Search results for: preoperative geriatric scores

Authors: Jeongwoo Lee

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Children are the most vulnerable travelers and they are at risk for pedestrian injury. Creating a safe route to school is important because walking to school is one of the main opportunities for promotion of needed physical exercise among children. This study examined how the built environmental attributes near an elementary school influence traffic accidents among school-aged children. The study used two complementary data sources including the locations of police-reported pedestrian crashes and the built environmental characteristics of school areas. The environmental attributes of road segments were collected through GIS measurements of local data and actual site audits using the inventory developed for measuring pedestrian-crash risk scores. The inventory data collected at 840 road segments near 32 elementary schools in the city of Ulsan. We observed all segments in a 300-meter-radius area from the entrance of an elementary school. Segments are street block faces. The inventory included 50 items, organized into four domains: accessibility (17items), pleasurability (11items), perceived safety from traffic (9items), and traffic and land-use measures (13items). Elementary schools were categorized into two groups based on the distribution of the pedestrian-crash hazard index scores. A high pedestrian-crash zone was defined as an school area within the eighth, ninth, and tenth deciles, while no pedestrian-crash zone was defined as a school zone with no pedestrian-crash accident among school-aged children between 2013 and 2016. No- and high pedestrian-crash zones were compared to determine whether different settings of the built environment near the school lead to a different rate of pedestrian-crash incidents. The results showed that a crash risk can be influenced by several environmental factors such as a shape of school-route, number of intersections, visibility and land-use in a street, and a type of sidewalk. The findings inform policy for creating safe routes to school to reduce the pedestrian-crash risk among children by focusing on school zones.

Keywords: active school travel, school zone, pedestrian crash, safety route to school

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Authors: Bilgen Ozluk, Ayfer Karaaslan

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Introduction: Adaptation to university life is a difficult process for students. In peer support, students are expected to help other students or sometimes adults using their helping skills. Therefore, it is expected that peer support will have significant effect on students’ adaptation to university life. Aim: This study was conducted with the aim of determining the effect of peer support on adaptation to university life in the first year students of the faculty of health sciences. Methods: The population consists of 340 first year university students receiving education in the departments of nursing, health management, social services, nutrition and dietetics, physiotherapy and rehabilitation at an university located in the province of Konya. The sample of the study consisted of 274 students who voluntarily participated in the study. The data were collected between the dates 23 May 2016 and 3 June 2016. The data were collected using the socio-demographic information, the peer support scale and the university life adaptation scale. Ethical approvals for the study and permission from the university were taken. Numbers, percentages, averages, one-Way ANOVA, pearson correlation analysis and regression analysis have been used in assessing the data. Findings: When the problems most frequently encountered by students just starting the university were ordered, problems regarding their classes took the first place by 41.6%, socio-cultural problems took the second place by 38.7%, and economic problems took the third place by 37.6%. The mean total score of the Adaptation to University Life Scale was found to be 216.78±32.15. Considering that the lowest and highest scores that can be gained from the scale are 132 and 289 respectively, it was found that the adaptation to university life levels of the students were higher than the average. The mean adaptation to university life score of the nursing students was higher than those of the students of other departments. The mean score of ‘the Peer Support Scale’ was found to be 47.24±10.27. Considering that the lowest and highest scores that can be gained from the scale are 17 and 68 respectively, it was found that the peer support levels of the students were higher than the average. As a result of the regression analysis, it was found that 20% of the total variance regarding adaptation to university life was explained by peer support. Conclution: Receiving the support peer groups becomes highly important in the university adaptation process of first-year students. Peer support will create the means for easier completion of this difficult transition process.

Keywords: adaptation to university life, first years, peer support, university student

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Authors: Ravid Yinon

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Introduction: Pelvic trauma causes high mortality, particularly among the elderly population. Pelvic injury ranges from low-energy incidents such as falls to high-energy trauma like motor vehicle accidents. The mortality rate among high-energy trauma patients is higher, as can be expected. The elderly population is more vulnerable to pelvic trauma even at low energy mechanisms due to the fragility and diminished physiological reserve of these patients. The aim of this study is to examine whether there is a higher long-term mortality in pelvic injuries in the elderly from the low-energy mechanism than those injured in high energy. Methods: A retrospective cohort study was conducted in a level 1 trauma center with injured patients aged 65 years and over with pelvic trauma. The patients were divided into two groups of low and high-energy mechanisms of injury. Multivariate analysis was conducted to characterize the differences between the groups. Results: There were 585 consecutive injured patients over the age of 65 with a documented pelvic injury who were treated at the primary trauma center between 2008-2020. The injured in the high energy group were younger (mean HE- 75.18, LE-80.73), with fewer comorbidities (mean 0.78 comorbidities at HE and 1.28 at LE), more men (52.6% at HE and 27.4% at LE), were consumed more treatments facilities such as angioembolization, ICU admission, emergency surgeries and blood products transfusion and higher mortality rate at admission (HE- 19/133, 14.28%, LE- 10/452, 2.21%) compared to the low energy group. However, in a long-term follow-up of one year after the injury, mortality in the low-energy group was significantly higher (HE- 14/114, 12.28%, LE- 155/442, 35.06%). Discussion: Although it can be expected that in the mechanism of high energy, the mortality rate in the long term would be higher, it was found that mortality at the low energy patient was higher. Apparently, low-energy pelvic injury in geriatric patients is a measure of frailty in these patients, causes injury to more frail and morbid patients, and is a predictor of mortality in this population in the long term. Conclusion: The long-term follow-up of injured elderly with pelvic trauma should be more intense, and the healthcare provider should put more emphasis on the rehabilitation of these special patient populations in an attempt to prevent long-term mortality.

Keywords: pelvic trauma, elderly trauma, high energy trauma, low energy trauma

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Authors: Betül sönmez, Fatma Azizoğlu, S. Bilge Hapçıoğlu, Aytolan Yıldırım

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Background: Social innovativeness contains the procurement of a sustainable benefit for a number of problems from working conditions to education, social development, health, and from environmental control to climate change, as well as the development of new social productions and services. Objectives: This study was conducted to determine the correlation between the social innovation tendency of nursing and medical faculty students and value types. Methods and participants: The population of this correlational study consisted of third-year students studying at a medical faculty and a nursing faculty in a public university in Istanbul. Ethics committee approval and permission from the school administrations were obtained in order to conduct the study and voluntary participation of the students in the study was ensured. 524 questionnaires were obtained with a total return rate of 57.1% (65.0% in nurse student and 52.1% in physic students). The data of the study were collected by using the Portrait Values Questionnaire and a questionnaire containing the Social Innovativeness Scale. Results: The effect of the subscale scores of Portrait Values Questionnaire on the total score of Social Innovativeness Scale was 26.6%. In the model where a significance was determined (F=37.566; p<0.01), the highest effect was observed in the subscale of universalism. The effect of subscale scores obtained from the Portrait Values Questionnaire, as well as age, gender and number of siblings was 25% on the Social Innovativeness in nursing students and 30.8% in medical faculty students. In both models where a significance was determined (p<0.01), the nursing students had the values of power, universalism and kindness, whereas the medical faculty students had the values of self-direction, stimulation, hedonism and universalism showed the highest effect in both models. Conclusions: Universalism is the value with the highest effect upon the social innovativeness in both groups, which is an expected result by the nature of professions. The effect of the values of independent thinking and self-direction, as well as openness to change involving quest for innovation (stimulation), which are observed in medical faculty students, also supports the literature of innovative behavior. These results are thought to guide educators and administrators in terms of developing socially innovative behaviors.

Keywords: social innovativeness, portrait values questionnaire, nursing students, medical faculty students

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Authors: Peter Akayuure

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One key determinant of the quality of mathematics learning is the teacher’s ability to assess students adequately and effectively and make assessment an integral part of the instructional practices. If the mathematics teacher lacks the required literacy to perform classroom assessment roles, the true trajectory of learning success and attainment of curriculum expectations might be indeterminate. It is therefore important that educators and policymakers understand and seek ways to improve the literacy level of mathematics teachers to implement classroom assessments that would meet curriculum demands. This study employed a descriptive survey design to explore perceived levels of assessment literacy of mathematics teachers to implement classroom assessment with the school based assessment framework in Ghana. A 25-item classroom assessment inventory on teachers’ assessment scenarios was adopted, modified, and administered to a purposive sample of 48 mathematics teachers from eleven Senior High Schools. Seven other items were included to further collect data on their self-efficacy towards assessment literacy. Data were analyzed using descriptive and bivariate correlation statistics. The result shows that, on average, 48.6% of the mathematics teachers attained standard levels of assessment literacy. Specifically, 50.0% met standard one in choosing appropriate assessment methods, 68.3% reached standard two in developing appropriate assessment tasks, 36.6% reached standard three in administering, scoring, and interpreting assessment results, 58.3% reached standard four in making appropriate assessment decisions, 41.7% reached standard five in developing valid grading procedures, 45.8% reached standard six in communicating assessment results, and 36.2 % reached standard seven by identifying unethical, illegal and inappropriate use of assessment results. Participants rated their self-efficacy belief in performing assessments high, making the relationships between participants’ assessment literacy scores and self-efficacy scores weak and statistically insignificant. The study recommends that institutions training mathematics teachers or providing professional developments should accentuate assessment literacy development to ensure standard assessment practices and quality instruction in mathematics education at senior high schools.

Keywords: assessment literacy, mathematics teacher, senior high schools, Ghana

Procedia PDF Downloads 118

Authors: Laura E. Hall, Joel Monárrez-Espino, Luz María Tejada Tayabas

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College students are at risk of weight gain and poor dietary habits, and health behaviours established during this period have been shown to track into midlife. They may therefore be an important target group for health promotion strategies, yet there is a lack of literature regarding dietary intakes and associated factors in this group, particularly in middle-income countries such as Mexico. The aim of this exploratory research was to describe and compare reported dietary intakes among nursing and nutrition college students at two public universities in Mexico, and to explore the relationship between demographic, behavioural and other health-related factors and the risk of low diet quality. Mexican college students (n=444) majoring in nutrition or nursing at two urban universities completed questionnaires regarding dietary and health-related behaviours and risks. Dietary intake was assessed via 24-hour recall. Weight, height and abdominal circumference were measured. Descriptive statistics were reported and nutrient intakes were compared between colleges and study tracks using Student’s t tests, odds ratios and Pearson chi square tests. Two dietary quality scores were constructed to explore the relationship between demographic, behavioural and other health-related factors and the diet quality scores using binary logistic regression. Analysis was performed using SPSS statistics, with differences considered statistically significant at p<0.05. The response rate to the survey was 91%. When macronutrients were considered as a percentage of total energy, the majority of students had protein intakes within recommended ranges, however one quarter of students had carbohydrate and fat intakes exceeding recommended levels. Three quarters had fibre intakes that were below recommendations. More than half of the students reported intakes of magnesium, zinc, vitamin A, folate and vitamin E that were below estimated average requirements. Students studying nutrition reported macronutrient and micronutrient intakes that were more compliant with recommendations compared to nursing students, and students studying in central-north Mexico were more compliant than those studying in southeast Mexico. Breakfast skipping (Adjusted Odds Ratio (OR) = 5.3; 95% Confidence Interval (CI) = 1.2-22.7), risk of anxiety (OR = 2.3; CI = 1.3-4.4), and university location (OR = 1.6; CI = 1.03-2.6) were associated with a greater risk of having a low macronutrient score. Caloric intakes <1800kcal (OR = 5.8; CI = 3.5-9.7), breakfast skipping (OR = 3.7; CI = 1.4-10.3), vigorous exercise ≤1h/week (OR = 2.6; CI = 1.3-5.2), soda consumption >250mls/day (OR = 2.0; CI = 1.2-3.3), unhealthy diet perception (OR = 1.9; CI = 1.2-3.0), and university location (OR = 1.8; CI = 1.1-2.8) were significantly associated with greater odds of having a low micronutrient score. College students studying nursing and nutrition did not report ideal diets, and these students should not be overlooked in public health interventions. Differences in dietary intakes between universities and study tracks were evident, with more favourable profiles evident in nutrition compared to nursing, and North-central compared to Southeast students. Further, demographic, behavioural and other health-related factors were associated with diet quality scores, warranting further research.

Keywords: college student, diet quality, nutrient intake, young adult

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Authors: Ibrahim M. I. Hamoda, Ahmed R. Z. Baghdadi, Mohammed K. Mohamed, Nawal A. Abu-Shady

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Background: Most of patients with vestibular dysfunction suffering from balance disorders, Abnormality in balance increase effort and exertion which affect the independency, so this study might be a guide in managing balance problem and consequently improve walking with less exertion and maximum function. Purpose: to analyze and discuss the effect of transcranial magnetic therapy on balance in patients with vestibular dysfunction. Methods: forty subjects from both sexes were classified to divided randomly into two equal groups; Group I study group: this group received transcranial magnetic therapy, with a selected physical therapy program for improving balance and vestibular disorders (Balance training, Cawthorne-Cooksey Exercises) and group II (control group): this group received a selected physical therapy program as group I without transcranial magnetic therapy. This treatment procedure will be applied three times weekly for three months. The mean age was 54.53±3.44 and 55.33±2.32 years and BMI 35.7±3.03 and 35.73±1.03 kg/m2 for group I and II respectively. The Biodex Balance System, Berge balances scale (BBS) and brain MRI were used for assessment. Assessments were conducted before and after treatment. The treatment program for group I included balance training, Cawthorne-Cooksey Exercises and pulsed magnetic therapy (Parameters used in the program of 20 minutes, Intensity 2 gausses, Frequency 1 Hz). This selected program was done in approximately one hour every other day for three month. The treatment program group II Patients received the same program as group A without transcranial magnetic therapy. Results: The One-way ANOVA revealed that there were no significant differences in BBS scores, overall balance index, Anterior / posterior balance index, Medial / lateral balance index and dynamic limits of stability between both groups. Moreover, the BBS scores increased and overall balance index, Anterior / posterior balance index, Medial / lateral balance index and dynamic limits of stability decreased significantly after treatment in group I and II compared with before treatment. Interpretation/Conclusion: Adding pulsed magnetic therapy to balance training, Cawthorne-Cooksey Exercises has no effect on static and dynamic balance in patients with balance problems due to benign positional paroxysmal vertigo.

Keywords: balance, transcranial magnetic therapy, vestibular dysfunction, biomechanic

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Authors: Telma Fontao de Castro, Kylee Miller, Maria Xavier Araújo, Isabel Brandao, Sandra Torres

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Objective: There is a dearth of research investigating the long-term emotional functioning of individuals recovered from anorexia nervosa (AN). This 15-year longitudinal study aimed to examine whether difficulties in cognitive processing of emotions persisted after long-term AN recovery and its link to anxiety and depression. Method: Twenty-four females, who were tested longitudinally during their acute and recovered AN phases, and 24 healthy control (HC) women, were screened for anxiety, depression, alexithymia, and emotion regulation difficulties (ER; only assessed in recovery phase). Results: Anxiety, depression, and alexithymia levels decreased significantly with AN recovery. However, scores on anxiety and difficulty in identifying feelings (alexithymia factor) remained high when compared to the HC group. Scores on emotion regulation difficulties were also lower in HC group. The abovementioned differences between AN recovered group and HC group in difficulties in identifying and accepting feelings and lack of emotional clarity were no longer present when the effect of anxiety and depression was controlled. Conclusions: Findings suggest that emotional dysfunction tends to decrease in AN recovered phase. However, using an HC group as a reference, we conclude that several emotional difficulties are still increased after long-term AN recovery, in particular, limited access to emotion regulation strategies, and difficulty controlling impulses and engaging in goal-directed behavior, thus suggesting to be a trait vulnerability. In turn, competencies related to emotional clarity and acceptance of emotional responses seem to be state-dependent phenomena linked to anxiety and depression. In sum, managing emotions remains a challenge for individuals recovered from AN. Under this circumstance, maladaptive eating behavior can serve as an affect regulatory function, increasing the risk of relapse. Emotional education and stabilization of depressive and anxious symptomatology after recovery emerge as an important avenue to protect from long-term AN relapse.

Keywords: alexithymia, anorexia nervosa, emotion recognition, emotion regulation

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Authors: Dorottya Horváth, Andras Lang, Diana Varro-Horvath

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This research activity and study is part of a major research effort to gain an integrative, neuropsychological, and personality psychological understanding of Attention Deficit Hyperactivity Disorder (ADHD) and thus improve the specification of diagnostic and therapeutic care. In the past, the neuropsychology section has investigated working memory, executive function, attention, and behavioural manifestations in children. Currently, we are looking for personality psychological protective factors for ADHD and its symptomatic exacerbation. We hypothesise that secure attachment, adaptive emotion regulation, and high resilience are protective factors. The aim of this study is to measure and report the results of a Hungarian sample of the Cognitive Emotion Regulation Questionnaire for Children (CERQ-k) because before studying groups with different developmental differences, it is essential to know the average scores of groups with neurotypical devel-opment. Until now, there was no Hungarian version of the above test, so we used our own translation. This questionnaire has been developed to assess children's thoughts after experiencing negative life events. It consists of 4-4 items per subscale, for a total of 36 items. The response categories for each item range from 1 (almost never) to 5 (almost always). The subscales were self-blame, blaming others, acceptance, planning, positive refocusing, rumination or thought-focusing, positive reappraisal, putting into perspective, and catastrophizing. The data for this study were collected from 120 children aged 9-14 years. It was analysed using descriptive statistical analysis, where the mean and standard deviation values for each age group, as well as the Cronbach's alpha value, were significant in testing the reliability of the questionnaire. The results showed that the questionnaire is a reliable and valid measuring instrument also on a Hungarian sample. These developments and results will allow the use of a version of the Cognitive Emotion Regulation Questionnaire for children in Hungarian and pave the way for the study of different developmental groups such as children with learning disabilities and/or with ADHD.

Keywords: neurotypical development, emotion regulation, negative life events, CERQ-k, Hungarian average scores

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Authors: Loveneet Kaur

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Introduction: Osteoarthritis (OA) is one of the leading causes of disability, and the knee is the most commonly affected joint in the body. The last resort for treatment of knee OA is Total Knee Replacement (TKR) surgery. Despite numerous advances in prosthetic design, patients do not reach normal function after surgery. Current surgical decisions are made on 2D radiographs and patient interviews. Aims: The aim of this study was to compare knee kinematics pre and post-TKR surgery using computer-animated images of patient-specific models under everyday conditions. Methods: 7 subjects were recruited for the study. Subjects underwent 3D gait analysis during 4 everyday activities and medical imaging of the knee joint pre- and one-month post-surgery. A 3D model was created from each of the scans, and the kinematic gait analysis data was used to animate the images. Results: Improvements were seen in a range of motion in all 4 activities 1-year post-surgery. The preoperative 3D images provide detailed information on the anatomy of the osteoarthritic knee. The postoperative images demonstrate potential future problems associated with the implant. Although not accurate enough to be of clinical use, the animated data can provide valuable insight into what conditions cause damage to both the osteoarthritic and prosthetic knee joints. As the animated data does not require specialist training to view, the images can be utilized across the fields of health professionals and manufacturing in the assessment and treatment of patients pre and post-knee replacement surgery. Future improvements in the collection and processing of data may yield clinically useful data. Conclusion: Although not yet of clinical use, the potential application of 3D animations of the knee joint pre and post-surgery is widespread.

Keywords: Orthoporosis, Ortharthritis, knee replacement, TKR

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Authors: Mangala M. Pai, B. V. Murlimanju, Latha V. Prabhu, P. J. Jiji , Vandana Blossom

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Background:To study the morphological parameters of the axis vertebra in anatomical specimens. Methods: The present study was designed to obtain the morphometric data of axis vertebra. The superior and inferior articular facets of the axis were macroscopically observed for their shapes and the different parameters were measured using the digital Vernier caliper. It included 20 dried axis bones, which were obtained from the anatomy laboratory. Results: The morphometric data obtained in the present study are represented in the tables. The side wise comparison of the length and width of the articular facets of the axis vertebra were done. The present study observed that, there is no statistically significant difference observed among the parameters of right and left side articular facets (p>0.05). The superior and inferior articular facets were observed to have variable shapes. The frequencies of different shapes of superior and inferior articular facets are represented in figures. All the shapes of the inferior and superior articular facets were symmetrical over the right and left sides. Among the superior articular facets, the constrictions were absent in 13 cases (65%), 2 (10%) exhibited a single constriction, 3 (15%) had 2 constrictions and 2 (10%) were having 3 constrictions. The constrictions were absent in 11 (55%) of the inferior articular facets, 3 (15%) of them had 1 constriction, 3 (15%) were having 2 constrictions, 2 (10%) exhibited 3 constrictions and 1 (5%) of them had 4 constrictions. The constrictions of the inferior and superior articular facets were symmetrical over the right and left sides. Conclusion: We believe that the present study has provided additional information on the morphometric data of the axis vertebra. The data are important to the neurosurgeons, orthopedic surgeons and radiologists. The preoperative assessment of the axis vertebra may prevent dangerous complications like spinal cord and nerve root compression during the surgical intervention.

Keywords: axis, articular facet, morphology, morphometry

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Authors: Hsin-Chieh Lee, Fen-Ling Kuo, Jui-Chi Lin

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Background: Upper extremity functional impairment that occurs after stroke includes hemiplegia, synergy movement, muscle hypertonicity, and somatosensory impairment, which result in inefficient and inaccurate movement. Robot-assisted rehabilitation is an intensive training approach that is effective in sensorimotor and hand function recovery. However, these systems mostly focused on the proximal part of the upper limb rather than the distal part. The device used in our study was Gloreha Sinfonia, which focuses on the distal part of the upper limb and uses a dynamic support system to facilitate the whole limb function. The objective of this study was to investigate the effects of robot-assisted therapy (RT) with Gloreha device on sensorimotor, and ADLs in patients with stroke. Method: Patients with stroke (N=25) participated AB or BA (A = 12 RT sessions and B = 12 conventional therapy (CT) sessions) for 6 weeks (60 min at each session, twice a week), with 1-month break for washout period. The performance of the patients was assessed by a blinded assessor at 4 time points (pretest 1, posttest 1, pretest 2, posttest 2) which including the Fugl–Meyer Assessment-upper extremity (FMA-UE), box and block test, electromyography of the extensor digitorum communis (EDC) and brachioradialis, a grip dynamometer for motor evaluation; Semmes–Weinstein hand monofilament and Revision of the Nottingham Sensory Assessment for sensory evaluation; and the Modified Barthel Index (MBI) for assessing the ADL ability. Result: RT group significantly improved FMA-UE proximal scores (p = 0.038), FMA-UE total scores (p = 0.046), and MBI (p = 0.030). The EDC exhibited higher efficiency during the small block grasping task in the RT group than in the CT group (p = 0.050). Conclusions: RT with the Gloreha device might lead to beneficial effects on arm motor function, ADL ability, and EDC muscle recruitment efficacy in patients with subacute to chronic stroke.

Keywords: activities of daily living, hand function, robotic rehabilitation, stroke

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Authors: Yijun Shao, Yan Cheng, Rashmee U. Shah, Charlene R. Weir, Bruce E. Bray, Qing Zeng-Treitler

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Deep neural network (DNN) models are being explored in the clinical domain, following the recent success in other domains such as image recognition. For clinical adoption, outcome prediction models require explanation, but due to the multiple non-linear inner transformations, DNN models are viewed by many as a black box. In this study, we developed a deep neural network model for predicting 1-year mortality of patients who underwent major cardio vascular procedures (MCVPs), using temporal image representation of past medical history as input. The dataset was obtained from the electronic medical data warehouse administered by Veteran Affairs Information and Computing Infrastructure (VINCI). We identified 21,355 veterans who had their first MCVP in 2014. Features for prediction included demographics, diagnoses, procedures, medication orders, hospitalizations, and frailty measures extracted from clinical notes. Temporal variables were created based on the patient history data in the 2-year window prior to the index MCVP. A temporal image was created based on these variables for each individual patient. To generate the explanation for the DNN model, we defined a new concept called impact score, based on the presence/value of clinical conditions’ impact on the predicted outcome. Like (log) odds ratio reported by the logistic regression (LR) model, impact scores are continuous variables intended to shed light on the black box model. For comparison, a logistic regression model was fitted on the same dataset. In our cohort, about 6.8% of patients died within one year. The prediction of the DNN model achieved an area under the curve (AUC) of 78.5% while the LR model achieved an AUC of 74.6%. A strong but not perfect correlation was found between the aggregated impact scores and the log odds ratios (Spearman’s rho = 0.74), which helped validate our explanation.

Keywords: deep neural network, temporal data, prediction, frailty, logistic regression model

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Authors: Swathi Sampath, V. Kalaichelvi

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The assessment of the risk posed by a borrower to a lender is one of the common problems that financial institutions have to deal with. Consumers vying for a mortgage are generally compared to each other by the use of a number called the Credit Score, which is generated by applying a mathematical algorithm to information in the applicant’s credit report. The higher the credit score, the lower the risk posed by the candidate, and the better he is to be taken on by the lender. The objective of the present work is to use fuzzy logic and linguistic rules to create a model that generates Credit Scores.

Keywords: credit scoring, fuzzy logic, mortgage, risk assessment

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Authors: Khalil Ullah Khan

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Linguistic abilities in students with hearing impairment yet remain a concern for educationists. The emerging technological support and provisions in the recent era vow to have addressed the situation and claim significant contributions in terms of linguistic repertoire. Being a descriptive and quantitative paradigm of study, the purpose of this research set forth was to assess the linguistic competencies of students with hearing impairment in the English language. The goals were further broken down to identify the level of reading abilities in the subject population. The population involved students with HI studying at a higher secondary level in Lahore. A simple random sampling technique was used to choose a sample of fifty students. A purposive curriculum-based assessment was designed in line with the accelerated learning program by the Punjab Government to assess Linguistic competence among the sample. Further to it, an Informal Reading Inventory (IRI) corresponding to reading levels was also developed by researchers duly validated and piloted before the final use. Descriptive and inferential statistics were utilized to reach the findings. Spearman’s correlation was used to find out the relationship between the degree of hearing loss, grade level, gender and type of amplification device. An Independent sample t-test was used to compare means among groups. Major findings of the study revealed that students with hearing impairment exhibit significant deviation from the mean scores when compared in terms of grades, severity and amplification device. The study divulged that respective students with HI have yet failed to qualify for an independent level of reading according to their grades, as the majority fall at the frustration level of word recognition and passage comprehension. The poorer performance can be attributed to lower linguistic competence, as it is shown in the frustration levels of reading, writing and comprehension. The correlation analysis did reflect an improved performance grade. Wise. However, scores could only correspond to frustration level, and independent levels were never achieved. Reported achievements at the instructional level of the subject population may further to linguistic skills if practiced purposively.

Keywords: linguistic competence, hearing impairment, reading levels, educationist

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Authors: Ali Ahmadi, Maryam Abbasi, Mohammad Mehdi Parsaei

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Background: Stress in the workplace today is one of the most important public health concerns and a serious threat to the health of the workforce worldwide. Occupational stress can cause occupational events and reduce quality of life. As a result, it has a very undesirable impact on the performance of organizations, companies, and their human resources. This study aimed to evaluate the relationship between job stress dimensions and occupational accidents in industrial factories in Southwest Iran. Materials and Methods: This cross-sectional study was conducted among 200 workers in the summer of 2023 in the Southwest of Iran. To select participants, we used a convenience sampling method. The research tools in this study were the Health and Safety Executive (HSE) stress questionnaire with 35 questions and 7 dimensions and demographic information. A high score on this questionnaire indicates that there is low job stress and pressure. All workers completed the informed consent form. Univariate analysis was performed using chi-square and T-test. Multiple regression analysis was used to estimate the odds ratios (OR) and 95% confidence interval (CI) for the association of stress-related factors with job accidents in participants. Stata 14.0 software was used for analysis. Results: The mean age of the participants was 39.81(6.36) years. The prevalence of job accidents was 28.0% (95%CI: 21.0, 34.0). Based on the results of the multiple logistic regression with the adjustment of the effect of the confounding variables, one increase in the score of the demand dimension had a protective impact on the risk of job accidents(aOR=0.91,95%CI:0.85-0.95). Additionally, an increase in one of the scores of the managerial support (aOR=0.89, 95% CI: 0.83-0.95) and peer support (aOR=0.76, 95%CI: 0.67-87) dimensions was associated with a lower number of job accidents. Among dimensions, an increase in the score of relationship (aOR=0.89, 95%CI: 0.80-0.98) and change (aOR=0.86, 95%CI: 0.74-0.96) reduced the odds of the accident's occurrence among the workers by 11% and 16%, respectively. However, there was no significant association between role and control dimensions and the job accident (p>0.05). Conclusions: The results show that the prevalence of job accidents was alarmingly high. Our results suggested that an increase in scores of dimensions HSE questioners is significantly associated with a decrease the accident occurrence in the workplace. Therefore, planning to address stressful factors in the workplace seems necessary to prevent occupational accidents.

Keywords: HSE, Iran, job stress occupational accident, safety, occupational health

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Authors: Arun C. Gulani, Aaishwariya A. Gulani, Amanda Southall

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Background: Laser Corneoplastique™ as a least interventional, visually promising technique for patients with vision disability from corneal scars of varied causes has been retrospectively reviewed and proves to cause a paradigm shift in mindset and approach towards corneal scars as a Refractive surgery aiming for emmetropic, unaided vision of 20;/20 in most cases. Three decades of work on this technique has been compiled in this 15-year study. Subject and Methods: The objective of this study was to determine the success of Laser Corneoplastique™ surgery as a treatment of corneal scar cases. A survey of corneal scar cases caused by various medical histories that had undergone Laser Corneoplastique™ surgery over the past twenty years by a single surgeon Arun C. Gulani, M.D. were retrospectively reviewed. The details of each of the cases were retrieved from their medical records and analyzed. Each patient had been examined thoroughly at their preoperative appointments for stability of refraction and vision, depth of scar, pachymetry, topography, pattern of the scar and uncorrected and best corrected vision potential, which were all taken into account in the patients' treatment plans. Results: 64 eyes of 53 patients were investigated for scar etiology, keratometry, visual acuity, and complications. There were 25 different etiologies seen, with the most common being a Herpetic scar. The average visual acuity post-op was, on average, 20/23.55 (±7.05). Laser parameters used were depth and pulses. Overall, the mean Laser ablation depth was 30.67 (±19.05), ranging from 2 to 73 µm. Number of Laser pulses averaged 191.85 (±112.02). Conclusion: Refractive Laser Corneoplastique™ surgery, when practiced as an art, can address all levels of ametropia while reversing complex corneas and scars from refractive surgery complications back to 20/20 vision.

Keywords: corneal scar, refractive surgery, corneal transplant, laser corneoplastique

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Authors: Naridchaya Aberdour, Joanna Kao, Anne Miller, Timothy Shore, Richard Maher, Zhixin Liu

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Background: COVID-19 has and continues to be a strain on healthcare globally, with the number of patients requiring hospitalization exceeding the level of medical support available in many countries. As chest x-rays are the primary respiratory radiological investigation, the Radiological Assessment of Lung Edema (RALE) score was used to quantify the extent of pulmonary infection on baseline imaging. Assessment of RALE score's reproducibility and associations with clinical outcome parameters were then evaluated to determine implications for patient management and prognosis. Methods: A retrospective study was performed with the inclusion of patients testing positive for COVID-19 on nasopharyngeal swab within a single Local Health District in Sydney, Australia and baseline x-ray imaging acquired between January to June 2020. Two independent Radiologists viewed the studies and calculated the RALE scores. Clinical outcome parameters were collected and statistical analysis was performed to assess RALE score reproducibility and possible associations with clinical outcomes. Results: A total of 78 patients met inclusion criteria with the age range of 4 to 91 years old. RALE score concordance between the two independent Radiologists was excellent (interclass correlation coefficient = 0.93, 95% CI = 0.88-0.95, p<0.005). Binomial logistics regression identified a positive correlation with hospital admission (1.87 OR, 95% CI= 1.3-2.6, p<0.005), oxygen requirement (1.48 OR, 95% CI= 1.2-1.8, p<0.005) and invasive ventilation (1.2 OR, 95% CI= 1.0-1.3, p<0.005) for each 1-point increase in RALE score. For each one year increased in age, there was a negative correlation with recovery (0.05 OR, 95% CI= 0.92-1.0, p<0.01). RALE scores above three were positively associated with hospitalization (Youden Index 0.61, sensitivity 0.73, specificity 0.89) and above six were positively associated with ICU admission (Youden Index 0.67, sensitivity 0.91, specificity 0.78). Conclusion: The RALE score can be used as a surrogate to quantify the extent of COVID-19 infection and has an excellent inter-observer agreement. The RALE score could be used to prognosticate and identify patients at high risk of deterioration. Threshold values may also be applied to predict the likelihood of hospital and ICU admission.

Keywords: chest radiography, coronavirus, COVID-19, RALE score

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Authors: Erna Judith Roach, Nalini Bhaskaranand

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Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.

Keywords: childhood asthma, drug administration, mothers of children, inhaler

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Authors: Li Jiuen Ong, Magdalin Cheong, Sri Rahayu, Lek Alexander, Pei Ting Tan

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Background: Previous programme evaluations from the diabetes training programme conducted in Changi General Hospital revealed that healthcare professionals (HCPs) are keen to receive advance diabetes training and education, specifically in medical, nutritional therapy. HCPs also expressed a preference for interactive activities over didactic teaching methods to enhance their learning. Since the War on Diabetes was initiated by MOH in 2016, HCPs are challenged to be actively involved in continuous education to be better equipped to reduce the growing burden of diabetes. Hence, streamlining training to incorporate an element of fun is of utmost importance. Aim: The nutrition programme incorporates game play using an interactive board game that aims to provide a more conducive and less stressful environment for learning. The board game could be adapted for training of community HCPs, health ambassadors or caregivers to cope with the increasing demand of diabetes care in the hospital and community setting. Methodology: Stages for game’s conception (Jaffe, 2001) were adopted in the development of the interactive board game ‘Sweet Score™ ’ Nutrition concepts and topics in diabetes self-management are embedded into the game elements of varying levels of difficulty (‘Easy,’ ‘Medium,’ ‘Hard’) including activities such as a) Drawing/ sculpting (Pictionary-like) b)Facts/ Knowledge (MCQs/ True or False) Word definition) c) Performing/ Charades To study the effects of game play on knowledge acquisition and perceived experiences, participants were randomised into two groups, i.e., lecture group (control) and game group (intervention), to test the difference. Results: Participants in both groups (control group, n= 14; intervention group, n= 13) attempted a pre and post workshop quiz to assess the effectiveness of knowledge acquisition. The scores were analysed using paired T-test. There was an improvement of quiz scores after attending the game play (mean difference: 4.3, SD: 2.0, P<0.001) and the lecture (mean difference: 3.4, SD: 2.1, P<0.001). However, there was no significance difference in the improvement of quiz scores between gameplay and lecture (mean difference: 0.9, 95%CI: -0.8 to 2.5, P=0.280). This suggests that gameplay may be as effective as a lecture in terms of knowledge transfer. All the13 HCPs who participated in the game rated 4 out of 5 on the likert scale for the favourable learning experience and relevance of learning to their job, whereas only 8 out of 14 HCPs in the lecture reported a high rating in both aspects. 16. Conclusion: There is no known board game currently designed for diabetes training for HCPs.Evaluative data from future training can provide insights and direction to improve the game format and cover other aspects of diabetes management such as self-care, exercise, medications and insulin management. Further testing of the board game to ensure learning objectives are met is important and can assist in the development of awell-designed digital game as an alternative training approach during the COVID-19 pandemic. Learning through gameplay increases opportunities for HCPs to bond, interact and learn through games in a relaxed social setting and potentially brings more joy to the workplace.

Keywords: active learning, game, diabetes, nutrition

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Authors: Mohan Bilikallahalli Sannathimmappa, Vinod Nambiar, Rajeev Aravindakshan

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Background: Image-based teaching-learning module is innovative student-centered andragogy. The objective of our study was to explore medical students’ perception of effectiveness of image-based learning strategy in promoting their lifelong learning skills and evaluate its impact on improving students’ exam grades. Methods: A prospective single-cohort study was conducted on undergraduate medical students of the academic year 2021-22. The image-based teaching-learning module was assessed through pretest, posttest, and exam grades. Students’ feedback was collected through a predesigned questionnaire on a 3-point Likert Scale. The reliability of the questionnaire was assessed using Cronbach’s alpha coefficient test. In-Course Exam-4 results were compared with In-Course Exams 1, 2, and 3. Correlation coefficients were worked out wherever relevant to find the impact of the exercise on grades. Data were collected, entered into Microsoft Excel, and statistically analyzed using SPSS version 22. Results: In total, 127 students were included in the study. The posttest scores of the students were significantly high (24.75±) as compared to pretest scores (8.25±). Students’ opinion towards the effectiveness of image-based learning in promoting their lifelong learning skills was overwhelmingly positive (Cronbach’s alpha for all items was 0.756). More than 80% of the students indicated image-based learning was interesting, encouraged peer discussion, and helped them to identify, explore, and revise key information and knowledge improvement. Nearly 70% expressed image-based learning enhanced their critical thinking and problem-solving skills. Nine out of ten students recommended image-based learning module for future topics. Conclusion: Overall, Image-based learning was found to be effective in achieving undergraduate medical students learning outcomes. The results of the study are in favor of the implementation of Image-based learning in Microbiology courses. However, multicentric studies are required to authenticate our study findings.

Keywords: active learning, knowledge, medical education, microbes, problem solving

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Authors: John Faucett, Hao Wu, Bruce Moore, Sean Nadji

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The demands of the ministry often conflict with responsibilities at home, and clergy often experience domain ambiguity between the domains of work and family. However, the unique level of family involvement in the pastor’s profession might enrich the pastor’s ministry as well as the functioning of the family unit. Life in the church family might offer clergy family members a sense of meaning and purpose, social support, and a feeling of belonging. Church activities can offer enhanced opportunities for family interaction. The purpose of this study was to investigate the relationships of work/family enrichment to clergy job satisfaction, burnout, engagement, and withdrawal. Method: Participants were clergy serving within a state conference of the United Methodist Church. A survey was administered electronically, with e-mails and the United Methodist Church (UMC) Facebook page used as access points to the survey. Usable responses for this portion of the survey were obtained from 132 clergy. Participants completed The Work-Family Enrichment Scales, The Utrecht Work Engagement Scale, The Scale of Emotional Exhaustion in Ministry, The Satisfaction in Ministry Scale, and a scale of withdrawal developed for the present study. They also answered questions relating to how involved their spouses are in their ministry and the degree to which spouse involvement in church ministry strengthens church ministry. Findings: Higher scores for work to family enrichment correlated positively with job satisfaction (r = - .69, p < .01) and engagement (r = .50, p < .01), and negatively with burnout (r = -.48, p < .01) and withdrawal (r = -.46, p < .01). Higher scores for family to work enrichment correlated positively with job satisfaction (r = .29, p = .01) and engagement (.24, p < .05), and negatively with burnout (r = -.48, p < .01), and withdrawal (r = -.46, p < .01). Hierarchical regression analysis suggested that clergy perceptions concerning the degree to which spouse involvement in church ministry strengthens church ministry moderates the relationship between degree of spouse involvement in church activities and clergy withdrawal. To the degree that spouse involvement is believed to strengthen ministry, high spouse involvement is related to less clergy withdrawal (Multiple R-Squared = .068, Adj. R-Squared = .043, F = 2.69 on 3 & 110 DF, p = .05). Concluding Statement: Clergy job attitudes are related to work/family enrichment. Spouse involvement in parish ministry is associated with less clergy withdrawal, as long as clergy believe spouse involvement strengthens their ministry.

Keywords: clergy, emotional exhaustion, job engagement, job satisfaction, work/family enrichment

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Authors: Ahmed Torad

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Background: Knee osteoarthritis (OA) is a prevalent musculoskeletal condition characterized by pain and functional impairment. While various rehabilitation approaches have been employed, the effectiveness of high-intensity interval training (HIIT) compared to traditional rehabilitation exercises remains unclear. Objective: This randomized controlled trial aimed to compare the effects of HIIT and traditional rehabilitation exercises on pain reduction, functional improvement, and quality of life in individuals with knee OA. Methods: A total of 120 participants diagnosed with knee OA were randomly allocated into two groups: the HIIT group (n=60) and the traditional rehabilitation group (n=60). The HIIT group participated in a 12-week supervised program consisting of high-intensity interval exercises, while the traditional rehabilitation group followed a conventional physiotherapy regimen. Outcome measures included visual analog scale (VAS) pain scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Short Form-36 Health Survey (SF-36) at baseline and after the intervention period. Results: Both groups showed significant improvements in pain scores, functional outcomes (WOMAC), and quality of life (SF-36) after 12 weeks of intervention. However, the HIIT group demonstrated superior pain reduction (p<0.001), functional improvement (p<0.001), and physical health-related quality of life (p=0.002) compared to the traditional rehabilitation group. No significant differences were observed in mental health-related quality of life between the two groups. Conclusion: High-intensity interval training appears to be a more effective rehabilitation approach than traditional exercises for individuals with knee osteoarthritis, resulting in greater pain reduction, improved function, and enhanced physical health-related quality of life. These findings suggest that HIIT may represent a promising intervention strategy for managing knee OA and enhancing the overall well-being of affected individuals.

Keywords: knee osteoarthritis, high-intensity interval training, traditional rehabilitation exercises, randomized controlled trial, pain reduction, functional improvement, quality of life

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Authors: Laila Seada, Ashraf Ibrahim, Amjad Al Shammari

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Background and Objectives: Breast carcinoma is the most common cancer of females in Hail region, accounting for 31% of all diagnosed cancer cases followed by thyroid carcinoma (25%) and colorectal carcinoma (13%). Methods: In the present retrospective study, all cases of breast lesions received at the histopathology department in King Khalid Hospital, Hail, during the period from May 2011 to April 2016 have been retrieved from department files. For all cases, a trucut biopsy, lumpectomy, or modified radical mastectomy was available for histopathologic diagnosis, while 105/140 (75%) had, as well, preoperative fine needle aspirates (FNA). Results: 49 cases out of 140 (35%) breast lesions were carcinomas: 44/49 (89.75%) was invasive ductal, 2/49(4.1%) invasive lobular carcinomas, 1/49(2.05%) intracystic low grade papillary carcinoma and 2/49 (4.1%) ductal carcinoma in situ (DCIS). Mean age for malignant cases was 45.06 (+/-10.58): 32.6% were below the age of 40 and 30.6 below 50 years, 18.3% below 60 and 16.3% below 70 years. For the benign group, mean age was 32.52 (+/10.5) years. Benign lesions were in order of frequency: 34 fibroadenomas, 14 fibrocystic disease, 12 chronic mastitis, five granulomatous mastitis, three intraductal papillomas, and three benign phyllodes tumor. Tubular adenoma, lipoma, skin nevus, pilomatrixoma, and breast reduction specimens constituted the remaining specimens. Conclusion: Breast lesions are common in our series and invasive carcinoma accounts for more than 1/3^rd of the lumps, with 63.2% incidence in pre-menopausal ladies, below the age of 50 years. FNA as a non-invasive procedure, proved to be an effective tool in diagnosing both benign and malignant/suspicious breast lumps and should continue to be used as a first assessment line of palpable breast masses.

Keywords: age incidence, breast carcinoma, fine needle aspiration, hail region

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Authors: Adriane Amend, Leidiene Ferreira Santos, Daniella Pires Nunes

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The experience of assuming or caring for older persons dependents by relatives is a complex task that encompasses or affective involvement, the demand for technical activities and or psychological support. It would be necessary to understand the situations related to the caregiver, the person and the environment, which help the family difficulty, as a caregiver to lead this role. Objective: To identify the forces that drive and restrict the care process of family caregivers of the older adults. Method: Descriptive and exploratory research, with a qualitative approach, which has as a reference the Force Field Theory. Five family caregivers of older adult’s dependents residing in the city of Palmas, Tocantins, Brazil will participate. The data were collected from December 2021 to February 2022, through a semi-structured individual interview, and submitted to content analysis. Results: As forces that drive or process of caring for family caregivers were: the account of compassionate attitudes and patience of the caregiver (I); to the collaboration of the other person to the care and to the body structure of the same (Other); and the supports of other people not cared for and structural, such as adaptations in the room, read and bathroom, as in the presence of air conditioners (Environment). Among the restrictive forces of care we mention difficulties in delegating care to another person, or stress of care and other personal demands (I); imposition of the older person about care and e a transfer from bed to hip (Other); e lack of accessibility of the house and absence of air conditioning and hospital bed (Environment). Conclusion: The results show that there are driving forces with the caregiver's attitude and feelings, a bond as an idol and support for the caregiver and the environment. On the other hand, conflicting ties, absence of physical structure and daily and continuous care shifts, can significantly compromise well-being or the cycle of older adult, caregiver and care.

Keywords: caregivers, frail elderly, perception, geriatric nursing

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Authors: Onesimus Bulus Shiaki

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The study investigated the effect of cooperative learning strategy on mathematics achievement and retention among senior secondary school students of different abilities in Taraba State Nigeria. Cooperative learning strategy could hopefully contribute to students’ achievement which will spur the teachers to develop strategies for better learning. The quasi-experimental of pretest, posttest and control group design was adopted in this study. A sample of one hundred and sixty-four (164) Senior Secondary Two (SS2) students were selected from a population of twelve thousand, eight hundred and seventy-three (12,873) SS2 Students in Taraba State. Two schools with equivalent mean scores in the pre-test were randomly assigned to experimental and control groups. The experimental group students were stratified according to ability levels of low, medium and high. The experimental group was guided by the research assistants using the cooperative learning instructional package. After six weeks post-test was administered to the two groups while the retention test was administered two weeks after the post-test. The researcher developed a 50-item Mathematics Achievement Test (MAT) which was validated by experts obtaining the reliability coefficient of 0.87. Mean scores and standard deviations were used to answer the research questions while the Analysis of Co-variance (ANCOVA) was used to test the hypotheses. Major findings from the statistical analysis showed that cooperative learning strategy has a significant effect on the mean achievement of students as well as retention among students of high, medium and low ability in mathematics. However, cooperative learning strategy has no effect on the interaction of ability level and retention. Based on the results obtained, it was therefore recommended that the adoption of the use of cooperative learning strategy in the teaching and learning of mathematics in senior secondary schools be initiated, maintained and sustained for the benefit of senior secondary school students in Taraba State. Periodic Government sponsored in-service training in form of long vacation training programme, workshops, conferences and seminars on the nature, scope, and use of cooperative learning strategy should be organized for senior secondary school mathematics teachers in Taraba state.

Keywords: ability level, cooperative learning, mathematics achievement, retention

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Authors: Dada. O.Akinola, Uche. I. Ebele, Bamiro .A.Rafatu, Akinbami A. Akinsegun, Dada O. Adeyemi, Adeyemi. O. Ibukun, Okunowo O.Bolanle, Abdulateef O. Kareem, Ibrahim.N. Ismaila, Dosu Rihanat

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Background: Hyperglycaemia alters qualitatively and quantitatively all the full blood count parameters. The alterations among other factors are responsible for the macrovascular and microvascular complications associated with diabetes mellitus (DM). This study is aimed at correlating haematological parameters in DM subjects with their fasting blood glucose (FBG) and anthropometric parameters. Materials and Methods: This was a cross-sectional study of participants attending DM clinic of Lagos State University Teaching Hospital (LASUTH), Ikeja. The study recruited one hundred and two (102) DM subjects and one hundred (100) non-DM controls. Venous blood samples were collected for full blood count (FBC) assay while FBG was done, structured questionnaires were administered, and anthropometric measurements of all participants were done. Data were analyzed with Statistical Package for Social Science (SPSS) version 23. P was set at ≤0.05. Results: The mean age of DM patients was 64.32± 11.31 years. Using a haemoglobin concentration cut-off of 11g/dl, 39.2%, and 13% DM and control participants respectively had values lower than 11g/dl. A total of 22.5% and 3% of DM and controls respectively gave a history of previous blood transfusion.White blood cells count and platelet count means were (6.12±1.60 and 5.30±7.52,p=0.59) and (213.31±73.58 and 228.91±73.21,p = 0.26) *109/L in DM subjects and controls respectively. FBG and all the anthropometric data in DM subjects were significantly higher than in controls. Conclusions: The prevalence of anaemia in DM subjects was three times higher than in controls. The white blood cell count was higher but not statistically significant in DM compared with controls. But platelet count was higher but not statistically significant in controls compared with DM subjects.

Keywords: haematological profile, diabetes mellitus, anthropometric data, fasting blood glucose

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Authors: Apurva Sapra

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The aim of this research was to study and compare the nature of expected, feared and hoped-for selves in institutionalized adolescent boys in two residential settings – an observation home with children in conflict with the law, and a children’s home with children in need of care and protection. The study uses a concurrent mixed methods design, in which eight adolescent boys from each group, aged 13-17, were asked to respond to a questionnaire, followed by an in-depth interview. The questionnaire looked into the total scores on current, probable and hoped-for/feared positive and negative self-descriptors. Possible selves of both groups were found to be influenced by their unique histories, such as with their experience of violence, interaction with the police and emphasis given on education. Expected selves and hoped-for selves were similar within the two groups. However, they were more concrete and attainable in the observation home and more ambitious in the children’s home. Quantitative results showed that on the positive self-descriptors, the participants in the observation home had a slightly lower total score on the current parameter as on the probable and hoped-for parameters. The participants in the children’s home showed similar results on current and probable positive self-descriptors, with higher scores on the hoped-for parameter. For most of the negative self-descriptors, the current score for the observation home group was lower than the expected score, and for the children’s home group, they were feared slightly more than they were expected. Along with the nature of possible selves, the study also looked into threats and support to desired and feared possible selves, as well as strategies to attain the desired possible selves and avoid feared possible selves. While threats to possible selves were identified as external and internal in both groups, the participants in the children’s home tended to identify threats as external. The categories of support were similar across the two groups, although the nature of support provided differed. Strategies adopted by participants in the observation home could be clearly divided as past, present and future strategies, while those adopted by participants in the children’s home had an overlap with past and future strategies. The institution was perceived as having a negative influence for the future in the observation home group, but positive in the children’s home group. Limitations of the study and recommendations for future research, policy setting and the counselling profession are discussed.

Keywords: adolescents, expected self, feared self, hoped-for self, institutions, possible selves

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Authors: Lalit Tejwani, Reetika Sharma, Arun Singhvi, Himanshu Shekhar

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Purpose: To assess the efficacy of collagen matrix implant (Ologen) in phacotrabeculectomy augmented with mitomycin C (MMC). Methods: A biodegradable collagen matrix (Ologen) was placed in the subconjunctival and subscleral space in twenty-two eyes of 22 patients with glaucoma and cataract who underwent combined phacoemulsification and trabeculectomy augmented with MMC. All of them were examined preoperatively and on the first postoperative day. They were followed for twelve months after surgery. Any intervention needed in follow-up period was noted. Any complication was recorded. The primary outcome measure was postoperative intraocular pressure at one year follow-up. Any additional postoperative treatments needed and adverse events were noted. Results: The mean age of patients included in the study was 57.77 ± 9.68 years (range=36 to 70 years). All the patients were followed for at least one year. Three patients had history of failed trabeculectomy. Fifteen patients had chronic angle closure glaucoma with cataract, five had primary open angle glaucoma with cataract, one had uveitic glaucoma with cataract, and one had juvenile open angle glaucoma with cataract. Mean preoperative IOP was 32.63 ± 8.29 mm Hg, eighteen patients were on oral antiglaucoma medicines. The mean postoperative IOP was 10.09 ± 2.65 mm Hg at three months, 10.36 ± 2.19 mm Hg at six months and 11.36 ± 2.72 mm Hg at one year follow up. No adverse effect related to Ologen was seen. Anterior chamber reformation was done in five patients, and three needed needling of bleb. Four patients needed additional antiglaucoma medications in the follow-up period. Conclusions: Combined phacotrabeculectomy with MMC with Ologen implantation appears to be a safe and effective option in glaucoma patients needing trabeculectomy with significant cataract. Comparative studies with longer duration of follow-up in larger number of patients are needed.

Keywords: combined surgery, ologen, phacotrabeculectomy, success

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Authors: Bahar Ayberk

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The study was conducted to determine the relationship between physical fitness and academic performance among university students. A far-famed saying ‘Sound mind in a sound body’ referring to the potential quality of increased physical fitness in the intellectual development of individuals seems to be endorsed. There is a growing body of literature the impact of physical fitness on academic achievement, especially in elementary and middle-school aged children. Even though there are numerous positive effects related to being physically active and physical fitness, their effect on academic achievement is not very much clear for university students. The subjects for this study included 25 students (20 female and 5 male) enrolled in Yeditepe University, Physiotherapy and Rehabilitation Department of Health Science Faculty. All participants filled in a questionnaire about their socio-demographic status, general health status, and physical activity status. Health-related physical fitness testing, included several core components: 1) body composition evaluation (body mass index, waist-to-hip ratio), 2) cardiovascular endurance evaluation (queen’s college step test), 3) muscle strength and endurance evaluation (sit-up test, push-up test), 4) flexibility evaluation (sit and reach test). Academic performance evaluation was based on student’s Cumulative Grade Point Average (CGPA). The prevalence of the subjects participating physical activity was found to be 40% (n = 10). CGPA scores were significantly higher among students having regular physical activity when we compared the students having regular physical activities or not (respectively 2,71 ± 0.46, 3.02 ± 0.28 scores, p = 0.076). The result of the study also revealed that there is positive correlation relationship between sit-up, push up and academic performance points (CGPA) (r = 0.43, p ≤ 0.05 ) and negative correlation relationship between cardiovascular endurance parameter (Queen's College Step Test) and academic performance points (CGPA) (r = -0.47, p ≤ 0.05). In conclusion, the findings confirmed that physical fitness level was generally associated with academic performance in the study group. Cardiovascular endurance and muscle strength and endurance were associated with student’s CGPA, whereas body composition and flexibility were unrelated to CGPA.

Keywords: academic performance, health-related physical fitness, physical activity, physical fitness testing

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