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The Journal of Nutrition, Health & Aging May 2024Post-stroke fatigue (PSF) is an experience characterized by an early feeling of exhaustion with fatigue, a lack of energy, and difficulty in exertion, both motor and...
OBJECTIVES
Post-stroke fatigue (PSF) is an experience characterized by an early feeling of exhaustion with fatigue, a lack of energy, and difficulty in exertion, both motor and cognitive. To counteract fatigue and limit its effects on activities of daily living, the use of vitamins and minerals is known in addition to the pharmacological approach. However, few studies have evaluated the effect of vitamin and mineral supplementation on fatigue management. SiderAL® Med is a food for special medical purposes with a complete formulation containing vitamins, sucrosomal minerals, copper and algal calcium. The aim of the study is to evaluate whether nutritional supplementation with SiderAL® Med improves the symptom of fatigue and motor and cognitive function in stroke patients.
DESIGN
This is a pilot, randomized study with a control group.
SETTING
Post-Acute Rehabilitation Unit of the Fondazione Policlinico "A. Gemelli" IRCCS.
PARTICIPANTS
Twenty-four patients with stroke outcomes, admitted to rehabilitation, were recruited and randomized into the experimental group (Sid-G) and the control group (CG).
INTERVENTION
The Sid-G patients, in association with the pharmacological and rehabilitation therapy foreseen during hospitalization, took SiderAL® Med, one sachet per day for 8 weeks, while the CG patients underwent only the pharmacological and rehabilitation therapy foreseen in the daily routine.
MEASUREMENTS
All patients were assessed at baseline (T0), after 4 weeks (T1), after 8 weeks (T2) and after 12 weeks (T3) for motor and cognitive fatigue, balance, walking, functional capacity, cognitive performance, autonomy, quality of life and body composition.
RESULTS
Both Sid-G and CG patients showed significant improvement on most rating scales between T0-T1-T2-T3 (p = 0.0001). When comparing the two groups, a statistically significant difference emerged in favor of Sid-G with regard to motor fatigue (p = 0.007), cognitive fatigue (p = 0.009) and total fatigue (p = 0.034); balance (p < 0.001), functional capacity (p < 0.001); cognitive performance (p = 0.004); bone mineral content (p = 0.005), lean mass (p = 0.005), total mass (p < 0.001) and percentage of fat mass (p = 0.039).
CONCLUSION
Nutritional supplementation with SiderAL® Med, in concert with intensive rehabilitation treatment, appears to be effective in managing fatigue and improving motor and cognitive performance and body composition, representing a valuable tool to associate with rehabilitation treatment in stroke patients.
PubMed: 38696891
DOI: 10.1016/j.jnha.2024.100256 -
Children (Basel, Switzerland) Oct 2023Healthy People 2030 emphasizes personal health literacy (individual skills) and organizational health literacy-the degree to which organizations equitably enable...
BACKGROUND
Healthy People 2030 emphasizes personal health literacy (individual skills) and organizational health literacy-the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. However, research on the latter is in the early stages.
METHODS
This study describes an organizational health literacy assessment in a U.S. urban academic children's hospital. A variety of evidence-based health literacy assessments were used to assess patient information materials and the environment, including institutional practices, navigation, culture and language, and communication. Trained interviewers and analysts reached consensus for all assessments.
RESULTS
SMOG scores ( = 9) ranged from 7th- to 14th-grade reading level (average = 11.3). PEMAT-P scores ( = 9) ranged from 43.8% to 93.8% understandability and 0% to 80% actionability. CDC CCI scores (literacy demand) ( = 6) ranged from 18.2% to 58.8% (≥90% = excellent). SAM scores (suitability) ( = 6) fell in the "adequate" range (43.2-58.3%). The PMOSE/IKIRSCH scores (complexity) ( = 3) noted low-moderate difficulty. Apter's Hierarchy ( = 4) revealed three numeracy domains (50% = descriptive purposes and decision-making, 100% = interpreting information). Walking interviews highlighted organizational facilitators and barriers related to the pre-visit and visit environments. HLE2 domain scores ranged from 52% to 68%.
CONCLUSIONS
Organizational health literacy demands far outweigh the average literacy skills of adults in the U.S. (patients and staff). Findings can be used to hone quality improvement and other processes to focus on structural solutions to increase health equity.
PubMed: 37892321
DOI: 10.3390/children10101658 -
COVID-19 pandemic and mental health in Spain: An analysis of their relationship using Google Trends.Spanish Journal of Psychiatry and... 2023This study aims to examine the public interest that exists on Internet regarding various mental health topics and its relationship with evolution of COVID-19 pandemic in...
INTRODUCTION
This study aims to examine the public interest that exists on Internet regarding various mental health topics and its relationship with evolution of COVID-19 pandemic in Spain.
MATERIALS AND METHODS
Google Trends was used to explore relative search volume (RSV) for the following terms related with mental health (TRMH): "anxiety", "depression", "stress", "insomnia" and "suicide"; between January and December 2020. The cross-correlation function was performed to assess association between new COVID-19 cases and RSV levels for TRMH. Finally, Mann-Whitney test was used to examine differences between RSV values for TRMH before and after of state of alarm declarations on March and October 2020.
RESULTS
The "anxiety" term showed the highest RSV indices. A significant correlation was found between new COVID-19 cases and RSV for "anxiety" with a time-lag of +1 week (r=0.49; p<.05). Was found an increase of SRV for "anxiety" (U=0.00; p=.01) and a decrease of SRV for "depression" (U=1.00; p=.04) between 4-week period before and after state of alarm of March 2020. Regarding the state of alarm of October 2020, a higher RSV for "anxiety" (U=0.50; p=.02) was found in the four weeks after it compared with a similar previous period.
CONCLUSIONS
Anxiety is the mental health topic of greatest public interest on Internet in context of COVID-19 pandemic. Public concern about anxiety rises one week after the increase in COVID-19 cases and is greater after introduction of control measures that entail any type of mobility restriction or activity limitation. There is a greater general need for information on anxiety at specific times in the pandemic evolution.
Topics: Humans; COVID-19; Pandemics; Mental Health; Search Engine; Spain
PubMed: 34004379
DOI: 10.1016/j.rpsm.2021.05.001 -
BMC Public Health Oct 2023Persons with disability may have a higher HIV prevalence and be less likely than persons without disability to know their HIV-positive status, access antiretroviral...
Differences between persons with and without disability in HIV prevalence, testing, treatment, and care cascade in Tanzania: a cross-sectional study using population-based data.
BACKGROUND
Persons with disability may have a higher HIV prevalence and be less likely than persons without disability to know their HIV-positive status, access antiretroviral therapy (ART), and suppress their HIV viral load (HIV care cascade). However, studies examining differences between persons with and without disability in HIV prevalence and the HIV care cascade are lacking. Using the Tanzania HIV Impact Survey (THIS) data collected between October 2016 and August 2017, we assessed differences in HIV prevalence and progress towards achieving the 2020 HIV care cascade target between persons with and without disability.
METHODS
Using the Washington Group Short Set (WG-SS) Questions on Disability, we defined disability as having a functional difficulty in any of the six life domains (seeing, hearing, walking/climbing, remembering/ concentrating, self-care, and communicating). We classified respondents as disabled if they responded having either "Some Difficulty", "A lot of difficulties" or "Unable to" in any of the WG-SS Questions. We presented the sample characteristics by disability status and analyzed the achievement of the cascade target by disability status, and sex. We used multivariable logistic regressions, and adjusted for age, sex, rural-urban residence, education, and wealth quintile.
RESULTS
A total of 31,579 respondents aged 15 years and older had HIV test results. Of these 1,831 tested HIV-positive, corresponding to an estimated HIV prevalence of 4.9% (CI: 4.5 - 5.2%) among the adult population in Tanzania. The median age of respondents who tested HIV-positive was 32 years (with IQR of 21-45 years). HIV prevalence was higher (5.7%, 95% CI: 5.3-7.4%) among persons with disability than persons without disability (4.3%, 95% CI: 4.0 - 4.6%). Before adjustment, compared to women without disability, more women with disability were aware of their HIV-positive status (n = 101, 79.0%, 95% CI: 68.0-87.0% versus n = 703, 63.0%, 95% CI: 59.1-66.7%) and accessed ART more frequently (n = 98, 98.7%, 95% CI: 95.3-99.7% versus n = 661, 94.7%, 95% CI: 92.6-96.3%). After adjusting for socio-demographic characteristics, the odds of having HIV and of accessing ART did not differ between persons with and without disability. However, PLHIV with disability had higher odds of being aware of their HIV-positive status (aOR 1.69, 95% 1.05-2.71) than PLHIV without disability. Men living with HIV and with disability had lower odds (aOR = 0.23, 95% CI: 0.06-0.86) to suppress HIV viral loads than their counterparts without disability.
CONCLUSION
We found no significant differences in the odds of having HIV and of accessing ART between persons with and without disability in Tanzania. While PLHIV and disability, were often aware of their HIV-positive status than their non-disabled counterparts, men living with HIV and with disability may have been disadvantaged in having suppressed HIV viral loads. These differences are correctable with disability-inclusive HIV programming. HIV surveys around the world should include questions on disability to measure potential differences in HIV prevalence and in attaining the 2025 HIV care cascade target between persons with and without disability.
Topics: Adult; Male; Humans; Female; Young Adult; Middle Aged; Cross-Sectional Studies; Prevalence; Tanzania; HIV Infections; Disabled Persons
PubMed: 37880641
DOI: 10.1186/s12889-023-17013-8 -
Frontiers in Psychology 2024The use of mobile exoskeletons as assistive walking devices has the potential to affect the biomechanics of the musculoskeletal system due to their weight and restricted...
BACKGROUND
The use of mobile exoskeletons as assistive walking devices has the potential to affect the biomechanics of the musculoskeletal system due to their weight and restricted range of motion. This may result in physical and cognitive load for the user. Understanding how lower extremity loading affects cognitive-motor interference is crucial for the design of wearable devices, including powered exoskeletons, and the development of effective training interventions.
OBJECTIVE
This study aims to examine the effects of modified leg mechanics on cognitive-motor interference in dual-task walking. Gait variability, as an indicator of motor control, was analyzed to investigate its relation to cognitive task difficulty and to determine whether lower extremity loading modifies this relationship. Additionally, the impact on the gait pattern, as represented by the mean values of spatio-temporal gait parameters were investigated.
METHOD
Fifteen healthy young adults walked on a treadmill with and without weight cuffs bilaterally attached to their thighs and shanks while performing a visual-verbal Stroop test (simple task) and a serial subtraction task (difficult task). Dependent variables include mean values and variability (coefficients of variation) of step length, step width, stride time and double support time. Additionally, secondary task performance as correct response rates and perceived workload were assessed.
RESULTS
Double support time variability decreased during dual-task walking, but not during walking with modified leg mechanics while performing the difficult secondary task. Walking with modified leg mechanics resulted in increased gait variability compared to normal walking, regardless of cognitive load. During walking with modified leg mechanics, step length, step width, and stride time increased, while double support time decreased. The secondary tasks did not affect the gait pattern.
CONCLUSION
The interplay between an external focus of attention and competition for attentional resources may influence the variability of double support time. The findings suggest that walking with modified leg mechanics could increase cognitive-motor interference for healthy young adults in demanding dual-task situations. Therefore, it is important to analyze the underlying mechanisms of cognitive-motor interference in the context of human-exoskeleton interaction.
PubMed: 38699569
DOI: 10.3389/fpsyg.2024.1375029 -
BMC Public Health Sep 2023Disability was a major public health problem in China. However, the prevalence of disabilities in community-dwelling adults and their relationships to chronic physical...
BACKGROUND
Disability was a major public health problem in China. However, the prevalence of disabilities in community-dwelling adults and their relationships to chronic physical conditions were unclear. We aimed to estimate the prevalence of disabilities and associated factors among a large community-based cohort in China.
METHODS
Participants who were local permanent residents aged 18 years or above and completed the disability assessments were selected from the Cohort study on Chronic Disease of Communities Natural Population in Beijing, Tianjin and Hebei (CHCN-BTH) from 2017 to 2019. Disability was assessed using five questions about impairments and activity limitations based on the International Classification of Functioning (ICF), Disability and Health. Univariate, multivariate and multilevel logistic regressions were conducted to estimate the associations between disabilities and associated factors.
RESULTS
Totally, 12,871 community-dwelling adults completed the survey. Among of them, 12.9% (95% CI: 12.3%-13.5%) reported having any disability. The prevalence of any disability was significantly higher in participants who were older age, widowed, retired and smokers, had higher BMI, average monthly income < 5000 RMB, lower education level, lower physical exercise frequency and heavy physical labor. Multilevel logistic regressions showed that there were significant associations between disabilities with chronic physical conditions, especially in the vision impairment with lower back pain, and hearing impairment as well as difficulty walking without special equipment with injuries.
CONCLUSIONS
Many Chinese adults suffered from disabilities. Sustained efforts should be made to develop specific population-based health promotion and prevention programs for disabilities in China.
TRAIL REGISTRATION
ChiCTR1900024725 (25/07/2019).
Topics: Adult; Humans; Cohort Studies; Prevalence; Retirement; China; East Asian People; Disabled Persons
PubMed: 37670230
DOI: 10.1186/s12889-023-15066-3 -
International Medical Case Reports... 2023Tumor-induced osteomalacia (TIO) can cause osteomalacia due to excessive production of fibroblast growth factor 23 (FGF23) by the tumor. Since TIO is a very rare...
Tumor-induced osteomalacia (TIO) can cause osteomalacia due to excessive production of fibroblast growth factor 23 (FGF23) by the tumor. Since TIO is a very rare disease, it is often misdiagnosed as intervertebral disc herniation, spondyloarthritis, or osteoporosis. We report a 65-year-old man who developed generalized arthralgia and difficulty walking two years ago and was diagnosed with multiple fractures throughout his body. He was initially diagnosed with osteoporosis and was treated with calcitriol. However, he was referred to our hospital since his symptoms did not improve. We diagnosed tumor-induced osteomalacia based on low serum phosphorus, high bone-type alkaline phosphatase, high FGF23 levels, and the presence of two tumors. The responsible tumor was identified using FGF23 levels in venous sampling. As the location of the tumor made surgical resection difficult, we selected treatment with burosumab, a human monoclonal antibody against FGF23, leading to improvement in the hypophosphatemia and pain, such that he was able to walk with a cane. In cases of osteoporosis with hypophosphatemia, general physicians should keep TIO in mind, and attempt to identify the responsible tumor lesion.
PubMed: 37840970
DOI: 10.2147/IMCRJ.S425599 -
International Journal of Biometeorology Jun 2024Examining how heat affects people with Parkinson's disease is essential for informing clinical decision-making, safety, well-being, and healthcare planning. While there...
Examining how heat affects people with Parkinson's disease is essential for informing clinical decision-making, safety, well-being, and healthcare planning. While there is evidence that the neuropathology associated with Parkinson's disease affects thermoregulatory mechanisms, little attention has been given to the association of heat sensitivity to worsening symptoms and restricted daily activities in people with this progressive disease. Using a cross-sectional study design, we examined the experiences of people diagnosed with Parkinson's disease in the heat. Two-hundred and forty-seven people completed an online survey (age: 66.0 ± 9.2 years; sex: male = 102 (41.3%), female = 145 (58.7%)), of which 195 (78.9%) reported becoming more sensitive to heat with Parkinson's disease. Motor and nonmotor symptoms worsened with heat in 182 (73.7%) and 203 (82.2%) respondents, respectively. The most commonly reported symptoms to worsen included walking difficulties, balance impairment, stiffness, tremor, fatigue, sleep disturbances, excess sweating, difficulty concentrating, and light-headedness when standing. Concerningly, over half indicated an inability to work effectively in the heat, and nearly half reported that heat impacted their ability to perform household tasks and social activities. Overall, heat sensitivity was common in people with Parkinson's disease and had a significant impact on symptomology, day-to-day activities and quality of life.
Topics: Humans; Parkinson Disease; Male; Female; Aged; Middle Aged; Cross-Sectional Studies; Hot Temperature; Thermosensing; Activities of Daily Living; Surveys and Questionnaires
PubMed: 38602550
DOI: 10.1007/s00484-024-02658-w -
Journal of Clinical Medicine Oct 2023Impaired physical mobility in hemodialysis (HD) patients is considered an important modifiable risk factor of increased all-cause morbidity and mortality. To our...
Impaired physical mobility in hemodialysis (HD) patients is considered an important modifiable risk factor of increased all-cause morbidity and mortality. To our knowledge, no study to date has determined the overall burden of limited physical mobility in prevalent HD patients. The aim of this research is to investigate impaired physical mobility and its clinical correlates. We conducted a cross-sectional observational study in all patients of the Centre for Acute and Complicated Dialysis at the University Medical Centre of Ljubljana, where the most complex patients receive HD on average three times per week. The data were collected through interviews based on a prepared questionnaire and medical history review. A total of 205 patients were included in this study (63.9 ± 15.4 years). Sixty percent (122/205) of the patients had little or no physical mobility impairment, and others were categorized with a minor or severe mobility limitation. A minor mobility impairment was found in 21% (43/205) of patients: 10 patients (5%) used a mobility aid in the form of a crutch, 9 patients (4%) were dependent on two crutches or a walker, and 24 patients (12%) were temporarily dependent on the assistance of a third person. Severe mobility limitations were observed in 22% (40/205) of patients, ranging from being confined to bed (19/205, 9%), confined to bed but able to perform some movements (19/205, 9%), and ambulatory but dependent on the assistance of a third person for locomotion (2/205, 1%). The most common causes of the limitation of mobility were neurological (19/40, 47.5%), cardiovascular (9/40, 22.5%), musculoskeletal (8/40, 20%), and other causes (4/40, 10%). A significant, moderate positive correlation was observed between mobility problems and the age of the participants (r = 0.36, < 0.001), while a significant, small positive correlation was obtained between the mobility problems and C-reactive protein (r = 0.15, = 0.044). Moreover, mobility problems had a small but significant negative correlation with albumin levels (r = -0.15, = 0.042). When controlling for age, results yield no significant correlations, and, in regression analysis, only the age ( < 0.001) and male gender ( = 0.007) of the participants were independent predictors of mobility impairment. We conclude that impaired mobility has a high overall prevalence among chronic HD patients. Strategies to prevent and improve mobility limitations are strongly needed.
PubMed: 37892773
DOI: 10.3390/jcm12206634 -
Frontiers in Rehabilitation Sciences 2024The ability of children to accomplish progressively more difficult gross motor tasks follows a predictable sequence that has been well documented as part of development....
INTRODUCTION
The ability of children to accomplish progressively more difficult gross motor tasks follows a predictable sequence that has been well documented as part of development. Current existing instruments were developed independently using classical test theory methods which led to the lack of a universal measurement scale and unit. The purpose of this study was to test a specification equation, anchored to commonly accepted and reproducible tasks in gross motor development, to generate a universal measurement scale and unit of measurement, called the Gross Motor (GM) unit.
METHODS
We rated component measures for each of the gross motor development tasks on the Gross Motor Function Measure-66 (GMFM). The GMFM is a gross motor development measure created with Rasch measurement theory to quantify observed difficulty levels measured on an interval scale. Component measures for body position, movement, and support were based on hypothesized contributions to gross motor development based on theory. Forward stepwise linear regression was used to test a specification equation. The specification equation was anchored to reference points to fix a unit size.
RESULTS
Our specification equation explained 87% of the variance in observed gross motor task difficulty. Predicted difficulty for gross motor tasks was strongly associated with observed task difficulty ( = 0.94, < 0.0001). Our specification equation was anchored to 1) lying supine (0 GM units) and 2) walking unsupported (100 GM units) setting the size of the GM unit to 1/100 of the distance between lying supine and unsupported walking.
DISCUSSION
Our specification equation allows for experimental testing of gross motor development theories. This approach provides a framework for refining our understanding and measurement of gross motor development and creates a universal scale and unit. We expect that this will facilitate placing many, if not all, current gross motor development instruments on the same measurement scale.
PubMed: 38343789
DOI: 10.3389/fresc.2024.1243336