Methods: A cross-sectional study was conducted in a single center in Malaysia via recruiting care providers of patients with TBI. The modified caregiver strain index (MCSI) questionnaires were utilized to ascertain the level of strain. The demographic data of informal care providers were also obtained. Independent sample t-test, analysis of variance (ANOVA), and a linear regression model were processed for data analysis.
Results: A total of 140 informal care providers were included in the study. More than half of informal care providers claimed to have strain (54.3%). Factors associated with increased strain include receiving tertiary education, being of Chinese background, and employed experience higher strain level. Informal care providers with characteristics such as being single, retired and provided care for 5 years experienced a lower level of strain.
Conclusion: Guidance on integrating the TBI knowledge into practice, assessing the care provider's level of strain regularly and providing supportive measures may aid in supporting informal care providers at risk.
OBJECTIVES: To investigate the clinical features of the thoracolumbar region associated with BP in horses and to use some of the clinical features to classify equine BP.
METHODS: Twenty-four horses comprised of 14 with BP and 10 apparently healthy horses were assessed for clinical abnormality that best differentiate BP from normal horses. The horses were then graded (0-5) using the degree of pain response, muscular hypertonicity, thoracolumbar joint stiffness and overall physical dysfunction of the horse.
RESULTS: The common clinical features that significantly differentiate horses with BP from non-BP were longissimus dorsi spasm at palpation (78.6%), paravertebral muscle stiffness (64.3%), resist lateral bending (64.3%), and poor hindlimb impulsion (85.7%). There were significantly (p < 0.05) higher scores for pain response to palpation, muscular hypertonicity, thoracolumbar joint stiffness and physical dysfunction among horses with BP in relation to non-BP. A significant relationship exists between all the graded abnormalities. Based on the cumulative score, horses with BP were categorized into mild, mild-moderate, moderate and severe cases.
CONCLUSIONS: BP in horse can be differentiated by severity of pain response to back palpation, back muscle hypertonicity, thoracolumbar joint stiffness, physical dysfunctions and their cumulative grading score is useful in the assessment and categorization of BP in horses.
DESIGN: Instrument development.
METHOD: Focus group discussions were conducted among informal carers and healthcare specialists in March 2017. The content validity was determined by the mean of the item content validity index. A reliability test was performed by the Kuder-Richardson 20 and Pearson's correlation coefficient among 40 informal carers of patients with a traumatic brain injury in the rehabilitation medicine department of a tertiary hospital from August-September 2017.
RESULTS: The final 34-item questionnaire covers the nature of traumatic brain injury, the consequences of traumatic brain injury, the rehabilitation process, and the role of the caregiver. The item content means ranged from 0.8-1.00, and the difficulty of knowledge items ranged from 0.18-0.98. The internal consistency reliability and correlation coefficient were 0.70 and 0.84, respectively.
METHODS: This cross-sectional observational study included 75 older adults who were at least 3 months poststroke and 50 age-matched healthy controls. Depressive symptoms were quantified using the World Health Organization Quality of Life Brief version (WHOQoL-BREF). Physical function was examined using Functional Ambulation Category, grip strength, 5 times Sit-to-Stand test, and Box and Block tests. The Montreal Cognitive Assessment and visual-manual reaction time were used to index cognitive function. Depressive symptom was quantified using the Patient Health Questionnaire-9. The Barthel Index and Fatigue Severity Scale were used to quantify activity limitation. Social participation and environmental participation were assessed using the Assessment of Life Habit and Craig Hospital Inventory of Environment Factors, respectively. Linear stepwise regression models were used to determine explanators for WHOQoL-BREF domain scores.
RESULTS: Individuals with stroke demonstrated significantly worse QoL on all WHOQoL-BREF domains compared with healthy controls. Stroke was a strong determinant for QoL and explained 16% to 43% of variances. Adding other outcome measures significantly improved the robustness of the models (R change = 12%-32%). The physical, psychological, social, and environmental domains of WHOQoL-BREF were all explained by the LIFE-H scores (β = -10.58, -3.37, 4.24, -5.35, respectively), while psychological, social, and environmental domains were explained by Montreal Cognitive Assessment scores (β = .47, 0.78, 0.54, respectively).
CONCLUSION: Social participation and cognition were strong determinants of QoL among urban-dwelling older adults with stroke. Social and recreational activities and cognitive rehabilitation should therefore be evaluated as potential strategies to improve the well-being of older adults affected by stroke.
OBJECTIVE: This study was sought to assess the level of cognitive functions and linked with blood oxidative status during normal aging in rats.
METHODS: A longitudinal study using male Sprague Dawley rats was performed starting from the age of 14 months old to 27 months old. Cognitive functions tests such as open field, Morris water maze and object recognition were determined at the age of 14, 18, 23, and 27 months old and were compared with group 3 months old. Blood was collected from the orbital venous sinus and oxidative status was determined by measuring the level of DNA damage, lipid peroxidation, protein oxidation and antioxidant enzymes activity.
RESULTS: Aged rats showed declining exploratory behavior and increased in the level of anxiety as compared to the young rats. The level of DNA damage increased with increasing age. Interestingly, our study found that both levels of malondialdehyde and plasma carbonyl content decreased with age. In addition, the level of superoxide dismutase activity was significantly decreased with age whereas catalase activity was significantly increased from 18 months of age. However, no significant difference was found in glutathione peroxidase activity among all age groups.
CONCLUSION: The progressions of cognitive impairment in normal aging rats are linked to the increment in the level of DNA damage.
OBJECTIVE: To describe the pathological changes, identification and distribution of B. melitensis in foetuses of experimentally infected does.
METHODS: Twelve female goats of approximately 90 days pregnant were divided into 4 groups. Group 1 was exposed intra-conjunctival to 100 µL of sterile PBS while goats of Groups 2, 3 and 4 were similarly exposed to 100 µL of an inoculum containing 109 CFU/mL of live B. melitensis. Goats of these groups were killed at 15, 30 and 60 days post-inoculation, respectively. Foetal fluid and tissues were collected for bacterial identification (using direct bacterial culture, PCR and immuno-peroxidase staining) and histopathological examination.
RESULTS: Bilateral intra-conjunctival exposure of pregnant does resulted in in-utero infection of the foetuses. All full-term foetuses of group 4 were either aborted or stillborn, showing petechiations of the skin or absence of hair coat with subcutaneous oedema. The internal organs showed most severe lesions. Immune-peroxidase staining revealed antigen distribution in all organs that became most extensive in group 4. Brucella melitensis was successfully isolated from the stomach content, foetal fluid and various other organs.
CONCLUSION: Vertical transmission of caprine brucellosis was evident causing mild to moderate lesions in different organs. The samples of choice for isolation and identification of B. melitensis are stomach content as well as liver and spleen tissue.