Search results for: medication use self efficacy

Authors: Man Chung Chu

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In the dynamic family interaction, parental self-efficacy is connected with parent-child attachment. Parental self-efficacy and its corresponding behavior played an influential role in the lifespan development of the child. Recently, Mindful parenting is popularly addressed as it lightens parents’ awareness to their own thoughts feelings and behaviors by adapting a nonjudgmental attitude in the present moment being with the child. The effectiveness of mindful parent is considerably significant in enhancing parent-child relationship as well as family functioning. Parenting in early developmental stage is always challenging and essential for later growth, however, literature is rarely exploring the mediation of mindful parenting on the effect of parent self-efficacy on parent-child attachment in preschoolers’ families. The mediation effect of the research shed light on how mindful parenting should head, where parental self-efficacy training should be incorporated together with mindful family program in attempt to yield the best outcome in the family of young-aged children. Two hundred and eight (208) parents, of two to six years old children, were participated in the study and results supported the significance in the mediator effect of mindful parenting in both facets, i.e. Parent-focused - ‘Mindful Discipline’ and Child-focused – ‘Being in the moment with the child’ where parental self-efficacy is a significant predictor of mindful parenting. The implication of the result suggests that mindful parenting would be a therapeutic framework in promoting family functioning and child’s well-being, it would also be a ‘significant helping hand’ in maintaining continuous secure attachment relationship and growing their mindful children in a family.

Keywords: mediation effect, mindful parenting, parental self efficacy, parent-child attachment, preschoolers

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Authors: Yi-Wen Chen, Hsueh-Liang Fan

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Evidence shows that start-ups success is positively correlated with innovation speed. However, new ventures are seldom able to acquire abundant resources for new product development (NPD), which means that entrepreneurs may depend on personal creativity instead of physical investments to achieve and accelerate speed of first product launch. This study accentuates the role of entrepreneurial bricolage, which defined as making do by applying combinations of the resources at hand to new problems and opportunities, in the relations of creative self-efficacy and innovation speed. This study uses structural equation modeling to test the hypotheses in a sample of 203 start-ups operating various creative markets. Results reveal that creative self-efficacy is positively and directly associated with innovation speed, whereas entrepreneurial bricolage plays a full mediator. These findings offer important theoretical and practical implications.

Keywords: creative self-efficacy, innovation speed, entrepreneurial bricolage, new ventures

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Authors: Roselyn Chipojola, Shu-yu Kuo

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Background: Breastfeeding self-efficacy in both mothers and fathers play a crucial role in improving exclusive breastfeeding rates. However, less is known on the relationship and predictors of paternal and maternal breastfeeding self-efficacy. This study aimed to examine the relationship and associated factors of breastfeeding self-efficacy (BSE) among mothers and fathers in Malawi. Methods: A cross-sectional study was conducted on 180 pairs of postpartum mothers and fathers at a tertiary maternity facility in central Malawi. BSE was measured using the Breastfeeding Self-Efficacy Scale Short-Form. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale. A structured questionnaire was used to collect demographic and health variables. Data were analyzed using multivariable logistic regression and multinomial logistic regression. Results: A higher score of self-efficacy was found in mothers (mean=55.7, Standard Deviation (SD) =6.5) compared to fathers (mean=50.2, SD=11.9). A significant association between paternal and maternal breastfeeding self-efficacy was found (r= 0. 32). Age, employment status, mode of birth was significantly related to maternal and paternal BSE, respectively. Older age and caesarean section delivery were significant factors of combined BSE scores in couples. A higher BSE score in either the mother or her partner predicted higher exclusive breastfeeding rates. BSE scores were lower when couples’ depressive symptoms were high. Conclusion: BSE are highly correlated between Malawian mothers and fathers, with a relatively higher score in maternal BSE. Importantly, a high BSE in couples predicted higher odds of exclusive breastfeeding, which highlights the need to include both mothers and fathers in future breastfeeding promotion strategies.

Keywords: paternal, maternal, exclusive breastfeeding, breastfeeding self‑efficacy, malawi

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Authors: Agah Tugrul Korucu

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Information and communication technologies have become an important part of our daily lives with significant investments in technology in the 21st century. Individuals are more willing to design and implement computer-related activities, and they are the main component of computer self-efficacy and self-efficacy related to the fact that the increase in information technology, with operations in parallel with these activities more successful. The Self-efficacy level is a significant factor which determines how individuals act in events, situations and difficult processes. It is observed that individuals with higher self-efficacy perception of computers who encounter problems related to computer use overcome them more easily. Therefore, this study aimed to examine self-efficacy perceptions of pre-service art and music teachers towards the use of information and communication technologies in terms of different variables. Research group consists of 60 pre-service teachers who are studying at Necmettin Erbakan University Ahmet Keleşoğlu Faculty of Education Art and Music department. As data collection tool of the study; “personal information form” developed by the researcher and used to collect demographic data and "the perception scale related to self-efficacy of informational technology" are used. The scale is 5-point Likert-type scale. It consists of 27 items. The Kaiser-Meyer-Olkin (KMO) sample compliance value is found 0.959. The Cronbach alpha reliability coefficient of the scale is found to be 0.97. computer-based statistical software package (SPSS 21.0) is used in order to analyze the data collected by data collection tools; descriptive statistics, t-test, analysis of variance are used as statistical techniques.

Keywords: self-efficacy perceptions, teacher candidate, information and communication technologies, art teacher

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Authors: Nannapus Saramad, Rewwadee Petsirasan, Jom Suwanno

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Background: This retrospective study design was to describe average blood pressure, blood pressure level, target blood pressure control rate post-stroke BP control in the year following discharge from Sichon hospital, Sichon District, Nakhon Si Thammarat province. The secondary data analysis was employed from the patient’s health records with patient or caregiver interview. A total of 232 eligible post-acute ischemic strokes in the year following discharge (2017-2018) were recruited. Methods: Data analyses were applied to identify the relationship values of single variables were determined through univariate analyses: The Chi-square test, Fisher exact test, the variables found to have a p-value < 0.2 were analyzed by the binary logistic regression Results: Most of the patients in this study were men 61.6%, an average age of 65.4 ± 14.8 years. Systolic blood pressure levels were in the grade 1-2 hypertension and diastolic pressure at optimal and normal at all times during the initial treatment through the present. The results revealed 25% among the groups under the age of 60 achieved BP control; 36.3% for older than 60 years group; and 27.9% for diabetic group. The multivariate analysis revealed the final relationship of four significant variables: 1) receiving calcium-channel blocker (p =.027); 2) medication adherence of antihypertensive (p = .024) 3) medication adherence of antiplatelet ( p = .020); and 4) medication behavior ( p = . 010) . Conclusion: The medical nurse and health care provider should promote their adherence to behavior to improve their blood pressure control.

Keywords: acute ischemic stroke, target blood pressure control, medication adherence, recurrence stroke

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Authors: Ziwei Qi

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This paper focuses on issues on Urbanization, Rural Migration and Neighborhood Collective Efficacy in urban China. The urbanization and migration trend and policies in China will be discussed and the various mechanisms through which social structures affect economic action and the consequent of social disequilibrium due to urbanization will be discussed. The positive and negative propositions on urbanization will also be highlighted. The primary methodologies applied in the paper will be the theoretical application and empirical implication on urbanization in developing countries. Western sociological theories, including theories in urban criminology /sociology including social disorganization, theories of social capital and collective efficacy will be applied and analyzed to test the market society in Chinese economic and cultural setting.

Keywords: collective efficacy, civic engagement, rural migration, urbanization

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Authors: Amir Feily, Hazhir Shahmoradi Akram, Mojtaba Ghaedi, Farshid Javdani, Naser Hatami, Navid Kalani, Mohammad Zarenezhad

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Background: Filler-induced facial skin ischemia is a potential complication of dermal filler injections that can result in tissue damage and necrosis. Nitroglycerin has been suggested as a treatment option due to its vasodilatory effects, but its efficacy in this context is unclear. Methods: A narrative review was conducted to examine the available evidence on the efficacy of nitroglycerin in filler-induced facial skin ischemia. Relevant studies were identified through a search of electronic databases and manual searching of reference lists. Results: The review found limited evidence supporting the efficacy of nitroglycerin in this context. While there were case reports where the combination of nitroglycerin and hyaluronidase was successful in treating filler-induced facial skin ischemia, there was only one case report where nitroglycerin alone was successful. Furthermore, a rat model did not demonstrate any benefits of nitroglycerin and showed harmful results. Conclusion: The evidence regarding the efficacy of nitroglycerin in filler-induced facial skin ischemia is inconclusive and seems to be against its application. Further research is needed to determine the effectiveness of nitroglycerin alone and in combination with other treatments for this condition. Clinicians should consider limited evidence bases when deciding on treatment options for patients with filler-induced facial skin ischemia.

Keywords: nitroglycerin, facial, skin ischemia, fillers, efficacy, narrative review

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Authors: A. Mech

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Repetitive transcranial magnetic stimulation has proven to be a valuable treatment option for patients who have failed to respond to multiple courses of antidepressant medication. In fact, the American Psychiatric Association recommends TMS after one failed treatment course of antidepressant medication. Genetic testing has proven valuable for pharmacokinetic variables, which, if understood, could lead to more efficient dosing of psychotropic medications to improve outcomes. Pharmacodynamic testing can identify biomarkers, which, if addressed, can improve patients' outcomes in antidepressant therapy. Monotherapy treatment of major depressive disorder with methylated B vitamin treatment has been shown to be safe and effective in patients with MTHFR polymorphisms without waiting for multiple trials of failed medication treatment for depression. Such treatment has demonstrated remission rates similar to antidepressant clinical trials. Combining pharmacodynamics testing with repetitive TMS treatment with NeuroStar has shown promising potential for enhancing remission rates and durability of treatment. In this study, a retrospective chart review (ongoing) of patients who obtained repetitive TMS treatment enhanced by dietary supplementation guided by Pharmacodynamic testing, displayed a greater remission rate (90%) than patients treated with only NeuroStar TMS (62%).

Keywords: improved remission rate, major depressive disorder, pharmacodynamic testing, rTMS outcomes

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Authors: Sushma Tejwani, Shoruba Dinakaran, Rupa Rokhade, K. Bhujang Shetty

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Introduction and aim: One of the major causes for failure of trabeculectomy is fibrosis and scarring of subconjunctival tissue around the bleb, and hence intra operative usage of anti-fibrotic agents like Mitomycin C (MMC) has become very popular. However, the long term effects of MMC like thin, avascular bleb, hypotony, bleb leaks and late onset endophthalmitis cannot be ignored, and may preclude its usage in routine trabeculectomy. In this particular study we aim to study the outcomes of trabeculectomy with and without MMC in uncomplicated glaucoma patients. Methods: Retrospective study of series of patients that underwent trabeculectomy with or without cataract surgery in glaucoma department of a tertiary eye care centre by a single surgeon for primary open angle glaucoma (POAG), angle closure glaucoma (PACG), Pseudoexfoliation glaucoma (PXF glaucoma). Patients with secondary glaucoma, juvenile and congenital glaucoma were excluded; also patients undergoing second trabeculectomy were excluded. The outcomes were studied in terms of IOP control at 1 month, 6 months, and 1 year and were analyzed separately for surgical outcomes with and without MMC. Success was considered if IOP was < 16 mmHg on applanation tonometry. Further, the necessity of medication, 5 fluorouracil (5FU) postoperative injections, needling post operatively was noted. Results: Eighty nine patient’s medical records were reviewed, of which 58 patients had undergone trabeculectomy without MMC and 31 with MMC. Mean age was 62.4 (95%CI 61- 64), 34 were females and 55 males. MMC group (n=31): Preoperative mean IOP was 21.1mmHg (95% CI: 17.6 -24.6), and 22 patients had IOP > 16. Three out of 33 patients were on single medication and rests were on multiple drugs. At 1 month (n=27) mean IOP was 12.4 mmHg (CI: 10.7-14), and 31/33 had success. At 6 months (n=18) mean IOP was 13mmHg (CI: 10.3-14.6) and 16/18 had good outcome, however at 1 year only 11 patients were available for follow up and 91% (10/11) had success. Overall, 3 patients required medication and one patient required postoperative injection of 5 FU. No MMC group (n=58): Preoperative mean IOP was 21.9 mmHg (CI: 19.8-24.2), and 42 had IOP > 16 mmHg. 12 out of 58 patients were on single medication and rests were on multiple drugs. At 1 month (n=52) mean IOP was14.6mmHg (CI: 13.2-15.9), and 45/ 58 had IOP < 16mmHg. At 6 months (n=31) mean IOP was 13.5 mmHg (CI: 11.9-15.2) and 26/31 had success, however at 1 year only 23 patients came for follow up and of these 87% (20/23) patients had success. Overall, 1 patient required needling, 5 required 5 FU injections and 5 patients required medication. The success rates at each follow up visit were not significantly different in both the groups. Conclusion: Intra-operative MMC usage may not be required in all patients undergoing trabeculectomy, and the ones without MMC also have fairly good outcomes in primary glaucoma.

Keywords: glaucoma filtration surgery, mitomycin C, outcomes of trabeculectomy, wound modulation

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Authors: Suparpit von Bormann, Winai Sayorwan, Sirichai Channim, Sararat Rungruangkhanarak, Premchai Suksamran, Piyaporn Srisuk, Piyatida Phosri

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The best medicine will not work if the patient does not take them. There are several methods developed to help patients to be adherent to medicine. However, non-adherent rate still high: 24% in physically ill and 42% in mentally ill patients. Moreover, patients might feel less confident when carrying medicine around. Normal medicine box has no alarm; whereas the one with alarm is not handy and might be left at home. Therefore, Medication Reminder (MR) was invented. MR is a medicine pocket that has an alarm clock to remind the patient when it is the time to take medicine. It also has a small light indicating the medicine the patient has to take. This pocket is attached within a purse or wallet because most people forget medicine but do not forget to take their money. This research was conducted to develop innovation assisting patients to take their medicine on time. Samples were 24 volunteers who went out to work every day. Uncoated tablets, coated tablets, and capsules were filled in three types of containers: MR, plastic bag with ziplock, and normal plastic box. Each volunteer carried three types of containers everywhere during day time. After three days, medicines were tested for physical quality (appearance, odor, color, hardness, and weight) in laboratory. Medication adherence and satisfaction questionnaires were completed by participants. The results showed that MR showed significant improvement in participants’ adherence than plastic bag with ziplock, and normal plastic box at p < .001 (x̄(SD) = 11.16(0.75), 7.83(0.98), 8.83(1.32), respectively). Based on the quality test, MR and normal plastic box significantly better protected medicine than plastic bag with zip lock at p < .001 (x̄(SD) = 4(0.00), 4(0.00), 2.5(0.54), respectively). Most participants were satisfied with the innovation in highest level (4.50 out of 5). MR has a potential to improve adherent rates of participants and therefore to be an innovation that helps reducing the cost of treatment due to non-adherence. MR also has a potential in commercial aspect due to its effects in preserving quality of medicine. MR can be integrated with local products such as silk purse that can increase income for local people.

Keywords: medication, reminder, adherence, satisfaction

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Authors: Abdmohammad Mousavi, Mohsen Shams, Mehdi Akbartabar Toori, Ali Mousavizadeh, Mohammad Ali Morowatisharifabad

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Introduction: The effectiveness of Transtheoretical Model constructs on dietary behavior change has been subject to questions by some studies. The objective of this study was to determine the relationship between self–efficacy and decisional balance as mediator variables and transfer obese and overweight women among the stages of behavior change of calorie balanced dietary intake. Method: In this cross-sectional study, 448 obese and overweight 20-44 years old women were selected from three health centers in Yasuj, a city in south west of Iran. Anthropometric data were measured using standard techniques. Demographic, stages of change, self-efficacy and decisional balance data were collected by questionnaires and analyzed using One–Way ANOVA and Generalized Linear Models tests. Results: Demographic and anthropometric variables were not different significantly in different stages of change related to calorie intake except the pre-high school level of education (P=.047, OR=502, 95% CI= .255 ~ .990). Mean scores of Self-efficacy ( F(4.425)= 27.09, P= .000), decisional balance (F(4.394), P= .004), and pros (F(4.430)=5.33, P=000) were different significantly in five stages of change. However, the cons did not show a significant change in this regard (F(4.400)=1.83, P=.123). Discussion: Women movement through the stages of changes for calorie intake behavior can be predicted by self efficacy, decisional balance and pros.

Keywords: transtheoretical model, stages of change, self efficacy, decisional balance, calorie intake, women

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Authors: Gianna Zou

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Propensity score matching (PSM), introduced by Paul R. Rosenbaum and Donald Rubin in 1983, is a popular statistical matching technique which tries to estimate the treatment effects by taking into account covariates that could impact the efficacy of study medication in clinical trials. PSM can be used to reduce the bias due to confounding variables. However, PSM assumes that the response values are normally distributed. In some cases, this assumption may not be held. In this paper, a machine learning method - Bayesian Additive Regression Tree (BART), is used as a more robust method of matching. BART can work well when models are misspecified since it can be used to model heterogeneous treatment effects. Moreover, it has the capability to handle non-linear main effects and multiway interactions. In this research, a BART Matching Method (BMM) is proposed to provide a more reliable matching method over PSM. By comparing the analysis results from PSM and BMM, BMM can perform well and has better prediction capability when the response values are not normally distributed.

Keywords: BART, Bayesian, matching, regression

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Authors: Mohd Ibrahim K. Azeez, Mohammed Sani Ibrahim, Rosemawati Mustapa, Maisarah A. Malik, Chandrakala Varatharajoo, Wee Akina Sia Seng Lee

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The leadership of the principals is known to be a key indicator in development and school performance. Therefore, this study was undertaken to assess the extent of the influence of instructional leadership in the field of supervision and curriculum focus on capacity development competence in the field of communication and teamwork. In addition, this study also examines self-efficacy mediator school leadership in the field of self-improvement and self-management of school principals. The study involved 383 guest teachers from 55 secondary schools for leadership in schools. Data was analyzed using SEM aid program AMOS 21. The final result shows partial mediation model was the best model fit to obtain the best goodness of fit of (X2/df = 4.663, CFI = 0.922, GFI = 0.778, TLI = 0914, NFI = 0.903, and RMSEA = 0.098) compared to the direct effect model of the findings (X2/df = 5.319, CFI = 0.908, GFI = 0755, TLI = 0.899, NFI = 0.889, and RMSEA = 0.106). While the findings of the fully mediator model with a self-efficacy refers principals as a mediator as follows (X2/df = 4.838, CFI = 0918, GFI = 0772, TLI = 0.910, NFI = 0.899, and RMSEA = 0.100). Therefore, it can be concluded that the findings clearly demonstrate self-efficacy variables principals become a mediator in the relationship between instructional leadership capacity and competency development.

Keywords: instructional leadership, capacity development, self-efficacy, competency

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Authors: Raeed Alanazi

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Introduction: Nursing students have a crucial role to play in the inhibition of infectious diseases and, therefore, must be trained in infection control and prevention modules prior to entering clinical settings. Simulations have been found to have a positive impact on infection control skills and the use of standard precautions. Aim: The purpose of this study was to use the four sources of self-efficacy in explaining the level of clinical self-efficacy and adherence to infection control practices in Saudi nursing students during simulation practice. Method: A cross-sectional design with convenience sampling was used. This study was conducted in all Saudi nursing schools, with a total number of 197 students participated in this study. Three scales were used simulation self- efficacy Scale (SSES), the four sources of self-efficacy scale (SSES), and Compliance with Standard Precautions Scale (CSPS). Multiple linear regression was used to test the use of the four sources of self-efficacy (SSES) in explaining level of clinical self-efficacy and adherence to infection control in nursing students. Results: The vicarious experience subscale (p =.044) was statistically significant. The regression model indicated that for every one unit increase in vicarious experience (observation and reflection in simulation), the participants’ adherence to infection control increased by .13 units (β =.22, t = 2.03, p =.044). In addition, the regression model indicated that for every one unit increase in education level, the participants’ adherence to infection control increased by 1.82 units (beta=.34= 3.64, p <.001). Also, the mastery experience subscale (p <.001) and vicarious experience subscale (p = .020) were shared significant associations with clinical self-efficacy. Conclusion: The findings of this research support the idea that simulation-based learning can be a valuable teaching-learning method to help nursing students develop clinical competence, which is essential in providing quality and safe nursing care.

Keywords: simulation-based learning, clinical self-efficacy, infection control, nursing students

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Authors: Mirzaii Khadigeh

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Background and objectives: Sexual health education is an important part of health promotion services. The major role of sex education is on mothers’ shoulders. So, they have to be equipped with enough knowledge, attitude and self-efficacy for teens’ education. The present study aimed to determine the effect of team-learning and multimedia software on mothers’ knowledge, attitudes and self-efficacy in sexual health education to 12-14-year-old sons in Mashhad in 1395. Materials and methods: In this research, two experimental and one control group were employed using random sampling, which was done on 132 mothers of high school pupils. They were randomly assigned into experimental and control groups. The data were collected using demographic information and a researcher-constructed questionnaire to investigate the mothers’ knowledge, attitude, and self-efficacy and DASS21(The Depression, Anxiety and Stress Scale). They were run after confirming their reliability and validity. Intervention for the multimedia group was in the form of four CDs- each for 45 minutes- that were given to the mothers each week. At the end of the fourth week, a question-and-answer session was administered for 60 minutes. The team-learning group received intervention once a week (totally four weeks). Two weeks later, the data were collected and analyzed via Chi-square, Fisher, Kruskal-Wallis and ANOVA. Findings: Knowledge, attitude and self-efficacy of mothers in sexual health before the intervention did not have any significant differences (p >0.05). At the end of the study, the difference between the scores of the knowledge, attitude and self-efficacy in the three groups was meaningfully different (p < 0/001), but the difference between the two groups of multimedia and team-learning was not significant (p> 0.05 ). Discussion and conclusion: The result reported the efficacy of both team-leaning and multimedia software, which implies that the multimedia software training method was as effective as team-learning training one on the knowledge, attitude and self-efficacy of mothers. But, the multimedia training method is highly advised due to its availability, flexibility, and interest.

Keywords: training one on the knowledge, attitude, self-efficacy of mothers, boys

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Authors: Maryam Bahreini, Mostafa Talebi Garekani, Fatemeh Rasooli, Atefeh Abdollahi

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Introduction: Procedural sedation and analgesia have been desirable to handle painful procedures. The trend to find the agent with more efficacy and less complications is still controversial; thus, many sedative regimens have been studied. This study tried to assess the effectiveness and adverse effects of thiopental sodium-fentanyl with the known medication, ketamine-propofol for procedural sedation in the emergency department. Methods: Consenting patients were enrolled in this randomized double-blind trial to receive either 1:1 ketamine-propofol (KP) or thiopental-fentanyl (TF) 1:1 mg: Mg proportion on a weight-based dosing basis to reach the sedation level of American Society of Anesthesiologist class III/IV. The respiratory and hemodynamic complications, nausea and vomiting, recovery agitation, patient recall and satisfaction, provider satisfaction and recovery time were compared. The study was registered in Iranian randomized Control Trial Registry (Code: IRCT2015111325025N1). Results: 96 adult patients were included and randomized, 47 in the KP group and 49 in the TF group. 2.1% in the KP group and 8.1 % in the TF group experienced transient hypoxia leading to performing 4.2 % versus 8.1 % airway maneuvers for 2 groups, respectively; however, no statistically significant difference was observed between 2 combinations, and there was no report of endotracheal placement or further admission. Patient and physician satisfaction were significantly higher in the KP group. There was no difference in respiratory, gastrointestinal, cardiovascular and psychiatric adverse events, recovery time and patient recall of the procedure between groups. The efficacy and complications were not related to the type of procedure or patients’ smoking or addiction trends. Conclusion: Ketamine-propofol and thiopental-fentanyl combinations were effectively comparable although KP resulted in higher patient and provider satisfaction. It is estimated that thiopental fentanyl combination can be as potent and efficacious as ketofol with relatively similar incidence of adverse events in procedural sedation.

Keywords: adverse effects, conscious sedation, fentanyl, propofol, ketamine, safety, thiopental

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Authors: Shanza Akram, Samir Salah, Imran Saleem, Jassim Abdou, Ashraf Al Zaabi

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Estimated prevalence of asthma in UAE is around 10% (900,000 people). Patients with persistent symptoms despite using high dose ICS plus a second controller +/- Oral steroids are considered to have severe asthma. Omalizumab (Xolair) is an anti-IgE monoclonal antibody approved as add-on therapy for severe allergic asthma. The objective of our study was to obtain baseline characteristics of our local cohort, to determine the efficacy of omalizumab based on clinical outcomes pre and post 52 weeks of treatment and to assess safety and tolerability. Medical records of patients receiving omalizumab therapy for asthma at Zayed Military Hospital, Abu Dhabi were retrospectively reviewed. Patients fulfilling the criteria for severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months pre and post omalizumab were analyzed by taking into account the number of exacerbations, hospitalizations, maintenance of medication dosages, the need for reliever therapy and PFT’s. 21 patients (5 females) with mean age 41 years were included. The mean duration of therapy was 22 months. 19 (91%) patients had Allergic Rhinitis/Sinusitis. Mean serum total IgE level was 648 IU/ml (65-1859). 11 (52%) patients were on oral maintenance steroids pre-treatment. 7 patients managed to stop steroids on treatment while 4 were able to decrease the dosage. Mean exacerbation rate decreased from 5 per year pre-treatment to 1.36 while on treatment. The number of hospitalizations decreased from a mean of 2 per year to 0.9 per year. Reliever inhaler usage decreased from mean of 40 to 15 puffs per week.2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects. Patient compliance was poor in some cases. Treatment with omalizumab reduced the number of exacerbations, hospitalizations, maintenance and reliever medications, and is generally well tolerated. Our results show that there is room for improved documentation in terms of symptom recording and use of rescue medication at our institution. There is also need for better patient education and counseling in order to improve compliance.

Keywords: asthma, exacerbations, omalizumab, IgE

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Authors: Asmaa Baghli

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Self-acceptance is one of the most pertinent notions that attracted the attention of many scholars. These latters believed that the sense of self-acceptance for people contributes in the emergence of their self-esteem and helps to improve their efficacy level. Simply defined, self-acceptance stands for the ability of the person to admire and accept herself and her potentials. This fact is believed to participate in the personal image creation depending on the qualities and features possessed. Hitherto, the following paper aims, first, to provide a brief and concise definition of self-acceptance, self-esteem and self-efficacy. It tries to explain the correlation between the three concepts along with its linkage to language teaching. Then, it examines teachers’ acceptance level and its influence on their classroom actions. For that purpose, the main methodology undertaken is the mixed method. That means the combination between both quantitative and qualitative research methods. The prime tools selected are a questionnaire and self-acceptance test for teachers. Finally, it suggests some techniques for developing teachers’ self-acceptance.

Keywords: competence, development, efficacy, Self-acceptance, self-esteem, teachers

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Authors: Irene Kretchy, Frances Owusu-Daaku, Samuel Danquah

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Hypertension is the leading risk factor for cardiovascular diseases, and a major cause of death and disability worldwide. This study examined whether psychosocial variables influenced patients’ perception and experience of side effects of their medicines, how they coped with these experiences and the impact on mental health and medication adherence to conventional hypertension therapies. Methods: A hospital-based mixed methods study, using quantitative and qualitative approaches was conducted on hypertensive patients. Participants were asked about side effects, medication adherence, common psychological symptoms, and coping mechanisms with the aid of standard questionnaires. Information from the quantitative phase was analyzed with the Statistical Package for Social Sciences (SPSS) version 20. The interviews from the qualitative study were audio-taped with a digital audio recorder, manually transcribed and analyzed using thematic content analysis. The themes originated from participant interviews a posteriori. Results: The experiences of side effects – such as palpitations, frequent urination, recurrent bouts of hunger, erectile dysfunction, dizziness, cough, physical exhaustion - were categorized as no/low (39.75%), moderate (53.0%) and high (7.25%). Significant relationships between depression (x 2 = 24.21, P < 0.0001), anxiety (x 2 = 42.33, P < 0.0001), stress (x 2 = 39.73, P < 0.0001) and side effects were observed. A logistic regression model using the adjusted results for this association are reported – depression [OR = 1.9 (1.03 – 3.57), p = 0.04], anxiety [OR = 1.5 (1.22 – 1.77), p = < 0.001], and stress [OR = 1.3 (1.02 – 1.71), p = 0.04]. Side effects significantly increased the probability of individuals to be non-adherent [OR = 4.84 (95% CI 1.07 – 1.85), p = 0.04] with social factors, media influences and attitudes of primary caregivers further explaining this relationship. The personal adoption of medication modifying strategies, espousing the use of complementary and alternative treatments, and interventions made by clinicians were the main forms of coping with side effects. Conclusions: Results from this study show that contrary to a biomedical approach, the experience of side effects has biological, social and psychological interrelations. The result offers more support for the need for a multi-disciplinary approach to healthcare where all forms of expertise are incorporated into health provision and patient care. Additionally, medication side effects should be considered as a possible cause of non-adherence among hypertensive patients, thus addressing this problem from a Biopsychosocial perspective in any intervention may improve adherence and invariably control blood pressure.

Keywords: biopsychosocial, hypertension, medication adherence, psychological disorders

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Authors: Cristina Costa-Lobo, Ana Medeiros, Ana Campina

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This study refers to the appropriateness of the psychopedagogical intervention programs focused on the adjustment and psychological well-being of children with characteristics of giftedness and the interests of promoting specialized and permanent follow-up to these children. It was intended to find out the impact on perceived self-efficacy in children with characteristics of giftedness after the frequency of a psychopedagogical intervention program. For this was applied to Multidimensional Scale Perceived Self-Efficacy, in two times (pre and post program frequency), in a quasi-experimental design. Innovative data are presented in reports to the relationship of perceived self-efficacy with giftedness, highlighting the evidence of this program focusing on the development of personal, social and emotional skills, applied to 20 children with characteristics of giftedness, in Northern Portugal, in the 2014-2015 school year, have no influence on perceived self-efficacy of children with characteristics of giftedness. The main implication of this research is congruent with the conclusions of studies that point that the greatest challenge in the education of children with characteristics of giftedness is to extend the traditional investment in intellectual production and creative capital to include an equal investment in social capital and the development of competencies of executive functions, dimensions that development programs stimulate. This study appeals to the need of children with characteristics of giftedness to be targets of psychopedagogical intervention programs with the constant specialization and constant updating of the knowledge of the professionals who work with them, motivated by being individuals with such specific and ever-changing characteristics reflecting an inclusive school life.

Keywords: giftedness, perceived self-efficacy, EMAEP, psychopedagogical intervention programs

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Authors: A. Poukens, I. Sluyts, A. Krings, J. Swartenbroekx, D. Geeroms, J. Poukens

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Introduction and Objectives: It has been known for many years that with the administration of intravenous medication, a rather significant part of the planned to be administered infusion solution, the residual volume ( the volume that remains in the IV line and or infusion bag), does not reach the patient and is wasted. This could possibly result in under dosage and diminished therapeutic effect. Despite the important impact on the patient, the reduction of residual volume lacks attention. An optimized and clearly stated protocol concerning the reduction of residual volume in an IV line is necessary for each hospital. As described in my Master’s thesis, acquiring the degree of Master in Hospital Pharmacy, administration of intravenous medication can be optimized by reduction of the residual volume. Herewith effectiveness, user-friendliness, cost efficiency and safety were taken into account. Material and Methods: By usage of a literature study and an online questionnaire sent out to all Flemish hospitals and hospitals in the Netherlands (province Limburg), current flush methods could be mapped out. In laboratory research, possible flush methods aiming to reduce the residual volume were measured. Furthermore, a self-developed experimental method to reduce the residual volume was added to the study. The current flush methods and the self-developed experimental method were compared to each other based on cost efficiency, user-friendliness and safety. Results: There is a major difference between the Flemish and the hospitals in the Netherlands (Province Limburg) concerning the approach and method of flushing IV lines after administration of intravenous medication. The residual volumes were measured and laboratory research showed that if flushing was done minimally 1-time equivalent to the residual volume, 95 percent of glucose would be flushed through. Based on the comparison, it became clear that flushing by use of a pre-filled syringe would be the most cost-efficient, user-friendly and safest method. According to laboratory research, the self-developed experimental method is feasible and has the advantage that the remaining fraction of the medication can be administered to the patient in unchanged concentration without dilution. Furthermore, this technique can be applied regardless of the level of the residual volume. Conclusion and Recommendations: It is recommendable to revise the current infusion systems and flushing methods in most hospitals. Aside from education of the hospital staff and alignment on a uniform substantiated protocol, an optimized and clear policy on the reduction of residual volume is necessary for each hospital. It is recommended to flush all IV lines with rinsing fluid with at least the equivalent volume of the residual volume. Further laboratory and clinical research for the self-developed experimental method are needed before this method can be implemented clinically in a broader setting.

Keywords: intravenous medication, infusion therapy, IV flushing, residual volume

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Authors: P. Maheshwari, M. Brindavan

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The present research aimed to study the level of socio-emotional skills and perceived self-efficacy of children with learning disability. The study further investigated the relationship between the levels of socio-emotional skills, perceived self-efficacy and academic achievement of children with learning disability. The sample comprised of 40 children with learning disability as their primary condition, belonging to middle or upper middle class, living with both the parents, residing in Mumbai. Purposive or Judgmental and snowball sampling technique was used to select the sample for the study. Proformas in the form of questionnaires were used to obtain the background information of the children with learning disability. A self-constructed Child’s Perceived Self-Efficacy Assessment Scale and Child’s Social and Emotional Skills Assessment Scale was used to measure the level of child’s perceived self-efficacy and their level of social and emotional skill respectively. Academic scores of the child were collected from the child’s parents or teachers and were converted into a percentage. The data was analyzed quantitatively using SPSS. Spearman rho or Pearson Product Moment correlation was used to ascertain the multiple relationships between child’s perceived self-efficacy, child’s social and emotional skills and child’s academic achievement. The findings revealed majority (27) of the children with learning disability perceived themselves having above average level of social and emotional skills while 13 out of 40 perceived their level of social and emotional skills at an average level. Domain wise analyses revealed that, in the domain of self- management (26) and relationship skills (22) more number of the children perceived themselves as having average or below average level of social and emotional skills indicating that they perceived themselves as having average or below average skills in regulating their emotions, thoughts, and behaviors effectively in different situations, establishing and maintaining healthy and rewarding relationships with diverse groups and individuals. With regard to perceived self-efficacy, the majority of the children with learning disability perceived themselves as having above average level of self-efficacy. Looking at the data domain wise it was found that, in the domains of self-regulated learning and emotional self-efficacy, 50% of the children perceived themselves at average or below average level, indicating that they perceived themselves as average on competencies like organizing academic activities, structuring environment to make it conducive for learning, expressing emotions in a socially acceptable manner. Further, the correlations were computed, and significant positive correlations were found between children’s social and emotional skills and academic achievement (r=.378, p < .01), and between children’s social and emotional skills and child’s perceived self-efficacy (r = .724, p < .01) and a positive significant correlation was also found between children’s perceived self-efficacy and academic achievement (r=.332, p < .05). Results of the study emphasize on planning intervention for children with learning disability focusing on improving self-management and relationship skills, self-regulated learning and emotional self-efficacy.

Keywords: learning disability, social and emotional skills, perceived self-efficacy, academic achievement

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Authors: Tayyaba Zahra, Shehla Gul Bokhari, Asim Khalid Mahmood, Raheela Akhtar, Khizar Matloob

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In Pakistan, dogs are commonly infested with ticks, especially in summers, causing not only dermatological issues but also systemic problems. Persistence of tick infestation often leads to heavy losses. Different acaricides are locally available with variable efficacy; however, recurrence of infestation is commonly reported. The present study was thus designed to compare the efficacy of a novel drug Fluralaner and conventionally used Ivermectin against tick infestation. Dogs positive for tick infestation were randomly divided into 2 groups viz, Groups A and B having 8 dogs each. Ticks were enumerated manually from the whole body of dogs at day 0 before the administration of drugs Dogs in Group A were treated with Fluralaner at day 0, and dogs in Group B were treated with Ivermectin. Post-treatment, ticks were counted again at days 7, 14, 21, 28, and 35. At day 07 of the study, no tick was found on the dogs treated with Fluralaner, while many ticks were present on the dogs treated with Ivermectin showing an efficacy up to 50%. On the consecutive follow-up evaluations, similar results were found for Fluralaner while the efficacy of Ivermectin was further reduced to less than 50%. Furthermore, Fluralaner treated dogs had better RBC counts, PCV, Hgb concentration, LFTs, RFTs post-treatment than the dogs treated with Ivermectin. Statistically, oral Fluralaner proved a more effective drug (P≤0.05)than oral Ivermectin against tick infestation in dogs.

Keywords: fluralaner, ivermectin, dogs, tick infestations

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Authors: Behdoukht Mall Amiri, Zohreh Gheydar

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The thrust of the current study was to investigate the relationship among EFL learners' creativity (CR), emotional intelligence (EI), and self-efficacy (SE). To this end, a group of 120 male and female learners, between the ages of 19 and 35 studying BA in English Translation and MA in Teaching English at Islamic Azad University, Central Tehran were selected using convenient sampling and were given three questionnaires: Bar-On’s EQ-I questionnaire by Bar-On (1997), the General Self-Efficacy Scale questionnaire (SGSES) by Sherer et al. (1982), and a questionnaire of creativity (CR) by O'Neil, Abedi, and Spielberger (1992). Analysis of the results through Pearson Moment Correlation Coefficient showed that there was not a significant relationship between students’ CR and EI, and EI and SE. In addition, CR and SE were correlated significantly but negatively. Multiple regressions revealed that CR could significantly predict SE. Regarding the findings of the study, the obtained results may help EFL teachers, teacher trainers, materials developers, and educational policy makers to possess a broader perspective and heightened degree knowledge toward the TEFL practice and to take practical steps toward the attainments of the desired objectives of the profession.

Keywords: creativity, emotional intelligence, self-efficacy, learning

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Authors: Mohamed S. Osman, Mohamed R. Nosair

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The study aims to determine the effects of mindfulness on self-efficacy and professional success among educators of general and special education at Qatar Independent. The study sample will consist of 100 educators from the males and females divided to (50) educators of general education and (50) educators of Special Education in primary, and high schools. They will response to mindfulness scale and the scale of self-efficacy. In addition, use reports of the assessment by the Department of Education for their performance and assessments of their supervisors. The study will examine the effect of some variables such as differences between educators from general and special education, as well as the differences between males and females and years of experience. The study will use a statistic descriptive approach and Correlative analysis such as; means and the Pearson correlation coefficient. The study may predicts differences between educators in all variables study.

Keywords: mindfulness, educators, general education, special education, academic performance, self-efficacy

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Authors: Yea-Pyng Lin

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Evidence-based nursing (EBN) can improve quality of patient care and reduce medical expenses. Development of training and consultation program according to nurses’ needs and difficulties is essential to promote their competence and self-efficacy in EBN. However, limited research evaluated the effects of EBN program on EBN self-efficacy among nurses. This study aimed to evaluate the effects of an EBN consultation program on self-efficacy and outcome expectancy of evidence-based practice (EBP) among nurses. A two-group pretest-posttest quasi-experimental design was used. A purposive sample of full-time nurses was recruited from a hospital. Experimental group (n=28) received the EBN consultation program including 18-hour EBN training courses, hand-on practices and group discussion by faculty mentors. Control group (n=33) received regular in-service education with no EBN program. All participants received baseline and post-test assessment using Chinese version of Self-Efficacy in EBP scale (SE-EBP) and Outcome Expectancy for EBP scale (OE-EBP). After receiving EBN consultation program, experimental group’s posttest scores of SE-EBP (t=-4.98, p<0.001) and OE-SEP (t=-3.65, p=0.001) were significantly higher than those of the pretests. By controlling the age and years of nursing work experience, the experimental group‘s SE-EBP(F=10.47, p=0.002) and OE-SEP(F=9.53, p=0.003) scores were significantly improved compared to those of the control group. EBN program focus on hand-on practice and group discussion by faculty mentors in addition to EBN training courses can improve EBP self-efficacy and outcome expectancy among nurses. EBN program focus on English literature reading, database searching, and appraisal practice according to nurses’ needs and difficulties can promote implementation of EBN.

Keywords: evidence-based nursing, evidence-based practice, consultation program, self-efficacy, outcome expectancy

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Authors: Yuxi Wang, Xuan Gao

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Traditional Chinese medicine has been used in the treatment of coronary heart disease (CHD) for centuries, and in recent years, the research data on the efficacy of traditional Chinese medicine through clinical trials has gradually increased to explore its real efficacy and internal pharmacology. However, due to the complexity of traditional Chinese medicine prescriptions, the efficacy of each component is difficult to clarify, and pharmacological research is challenging. This study aims to systematically review and clarify the clinical efficacy of traditional Chinese medicine in the treatment of coronary heart disease through a meta-analysis. Based on PubMed, CNKI database, Wanfang data, and other databases, eleven randomized controlled trials and 1091 CHD subjects were included. Two researchers conducted a systematic review of the papers and conducted a meta-analysis supporting the positive therapeutic effect of traditional Chinese medicine in the treatment of CHD.

Keywords: coronary heart disease, Chinese medicine, treatment, meta-analysis

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Authors: Yi-Ying Lin, Su-Guo, Chia-Hao, Ming-Szu Hong

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Objectives: Smoking is a common addictive behavior in teenagers. Long-term smoking is hazardous to health, causes family and social expenditure, and is an important topic that should not be overlooked by academia or the government. The aims of this study are to examine the effectiveness of these courses in terms of teenagers’ knowledge and attitudes towards the hazards of smoking and the effectiveness of their self-efficacy in rejecting smoking. Methods: This study adopted a pre-test post-test design and selected 7th, 8th, 10th, and 11th graders from two junior high schools. Total of 1073 valid questionnaires were collected. The self-completed questionnaire included background information, smoking status of relatives staying with the subject, attitudes of parents towards child smoking, knowledge and attitudes towards smoking, and anti-smoking self-efficacy. Results and clinical applications: Subjects in the experimental group underwent course interventions, which are 'smoking prevention courses,' in the semester. After course intervention, it was found that the intervention showed significant efficacy in terms of knowledge and self-efficacy in rejecting smoking in senior high school students but no efficacy in junior high school. We recommend that this course can be used in normal senior high schools. With regards to junior high schools, smoking prevention courses should be designed to be gamified, or combined with activities with both anti-smoking messages and entertainment at the same time, so that knowledge, attitudes, and self-efficacy can be subconsciously cultivated.

Keywords: adolescent students, smoking knowledge, attitudes, anti-smoking self-efficiency, smoking prevention intervention

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Authors: Yei Mian Adrian Yap

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How we idealize the regular schools to be inclusive as much as possible hinges on mainstream teachers’ attitudes and teaching-efficacy towards the inclusion of students with special needs in the regular schools. This research studies the Japanese and Singaporean mainstream teachers’ attitudes and teaching-efficacy towards the inclusion of students with special needs in the regular classrooms by investigating what key variables influence their attitudes and teaching-efficacy and how they strategize to address their challenges to include their students with special needs in their regular classrooms. In order to understand the nature of teachers’ attitudes and teaching-efficacy towards the inclusive education, a mixed-method research methodology was carried out in Japan and Singapore; it involved an explanatory sequential method of employing quantitative research first before qualitative research. In the quantitative research, 189 Japanese and 183 Singaporean teachers were invited to participate in the questionnaires and out of these participants, 38 Japanese and 15 Singaporean teachers shared their views during their semi-structured interviews. Based on the empirical findings, Japanese teachers’ attitudes and teaching-efficacy were more likely to be influenced by their experiences in teaching students with special needs, knowledge about disability legislation, presence of their disabled family members and level of confidence to teach students with special needs. On the other hand, Singaporean teachers’ attitudes and teaching-efficacy were affected by gender, educational level, received trainings in special needs education, knowledge about disability legislation and level of confidence to teach students with special needs. Both country results also demonstrated that there was a positive correlation between their teaching-efficacy and attitude. Narrative findings further expanded the reasons behind these quantitative factors that shaped teachers’ attitudes and teaching-efficacy. Also it discussed the various problems faced by Japanese and Singaporean teachers and how they identified their coping strategies to circumvent their challenges in including their students with special needs in their regular classrooms. The significance of this research manifests in necessary educational reforms in both countries especially in the context of inclusive education. These findings may not be as definitive as expected but it is believed that it could provide useful information on the current situation about teachers’ concerns towards the inclusive education. In conclusion, this research could potentially make its positive contribution to the body of literature on teachers’ attitudes and teaching-efficacy in the context of Asian developed countries and these findings could posit that regular teachers’ positive attitudes and strong sense of teaching self-efficacy could directly improve the success rate of inclusion of students with special needs in the regular classrooms.

Keywords: attitudes, inclusive education, special education, teaching-efficacy

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Authors: Young Ae Song, So Yun Kim, Nan Ji Kim, So Young Jang, Yun Mee Park, Mi Jin Lee, Ji Yeon Lee

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Background & Purpose: Many patients have psychological problems such as depression and anxiety during the rehabilitation period. Such psychological instability affects the prognosis of the patient in the long term. We develop a nursing intervention program for rehabilitation inpatients using a rehabilitation self –management note and evaluate the effects of the program on depression, motivation, and self-efficacy. Methods: The study was conducted using a nonequivalent control group non-synchronized design. Participants were rehabilitation inpatients, 27 patients in the control group and 20 in the experimental group. Questionnaires were completed three times (pretest, 5 days, 10 days) Final data for 40 patients were analyzed, 23 patients in the control group and 17 in the experimental group. Data were analyzed using x2-test, t-test, and repeated measure ANOVA. Results: Depression in the experimental group decreased compared to the control group, but it was not significant. The motivation for the experimental group changed significantly (F=3.90, p=.029) and self-efficacy increased, but not significantly (F=0.59, p=.559) Conclusion: Results of this study indicate that nursing intervention programs for rehabilitation inpatients could be useful to decrease depression and to improve motivation and self-efficacy.

Keywords: depression, motivation, self-efficacy, rehabilitation inpatient, self-management workbook

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