Search results for: children care

Authors: Kyung Min Kwom, Young Joo Lee

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Purpose: Up to 90% of pancreatic cancer patient suffer from neuropathic pain. In palliative care setting, pain control in a pancreatic cancer patient is one of the major goals. Ketamine is a NMDA receptor antagonist effective in neuropathic pain. Also, there have been studies about opioid sparing effect of ketamine. This study was held in palliative care unit among pancreatic cancer patients to find out the factors related to ketamine use and the opioid sparing effect. Methods: Medical records of pancreatic cancer patients admitted to St. Mary’s hospital palliative care unit from 2013.1 to 2014.12 were reviewed. Patients were divided into two categories according to ketamine use. Also, opioid use before and after ketamine use was compared in ketamine group. Results: Compared to non ketamine use group, patients in ketamine group required a higher dose of opioid. Total opioid dose, daily opioid dose, number of daily rescue medication, daily average rescue dose were statistically significantly higher in ketamine group. Opioid requirement was increased after ketamine administration. Conclusion: In this study, ketamine group required more opioid. Ketamine is frequently considered in patients with severe pain, requiring high amount of opioid. Also, ketamine did not have an opioid sparing effect. Future studies about palliative use of ketamine in a larger number of patients are required.

Keywords: ketamine, opioid sparing, palliative care, pancreatic cancer

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Authors: Eun Jae Ko, In Young Sung, Eui Soo Joeng

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Oropharyngeal dysphagia is prevalent in children with cerebral palsy (CP). There are many studies concerning this problem, however, studies examining long term outcomes of dysphagia using videofluoroscopic study (VFSS) are very rare. The Aim of this study is to investigate long-term outcomes of dysphagia in children with severe CP using initial VFSS. It was a retrospective study and chart review was done from January 2000 to December 2013. Thirty one patients under 18 years who have been diagnosed as CP in outpatient clinic of Rehabilitation Medicine, and who did VFSS were included. Long-term outcomes such as feeding method, height percentile, weight percentile, and body mass index (BMI) were tracked up for at least 3 years by medical records. Significant differences between initial and follow-up datas were investigated. The patients consisted of 18 males and 13 females, and the mean age was 31.0±18.0 months old. 64.5% of patients were doing oral diet, and 25.8% of patients were doing non-oral diet. When comparing VFSS findings among oral feeding patients, oral and non-oral feeding patients, and non-oral feeding patients at initial period, dysphagia severity, supraglottic penetration, and subglottic aspiration showed significant differences. Most of the patients who could feed orally at initial period were found to have the same feeding method at follow-up. But among eight patients who required non-oral feeding initially, three patients became possible to feed orally, and one patient was doing oral and non-oral feeding method together at follow-up. Follow up feeding method showed correlation with dysphagia severity by initial VFSS. Weight percentile was decreased in patients with GMFCS level V at follow up, which may represent poor nutritional status due to severe dysphagia compared to other patients. Initial VFSS severity would play a significant role in making an assumption about future diet in children with severe CP. Patients with GMFCS level V seem to have serious dysphagia at follow up and have nutritional deficiency over time, therefore, more careful nutritional support is needed in children with severe CP are suggested.

Keywords: cerebral palsy, child, dysphagia, videofluoroscopic study

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Authors: Deirdre Mc Grath, Joanne Reid

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Background: Ovarian cancer is the leading cause of mortality among gynaecologic cancers in developed countries and the seventh most common cancer worldwide with nearly 240,000 women diagnosed each year. Although it is recognized engaging in exercise results in positive health care outcomes, women with ovarian cancer are reluctant to participate. No evidence currently exists focusing on how to successfully implement an exercise intervention program for patients with ovarian cancer, using a realist approach. There is a requirement for the implementation of exercise programmes within the oncology health care setting as engagement in such interventions has positive health care outcomes for women with ovarian cancer both during and following treatment. Aim: To co-design the implementation of an exercise intervention for women following treatment for ovarian cancer. Methods: This study is a realist evaluation using quantitative and qualitative methods of data collection and analysis. Realist evaluation is well-established within the health and social care setting and has in relation to this study enabled a flexible approach to investigate how to optimise implementation of an exercise intervention for this patient population. This single centre study incorporates three stages in order to identify the underlying contexts and mechanisms which lead to the successful implementation of an exercise intervention for women who have had treatment for ovarian cancer. Stage 1 - A realist literature review. Stage 2 -Co-design of the implementation of an exercise intervention with women following treatment for ovarian cancer, their carer’s, and health care professionals. Stage 3 –Implementation of an exercise intervention with women following treatment for ovarian cancer. Evaluation of the implementation of the intervention from the perspectives of the women who participated in the intervention, their informal carers, and health care professionals. The underlying program theory initially conceptualised before and during the realist review was developed further during the co-design stage. The evolving program theory in relation to how to successfully implement an exercise for these women is currently been refined and tested during the final stage of this realist evaluation which is the implementation and evaluation stage. Results: This realist evaluation highlights key issues in relation to the implementation of an exercise intervention within this patient population. The underlying contexts and mechanisms which influence recruitment, adherence, and retention rates of participants are identified. Conclusions: This study will inform future research on the implementation of exercise interventions for this patient population. It is anticipated that this intervention will be implemented into practice as part of standard care for this group of patients.

Keywords: ovarian cancer, exercise intervention, implementation, Co-design

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Authors: Rui Wang, Luodi Yu, Dan Huang, Hsuan-Chih Chen, Yang Zhang, Suiping Wang

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Enhanced discrimination of pure tones but diminished discrimination of speech pitch (i.e., lexical tone) were found in children with autism who speak a tonal language (Mandarin), suggesting a speech-specific impairment of pitch perception in these children. However, in tonal languages, both lexical tone and vowel are phonemic cues and integrally dependent on each other. Therefore, it is unclear whether the presence of phonemic vowel dimension contributes to the observed lexical tone deficits in Mandarin-speaking children with autism. The current study employed a multi-feature oddball paradigm to examine how vowel and tone dimensions contribute to the neural responses for syllable change detection and involuntary attentional orienting in school-age Mandarin-speaking children with autism. In the oddball sequence, syllable /da1/ served as the standard stimulus. There were three deviant stimulus conditions, representing tone-only change (TO, /da4/), vowel-only change (VO, /du1/), and change of tone and vowel simultaneously (TV, /du4/). EEG data were collected from 25 children with autism and 20 age-matched normal controls during passive listening to the stimulation. For each deviant condition, difference waveform measuring mismatch negativity (MMN) was derived from subtracting the ERP waveform to the standard sound from that to the deviant sound for each participant. Additionally, the linear summation of TO and VO difference waveforms was compared to the TV difference waveform, to examine whether neural sensitivity for TV change detection reflects simple summation or nonlinear integration of the two individual dimensions. The MMN results showed that the autism group had smaller amplitude compared with the control group in the TO and VO conditions, suggesting impaired discriminative sensitivity for both dimensions. In the control group, amplitude of the TV difference waveform approximated the linear summation of the TO and VO waveforms only in the early time window but not in the late window, suggesting a time course from dimensional summation to nonlinear integration. In the autism group, however, the nonlinear TV integration was already present in the early window. These findings suggest that speech perception atypicality in children with autism rests not only in the processing of single phonemic dimensions, but also in the dimensional integration process.

Keywords: autism, event-related potentials , mismatch negativity, speech perception

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Authors: Swati Srivastava, Ashish Kumar Upadhyay

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Using longitudinal data from three waves of Young Lives Study and Ordinary Least Square methods, study has investigated the effect of birth order and arrival of younger siblings on child development in India. Study used child’s height for age z-score, weight for age z-score, BMI for age z-score, Peabody Picture Vocabulary Test (PPVT-Score)c, maths score, Early Grade Reading Assessment Test (ERGA) score, and memory score to measure the physical and cognitive development of child during wave-3. Findings suggest that having a high birth order is detrimental for child development and the gap between adjacent siblings is larger for children late in the birth sequences than early in the birth sequences. Study also reported that not only older siblings but arrival of younger siblings before assessment of test also reduces the development of a child. The effects become stronger in case of female children than male children.

Keywords: height for age z-score, weight for age z-score, BMI for z-score, PPVT score, math score, EGRA score, memory score, birth order, siblings, Young Lives Study, India

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Authors: Van Son Huynh, Thanh Huan Nguyen, Tat Thien Do, Thi Mai Thu Nguyen, Thien Vu Giang

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Given the necessity for substantial and all-encompassing educational reform, particularly in elementary Education, it is imperative to prioritize learner-centered instruction at the elementary level. This study focuses on the difficulties encountered in overseeing learner-centered instructional activities for elementary school children in Ho Chi Minh City (HCMC), the largest city in Vietnam in terms of population. Although learner-centered solutions have been implemented, there are still certain weaknesses, including an emphasis on content and worries about lax monitoring. The purpose of this study, named "Management of Learner-Centered Teaching Activities for Primary School Students in HCMC," is to enhance and advance theories related to the management of learner-centered teaching activities. The study evaluates the present condition of learner-centered teaching activities and management practices in HCMC, aiming to suggest solutions for improving the efficiency of managing such activities in primary schools.

Keywords: primary school, school children in Ho Chi Minh City, learner-centered instructional activities, learner-centered teaching activities and management.

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Authors: Auni Idi Muhire

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Background: Prior to April 2012, resuscitations were often ineffective resulting in poor patient outcomes. An initiative was implemented at Rwanda Military Hospital (RMH) to review root causes and plan strategies to improve patient outcomes. An interdisciplinary committee was developed to review this problem. Purpose: Analyze the frequency, obstacles, and outcome of patient resuscitation following cardiac and/or respiratory arrest. Methods: A form was developed to allow recording of all actions taken during resuscitation including response times, staff present, and equipment and medications used. Results:-The patient population requiring the most resuscitation effort are the intensive care patients, most frequently the neonatal the intensive care patients (42.8%) -Despite having trained staff representatives, not all resuscitations follow protocol -Lack of compliance with drug administration guidelines was noted, particularly in initiating use of drugs despite the drug being available (59%). Lesson Learned: Basic Life Support training for interdisciplinary staff resulted in more effective response to cardiac and/or respiratory arrest at RMH. Obstacles to effective resuscitation included number of staff, knowledge and skill level of staff, availability of appropriate equipment and medications, staff communication, and patient Do not Attempt Resuscitation (DNR) status.

Keywords: resuscitation, case analysis of knowledge versus practice, intensive care, critical care

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Authors: Perpetua Modjadji, Sphiwe Madiba

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Background: The growth patterns of children are good nutritional indicators of their nutritional status, health, and socioeconomic level. However, the maternal factors and the belief system of the society affect the growth of children promoting undernutrition. This study determined the influence of maternal factors on growth patterns of schoolchildren in a rural site. Methods: A convergent mixed method study was conducted among 508 schoolchildren and their mothers in Dikgale Health and Demographic Surveillance System Site, South Africa. Multistage sampling was used to select schools (purposive) and learners (random), who were paired with their mothers. Anthropometry was measured and socio-demographic, obstetrical, household information, maternal influence on children’s nutrition, and growth were assessed using an interviewer administered questionnaire (quantitative). The influence of the cultural beliefs and practices of mothers on the nutrition and growth of their children was explored using focus group discussions (qualitative). Narratives of mothers were used to best understand growth patterns of schoolchildren (mixed method). Data were analyzed using STATA 14 (quantitative) and Nvivo 11 (qualitative). Quantitative and qualitative data were merged for integrated mixed method analysis using a joint display analysis. Results: Mean age of children was 10 ± 2 years, ranging from 6 to 15 years. Substantial percentages of thinness (25%), underweight (24%), and stunting (22%) were observed among the children. Mothers had a mean age of 37 ± 7 years, and 75% were overweight or obese. A depressed socio-economic status indicated by a higher rate of unemployment with no income (82.3%), and dependency on social grants (86.8%) was observed. Determinants of poor growth patterns were child’s age and gender, maternal age, height and BMI, access to water supply, and refrigerator use. The narratives of mothers suggested that the children in most of their households were exposed to poverty and the inadequate intake of quality food. Conclusion: Poor growth patterns were observed among schoolchildren while their mothers were overweight or obese. Child’s gender, school grade, maternal body mass index, and access to water were the main determinants. Congruence was observed between most qualitative themes and quantitative constructs. A need for a multi sectoral approach considering an evidence based and feasible nutrition programs for schoolchildren, especially those in rural settings and educating mothers, cannot be over-emphasized.

Keywords: growth patterns, maternal factors, rural context, schoolchildren, South Africa

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Authors: Fengjuan Wang, Azilawati Jamaludin

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Developmental Dyscalculia (DD) is defined as a particular learning difficulty with continuous challenges in learning requisite math skills that cannot be explained by intellectual disability or educational deprivation. Recent studies have increasingly recognized that DD is a heterogeneous, instead of monolithic, learning disorder with not only cognitive and behavioral deficits but so too neural dysfunction. In recent years, neuroimaging studies employed group comparison to explore the neural underpinnings of DD, which contradicted the heterogenous nature of DD and may obfuscate critical individual differences. This research aimed to investigate the neural heterogeneity of DD using case studies with functional near-infrared spectroscopy (fNIRS). A total of 54 aged 6-7 years old of children participated in this study, comprising two comprehensive cognitive assessments, an 8-minute resting state, and an 8-minute one-digit addition task. Nine children met the criteria of DD and scored at or below 85 (i.e., the 16th percentile) on the Mathematics or Math Fluency subtest of the Wechsler Individual Achievement Test, Third Edition (WIAT-III) (both subtest scores were 90 and below). The remaining 45 children formed the typically developing (TD) group. Resting-state data and brain activation in the inferior frontal gyrus (IFG), superior frontal gyrus (SFG), and intraparietal sulcus (IPS) were collected for comparison between each case and the TD group. Graph theory was used to analyze the brain network under the resting state. This theory represents the brain network as a set of nodes--brain regions—and edges—pairwise interactions across areas to reveal the architectural organizations of the nervous network. Next, a single-case methodology developed by Crawford et al. in 2010 was used to compare each case’s brain network indicators and brain activation against 45 TD children’s average data. Results showed that three out of the nine DD children displayed significant deviation from TD children’s brain indicators. Case 1 had inefficient nodal network properties. Case 2 showed inefficient brain network properties and weaker activation in the IFG and IPS areas. Case 3 displayed inefficient brain network properties with no differences in activation patterns. As a rise above, the present study was able to distill differences in architectural organizations and brain activation of DD vis-à-vis TD children using fNIRS and single-case methodology. Although DD is regarded as a heterogeneous learning difficulty, it is noted that all three cases showed lower nodal efficiency in the brain network, which may be one of the neural sources of DD. Importantly, although the current “brain norm” established for the 45 children is tentative, the results from this study provide insights not only for future work in “developmental brain norm” with reliable brain indicators but so too the viability of single-case methodology, which could be used to detect differential brain indicators of DD children for early detection and interventions.

Keywords: brain activation, brain network, case study, developmental dyscalculia, functional near-infrared spectroscopy, graph theory, neural heterogeneity

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Authors: Ana Paula Soares, Alexandrina Lages, Helena Oliveira, Francisco-Javier Gutiérrez-Domínguez, Marisa Lousada

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From an early age, exposure to a spoken language allows us to implicitly capture the structure underlying the succession of the speech sounds in that language and to segment it into meaningful units (words). Statistical learning (SL), i.e., the ability to pick up patterns in the sensory environment even without intention or consciousness of doing it, is thus assumed to play a central role in the acquisition of the rule-governed aspects of language and possibly to lie behind the language difficulties exhibited by children with development language disorder (DLD). The research conducted so far has, however, led to inconsistent results, which might stem from the behavioral tasks used to test SL. In a classic SL experiment, participants are first exposed to a continuous stream (e.g., syllables) in which, unbeknownst to the participants, stimuli are grouped into triplets that always appear together in the stream (e.g., ‘tokibu’, ‘tipolu’), with no pauses between each other (e.g., ‘tokibutipolugopilatokibu’) and without any information regarding the task or the stimuli. Following exposure, SL is assessed by asking participants to discriminate between triplets previously presented (‘tokibu’) from new sequences never presented together during exposure (‘kipopi’), i.e., to perform a two-alternative-forced-choice (2-AFC) task. Despite the widespread use of the 2-AFC to test SL, it has come under increasing criticism as it is an offline post-learning task that only assesses the result of the learning that had occurred during the previous exposure phase and that might be affected by other factors beyond the computation of regularities embedded in the input, typically the likelihood two syllables occurring together, a statistic known as transitional probability (TP). One solution to overcome these limitations is to assess SL as exposure to the stream unfolds using online techniques such as event-related potentials (ERP) that is highly sensitive to the time-course of the learning in the brain. Here we collected ERPs to examine the neurofunctional correlates of SL in preschool children with DLD, and chronological-age typical language development (TLD) controls who were exposed to an auditory stream in which eight three-syllable nonsense words, four of which presenting high-TPs and the other four low-TPs, to further analyze whether the ability of DLD and TLD children to extract-word-like units from the steam was modulated by words’ predictability. Moreover, to ascertain if the previous knowledge of the to-be-learned-regularities affected the neural responses to high- and low-TP words, children performed the auditory SL task, firstly, under implicit, and, subsequently, under explicit conditions. Although behavioral evidence of SL was not obtained in either group, the neural responses elicited during the exposure phases of the SL tasks differentiated children with DLD from children with TLD. Specifically, the results indicated that only children from the TDL group showed neural evidence of SL, particularly in the SL task performed under explicit conditions, firstly, for the low-TP, and, subsequently, for the high-TP ‘words’. Taken together, these findings support the view that children with DLD showed deficits in the extraction of the regularities embedded in the auditory input which might underlie the language difficulties.

Keywords: development language disorder, statistical learning, transitional probabilities, word segmentation

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Authors: Zahra R. Almansoor

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Background: Selective serotonin reuptake inhibitors (SSRI’s) and cognitive behavioural therapy (CBT) are the main treatment methods used for patients with obsessive compulsive disorder (OCD) under the National Institute of Health and Care Excellence (NICE) guidelines. Yet many patients are left with residual symptoms or remit, so several other therapeutic approaches have been explored. Objective: The objective was to systematically review the available literature regarding the treatment efficacy of current and potential approaches and diagnostic strategies. Method: First, studies were examined concerning diagnosis, prognosis, and influencing factors. Then, one reviewer conducted a systematic search of six databases using stringent search terms. Results of studies exploring the efficacy of treatment interventions were analysed and compared separately for adults and children. This review was limited to randomised controlled trials (RCT’s) conducted from 2016 onwards, and an improved Y-BOCS (Yale- Brown obsessive compulsive scale) score was the primary outcome measure. Results: Technology-based interventions including internet-based cognitive behavioural therapy (iCBT) were deemed as potentially effective. Discrepancy remains about the benefits of SSRI use past one year, but potential medication adjuncts include amantadine. Treatments such as association splitting and family and mindfulness strategies also have future potential. Conclusion: A range of potential therapies exist, either as treatment adjuncts to current interventions or as sole therapies. To further improve efficacy, it may be necessary to remodel the current NICE stepped-care model, especially regarding the potential use of lower intensity, cheaper treatments, including iCBT. Although many interventions show promise, further research is warranted to confirm this.

Keywords: family and group treatment, mindfulness strategies, novel treatment approaches, standard treatment, technology-based interventions

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Authors: Claudia Carbajal, Jija Dutt, Smriti Pahwa, Sumukhi Vaid, Karishma Vats

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ASER Centre, the research and assessment arm of Pratham Education Foundation sees measurement as the first stage of action. ASER uses primary research to push and give empirical foundations to policy discussions at a multitude of levels. At a household level, common citizens use a simple assessment (a floor-level test) to measure learning across rural India. This paper presents the evidence on the applicability of an ASER approach to the health sector. A citizen-led assessment was designed and executed that collected information from young mothers with children up to a year of age. The pilot assessments were rolled-out in two different models: Paid surveyors and student volunteers. The survey covered three geographic areas: 1,239 children in the Jaipur District of Rajasthan, 2,086 in the Rae Bareli District of Uttar Pradesh, and 593 children in the Bhuj Block in Gujarat. The survey tool was designed to study knowledge of health-related issues, daily practices followed by young mothers and access to relevant services and programs. It provides insights on behaviors related to infant and young child feeding practices, child and maternal nutrition and supplementation, water and sanitation, and health services. Moreover, the survey studies the reasons behind behaviors giving policy-makers actionable pathways to improve implementation of social sector programs. Although data on health outcomes are available, this approach could provide a rapid annual assessment of health issues with indicators that are easy to understand and act upon so that measurements do not become an exclusive domain of experts. The results give many insights into early childhood health behaviors and challenges. Around 98% of children are breastfed, and approximately half are not exclusively breastfed (for the first 6 months). Government established diet diversity guidelines are met for less than 1 out of 10 children. Although most households are satisfied with the quality of drinking water, most tested households had contaminated water.

Keywords: citizen-led assessment, rapid health assessment, Infant and Young Children Feeding, water and sanitation, maternal nutrition, supplementation

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Authors: Osk Dagsdottir

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Background—Gait classifying allows clinicians to differentiate gait patterns into clinically important categories that help in clinical decision making. Reliable comparison of gait data between normal and patients requires knowledge of the gait parameters of normal children's specific age group. However, there is still a lack of the gait database for normal children of different ages. Objectives—This study aims to investigate the kinematics of the lower limb joints during gait for normal children in different age groups. Methods—Fifty-three normal children (34 boys, 19 girls) were recruited in this study. All the children were aged between 5 to 16 years old. Age groups were defined as three types: young child aged (5-7), child (8-11), and adolescent (12-16). When a participant agreed to take part in the project, their parents signed a consent form. Vicon® motion capture system was used to collect gait data. Participants were asked to walk at their comfortable speed along a 10-meter walkway. Each participant walked up to 20 trials. Three good trials were analyzed using the Vicon Plug-in-Gait model to obtain parameters of the gait, e.g., walking speed, cadence, stride length, and joint parameters, e.g., joint angle, force, moments, etc. Moreover, each gait cycle was divided into 8 phases. The range of motion (ROM) angle of pelvis, hip, knee, and ankle joints in three planes of both limbs were calculated using an in-house program. Results—The temporal-spatial variables of three age groups of normal children were compared between each other; it was found that there was a significant difference (p < 0.05) between the groups. The step length and walking speed were gradually increasing from young child to adolescent, while cadence was gradually decreasing from young child to adolescent group. The mean and standard deviation (SD) of the step length of young child, child and adolescent groups were 0.502 ± 0.067 m, 0.566 ± 0.061 m and 0.672 ± 0.053 m, respectively. The mean and SD of the cadence of the young child, child and adolescent groups were 140.11±15.79 step/min, 129±11.84 step/min, and a 115.96±6.47 step/min, respectively. Moreover, it was observed that there were significant differences in kinematic parameters, either whole gait cycle or each phase. For example, RoM of knee angle in the sagittal plane in the whole cycle of young child group is (65.03±0.52 deg) larger than child group (63.47±0.47 deg). Conclusion—Our result showed that there are significant differences between each age group in the gait phases and thus children walking performance changes with ages. Therefore, it is important for the clinician to consider the age group when analyzing the patients with lower limb disorders before any clinical treatment.

Keywords: action research, creative learning, mathematics education, professional development

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Authors: Hsiao-Lan Wang, Chun-Han Chiang, I-Chen Chen

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In Chinese Mandarin, lexical tones play an important role to provide contrasts in word meaning. They are pitch patterns and can be quantified as the fundamental frequency (F0), expressed in Hertz (Hz). In this study, we aim to investigate the influence of frequency discrimination on Chinese children’s performance of reading abilities. Fifty participants from 3rd to 4th grades, including 24 children with reading difficulties and 26 age-matched children, were examined. A serial of cognitive, language, reading and psychoacoustic tests were administrated. Magnetoencephalography (MEG) was also employed to study children’s auditory sensitivity. In the present study, auditory frequency was measured through slide-up pitch, slide-down pitch and frequency-modulated tone. The results showed that children with Chinese reading difficulties were significantly poor at phonological awareness and auditory discrimination for the identification of frequency-modulated tone. Chinese children’s character reading performance was significantly related to lexical tone awareness and auditory perception of frequency-modulated tone. In our MEG measure, we compared the mismatch negativity (MMNm), from 100 to 200 ms, in two groups. There were no significant differences between groups during the perceptual discrimination of standard sounds, fast-up and fast-down frequencies. However, the data revealed significant cluster differences between groups in the slow-up and slow-down frequencies discrimination. In the slow-up stimulus, the cluster demonstrated an upward field map at 106-151 ms (p < .001) with a strong peak time at 127ms. The source analyses of two dipole model and localization resolution model (CLARA) from 100 to 200 ms both indicated a strong source from the left temporal area with 45.845% residual variance. Similar results were found in the slow-down stimulus with a larger upward current at 110-142 ms (p < 0.05) and a peak time at 117 ms in the left temporal area (47.857% residual variance). In short, we found a significant group difference in the MMNm while children processed frequency-modulated tones with slow temporal changes. The findings may imply that perception of sound frequency signals with slower temporal modulations was related to reading and language development in Chinese. Our study may also support the recent hypothesis of underlying non-verbal auditory temporal deficits accounting for the difficulties in literacy development seen developmental dyslexia.

Keywords: Chinese Mandarin, frequency modulation sweeps, magnetoencephalography, mismatch negativity, reading difficulties

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Authors: Rana Alkhamra

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Background: Child's earliest experiences with books and stories during the first years of his life are strongly linked with the development of his early language and literacy skills. Interacting in routine learning activities, such as shared book reading, storytelling, and teaching about the letters of the alphabet make a critical foundation for early learning, language growth and emergent literacy. Aim: The current study explores family and preschool early interactive literacy practices in families and preschools (nursery and kindergarten) in Jordan. It highlights the importance of early interactive literacy activities on child language and literacy growth and development. Methods: This is a cross sectional study that surveyed 243 Jordanian families. The survey investigated literacy routine practices, largely shared books reading, at home and at preschool; child speech and language development; and family demographics. Results: Around 92.5% of the families read books and stories to their children, as frequently as 1-2 times weekly or monthly (75%). Only 19.6% read books on daily basis. Many families reported preferring story-telling (97%). Despite that families acknowledged the importance of early literacy activities, on language, reading and writing, cognitive, and academic development, 45% asked for education and training pertaining to specific ways and ideas to help their young children develop language and literacy skills. About 69% of the families reported reading books and stories to their children for 15 minutes a day, while 71.2% indicated having their children watch television for 3 to > 6 hours a day. At preschool, only 52.8% of the teachers were reported to read books and stories. Factors like parent education, monthly income, living inside (33.6%) or outside (66.4%) the capital city of Amman significantly (p < 0.05) affected child early literacy interactive activities whether at home or at preschool. Conclusion: Early language and literacy skills depend largely on the opportunities and experiences provided to children in the home and in preschool environment. Family literacy programs can play an important role in bridging the gap in early literacy experiences for families that need help. Also, speech therapists can work in collaboration with families and educators to ensure that young children have high quality and sufficient opportunities to participate in early literacy activities both at home and in preschool environments.

Keywords: literacy, interactive activities, language, practices, family, preschool, Jordan

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Authors: R. M. Chandler, A. J. Stringer

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In adults, short bursts of high-intensity exercise (intensities between 80-95% of maximum heart rates) increase cardiovascular and metabolic function without the time investment of traditional aerobic training. Similar improvements in various health indices are also becoming increasingly evident in children in countries other than the United States. In the United States, physical education programs have become shorter in length and fewer in frequency. With this in the background, it is imperative that health and physical educators delivered well-organized and focused fitness programs that can be tolerated across many different somatotypes. Perhaps the least effective lag-time in a US physical education (PE) class is the first 10 minutes, a time during which children warm up. Replacing a traditional PE warmup with a 10 min high-intensity excise protocol is a time-efficient method to impact health, leaving as much time for other PE material such as skill development, motor behavior development as possible. This supplemented 10 min high-intensity exercise increases cardiovascular function as well as induces favorable body composition changes in as little as six weeks with further enhancement throughout a semester of activity. The supplemental high-intensity exercise did not detract from the PE lesson outcomes.

Keywords: cardiovascular fitness, high intensity interval training, high intensity exercise, pediatric

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Authors: Katie Jerram, Jacqui Nevols, Rebecca Howes, Hayley Richardson, Debbie Suso, Thomas Batten, Reny Mathai

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Pyomyositis is an uncommon acute purulent skeletal muscle infection, usually caused by Staphylococcus aureus, occurring either spontaneously or following local trauma. Immunocompromise is a risk factor. It presents with pyrexia, pain, and tenderness of the affected muscle, which may have a firm ‘woody’ feel. Management usually involves surgery and prolonged courses of antibiotics, but alongside these active treatments, palliation of symptoms such as pain is also a priority. A short case series of diabetic inpatients under the care of the Renal Medicine team with pyomyositis is presented, demonstrating that Hospital Palliative Care Teams may be well placed to provide symptom management advice by working jointly with the patient’s medical or surgical team. A review of the literature on the management of pain in pyomyositis is also presented, and there was no clear consensus on the best strategy. It may be that a combination of analgesics and adjuncts is the most effective strategy, perhaps combined with the holistic approach used within palliative care.

Keywords: pyomyositis, pain, palliation, analgesia

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Authors: Hsin-Yi Lo, Huang-Ju Jiun, Yu-Chiao Chu

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Hemodynamic monitoring is an important in the intensive care unit. Advances in medical technology in recent years, more diversification of intensive care equipment, there are many kinds of instruments available for monitoring of hemodynamics, Edwards Lifesciences Hemodynamic Monitoring (FloTrac) is one of them. The recent medical safety incidents in parameters were changed, nurses have not to notify doctor in time, therefore, it is hoped to analyze the current problems and find effective improvement strategies. In August 2021, the survey found that only 74.0% of FloTrac correctness of operation, reasons include lack of education, the operation manual is difficulty read, lack of audit mechanism, nurse doesn't know those numerical changes need to notify doctor, work busy omission, unfamiliar with operation and have many nursing records then omissions. Improvement methods include planning professional nurse education, formulate the secret arts of FloTrac, enacting an audit mechanism, establish FloTrac action learning, make「follow the sun」care map, hold simulated training and establish monitoring data automatically upload nursing records. After improvement, FloTrac correctness of operation increased to 98.8%. The results are good, implement to the ICU of the hospital.

Keywords: hemodynamic monitoring, edwards lifesciences hemodynamic monitoring, multiple strategies, intensive care

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Authors: Adriana Salgado, Sandra Castaneda, Ivan Perez

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Learning to read and write is a complex process involving several cognitive skills, contextual, and cultural environments. The basis of this development is linguistic skills, such as the ability to name and understand vocabulary, retell a story, phonological awareness, letter knowledge, among others. In children with autism spectrum disorder (ASD), one of the main concerns is related to language disorders. Nevertheless, most of the children with ASD are able to decode written information but have difficulties in reading comprehension. The research of these processes in the Spanish-speaking population is limited. However, the increasing prevalence of this diagnosis (1 in 115 children) in Mexico has implications at different levels. Educational research is an important area of interest in ASD children, such as emergent literacy. Reading and writing expand the possibilities of academic, cultural, and social information access. Taking this information into account, the objective of this research was to identify the relationship between language skills, alphabet knowledge, phonological awareness, and early reading and writing in ASD Spanish-speaking children. The method used for this research was based on tasks that were selected, adapted and in some cases designed to measure initial reading and writing, as well as language skills (naming, receptive vocabulary, and narrative skills), phonological awareness (similar phonological word pairs, beginning sound awareness and spelling) and letter knowledge, in a sample of 45 children (38 boys and 7 girls) with prior diagnosis of ASD. Descriptive analyses, as well as bivariate correlations, cluster analysis, and canonical correspondence, were obtained for the data results. Results showed that variability was large; however, it was possible to characterize the sample in low, medium, and high score groups regarding children performance. The low score group (46.7% of the sample), had a null or deficient performance in language skills and phonological awareness, some could identify up to five letters of the alphabet, showed no early reading skills but they could scribble. The middle score group was characterized by a highly variable performance in different tasks, with better language skills in receptive and naming vocabulary, some narrative, letter knowledge, and phonological awareness (beginning sound awareness) skills. The high score group, (24.4% of the sample) had the best performance in language skills in relation to the sample data, as well as in the rest of the measured skills. Finally, scores were canonically correlated between naming, receptive vocabulary, narrative, phonological awareness, letter knowledge and initial learning of reading and writing skills for the high score group and letter knowledge, naming and receptive vocabulary for the lower score group, which is consistent with previous research in typical and ASD children. In conclusion, the obtained data is consistent with previous studies. Despite large variability, it was possible to identify performance profiles and relations based on linguistic, phonological awareness, and letter knowledge skills. These skills were predictor variables of the initial development of reading and writing. The above has implications for a future program and strategies development that may benefit the acquisition of reading and writing in ASD children.

Keywords: autism, autism spectrum disorders, early literacy, emergent literacy

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Authors: Vera Lúcia Raposo

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The right to health care – usually known as the right to health – is recognized in many national laws and Constitutions, as well as in international human rights documents. The kind of health care that citizens are entitled to receive, especially in the framework of the National Health Service, is usually identified with conventional medicine. However, since ancient times that a different form of medicine – alternative, traditional or nonconventional medicine – exists. In recent times it is attracting increasing interest, as it is demonstrated by the use of its specific knowledge either by pharmaceutical companies either by modern health technologies. Alternative medicine refers to a holistic approach to body and mind using herbal products, animal parts and minerals instead of technology and pharmaceutical drugs. These notes contributed to a sense of distrust towards it, accusing alternative medicine of being based on superstition and ignorance. However, and without denying that some particular practices lack indeed any kind of evidence or scientific grounds, the fact is that a substantial part of alternative medicine can actually produce satisfactory results. The paper will not advocate the substitution of conventional medicine by alternative medicine, but the complementation between the two and their specific knowledge. In terms of the right to health, as a fundamental right and a human right, this thesis leads to the implementation of a wider range of therapeutic choices for patients, who should be entitled to receive different forms of health care that complement one another, both in public and private health facilities. This scenario would demand a proper regulation for alternative medicine, which nowadays does not exist in most countries, but it is essential to protect patients and public health in general and to reinforce confidence in alternative medicine.

Keywords: alternative medicine, conventional medicine, patient’s rights, right to health

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Authors: Karlygash Tulendieva

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Presently vaccination is the most effective method of prevention of flu and its complications. The purpose of this study was to analyze the impact of the increase of coverage of the population of South Kazakhstan region with flu vaccination and decrease of the ARVI morbidity. The analysis was performed on the data of flu vaccination of risk groups, including children under one year and pregnant women. Data on ARVI morbidity during 2010-2015 and data on vaccination were taken from the reports of the Epidemiological Surveillance Unit of Department of Consumers’ Rights Protection of South Kazakhstan region. Coverage with flu vaccination of the risk groups was annually increasing and in 2015 it reached 16% (450,000/2,800,682) from the total population. The ARVI morbidity rate in the entire population in 2010 was 2,010.4 per 100,000 of the population and decreased 3.2 times to 609.9 per 100,000 of the population in 2015. Annual growth was observed from 2010 to 2015 of specific weight of the vaccinated main risk groups: healthcare workers by 51% (from 17,331 in 2010 to 33,538 in 2015), children with chronic pulmonary and cardio-vascular diseases, immune deficiency, weak and sickly children above six months by 39% (from 63,122 in 2010 to 158,023 in 2015), adults with chronic co-morbidities by 27% (from 44,271 in 2010 to 162,595 in 2015), persons above 65 by 17% (from 10,276 in 2010 to 57,875 in 2015), and annual coverage of pregnant women on second or third trimester from 34,443 in 2010 to 37,969 in 2015. Starting from 2013 and until 2015 vaccination was performed in the region with coverage of at least 90% of children from 6 months to one year. The ARVI morbidity in this age group decreased 3.3 times from 8,687.8 per 100,000 of the population in 2010 to 2,585.8 per 100,000 of the population in 2015. Vaccination of pregnant women on 2-3 trimester was started in the region in 2012. Annual increase of vaccination coverage of pregnant women from 86.1% (34,443/40,000) in 2012 to 95% (37,969/40,000) in 2015 decreased the morbidity 1.5 times from 4,828.8 per 100,000 of population in 2012 to 3,022.7 per 100,000 of population in 2015. Following the increase of vaccination coverage of the population in South Kazakhstan region, the trend was observed of decrease of ARVI morbidity rates among the population and main risk groups, among pregnant women and children under one year.

Keywords: acute respiratory viral infections, flu, risk groups, vaccination

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Authors: Arsalan Jabbar, Wajiha Javed, Nelofer Mehboob, Zahid Memon

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Introduction: There are multiple social, individual and cultural factors that influence an individual’s decision to adopt family planning methods especially among non-users in patriarchal societies like Pakistan.Non-users, if targeted efficiently, can contribute significantly to country’s CPR. A research study showed that non-users if convinced to adopt lactational amenorrhea method can shift to long-term methods in future. Research shows that if non-users are targeted efficiently a 59% reduction in unintended pregnancies in Saharan Africa and South-Central and South-East Asia is anticipated. Methods: We did secondary data analysis on Pakistan Demographic Heath Survey (2012-13) dataset. Use of contraception (never-use/ever-use) was the outcome variable. At univariate level Chi-square/Fisher Exact test was used to assess relationship of baseline covariates with contraception use. Then variables to be incorporated in the model were checked for multi-collinearity, confounding, and interaction. Then binary logistic regression (with an urban-rural stratification) was done to find the relationship between contraception use and baseline demographic and social variables. Results: The multivariate analyses of the study showed that younger women (≤ 29 years) were more prone to be never users as compared to those who were > 30 years and this trend was seen in urban areas (AOR 1.92, CI 1.453-2.536) as well as rural areas (AOR 1.809, CI 1.421-2.303). While looking at regional variation, women from urban Sindh (AOR 1.548, CI 1.142-2.099) and urban Balochistan (AOR 2.403, CI 1.504-3.839) had more never users as compared to other urban regions. Women in the rich wealth quintile were more never users and this was seen both in urban and rural localities (urban (AOR 1.106 CI .753-1.624); rural areas (AOR 1.162, CI .887-1.524)) even though these were not statistically significant. Women idealizing more children(> 4) are more never users as compared to those idealizing less children in both urban (AOR 1.854, CI 1.275-2.697) and rural areas (AOR 2.101, CI 1.514-2.916). Women who never lost a pregnancy were more inclined to be non-users in rural areas (AOR 1.394, CI 1.127-1.723) .Women familiar with only traditional or no method had more never users in rural areas (AOR 1.717, CI 1.127-1.723) but in urban areas it wasn’t significant. Women unaware of Lady Health Worker’s presence in their area were more never users especially in rural areas (AOR 1.276, CI 1.014-1.607). Women who did not visit any care provider were more never users (urban (AOR 11.738, CI 9.112-15.121) rural areas (AOR 7.832, CI 6.243-9.826)). Discussion/Conclusion: This study concluded that government, policy makers and private sector family planning programs should focus on the untapped pool of never users (younger women from underserved provinces, in higher wealth quintiles, who desire more children.). We need to make sure to cover catchment areas where there are less LHWs and less providers as ignorance to modern methods and never been visited by an LHW are important determinants of never use. This all is in sync with previous literate from similar developing countries.

Keywords: contraception, demographic and health survey, family planning, never users

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Authors: Gabriella Notarianni Burk

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The present study investigates the Aspect Hypothesis (AH) in Italian child language in the production of frog story narratives from the CHILDES database. The AH is based on the assumption that children initially encode aspectual and lexical distinctions rather than temporal relations. Children from a variety of first languages have been shown to mark past initially with achievements and accomplishments (telic predicates) and in later stages with states and activities (atelic predicates). Aspectual distinctions in Romance languages are obligatorily and overtly encoded in the inflectional morphology. In Italian the perfective viewpoint is realized by the passato prossimo, which expresses a temporal and aspectual meaning of pastness and perfectivity, whereas the imperfective viewpoint in the past tense is realized by the imperfetto. The aim of this study is to assess the role of lexical aspect in the acquisition of tense and aspect morphology and to understand if Italian children’s mapping of aspectual and temporal distinctions follows consistent developmental patterns across languages. The research methodology aligns with the cross-linguistic designs, tasks and coding procedures previously developed in the frog story literature. Results from two-factor ANOVA show that Italian children (age range: 4-6) exhibited a statistically significant distinction between foregrounded perfective and backgrounded imperfective marking. However, a closer examination of the sixty narratives reveals an idiosyncratic production pattern for Italian children, whereby the marking of imperfetto deviates from the tenets of AH and emerges as deictic tense to entail completed and bounded events in foreground clauses. Instances of ‘perfective’ uses of imperfetto were predominantly found in the four-year old narratives (25%). Furthermore, the analysis of the perfective marking suggests that morphological articulation and diatopic variation may influence the child production of formal linguistic devices in discourse.

Keywords: actionality, aspect, grounding, temporal reference

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Authors: Hsin-Yi Lo, Chia-Yu Hsu

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This article is the nursing experience of a multiple trauma case using Swanson's theory of caring, the nursing period is from May 31 to June 4, 2021, collect data through observation, written talks, interviews, listening, direct care and physical assessment, established cases with health problems such as acute pain, impaired tissue integrity, and anxiety. Nursing process including, evaluate the pain index with the pain assessment scale, assist in acupoint massage, use a corset to fix the wound, and give the patient listening to favorite radio programs to divert attention and relieve pain problems; promote wound healing and avoid infection by assessing wound condition and exudation, changing dressings with aseptic technique, and providing appropriate dressings; encourage patients to express their feelings, provide companionship, and assist in self-care and participation in treatment plans, to enable the case to overcome the anxiety caused by being admitted to the intensive care unit for the first time and not knowing about the disease, and assist the case to overcome the injury caused by the accident and return to normal life. There is no video equipment in the intensive care unit during the nursing period. In response to the problem that family visits cannot be opened during the epidemic, it is a limitation this time. It is recommended that the hospital take this into consideration in the future. In the post-epidemic era, it can reduce the risk of various infections for patients and family members. Traveling between home and hospital, improving the quality of high-quality and technological care.

Keywords: swanson's theory of caring, multiple trauma, anxiety, nursing experience

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Authors: Efleda Preclaro Tolentino

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Research indicates that an educator’s belief system is reflected in the way they structure the learning environment. Their values and belief system have the potential to positively impact school readiness through an understanding of children’s development and the creation of a stable, motivating environment. Based on the premise that the social environment influences the development of social skills, knowledge construct, and shared values of young children, this study examined verbal and nonverbal exchanges between early childhood teachers and their preschool students within the context of remote learning. Using the qualitative method of data collection, the study determined the nature of interactions between preschoolers and their teachers within a remote learning environment at a preschool in Southeast Asia that utilized the Mother Tongue-based Multilingual Education (MTBMLE) Approach. From the lens of sociocultural theory, the study investigated preschoolers’ use of literacies to convey meaning and to interact within a remote learning environment. Using a Strengths Perspective, the study revealed the creativity and resourcefulness of preschoolers in expressing themselves through trans-literacies that were made possible by the use of online mode of learning within cultural and subcultural norms. The study likewise examined how social skills acquired by young children were transmitted (verbally or nonverbally) in their interactions with peers during Zoom meetings. By examining the dynamics of social exchanges between teachers and children, the findings of the study underscore the importance of providing support for preschool students as they apply acquired values and shared practices within a remote learning environment. The potential of distance learning in the early years will be explored, specifically in supporting young children’s language and literacy development. At the same time, the study examines the role of teachers as cultivators of trans-literacies. The teachers’ skillful use of technology in facilitating young children’s learning, as well as in supporting interactions with families, will be examined. The findings of this study will explore the potential of distance learning in early childhood education to establish continuity in learning, supporting young children’s social and emotional transitions, and nurturing trans-literacies that transcend prevailing definitions of learning contexts. The implications of teachers and parents working collaboratively to support student learning will be examined. The importance of preparing teachers to be resourceful, adaptable, and innovative to ensure that learning takes place across a variety of modes and settings will be discussed.

Keywords: transliteracy, preschoolers, remote learning, strengths perspective

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Authors: Emily Saurman, David Lyle

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In Australia, a well serviced rural town might have a psychiatrist visit once-a-month with more frequent visits from a psychiatric nurse, but many have no resident access to mental health specialists. Access to specialist care, would not only reduce patient distress and benefit outcomes, but facilitate the effective use of limited resources. The Mental Health Emergency Care-Rural Access Program (MHEC-RAP) was developed to improve access to specialist emergency mental health care in rural and remote communities using telehealth technologies. However, there has been no current benchmark to gauge program efficiency or capacity; to determine whether the program activity is justifiably sufficient. The evaluation of MHEC-RAP used multiple methods and applied a modified theory of access to assess the program and its aim of improved access to emergency mental health care. This was the first evaluation of a telepsychiatry service to include a time and motion study design examining program time expenditure, efficiency, and capacity. The time and motion study analysis was combined with an observational study of the program structure and function to assess the balance between program responsiveness and efficiency. Previous program studies have demonstrated that MHEC-RAP has improved access and is used and effective. The findings from the time and motion study suggest that MHEC-RAP has the capacity to manage increased activity within the current model structure without loss to responsiveness or efficiency in the provision of care. Enhancing program responsiveness and efficiency will also support a claim of the program’s value for money. MHEC-RAP is a practical telehealth solution for improving access to specialist emergency mental health care. The findings from this evaluation have already attracted the attention of other regions in Australia interested in implementing emergency telepsychiatry programs and are now informing the progressive establishment of mental health resource centres in rural New South Wales. Like MHEC-RAP, these centres will provide rapid, safe, and contextually relevant assessments and advice to support local health professionals to manage mental health emergencies in the smaller rural emergency departments. Sharing the application of this methodology and research activity may help to improve access to and future evaluations of telehealth and telepsychiatry services for others around the globe.

Keywords: access, emergency, mental health, rural, time and motion

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Authors: S. Mantzoukis, M. Gerasimou, P. Christodoulou, N. Varsamis, G. Kolliopoulou, N. Zotos

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Purpose: Patients in Intensive Care Units (ICU) are exposed to a different spectrum of microorganisms relative to the hospital. Due to the fact that the majority of these patients are intubated, bronchial secretions should be examined. Material and Method: Bronchial secretions should be taken with care so as not to be mixed with sputum or saliva. The bronchial secretions are placed in a sterile container and then inoculated into blood, Mac Conkey No2, Chocolate, Mueller Hinton, Chapman and Saboureaud agar. After this period, if any number of microbial colonies are detected, gram staining is performed and then the isolated organisms are identified by biochemical techniques in the automated Microscan system (Siemens) followed by a sensitivity test in the same system using the minimum inhibitory concentration MIC technique. The sensitivity test is verified by a Kirby Bauer test. Results: In 2017 the Laboratory of Microbiology received 365 samples of bronchial secretions from the Intensive Care Unit. 237 were found positive. S. epidermidis was identified in 1 specimen, A. baumannii in 60, K. pneumoniae in 42, P. aeruginosa in 50, C. albicans in 40, P. mirabilis in 4, E. coli in 4, S. maltophilia in 6, S. marcescens in 6, S. aureus in 12, S. pneumoniae in 1, S. haemolyticus in 4, P. fluorescens in 1, E. aerogenes in 1, E. cloacae in 5. Conclusions: The majority of ICU patients appear to be a fertile ground for the development of infections. The nature of the findings suggests that a significant part of the bacteria found comes from the unit (nosocomial infection).

Keywords: bronchial secretions, cultures, infections, intensive care units

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Authors: Diane Ghanem, Whitney Kagabo, Rebecca Engels, Uma Srikumaran, Babar Shafiq

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Hospitalist co-management of orthopaedic surgery patients is a growing trend across the country. It was created as a collaborative effort to provide overarching care to patients with the goal of improving their postoperative care and decreasing in-hospital medical complications. The aim of this project is to provide a guide for implementing and optimizing a hospitalist co-management service in orthopaedic surgery. Key leaders from the hospitalist team, orthopaedic team and quality, safety and service team were identified. Multiple meetings were convened to discuss the comanagement service and determine the necessary building blocks behind an efficient and well-designed co-management framework. After meticulous deliberation, a consensus was reached on the final service agreement and a written guide was drafted. Fundamental features of the service include the identification of service stakeholders and leaders, frequent consensus meetings, a well-defined framework, with goals, program metrics and unified commands, and a regular satisfaction assessment to update and improve the program. Identified pearls for co-managing orthopaedic surgery patients are standardization, timing, adequate patient selection, and two-way feedback between hospitalists and orthopaedic surgeons to optimize the protocols. Developing a service agreement is a constant work in progress, with meetings, discussions, revisions, and multiple piloting attempts before implementation. It is a partnership created to provide hospitals with a streamlined admission process where at-risk patients are identified early, and patient care is optimized regardless of the number or nature of medical comorbidities. A wellestablished hospitalist co-management service can increase patient care quality and safety, as well as health care value.

Keywords: co-management, hospitalist co-management, implementation, orthopaedic surgery, quality improvement

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Authors: Fatima Ahdash

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Over the last 6-7 years, the UK has resorted to using the family courts and the family justice system more generally as a way of dealing with children and young people either traveling to or returning from ISIS territories in the Middle East. This is an important innovation in counter-terrorism laws and practices in the UK: never before have the family courts been used for the purpose of preventing and countering terrorism anywhere in the world. This paper will examine this innovation; it will explore how, why, and the implications of the interaction between family law and counter-terrorism, particularly on the human rights of the parents and children involved. It will question whether the use of the family courts provides a more useful, and perhaps human rights compliant, method of tackling terrorism and extremism when compared to other more Draconian legal and administrative methods.

Keywords: counter-terrorism, family justice, law, human rights

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Authors: Beatrice Tayo Ajayi, Dzever Linus Terry

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Pupils with autism in the general classroom have dare need to be adequately catered for in social and academic activities for successful attainment in school work and future life. However, adequate catering for autistic children by teachers that basically received no training in content related to inclusive education and lack the ability to use inclusive strategies during classroom instruction appears to be a mirage. This paper intends to examine the current classroom environment in relation to the level to which autistic primary school pupils are catered for in the regular classroom. The study also seeks to identify the challenges teachers experience in the course of catering to the needs of children with autism and the way out. The sample consists of thirty (30) primary school teachers of Ondo West Local Government Area, Ondo State, Nigeria (10 male, 15 female), age grades between twenty five (25) to sixty (60). Data collection will be a survey using the researcher developed 18 statements Four Point- Likert Scale type to assess the level to which participants agree or disagree with the statement about catering for pupils with autism. Results are to be evaluated using descriptive statistical methods of mean scores and t-test.

Keywords: autism, catering, general classroom, way forward

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