To assess the prevalence of persistent functional impairment after coronavirus disease (COVID-19), we assessed 118 individuals 3-4 months after their initial COVID-19 diagnosis with a symptom survey, ...work productivity and activity index questionnaire, and 6-minute walk test. We found significant persistent symptoms and functional impairment, even in non-hospitalized patients with COVID-19.
To systematically assess late outcomes of acute pulmonary embolism (PE) and to investigate the clinical implications of post-PE impairment (PPEI) fulfilling prospectively defined criteria.
A ...prospective multicentre observational cohort study was conducted in 17 large-volume centres across Germany. Adult consecutive patients with confirmed acute symptomatic PE were followed with a standardized assessment plan and pre-defined visits at 3, 12, and 24 months. The co-primary outcomes were (i) diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH), and (ii) PPEI, a combination of persistent or worsening clinical, functional, biochemical, and imaging parameters during follow-up. A total of 1017 patients (45% women, median age 64 years) were included in the primary analysis. They were followed for a median duration of 732 days after PE diagnosis. The CTEPH was diagnosed in 16 (1.6%) patients, after a median of 129 days; the estimated 2-year cumulative incidence was 2.3% (1.2-4.4%). Overall, 880 patients were evaluable for PPEI; the 2-year cumulative incidence was 16.0% (95% confidence interval 12.8-20.8%). The PPEI helped to identify 15 of the 16 patients diagnosed with CTEPH during follow-up (hazard ratio for CTEPH vs. no CTEPH 393; 95% confidence interval 73-2119). Patients with PPEI had a higher risk of re-hospitalization and death as well as worse quality of life compared with those without PPEI.
In this prospective study, the cumulative 2-year incidence of CTEPH was 2.3%, but PPEI diagnosed by standardized criteria was frequent. Our findings support systematic follow-up of patients after acute PE and may help to optimize guideline recommendations and algorithms for post-PE care.
The aim of this study was to characterize the network structure of grief-related functional impairment symptoms as measured by The Grief Impairment Scale (GIS) in 520 Peruvian individuals who have ...experienced the death of a family member or loved one. A psychological network model was applied to evaluate the estimation, stability, and accuracy of the network during the analysis sequence. The results indicated that the inability to perform activities at work, school, or home was the most central symptom in the entire network. However, the presence of high instability in the centrality indices indicates that the central node may differ in other cultural contexts. The networks were invariant according to sex. The most influential node in the women's group was their inability to perform activities at work, school, or home. In men, the most central node was the presence of health problems due to bereavement. The results would help to better understand functional impairment due to bereavement
Gratitude is a valuable emotion with an array of functional outcomes. Nonetheless, research on gratitude in organizations is limited. In this article we develop a multi-level model of gratitude ...composed of episodic gratitude at the event level, persistent gratitude at the individual level, and collective gratitude at the organizational level. We then consider the types of human resource initiatives that organizations can develop to cultivate employee gratitude and the contingencies of gratitude's emergence at the individual and organizational levels of analysis. Finally, we elucidate the benefits of gratitude for organizations and their employees. The result is a deeper understanding of how gratitude unfolds in organizations and the role that organizations themselves can play in influencing emotions at multiple levels in the workplace.
The current study aims to compare college adjustment and the effects of the COVID-19 pandemic on first-year students with and without ADHD.
Two cohorts (pre-pandemic, during the pandemic) of ...first-year, undergraduate college students (
= 3,006;
=18.32) were recruited from a multisite research consortium across several universities.
First-year participants self-reported on ADHD diagnosis and symptoms, functional impairments, and experiences transitioning to college.
First-year college students with and without ADHD reported significantly greater academic, daily living, and overall functional impairments during the pandemic compared to pre-pandemic. Compared to college students without ADHD, college students with ADHD reported greater functional impairment, more difficulty adjusting to the academic demands of college, and were less likely to feel valued at their institution.
First-year college students with and without ADHD experienced greater difficulties navigating the transition to college during the pandemic. Psychosocial and academic supports to help students transition to college are needed.
Background:
Many concerns have been raised regarding the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for Internet gaming disorder and International Classification ...of Diseases, 11th Revision (ICD-11) criteria for gaming disorder.
Aims:
In this study, we demonstrated the diagnostic validity of each criterion for Internet gaming disorder in the DSM-5 in terms of their intensity and frequency thresholds and evaluated functional impairments, unhealthy behaviors and complications among adults with Internet gaming disorder and gaming disorder.
Methods:
We recruited 69 subjects with Internet gaming disorder, 69 regular gamers and 69 controls without regular gaming based on diagnostic interviewing conducted by a psychiatrist according to the DSM-5 Internet gaming disorder criteria.
Results:
Except for the ‘deceiving’ and ‘escapism’ criteria, all criteria for Internet gaming disorder had a diagnostic accuracy ranging from 84.7% to 93.5% in differentiating between adults with Internet gaming disorder and regular gamers. A total of 44 participants with Internet gaming disorder (63.8%) fulfilled the gaming disorder criteria. In addition, 89% and 100% of the Internet gaming disorder and gaming disorder groups, respectively, had academic, occupational or social functional impairment. Both the Internet gaming disorder and gaming disorder groups had higher rates of delayed sleep phase syndrome and insomnia. The gaming disorder group also had a higher obesity proportion.
Conclusion:
The ‘deceiving’ and ‘escapism’ criteria had relatively lower diagnostic accuracy. Both the Internet gaming disorder and gaming disorder groups demonstrated functional impairments and unhealthy behaviors. They also exhibited complications, such as obesity and sleep disorders. These results support the utility of the DSM-5 Internet gaming disorder and ICD-11 gaming disorder criteria in identifying individuals who need treatment for both gaming addiction symptoms and complications resulting from the addiction.
Functional impairment rating scales are few in numbers and have mainly been examined in clinical populations. The Weiss Functional Impairment Rating Scale—Parent report (WFIRS-P) is a case in point. ...We tested the psychometric properties of the WFIRS-P in the largest general population study to date and for the first time examined the factor structure of the scale in a general population setting. Participants were 2,027 schoolchildren aged 6 to 11. Parents/caregivers completed the WFIRS-P and criterion measures of quality of life, attention-deficit/hyperactivity disorder, and behavioral/emotional symptoms. Confirmatory factor analysis and convergent/divergent validity analyses supported a six-factor structure: family, life skills, self-concept, social activities, and the separation of the school domain into two smaller domains covering school learning and school behavior. Children with and without a history of referral differed significantly on all six domains supporting the external validity. In conclusion, the WFIRS-P was found to generate valid scores in a general population sample.
Contemporary estimates of the association between functional impairment and health costs among United States (US) older adults who documented having pain are unavailable. We used a retrospective ...database design and developed unadjusted and adjusted linear regression models to assess total, office, outpatient, emergency department, inpatient, and prescribed drug costs between older US adults with and without functional impairment. We included US adults aged ≥ 50 in the 2020 Medical Expenditure Panel Survey dataset who documented having pain in the past month. We also included only those who had positive health costs. Among the 40,092,210 US adults aged ≥ 50 who documented having pain in the past month, we found 37% had functional impairment. In adjusted linear regression models, we found adults with functional impairment (versus adults without functional impairment) had 57.2% higher total health costs and 54.1% higher prescribed drug costs. We did not observe any statistical differences between groups for office, outpatient, emergency department, or inpatient costs. In conclusion, the higher total and prescribed drug costs we found among US older adults with pain and a functional impairment draws attention to the financial burden of functional impairment among these individuals, which needs to be addressed.
Objective: To examine the psychometric properties of a German adaptation of the Weiss Functional Impairment Rating Scale–Parent Report (WFIRS-P) in a clinical sample of children (4-12 years) with ...externalizing behavior disorders. Method: Data were collected within two clinical trials (N = 264). Factorial validity, reliability, and divergent validity from symptoms of ADHD and oppositional defiant disorder (ODD) were assessed. Results: Confirmatory factor analyses revealed that a bifactor model consistent with the theoretical assumption of a general construct of impairment (total scale) and additional specific factors (subscales) provided satisfactory data fit. Model-based reliability estimates showed that both the general construct and specific factors accounted for item variance. Internal consistencies were >.70, part–whole corrected item–scale correlations mostly >.30. Correlations between the WFIRS-P Scales and ADHD and ODD symptoms were low to moderate. Conclusion: The results support the factorial validity, reliability, and divergent validity of the WFIRS-P.
Background
Lack of agreement about criteria and terminology for children's language problems affects access to services as well as hindering research and practice. We report the second phase of a ...study using an online Delphi method to address these issues. In the first phase, we focused on criteria for language disorder. Here we consider terminology.
Methods
The Delphi method is an iterative process in which an initial set of statements is rated by a panel of experts, who then have the opportunity to view anonymised ratings from other panel members. On this basis they can either revise their views or make a case for their position. The statements are then revised based on panel feedback, and again rated by and commented on by the panel. In this study, feedback from a second round was used to prepare a final set of statements in narrative form. The panel included 57 individuals representing a range of professions and nationalities.
Results
We achieved at least 78% agreement for 19 of 21 statements within two rounds of ratings. These were collapsed into 12 statements for the final consensus reported here. The term ‘Language Disorder’ is recommended to refer to a profile of difficulties that causes functional impairment in everyday life and is associated with poor prognosis. The term, ‘Developmental Language Disorder’ (DLD) was endorsed for use when the language disorder was not associated with a known biomedical aetiology. It was also agreed that (a) presence of risk factors (neurobiological or environmental) does not preclude a diagnosis of DLD, (b) DLD can co‐occur with other neurodevelopmental disorders (e.g. ADHD) and (c) DLD does not require a mismatch between verbal and nonverbal ability.
Conclusions
This Delphi exercise highlights reasons for disagreements about terminology for language disorders and proposes standard definitions and nomenclature.
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