The relationship between levels of physical activity and participation in everyday life in stroke survivors: A systematic review and meta-analysis.

BACKGROUND: Stroke survivors demonstrate decreased physical activity (PA) and take time to return to participation in everyday life, but the relationship between the two variables is unknown. OBJECTIVE: To investigate the correlation and trajectory over time between levels of PA and participation in everyday life in stroke survivors. METHODS: PubMed, Web of Science, Scopus, SPORTDiscus, Rehabilitation&Sport Medicine Source, and PEDro databases were searched from inception to January 2024. Cross-sectional and prospective studies evaluating both levels of PA and participation in stroke survivors were included. Two reviewers independently conducted the study selection, data extraction, and quality assessment. Meta-analyses of pooled correlation coefficients were calculated when at least two studies reported a correlation coefficient between the same PA and participation outcomes. RESULTS: Of 4962 studies identified, 49 were included in the systematic review. Studies were rated high (55%%) or fair (45%) quality. A wide range of monitoring methodologies for assessing PA and participation were found in the 23 prospective studies. Seven studies were included in the meta-analyses, showing a positive moderate correlation between PA time and participation in activities of daily living (n = 148; r = 0.52; P < 0.01; I2 = 81%) in participants <6 months post-stroke, and between PA time and the participation in all areas (n = 126; r = 0.44; P < 0.01; I2 = 0%) in participants ≥6 months post-stroke. Overall, while PA showed significant improvements over time, participation only showed a tendency. CONCLUSIONS: Despite the heterogeneity, consistent positive associations were found between PA time and participation levels in some areas. Establishing consensus is crucial to reduce heterogeneity and facilitate data pooling.

Duration of daily life activities in persons with and without obsessive-compulsive disorder.

Persons with obsessive-compulsive disorder (OCD) are often impaired in their daily level of functioning due to their time-consuming obsessions and/or compulsions. To date, however, studies are lacking that quantify how much time persons with OCD actually spend on activities of daily living. Therefore, the current study assessed 13 daily life activities (in minutes) with a self-report questionnaire in 299 persons with OCD at admission to inpatient treatment and 300 age- and sex-matched persons without OCD. A majority of persons with OCD indicated that they experienced obsessions and/or compulsions when leaving (84%) and cleaning (70%) the apartment, grocery shopping (66%), changing clothes (66%), and showering with (62%) and without (63%) shampooing. Persons with OCD who experienced obsessions and/or compulsions during a given daily life activity-but not those who did not experience obsessions and/or compulsions during these activities-reported longer durations for performing 10 of the 13 activities than persons without OCD. For most activities, longer durations related weakly but significantly to higher OCD symptom severity. Results indicate that the duration of daily life activities seems to depend more on whether persons with OCD experience obsessions and/or compulsions during a specific activity and less on whether a person is diagnosed with OCD in general. Future studies may use other assessment methods that allow for tracking the duration in daily life in real time.

Enhancing cognitive flexibility and working memory in individuals with mild cognitive impairment: Exploring the impact of virtual reality on daily life activities.

Mild Cognitive Impairment (MCI) serving as a transitional stage between normal aging and dementia. This study aimed to explore the impact of virtual reality (VR) on enhancing cognitive flexibility, working memory, and daily life activities. Forty participants diagnosed with MCI were randomly assigned to either an intervention group (N = 20) or a control group (N = 20). Evaluations were at baseline, post-training, and three months post-training using various cognitive assessment tools. Results showed that the VR-based cognitive rehabilitation significantly improved instrumental activities of daily living performance, visual and verbal working memory, and reduced anxiety and depression symptoms. While cognitive flexibility did not exhibit significant improvement, these findings highlight VR interventions as a potential avenue for improving cognitive and functional aspects, and alleviating psychological symptoms in individuals with MCI. Further research with larger sample sizes and extended follow-up periods is recommended to establish the long-term effectiveness of such interventions.

Technology-Based Health Promotion Training Among Stroke Patients: A Randomized Controlled Trial.

Stroke is a disease with a heavy social and familial care burden that can cause permanent brain damage, long-term disability, and/or death. This study aimed to determine the effect of technology-based health promotion training on the daily life activities, quality of life, and self-care of stroke patients. The study design was a Randomized Controlled Trial. The study sample included persons diagnosed with stroke diagnosed with stroke and were receiving inpatient treatment in the neurology clinic of a university hospital. The sample size was calculated as a total of 70 patients, 35 interventions and 35 controls. The intervention group patients received telephone-based education and follow-up grounded in Orem's Self-Care Theory over a 12-week period subsequent to their discharge. The educational content was divided into three distinct categories: self-care needs with regard to health deviations, developmental self-care needs, and universal self-care practices. Data were collected using the Montreal Cognitive Assessment Scale, the Katz Index of Independence in Activities of Daily Living, Stroke-Specific Quality of Life Scale, and the Exercise of Self-Care Agency Scale. The Independent Sample T-Test was used for intergroup comparisons, and the Dependent Sample T-Test was used for intragroup pre-test and post-test comparisons. Independent variables affecting the post-test scores, such as age and gender, were analyzed using the multiple linear regression model. The scale sub-dimension variables were compared using the multivariate analysis of variance test according to the groups. When compared with the control group patients after the training, it was determined that there was a statistically significant difference in the intervention group patients' mean scores for the Stroke-Specific Quality of Life Scale (t = 11.136, p = .001) and the Exercise of Self-Care Agency Scale (t = 14.358, p = .000). Training interventions led to enhanced awareness and knowledge about stroke among the intervention group patients. They also fostered the development of healthier lifestyle behaviors and bolstered both self-care abilities and quality of life.

Short- to Long-Term Effects of Virtual Reality on Motor Skill Learning in Children With Cerebral Palsy: Systematic Review and Meta-Analysis.

BACKGROUND: Many studies have started integrating virtual reality (VR) into neurorehabilitation for children with cerebral palsy (CP). The results of the effects of VR on motor skill learning, including the short- to long-term results of relevant studies, must be pooled in a generic framework. OBJECTIVE: This systematic review and meta-analysis aimed to investigate the short- to long-term effects of therapies including VR on motor skill learning in children with CP. METHODS: Two examiners followed the inclusion and exclusion criteria of the "Participant, Intervention, Control, and Outcome" framework. Randomized controlled trials (RCTs) and non-RCTs were considered if they compared VR-included interventions with control groups on motor functions and daily life activities in children with CP. PubMed, ScienceDirect, Embase, and IEEE Xplore databases were searched. The modified Downs and Black assessment was used to assess the methodological quality of the included studies. Meta-analyses and subgroup analyses for RCTs were conducted whenever possible. RESULTS: A total of 7 RCTs, 2 non-RCTs, and 258 children with CP were included. The priority focus of 78% (7/9) of the studies was upper limb functions. There was a significant short-term effect of adding VR to conventional therapies on upper limb functions when compared with conventional therapies (P=.04; standardized mean difference [SMD]=0.39, 95% CI 0.01-0.76). The overall medium- to long-term effects showed a trend toward favoring the VR group, although the difference was not statistically significant (P=.06; SMD=0.37, 95% CI -0.02 to 0.77). For balance (P=.06; SMD=1.04, 95% CI -0.04 to 2.12), gross motor functions (P=.30; SMD=2.85, 95% CI -2.57 to 8.28), and daily life activities outcomes (P=.21; SMD=0.29, 95% CI -0.16 to 0.74), the overall effect in the short term also showed a trend toward favoring the VR group, but these results were not statistically significant. CONCLUSIONS: VR seems to have additional benefits for motor skill learning in children with CP. Studies with follow-up outcomes of VR training focusing on balance and gross motor functions in patients with CP were quite limited. Future research on balance and gross motor function outcomes should target particularly long-term results of therapies including VR on motor skill learning. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42021227734; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021227734.

The Chinese version of the self-efficacy scale for daily life activities among older adults: translation, validity and reliability.

OBJECTIVE: To translate and cross-culturally adapt the Self-efficacy Scale for Daily Life Activities among Older Adults (SSDLAOA) into Chinese, as well as to examine the psychometric properties of the Chinese version of the SSDLAOA (C-SSDLAOA) in a Chinese community-based older adult population. METHODS: This study used a cross-sectional survey. The psychometric properties of the C-SSDLAOA were evaluated among 355 older adults recruited from three communities in Huzhou, including internal reliability, test-retest reliability, face validity, content validity, construct validity, and concurrent validity. RESULTS: The C-SSDLAOA was consistent with the original version, which consisted of five dimensions and 23 items. The confirmatory factor analysis indicated a good fit for each indicator (χ2 /df=1.387, RMSEA = 0.043, CFI = 0.967, TLI = 0.962, and SRMR = 0.042). The Cronbach's alpha was 0.909, and the test-retest reliability was 0.966, with good internal consistency and stability. The content validity index of the items ranged from 0.83 to 1.00, while the content validity index of the scale was 0.96. The correlation between the C-SSDLAOA and GSES was 0.886, with good concurrent validity. CONCLUSIONS: The C-SSDLAOA is a reliable and valid instrument for assessing self-efficacy for daily life activities in Chinese community-dwelling older adults.

Assessment of COVID-19 lockdown effect on early Alzheimer Disease progression.

INTRODUCTION: Recently, many aspects of daily life have changed due to the COVID-19 pandemic. Patients with Alzheimer Disease (AD) could be more vulnerable to those daily life changes as experts expected. Mainly, the lockdown involved reduced social contact and cognitive stimulation. So, it could affect the AD expression, increasing the patients' disabilities development. OBJECTIVE: The aim of this study is to evaluate the effect of COVID-19 lockdown on cognitive impairment progression in early AD patients. METHODOLOGY: The participants were patients with mild cognitive impairment due to AD (MCI-AD) from the Neurology Unit (La Fe Hospital), who were neuropsychologically evaluated (cognitive impairment, daily activity tests) twice over 2 years. They were classified into a case group (n = 21), evaluated before and after lockdown condition, and a control group (n = 20), evaluated entirely before the lockdown condition. RESULTS: All the participants showed increasing cognitive impairment and functional deterioration over the 2-year period of evaluation (p < 0.05). However, a faster worsening was not observed as a consequence of the COVID-19 pandemic and the lockdown condition. In fact, the statistical significance observed between the two study groups for daily life activities showed that the worsening was even lesser in the group evaluated under the lockdown condition. CONCLUSION: Medium-term effects of COVID-19 lockdown could not involve an acceleration of the cognitive decline in MCI-AD patients in a 2-year evaluation period. In addition, the least worsening observed for daily living activities in the case group was probably due to the change in routines. Therefore, the common assumption of cognitive worsening of AD progression due to the lockdown in comparison with normal disease progression was not demonstrated in this study, at least for MCI-AD cases. However, more longitudinal studies are required to evaluate long-term effects in these patients.

Rehabilitación del miembro superior a través de la imagineria motora graduada y sistema de realidad virtual tras un ictus: un estudio piloto / Upper limb rehabilitation through graded motor imagery and virtual reality system after stroke: a pilot study

Objetivos: evaluar el efecto de una intervención combinada de Realidad Virtual e Imaginería Motora Graduada sobre la funcionalidad del miembro superior afecto en adultos con ictus en fase crónica. Métodos: un estudio piloto, cuasiexperimental, de un único grupo, en el que participaron 5 pacientes adultos con ictus en fase crónica durante 5 semanas, durante el cual recibieron tratamiento combinado de Realidad Virtual y de Imaginería motora graduada. La funcionalidad del miembro superior se evaluó con la escala Fugl-Meyer Assessment, Motor Activity Log-30, Abilhand, Barthel, Asworth, Box and Blocks, Nine Hole Peg Test y medidas propias del dispositivo de Realidad Virtual y de la lateralidad. Resultados: la Realidad Virtual e Imaginería motora graduada mejoraron la funcionalidad del miembro superior, mejorando resultados en la lateralidad (p= 0,043) y la RV de la actividad no 2(p= 0,043), respectivamente, así como el cuestionario Motor Activity Log-30, en el que se obtuvo diferencias estadísticamente significativas entre la valoración inicial y final con una (p= 0,043). Conclusiones: la intervención combinada con RV e IMG parece mejorar la funcionalidad del miembro superior en adultos con ictus en fase crónica, pero sería necesario realizar estudios con un tamaño muestral mayor, para determinar la efectividad y las posibles mejorías de la funcionalidad de las extremidades al combinar la RV y la IMG.(AU)

Objective: This study aims to evaluate the effect of a combined Virtual Reality and Graded Motor Imaging intervention on the functionality of the affected upper limb in adults with chronic stroke. Methods: A single- group, quasi-experimental, pilot study involving 5 adult patients with chronic stroke for 5 weeks, during which they received combined VR and IMG treatment. Upper limb functionality was assessed with the Fugl- Meyer Assessment, Motor Activity Log-30, Abilhand, Barthel, Asworth, Box and Blocks and Nine Hole Peg Test, as well as the tools from the VR and GMI devices. Results: VR and IMG improved the functionality of the upper limb, improving results in laterality (p= 0.043) and VR of activity no. 2 (p= 0.043), respectively, as well as the Motor Activity Log-30 questionnaire, in which statistically significant differences were obtained between the initial and final assessment with a (p= 0.043). Conclusions: Combined intervention with VR and IMG appears to improve upper limb function in adults with chronic stroke, but studies with larger sample sizes are needed to determine the effectiveness and possible improvements in limb function when combining VR and IMG.(AU)

Influencia del área ocupacional de ocio en la participación social de niños del contexto rural / Influence of leisure on the social participation of children in the rural context

Objetivos: determinar la influencia de las actividades de ocio de niños del contexto rural sobre la participación social. Métodos: estudio cuantitativo descriptivo correlacional en el que se utilizo el Cuestionario Volitivo Pediátrico (PVQ) para la variable independiente Ocio; y la Evaluación de Habilidades de Comunicación e Interacción (ACIS) para la variable dependiente para determinar el grado de significancia como quehacer, con relación a su contexto, sobre los roles, intereses y ocupaciones propios de la población infantil rural pertenecientes a una comunidad educativa. Resultados: demostramos diferencias significativas entre la influencia que determina la actividad libre sobre la participación social identificando una sinergia contraproducente ante la satisfacción del ocio, pues se eligen actividades en el tiempo libre por características del contexto rural, pero resultan no ser acciones de disfrute en su totalidad para los niños que conllevo a la interrupción de experiencias con sentido y significado personal para los niños rurales comprobando en términos de correlación, que la actividad libre de ocio tiene un impacto inversamente proporcional para el favorecimiento o interrupción de la participación social. Además, la actividad semiestructurada demuestra mayor dirigencia para modular y facilitar acciones propias y afines a las habilidades sociales. Conclusiones: debido a las diferencias de puntuaciones satisfactorias entre la acción libre y semiestructurada es conciso desarrollar planes comunitarios que inicien por forjar habilidades personales, intereses y satisfacciones propias a los niños rurales para resultados intrínsecos que permitan forjar el desarrollo del ocio como proaccion a la participación social, asimismo proyectar a los terapeutas ocupacionales como garantes y promotores de espacios para la exploración y participación del ocio, juego como derecho fundamental de la niñez y como ocupación significativa dentro del desarrollo del ser ocupacional.(AU)

Objective: To determine the influence of leisure activities on social participation in rural children. Methods: For this research, the variables of leisure and social participation were described through the application of standardized instruments for data collection, namely the PVQ (Pediatric Volitional Questionnaire) and the ACIS (Assessment of Communication and Interaction Skills) from Occupational Therapy. The aim was to determine the influence in terms of correlation and its degree of significance as an occupation, in relation to its context, on the roles, interests and occupations of the rural child population belonging to an educational community. The research methodology used was quantitative, descriptive, and correlational. Results: We identified a counterproductive synergy regarding leisure satisfaction, since activities are chosen in free time, but they are not actions of enjoyment in their entirety, which leads to the interruption of experiences with meaning and personal meaning. Correlation analysis revealed that free leisure activities inversely have an inversely proportional impact for the promotion or interruption of social participation. Conclusions: Occupational therapists should focus their efforts on promoting life skills within educational institutions. These institutions should serve as guarantors and promoters of spaces for the exploration and participation in leisure, games, recreation, and free time, which are fundamental rights of children and significant occupations for their occupational development.(AU)

Effect of Chair Yoga Therapy on Functional Fitness and Daily Life Activities among Older Female Adults with Knee Osteoarthritis in Taiwan: A Quasi-Experimental Study.

This study aims to examine the effectiveness of chair yoga therapy on improving functional status and daily life activity scores in older female adults with knee osteoarthritis living in the community. A quasi-experimental design was adopted. In total, 85 female participants with knee osteoarthritis were assigned to the chair yoga therapy intervention group (n = 43) or the comparison (n = 42) group. A 12-week chair yoga exercise program was provided to the intervention group two times per week from January to April 2020. The primary outcomes, which include changes in physical functional ability, body mass index, and biophysiological indicators, were evaluated for all participants in the pre- and post-measures time periods. The analysis shows that the participants had a significantly higher level of functional fitness and daily life activity scores after the chair yoga intervention. This finding indicates that the chair yoga program was effective in improving the functional fitness and daily life activity scores of community-dwelling elderly females with knee osteoarthritis.

Comparison of herbal medicines and pain relief medications in the treatment of primary dysmenorrhoea among female medical students at Taibah University.

Objectives: Dysmenorrhoea is a common gynaecological problem that affects many women during their reproductive years. The objectives of this study were to describe the different treatments used for primary dysmenorrhoea (PD) among medical students at Taibah University, and to investigate the link between pain severity and daily life activities in relation to the type of dysmenorrhoea treatment. Methods: A cross-sectional study was conducted on 301 female medical students through an 18-item self-administered electronic questionnaire to screen for students with PD. The questionnaire included sociodemographic characteristics, details of self-management methods (types and adverse events), daily life domains affected by pain, and the Visual Analogue Scale score for the pain (wherein a score ≥7 indicated severe pain). Chi-square test, a multivariate regression model, and correlation analysis were used for data analysis. Results: The prevalence of PD among respondents was 71.8%. Medications were used by more than half of the respondents (51.9%), and were mainly non-steroidal anti-inflammatory drugs (53.5%) and paracetamol (47.5%). Among the participants, 14.1% used herbal medicines, cinnamon (55.7%), chamomile (40.7%), and ginger (33.3%). Other pain relief modalities were used by 34% of participants. Most students with a history of PD (80.6%) reported effects on their daily activities, mainly mood disturbance. Students using medications were more likely to have severe pain (72.7%) and an affect on daily activities (92.9%) than those using herbal medicines (44.4% and 88.9%, respectively) and other treatments (47.7% and 70.8%, respectively) (p < 0.001). Conclusions: Medications were more commonly used than herbal medicines and other relief methods. Effects of PD on daily life activities were observed among most students treated with medications. We recommend health promotion programmes to increase the awareness regarding different pain relief methods.

Testing the mood brightening hypothesis: Hedonic benefits of physical, outdoor, and social activities in people with anxiety, depression or both.

BACKGROUND: The mood brightening hypothesis postulates that people with depressive symptoms report more positive affect (PA) and less negative affect (NA) than healthy controls after rewarding daily life activities. Whether mood brightening also occurs in people with anxiety symptoms remains unclear. This study examined effects of physical activity, being outdoors, and social activity on PA and NA across different levels of depression and anxiety symptoms in the general Dutch population. METHODS: Participants completed an electronic diary on their smartphone, thrice daily over 30 days, to assess activities and affect (n = 430; 22,086 assessments). We compared five groups based on their scores on the Depression, Anxiety and Stress Scales: asymptomatic participants, participants with mild symptoms of depression and/or anxiety, depression symptoms, anxiety symptoms, and comorbid depression and anxiety symptoms. Multilevel linear regression models with interaction terms were used to compare the association between activities and affect in these five groups. RESULTS: All activities were associated with increased PA and reduced NA in all groups. We found a mood brightening effect in participants with depression, as physical activity and being outdoors were associated with reduced NA. Participants with depression had increased PA and reduced NA when in social company compared to asymptomatic participants. No mood brightening effects were observed in participants with anxiety or comorbid depression and anxiety. LIMITATIONS: Our sample included mainly women and highly educated subjects, which may limit the generalizability of our findings. CONCLUSION: Mood brightening is specific to depression, and typically stronger when in social company.

Occupational intervention in mental health hospitals: Study of contextual impact.

BACKGROUND: Recovery-promoting and occupation-oriented interventions for people with schizophrenia who receive in-patient services are scarcely investigated, limiting our understanding of the factors affecting intervention effectiveness and hindering occupational inclusion. AIMS: To investigate the impact of contextual factors on the effectiveness of 'Occupational Connections' (OC) - occupational intervention for in-patient psychiatric settings. MATERIALS AND METHODS: Quasi-experimental, single-blind study compared between inpatients with schizophrenia participating in OC (N = 14) and those receiving treatment as usual only (N = 16) on primary outcomes of participation dimensions and recovery-orientation of the service, and on secondary outcomes of cognition, symptom severity, and functional capacity. RESULTS: Participation in OC in a new context appears to contribute to improvement in cognitive fluency and flexibility, schizophrenia symptoms, and functional capacity (-2.8 0.05) or reduction (-2.25

Early signs of functioning and contextual factors in children 0 to 6 years of age at high risk of or with developmental coordination disorder: A scoping review.

BACKGROUND: Developmental coordination disorder (DCD) can significantly impact body structures and functions, activities, participation and contextual factors. Using a scoping review methodology, we aimed to identify the characteristics or signs that can have an early impact on the development and functioning of children with DCD between 0 and 6 years. METHODS: We searched the Medline, Cochrane and PEDro databases. The screening of the 1580 articles obtained was conducted independently and in duplicate. From the included articles, among others, we extracted results that reported the early developmental characteristics of children at high risk or diagnosed with DCD, the components of the International Classification of Functioning (ICF) and the F-Words studied in the results or the agents involved in the evaluation. RESULTS: Seventeen articles were included in the review. From them, a set of early signs of DCD-general and specific-were collected that reflected the existence of restrictions in daily life activities from an early age and in certain routines, such as eating, dressing, grooming or playing. The most studied components of the ICF were activities and participation, with functioning being the most studied F-word. CONCLUSIONS: Detection of activity limitations and restrictions in participation between 0 and 6 years in children with DCD is possible. Recognition of parental concerns and early assessment could facilitate the follow-up of children at high risk for DCD and their inclusion in screening programs that include standardized tools for their diagnosis.

OSDI Questions on Daily Life Activities Allow to Detect Subclinical Dry Eye in Young Contact Lens Users.

Dry eye disease (DED) is difficult to detect in young contact lens (CL) wearers, who usually have no signs, mild symptoms and an ocular surface disease index (OSDI) below the DED diagnosis values (OSDI ≥ 13). We investigate if some of the 12 OSDI questions (OSDI A­ocular symptoms; OSDI B­vision-related functionality; OSDI C­environmental triggers) contribute the most to classify young CL as symptomatic. TBUT and tear volume are also measured. Age, gender and refraction error-matched eye glasses (EG) wearers participated as the control. CL and EG data were compared with t-test and z-test. Confusion matrices and logistic correlation analyses were performed to define the contribution of each OSDI question to classify symptomatic subjects. OSDI classified symptomatic CL better than the tear volume or TBUT values. In CL, only OSDI B and C values were significantly higher in symptomatic vs. asymptomatic subjects (p < 0.001), while values of all twelve OSDI questions were significantly higher in symptomatic vs. asymptomatic EG (p < 0.05−0.001). All OSDI questions contribute equally to identify symptomatic EG, while only OSDI B questions on daily life visual functions are significant to classify symptomatic CL wearers at risk to develop DED or at a subclinical stage. CL wearers scoring ≥ 2 on the OSDI B questions should be considered for preventive treatments, even if their clinical sings are scarce or absent.

Safety and Confidence in Local Law Enforcement and Government During Serial Shooting Events: Association With Daily Life Activities.

OBJECTIVE: This study examined the relationship of perceived safety and confidence in local law enforcement and government to changes in daily life activities during the Washington, DC, sniper attacks. METHODS: Participants were 1238 residents from the Washington, DC metropolitan area who were assessed using an Internet survey that included items related to safety at work, at home, and in general, confidence in law enforcement/government, and changes in routine daily life activities. RESULTS: A majority of participants (52%, n = 640) reported changing their daily life activities, with approximately one-third identifying changes related to being in large places and getting gas. Perceived safety was associated with confidence in local law enforcement/government. After adjusting for demographics, lower feelings of safety and less confidence in law enforcement/government were related to a higher likelihood of altered daily activities. Confidence in local law enforcement/government modified the association of safety with changes in daily activities. Among participants with high safety, less confidence in local law enforcement/government was associated with greater changes in daily life activities. CONCLUSIONS: Serial shooting events affect feelings of safety and disrupt routine life activities. Focus on enhancing experiences of safety and confidence in local law enforcement and government may decrease the life disruption associated with terrorist shootings.

Public Health Safety in Community Living Circles Based on a Behavioral Motivation Perspective: Theoretical Framework and Evaluation System.

Public health problems, such as the spread of COVID-19 and chronic diseases, are mainly caused by the daily life activities of community residents. Therefore, there is a need to build a healthy and safe community living circle through the evaluation of health behaviors in daily life. This paper proposes a theoretical framework and evaluation system for public health safety in community living circles, from a behavioral motivation perspective. Firstly, based on the behavioral motivation theory, a theoretical framework for the study of public health safety in community living circles is constructed from the perspective of the "project-activity-health" coupling relationship network, regarding community residents' daily life activities. Then, a public health safety evaluation system for community living circles is proposed based on this framework, which includes the following: (1) identifying the scope of community living circles based on Spatio-temporal Activities Analysis; (2) Based on the theory of protection motivation, a health behavior evaluation model based on the three elements of "spatial and temporal geographical environment-daily life activities-public health safety" is established; (3) Based on the hierarchy of public health problems, a public health safety evaluation model of the community living circle is established. The behavioral motivation-based evaluation system explores a new approach and research paradigm for community-scale public health safety theory; this will help to achieve the goal of "healthy communities" when further empirical evidence is available.

Mães com Deficiência e Maternidade: Cotidiano, Redes de Apoio e Relação com a Escola / Mothers with Disabilities and Motherhood: Everyday Life, Support Networks and Relationship with School

RESUMO: Cerca de metade das pessoas com deficiência no Brasil são mulheres e uma parte delas torna-se mãe. Entretanto, não há dados na literatura sobre as necessidades específicas dessa população. Assim sendo, este artigo tem por objetivo apresentar as percepções de mulheres com deficiência física e visual sobre si mesmas, sobre o cotidiano da maternidade, as redes de apoio e a relação da família com a escola. A pesquisa seguiu a metodologia qualitativa e utilizou narrativas como forma de coletar dados. Participaram do estudo seis mulheres, sendo três com deficiência visual e três com deficiência física. Os resultados estão apresentados em duas categorias: 1) concepções das mulheres sobre sua deficiência, que reúne falas sobre como a interação com a sociedade afeta a concepção que elas têm de si mesmas; e 2) cotidiano da maternidade, que discute os relatos sobre o cotidiano e as experiências dessas mulheres como mães, incluindo suas redes de apoio formal e informal, os desafos diários e as adaptações necessárias no cuidado com seus filhos, as relações com a escola e a comunidade e a maneira como as crianças se desenvolvem e se organizam frente às limitações da mãe. As narrativas trouxeram elementos importantes do cotidiano dessas mulheres que são invisíveis perante a sociedade e os profssionais que atuam junto às pessoas com deficiência, indicando a necessidade de fomentar práticas profssionais e mais pesquisas sobre o tema, com a perspectiva de promover uma sociedade mais inclusiva.

ABSTRACT: About half of the people with disabilities in Brazil are women, and some of them become mothers. However, there is no data in literature about the specific needs of this population. Tus, this paper aims to present the perceptions of women with physical and visual disabilities about themselves, about everyday life as mothers, about support networks and the relationship between family and school. The research followed a qualitative methodology and used narratives as a means of data collection. Six women participated in the study, three with visual impairment and three with physical disability. The findings are presented in two categories: 1) women's conceptions of their disability, which summarizes their expressions about interactions with society that affect their self-image; and 2) daily life of motherhood, which addresses the accounts of these women's daily lives and experiences as mothers, including their formal and informal support networks, daily challenges and necessary adjustments in caring for their children, relationships with school and the community, and how the children develop and self-organize in the face of their mother's limitations. The narratives brought to light important elements of these women's daily lives that are invisible to society and to professionals working with people with disabilities. This shows the need to promote professional practices and more research on the subject in order to create a more inclusive society.

Sarcopenia como factor predictor de dependencia y funcionalidad en adultos mayores mexicanos / Sarcopenia as a predictor of dependency and functionality in older Mexican adults México

Objetivo: Determinar la influencia de la sarcopenia en la funcionalidad de Adultos Mayores Mexicanos. Método: diseño correlacional-predictivo. Muestra: 316 adultos mayores que asistieron al centro de actividades artísticas y deportivas. Instrumentos: cédula de datos sociodemográficos-clínicos, SARC-F, índice de Barthel y escala de Lawton. Resultados: La sarcopenia tiene impacto negativo sobre las actividades instrumentales de la vida diaria e influye en mayor porcentaje en las básicas convirtiéndola en variable predictora explicando un 34% las actividades de la vidia diaria y un 22% las instrumentales. Conclusiones: La sarcopenia es una variable predictora para las actividades básicas e instrumentales de la vida diaria. Los resultados presentados plantean bases para futuras intervenciones multidisciplinarias para disminuir el riesgo de sarcopenia y complicaciones en quienes la padecen. Es necesario adoptar estrategias de valoración de individuos con sarcopenia o en riesgo de desarrollarla, a través de consultas en el primer nivel de atención, para prevenirla.(AU)

Objective: To determine the influence of sarcopenia on the functionality of Mexican Older Adults. Method: correlational-predictive design. Sample, 316 older adults who attended the center for artistic and sports activities. Sociodemographic-clinical data card instruments, SARC-F, Barthel index and Lawton scale. Results: Sarcopenia has a negative impact on the instrumental activities of daily life and influences a greater percentage in the basic ones, making it a predictor variable, explaining 34% of the activities of daily life and 22% of the instrumental ones. Conclusions. Sarcopenia is a predictor variable for basic and instrumental activities of daily living. The results presented present bases for future multidisciplinary interventions to reduce the risk of sarcopenia and complications in those who suffer from it. It is necessary to adopt assessment strategies for individuals with sarcopenia or at risk of developing it, through consultations at the first level of care for its prevention.(AU)