Search results for: medication use self efficacy

Authors: Gadia Duhita, Noorhana, Tjhin Wiguna

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Background: ADHD is the most common behavioural disorder in Indonesia. A stimulant, specifically methylphenidate, has been the first drug of choice for an ADHD treatment more than half a century. During the last decade, non-stimulant therapy (atomoxetine) for ADHD treatment has been developing. Growing evidence of its efficacy and the difference in its side effects profile to stimulant therapy have made methylphenidate’s position as a first line therapy for ADHD in need of re-evaluation. Both methylphenidate and atomoxetine have proven themselves against placebos in reducing core symptoms of ADHD. More recent studies directly compare the efficacy of methylphenidate and atomoxetine. Objective: The objective of this paper is to find out if either methylphenidate or atomoxetine is superior to another. This paper will assess the validity, importance, and applicability of current available evidence which compare the effectivity, efficacy, and safety of methylphenidate to atomoxetine for treatment in children and adolescents with ADHD. Method: The articles were searched for through the PubMed and Cochrane databases with “attention deficit/hyperactivity disorder OR adhd”, “methylphenidate”, and “atomoxetine” as the search keywords. Two articles which were relevant and eligible were chosen by using inclusion and exclusion criterias to be critically appraised. Result: The study by Hazel et al. showed that the efficacy of methylphenidate and atomoxetine are comparable for treatment in child and adolescent ADHD. The result shows 53.6% (95% CI 48.5%-58.4%) of the patient responded to the treatment by atomoxetine and 54.4% (95% CI 47.6%-61.1%) patients responded to methylphenidate, with the difference in proportion of–0.9% (95% CI –9.2%-7.5%). The other study by Hanwella et al. also showed that the efficacy of atomoxetine was not inferior to metilphenidate (SMD = 0.09, 95% CI –0.08-0.26) (Z = 1.06, p = 0.29). However, the sub-group analysis showed that OROS methylphenidate is more effective compared to atomoxetine (SMD = 0.32, 95% CI 0.12-0.53) (Z = 3.05, p < 0.02). Conclusion: The efficacy of methylphenidate and atomoxetine in reducing symptoms of ADHD is comparable. None is proven inferior to another. The choice of pharmacological tratment children and adolescents with ADHD should be made based on contraindication and the side effects profile of each drug.

Keywords: attention deficit/hyperactivity disorder, ADHD, atomoxetine, methylphenidate

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Authors: Frederick Huie, Lauren Fusfeld, William Burchenal, Scott Howell, Alyssa McVey, Thomas F. Goss

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Alzheimer’s Disease (AD) is a degenerative brain disease characterized by memory loss and cognitive decline that presents a substantial economic burden for patients and health insurers in the US. This study evaluates the payer budget impact of the DISCERN™ test in the diagnosis and management of patients with symptoms of dementia evaluated for AD. DISCERN™ comprises three assays that assess critical factors related to AD that regulate memory, formation of synaptic connections among neurons, and levels of amyloid plaques and neurofibrillary tangles in the brain and can provide a quicker, more accurate diagnosis than tests in the current diagnostic pathway (CDP). An Excel-based model with a three-year horizon was developed to assess the budget impact of DISCERN™ compared with CDP in a Medicare Advantage plan with 1M beneficiaries. Model parameters were identified through a literature review and were verified through consultation with clinicians experienced in diagnosis and management of AD. The model assesses direct medical costs/savings for patients based on the following categories: •Diagnosis: costs of diagnosis using DISCERN™ and CDP. •False Negative (FN) diagnosis: incremental cost of care avoidable with a correct AD diagnosis and appropriately directed medication. •True Positive (TP) diagnosis: AD medication costs; cost from a later TP diagnosis with the CDP versus DISCERN™ in the year of diagnosis, and savings from the delay in AD progression due to appropriate AD medication in patients who are correctly diagnosed after a FN diagnosis.•False Positive (FP) diagnosis: cost of AD medication for patients who do not have AD. A one-way sensitivity analysis was conducted to assess the effect of varying key clinical and cost parameters ±10%. An additional scenario analysis was developed to evaluate the impact of individual inputs. In the base scenario, DISCERN™ is estimated to decrease costs by $4.75M over three years, equating to approximately $63.11 saved per test per year for a cohort followed over three years. While the diagnosis cost is higher with DISCERN™ than with CDP modalities, this cost is offset by the higher overall costs associated with CDP due to the longer time needed to receive a TP diagnosis and the larger number of patients who receive a FN diagnosis and progress more rapidly than if they had received appropriate AD medication. The sensitivity analysis shows that the three parameters with the greatest impact on savings are: reduced sensitivity of DISCERN™, improved sensitivity of the CDP, and a reduction in the percentage of disease progression that is avoided with appropriate AD medication. A scenario analysis in which DISCERN™ reduces the utilization for patients of computed tomography from 21% in the base case to 16%, magnetic resonance imaging from 37% to 27% and cerebrospinal fluid biomarker testing, positive emission tomography, electroencephalograms, and polysomnography testing from 4%, 5%, 10%, and 8%, respectively, in the base case to 0%, results in an overall three-year net savings of $14.5M. DISCERN™ improves the rate of accurate, definitive diagnosis of AD earlier in the disease and may generate savings for Medicare Advantage plans.

Keywords: Alzheimer’s disease, budget, dementia, diagnosis.

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Authors: Burra Vijitha

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A prospective randomized comparative study for the prevention of postoperative nausea and vomiting in the patients undergoing general anesthesia ,for elective laparoscopic surgeries with respect to efficacy and side effects of granisetron and palonosetron. Sixty adult patients of class ASA 1,2 of either sex in age group between 20-70 yrs,scheduled for elective laparoscopic surgeries were selected for the study.Patients were randomly divided into two groups 30 each. Group G: Granisetron group (n=30), 40µg/kg; Group P: Palonosetron group (n=30), 0.075 mg. at end of surgery before extubation group G patients 40 µg/kg of inj.granisetron and group P patients received 0.075 mg of inj.palonosetron slow iv over 30 sec.In post anesthesia care unit, episodes of nausea and vomiting experienced by each patient was recorded by direct questioning the patient .study medication was assessed in terms of incidence of nausea and vomiting during periods of 0-4 hrs,4-12 hrs,12-24 hrs,24-48hrs.our study demonstrated that complete response for those patients who received granisetron were 86.66%,80% and 66.66% ,while those received palonosetron were 100%,86.6%,90% between 0-4hrs,4-12hrs,12-24 hrs. It shows no statistically signidficant differences between the baseline values of hemodynamic variables beween two groups during study. Keywords: Granisetron, nausea, palonosetron, vomiting.

Keywords: granisetron, palonosetron, nausea, vomiting

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Authors: Larissa Burruano, Sergey Grabovyj, Irina Nguen

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The study aimed to assess the level of adherence to anti retroviral therapy (ART) and to examine the relationship between adherence and risk behavior factor (drug use) among patients infected with HIV. The patients with newly diagnosed or established HIV infection under follow-up at the Sumskij Regional Centre for AIDS Prevention in Ukraine were eligible for this study. Medical records were used to measure the patient’s adherence to medication. Measurements were obtained at month 6 and at month 12 to calculate the number of medication omission during the past 30 days: (on a 2-point scale – once until three in a month – were considered adherent, three and more in a month – were considered non-adherent). Of the 50 study participants, 27 (54.0%) were men and 23 (46.0%) women. The mean age is 35.2 years (SD= 5.1). A majority of the patients (82.0%) is in the age group of 25-30 years. The main level of adherence was 74.0% and 66.0% at 6 and 12 months, respectively. The main routes of HIV transmission were drug injection among men 12 (44.4%) and sexual contact among women 11 (47.8%). Univariate analyses indicated that patients who had lower level of education were more likely to have been non-adherent at month 6- (X2 =5.1, n=50, p < .05) and at month 12 (X2 = 4.34, n=50, p < .05). Multivariate tests showed that only age (OR= 1.163 [95% CI 0.98–1.370]) was significant independent predictor of treatment adherence, while gender, education, employment status were not predictive for the risk of developing non-compliance. There was not a significant interaction between non-adherence and intravenous drug use. Consistent with these findings, younger people were more likely to have missed a dose of their medication because they had a greater sense of invulnerability than older patients. The study indicates that the socio demographic characteristic should be taken into an account in the future research regarding adherence in the case of HIV infection. If the patient anti retroviral adherence can be improved by qualitatively better medical care in all regions of the Ukraine, behavioral changes in the population can to be expected in the long term.

Keywords: HIV, antiretroviral therapy, adherence, Ukraine, Eastern Europe

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Authors: Asma Alzahrani, Elizabeth Stojanovski

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This study investigated factors that influence mathematics achievement based on a sample of ninth-grade students (N  =  21,444) from the High School Longitudinal Study of 2009 (HSLS09). Key aspects studied included efficacy in mathematics, interest and enjoyment of mathematics, identity with mathematics and future utility beliefs and how these influence mathematics achievement. The predictability of mathematics achievement based on these factors was assessed using correlation coefficients and multiple linear regression. Spearman rank correlations and multiple regression analyses indicated positive and statistically significant relationships between the explanatory variables: mathematics efficacy, identity with mathematics, interest in and future utility beliefs with the response variable, achievement in mathematics.

Keywords: Mathematics achievement, math efficacy, mathematics interest, factors influence

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Authors: Teresa M. Odipo

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Inclusive physical education and an inclusive educational approach in German schools have received much attention in recent years due to the UN Convention on the rights of persons with disabilities proposals, which came into force in Germany in 2009. The aim of inclusive PE is to include children with disabilities and able bodied children, based on the idea, that all children should attend school together. While PE mostly took place in a heterogeneous environment, introducing children with all kinds of disabilities posed more challenges to the teachers, when children with disabilities were included. Therefore it is important that the educational approach should include pre-service teachers’ (PST) self-efficacy for and their attitudes towards inclusive practices. The PSTs’ self-efficacy for inclusive practices is one of the strongest predictors of the success of the inclusion reforms introduced in 2009, in order to improve PSTs’ ability to handle these very new challenges. PE stands out because the very nature of sport involves the body which means that all children, especially those with special needs should be treated in an appropriate manner. Up till now, it has been mostly English-speaking countries that have been assessed for inclusive practices in PE. Due to the lack of research in Germany, there is a strong need to question PSTs’ prepared-ness. This paper presents results from the 2016 survey conducted on around 100 PSTs by the German University of Sports in Cologne and opens up new directions within PSTs’ education, concerning their attitudes and self-efficacy towards inclusive PE. These new aspects will be included in the construction of new learning and teaching tools to improve pre-service teachers’ education for inclusive Physical Education.

Keywords: attitudes, inclusive physical education, pre-service teachers, self-efficacy

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Authors: Nabil Ahmed Kamal Badawy, Ali Falah Alhajraf, Mawaheb Falah Alsamdan

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Objectives: To estimate the prevalence of self-medication with over-the-counter pain relievers (acetaminophen, ibuprofen, and aspirin) among Kuwaiti citizens above the age of 16 years old and describe their patterns of use, perceived awareness of, and concerns about the drugs’ potential side effects. Design: A descriptive cross-sectional questionnaire-based survey. Setting: Samples were selected from the six Kuwaiti governorates. Subjects: The data were collected over a four-month period in 2012, from 850 subjects who identified as Kuwaiti citizens. These subjects were recruited using stratified random sampling. Results: Overall, a 67% response rate was obtained. In total, 68% (573) of the respondents reported the use of over-the-counter pain relievers. Women, middle-aged or single individuals, and those who had completed higher education used these drugs more than any other subgroup (p<0.05). We found evidence of inappropriate use of these drugs, with 15% (88) of the consumers using them almost daily. Further, 19% (111) of the consumers exceeded the recommended dosage at least once. Not only were 81% of the consumers unaware of the potential side effects, but also more than 61% were not concerned about them. Women were more knowledgeable than men regarding the maximum dose (p=0.036, OR 1.49, CI 1.03–2.17). Consumers with higher levels of education did not show distinct knowledge regarding the maximum allowed dose of the drugs (p=0.252, OR 1.71, CI 0.68-4.25). Conclusion: The results showed a high prevalence of self-medication with over-the-counter pain relievers among Kuwaiti citizens. The subjects showed marked unawareness and a lack of concern regarding the potential complications resulting from the inappropriate use of these analgesics. This demonstrates the need for educational interventions directed toward both patients and health care workers.

Keywords: awareness of side effects, concern, patterns of use, prevalence

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Authors: Tiffany Karalis Noel

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The purpose of this study was to examine the factors attributed to the self-efficacy of beginning secondary content area teachers as they moved through their student teaching experiences. This study used a narrative inquiry methodology to understand the variables attributed to teacher self-efficacy among a group of secondary content area teacher candidates. The primary purpose of using a narrative inquiry methodology was to share the stories of content area teacher candidates’ student teaching experiences. Focused research questions included: (1) To what extent does teacher education preparation affect the self-efficacy of beginning content area teachers? (2) Which recurrent elements of teacher education affect the self-efficacy of beginning teachers, regardless of content area? (3) How do the findings from research questions 1 and 2 inform teacher educators? The findings of this study suggest that teacher education preparation affects the self-efficacy of beginning secondary teacher candidates across the content areas; accordingly, the findings of this study provide insight for teacher educators to consider the areas where teacher education programs are failing to provide adequate preparation. These teacher candidates emphasized the value of adequate preparation throughout their teacher education programs to help inform their student teaching experiences. In order to feel effective and successful as beginning teachers, these teacher candidates required additional opportunities to apply the practical application of their teaching skills prior to the student teaching experience, the incorporation of classroom management strategy coursework into their curriculum, and opportunities to explore the extensive demands of the teaching profession ranging from time management to dealing with difficult parents, to name a few referenced examples. The teacher candidates experienced feelings of self-doubt related to their effectiveness as teachers when they were unable to employ successful classroom management strategies, pedagogical techniques, or even feel confidence in navigating challenging conversations with students, parents, and/or administrators. In order to help future teacher candidates and beginning teachers in general overcome these barriers, additional coursework, fieldwork, and practical application experiences should be provided in teacher education programs to help boost the self-efficacy of student teachers.

Keywords: self-efficacy, teacher efficacy, secondary preservice teacher education, teacher candidacy, student teaching

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Authors: Domingos Vita, Patrick Brady

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Background: There is a tuberculosis (TB) epidemic in Angola that has been getting worse for more than a decade despite the active implementation of the DOTS strategy. The aim of this study was to directly interrogate healthcare workers involved in TB control on what they consider to be the drivers of the TB epidemic in Angola. Methods: Twenty four in-depth qualitative interviews were conducted with medical staff working in this field in the provinces of Luanda and Benguela. Results: The healthcare professionals see the migrant working poor as a particular problem for the control of TB. These migrants are constructed as ‘Rural People’ and are seen as non-compliant and late-presenting. This is a stigmatized and marginal group contending with the additional stigma associated with TB infection. The healthcare professionals interviewed also see the interruption of treatment and self medication generally as a better explanation for the TB epidemic than urbanization or lack of medication. Conclusions: The local narrative is in contrast to previous explanations used elsewhere in the developing world. To be effective policy must recognize the local issues of the migrant workforce, interruption of treatment and the stigma associated with TB in Angola.

Keywords: Africa, Angola, migrants, qualitative, research, tuberculosis

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Authors: Kamel Abd Elaziz Mohamed

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Introduction: Drug related problems (DRPs) are of major concern, affecting patients of both sex. They impose considerable economic burden on the society and the health-care systems. Aim of the work: The aim of this work was to identify and categorize drug-related problems in adult intensive care unit. Patients and methods: The study was a prospective, observational study as eighty six patients were included. They were consecutively admitted to ICU through the emergency room or transferred from the general ward due to DRPs. Parameters included in the study as length of stay in ICU, need for cardiovascular support or mechanical ventilation, dialysis, as well as APACHE II score were recorded. Results: Drug related problems represent 3.6% of the total ICU admission. The median (range) of APACHE II score for 86 patients included in the study was 17 (10-23), and length of ICU stay was 2.4 (1.5-4.2) days. In 45 patients (52%), DRP was drug over dose (group 1), while other DRP was present in the other 41 patients (48%, group 11). Patients in group 1 were older (39 years versus 32 years in group 11), with significant impaired renal function. The need of inotropic drugs and mechanical ventilation as well as the length of stay (LOS) in ICU was significantly higher in group 1. There were no significant difference in GCS between both groups, however APACHE II score was significantly higher in group 1. Only four patients (4.6%) were admitted by suicidal attempt as well as three patients (3.4%) due to trauma drug-related admissions, all were in (group 1). Nineteen percent of the patients had drug related problem due to hypoglycaemic medication followed by tranquilizer (15%). Adverse drug effect followed by failure to receive medication were the most causes of drug problem in (group11).The total mortality rate was 4.6%, all of them were eventually non preventable. Conclusion: The critically ill patients admitted due to drug related problems represented a small proportion (3.6%) of admissions to the ICU. Hypoglycaemic medication was one of the most common causes of admission by drug related problems.

Keywords: drug related problems, ICU, cost, safety

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Authors: Bishakha Majumdar, Ranjeet Nambudiri

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Considerable dichotomy exists in research regarding the role of optimism and self-efficacy in work and career outcomes. Optimism and self-efficacy are related to performance, commitment and engagement, but also are implicated in seeing opportunities outside the firm and switching jobs. There is absence of research capturing these opposing strands of findings in the same model and providing a holistic understanding of how the expectancy beliefs operate in case of the working professional. We attempt to bridge this gap by proposing that career-decision self-efficacy and career outcome expectations affect intention to quit through the competitive mediation pathways of internal and external marketability. This model provides a holistic picture of the role of career expectancy beliefs on career outcomes, by considering perceived career opportunities both inside and outside one’s present organization. The understanding extends the application of career expectancy beliefs in the context of career decision-making by the employed individual. Further, it is valuable for reconsidering the effectiveness of hiring and retention techniques used by a firm, as selection, rewards and training programs need to be supplemented by interventions that specifically strengthen the stability pathway.

Keywords: career decision self-efficacy, career outcome expectations, marketability, intention to quit, job mobility

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Authors: Kailen Krame

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This paper presents a review of the literature on the efficacy of mindfulness-based interventions for reducing occupational stress and burnout among K-12 educators. An in-depth discussion of the incidence and impact of teacher stress and burnout is provided, as a wealth of literature indicates that this issue is of growing concern and has important implications not only for individual educators but also for students and the school as an organization. Given the evidence of a link between teacher wellbeing and student outcomes, this topic is worth further investigation in order to better understand sources of stress and burnout and propose adequate coping strategies for today’s educators. As a potential solution to teacher stress and burnout, mindfulness-based interventions are reviewed in-depth, and an overview of the history, diverse application, and effects of mindfulness practice are provided. Relevant outcomes of educator mindfulness training presented in the literature include increased emotional regulation, self-efficacy, and personal wellbeing, among several others. Lastly, additional implications and benefits of educator mindfulness training are explored, limitations of the current research are reviewed, and apparent best practices are proposed.

Keywords: educator burnout, emotional regulation, mindfulness, self-efficacy, stress-reduction

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Authors: Farzaneh Ziaee, Mohammad Ziaee

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N-acetyl-L-cysteine (NAC) is a well-known mucolytic agent, and recently its efficacy has been examined for the prevention and remediation of several diseases such as lung infections caused by Coronavirus. Also, it is administrated as the main antidote in paracetamol overdose and is effective for the treatment of idiopathic pulmonary fibrosis (IPF), chronic obstructive pulmonary disease (COPD). This medicine is used as an antioxidant to prevent diabetic kidney disease (nephropathy). In this study, a method for the acylation of amino acids is employed to manufacture this drug in a height yield. Regarding this patented path, NAC can be made in a single batch step at ambient pressure and temperature. Moreover, this study offers a technique to make peptide bonds which is of interest for pharmaceutical and medicinal industries. The separation process was undertaken using appropriate solvents to achieve an excellent purification level. The synthesized drug was characterized via proton nuclear magnetic resonance (1H NMR), high-performance liquid chromatography (HPLC), Fourier transform infrared spectroscopy (FT-IR), elemental analysis, and melting point.

Keywords: N-acetylcysteine, synthesis, mucolytic medication, lung anti-inflammatory, COVID-19, antioxidant, pharmaceutical supplement, characterization

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Authors: John Lyndon C. Lunnay

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This study discerns to evaluate the antidiabetic efficacy of pig bile on alloxan-induced BALB/c mice. The experimental animals were divided and selected using RCBD into 5 groups (n= 4): T1 (negative control), T2 (1ml/kg), T3 (2ml/kg), T4 (3ml/kg) and T5 (Glibenclamide). Hyperglycemia was induced by injecting 1% alloxan monohydrate intraperitoneally. A glucose tolerance test was performed using a 2g/kg glucose solution, and blood glucose levels were measured at different time intervals. 14 days of monitoring was also done to ensure effectivity and efficacy of the different treatments. Bodyweight was also determined. Results show that administration of treatments on test animals significantly reverted the blood glucose levels of mice in 60 minutes and 120 minutes using an oral glucose tolerance test. After 14 days of monitoring, normal blood glucose levels were seen significantly on T2 (1ml/kg), T3 (2ml/kg), T4 (3ml/kg), and T5 (Glibenclamide), which only suggests the efficacy of pig bile on lowering glucose levels on alloxan-induced diabetic mice. Bodyweight analysis shows no significant difference. Duncan’s multiple range test (DMRT) shows comparable efficacy and effectivity between T4 (3ml/kg) and T5 (Glibenclamide) on lowering BGL at different day and time intervals.

Keywords: pig bile, BALB/c mice, blood glucose, Gllibenclamide

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Authors: Amina Ottozbeer, Nazanin Derakhshan

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Emotion regulation, a transdiagnostic process, is often impaired in individuals with high trait anxiety due to compromised executive functioning and attentional control. Recent research underscores the importance of studying individual differences and contextual factors in understanding the adaptability of emotion regulation processes, particularly in those with high trait anxiety. Prior studies have emphasized the role of self-efficacy in promoting positive cognitive flexibility outcomes and mitigating executive function impairments in highly anxious individuals. Accordingly, the objective of this study was to examine the moderating influence of attentional control, cognitive flexibility, and self-efficacy on the relationship between trait anxiety and emotion regulation. Using a correlational design, an online study was conducted with a sample of 82 participants (mean age: 22 years). Self-report questionnaires measured individual difference variables. The Classic Stroop Task assessed attentional control as an objective measure of cognitive flexibility . The findings revealed three significant interactions. Firstly, high cognitive flexibility and self-efficacy were linked to reduced expressive suppression in individuals with low trait anxiety. Secondly, elevations in cognitive flexibility and self-efficacy were associated with increased suppression in those with high trait anxiety. Thirdly, high trait anxiety was associated with reduced attentional control. The results suggest that typically adaptive processes can yield different outcomes in highly anxious populations, highlighting the need to explore additional variables that could alter the impact of cognitive flexibility and self-efficacy on emotion regulation in individuals with high anxiety. These findings have significant clinical implications, emphasizing the need to consider individual differences in emotion regulation and trait anxiety to inform more effective psychological treatments.

Keywords: attentional control, trait anxiety, emotional dysregulation, transdiagnostic, individual differences

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Authors: Pei Xin Ker

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The purpose of this study is to examine the influence of teachers’ self-efficacy (TSE) on teachers’ perceptions of the levels of implementation of the NPSC. A total of 187 respondents were selected by using purposive homogeneous sampling to represent preschool teachers in Selangor and Kuala Lumpur. This study involved a cross-sectional survey in which quantitative data were collected and analysed using descriptive statistics. The survey was containing 74 questionnaire items created using Google Form and distributed through online platforms such as WhatsApp, Telegram, and Facebook Messenger. The results indicated a high level of overall self-efficacy among the preschool teachers and the overall teachers' perceived level of NPSC. The findings also showed a significant and positive relationship at a high level between TSE and teachers' perceptions of the level of implementation of NPSC. Student involvement was one of the TSE factors that had the greatest influence in shaping teachers' perceptions of the level of implementation of NPSC. The findings of the predictors to teachers' perceptions of the implementation of NPSC within this study can be used as an indication to the researchers to reassure the validity of this study by repeating with similar research settings. Further studies to include other factors are also encouraged to explore the possible factors that may influence the teachers' perceptions of the implementation of NPSC.

Keywords: teachers’ self-efficacy, national preschool standard curriculum, preschool teachers, preschool education

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Authors: Oyesoji Aremu, Taiwo Williams

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This study examined some factors (academic self-efficacy, locus of control, motivation and gender) that could predict academic dishonesty among serially frustrated students in Ogun State, South West, Nigeria. Serial academically frustrated students are students who are unable to attain and meet academic expectations set by themselves or significant others. A sample of 250 undergraduate students selected from two faculties from a University in Ogun State,South West Nigeria took part in the study. Multiple regression analysis was employed to determine the joint and relative contributions of the independent variables to the prediction of the dependent variable. T-test was used to test the hypothesis determining the gender difference between the independent variables (academic self-efficacy, locus of control and motivation) and academic dishonesty of serial academically frustrated male and female students. The results of the study showed all the independent variables jointly contributed to predicting academic dishonesty, while only academic self-efficacy and motivation had relative contributions to the dependent measure. There was no significant difference in the academic self-efficacy and motivation among males and females on academic dishonesty of the serial academically frustrated students but locus of control showed a significant difference between male and female students on academic dishonesty. Implications for counseling of the findings are discussed in the study.

Keywords: academic dishonesty, serially frustrated students, academic self-efficacy, locus of control

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Authors: Ahmed E. Al-Sabri, Mohamed A. Moslem, Sarfaraz Hadi

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To avoid the harmful effects of the chemical fungicides on the human and minimize the environmental pollution, an alternative eco-friendly control strategies should be developed. The extract of Commiphora myhrra L. was tested against twenty fungal genera isolated from the indoor air collected from different rooms in King Saud University, Kingdom of Saudi Arabia. Disc diffusion test was modified for use in this study and the collected data was statistically analyzed. Variable antifungal efficacy of different myrrh extract was recorded against the investigated fungal genera. The efficacy of the extract was increased as the concentration increased. The highest growth inhibition (74.6%) was against Acremonium strictum followed by Trichoderma psuedokoningii (70.6%). On contrast, the lowest efficacy (12.7%) was against Ulocladium consortiale. It could be concluded that myrrh extract is promised as a source of substances from which of safer and eco-friendly could be used as antimicrobial agents against a number of pathogenic fungi.

Keywords: antifungal, myrrh, antimicrobial, medicinal plant

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Authors: Sarantos Psycharis

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Physical Computing, as an instructional model, is applied in the framework of the Engineering Pedagogy to teach “transversal/cross-cutting ideas” in a STEM content approach. Labview and Arduino were used in order to connect the physical world with real data in the framework of the so called Computational Experiment. Tertiary prospective engineering educators were engaged during their course and Computational Thinking (CT) concepts were registered before and after the intervention across didactic activities using validated questionnaires for the relationship between self-efficacy, computer programming, and CT concepts when STEM content epistemology is implemented in alignment with the Computational Pedagogy model. Results show a significant change in students’ responses for self-efficacy for CT before and after the instruction. Results also indicate a significant relation between the responses in the different CT concepts/practices. According to the findings, STEM content epistemology combined with Physical Computing should be a good candidate as a learning and teaching approach in university settings that enhances students’ engagement in CT concepts/practices.

Keywords: arduino, computational thinking, computer programming, Labview, self-efficacy, STEM

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Authors: Abdreheman Seid Abdella

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This study examined instructors willingness, self-efficacy beliefs, attitudes and knowledge about provisions of instructional accommodations for students with disabilities in universities. Major concepts used in this study operationally defined and some models of disability were reviewed. Questionnaires were distributed to a total of 181 instructors from four universities and quantitative data was generated. Then to analyze the data, appropriate methods of data analysis were employed. The result indicated that on average instructors had positive willingness, strong self-efficacy beliefs and positive attitudes towards providing instructional accommodations. In addition, the result showed that the majority of participants had moderate level of knowledge about provision of instructional accommodations. Concerning the relationship between instructors background variables and dependent variables, the result revealed that location of university and awareness raising training about Inclusive Education showed statistically significant relationship with all dependent variables (willingness, self-efficacy beliefs, attitudes and knowledge). On the other hand, gender and college/faculty did not show a statistically significant relationship. In addition, it was found that among the inter-correlation of dependent variables, the correlation between attitudes and willingness to provide accommodations was the strongest. Furthermore, using multiple linear regression analysis, this study also indicated that predictor variables like self-efficacy beliefs, attitudes, knowledge and teaching methodology training made statistically significant contribution to predicting the criterion willingness. Predictor variables like willingness and attitudes made statistically significant contribution to predicting self-efficacy beliefs. Predictor variables like willingness, Special Needs Education course and self-efficacy beliefs made statistically significant contribution to predict attitudes. Predictor variables like Special Needs Education courses, the location of university and willingness made statistically significant contribution to predicting knowledge. Finally, using exploratory factor analysis, this study showed that there were four components or factors each that represent the underlying constructs of willingness and self-efficacy beliefs to provide instructional accommodations items, five components for attitudes towards providing accommodations items and three components represent the underlying constructs for knowledge about provisions of instructional accommodations items. Based on the findings, recommendations were made for improving the situation of instructional accommodations in Ethiopian universities.

Keywords: willingness, self-efficacy belief, attitude, knowledge

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Authors: Nasser Mansour, Ziad Said, Abdullah Abu-Tineh

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STEM teachers face the challenge of possessing expertise not only in their subject disciplines but also in the pedagogical knowledge required for integrated STEM lessons. However, research reveals a lack of pedagogical competencies related to project-based learning (PBL) in the STEM context. To bridge this gap, the study examines teachers' competencies and self-efficacy in TPACK (Technological Pedagogical Content Knowledge) and its specific integration with PBL and STEM content. Data from 245 specialized science and math teachers were collected using a questionnaire. The study emphasizes the importance of addressing gender disparities, supporting formal teacher education, and recognizing the expertise and experiences of STEM teachers in effective technology integration. The findings indicate that gender plays a role in self-efficacy beliefs, with females exhibiting higher confidence in pedagogical knowledge and males demonstrating higher confidence in technological knowledge. Teaching experience and workload factors have a limited impact on teachers' Technological Pedagogical Content Knowledge (TPACK). These findings enhance our understanding of contextual factors impacting science and math teachers' self-efficacy in utilizing TPACK for STEM and PBL. They inform the development of targeted interventions, professional development programs, and support systems to enhance teachers' competencies and self-efficacy in TPACK for teaching science and Mathematics through STEM and PBL.

Keywords: technological pedagogical content knowledge, TPACK, STEM, project-based learning, PBL, self-efficacy, mathematics, science

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Authors: Ivana Bulog, Ana Rimac Smiljanić, Sandra Pepur

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The financial fragility of households has received increased attention following the recent health crisis, which has created uncertainty and caused increased levels of stress and consequently impaired individual and family well-being. Job losses and/or reduced wages and insecurity increased the number of people that were unable to meet unexpected expenses, which, in many cases, led to increased household debt levels. This presents a threat to the stability of the financial system and the whole economy; therefore, reducing financial fragility and improving financial literacy present challenges for academicians, practitioners, and policymakers. Concerning financial fragility, significant research attention has been devoted to financial knowledge and financial literacy. However, apart from specific knowledge, personal characteristics are of great importance in making financial decisions in the household. Self-efficacy is one of the personal non-cognitive attributes that is a valuable framework for understanding how household financial decisions are made. Thus, this research proposes that individual levels of financial literacy and self-efficacy are related to the indebtedness and financial instability of the household. The primary data were collected using a structured, self-administered online questionnaire, and a snowball sampling method was applied to reach the participants. Preliminary results confirm our assumptions on the influence of financial literacy and self-efficacy on household financial stability.

Keywords: financial literacy, self-efficacy, household financial fragility, well-being

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Authors: S. S. Patil, B. U. Janugade, S. V. Patil

Abstract:

Pulsatile systems are gaining a lot of interest as they deliver the drug at the right site of action at the right time and in the right amount, thus providing spatial and temporal delivery thus increasing patient compliance. These systems are designed according to the circadian rhythm of the body. Chronotherapeutics is the discipline concerned with the delivery of drugs according to inherent activities of a disease over a certain period of time. It is becoming increasingly more evident that the specific time that patients take their medication may be even more significant than was recognized in the past. The tradition of prescribing medication at evenly spaced time intervals throughout the day, in an attempt to maintain constant drug levels throughout a 24-hour period, may be changing as researcher’s report that some medications may work better if their administration is coordinated with day-night patterns and biological rhythms. The potential benefits of chronotherapeutics have been demonstrated in the management of a number of diseases. In particular, there is a great deal of interest in how chronotherapy can particularly benefit patients suffering from allergic rhinitis, rheumatoid arthritis and related disorders, asthma, cancer, cardiovascular diseases, and peptic ulcer disease.

Keywords: pulsatile drug delivery, chronotherapeutics, circadian rhythm, asthma, chronobiology

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Authors: Salima R. Rajwani, Tazeen Ali, Rubina Barolia, Yasmin Parpio, Nasreen Alwani, Salima B. Virani

Abstract:

Introduction: Nurses and physicians have a critical role in initiating lifesaving interventions during cardiac arrest. It is important that timely delivery of high quality Cardio Pulmonary Resuscitation (CPR) with advanced resuscitation skills and management of cardiac arrhythmias is a key dimension of code during cardiac arrest. It will decrease the chances of patient survival if the healthcare professionals are unable to initiate CPR timely. Moreover, traditional training will not prepare physicians and nurses at a competent level and their knowledge level declines over a period of time. In this regard, simulation training has been proven to be effective in promoting resuscitation skills. Simulation teaching learning strategy improves knowledge level, and skills performance during resuscitation through experiential learning without compromising patient safety in real clinical situations. The purpose of the study is to evaluate the effectiveness of simulation training in Advanced Cardiac Life Support Courses by using the selfefficacy tool. Methods: The study design is a quantitative research design and non-randomized quasi-experimental study design. The study examined the effectiveness of simulation through self-efficacy in two instructional methods; one is Medium Fidelity Simulation (MFS) and second is Traditional Training Method (TTM). The sample size was 220. Data was compiled by using the SPSS tool. The standardized simulation based training increases self-efficacy, knowledge, and skills and improves the management of patients in actual resuscitation. Results: 153 students participated in study; CG: n = 77 and EG: n = 77. The comparison was done between arms in pre and post-test. (F value was 1.69, p value is <0.195 and df was 1). There was no significant difference between arms in the pre and post-test. The interaction between arms was observed and there was no significant difference in interaction between arms in the pre and post-test. (F value was 0.298, p value is <0.586 and df is 1. However, the results showed self-efficacy scores were significantly higher within experimental group in post-test in advanced cardiac life support resuscitation courses as compared to Traditional Training Method (TTM) and had overall (p <0.0001) and F value was 143.316 (mean score was 45.01 and SD was 9.29) verses pre-test result showed (mean score was 31.15 and SD was 12.76) as compared to TTM in post-test (mean score was 29.68 and SD was 14.12) verses pre-test result showed (mean score was 42.33 and SD was 11.39). Conclusion: The standardized simulation-based training was conducted in the safe learning environment in Advanced Cardiac Life Suport Courses and physicians and nurses benefited from self-confidence, early identification of life-threatening scenarios, early initiation of CPR, and provides high-quality CPR, timely administration of medication and defibrillation, appropriate airway management, rhythm analysis and interpretation, and Return of Spontaneous Circulation (ROSC), team dynamics, debriefing, and teaching and learning strategies that will improve the patient survival in actual resuscitation.

Keywords: advanced cardiac life support, cardio pulmonary resuscitation, return of spontaneous circulation, simulation

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Authors: Derick Shi-Chen Ou, Liang-Yu Chen

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Background: Acupuncture, a potential alternative, and complementary therapy revealed insufficient evidence in depression treatment. The efficacy of acupuncture treatment was still uncertainty. To evaluate the effect of acupuncture in treating depression, the randomized controlled trials (RCTs) were examined. Methods: RCTs of the acupuncture therapy in treating major depression were searched from MEDLINE from 2007 to 2017. Keywords used for searching strategy included acupuncture, acupoint, and major depressive disorder. Results: Among the nine RCTs, four studies demonstrated great improvement in acupuncture treatment and five studies revealed the effectiveness of acupuncture intervention in medication. General trends suggest that acupuncture treatment is as effective as antidepressants with minimal side effects. Conclusion: Despite the promising results from the RCTs, there are still a variety of limitations, including small sample size, imprecise enrollment criteria, difficulties with blinding, randomization, short duration of study and lack of longitudinal follow-up. Therefore, the evidence that acupuncture as an alternative therapy for depression is inconclusive. More rigorously designed RCTs should be conducted in the future.

Keywords: acupuncture, major depressive disorders, randomized clinical trials, antidepressants

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Authors: AliAkbar Hafezi, Jamshid Abedi, Jalal Taherian, Behnam Kadkhodaei, Mahsa Elahi

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Background. Peripheral neuropathy is a common side effect of the administration of neurotoxic chemotherapy agents. This adverse effect is a major dose-limiting factor of many commonly used chemotherapy drugs. Currently, there are no Food and Drug Administration (FDA) approved medications for the prevention or treatment of chemotherapy-induced peripheral neuropathy. Therefore, this study was performed to investigate the efficacy and safety of metformin on paclitaxel-induced peripheral neuropathy (PIPN). Methods. In this randomized clinical trial, cancer patients who were candidates for chemotherapy with paclitaxel referred to the radiation oncology departments in Iran from 2022 to 2023 were studied. Patients were randomly divided into two groups; 1- Case group (n = 30) received metformin 500 mg orally twice a day after meals during chemotherapy with paclitaxel, and 2- Control group (30 people) received chemotherapy without metformin or any additional medication. Patients were visited in terms of numbness or other neurological symptoms two weeks before chemotherapy, 1-2 days before and weekly during chemotherapy, and at the end of the study. They were assessed by nerve conduction study (NCS) before intervention and one week after the end of chemotherapy. The primary outcome was the efficacy in reducing PIPN and the secondary outcome was adverse effects. Eventually, the outcomes were compared between the two groups of patients. Results. A total of 60 female cancer patients receiving chemotherapy with paclitaxel were evaluated in two groups. The groups were matched in terms of age, body mass index, fasting blood sugar, smoking, pathologic stage, and creatinine levels. The results showed that 18 patients (60.0 %) in the case group and 23 patients (76.6 %) in the control group had PIPN clinically (P = 0.267), and NCS showed 11 patients (36.6 %) in the case group and 15 patients (50.0 %) in the control group suffered from PIPN which no significant difference was observed between the two groups (P = 0.435). Diarrhea (n = 3; 10.0 %) and nausea (n = 3; 10.0 %) were the most common side effects of metformin in the case group and no serious side effects (lactic acidosis and anemia) were found in these patients. Conclusion. This study indicated that metformin did not significantly prevent PIPN in cancer patients receiving chemotherapy, although the frequency of peripheral neuropathy in the case group was lower than in the control group. The use of metformin in the patients had acceptable safety and no serious side effects were reported.

Keywords: peripheral neuropathy, chemotherapy, paclitaxel, metformin

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Authors: Firjeeth C. Paramba, Vamanjore A. Naushad, Nishan K. Purayil, Osama H. Mohammed, Prem Chandra

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Background: Fever is a common problem in adults visiting the emergency department. Extensive studies have been done in children comparing the efficacy of various antipyretics. However, studies on the efficacy of antipyretic drugs in adults are very scarce. To the best of our knowledge, no controlled trial has been carried out comparing the antipyretic efficacy of paracetamol (oral and intravenous) and intramuscular diclofenac in adults. Methods: In this parallel-group, open-label trial, participants aged 14–75 years presenting with fever who had a temperature of more than 38.5°C were enrolled and treated. Participants were randomly allocated to receive treatment with 1,000 mg oral paracetamol (n=145), 1,000 mg intravenous paracetamol (n=139), or 75 mg intramuscular diclofenac (n=150). The primary outcome was degree of reduction in mean oral temperature at 90 minutes. The efficacy of diclofenac versus oral and intravenous paracetamol was assessed by superiority comparison. Analysis was done using intention to treat principles. Results: After 90 minutes, all three groups showed a significant reduction in mean temperature, with intramuscular diclofenac showing the greatest reduction (−1.44 ± 0.43, 95% confidence interval [CI] −1.4 to −2.5) and oral paracetamol the least (−1.08 ± 0.51, 95% CI −0.99 to −2.2). After 120 minutes, there was a significant difference observed in the mean change from baseline temperature between the three treatment groups (P, 0.0001). Significant changes in temperature were observed in favor of intramuscular diclofenac over oral and intravenous paracetamol at each time point from 60 minutes through 120 minutes inclusive. Conclusion: Both intramuscular diclofenac and intravenous paracetamol showed superior antipyretic activity than oral paracetamol. However, in view of its ease of administration, intramuscular diclofenac can be used as a first-choice antipyretic in febrile adults in the emergency department.

Keywords: antipyretic, intramuscular, intravenous, paracetamol, diclofenac, emergency department

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Authors: Philip Friedlander, John Rutledge, Jason Suh

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Inhibition of programmed death-1 (PD-1) or its ligand PD-L1 confers therapeutic efficacy in a wide range of solid tumor malignancies. Primary or acquired resistance can develop through activation of immunosuppressive immune cells such as tumor-associated macrophages. The renin angiotensin system (RAS) systemically regulates fluid and sodium hemodynamics, but components are expressed on and regulate the activity of immune cells, particularly of myeloid lineage. We hypothesized that inhibition of RAS would improve the efficacy of PD-1/PD-L-1 treatment. A retrospective analysis was performed through a chart review of patients with solid metastatic malignancies treated with a PD-1/PD-L1 inhibitor between 1/2013 and 6/2019 at Valley Hospital, a community hospital in New Jersey, USA. Efficacy was determined by medical oncologist documentation of clinical benefit in visit notes and by the duration of time on immunotherapy treatment. The primary endpoint was the determination of efficacy differences in patients treated with an inhibitor of RAS ( ace inhibitor, ACEi, or angiotensin blocker, ARB) compared to patients not treated with these inhibitors. To control for broader antihypertensive effects, efficacy as a function of treatment with beta blockers was assessed. 173 patients treated with PD-1/PD-L-1 inhibitors were identified of whom 52 were also treated with an ACEi or ARB. Chi-square testing revealed a statistically significant relationship between being on an ACEi or ARB and efficacy to PD-1/PD-L-1 therapy (p=0.001). No statistically significant relationship was seen between patients taking or not taking beta blocker antihypertensives (p= 0.33). Kaplan-Meier analysis showed statistically significant improvement in the duration of therapy favoring patients concomitantly treated with ACEi or ARB compared to patients not exposed to antihypertensives and to those treated with beta blockers. Logistic regression analysis revealed that age, gender, and cancer type did not have significant effects on the odds of experiencing clinical benefit (p=0.74, p=0.75, and p=0.81, respectively). We conclude that retrospective analysis of the treatment of patients with solid metastatic tumors with anti-PD-1/PD-L1 in a community setting demonstrates greater clinical benefit in the context of concomitant ACEi or ARB inhibition, irrespective of gender or age. This data supports the development of prospective assessment through randomized clinical trials.

Keywords: angiotensin, cancer, immunotherapy, PD-1, efficacy

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Authors: Alfred M. Caronia

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The aim of this pilot study was to explore an NCAA Division 1 female volleyball players’ experience of a strength and conditioning program and the result this has on self-efficacy of sport skill performance. This phenomenological study comprised of 10 college aged participants that have strength training program experience. Data was collected using semi-structured interviews and a reflective journal; the transcribed interviews were analyzed using qualitative content analysis. From the analysis, four themes emerged: performance enhancement, injury prevention, motivational experience, and learning experience. From the players’ perspective, care needs to be taken to explain the purpose of an exercise and the benefit it will have for a play performance. Other factors that play an important role in a strength training program are team motivation, individual goal setting, bonding, and communication with the strength coach, as all these items appear to be fundamentals of coaching.

Keywords: self-efficacy, skill performance, sports performance, strength training

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Authors: Riin Seema

Abstract:

Guidance and counseling as a whole-school responsibility is a global trend. Counseling is a specific competence, that consist of cognitive, emotional, attitudinal, and behavioral components. To authors best knowledge, there are no self-assessment scales for teachers in the whole world to measure teachers’ counseling competency. In 2016 an Estonian scale on teachers counseling competence was developed during an Interdisciplinary Project at Tallinn University. The team consisted of 10 interdisciplinary students (psychology, nursery school, special and adult education) and their supervisor. In 2017 another international Interdisciplinary Project was carried out for adapting the scale in English for international students. Firstly, the Estonian scale was translated by 2 professional translators, and then a group of international Erasmus students (again from psychology, nursery school, special and adult education) selected the most suitable translation for the scale. The developed ‘Teacher’s Counselling Competence Self-Efficacy Scale’ measures teacher’s self-efficacy beliefs in their own competence to perform different counseling tasks (creating a counseling relationship, using different reflection techniques, etc.). The scale consists of 47 questions in a 5-point numeric scale. The scale is created based on counseling theory and scale development and validation theory. The scale has been used as a teaching and learning material for counseling courses by 174 Estonian and 10 international student teachers. After filling out the scale, the students also reflected on the scale and their own counseling competencies. The study showed that the scale is unidimensional and has an excellent Cronbach alpha coefficient. Student’s qualitative feedback on the scale has been very positive, as the scale supports their self-reflection. In conclusion, the developed ‘Teacher’s Counselling Competence Self-Efficacy Scale’ is a useful tool for supporting student teachers’ learning.

Keywords: competency, counseling, self-efficacy, teacher students

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