Search results for: team outcomes

Authors: Malab Sana Balouch, Meenakshi Nayar

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Hemispatial Neglect is a common disorder primarily associated with right hemispheric stroke, in the acute phase of which it can occur up to 82% of the time. Such individuals fail to acknowledge or respond to people and objects in their left field of vision due to deficits in attention and awareness. Persistent hemispatial neglect significantly impedes post-stroke recovery, leading to longer hospital stays post-stroke, increased functional dependency, longer-term disability in ADLs and increased risk of falls. Recently, evidence has emerged for the use of dopamine agonist Rotigotine in neglect. The aim of our Quality Improvement Project (QIP) is to evaluate and better the current protocols and practice in assessment, documentation and management of neglect and rotigotine use at the Neurorehabilitation unit at Charing Cross Hospital (CNRU). In addition, it brings light to rotigotine use in the management of hemispatial neglect and paves the way for future research in the field. Our QIP was based in the CNRU. All patients admitted to the CNRU suffering from a right-sided stroke from 2nd of February 2018 to the 2nd of February 2021 were included in the project. Each patient’s multidisciplinary team report and hospital notes were searched for information, including bio-data, fulfilment of the inclusion criteria (having hemispatial neglect) and data related to rotigotine use. This includes whether or not the drug was administered, any contraindications to drug in patients that did not receive it, and any therapeutic benefits(subjective or objective improvement in neglect) in those that did receive the rotigotine. Data was simultaneously entered into excel sheet and further statistical analysis was done on SPSS 20.0. Out of 80 patients suffering from right sided strokes, 72.5% were infarcts and 27.5% were hemorrhagic strokes, with vast majority of both types of strokes were in the middle cerebral artery territory (MCA). A total of 31 (38.8%) of our patients were noted to have hemispatial neglect, with the highest number of cases being associated with MCA strokes. Almost half of our patients with MCA strokes suffered from neglect. Neglect was more common in male patients. Out of the 31 patients suffering from visuospatial neglect, only 16% actually received rotigotine and 80% of them were noted to have an objective improvement in their neglect tests and 20% revealed subjective improvement. After thoroughly going through neglect-associated documentation, the following recommendations/plans were put in place for the future. We plan to liaise with the occupational therapy team at our rehab unit to set a battery of tests that would be done on all patients presenting with neglect and recommend clear documentation of outcomes of each neglect screen under it. Also to create two proformas; one for the therapy team to aid in systematic documentation of neglect screens done prior to and after rotigotine administration and a second proforma for the medical team with clear documentation of rotigotine use, its benefits and any contraindications if not administered.

Keywords: hemispatial Neglect, right hemispheric stroke, rotigotine, neglect, dopamine agonist

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Authors: Twarakavi Venkata Suresh Kumar, Sailaja Kumar, B. Eswara Reddy

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In a world of tremendous technical developments, effective and efficient higher education has always been a major challenge. The rising number of educational institutions have made it mandatory for healthy competitions among the institutions. To evaluate the qualitative competence of these educations institutions in engineering and technology and related disciplines, an efficient assessment technique in internal and external quality has to be followed. To achieve this, the curriculum is to be developed into courses, and each course has to be presented in the form teaching lesson plan consisting of topics and session outcome known as Course Outcomes (COs), that easily map into different Programme Outcomes (POs). The major objective of these methodologies is to provide quality technical education to its students. Detailed clear weightage in CO-PO mapping helps in proper measurable COs and to devise the POs attainment is an important issue. This ensures in assisting the achievement of the POs with proper weightage to POs, and also improves the successive curriculum development. In this paper, we presented a methodology for mapping CO and PO considering the key elements supported by each PO. This approach is useful in evaluating the attainment of POs which is based on the attainment of COs using the existing data from students' marks taken from various test items. Such direct assessment tools are used to measure the degree to which each student has achieved each course learning outcome by the completion of the course. Hence, these results are also useful in measuring the PO attainment for improving the programme vision and mission.

Keywords: attainment, course outcomes, programme outcomes, educational institutions

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Authors: Michael Airton

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This case study examines the development of a new service delivery model for prisons that focuses on using NGO’s to provide more effective case management and post release support functions. The model includes the co-design of the service delivery model and innovative commercial agreements that encourage embedded service providers within the prison and continuity of services post release with outcomes based payment mechanisms. The collaboration of prison staff, probation and parole officers and NGO’s is critical to the success of the model and its ability to deliver value and positive outcomes in relation to desistance from offending.

Keywords: collaborative service delivery, desistance, non-government organisations, post release support services

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Authors: Fasil Wagnew, Kerri Viney, Kefyalew Addis Alene, Matthew Kelly, Darren Gray

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Background: Undernutrition is a risk factor for tuberculosis (TB), including poor treatment outcomes. However, evidence regarding the effect of undernutrition on TB treatment outcomes is not well understood. We aimed to evaluate the effect of undernutrition on sputum culture conversion and treatment outcomes among people with multi-drug resistance (MDR)-TB. Methods: We searched for publications in the Medline, Embase, Scopus, and Web of Science databases without restrictions on geography or year of publication. We conducted a random-effect meta-analysis to estimate the effects of undernutrition on sputum culture conversion and treatment outcomes. Two reviewers independently assessed the study eligibility, extracted the necessary information, and assessed the risk of bias. Depending on the nature of the data, odds ratio (OR) and hazard ratio (HR) with 95% confidence intervals (CIs) were used to summarize the effect estimates. Potential publication bias was checked using funnel plots and Egger’s tests. Results: Of 2358 records screened, 59 studies comprising a total of 31,254 people with MDR-TB were included. Undernutrition was significantly associated with a lower sputum culture conversion rate (HR 0·7, 95% CI 0·6–0·9, I2=67·1%) and a higher rate of mortality (OR 2·9, 95%CI 2·1–3·8, I2=23·7%) and unfavourable treatment outcomes (OR 1·8, 95%CI 1·5–2·0, I2=72·7%). There was no statistically significant publication bias in the included studies. Three studies were low, forty-two studies were moderate, and fourteen studies were high quality. Interpretations: Undernutrition was significantly associated with unfavourable treatment outcomes, including mortality and lower sputum culture conversion among people with MDR-TB. These findings have implications for supporting targeted nutritional interventions alongside standardised second-line TB drugs.

Keywords: undernutrition, MDR-TB, sputum culture conversion, treatment outcomes, meta-analysis

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Authors: Md. Shakhawat Ullah Chowdhury

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Mobile school is an innovative methodology in non-formal education to increase access to education for children during conflict through theatre for education for appropriate basic education to children during conflict. The continuous exposure to harsh environments and the nature of the lifestyles of children in conflict make them vulnerable. However, the mobile school initiative takes into consideration the mobile lifestyle of children in conflict. Schools are provided considering the pocket area of the street children with portable chalkboards, tin of books and materials as communities move. Teaching is multi-grade to ensure all children in the community benefit. The established mobile schools, while focused on basic literacy and numeracy skills according to traditions of the communities. The school teachers are selected by the community and trained by a theatre activist. These teachers continue to live and move with the community and provide continuous education for children in conflict. The model proposed a holistic team work to deliver education focused services to the street children’s pocket area where the team is mobile. The team consists of three members –an educator (theatre worker), a psychological counsellor and paramedics. The mobile team is responsible to educate street children and also play dramas which specially produce on the basis of national curriculum and awareness issues for street children. Children enjoy play and learn about life skills and basic literacy and numeracy skills which may be a pillar of humanitarian aid during conflict.

Keywords: vulnerable, children in conflict, mobile schooling, child-friendly

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Authors: Tamer Mesallam, Medhat Yousef, Ayna Almasaad

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BACKGROUND: Cochlear implantation (CI) in children with additional disabilities can be a fundamental and supportive intervention. Although, there may be some positive impacts of CI on children with multiple disabilities such as better outcomes of communication skills, development, and quality of life, the families of those children complain from the post-implant habilitation efforts that considered as a burden. OBJECTIVE: To investigate the outcomes of CI children with different co-disabilities through using the Meaningful Auditory Integration Scale (MAIS) and the Meaningful Use of Speech Scale (MUSS) as outcome measurement tools. METHODS: The study sample comprised 25 hearing-impaired children with co-disability who received cochlear implantation. Age and gender-matched control group of 25 cochlear-implanted children without any other disability has been also included. The participants' auditory skills and speech outcomes were assessed using MAIS and MUSS tests. RESULTS: There was a statistically significant difference in the different outcomes measure between the two groups. However, the outcomes of some multiple disabilities subgroups were comparable to the control group. Around 40% of the participants with co-disabilities experienced advancement in their methods of communication from behavior to oral mode. CONCLUSION: Cochlear-implanted children with multiple disabilities showed variable degrees of auditory and speech outcomes. The degree of benefits depends on the type of the co-disability. Long-term follow-up is recommended for those children.

Keywords: children with disabilities, Cochlear implants, hearing impairment, language development

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Authors: Tahir Khaleeq, Patrick Lancaster, Keji Fakoya, Pedro Ferreira, Usman Ahmed

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Introduction: Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety. Materials and Methods: A protocol was developed by the clinical team in collaboration with Advanced Physiotherapy Practitioners (APP) on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories; discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes. Results: In total 2489 patients were referred to VFC from internal and external sources. 734 patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. 87 patients were triaged into subspecialty clinics. 37 patients were felt to have been referred inappropriately. Discussion: BOA guidelines suggest all patients need to be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review, the remaining patients were appropriately followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient as well as make the most of the resources available.

Keywords: virtual fracture clinic, lockdown, trauma and orthopaedics, Covid- 19

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Authors: Mehdi Rezai, Asghar Zamani

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Virtual teams are a reality in today’s fast-paced world. With the possibility of commonly using common resources, an increase of inter-organizational projects, cooperation, outsourcing, and the increase in the number of people who work remotely or flexitime, an extensive and active presence of high-performance teams is a must. Virtual teams are a challenge by themselves. Their members remove the barriers of cultures, time regions and organizations, and they often communicate through electronic devices over considerable distances. Firstly, we examine the management of virtual teams by considering different issues such as cultural and personal diversities, communications and arrangement issues. Then we will examine individuals, processes and the existing tools in a team. The main challenge is managing high-performance virtual teams. First of all, we must examine the concept of performance. Then, we must focus on teams and the best methods of managing them. Constant improvement of performance, together with precisely regulating every individual’s method of working, increases the levels of performance in the course of time. High-performance teams exploit every issue as an opportunity for achieving high performance. And we know that doing projects with high performance is among every organization or team’s objectives. Performance could be measured using many criteria, among which carrying out projects in time, the satisfaction of stakeholders, and not exceeding budgets could be named. Elements such as clear objectives, clearly-defined roles and responsibilities, effective communications, and commitment to collaboration are essential to a team’s effectiveness. Finally, we will examine roles, systems, processes and will carry out a cause-and-effect analysis of different criteria in improving a team’s performance.

Keywords: virtual teams, performance, management, process, improvement, effectiveness

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Authors: Ali Muhammad

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The purpose of this study is to develop and test a theoretical framework which demonstrates the effect of procedural justice on four work outcomes: effective organizational commitmentو organizational trust, organizational citizenship behaviour, and adherence to rules. The new model attempts to explain how procedural justice effects work outcomes. Data were collected from 267 employees working in nine Kuwaiti business organizations. Structural equation modelling was used to analysis the data. A discussion of issues related to procedural justice is presented, as well as recommendations for future research.

Keywords: procedural justice, affective organizational commitment, organizational citizenship behaviour, organizational trust, adherence to rules

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Authors: Shiao-Wei Chu

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In order to enhance the ability of their graduates to compete in an increasingly globalized economy, the majority of universities in Taiwan require students to pass Freshman English in order to earn a bachelor's degree. However, many college students show low motivation in English class for several important reasons, including exam-oriented lessons, unengaging classroom activities, a lack of opportunities to use English in authentic contexts, and low levels of confidence in using English. Students’ lack of motivation in English classes is evidenced when students doze off, work on assignments from other classes, or use their phones to chat with others, play video games or watch online shows. Cooperative learning aims to address these problems by encouraging language learners to use the target language to share individual experiences, cooperatively complete tasks, and to build a supportive classroom learning community whereby students take responsibility for one another’s learning. This study includes approximately 50 student participants in a low-proficiency Freshman English class. Each week, participants will work together in groups of between 3 and 4 students to complete various in-class interactive tasks. The instructor will employ a reward system that incentivizes students to be responsible for their own as well as their group mates’ learning. The rewards will be based on points that team members earn through formal assessment scores as well as assessment of their participation in weekly in-class discussions. The instructor will record each team’s week-by-week improvement. Once a team meets or exceeds its own earlier performance, the team’s members will each receive a reward from the instructor. This cooperative learning approach aims to stimulate EFL freshmen’s learning motivation by creating a supportive, low-pressure learning environment that is meant to build learners’ self-confidence. Students will practice all four language skills; however, the present study focuses primarily on the learners’ reading comprehension. Data sources include in-class discussion notes, instructor field notes, one-on-one interviews, students’ midterm and final written reflections, and reading scores. Triangulation is used to determine themes and concerns, and an instructor-colleague analyzes the qualitative data to build interrater reliability. Findings are presented through the researcher’s detailed description. The instructor-researcher has developed this approach in the classroom over several terms, and its apparent success at motivating students inspires this research. The aims of this study are twofold: first, to examine the possible benefits of this cooperative approach in terms of students’ learning outcomes; and second, to help other educators to adapt a more cooperative approach to their classrooms.

Keywords: freshman English, cooperative language learning, EFL learners, learning motivation, zone of proximal development

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Authors: J. Congalton, K. Logan, B. Crump

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Software is a critical aspect of modern life. However it is costly to develop and industry initiatives have focused on reducing costs and improving the productivity. Increasing, software is being developed in teams, and with greater globalization and migration, the teams are becoming more ethnically diverse. This study investigated whether diversity in terms of ethnicity impacted on the productivity of software development. Project managers of software development teams were interviewed. The study found that while some issues did exist due to language problems, when project managers created an environment of trust and friendliness, diversity made a positive contribution to productivity.

Keywords: diversity, project management, software development, team work

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Authors: Ravshan A. Ibadov, Sardor Kh. Ibragimov

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Objective. The aim of the study was to optimize the protocol of cardiopulmonary resuscitation (CPR) after cardiovascular surgical interventions. Methods. The experience of CPR conducted on patients after cardiovascular surgical interventions in the Department of Intensive Care and Resuscitation (DIR) of the Republican Specialized Scientific-Practical Medical Center of Surgery named after Academician V. Vakhidov is presented. The key to the new approach is the rapid elimination of reversible causes of cardiac arrest, followed by either defibrillation or electrical cardioversion (depending on the situation) before external heart compression, which may damage sternotomy. Careful use of adrenaline is emphasized due to the potential recurrence of hypertension, and timely resternotomy (within 5 minutes) is performed to ensure optimal cerebral perfusion through direct massage. Out of 32 patients, cardiac arrest in the form of asystole was observed in 16 (50%), with hypoxemia as the cause, while the remaining 16 (50%) experienced ventricular fibrillation caused by arrhythmogenic reactions. The age of the patients ranged from 6 to 60 years. All patients were evaluated before the operation using the ASA and EuroSCORE scales, falling into the moderate-risk group (3-5 points). CPR was conducted for cardiac activity restoration according to the American Heart Association and European Resuscitation Council guidelines (Ley SJ. Standards for Resuscitation After Cardiac Surgery. Critical Care Nurse. 2015;35(2):30-38). The duration of CPR ranged from 8 to 50 minutes. The ARASNE II scale was used to assess the severity of patients' conditions after CPR, and the Glasgow Coma Scale was employed to evaluate patients' consciousness after the restoration of cardiac activity and sedation withdrawal. Results. In all patients, immediate chest compressions of the necessary depth (4-5 cm) at a frequency of 100-120 compressions per minute were initiated upon detection of cardiac arrest. Regardless of the type of cardiac arrest, defibrillation with a manual defibrillator was performed 3-5 minutes later, and adrenaline was administered in doses ranging from 100 to 300 mcg. Persistent ventricular fibrillation was also treated with antiarrhythmic therapy (amiodarone, lidocaine). If necessary, infusion of inotropes and vasopressors was used, and for the prevention of brain edema and the restoration of adequate neurostatus within 1-3 days, sedation, a magnesium-lidocaine mixture, mechanical intranasal cooling of the brain stem, and neuroprotective drugs were employed. A coordinated effort by the resuscitation team and proper role allocation within the team were essential for effective cardiopulmonary resuscitation (CPR). All these measures contributed to the improvement of CPR outcomes. Conclusion. Successful CPR following cardiac surgical interventions involves interdisciplinary collaboration. The application of an optimized CPR standard leads to a reduction in mortality rates and favorable neurological outcomes.

Keywords: cardiac surgery, cardiac arrest, resuscitation, critically ill patients

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Authors: Elucir Gir, Laelson Rochelle Milanês Sousa, Renata Karina Reis, Soraia Assad Nasbine Rabeh, Mayra Gonçalves Menegueti, Ana Cristina de Oliveira e Silva, Sheila Araújo Teles

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Context and significance: Nursing team professionals faced challenges in combating the COVID-19 pandemic around the world. They were subjected to exhausting workloads and prolonged use of Personal Protective Equipment. Using N95 masks for long periods of time can cause skin changes. In this context, health professionals who worked on the front lines of fighting the pandemic were more exposed to possible physical and psychological changes. Objective: The aim of the study was to analyze the factors associated with skin lesions resulting from the use of N95 masks among nursing team professionals. Method: The study was carried out in all regions of Brazil from October to December 2020, with professionals from the nursing team who worked in health care during the COVID-19 pandemic. Participants were recruited via social media, and information was collected electronically and stored on the Survey Monkey platform. Descriptive statistics were used to characterize the sample, association tests (Chi-square), with a statistical significance level of p < 0.05. Factors associated with skin lesions resulting from the use of an N95 mask were determined by Binary Logistic Regression, with a significance level of 5% (α = 0.05). Results: 8,405 nursing professionals participated in the study, 5,492 nurses (65.3%), 2,747 nursing technicians (32.7%), and 7,084 females (84.3%). Female nursing team professionals were 1.4 times more likely to develop skin lesions due to the use of N95 masks when compared to males (OR 1.4 [CI95% 1.22 – 1.59] p < 0.001). The following protective factors were identified: nursing technician (ORA 0.608 [CI95% 0.43 – 0.86] p = 0.005) and not having provided assistance in field hospitals for COVID-19 (0.73 [CI95% 0.65-0.81] p<0.000). Conclusion: It was concluded that female nursing team professionals were more likely to have skin changes related to the use of N95 masks. The need for intervention studies is emphasized in order to explore measures to prevent these types of injuries. Descritores: Nursing professionals; COVID-19; SARS-CoV-2; Brazil.

Keywords: nursing professionals, COVID-19, SARS-CoV-2, Brazil

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Authors: Sean Roy, Mercedes Miller

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A study was conducted to assess the positive outcomes related to Filipino human trafficking survivors working at a social enterprise. As most existing research on human survivors pertains to the adverse outcomes of victims, the researchers were seeking to fill the dearth of existing data related to positive outcomes. A quantitative study was conducted using a convenience sample of 41 participants within three staggered cohorts of the social enterprise. A Kruskal-Wallis H test was conducted and indicated that participants in the third cohort (who were employed at the social enterprise the longest) had significantly lower anxiety scores than participants in other cohorts. This study indicates that social enterprises hold the promise of positively impacting anxiety of human trafficking survivors and provides a starting point for researchers looking to assess ways to positively influence the lives of survivors.

Keywords: human trafficking, Philippines, quantitative analysis, self-identity

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Authors: Khatija Bahdur, Duane Dell’Oca

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There is limited information on how altitude impacts performance in a team sport. Most altitude research in football has been conducted at high elevation ( > 2500m), resulting in a chasm of understanding whether low to moderate altitude affects performance. The South African Premier Soccer League (PSL) fixtures entail matches played at altitudes from sea level to 1700m above mean sea level. Despite coaches highlighting the effect of altitude on performance outcomes in matches, further research is needed to establish whether altitude does impact match results. Greater insight into if and how altitude impacts performance in the PSL will assist coaches in deciding if and how to incorporate altitude in their planning. The purpose of this study is to fill in this gap through the use of a retrospective analysis of PSL matches. This quantitative study is based on a descriptive analysis of 181 PSL matches involving one team based at sea-level, taking place over a period of thirteen seasons. The following data were obtained: altitude at which the match was played, match result, the timing of goals, and timing of substitutions. The altitude was classified in 2 ways: inland ( > 500m) and coastal ( < 500m) and also further subdivided into narrower categories ( < 500m, 500-1000m, 1000-1300m; 1300-1500m, > 1500m). The analysis included a 2-sample t-test to determine differences in total goals scored and timing of goals for inland and coastal matches and the chi-square test to identify the significance of altitude on match results. The level of significance was set at the alpha level of 0.05. Match results are significantly affected by the altitude and level of altitude within inland teams most likely to win when playing at inland venues (p=0.000). The proportion of draws was slightly higher at the coast. At altitudes between 500-1000m, 1300-1500m, and 1500-1700m, a greater percentage of matches were won by coastal teams as opposed to draws. The timing of goals varied based on the team’s base altitude and the match elevation. The most significant differences were between 36-40 minutes (p=0.023), 41-45 minutes (p=0.000) and 50-65 minutes (p=0.000). When breaking down inland team’s matches to different altitude categories, greater differences were highlighted. Inland teams scored more goals per minute between 10-20 minute (p=0.009), 41-45 minutes (p=0.003) and 50-65 minutes (p=0.015). The total number of goals scored per match at different altitudes by a) inland teams (p=0.000), b) coastal teams (p=0.006). Coastal teams made significantly more substitutions when playing at altitude (p=0.034), although there were no significant differences when comparing the different altitude categories. The timing of all three changes, however, did vary significantly at the different altitudes. There were no significant differences in timing or number of substitutions for inland teams. Match results and timing of goals are influenced by altitude, with differences between the level of altitude also playing a role. The trends indicate that inland teams win more matches when playing at altitude against coastal teams, and they score more goals just prior to half-time and in the first quarter of the second half.

Keywords: coastal teams, inland teams, timing of goals, results, substitutions

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Authors: Raheel Shakoor Siddiqui, Sanjay Narayana Murthy, Manikandar Srinivas Cheruvu, Kash Akhtar

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Major trauma is a dynamic public health epidemic that is continuously evolving. Major trauma care services rely on multi-disciplinary team input involving highly trained pre and in-hospital critical care teams. Pre-hospital critical care teams (PHCCTs), major trauma centres (MTCs), trauma units, and rehabilitation facilities all form an efficient and organised trauma system. England comprises 27 MTCs funded by the National Health Service (NHS). Major trauma care entails enhanced resuscitation protocols coupled with the expertise of dedicated trauma teams and rapid radiological imaging to improve trauma outcomes. Literature reports a change in the demographic of major trauma as elderly patients (silver trauma) with injuries sustained from a fall of 2 metres or less commonly present to services. Evidence of an increasing population age with multiple comorbidities necessitates treatment within the first hour of injury (golden hour) to improve trauma survival outcomes. Staffing and funding pressures within the NHS have subsequently led to a shortfall of available physician-led PHCCTs. Thus, there is a strong emphasis on targeted research and funding to appropriately deploy resources to deprived areas. This review article will discuss the current English trauma system whilst critically appraising present challenges, identifying insufficiencies, and recommending aims for an improved future trauma system in England.

Keywords: trauma, orthopaedics, major trauma, trauma system, trauma network

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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: Olga Maksakova

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A work with unconscious patients after acute brain damages besides special knowledge and practical skills of all the participants requires a very specific organization. A lot of said about team approach in neurorehabilitation, usually as for outpatient mode. Rehabilitologists deal with fixed patient problems or deficits (motion, speech, cognitive or emotional disorder). Team-building means superficial paradigm of management psychology. Linear mode of teamwork fits casual relationships there. Cases with deep altered states of consciousness (vegetative states, coma, and confusion) require non-linear mode of teamwork: recovery of consciousness might not be the goal due to phenomenon uncertainty. Rehabilitation team as Semi-open Complex System includes the patient as a part. Patient's response pattern becomes formed not only with brain deficits but questions-stimuli, context, and inquiring person. Teamwork is sourcing of phenomenology knowledge of patient's processes as Third-person approach is replaced with Second- and after First-person approaches. Here is a chance for real-time change. Patient’s contacts with his own body and outward things create a basement for restoration of consciousness. The most important condition is systematic feedbacks to any minimal movement or vegetative signal of the patient. Up to now, recovery work with the most severe contingent is carried out in the mode of passive physical interventions, while an effective rehabilitation team should include specially trained psychologists and psychotherapists. It is they who are able to create a network of feedbacks with the patient and inter-professional ones building up the team. Characteristics of ‘Team-Patient’ system (TPS) are energy, entropy, and complexity. Impairment of consciousness as the absence of linear contact appears together with a loss of essential functions (low energy), vegetative-visceral fits (excessive energy and low order), motor agitation (excessive energy and excessive order), etc. Techniques of teamwork are different in these cases for resulting optimization of the system condition. Directed regulation of the system complexity is one of the recovery tools. Different signs of awareness appear as a result of system self-organization. Joint meetings are an important part of teamwork. Regular or event-related discussions form the language of inter-professional communication, as well as the patient's shared mental model. Analysis of complex communication process in TPS may be useful for creation of the general theory of consciousness.

Keywords: rehabilitation team, urgent rehabilitation, severe brain damage, consciousness disorders, complex system theory

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Authors: Farah Syazwani Hilmy Zaki

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Background: Compared to adult cardiopulmonary resuscitation (CPR), high-quality research and evidence on pediatric CPR remain relatively scarce. This knowledge gap hinders the development of optimal guidelines and best practices for resuscitating children. Objectives: To explore pediatric intensive care unit (PICU) CPR current practices in PICU of Institut Jantung Negara (IJN) Malaysia. Method: The research employed a qualitative approach, utilising case study research design. The data collection process involved in-depth interviews and reviewing the Resuscitation Feedback Form. Purposive sampling was used to select two cases consisting of 14 participants. The study participants comprised a cardiologist, one anaesthetist, and twelve nurses. The data collected were transcribed and entered into NVivo software to facilitate theme development. Subsequently, thematic analysis was conducted to analyse the data. Findings: The study yielded key findings regarding the enhancement of PICU CPR practices. These findings are categorised into four themes, namely routine procedures, resuscitation techniques, team dynamics, and individual contributions. Establishment of cohesive team is crucial in facilitating the effectiveness of resuscitation. According to participants, lack of confidence, skills and knowledge presents significant obstacles to effective PICU CPR. Conclusion: The findings of this study indicate that the participants express satisfaction with the current practices of PICU CPR. However, the research also highlights the need for enhancements in various areas, including routine procedures, resuscitation techniques, as well as team and individual factors. Furthermore, it was suggested that additional training be conducted on the resuscitation process to enhance the preparedness of the medical team.

Keywords: cardiopulmonary resuscitation, feedback, nurses, pediatric intensive care unit

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Authors: Juntip Kanjanasilp, Ratree Sawangjit, Kanokporn Meelap, Kwanchanok Kruthakool

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Depression is a common mental health disorder. Antidepressants are effective pharmacological treatments, but most patients have low medication adherence. This study aims to systematic review and meta-analysis what method increase the antidepressants adherence efficiently and improve clinical outcome. Systematic review of articles of randomized controlled trials obtained by a computerized literature search of The Cochrane, Library, Pubmed, Embase, PsycINFO, CINAHL, Education search, Web of Science and ThaiLIS (28 December 2017). Twenty-three studies were included and assessed the quality of research by ROB 2.0. The results reported that printing media improved in number of people who had medication adherence statistical significantly (p= 0.018), but education, phone call, and program utilization were no different (p=0.172, p=0.127, p=0.659). There was no significant difference in pharmacist’s group, health care team’s group and physician’s group (p=0.329, p=0.070, p=0.040). Times of intervention at 1 month and 6 months improved medication adherence significantly (p= 0.0001, p=0.013). There was significantly improved adherence in single intervention (p=0.027) but no different in multiple interventions (p=0.154). When we analyzed medication adherence with the mean score, no improved adherence was found, not relevant with who gives the intervention and times to intervention. However, the multiple interventions group was statistically significant improved medication adherence (p=0.040). Phone call and the physician’s group were statistically significant improved clinical outcomes in number of improved patients (0.025 and 0.020, respectively). But in the pharmacist’s group and physician’s group were not found difference in the mean score of clinical outcomes (p=0.993, p=0.120, respectively). Times to intervention and number of intervention were not significant difference than usual care. The overall intervention can increase antidepressant adherence, especially the printing media, and the appropriate timing of the intervention is at least 6 months. For effective treatment, the provider should have experience and expert in caring for patients with depressive disorders, such as a psychiatrist. Medical personnel should have knowledge in caring for these patients also.

Keywords: depression, medication adherence, clinical outcomes, systematic review, meta-analysis

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Authors: Sheila Santharamohana, Susan Bennett

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Historically, the attrition rates in secondary schools of Indigenous people or Orang Asli of Malaysia have been a cause for nationwide concern. Efforts to increase student engagement focusing on curriculum re-design and aid have not had the targeted impact. The scope of the research explored a change model incorporating project-based learning and wrap-around support through school-community partnerships to increase Orang Asli engagement, student outcomes and improve cultural connectedness. The evaluation methodology was mixed-method comprising a student questionnaire, interviews, and document analysis. Data and evidence were gathered from school staff, community, the Orang Asli governmental authority (JAKOA) and external agencies. Findings from the year-long research suggests shared values and goals in school-community partnerships foster responsive leadership and is key to safeguarding vulnerable Orang Asli, resulting in improved student outcomes. The research highlighted the barriers to the recognition and distinct needs and unique values of the Orang Asli that impact their educational equity and outcomes.

Keywords: Indigenous Education, Cultural Connectedness, School-Community Partnership, Student Outcomes

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Authors: M. Jafari Toosy, A. Zamani

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This article, considering the result of pandemics at the international level and all activities and projects performed virtually and the need for resource management and virtual teams in this period identifies the components of virtual management after searching the available resources. Exploration of virtual management in the pandemic era is explored in 10 international articles. The results of research with this method and according to the tasks and topics related to management knowledge and definition of virtual teams can be divided into topics such as planning, decision making, control, organization, leadership, attention to growth and capability, resources and facilities, Communication, creativity, innovation and security. In order to explain the nature of virtual management, a definition of virtual management was provided.

Keywords: management, virtual, virtual team management, pandemic, team

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Authors: Wafaa M. El- Kotb, Soheir Mohamed Weheida, Manal E. Fareed

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The aim of this study was to determine the effect of implementing a teaching module about diet and exercises on clinical outcomes of patients with gout. Subjects: A purposive sample of 60 adult gouty patients was selected and randomly and alternatively divided into two equal groups 30 patients in each. Setting: The study was conducted in orthopedic out patient's clinic of Menoufia University. Tools of the study: Three tools were utilized for data collection: Knowledge assessment structured interview questionnaire, Clinical manifestation assessment tools and Nutritional assessment sheet. Results: All patients of both groups (100 %) had poor total knowledge score pre teaching, while 90 % of the study group had good total knowledge score post teaching by three months compared to 3.3 % of the control group. Moreover the recovery outcomes were significantly improved among study group compared to control group post teaching. Conclusion: Teaching study group about diet and exercises significantly improved their clinical outcomes. Recommendation: Patient's education about diet and exercises should be ongoing process for patients with gout.

Keywords: clinical outcomes, diet, exercises, teaching module

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Authors: Nithra Kitreerawutiwong, Sunsanee Mekrungrongwong, Artitaya Wongwonsin, Chakkraphan Phetphoom, Buaploy Phromjang

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Background: Thailand has implemented a district health system based on the concept of primary health care. Since 2014, Family Care Team (FCT) was launched to improve the quality of care through a multidisciplinary team include not only the health sector but also social sector work together. FCT classified into 3 levels: district, sub-district, and community. This system now consists of 66,353 teams, including 3,890 teams at district level, 12,237 teams at the sub-district level, and 50,326 teams at the community level. There is a report regarding assessment the situation and perception on FCT, however, relatively few examined the operationality of this policy. This study aimed to explore the perception of district manager on the process of the implementation of FCT policy and the factors associating to implement FCT in the district health system. Methods/Results: Forty in-depth interviews were performed: 5 of primary care manager at the provincial medical health office, 5 of community hospital director, 5 of district administrative health office, 10 of sub-district health promoting hospital, and 10 of local organization. Semi-structure interview guidelines were used in the discussions. The data was analyzed by thematic analysis. This policy was formulated based on the demographic change and epidemiology transition to serve a long term care for elderly. Facilitator factors are social capital in district health systems such as family health leader and multidisciplinary team. Barrier factors are communication to the frontline provider and local organization. The output of this policy in relation to the structure of FCT is well-defined. Unanticipated effects include training of FCT in community level. Conclusion: Early feedback from healthcare manager is valuable information for the improvement of FCT to function optimally. Moreover, in the long term, health outcome need to be evaluated.

Keywords: family care team, district health system, primary care, qualitative study

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Authors: Mariam Shah

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Strict liability is frequently used in magistrate’s courts for TV license and driving offences.There is existing research suggesting that the strict liability approach to criminal offences can result in ‘absurd’ judicial outcomes, or potentially ‘injustice’.This paper will discuss the potential merits of strict liability as a method for dealing with shoplifting offences.Currently, there is disparity in sentencing outcomes in the UK, particularly in relation to shoplifting offences.This paper will question whether ‘injustice’ is actually in the differentiation of defendants based upon their ‘perceived’ circumstances, which could be resulting in arbitrary judicial decision making.

Keywords: arbitrary, decision making, judicial decision making, shoplifting, stereotypes, strict liability

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Authors: Jemini Vyas, Oluwatobi Adeyoe, Jenny Branagan, Chandran Tanabalan, John Beatty, Aakash Pai

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Introduction: The development of robotic surgery has accelerated centralisation to tertiary centres, where robotic radical prostatectomy (RP) is offered. The purpose of concentrating treatment in high volume specialist centres is to improve the quality of care and patient outcomes. The aim of this study was to assess the impact on clinical outcomes of centralisation for locally diagnosed patients undergoing RP. Methods: Clinical outcomes for 169 consecutive laparoscopic & open RP pre-centralisation were retrospectively compared with 50 consecutive robotic RP conducted over a similar period post-centralisation. Preoperative risk stratification and time to surgery were collected. Perioperative outcomes, including length of stay (LOS) and complications, were collated. Post-operative outcomes, including erectile dysfunction (ED), biochemical recurrence (BCR), and urinary continence, were assessed. Results: Preoperative risk stratification showed no difference between the two groups. The median time from diagnosis to treatment was similar between the two groups (pre-centralisation, 121 days, post-centralisation, 117 days). The mean length of stay (pre-centralisation, 2.1 days, post-centralisation, 1.6 days) showed no significant difference (p=0.073). Proportion of overall complications (pre-centralisation, 11.4%, post-centralisation, 8.7%) and complications, above Clavien-Dindo 2, were similar between the two groups (pre-centralisation1.2%, post-centralisation 2.2%). Post operative functional parameters, including continence and ED, were comparable. Five-year BCR free rate was 78% for the pre-centralisation group and 79% for the post centralisation group. Conclusion: For our cohort of patients, clinical outcomes have remained static during centralisation. It is imperative that centralisation is accompanied by increased capacity, streamlining of pathways, and training to ensure that improved quality of care is achieved. Our institution has newly acquired a robot, and prospectively studying this data may support the reversal of centralisation for RP surgery.

Keywords: prostate, cancer, prostatectomy, clinical

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Authors: S. Priya

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A project based learning assignment in English for Specific Purposes (ESP) context based on Communicative English as prescribed in the university syllabus for engineering students and its learning outcome from ESP context is the focus of analysis through this paper. The task based on Project Based Learning (PBL) was conducted in the digital language lab which had audio visual aids to support the team presentation. The total strength of 48 students of Mechanical Branch were divided into 6 groups, each consisting of 8 students. The group members were selected on random numbering basis. They were given a group task to represent a power point presentation on a topic related to their core branch. They had to discuss the issue and choose their topic and represent in a given format. It provided the individual role of each member in the presentation. A brief overview of the project and the outcome of its technical aspects were also had to be included. Each group had to highlight the contributions of that innovative technology through their presentation. The power point should be provided in a CD format. The variations in the choice of subjects, their usage of digital technologies, co-ordination for competition, learning experience of first time stage presentation, challenges of team cohesiveness were some criteria observed as their learning experience. For many other students undergoing the stages of planning, preparation and practice as steps for presentation had been the learning outcomes as given through their feedback form. The evaluation pattern is distributed for individual contribution and group effectiveness which promotes quality of presentation. The evaluated skills are communication skills, group cohesiveness, and audience response, quality of technicality and usage of technical terms. This paper thus analyses how project based learning improves the communication, life skills and technical skills in English for Specific learning context through PBL.

Keywords: language lab, ESP context, communicative skills, life skills

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Authors: Stefanie Santorsola, Natasha Frank

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Improving healthcare safety necessitates examining current trends and beliefs about safety and devising strategies to improve. Errors in healthcare continue to increase and be experienced by patients, which is preventable and directly correlated to a breakdown in healthcare communication. TeamSTEPPS is an evidence-based process designed to improve the quality and safety of healthcare by improving communication and team processes. Communication is at the core of effective team collaboration and is vital for patient safety. TeamSTEPPS offers insights and strategies for improving communication and teamwork and reducing preventable errors to create a safer healthcare environment for patients. The academic, clinical, and educational environment for nursing students is vital in preparing them for professional practice by providing them with foundational knowledge and abilities. This environment provides them with a prime opportunity to learn about errors and the importance of effective communication to enhance patient safety, as nursing students are often unprepared to deal with errors. Proactively introducing and discussing errors through a supportive culture during the nursing student’s academic beginnings has the potential to carry key concepts into practice to improve and enhance patient safety. TeamSTEPPS has been used globally and has collectively positively impacted improvements in patient safety and teamwork. A workshop study was introduced in winter 2023 of registered practical nurses (RPN) students bridging to the baccalaureate nursing program; the majority of the RPNs in the bridging program were actively employed in a variety of healthcare facilities during the semester. The workshop study did receive academic institution ethics board approval, and participants signed a consent form prior to participating in the study. The premise of the workshop was to introduce TeamSTEPPS and a variety of strategies to these students and have students keep a reflective journal to incorporate the presented communication strategies in their practicum setting and keep a reflective journal on the effect and outcomes of the strategies in the healthcare setting. Findings from the workshop study supported the objective of the project, resulting in students verbalizing notable improvements in team functioning in the healthcare environment resulting from the incorporation of enhanced communication strategies from TeamSTEPPS that they were introduced to in the workshop study. Implication for educational institutions is the potential of further advancing the safety literacy and abilities of nursing students in preparing them for entering the workforce and improving safety for patients.

Keywords: teamstepps, education, patient safety, communication

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Authors: Gali Moritz, Jacqueline H. Becker, Jyoti V. Ankam, Kimberly Arcoleo, Matthew Wysocki, Roee Holtzer, Juan Wisnivesky, Paula J. Busse, Alex D. Federman, Sunit P. Jariwala, Jonathan M. Feldman

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Objective: Cognitive impairment (CI), whose incidence is greater among ethnic/racial minorities, is a significant barrier to asthma self-management (SM) behaviors and outcomes in older adults. The aim of this study was to examine the relationships between CI, assessed using the Montreal Cognitive Assessment (MoCA), and asthma SM behaviors and outcomes in a sample of predominantly Black and Hispanic participants. Additionally, we evaluated whether using two different MoCA cutoff scores influenced the association between CI and study outcomes. Methods: Baseline cross-sectional data were extracted from a longitudinal study of older adults with asthma (N=165) age≥ 60 years and used for analysis. Cognition was assessed using the MoCA. Asthma control, asthma-related quality of life (QOL), inhaled corticosteroid (ICS) dosing, and ICS adherence were assessed using self-report. The inhaler technique was observed and rated. Results: Using established MoCA cutoff scores of 23 and 26 yielded 45% and 74% CI rates, respectively. CI, defined using the 23 cutoff score, was significantly associated with worse asthma control (p=.04) and worse ICS adherence (p=.01). With a cutoff score of 26, only asthma-related QOL was significantly associated with CI (p=.03). Race/ethnicity and education did not moderate the relationships between CI and asthma SM behaviors and outcomes. Conclusions: CI in older adults with asthma is associated with important clinical outcomes, but this relationship is influenced by the cutoff score used to define CI.

Keywords: cognition, respiratory, elderly, testing, adherence, validity

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Authors: Seyed Hossein Alavi, Farshad Ghazalian, Soghra Jamshidi

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Nowadays, athletic aggression discussion is considered as an important issue in sports psychology and sports effects have been noted by researchers from a long time ago. In this research, the amount of aggression among athletic students of different sport courses will be surveyed and compared. Statistics society in this research consists of all of boy athletic students in wrestling, taekwondo, football, and basketball of Mahmoudabad City that are 200 persons and the limitation of their ages are between 12-15 years old. Among all athletic students of different sport courses, 40 persons were chosen randomly for the sample. The method of research is a descriptive-comparative type that has been done according to field study and for measurement of examinations aggression amount, we have used Ayzank exam. In analysis step of foundations, for comparison of aggression of examined group, we have used Varian’s analysis exam. Research results show that among aggression amounts of athletic students of wrestling, taekwondo, football and basketball, there is no fundamental difference (p < 0.05). Stimulation of guest team with the host team fans, referees performance, exhaustion, physical confrontations, team position in the tournament table, and so on. There is no significant difference among aggression amount of selected sport athletic students.

Keywords: aggression, athletic, student, sports

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