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Two of the main features of idiopathic normal pressure hydrocephalus (iNPH) are disturbed gait and cognition. These features are typically investigated separately, but here we combined walking with a cognitive task to investigate if older adults with iNPH were more susceptible to dual-task interference on walking than those without iNPH. In total, 95 individuals from the general population participated in our study. Of these, 20 were classified as Possible iNPH (median [interquartile range, IQR] 80 years [75–82.5]) and 75 as Unlikely iNPH (74 years [72–78]). Conversation, 10-m walking, semantic and phonemic verbal fluency were performed either combined or independently. "Stopping walking while talking" was noted. Pairwise comparisons and multiple logistic regression analyses were used. We found that the Possible iNPH group was older, stopped walking more frequently during the conversation, and had a slower single-task pace. The dual-task pace was slower for both groups. Only single-task walking pace could predict Possible iNPH when adjusted for age. We could establish a dual-task cost on gait performance in this sample of older adults from the general population, but the cost was not exclusive for individuals with Possible iNPH. To further assess the value of dual-task testing in iNPH, including observations of stopping walking while talking, a study of a clinical iNPH material with more severe symptoms would be valuable. [ABSTRACT FROM AUTHOR]

Purpose: Deep brain stimulation (DBS) is often successful in alleviating motor symptoms of essential tremor (ET); however, DBS may also induce adverse speech effects. The caudal zona incerta (cZi) is a promising DBS target for tremor, but less is known about the consequences of cZi DBS for speech. This preliminary study examined how habitual cZi DBS and cZi stimulation at high amplitudes may affect speech function in persons with ET. Method: Fourteen participants with ET were evaluated: off stimulation, on habitual cZi DBS, and with unilateral cZi stimulation at increasing stimulation amplitudes. At each stimulation condition, the participants read three 16-word sentences. Two speech-language pathologists made audioperceptual consensus ratings of overall speech function, articulation, and voice using a visual sort and rate method. Rated functions when off stimulation, on habitual cZi DBS, and at maximal-amplitude stimulation were compared using Friedman nonparametric tests. For participants with bilateral habitual DBS (n = 5), the effects of bilateral and unilateral stimulation were described in qualitative terms. Results: Habitual cZi DBS had no significant group-level effect on any of the investigated speech parameters. Maximal-amplitude stimulation had a small but significant negative effect on articulation. Participants with reduced articulatory precision (n = 9) had more medially placed electrodes than the nonaffected group (n = 5). Bilateral and unilateral left stimulation had comparable effects on speech. Conclusions: Findings from this preliminary study of cZi DBS indicate that speech is generally not affected by stimulation at habitual levels. High-amplitude cZi stimulation may, however, induce adverse effects, particularly on articulation. Instances of decreased articulatory function were associated with stimulation of more medial electrode contacts, which could suggest cerebello-rubrospinal involvement. [ABSTRACT FROM AUTHOR]

Abstract: Mental health inpatient milieus have repeatedly been found to be associated with passivity, social disengagement, and low levels of interaction with staff. However, little is known about patients’ experiences related to different ward activities. In the present study, we aimed to study the reports of activities and associated experiences of patients admitted to acute psychiatric inpatient wards. Disengaged, inactive, and solitary activities were hypothesized to be associated with less reward and more distress than their counterparts. We also aimed to investigate if such activities predicted distress, and if they were associated with clinical severity. Participants (n = 102) recorded their activities along with concurrent ratings of reward and distress in a structured 1‐day diary, and nurses provided clinical severity ratings. On average, 3.74 of the 11 hours assessed (34%) were spent doing nothing, only 0.88 hours (8%) were spent with staff, and most of the time was spent in solitude. Doing nothing, being alone, and passivity were associated with the greatest levels of distress and lowest levels of reward, whereas informal socializing demonstrated the opposite pattern. Distress was not predicted by activity or reward when adjusting for baseline distress. Clinical severity was not associated with the amount of time spent alone or the experience of reward during activity. In conclusion, the risk for passivity and social disengagement during admission prevails. This activity pattern could have detrimental emotional consequences and warrants action, but more studies are needed to determine if activity actually precedes emotional experience. [ABSTRACT FROM AUTHOR]

Aim To compare different levels of self-rated pain and determine if they predict anticipated early physical recovery in patients undergoing general and orthopaedic surgery. Background Previous research has indicated that average self-rated pain reflects patients' ability to recover the same day. However, there is a knowledge gap about the feasibility of using average pain ratings to predict patients' physical recovery for the next day. Design Descriptive, quantitative repeated measures. Methods General and orthopaedic inpatients ( n = 479) completed a questionnaire (October 2012-January 2015) about pain and recovery. Average pain intensity at rest and during activity was based on the Numeric Rating Scale and divided into three levels (0-3, 4-6, 7-10). Three out of five dimensions from the tool 'Postoperative Recovery Profile' were used. Because few suffered severe pain, general and orthopaedic patients were analysed together. Results Binary logistic regression analysis showed that average pain intensity postoperative day 1 significantly predicted the impact on recovery day 2, except nausea, gastrointestinal function and bladder function when pain at rest and also nausea, appetite changes, and bladder function when pain during activity. High pain ratings ( NRS 7-10) demonstrated to be a better predictor for recovery compared with moderate ratings ( NRS 4-6), day 2, as it significantly predicted more items in recovery. Conclusion Pain intensity reflected general and orthopaedic patients' physical recovery postoperative day 1 and predicted recovery for day 2. By monitoring patients' pain and impact on recovery, patients' need for support becomes visible which is valuable during hospital stays. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to follow the symptom trajectory of community-dwelling older people with multimorbidity and to explore the effect on symptom burden from an ambulatory geriatric care unit, based on comprehensive geriatric assessment. Background Older community-dwelling people with multimorbidity suffer from a high symptom burden with a wide range of co-occurring symptoms often resulting to decreased health-related quality of life. There is a need to move from a single-disease model and address the complexity of older people living with multimorbidity. Design Secondary outcome data from the randomized controlled Ambulatory Geriatric Assessment Frailty Intervention Trial ( AGe- FIT). Methods Symptom trajectory of 31 symptoms was assessed with the Memorial Symptom Assessment Scale. Data from 247 participants were assessments at baseline, 12 and 24 months, 2011-2013. Participants in the intervention group received care from an ambulatory geriatric care unit based on comprehensive geriatric assessment in addition to usual care. Results Symptom prevalence and symptom burden were high and stayed high over time. Pain was the symptom with the highest prevalence and burden. Over the 2-year period 68-81% of the participants reported pain. Other highly prevalent and persistent symptoms were dry mouth, lack of energy and numbness/tingling in the hands/feet, affecting 38-59% of participants. No differences were found between the intervention and control group regarding prevalence, burden or trajectory of symptoms. Conclusions Older community-dwelling people with multimorbidity had a persistent high burden of symptoms. Receiving advanced interdisciplinary care at an ambulatory geriatric unit did not significantly reduce the prevalence or the burden of symptoms. [ABSTRACT FROM AUTHOR]

Background Imitation, a key vehicle for both cognitive and social development, is often regarded as more difficult for children with autism spectrum disorders (ASD) than for children with Down syndrome (DS) or typically developing (TD) children. The current study investigates similarities and differences in observed elicited, spontaneous and deferred imitation using both actions with objects and gestures as imitation tasks in these groups. Methods Imitation among 19 children with autism was compared with 20 children with DS and 23 TD children matched for mental and language age. Results Elicited imitation resulted in significantly lower scores for the ASD group compared with the other two groups, an effect mainly carried by a low level of gesture imitation among ASD children. We observed no differences among the groups for spontaneous imitation. However, children with ASD or DS displayed less deferred imitation than the TD group. Proneness to imitate also differed among groups: only 10 (53%) of the children with autism responded in the elicited imitation condition compared with all children with DS and almost all TD children (87%). Conclusions These findings add to our understanding of the kind of imitation difficulties children with ASD might have. They also point to the necessity of not equating various imitation measures because these may capture different processes and be differently motivating for children with autism. [ABSTRACT FROM AUTHOR]

Aim To describe and compare general health and state anxiety before surgery and up to 6 months after surgery in patients with colorectal cancer undergoing elective rectal resection, abdominoperineal resection or colonic resection in an enhanced recovery context. Background Little is known about patient-reported health and anxiety after colorectal cancer surgery in an enhanced recovery context. Design A prospective cohort study. Methods Data were collected from October 2011-February 2013. The questionnaires - EuroQol 5-Dimensions 3-Levels and State-Trait Anxiety Inventory - were answered before surgery, at discharge and 1 and 6 months after surgery. Data were analysed using inferential statistics to describe differences between groups of patients (Kruskal-Wallis test) and between assessments within groups (Friedman's anova). Results Patients ( N = 105), divided into three groups based on surgical procedure, showed a high health index and a low state anxiety in all assessments without differences between the groups. Patients considered for abdominoperineal resection rated their pre-operative health as significantly higher than patients after rectal and colonic resections did. Within groups, patients recovering from abdominoperineal resection and rectal resection deteriorated significantly in health index 1 month after surgery. However, after 6 months they had improved again. After colonic resection, patients improved significantly in self-rated health and anxiety 1 month after surgery with no further discernible improvement after 6 months. Conclusion The study showed that patients generally had a high level of health and a low level of anxiety throughout the study period. Only a few differences occurred between assessments within groups. [ABSTRACT FROM AUTHOR]