Search Results (79)

This study underscores how perceived social support, loneliness, and mental well-being shape the emotional bonds that Spanish cat and dog owners form with their pets. A total of 298 participants completed an online survey, including 109 cat owners (36.5%) and 189 dog owners (63.4%). Standardized and validated instruments were used: the Medical Outcomes Study Social Support Survey (MOS-SSS), the UCLA Loneliness Scale, the Warwick–Edinburgh Mental Well-Being Scale (WEMWBS), and the Lexington Attachment to Pets Scale (LAPS). The results confirmed that the attachment to dogs tends to be stronger than to cats, with demographic factors such as gender and age also playing a significant role in the attachment levels. While psychosocial variables did not directly predict the overall attachment scores, lower perceived social support was significantly associated with higher scores on the person substitution subscale among dog owners, indicating that dogs may serve as emotional substitutes for human companionship in socially vulnerable individuals. No comparable association was found among cat owners. These findings highlight species-specific differences in the human–pet bond and emphasize the multifaceted nature of attachment. This study underscores the importance of considering both demographic and psychosocial factors to better understand how pets contribute to human emotional well-being. Full article

Background: Food insecurity and social isolation among older adults are pressing public health concerns that significantly impact physical and mental health outcomes. The COVID-19 pandemic exacerbated these challenges while forcing innovative adaptations to traditional congregate meal programs. Objective: This study examined the effectiveness of Kūpuna U, an alternative flexible congregate meal program comprising three models (virtual, hybrid, and traditional), in addressing food insecurity, loneliness, and self-rated health among older adults in Hawaiʻi. Methods: A quasi-experimental study with non-equivalent groups analyzed secondary program evaluation data. Participants (N = 270, follow-up N = 116) self-selected into virtual (grab-and-go meals + online activities), hybrid (grab-and-go meals + virtual and in-person activities), or traditional (in-person congregate meals + in-person activities) models. Food insecurity (6-item scale), loneliness (UCLA 3-item scale), and self-rated health (5-point scale) were measured at the baseline and 6-month follow-up. Results: The Virtual group showed significant improvements in food insecurity (baseline: 1.73 to follow-up: 0.04, p < 0.001) and self-rated health (baseline: 2.92 to follow-up: 3.72, p = 0.005). The Hybrid group demonstrated a significant increase in loneliness (baseline: 4.25 to follow-up: 5.00, p = 0.024). The Traditional group showed no significant changes in any outcome measures. Analysis of variance (ANOVA) revealed significant between-group differences for food insecurity (F = 9.047, p < 0.001) and self-rated health (F = 5.814, p = 0.004) change scores. Conclusions: The Virtual model demonstrated a superior effectiveness in improving food security and self-rated health outcomes. However, self-selection bias limits causal inferences. These findings suggest that flexible, technology-enhanced nutrition programs may effectively serve older adults with mobility or transportation barriers while maintaining program benefits. Full article

Background: Internal hemipelvectomies are rare procedures for primary musculoskeletal sarcomas of the bony pelvis. There is a sparse amount of data on functional outcomes and activity levels in postoperative patients. The aim of this study was to investigate functional outcomes, including sport activity levels, and the impact of tumor grade, resection margins, adjuvant therapies, pelvic reconstruction, and patient age at the time of surgery. Methods: Patients who underwent internal hemipelvectomy at our clinic between 1995 and 2019, with a minimum follow-up of 12 months, were assessed using the Musculoskeletal Tumor Society Score (MSTS), the Toronto Extremity Salvage Score (TESS), the Oxford Hip Score (OHS), and the University of Los Angeles Activity Scale (UCLA AS). Results: Our cross-sectional study included 29 patients (14 male, 15 female; 15 with chondrosarcoma, 8 with Ewing’s sarcoma, 2 with osteosarcoma, 2 with chordoma, and 2 with other sarcomas) with a median follow-up of 8.7 years (range: 12 months to 25.4 years; interquartile range (IQR): 13.1 years). The median MSTS was 16 (range: 1–30; IQR: 9), median TESS was 75.8% (range: 12.9–100%; IQR: 31.7%), median OHS was 35 (range: 10–48; IQR: 16), and median UCLA AS was 5 (range: 1–9; IQR: 3). Tumor grade, resection margins, chemotherapy, radiation therapy, and pelvic reconstruction had no significant effect on functional outcomes. Patient age at the time of surgery had a statistically significant effect on all measured outcome parameters, although all parameters exhibited a wide range and large IQR, likely reflecting the small, heterogeneous patient cohort. Conclusions: Surviving patients who underwent internal hemipelvectomy for primary musculoskeletal sarcomas of the pelvic bone demonstrated overall moderate to good functional outcomes and moderate sport activity levels. Full article

Background/Objectives: Cariprazine, a D3/D2 partial agonist, is one of the few recommended treatment options for bipolar 1 disorder (BP1D) in Southeast Asia. This study aims to generate insights from leading experts on the safe and effective use of cariprazine for BP1D, specifically by formulating practical recommendations not thoroughly covered in the existing literature. Methods: A formal consensus methodology using the modified RAND/UCLA Appropriateness Method was employed to develop consensus recommendations. The methodology included a targeted literature search, creation of clinical scenarios, two rounds of rating of the appropriateness of each scenario on a nine-point Likert scale by an expert panel of psychiatrists from Southeast Asia (n = 13), and a face-to-face discussion among the expert panel between the two rounds of rating. In the absence of disagreement, scenarios were classified as appropriate (7–9), equivocal (4–6), or inappropriate (1–3) based on median scores. Clinical scenarios were subsequently converted to consensus recommendations upon approval by the expert panel. Results: Most experts recommended a 4–8-week trial of cariprazine for bipolar depression (85%) and 3–4 weeks for acute mania/mixed (71%). For longer treatment, 61.5% and 69% recommended >1 year for acute mania/mixed and bipolar depression, respectively. Cariprazine was also considered suitable as first-line therapy, including for first-episode bipolar depression (Mdn: 8, IQR: 7–9) and first-episode mania (Mdn: 8; IQR: 8–9). Conclusions: The consensus recommendations may serve as practical guidance for clinicians to make informed decisions regarding the management of adult patients with BP1D, while considering the preferences and circumstances of individual patients. Full article

Background: While many patients report that their symptoms are influenced by weather conditions prior to their knee arthroplasty (TKA), how weather-related pain (WRP) evolves following surgery remains poorly understood. This study investigated the prevalence of WRP prior to and after TKA, assessed whether TKA resolves preoperative WRP, evaluated the incidence of new-onset WRP postoperatively, and identified associated risk factors. Methods: We prospectively surveyed 87 patients (121 TKAs) at a mean follow-up of 9 years (range: 1–26 years). Patients completed a standardized questionnaire assessing WRP before and after surgery, along with patient-reported outcome measures (WOMAC, UCLA activity score, and SF-12). Statistical analysis was performed to assess the associations between WRP and clinical or demographic variables, as well as patient-reported outcome measures (PROMs) in patients with and without WRP. Results: Preoperatively, 31% of patients (37/121 knees) reported WRP. Following TKA, WRP resolved in 48% of these cases (18/37 knees), persisted in 16% (19/121 knees), and developed de novo in 16% of patients (20 knees). Postoperative WRP was significantly associated with the presence of WRP in other joints (p < 0.0001), and with female sex (p < 0.0008). Preoperatively, patients with WRP had worse WOMAC scores for pain (p = 0.046), stiffness (p = 0.012), and physical function (p = 0.024). Despite these differences, all groups demonstrated significant improvement in PROMs postoperatively, with no differences between groups at final follow-up (p > 0.125). Conclusions: TKA leads to the resolution of WRP in nearly half of affected patients; however, a subset develops new or persistent WRP. Female sex, and multi-joint involvement are associated with WRP after TKA. These findings underscore the importance of preoperative counseling regarding expectations for pain relief, particularly in relation to weather sensitivity. Full article

Objective: This study evaluates whether one-year changes in physical activity (PA), pain intensity, and quality of life (QOL) after exercise therapy and education are larger than normal fluctuations over time in individuals with knee osteoarthritis. Method: Patients with knee osteoarthritis participating in the Good Life with Osteoarthritis in Denmark (GLA:D^®) exercise therapy and education program (n = 7603) and participants from the Osteoarthritis Initiative (OAI) who received no specific treatment (n = 1156) were included. PA was measured using the UCLA PA scale (1–10) in the GLA:D^® group and the PASE (0–531) in the OAI group. PASE scores were mapped to the UCLA distribution. Pain intensity was measured using a standardized visual analog scale (VAS, 0–100), and QOL was assessed via the KOOS QOL scale (0–100). Changes were categorized as increased, maintained, and decreased. To ensure comparability between GLA:D^® and OAI participants, we used entropy balancing, considering the covariables age, gender, BMI, depression, employment status, and our outcome variables at baseline. Results: At one year, 41% of GLA:D^® participants showed increased PA compared to 38% in the balanced OAI group (p = 0.015). Pain intensity decreased by ≥20 mm on the VAS in 39% of GLA:D^® and 27% of OAI participants (p < 0.001). QOL improved by ≥ 10 mm on the KOOS scale in 48% of GLA:D^® and 40% of OAI participants (p < 0.001). Additionally, for PA, pain, and QOL, 6%, 13%, and 7% more patients in the control group experienced worsening in these outcomes, respectively. Conclusions: Twelve percent more participants experienced clinically relevant pain reductions in the GLA:D^® group compared to OAI participants, and 3% and 8% more reported improvements in PA and QOL, respectively. Additionally, more patients in the control group experienced worsening in these outcomes. These differences indicate that clinically relevant pain improvements following exercise therapy and education may exceed normal fluctuations in patients with knee osteoarthritis. Full article

Background and Objectives: In Kazakhstan, during the COVID-19 pandemic, older adults faced unique challenges, such as limited healthcare resources and prolonged periods of social isolation. The aim of our study was to evaluate the sociodemographic and health-related factors associated with loneliness and psychological distress in older adults during the COVID-19 pandemic in Kazakhstan. Materials and Methods: In this cross-sectional study, a total of 445 participants aged 60 and above were recruited from Kazakhstan during the COVID-19 pandemic. The Patient Health Questionnaire-4 (PHQ-4) was used to measure psychological distress, anxiety, and depression. Loneliness was assessed using the UCLA Loneliness Scale (UCLA-3). The sociodemographic and health-related variables of the tested participants were analyzed. Results: Mean values from the UCLA-3 (p < 0.001), PHQ-4 (p < 0.001), anxiety (p < 0.001), and depression (p < 0.001) scores significantly differed between different categories of self-reported overall health. Significantly higher mean values were found in older adults with hypertension for UCLA-3 (p = 0.025), PHQ-4 (p = 0.001), anxiety (p = 0.001), and depression (p = 0.017); diabetes for UCLA-3 (p = 0.023), PHQ-4 (p = 0.029), and depression (p = 0.001); chronic heart failure for UCLA-3 (p = 0.005), PHQ-4 (p < 0.001), anxiety (p = 0.001), and depression (p < 0.001); cerebrovascular disease for UCLA-3 (p = 0.024), PHQ-4 (p = 0.002), anxiety (p = 0.001), and depression (p = 0.027); cardiovascular disease for UCLA-3 (p < 0.001), PHQ-4 (p < 0.001), anxiety (p < 0.001), and depression (p < 0.001); dementia for anxiety (p = 0.046); being single for UCLA-3 (p = 0.009), PHQ-4 (p = 0.031), and depression (p = 0.028); other ethnic backgrounds for PHQ-4 (p = 0.004) and anxiety (p = 0.013); and living in an urban place for PHQ-4 (p = 0.043). Being single was shown to be a significant predictor for loneliness (OR 2.21; 95%CI 1.28–3.84), anxiety (OR 2.09; 95%CI 1.14–3.84), and depression (OR 4.23; 95%CI 1.95–9.15). Below-average (OR 5.79; 95%CI 1.09–30.90) self-reported overall health was shown to be a significant predictor of anxiety. Conclusions: Our study demonstrated that numerous sociodemographic and health-related factors were associated with loneliness, anxiety, and depression in older adults from Kazakhstan during the COVID-19 pandemic. Full article

Background: Unicompartmental knee arthroplasty (UKA) is a viable treatment option for patients with isolated knee osteoarthritis. This study evaluated the clinical outcomes of the JII UK (Smith & Nephew, Memphis, TN, USA) hypoallergenic, fixed-bearing UKA implant in a medium cohort of patients undergoing both medial and lateral procedures with a short-term follow-up. Methods: A retrospective review was conducted on 257 consecutive patients who underwent primary UKA using the JII UK implant between December 2020 and December 2022. Clinical outcomes were assessed using the Knee Society Score (KSS), Knee Society Function Score (KSFS), Oxford Knee Score (OKS), UCLA Activity Score, Forgotten Joint Score (FJS-12), and satisfaction. Survivorship analysis was performed, and complications were recorded. Results: At the 2-year follow-up, the implant survival rate was 99.61%. Statistical significant improvements were observed in all clinical scores, with high patient satisfaction. The mean UCLA Activity Score increased from 4.53 preoperatively to 7.3 at 24 months. Conclusions: This study demonstrates promising short-term clinical outcomes for the hypoallergenic fixed-bearing medial and lateral UKA implant, with high patient satisfaction and a low complication rate. Further studies with longer follow-up periods are warranted to confirm these findings. Full article

While several studies have reported short-term clinical outcomes after medial patellofemoral ligament (MPFL) repair with suture tape augmentation, there is still a dearth of knowledge regarding midterm clinical outcomes. This study aimed to evaluate the midterm clinical outcomes of MPFL repair with suture tape augmentation in patients with patellar dislocation. We retrospectively reviewed the clinical records of patients who underwent MPFL repair with suture tape augmentation for at least one episode of patellar dislocation between 2015 and 2020. Patient-reported clinical outcomes (PROs) were evaluated via the International Knee Documentation Committee (IKDC) score and the knee injury osteoarthritis outcome score (KOOS). In total, 17 knees (4 males and 13 females) who underwent MPFL repair with suture tape augmentation with a mean follow-up of 54.6 ± 19.5 months were included in this study. PROs significantly improved from preoperatively to the final follow-up (IKDC score: 50.7 ± 26.6 vs. 88.8 ± 13.0, p < 0.001; KOOS: 68.8 ± 23.3 vs. 91.2 ± 8.4, p = 0.011) without reducing the patient’s activity level at the final follow-up (UCLA AS score: 7.9 ± 2.4 at preinjury vs. 7.9 ± 2.2 at the final follow-up, p = 0.655). Subgroup analysis revealed good postoperative outcomes, regardless of the patient’s skeletal maturity or the presence or absence of generalized laxity. In conclusion, MPFL repair with suture tape augmentation is a safe and effective treatment for midterm follow-up. Full article

Background/Objectives: Developmental dysplasia of the hip (DDH), defined by the malalignment of the femoral head and acetabulum, is a major precursor to coxarthrosis, posing substantial challenges during total hip arthroplasty (THA). Patients with coxarthrosis secondary to DDH often exhibit acetabular bone insufficiency, which makes challenging surgical reconstruction difficult. This study aimed to compare the radiologic and functional outcomes of robotically assisted and conventional manual THA techniques in patients with coxarthrosis secondary to Crowe type III–IV DDH. Methods: This prospective study included 40 patients divided into robotically assisted (n = 20) and conventional manual (n = 20) THA groups. Evaluations encompassed hip pain (Visual Analogue Scale, VAS), function (Harris hip score and University of California, Los Angeles, activity scale), quality of life (Short Form-12), and prosthesis sensation (Forgotten Joint Score-12). Radiologic outcomes included acetabular inclination and anteversion angles. Femoral shortening, operative duration, and follow-up times were also analyzed. Results: Demographic characteristics did not differ between groups (p > 0.05). Robotically assisted THA exhibited a significantly longer operative time (171.40 ± 11.96 vs. 150.30 ± 14.67 min; p = 0.001) but a shorter follow-up (29.3 ± 8.51 vs. 52.95 ± 18.96 months; p = 0.001), without a difference in the amount of femoral shortening (p = 0.947). Despite the extended surgical duration, the two techniques achieved comparable radiologic outcomes, with no significant differences in acetabular inclination or anteversion angles (p > 0.05). Functional assessments, including Harris hip scores (73.85 vs. 73.95; p = 0.978), UCLA activity scores, and VAS, indicated similar efficacy between groups. SF-12 physical and mental quality of life and Forgotten Joint Score-12 prosthesis sensation did not differ between groups (p > 0.05). Conclusions: This study concludes that robotically assisted and conventional manual THA present similar radiologic and functional outcomes in patients with coxarthrosis secondary to Crowe type III–IV DDH, as displayed by comparable acetabular anteversion and inclination alignment, femoral shortening, hip function, pain, quality of life, and prosthesis sensation scores. While robotically assisted THA requires a longer operative time, its precision in implant placement may hold potential advantages for long-term outcomes, demanding further investigation in extended follow-up studies. Full article

Background/Objectives: To evaluate the clinical and radiologic outcomes of arthroscopic augmented partial repair (APR) with acellular dermal matrix versus arthroscopic superior capsular reconstruction (SCR) in massive rotator cuff tears. Methods: The study included a total of 49 patients with massive rotator cuff tears who underwent arthroscopic APR (26 patients) and SCR (23 patients) between March 2018 and June 2021. Clinical scores, visual analog scores, and range of motion were collected preoperatively and postoperatively until the last follow-up. Preoperative and postoperative simple radiographs were evaluated for arthropathic changes and acromiohumeral distances (AHDs). Magnetic resonance imaging was performed to assess the integrity of repaired structures at 12 months postoperatively. Results: The average age of patients was 63.9 years (range 53–74 years), and the mean clinical follow-up period was 2.6 years (range 2.1–2.9). The average UCLA scores improved from 18.0 to 33.2 and from 16.3 to 32.1 in APR and SCR groups at the last follow-up, respectively. For the ranges of motion, the APR group consistently showed better external rotation ranges from the postoperative 6th month until the last follow-up (p < 0.05), and the APR group revealed better ranges of motion in forward flexion, abduction, and external rotation compared to the SCR group (p < 0.05). Postoperative AHD showed better improvement in the APR group than the SCR group (p < 0.05). Re-tears were found in two patients in each group (p > 0.05). Conclusions: Both APR and SCR groups showed comparable improvement in clinical outcomes in massive rotator cuff tears, while the APR group showed statistically significant improvement in the range of motion compared to the SCR group, especially for external rotations. Full article

Background/Objectives: Distal femur tumor resection with limb salvage is a demanding procedure that offers hope for patients by preserving the limb rather than opting for amputation. While limb salvage can improve both physical function and psychological well-being, there’s limited knowledge on how active patients remain afterward and how their Quality of Life (QoL) is affected, especially regarding physical activities and sports. This study investigates the quality of life of the patients through the development of motor activity, focusing on both physical and sporting activity of the above-mentioned individuals and their physical abilities to participate in activities of daily and sporting life after surgery. Methods: This study involved 16 patients aged 19–47 years who had undergone surgical resection and replacement of the distal femur for the treatment of sarcoma and were selected by random sampling from a total of 72 patients who had undergone a similar procedure. To explore the topic in depth, the researchers followed the triangulation method. From July 2023 to February 2024, we used surveys and interviews to explore their physical activity (PA) levels, sports participation, and QoL. This study included the International Physical Activity (PA) Questionnaire (IPAQ), the University of California and Los Angeles (UCLA) Activity Score, and semi-structured interviews. The data were analyzed using the statistical software packages SPSS 25 and Excel. Results: Most participants reported moderate to high levels of PA, according to IPAQ, and continued engaging in sports, with swimming, walking, and stair climbing being the most common activities. No significant relationship was found between their PA levels and factors such as age, BMI, or the side of the affected limb. Interviews showed that patients’ motivation and their surgeon’s guidance played key roles in their return to regular activities, though many exercised less frequently or intensely than recommended. Conclusions: Patients who undergo limb salvage surgery following distal femur tumor removal generally maintain a good level of physical activity, which supports their QoL. Encouraging these patients to stay active and even engage in sports appears feasible, especially when guided by medical professionals. These findings highlight the potential benefits of tailored rehab programs to improve long-term health and QoL in sarcoma survivors, although larger studies are needed for more comprehensive insights. Full article

Background: Sprengel’s Deformity (SD) is a rare condition of the shoulder girdle, appearing as the principal congenital anomaly of the shoulder in paediatric patients. The aim of this study is to document the combined experience of two paediatric orthopaedic departments in managing SD using the modified Green Procedure, with a specific emphasis on the clinical and functional outcomes reported by patients; Methods: from June 2010 to February 2023, 42 shoulders in 40 paediatric patients were surgically treated for SD at two paediatric orthopaedic departments. All patients were treated using the modified Green Procedure with or without clavicle osteotomy. To better evaluate the deformity, the Cavendish’s classification for aesthetic appearance and the Rigault’s classification for radiological aspect were used, while movements of abduction and flexion were quantified to assess shoulder mobility. Several dedicated questionnaires such as QuickDASH, the Shoulder Pain Index and the Shoulder Disability Index (SPADI) and finally the UCLA Shoulder Scale were submitted to assess the quality of life of the subjects and the ability to practice certain activities, including work and sports. Complications were evaluated according to the modified Clavien–Dindo–Sink classification; Results: The mean follow-up was 5 years (range, 1.0–13.6). Clavicular osteotomy, performed in 15 patients, improved post-operative abduction by a mean of 25° (95% CI: 11–39°; p = 0.001). Three patients had complications (7.1%), with two requiring re-operation. At follow-up, 67.5% of patients had a qDASH score < 7, highlighting excellent functional outcomes. Shoulder function showed moderate correlation with pre- and post-operative flexion. The SPADI and UCLASS scores indicated significant improvement, with 70.0% reporting high satisfaction. Factors like sex, associated anomalies, and surgical technique did not impact patient-reported outcomes or satisfaction; Conclusions: The modified Green’s technique has proven to be a safe procedure with a low rate of complications and satisfactory clinical and functional patient-reported outcomes. Full article

Background/Objectives: The projected increase from 58 million older adults in 2022 to 82 million by 2050 in the United States highlights the urgency of preparing nursing students to care for this aging population. However, studies reveal negative attitudes among nursing students toward older adults. A three-phased educational intervention that included an artificial intelligence (AI)-driven virtual simulation was implemented to address this. AI-generated simulations promise to expose marginalized groups and strengthen future nurses’ knowledge, skills, and attitudes. Methods: A convergent mixed-method design was used to measure the change in nursing students’ attitudes toward older adults, as measured by the UCLA Geriatrics Attitudes Survey and a Guided Reflection survey after participating in an Artificial Intelligence in Education learning event (n = 151). Results: The results indicate that post-intervention scores (M = 35.07, SD = 5.34) increased from pre-intervention scores (M = 34.50, SD = 4.86). This difference was statistically significant at the 0.10 significance level (t = 1.88, p = 0.06). The qualitative analysis indicated that the attitudes impacted were challenging and overcoming ageism, increased empathy and patience, and enhanced communication skills. Conclusions: Utilizing artificial intelligence technology during educational events effectively yields measurable learning outcomes. Cultivating positive attitudes toward older adults is essential for competent care in an aging society. This study was prospectively approved by the university’s Institutional Review Board (IRB) on 30 July 2021, IRB-FY22-3. Full article

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder with a significant impact on the quality of life of affected patients. This study aimed to correlate serum inflammatory markers with specific tools assessing quality of life, emotional well-being, and loneliness, such as the Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), and the UCLA Loneliness Scale. Methods: A pilot observational study including 37 patients with HS was conducted. Inflammatory serum markers, including C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR), were evaluated at baseline, 3 months, and 6 months later. Psychometric scores were also evaluated at the same study intervals. Results: DLQI was correlated with ESR at baseline (Spearman’s rho = 0.35, p = 0.03), indicating that poorer quality of life is associated with changes in this serum marker. Disease activity, as reflected by inflammatory markers, was associated with significant psychological burden. Specifically, a worse DLQI score was associated with higher ESR (estimate β = 0.14, 95% confidence interval [CI]: 0.05–0.22; p = 0.001) and higher CRP level (estimate β = 0.25, 95% CI: 0.02–0.48; p = 0.02). Similarly, a worse UCLA score was associated with higher ESR (estimate β = 0.11, 95% CI: 0.02–0.20, p = 0.01). Conclusions: Our study results underline the close relation between systemic inflammatory markers and clinical severity together with psychological burden in HS patients, as indicated by the significant association that was revealed between ESR/CRP and poorer psychometric scores. However, further research is warranted to validate these findings. Full article