hierarchical relationships among neighbors and colleagues within public spaces, thereby forming a structured hierarchy of subcultural groups.Individuals engage with colleagues, neighbors, and diverse individuals within daily life spaces to negotiate identity and hierarchy, thereby shaping the social space of the subject through public interactions. Our analysis posits that the orderliness of public spaces hinges upon empowerment and domain delineation; the preservation of order sustains the publicness, social connectivity, and interactive dynamics of such spaces. The tension between publicness and domain delineation may indeed serve as the linchpin of public space efficacy. Consequently, urban planning endeavors should prioritize the orderly attributes of public spaces and foster the development of human-centric urban environments.

Parents' experiences of family and daily life after their child's stay in the pediatric intensive care unit: a qualitative descriptive study.

INTRODUCTION: The stay of a critically ill child in a pediatric intensive care unit (PICU) is a significant experience for the family. Thus far, little is known regarding the impact of this stay on parents and their healthy children for whom no continuous aftercare services are offered. This study aimed to capture the post-stay experience and needs of parents after this traumatic event so that they could return to family and everyday life. METHODS: This qualitative descriptive study was conducted in collaboration with four pediatric intensive care units in Switzerland. It included parents whose children had fully recovered after a stay and who did not require continuous medical follow-up. All children were hospitalized in the PICU for at least 48 h. Data were collected through narrative pairs (n = 6) and individual interviews (n = 8). Interviews were audio recorded, transcribed, coded inductively according to Saldaña, and analyzed. RESULTS: The results showed three related phases that influence each other to restore normality in daily life: Trust and inclusion in the treatment process during the stay (1), processing after the stay (2), and returning to everyday life (3). CONCLUSION: Follow-up meetings should be available to all parents whose children have been hospitalized in the PICU. In particular, it should also be available to parents whose children have fully recovered and no longer have any medical disabilities.

Investigating cognitive impairment, biopsychosocial barriers, and predictors of return to daily life among older stroke survivors.

Purpose: The aim was to investigate the associations between cognitive impairment and biopsychosocial factors among older stroke survivors and predictors of poststroke return to daily life. Materials and methods: This cross-sectional study involved 117 stroke survivors (61% men) with an average age of 77 years (range 65-91). The participants completed two questionnaires (Riksstroke and Short Form 36 questionnaires). The Montreal Cognitive Assessment (MoCA) was used to assess cognitive abilities. The International Classification of Functioning, Disability, and Health (ICF) framework guided the selection of biopsychosocial variables. We used Spearman's correlation coefficient and multiple logistic regression in the analyses. Results: The average MoCA score was 21.7 points (range: 4-30, SD 5.6). The need for assistance from relatives and professionals, need for help with dressing and household chores, reliance on others for mobility, and reading and balance problems were correlated with more severe cognitive impairment (r = 0.20-0.33). Cognitive impairment, fatigue, and balance issues predicted an unfavorable return to daily life (odds ratio: 6.2-6.8). Conclusion: The study indicated that cognitive impairment is associated with difficulties in all ICF domains. Cognitive impairment, fatigue, and balance issues are associated with an unsuccessful return to daily life. Prioritizing these factors and screening for cognitive impairment with objective assessment tools may improve rehabilitation outcomes and enhance overall quality of life poststroke.

Development and psychometric properties of the Balance in Daily Life (BDL) scale in a population of frail older people.

BACKGROUND: Balance disorders in older people cause falls, which can have serious functional and economic consequences. No existing scale relates fall risk to daily life situations. This study describes the development, psychometric properties and construct validity of the Balance in Daily Life (BDL) scale, comprising seven routine tasks including answering a phone, carrying a heavy bag, and sitting down and getting up from a chair. METHODS: Frail patients aged 65 years or more were prospectively recruited from the geriatric rehabilitation department of a French university hospital. Inclusion criteria included autonomous walking over 20 m and modified Short Emergency Geriatric Assessment score 8-11. Patients with motor skills disorders and comprehension or major memory difficulties were excluded. Patients were assessed on Day 3 and Day 30 with the Balance in Daily Life scale, Timed Up and Go, one-leg stance time, sternal nudge and walking-while-talking tests. The scale was assessed for acceptability, quality, unidimensionality, internal consistency, reliability, temporal stability, responsiveness and construct validity. RESULTS: 140 patients (83 ± 6 years) were recruited, of whom 139 were assessed at Day 0 and 133 at Day 30. Acceptability was satisfactory (134/139 patients completed the test), quality assessment showed a slight floor effect (6 % of patients with minimal score) and evaluation of item redundancy found no strong correlation (Spearman <0.7). Unidimensionality was verified (Loevinger H coefficient > 0.5 for all items except item 6 = 0.4728). Internal consistency was good (Cronbach alpha = 0.86). Reliability and temporal stability were excellent (ICC = 0.97 and ICC = 0.92). Responsiveness was verified by significant score change p < 0.0001 between Day 0 and Day 30 (decreased by 1 [0; 2] point), in line with other score changes. Construct validity revealed that the Balance in Daily Life scale was convergent with results of the timed up-and-go and one-leg stance time (p < 0.0001 for both) and tended to be higher for participants who had not fallen in the previous 6 months (p = 0.0528). The new questionnaire was divergent to sternal nudge tests (p = 0.0002) and not related to the walking-while-talking test (p = 0.5969). CONCLUSION: The Balance in Daily Life scale has good psychometric properties for this population. Its simplicity and innovative nature mean that it can be applied in institutions while being easily modifiable to domestic settings. Study registration on clinicaltrials.gov: NCT0334382.

Sedentary behaviour may cause differences in physical outcomes and activities of daily living in older cardiovascular disease patients participating in phase I cardiac rehabilitation.

This study aimed to investigate the rate of sedentary behaviour and differences in physical outcomes and activities of daily living (ADL) based on sedentary behaviour time of hospitalized older cardiovascular disease patients undergoing phase I cardiac rehabilitation. Older cardiovascular disease patients were enrolled from October 2020 to September 2023 and were divided into the high sedentary behaviour group (≥ 480 min/day) and low sedentary behaviour group (< 480 min/day). Patients' clinical characteristics, usual gait speed, and Five Times Sit to Stand Test time were compared as indices of physical outcomes. Motor, cognitive, and total Functional Independence Measure (FIM) scores were used as indices of ADL and compared between groups using analysis of covariance. Final analysis included 402 patients (mean age: 76.7 years, female: 35.3%). The high sedentary behaviour group included 48.5% of the study patients. After adjustment for baseline characteristics, gait speed (0.80 ± 0.27 vs. 0.96 ± 0.23 m/s, p < 0.001) was lower and FTSST time (11.31 ± 4.19 vs. 9.39 ± 3.11 s, p < 0.001) was higher in the high sedentary behaviour group versus low sedentary behaviour group. Motor (85.82 ± 8.82 vs. 88.09 ± 5.04 points, p < 0.001), cognitive (33.32 ± 2.93 vs. 34.04 ± 2.24 points, p < 0.001), and total FIM scores (119.13 ± 10.66 vs. 122.02 ± 6.30 points, p < 0.001) were significantly lower in the high sedentary behaviour group versus low sedentary behaviour group after adjustment. In older cardiovascular disease patients in phase I cardiac rehabilitation, sedentary behaviour time might influence physical outcomes and ADL at discharge. It is thus important to consider the amount of sedentary behaviour time spent by these patients during daily life while hospitalized.

In a Strained Healthcare System, Patients with Advanced COPD Struggle to Access the Needed Support from the Healthcare Professionals - A Qualitative Study.

This study aimed to explore the self-management strategies of Danish patients living with advanced Chronic Obstructive Pulmonary Disease (COPD), with a particular focus on their daily life and their interactions with the respiratory outpatient clinic. Data were collected through semi-structured interviews with 11 patients with COPD affiliated with a Danish respiratory outpatient clinic. The data were thematically analyzed as suggested by Braun & Clarke. The analysis revealed one overarching theme, three main themes, and six subthemes. The overarching theme 'In a strained healthcare system patients with COPD struggle to access needed support to be able to self-manage their disease' revolved around the challenges that patients face in an overburdened healthcare system as they seek support to effectively self-manage their condition. The three main themes were: (1) Only physical symptoms provide legal access to the respiratory outpatient clinic, (2) For patients, the measurements serve as indicators of their health status and overall well-being, (3) Healthcare professionals' skills and not the mode of contact matters to the patients. Healthcare professionals should be aware that the rhetoric surrounding a busy healthcare system with a stressed-out staff also affects patients. Patients with COPD may be particularly sensitive to this message and try to avoid burdening the healthcare system further by setting aside their own needs. However, this approach can lead to neglecting symptoms of deterioration and mental symptoms, which increase the risk of disease progression and subsequent risk of hospital admission.

The relationship between rehabilitation motivation and upper limb motor function in stroke patients.

Objective: Insufficient motivation among post-stroke survivors may be an important factor affecting their motor function recovery. This study seeks to investigate the relationship between motivation and functional recovery in stroke patients undergoing rehabilitation training. Materials and methods: 103 stroke patients with upper limb impairments were studied during their hospital stays. Assessments were done before and after rehabilitation training to measure motivation, emotional state, motor function, and independence in daily activities. Data analysis was conducted to examine the distribution of these factors among the participants. Pearson and Spearman correlation analyses were used to study the relationships between motivation, emotional state, and motor function. Patients were divided into high and low motivation groups based on the Rehabilitation Motivation Scale (RMS), and chi-square and rank-sum tests were used to compare functional differences before and after treatment among patients with varying levels of motivation. Results: 66 participants were found to have low motivation in the initial assessment of the RMS (64.08%). Consistency in motivation levels was observed among patients with high motivation (r = 0.648, P<0.001). Apathy was identified as the main factor affecting motivation in patients with low motivation (p = 0.027), while depression and anxiety were not significantly correlated. Motivation was strongly linked to improvements in upper limb motor function, daily living activities, and self-exercise duration (p < 0.001) for stroke patients undergoing rehabilitation. Post-training, there was a notable increase in motivation, motor function, and independence in daily activities (p < 0.001). Increased rehabilitation motivation was linked to better upper limb motor function and daily independence in patients, particularly those with low motivation. This correlation was significant for both the FMA-UE and FIM scores. Discussion: Old patients with poor upper limb motor function often have low motivation, which hinders their recovery. Using strategies to boost motivation in stroke patients with impaired upper limb function could greatly improve their rehabilitation and motor skills. It is crucial to prioritize these intervention strategies. Conclusion: Enhancing rehabilitation motivation in stroke patients with low motivation and upper limb motor impairments can foster the restoration of their functional capabilities.

Comparison of trait and state mind wandering among schizotypal, subclinically depressed, and control individuals.

BACKGROUND: Mind wandering is a common phenomenon in daily life. However, the manifestations and cognitive correlates of mind wandering in different subclinical populations remain unclear. In this study, these aspects were examined in individuals with schizotypal traits and individuals with depressive symptoms, i.e., subclinical populations of patients with schizophrenia and depression. METHODS: Forty-two individuals with schizotypal traits, 42 individuals with subclinical depression, and 42 controls were recruited to complete a mind wandering thought sampling task (state level) and a mind wandering questionnaire (trait level). Measures of rumination and cognitive functions (attention, inhibition, and working memory) were also completed by participants. RESULTS: Both subclinical groups exhibited more state and trait mind wandering than did the control group. Furthermore, individuals with schizotypal traits demonstrated more trait mind wandering than individuals with subclinical depression. Rumination, sustained attention, and working memory were associated with mind wandering. In addition, mind wandering in individuals with subclinical depression can be accounted for by rumination or attention, while mind wandering in individuals with high schizotypal traits cannot be accounted for by rumination, attention, or working memory. CONCLUSIONS: The results suggest that individuals with high schizotypal traits and subclinical depression have different patterns of mind wandering and mechanisms. These findings have implications for understanding the unique profile of mind wandering in subclinical individuals.

The Link Between Childhood Abuse Experiences and Homeless People's Quality of Life: A Longitudinal Study.

Studies report a relatively high prevalence of childhood abuse experiences (CAE) among adult homeless people. Within homeless populations, people with CAE appear to be worse off than homeless people without such experiences. This study compares a broad set of factors influencing the quality of the daily lives of Dutch homeless people with and without CAE. It also examines the extent to which CAE are predictive of the rate of change in these factors 2.5 years after entering the social relief system. Data were used from an observational longitudinal multi-site cohort study following Dutch homeless people 2.5 years after entering the social relief system. The 4 constitutional conditions of the Social Quality Approach (living conditions, interpersonal embeddedness, societal embeddedness and self-regulation) were used to cluster the factors included in this study. Participants were interviewed twice, at baseline (N = 513) and at follow up (N = 378), using a quantitative questionnaire. At baseline and follow-up participants with CAE were more disadvantaged in each of the 4 conditions of social quality, except for societal embeddedness at follow-up. After 2.5 years, on average, all participants improved more or less at a similar rate on almost all factors, with a few exceptions: Significant differential changes over time were found regarding employment status, quality of relationships with family members and symptoms of depression and anxiety. Findings corroborate the broad, detrimental and persistent impact of CAE on the quality of daily lives of homeless people and the need for homelessness services to apply trauma-informed care.

Factors correlated with hearing aids adherence in older adults: a prospective controlled study.

OBJECTIVE: To investigate which factors influence the adherence to hearing aid (HA) use in elderly patients with moderate-to-severe hearing loss. METHODS: This observational, prospective, single-centre study enrolled patients with moderate-to-severe hearing loss. They were evaluated before and 1 year after having either one or two HAs fitted. RESULTS: A total of 86 patients were enrolled in the study and of these 69.8% (60 of 86; USER group) continued to use their HA at 1 year after fitting; six patients had not continued their use (NON-USERS). The USER group was younger than the NON-USER group, but the difference was not significant. The USER group had a significantly better unaided auditory threshold at baseline than the NON-USER group. HA use resulted in improvements in speech audiometry and auditory threshold. There was also a maintenance of cognitive function in the USER group. CONCLUSION: Use of HA for 1 year resulted in improved auditory performance and an absence of a deterioration of cognitive function.Trial registration: This research was retrospectively registered under no. NCT04333043 at ClinicalTrials.gov (http://www.clinicaltrials.gov/) on the 26 March 2020. This research has been registered with the Ethics Committee of the Area Vasta Emilia Nord under number 104, date of approval 17/07/2017.