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Published: 10 December 2022
Last updated: 29 January 2023

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1

McKenzie, Kirsten, and Sue Wood. "Asthma Terminology and Classification in Hospital Records." Health Information Management 34, no. 2 (June 2005): 27–33. http://dx.doi.org/10.1177/183335830503400203.

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Asthma is a national health priority area in Australia, and there is significant interest in capturing relevant detail about hospitalisations as a result of asthma. A public submission received by the National Centre for Classification in Health from a large teaching hospital in Victoria suggested that current classification terminology in ICD-10-AM did not adequately reflect the terms recorded in clinical inpatient records, and that patterns and severity of asthma better reflected current clinical terminology in Australian hospitals. The purpose of this study was to determine the validity of the public submission and inform future changes to ICD-10-AM. A representative sample of over 3000 asthma records across Australia and New Zealand were extracted, and the asthma terminology documented and codes assigned were recorded and analysed. The study concluded that there was little support for either pattern terminology or the current classification terminology; however, severity of asthma was commonly used in asthma documentation.
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2

Trautner, C., B. Richter, and M. Berger. "Cost-effectiveness of a structured treatment and teaching programme on asthma." European Respiratory Journal 6, no. 10 (November 1, 1993): 1485–91. http://dx.doi.org/10.1183/09031936.93.06101485.

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The purpose of this study was to perform a cost-effectiveness analysis of the structured treatment and teaching programme for patients with asthma (ATTP) at Dusseldorf University. We investigated whether the monetary benefits outweighed the costs of the intervention. Adult patients with moderate to severe asthma participated in a 5 day in-patient programme. Follow-up was 3 yrs. The incremental costs and benefits of the intervention, compared with standard treatment, were calculated. Costs were incurred by the hospitalization and by lost productivity. Compared to the year before the programme, (average reduction) days spent in hospital (5.2 days per patient per year), days of absence from work (18.4 days per patient per year), acute severe asthma attacks (3.8 attacks per patient per year), and physician consultations (2.3 visits per patient per month), decreased in the 3 yrs after the intervention. The programme produced net benefits of DM 12,850 (in 1991 German marks) per patient within 3 yrs. Within the health care sector, the net benefits were DM 5,900. Within 3 yrs, the paying bodies saved DM 2.70, and society as a whole saved DM 5 on each DM spent for the programme. We conclude that the intervention produced net monetary benefits. This result was stable over a wide range of variation of the outcome measures. Therefore, programme deserves implementation, not only for its demonstrated medical benefits but also for its economic savings.
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3

Lee, P. Y., and E. M. Khoo. "How Well were Asthmatic Patients Educated about Their Asthma? A Study at the Emergency Department." Asia Pacific Journal of Public Health 16, no. 1 (January 2004): 45–49. http://dx.doi.org/10.1177/101053950401600108.

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70 patients presented with acute asthma exacerbation requiring nebulised bronchodilator treatment at the emergency department of a teaching hospital in Kuala Lumpur, Malaysia, were interviewed over a two-week period in July 2001. The results showed that 45 (64%) patients had not been educated on the nature of asthma; 30 (43%) had not been advised on preventive measures or avoidance of triggers; 54 (77%) were not advised about the medications used and their side effects; 42 (60%) patients did not know the difference between reliever and preventive medications; 37 (53%) were unable to recognize features of worsening asthma and 68 (97%) were not told about the danger of non-prescribed self-medication or traditional medications. Only six (9%) patients were using peak flow meters and were taught self-management plans. The multiple regression results suggest that patients who were followed up at teaching hospital based clinics were better educated on asthma. In conclusion, asthmatic patients are still not educated well about their disease. Health care providers need to put more emphasis on asthma education so that the number of emergency room visits can be reduced. Asia Pac J Public Health 2004; 16(1): 45-49.
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4

Zeru, Tesfalidet Gebremeskel, Ephrem Engidawork, and Alemseged Beyene Berha. "Assessment of Asthma Control and Quality of Life among Asthmatic Patients Attending Armed Forces Referral and Teaching Hospital, Addis Ababa, Ethiopia." Pulmonary Medicine 2020 (July 29, 2020): 1–12. http://dx.doi.org/10.1155/2020/5389780.

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Background. The primary goal of asthma management is to achieve good asthma control. However, poor patient-physician communication, unavailability of appropriate medications, and lack of long-term goals have made asthma control difficult in developing countries. Poor assessment of asthma control and quality of life is a major cause of suboptimal asthma treatment worldwide, and information regarding this issue is scanty in developing countries like Ethiopia. This study thus attempted to assess the level of asthma control and quality of life in asthmatic patients attending Armed Forces Referral and Teaching Hospital. Methods. A cross-sectional study comprising 184 physician-diagnosed asthmatic patients was conducted using interview, chart review, and prescription assessment. Asthma control was assessed using Asthma Control Test, while asthma quality of life was assessed using Mini-Asthma Quality of Life Questionnaire (mini-AQLQ). Spearman’s rank correlation analysis was performed to understand the relationship between mean mini-AQLQ score and asthma control. Receiver operating characteristic curve analysis was performed to establish cut-off values for mini-AQLQ. Results. Asthma was uncontrolled in 67.9% subjects. There was a strong correlation between asthma control and quality of life (rs=0.772; P<0.01). A cut-off value for the quality of life was established at 4.97. Majority of the patients were taking two or three antiasthmatic drugs. Oral tablet and inhaler short-acting beta agonists (SABA) were the frequently combined drugs. Uncontrolled asthma was associated with middle-aged adults (adjusted odds ratio AOR=6.31; 95% CI: 2.06, 19.3; P=0.001), male gender (AOR=0.38; 95% CI: 0.15, 0.98; P=0.044), married (AOR=0.24; 95% CI: 0.08, 0.78; P=0.017), comorbidities (AOR=0.23; 95% CI: 0.09, 0.61; P=0.003), and oral SABA use (AOR=0.22; 95% CI: 0.09, 0.59; P=0.003). Male gender (AOR=0.36; 95% CI: 0.16, 0.84; P=0.018), intermittent asthma (AOR=0.18; 95% CI: 0.04, 0.86; P=0.032), use of oral corticosteroids (AOR=0.22; 95% CI: 0.06, 0.73; P=0.013), and SABA (AOR=0.39; 95% CI: 0.17, 0.89; P=0.026) were found to have a significant association with poor asthma-related quality of life. Conclusion. The findings collectively indicate asthma remains poorly controlled in a large proportion of asthma patients in the study setting. Moreover, quality of life appears to be directly related to asthma control. Healthcare providers should therefore focus on asthma education with an integrated treatment plan to improve asthma control and quality of life.
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5

Steel, S., S. Lock, N. Johnson, Y. Martinez, E. Marquilles, and R. Bayford. "A Feasibility Study of Remote Monitoring of Asthmatic Patients." Journal of Telemedicine and Telecare 8, no. 5 (October 2002): 290–96. http://dx.doi.org/10.1177/1357633x0200800508.

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We assessed the feasibility of a remote monitoring system for asthmatic patients to use in their own homes. Eighty-four patients were invited to participate following discharge from hospital after an acute exacerbation of their asthma. We remotely monitored 33 patients from two hospitals for two weeks. Their mean age was 34 years (range 17–50 years). Patient compliance with monitoring was 80% (range 45–231%) and compliance with transmitting the results using a modem was 52% (range 0–100%). The average time spent teaching patients how to perform measurements was 16 min (range 2–55 min) and time spent providing asthma education was 39 min (range 5–135 min). Ninety-six per cent of patients found the equipment easy or very easy to use and 92% said they would use the equipment again in the future. Medical intervention occurred in 48% of patients during the study period, which suggests that the use of remote monitoring could be important in reducing asthma morbidity and improving treatment outcomes.
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6

Krym, Valerie F., Brent Crawford, and Russell D. MacDonald. "Compliance with guidelines for emergency management of asthma in adults: experience at a tertiary care teaching hospital." CJEM 6, no. 05 (September 2004): 321–26. http://dx.doi.org/10.1017/s1481803500009581.

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ABSTRACTObjectives:Despite evidence-based clinical practice guidelines for the emergency management of asthma, substantial treatment variation exists. Our objective was to assess compliance with the Canadian Association of Emergency Physicians (CAEP) / Canadian Thoracic Society (CTS) Asthma Advisory Committee’s “Guidelines for the emergency management of asthma in adults” in the emergency department (ED) of a university-affiliated tertiary care teaching hospital.Methods:This retrospective study was conducted in a Canadian inner city adult ED. Investigators reviewed all ED records for the period from Jan. 1, 2001, to Dec. 31, 2001, and identified adult patients (i.e., &gt;18 years of age) with a primary ED diagnosis of asthma. Hospital records were then reviewed to document compliance with the CAEP/CTS asthma guidelines. Descriptive statistics, including means, standard deviations and frequencies were used to summarize information.Results:Overall compliance with the guidelines was 69.6%, (95% confidence interval, 64.7%–74.5%), but compliance ranged from 41.4% for severe asthma, 67.1% for moderate asthma, and 88.6% for mild asthma. Interobserver reliability for compliance assessment was excellent.Conclusions:Despite publication and dissemination of evidence-based guidelines for the management of acute asthma in adults, guideline compliance at a university-affiliated, inner city, tertiary care teaching hospital ED is suboptimal.
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Panda, Abinash, and Sadhana Panda. "Parental beliefs and practices in childhood asthma – A hospital based cross-sectional study." Panacea Journal of Medical Sciences 12, no. 1 (April 15, 2022): 128–33. http://dx.doi.org/10.18231/j.pjms.2022.024.

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Childhood asthma represents a significant burden, not only in terms of morbidity and reduced quality of life but also in terms of healthcare costs, as reflected by the high rates of unscheduled emergency department visits, hospitalization, and school absenteeism. Parents play a key link in asthma management and adherence to treatment regimen in the early years of childhood before children can manage their asthma independently. However, some parents have misconceptions regarding asthma and its medication, which could in turn influence children’s control of asthma.To find out the effect of parental beliefs and practices with respect to their knowledge about etiology, folk beliefs, home remedies, alternative therapies, etiology and pharmacotherapy in childhood asthma influence the pharmacotherapy and outcome of asthma management.The hospital based cross sectional study was carried out on a convenience sample of 82 parents of children, 5-14 years of age and clinically diagnosed with asthma of any form in the Department of Pediatrics, F.M. Medical College & Hospital, a tertiary care teaching hospital in Balasore town in the eastern part of India. The parents’ beliefs and practices were captured with the help of a pre-designed and validated questionnaire. Descriptive analytical statictics was used to analyse the demographic data. Chi square test was used to find out the association of beliefs, use of home remedies, folk beliefs and alternative therapies and the use of prescribed asthma medications as per standard reference. GraphPad Prism free trial version 7.0 was used for statistical analysis. Statistical significance was taken at a level of p ≤ 0.05.Majority of the children were in the age group of 10-14 years with a male predominance. Most of the primary care givers less than 40 years age and literate, 30 (36.6%) having more than two children and a family history of asthma. The common beliefs were that asthma was chest allergy, of hereditary origin. Exposure to dust, indoor smoke believed to be a significant potential triggering factor for asthma attack The participants (68.2%) believed that inhaled steroids had more side effects lead to dependency also believed using inhaler only when serious. Domiciliary treatment was preferred. 𝛽-agonist were the commonest medications.Parental beliefs and practices have a predominant role in the management of asthma in children. In order to enhance the level of perceptions among caregivers, education should include knowledge about asthma and its management, as there might be misperceptions about the use of inhalers and the safety of inhaled corticosteroids.
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K, Keerthi, Gireeshan V.K, and Deepthi K. "Is Parent Education Tool Effective in Improving Awareness among Parents of a Wheezing Child? A Pre-Experimental Study." Journal of Evidence Based Medicine and Healthcare 8, no. 06 (February 8, 2021): 298–301. http://dx.doi.org/10.18410/jebmh/2021/58.

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BACKGROUND Asthma is a common chronic disease in childhood. Globally, more than 339 million people are estimated to have asthma. The prevalence of childhood asthma in India is about 6 %. Even though childhood asthma is highly prevalent, the knowledge level among parents / caregivers about the disease, its risk factors, prevention and management is poor. Currently, in India there are no national or state level bodies to provide relevant information about the disease. The rationale of this study is to create a parent education tool that will provide the necessary details about the disease and to check the effectiveness by assessing the improvement in knowledge about childhood asthma among parents of wheezers after implementation of this self-prepared educational tool through a structured teaching programme. METHODS A pre-test post-test pre-experimental study was conducted among parents of children admitted to paediatric ward and intensive care unit of a tertiary care centre in North Kerala. A self-prepared questionnaire was used to assess the knowledge of parents before intervention. Intervention was done using an educational tool prepared by the researcher with the aid of power point presentation and hands on training on technique of using metered dose inhaler. Effectiveness of the tool was assessed after 10 days of intervention using the same questionnaire. Statistical analysis of collected data was done using Statistical Package for the Social Sciences (SPSS) version 26. RESULTS 51 parents were included in the study. The scoring of questionnaire before and after educational intervention was done as poor (< 10 score), average (11 - 20 score) and good (21 - 31 score). The mean score before intervention was 9.98 (SD = 3.14) and after intervention the score became 17.73 (SD = 2.562), and the difference was statistically significant (P = 0.00). Mean score of the knowledge regarding treatment and prevention of asthma improved to 10.18 (SD = 2.133) from 4.29 (SD = 2.212). CONCLUSIONS A well-developed parent education tool is a requirement for minor adjustments needed in the lifestyle of a child with asthma, which ensures proper prevention and treatment. KEYWORDS Childhood Asthma, Wheezing Child, Parent Education, Asthma Education Tool, Asthma Awareness
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9

Grant, Cameron C., Anne K. Duggan, and Catherine DeAngelis. "Independent Parental Administration of Prednisone in Acute Asthma: A Double-Blind, Placebo-Controlled, Crossover Study." Pediatrics 96, no. 2 (August 1, 1995): 224–29. http://dx.doi.org/10.1542/peds.96.2.224.

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Objective. To determine the effectiveness of a single dose of prednisone administered by a parent to a child early in an asthma attack. Design. A randomized, double-blind, placebo-controlled, crossover study with children enrolled for 12 months (6 months prednisone, 6 months placebo). Setting. A primary-care clinic and emergency department of an inner-city teaching hospital from March 1992 through May 1993. Children. Children 2 to 14 years of age enrolled in this clinic who had made two or more outpatient (emergency department or primary-care clinic) visits for acute asthma in the preceding year. Selection. There were 204 eligible children, of whom 86 were contacted and enrolled; of these, 78 (91%) completed the study. Intervention. Capsules containing prednisone (2 mg/kg up to 60 mg) or placebo. Parents were instructed to give their child one capsule for an asthma attack that had not improved after a dose of the child's regular acute asthma medicine. Measurements. Parents were interviewed every 3 months. Computerized patient records and chart reviews were used to verify parent reports. Outcome measures were the numbers of outpatient visits and hospitalizations for treatment of acute asthma. Results. Neither the total number of attacks nor the number for which medicine was used differed significantly by arm of study. There was a larger number of attacks resulting in outpatient visits when children were in the group that received prednisone (1.1 ± 0.59 versus 0.59 ± 0.86). This trend was less pronounced but persisted when limited to attacks for which the medicine was given (0.58 ± 0.99 versus 0.35 ± 0.55). Neither the number of attacks resulting in admission nor the number of hospital days differed significantly by arm of study. Conclusions. A single dose of prednisone available for use at home early in an asthma attack was associated with an increase in outpatient visits made for acute asthma. When prednisone was given for an attack, there was no reduction in outpatient visits. This intervention can not be recommended for children with asthma. These results should be confirmed in other pediatric populations.
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Kebede, Bezie, Girma Mamo, and Abebaw Molla. "Association of Asthma Control and Metered-Dose Inhaler Use Technique among Adult Asthmatic Patients Attending Outpatient Clinic, in Resource-Limited Country: A Prospective Study." Canadian Respiratory Journal 2019 (August 1, 2019): 1–6. http://dx.doi.org/10.1155/2019/6934040.

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Asthma is a heterogeneous disease which is characterized by chronic airway inflammation. It is a common chronic respiratory disease affecting 1–18% of population in different countries. It can be treated mainly with inhaled medications in several forms, including pressurized metered-dose inhaler (MDI). Patients encountered difficulty in using inhaler devices even after repeated demonstration and/re-evaluation. This could highly compromise patient treatment outcome/asthma control. To evaluate relationship between MDI use technique and asthma control among adult asthmatic patients who attend respiratory clinic in Jimma University Medical Center (JUMC), Southwest Ethiopia. A prospective observational study was conducted from March to August 22, 2018. All adult asthmatic patients who met the inclusion criteria were included in the study. Patient baseline assessment was conducted (patient demography, inhalation technique, adherence, and asthma control status). Inhalation technique was obtained using a standard checklist of steps recommended in National Institute of Health (NIH) guidelines. Patient adherence using asthma inhalation test and asthma control status was assessed by 2017 GINA guideline. Independent predictors of outcome were identified, strength of association between dependent and independent variables was determined by using ordinal logistic regression analysis, and statistical significance was considered at P<0.05. One hundred forty patients were included in the analysis. Among these, 26 (18.4%) patients were controlled, 65 (46.1%) partially controlled, and 35% uncontrolled. Proportion of patients with uncontrolled asthma were higher among inefficient as compared to efficient, whereas patients with controlled asthma were higher among efficient as compared to inefficient. Asthma control status is significantly associated with inhalation technique (P=0.006). Since most of the patients were inefficient and it is significantly associated with asthma control status, the hospital tried to adopt video MDI teaching program, and the patient should ask healthcare professionals how to take medication and they should bring their device to receive demonstration during visit. Health professionals should re-evaluate the patient during their hospital visit and encourage bringing their device to give demonstration.
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Hamdan, Saba Jassim, Zaid Al-Attar, and Imad Hashim. "Prevalence of Montelukast Use as an Add-On Therapy among Iraqi Asthmatics on Treatment Attending Al-Kindy Teaching Hospital and Al-Zahraa Center of Asthma and Allergy." Open Access Macedonian Journal of Medical Sciences 7, no. 14 (July 20, 2019): 2246–50. http://dx.doi.org/10.3889/oamjms.2019.645.

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BACKGROUND: Montelukast (Singulair) is a cysteinyl leukotriene receptor antagonist, used for the maintenance treatment of asthma and to relieve symptoms of seasonal allergic rhinitis and asthma, also used for exercise-induced bronchospasm. AIM: This study was performed to determine the prevalence of Montelukast use as an add-on therapy among Iraqi asthmatic patients on treatment. Comparing the effectiveness of regimens with and without montelukast. METHODS: This descriptive cross-sectional study was carried out on 73 Iraqi asthmatic patients on treatment of both sexes with age range (18-60) years old, attending Al-Kindy Teaching Hospital and Al-Zahraa Centre of Asthma and Allergy, Baghdad, for the period between February and March 2017. A questionnaire was specifically prepared to meet the objectives and was used to collect the data of the study. RESULTS: There was a significant statistical reduction of frequency in asthmatic attacks after Montelukast treatment (p-value < 0.05). Out of 73 patients, 39 were males, and 34 were females, 46 were jobless, 37 were married, 63 were urban residents, 63 were educated. Prevalence of exacerbation factors was as following: infection was found in 60.3% of the patients, exercise in 57.5%, dust in 72.6%, smoking in 60.6%, food in 24.7%, others (stress, perfumes) in 20.5%. The prevalence of Montelukast use in this study was 46% (34 patients). Out of 34 patients using Montelukast, 28 were using inhaled salbutamol, 5 were using oral salbutamol, 15 were using inhaled corticosteroids, 9 were using systematic corticosteroids, 2 were using xanthines, and 6 were using ketotifen. CONCLUSION: Montelukast was used as add-on therapy with the inhaled corticosteroids to reduce the required dose of inhaled corticosteroids also the use of Montelukast lead to reduced number of exacerbations which will be reflected on the use of inhaled salbutamol and systematic corticosteroids. Also, Montelukast was superior to xanthines and ketotifen as an add-on therapy.
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Hamdan, Saba Jasim. "The Efficacy and Prevalence of Montelukast Therapy in Cough-Variant Asthma Patients in Al-Kindy Teaching Hospital." Open Access Macedonian Journal of Medical Sciences 8, B (April 25, 2020): 156–59. http://dx.doi.org/10.3889/oamjms.2020.4102.

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BACKGROUND: Cough-variant asthma (CVA) is a type of asthma in which the main symptom is a dry, non-productive cough. OBJECTIVE: The objective of the study was to evaluate the therapeutic effect of Montelukast in CVA and to investigate the prevalence of Montelukast in CVA. METHODS: A cross-sectional study was conducted on 30 patients with chronic cough at least 8 weeks using Montelukast at Al-Kindy Hospital over the period of January 2018‒March 2018. An interview using questionnaire was used to collect the data that were specifically prepared to meet the objective of study including age, sex, associated disease, exacerbation factors, and classical therapy. RESULTS: There was a reduction of the symptoms associated with CVA after treatment with Montelukast. The prevalence of exacerbation factors was as follows: Dust (73.3%) of patients, food (36.7%), exercise (60%), psychological (56.7%), smoking (30%), and others (perfume and cold weather) (26.7%). The usage of Montelukast in this study was 73.3% (22 patients). Patients using Montelukast have shown improvement of symptoms as follows: Chest pain was relieved from 57.1% of patients, exhaustion (58.3%), vomiting (76.5%), sleep disturbance (54.5%), affecting daily life in 57.1%, and syncope 66.7%. CONCLUSION: The prevalence of Montelukast administration to the patients with chronic cough in our study was found to be more than 70% of the 30 total patients. Montelukast usage leads to reduction in the frequency of chronic cough and the symptoms associated with it.
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Gillani, Saima, Ghulam Abbas Qazi, Ibrahim ., Samiullah Khan, Shazia Bibi, and Abdul Hanan Farooq. "Comparison of Nebulized vs Systemic Corticosteroids for Management of Children Presenting with Acute Exacerbation of Asthma." Pakistan Journal of Medical and Health Sciences 16, no. 2 (February 26, 2022): 938–40. http://dx.doi.org/10.53350/pjmhs22162938.

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Objective: The aim of current study is to determine the outcomes of nebulized vs systemic corticosteroids for the treatment of children presenting with acute exacerbation asthma. Study Design: Simple blind/parallel study Place and Duration: Children Medical Center (CMC) / Dr Habib un Nabi Children Hospital Airport Road Mingora Swat and Pediatrics department of Ayub Medical College and Teaching Hospital, Abbottabad for the duration 06 months from April 2021 to September 2021. Methods: There were 60 cases of both genders presented with ages <10 years. Included patients had acute exacerbation of asthma. After obtaining written agreement, the demographics of all registered patients were recorded. Patients were split into 2-groups. Group I received nebulized corticosteroids and group II received systemic corticosteroids. Post treatment after 2 weeks of follow up outcomes among both groups were assessed by using oscillometric resistances. SPSS 21.0 version was used to analyze complete data. Results: There were 40 males (20 in each group) and 20 females (10 in each group). Mean age of the patients in group I was 5.8±7.45 years and group II had mean age 6.4±4.35 years. In group I 19 (63.3%) cases had family history of allergy and in group II 18 (60%) cases had history. Mean duration of asthma in group I was 3.4±6.15 years and in group II mean duration was 4.1±4.19 years. Mean hospitalization was lower in group I 1.5±3.14 days as compared to group II 2.8±9.31 days. By using oscillometric resistances reduction in disease severity was found higher in group I 4.1±5.14 as compared to group II 5.1±5.12 from 8.3±6.31. Conclusion: We concluded in this study that the use of nebulized steroids were effective and useful as compared to systemic steroid in the treatment of acute exacerbation asthma in terms of reduction of severity of disease and hospital stay.
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Prichard, Sarah S. "Treatment Modality Selection in 150 Consecutive Patients Starting Esrd Therapy." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 16, no. 1 (January 1996): 69–72. http://dx.doi.org/10.1177/089686089601600116.

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Objective The purpose of this study was to assess the reasons for treatment modality selection between hemodialysis (HD) and peritoneal dialysis (PD) in 150 consecutive patients in a single center. Design This study is a retrospective study using chart review as the data collection method. Setting A single tertiary care university teaching hospital. Patients One hundred and fifty consecutive patients starting end-stage renal disease (ESRD) therapy at the Royal Victoria Hospital in Montreal were assessed. Their treatment modality at 6 weeks after starting dialysis was recorded as their treatment modality. Patients transplanted or who died prior to that 6 week period were excluded. Main Outcome Measures The treatment modality, that is, either HD or PD, at 6 weeks after the initiation of ESRD was the modality assigned to the patient. Results One hundred and fifty patients started ESRD therapy of whom 83 went to HD and 67 to PD. Thirty-one patients were directed to HD, including 20 for social reasons, 3 with ostomies, and 6 with unsuitable abdomens. Fourteen patients were directed to PD, including 10 with severe cardiovascular disease, 3 with no vascular access, and one for geographical reasons. Of 31 diabetics who were encouraged to do PD, 17 went to PD and 14 to HD (10 for social reasons, 3 refused PD, and one with an inappropriate abdomen). Seventy-four patients were initially eligible for either PD or HD. Fifty percent (37) went to PD and 50% to HD. Of those going to HD, 15 went to self-care HD, of whom 7 had prior exposure to HD. Eleven were not informed regarding PD. There was no gender preference for PD versus HD. Conclusion We conclude that among informed patients, if given a choice of treatment modality, the majority will choose self-care dialysis including continuous ambulatory peritoneal dialysis (CAPD) or selfcare HD.
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Farag, Zahra Hassan Abdelaziz, and Elhadi Mohieldin Awooda. "Dental Erosion and Dentin Hypersensitivity among Adult Asthmatics and Non-asthmatics Hospital-based: A Preliminary Study." Open Dentistry Journal 10, no. 1 (November 4, 2016): 587–93. http://dx.doi.org/10.2174/1874210601610010587.

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Background: Asthma is a chronic inflammatory condition affecting the airways leading to spasm and swelling of the airways. The medications taken for the treatment of asthma can result in dental erosion and dentin hypersensitivity. Objectives: The aims of this study were to investigate the severity of dental erosion amongst adult asthmatics according to: gender, type and duration of medication taken and to compare dental erosion and dentin hypersensitivity between asthmatics and non-asthmatics. Subjects and Methods: Comparative, cross-sectional hospital based study among 40 asthmatics (M=15 & F=25) and 40 non-asthmatics (M=18 & F=22) in the age range of 18-60 year selected purposefully from Al-Shaab Teaching Hospital in Khartoum city. The Basic Erosive Wear Index was used for dental erosion assessment. Dentine hypersensitivity was determined by giving ice cold water and rated using the Visual Analogue Scale. Chi-square and Student’s t-test were used for statistical analysis with P value ≤.05. Results: There was an association between severity of dental erosion and presence of asthma (P=0.03), where asthmatics had a higher degree of erosion (moderate and severe) and non-asthmatics a lower degree. No significant association was found between dental erosion and gender, type and duration of medication among asthmatics group. A statistically significant difference was revealed in the degree of dentin hypersensitivity (P=0.00) among asthmatics (35.13%) and non-asthmatics (14.13%). Conclusion: Asthmatic patients had a higher degree of dental erosion and dentin hypersensitivity compared to non-asthmatics. Among asthmatic patients there was no association between severity of dental erosion and gender, type and duration medication was taken for.
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Khdair, Sura Abbas, Manal Khalid Abdulridha, and Mostafa Abdal Fatah. "Effect of Curcumin Supplement on Pulmonary Functions, Total and Differential White Blood Cell Count, Serum Level of Leptin and Body Mass Index in a Sample of Iraqi Patients with Chronic Bronchial Asthma." Al Mustansiriyah Journal of Pharmaceutical Sciences 19, no. 2 (June 1, 2019): 47–58. http://dx.doi.org/10.32947/ajps.v19i2.556.

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Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation together with increased oxidative stress that lead to clinical symptoms of asthma. Obesity is a known risk factor of asthma as the obesity is correlated with systemic inflammation and airway restriction. Curcumin, a natural product derived from the rhizomes of Curcuma longa (Turmeric), has a wide range of beneficial properties including anti-inflammatory and weight reducing agent. This study was designed to evaluate the effect of curcumin as supplement therapy on the pulmonary function, total and differential white blood cell count and metabolic status of chronic bronchial asthmatic patients. It is a prospective randomized controlled interventional study carried out on 40 patients visiting Al-Yarmouk teaching hospital and conducted from October 2017 to April 2018. The patients were allocated into group1; include 17 asthmatic patients assigned to receive conventional therapy for asthma alone, and group 2; include 23 asthmatic patients assigned to receive conventional therapy for asthma plus 750 mg curcumin capsule twice daily for two months. Results revealed significant improvement in forced expiratory volume in one second (FEV1) and the ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) in group 2 patients after two months(P<0.01). The total white blood cell count didn’t show any difference after treatment except decrease in neutrophil count after curcumin supplement (p< 0.05). The leptin level and body mass index present with no significant difference in both groups after two months (p >0.05).
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Gaidhane, Saket S., Akash A. Khobragade, Abhijeet Joshi, Monisha S. Chavan, Likith H. V., and Akshay A. Chaware. "A pharmacovigilance study in patients of chronic non-infective respiratory diseases attending outpatient department of pulmonary medicine in a tertiary care teaching hospital." International Journal of Basic & Clinical Pharmacology 10, no. 6 (May 25, 2021): 675. http://dx.doi.org/10.18203/2319-2003.ijbcp20212077.

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Background: Adverse drug reactions (ADR) are the known dangers of any medicinal therapy. They are not only responsible for increasing the mortality and morbidity but also for multiplying the health care expenditure. It is important to monitor the adverse effects of the drugs in the patients on treatment for chronic non-infective respiratory diseases attending OPD of pulmonary medicine in a tertiary care teaching hospitalMethods: The study was single-centric, non-randomized and observational hospital-based study which was carried out for a period of 1 and a half years in JJ Hospital. The patients who were included in the study suffered from either of the 4 diseases-Chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis or interstitial lung diseases (ILD). Data were analyzed by using Microsoft excel sheet. Based on the outcome of modified Hartwig and Siegel severity assessment scale, ADRs were grouped into various severity categories.Results: One hundred and thirty-two number of ADRs were seen in 69 out of 352 patients (19.6 %) of the study population. The occurrence of ADR was found slightly higher in males i.e., 53.62% as compared to females i.e., 46.38%. The patients who were on treatment for ILD showed highest percentage of ADRs i.e., 57.89% which is followed by bronchiectasis (17.39%), COPD (16.17%) and lastly asthma (10.26%). The ADRs belonging to GIT system were highest in number i.e., 80. The most frequently occurring ADR in the study was palpitation which occurred in 14 cases i.e., 20.29%. Out of 132 ADRs observed, 96 i.e., 72.73% belonged to the mild category and 36 ADRs i.e., 27.27% belonged to the moderate category. Not a single severe ADR was found in the study.Conclusions: It was found that 19.6% of the patient population suffered from ADRs, which is a considerable number. It is essential that health care professionals should support ADR monitoring process for the safety of the medicinal product. Proper implementation of ADR monitoring will help to reduce the harmful effects by early detection of drug safety problems in patients, assessing the risk-benefit in an individual and the population, improving the selection, rational use of drugs through the provision of timely warning to healthcare professionals.
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Bartram, Jack L., Miriam R. Fine-Goulden, Dido Green, Rahail Ahmad, and Baba PD Inusa. "Asthma in Pediatric Sickle Cell Acute Chest Syndrome: In An Inner City London Hospital." Blood 112, no. 11 (November 16, 2008): 2481. http://dx.doi.org/10.1182/blood.v112.11.2481.2481.

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Abstract Acute Chest Syndrome (ACS) is the second most common cause of hospitalisation in patients with Sickle Cell Disease (SCD) and up to 25% of those admitted will require intensive care management. ACS is a leading cause of death in SCD. It may also play a role in the development of chronic lung disease in SCD patients and the prevalence of Asthma in SCD patients is high. The pathogenesis of ACS is complex. Previous work has suggested a relationship between asthma and higher risk of ACS in children with SCD. Data in the UK is limited. Our aim therefore was to describe the presentation, course and outcome of ACS in our local SCD pediatric population, compared with those children who had ACS with SCD and physician diagnosed Asthma (Asthma). Methods: The data collection took place at The Evelina Children’s Hospital, which is part of St Thomas’ Hospital, a large teaching hospital in Central London, England. There are over 400 children with SCD registered, and around 30 new SCD births per year. A retrospective analysis of patient hospital electronic and paper records was performed of 63 ACS presentations over a three year period from 2003 to 2006. Inclusion in the study required a new infiltrate on chest radiograph plus acute respiratory symptoms in a patient with SCD under the age of 16 years. The group included 16 (25%) presentations in children with SCD and Asthma. Results: No Known Asthma 47 Presentations; Mean age 6.2 yrs (range 1–15yrs); HbSS 87%, HbSC13%; Previous ACS 26% (n=12); Mean length of stay 5.4 days (range 1–27); Mortality 0; Mean C-Reactive protein (CRP) on admission 70 (normal &lt;5); Mean oxygen saturations on presentation 92% in air (40% of patients presented with saturations &lt;92% in air) Physician Diagnosed Asthma 16 Presentations; Mean age 4.6 (range 1–15yrs); HbSS 94%, HbSC 6%; Previous ACS 63% (n=10); Mean length of stay 5.4 (range 2–14); Mortality 0; Mean CRP on admission 41; Mean oxygen saturations on presentation 92% in air (50% of patients presented with saturations &lt;92% in air) DISCUSSION: Demographics: Comparable in terms of age and haemoglobin genotype. Presentation: Patients with asthma were more likely to have had previous ACS. Children with asthma presented with a lower CRP. Treatment: The treatment in both groups including the use of blood transfusion, and need for transfer to intensive care were comparable. However there was an observed difference in the use of inhaled bronchodilators (non asthma 21% v asthma 50%). Steroids were rarely used (4%) to treat the patients who did not have a pre-existing diagnosis of asthma, however were used to treat most (94%) of those patients with asthma. Outcome: Length of stay was comparable, no deaths in either group. CONCLUSION: Although patients in our study group with asthma had a higher frequency of previous ACS episodes, we did not demonstrate that patients with asthma suffer a more severe course of illness.
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Vivian Tsai, Y., Caroline Derrick, Ismaeel Yunusa, Sharon Weissman, Majdi N. Al-hasan, Julie Ann Justo, and P. Brandon Bookstaver. "1388. Epidemiology and Treatment Outcomes of Nontuberculous Mycobacterial Infections at a Community Teaching Hospital in the Southeastern United States." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S779. http://dx.doi.org/10.1093/ofid/ofab466.1580.

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Abstract Background Gaps in evidence concerning the epidemiology of nontuberculous mycobacterial (NTM) organisms and their associated treatment outcomes are evident in the literature. The aim of this study was to describe NTM species distribution and susceptibility profile and associated treatment outcomes among adult patients at a tertiary referral hospital in the Southeastern United States. Methods A retrospective cohort study of adult patients with NTM infections from January 1, 2010 to June 30, 2020 was performed. Included patients had a positive culture for NTM species and clinical suspicion of infection. Patients were excluded if they had concurrent positive culture for M. tuberculosis (MTB) or monomicrobial culture for M. gordonae. Study endpoints included predictors for favorable treatment outcome, species distribution, and susceptibility at baseline. Favorable treatment outcome was defined as physician-guided cessation of therapy due to clinical improvement. Univariate followed by multivariate regression analysis was used to analyze favorable predictors. Results A total of 250 and 78 patients were included in microbiologic and outcomes cohorts, respectively. Among treated patients, 47 (60%) had a favorable treatment outcome. The outcomes cohort consisted primarily of non-Hispanic Caucasians (71%) with pulmonary infection (67%). The most common isolates observed were Mycobacterium avium complex (MAC) (67%) and M. abscessus (18%). Being self-pay, underweight, history of MTB treatment, and concurrent asthma were more common in those with unfavorable treatment outcomes. The significant favorable predictors included antibiotic change not due to escalation or de-escalation of therapy and private insurance. Among MAC isolates, clarithromycin and amikacin were highly susceptible; however, M. abscessus has reduced susceptibility to first-line agents such as amikacin, clarithromycin, and cefoxitin (Table 1). Table 1. Baseline Susceptibility Conclusion Considering the long incubation time, knowledge of prevalence, antimicrobial susceptibility patterns, and outcomes could guide empirical antimicrobial selection for NTM infections. This is particularly useful for M. abscessus infections where most isolates carry significant resistance to one or more first-line agents. Disclosures Julie Ann Justo, PharmD, MS, BCPS-AQ ID, bioMerieux (Speaker’s Bureau)Merck & Co. (Advisor or Review Panel member)Therapeutic Research Center (Speaker’s Bureau)Vaxart (Shareholder) P. Brandon Bookstaver, Pharm D, ALK Abello, Inc. (Grant/Research Support, Advisor or Review Panel member)Biomerieux (Speaker’s Bureau)Kedrion Biopharma (Grant/Research Support, Advisor or Review Panel member)
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Kokandi, Amal A. "Family Medicine Trainees’ Knowledge about Topical Corticosteroids in Jeddah, Saudi Arabia." Open Dermatology Journal 13, no. 1 (April 30, 2019): 13–18. http://dx.doi.org/10.2174/1874372201913010013.

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Background: Topical corticosteroids (TCS) are used to treat a variety of dermatological conditions. The fear of side effects sometimes affects the adherence to treatment. The aim of this study was to assess the knowledge and the attitude of family medicine residents under training for the use of TCS. Methods: Family medicine trainees attending an educational session were surveyed via live electronic questionnaires. Results: A total of 89 (out of 100 who attended the event) people responded to the questionnaire. Undergraduate teaching was the main source of information about TCS. Most of the respondents advised the use of TCS sparingly or using finger-tip unit amount. More than half of them thought TCS can be absorbed and it should not be used to some body areas such as eyelids. Majority of the respondents did not think that TCS use can lead to infections, weight gain or obesity, damage the skin if used for a few weeks, negatively affect health or lead to asthma. More than 40% thought that it is better to stop TCS treatment as soon as possible in atopic dermatitis patients. Conclusion: Family medicine trainees have some fears and misconceptions regarding TCS use. There is a need to increase the knowledge about TCS in undergraduate and postgraduate teaching.
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Chu, Isabel E.-Hui, Weranja Ranasinghe, Madeleine Nina Jones, and Philip McCahy. "Prone versus modified supine percutaneous nephrolithotomy: which is more cost effective in an Australian tertiary teaching hospital?" Journal of Clinical Urology 12, no. 5 (December 20, 2018): 391–95. http://dx.doi.org/10.1177/2051415818817131.

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Introduction: Percutaneous nephrolithotomy is currently one of the main treatment options for large renal stones, but the effect of positioning on comparative costing has been scarcely documented. We aimed to compare the cost effectiveness of modified supine with traditional prone percutaneous nephrolithotomy procedures in the context of Victoria, Australia. Materials and methods: A prospective group of 236 renal units (224 patients) was included in the two-site study, with 76 performed in the prone position and 160 performed in the modified supine position. Costing was calculated using a ‘bottom-up’, all-inclusive framework that generates per-hour costs for theatre, recovery unit and ward costs from base costs and maintenance costs. Percutaneous nephrolithotomy-specific equipment was added to calculate comparative costs of modified supine versus prone procedures. Chi squared and T tests were used for statistical analysis. Results: There was a significant difference in the overall costing between the modified supine and prone groups. The modified supine group had a lower total cost (AUD$6424.29) compared to the prone group (AUD$7494.79) ( P=0.007), lower operative costs (AUD$4250.93 vs. AUD$5084.29, P=0.002) and lower ward costs (AUD$533.55 vs. AUD$1130.20, P<0.001). There was no significant difference in recovery times in the modified supine and prone groups, although the modified supine group appeared to have shorter recovery times (AUD$690.69 vs. AUD$586.05, P=0.209). Conclusions: Modified supine percutaneous nephrolithotomy has significantly lower total costs, operative costs and ward costs compared to prone percutaneous nephrolithotomy. Larger randomised trials are needed to assess these findings further. Level of evidence: Not applicable for this multicentre audit.
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Anjum, M. Z., M. S. H. Ansari, S. Mustafa, T. M. Butt, and M. A. Qureshi. "Chylolymphatic Cysts in Children: A Rare Condition." Pakistan Journal of Medical and Health Sciences 15, no. 6 (June 30, 2021): 1503–5. http://dx.doi.org/10.53350/pjmhs211561503.

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Objective: To find out the clinical findings, anatomical types and preferred operative treatment for paediatric chylolymphatic cysts. Study Design: Prospective study Place and Duration of Study: Department of Pediatric Surgery/General Surgery Bahawal Victoria Hospital, Bahawalpur and Department of Pediatric Surgery/General Surgery Unit-ll, DHQ Teaching Hospital, Dera Ghazi Khan from 1st January 2018 to 31st December 2020 Methodology: Fifteen patients of either gender with age from 18 months to 8 years (96 months) enrolled. Clinical data of all the patients diagnosed as chylolymphatic cyst on exploration was recorded. Results: There were 8 (53.3%) females and 7 (46.7%) males with mean age was 49.80±27.07 (months). Four patients (26.66%) presented with abdominal mass, 5 patients (33.33%) presented with abdominal pain, 1 patient (6.66%) with abdominal mass and pain while 5 patients (33.33%) presented with signs of intestinal obstruction. Three (20%) had cysts at multiple sites, i.e., mesentery of jejunum, ileum and mesentery of sigmoid colon, 5 (33.33%) patients had cysts in jejunal mesentery while 9 (53.33%) patients’ cyst was found in ileal mesentery and 1 (6.66%) had cyst in mesentery of cecum. Fourteen underwent exploratory laparotomy and 1 was managed laparoscopically. Post-operative recovery in 14 patients was uneventful and 1 patient managed by open surgery underwent respiratory complications and later expired. No recurrence was noted during follow up period up to 6 months. Conclusion: Surgical exploration and surgical excision and sometimes resection anastomosis of gut is mainstay of treatment with excellent results. Key words: Paediatric mass abdomen, Mesenteric cysts, Chylolymphatic cyst, Paediatric surgery
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Al Obaidy, Muhammed Waheeb, Sura Ali Hussien, and Sawasn Abd al razak Taha. "ANALYSIS OF TUBERCULIN SKIN TEST IN ADULT ASTHMATIC PATIENTS USING STEROIDS AS PART OF THEIR MANAGEMENT." Global Journal of Health Science 10, no. 9 (August 11, 2018): 35. http://dx.doi.org/10.5539/gjhs.v10n9p35.

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BACKGROUND: Tuberculosis infection being one of the major risk factor for morbidity and mortality in developing countries according to WHO and CDC. The risk of developing TB increases significantly with the drop of immunity.Using steroid (prednisolone or its equivalent) at a dose of more than 15 mg/day more than 4 weeks is associated with significant drop in immunity, hence increasing the risks of being infected with TB to eight folds AIM OF THE STUDY: To assess the risk of developing TB infection in asthmatic patients that use steroid in their asthma treatment regime.MATERIALS &amp; METHODS: A prospective study designed to include patients complaining from Asthma who have visited Baghdad teaching hospital in the period from (June 2016 to June 2017) that included in-patients and out-patients.A questionnaire prepared to document the related information of most concern to the researcher and for the sake of study. RESULTS: In this study, we managed to enroll 60 patients. Male to female ratio was 7:23. 80% of the study cohort lived in urban residence and 20 % in suburban neighborhood. 33.3% of the patients had diabetes as comorbidity. 21.7 % of the patients used inhaled steroid as a modality of management of asthma, while 45% used systemic steroids, and 33.3 % used combined modality. Of the study cohort, 18.3 % used steroid for no more than 4 weeks, and the rest used it for more than 4 weeks. Regarding tuberculin test results, 11.7 % test positive.A significant correlations were found between the tuberculin test and the increasing age of the patient p=0.01, and the duration of use of steroids p=0.001, also, between TST and previous history of TB p=0.04.CONCLUSION: There is no relationship between the type of steroid and the risk of getting TB infection.The risk of steroid on immune system and the raise of risk increase with increasing subject age. The extended period of exposure to steroid will definitely increase the risk of TB infection.
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Din, Israr ud, Muhammad Hafeez, Muhammad Junaid, Arif Raza Khan, and Imran Khan. "ROLE OF RIGID BRONCHOSCOPY IN MANAGEMENT OF TRACHEOBRONCHIAL FOREIGN BODY ASPIRATION." Journal of Medical Sciences 28, no. 4 (December 31, 2020): 345–47. http://dx.doi.org/10.52764/jms.20.28.4.8.

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Objective: To determine the role of Rigid Bronchoscopy in Management of Tracheobronchial Foreign Body Aspiration. Material and Methods: This study was conducted in otolaryngology department, Khyber teaching hospital, Peshawar of one year duration from January 2018 to December 2019. Total 90 Patients of age 4 months to 14 years on clinical suspicion of foreign body bronchus were included, while patients with history of bronchial asthma, pulmonary tuberculosis and radio opaque foreign body bronchus were excluded. Results: Total number of patients was 90 in which male patients were 60 (66.67 %) and female patients were 30 (33.33 %), patients with foreign body bronchus were 80 (88.89%). Male patients with foreign body bronchus was 53 (58.89%) and female 27 (30.00%). In age range from 4 months to 3 years, 35(39%) Patients underwent bronchoscopy in which foreign body bronchus retrieved in 30(37.5%) patients. Conclusion: Patients with history of repeated chest infection, relieved by medicines for some time should not be over look, as vegetative foreign body bronchus are radiolucent and patients usually present late in respiratory compromised state, the clinician must urge, for prompt treatment as rigid bronchoscopy.
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Kuznetsova, O., and Yu Lanovenko. "Exacerbation of Psychosomatic Disorders in Teenagehood." Herald of Kiev Institute of Business and Technology 39, no. 1 (March 28, 2019): 33–37. http://dx.doi.org/10.37203/kibit.2019.39.07.

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The article raises questions about the protective mechanisms in adolescents which shows themselves as psychosomatic diseases. The profound changes in modern society, which require a person of constant adaptation in all spheres of life: live communication is replaced by electronic, robotization of work processes, uncontrolled flow of information, change of concepts, the destruction of traditions, leading to chronic stress, exhaustion and health problems. In particular, as a result of lack of attention and lively communication, excessive demands, replacement of emotional manifestation of love with material goods in the most vulnerable part of the population - adolescents there is a feeling of needlessness, which often leads to depressive states and emotional breakdowns which cause psychological disorders. The article deals with several types of manifestations of psychosomatic diseases, such as allergies, bronchial asthma, heart diseases, diseases of the digestive system and skin, and factors that cause their appearance. The causes of psychosomatic illness are still a controversial issue due to its versatility and ambiguity. The manifestation of the disease can be affected by a variety of factors that may not cause the disease if at least one of them to be removed. Because of this ambiguity, psychosomatics are beginning to be perceived as a mystified pseudoscience. Such an attitude causes distrust to the psychologists of specialists and adherents of this teaching. Study of diseases occurs exclusively in the medical sense. What is the source of treatment in hospitals, where medication slows down the development of complications of such chronic diseases as allergies, bronchial asthma and atopic dermatitis - without treating them thoroughly since these diseases are also psychological.
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Abd Ali, Mustafa N., Ahmed H. Jasim, Abdulrasool N. Nassr, and Monqith A. Kaddish. "Forced vital capacity (FVC), peaked expiratory flow rate (PEFR), are additional parameters in the assessment of the reversibility test." Journal of the Faculty of Medicine Baghdad 60, no. 1 (April 1, 2018): 24–27. http://dx.doi.org/10.32007/jfacmedbagdad.60135.

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Background: Spirometry is an important test performed in patients expect to have airway obstruction, assessment of intense reaction to inhalers (the trial of reversibility of airway blockade) is a normally utilized technique in clinical and academic studies. The consequences of this test are utilized to make choices on treatment, consideration, exclusion from diagnosis and other research think about, and for analytic marking [asthma versus chronic obstructive airway disease (COPD)]. Usually, the (FEV1) or (FVC) standards before and after giving of the bronchodilator are compared and the adjustment is processed to distinguish variations from the norm in lung volumes and air flow.Objective: The aim of this study was to investigate the effectiveness of FVC and PEFR as further constraints to evaluate bronchodilator reaction in asthmatic peoples with severe or moderate airflow blockade.Patients and methods: This study is cross sectional study performed in Baghdad teaching hospital where one hundred patient were enrolled in this study patients were detected with asthma and confirm airway blockade according to (GINA) guide lines. The pulmonary function for all members was investigated with a convenient spirometer (spiro-lab3 Spirometer) as stated by those measures from claiming American thoracic particular social order, The mean and standard deviation results of the predicted% values pulmonary function test were also used for comparisons were measured by t-test. A p-value of ≤ 0.05 considered to be significant statistically.Results: The post bronchodilator (post –BD) results of FVC, PEFR are greater than pre- bronchodilator where are statistically significant P value = 0.00. the amount of the changes of FVC post (BD) was more than 400ml from pre (BD) and the amount of the changes of PEFR post (BD) more than 1000ml from the pre (BD) both were p-value = 0.00.Conclusion: The asthmatic patients with moderate and severe airway obstruction, we observed that FVC and PEFR is a valuable important limit to FEV1 to evaluate reversibility reactionKeyword: forced vital capacity(FVC), peaked expiratory flow rate (PEFR), spirometry and forced expiratory volume in 1st second (FEV1).
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Testrow, Sean, Ryan McGovern, and Vicki Tully. "Secondary care interface: optimising communication between teams within secondary care to improve the rehabilitation journey for older people." BMJ Open Quality 10, no. 1 (February 2021): e001274. http://dx.doi.org/10.1136/bmjoq-2020-001274.

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Effective communication between members of the multidisciplinary team is imperative for patient safety. Within the Medicine for the Elderly wards at Royal Victoria Hospital (RVH) in Dundee, we identified an inefficient process of information-sharing between the orthopaedics outpatient department (OPD) at the main teaching hospital and our hospital’s rehabilitation teams, and sought to improve this by introducing several changes to the work system. Our aim was for all patients who attended the OPD clinic to have a plan communicated to the RVH team within 24 hours.Before our intervention, clinic letters containing important instructions for ongoing rehabilitation were dictated by the OPD team, transcribed and uploaded to an electronic system before the RVH team could access them. We analysed clinic attendances over a 4-week period and found that it took 15 days on average for letters to be shared with the RVH teams. We worked with both teams to develop a clinical communication tool and new processes, aiming to expedite the sharing of key information. Patients attended the OPD with this form, the clinician completed it at the time of their appointment and the form returned with the patient to RVH on the same day.We completed multiple Plan–Do–Study–Act cycles; before our project was curtailed by the COVID-19 pandemic. During our study period, seven patients attended the OPD with a form, with all seven returning to RVH with a completed treatment plan documented by the OPD clinician. This allowed rehabilitation teams to have access to clinic instructions generated by orthopaedic surgeons almost immediately after a patient attended the clinic, essentially eliminating the delay in information-sharing.The introduction of a simple communication tool and processes to ensure reliable transfer of information can expedite information-sharing between secondary care teams and can potentially reduce delays in rehabilitation.
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Barvaliya, Manish, Ashish Anovadiya, and Bhargav M. Purohit. "Introduction of web based e-learning in pharmacology: an innovative way." International Journal of Basic & Clinical Pharmacology 7, no. 10 (September 24, 2018): 2016. http://dx.doi.org/10.18203/2319-2003.ijbcp20183940.

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Background: In current scenario, poor attendances in classes and poor performances of students are a stimulus to think beyond the conventional teaching approach. Being current digital generation, students may show their affection to e-learning. Aim of this study was to introduce the e-learning in Pharmacology with objectives to evaluate its acceptability by students and faculties and learning gain of studentsMethods: Four inter-related e- modules for a topic “drugs used in treatment of bronchial asthma” were prepared and provided to the students. Pre-test was conducted before giving E-modules. Students were instructed to complete the e-modules in seven days and post-test was conducted on last day. Feedbacks from students and faculties were collected. Learning gain of students was evaluated along with their acceptability for e-modules.Results: Total of 147 students participated in the study but, 130 students completed pre-test and post-test, both. The absolute learning gain (% post-test score - % pre-test score) was found 23.3±19.2%. The class average normalized learning gain was found 0.32 (32%) that was significant, as per Hake’s criteria for the effectiveness of educational interventions. Slow speed of internet, background noise in modules, and size of e-modules were some technical problem faced by students. The most of students perceived the modules positively and demanded the e-modules for other topics. The faculties also perceived it positively and suggested to use e-modules additionally to classroom lectures.Conclusions: E-learning modules were taken positively by students and faculties and resulted in significant learning gain.
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Seneviratne, Sinali, Mark Marriott, and Mastura Monif. "065 Presence of anti-myelin oligodendrocyte glycoprotein antibodies in the serum of two patients following alemtuzumab therapy for suspected multiple sclerosis." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A21.2—A21. http://dx.doi.org/10.1136/jnnp-2019-anzan.57.

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IntroductionMyelin oligodendrocyte glycoprotein (MOG) antibody mediated disease is an autoimmune demyelinating disorder which can resemble multiple sclerosis (MS).1 2 Thus, this condition can be misdiagnosed and treated as MS.3 We present the clinical trajectory of two cases initially diagnosed as MS, treated with Alemtuzumab followed by clinical and radiological deterioration. Both were subsequently found to have anti MOG antibody in their serum.MethodsThis is a retrospective case study based on a medical record search of neuroimmunology clinics in two teaching hospitals in Victoria. We searched for patients treated with Alemtuzumab who subsequently tested positive for MOG antibody.ResultsWe found two young women who fulfilled the eligibility criteria. One patient presented with dizziness and vertigo, the other with unilateral optic neuritis. Both had supratentorial MRI lesions and were both diagnosed as having MS. Both patients experienced multiple relapses while on treatment for MS. Hence, they were commenced on Alemtuzumab therapy. Unexpectedly, both patients experienced a decline in their clinical status with worsening of expanded disability status scale (EDSS) and an increasing lesion load on MRI brain. Their serum anti MOG antibodies were then found to be positive. Subsequently, patients were treated with rituximab and plasma exchange with a favorable response.ConclusionsThese two cases demonstrate that Alemtuzumab is ineffective and in fact can worsen cases of anti-MOG antibody associated encephalomyelitis. This highlights the importance of anti MOG antibody testing when patients diagnosed with MS do not respond to Alemtuzumab and in those patients presenting with atypical features of MS.ReferencesWeber MS, Derfuss T, Metz I, Bruck W. Defining distinct features of anti-MOG antibody associated central nervous system demyelination. Ther Adv Neurol Disord. 2018;11:1756286418762083.Narayan R, Simpson A, Fritsche K, Salama S, Pardo S, Mealy M, et al. MOG antibody disease: A review of MOG antibody seropositive neuromyelitis optica spectrum disorder. Mult Scler Relat Disord. 2018;25:66–72.Wildemann B, Jarius S, Schwarz A, Diem R, Viehover A, Hahnel S, et al. Failure of alemtuzumab therapy to control MOG encephalomyelitis. Neurology 2017;89(2):207–9.
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Sedda, Luigi, Abdul Ashish, Alison Unsworth, Jane Martindale, Ramachandaran Sundar, and Martin Farrier. "Comparison of COVID-19 survival in relation to CPAP length of treatment and by comorbidity and transmission setting (community or hospital acquired) in a medium-sized UK hospital in 2020: a retrospective study." BMJ Open 12, no. 11 (November 2022): e060994. http://dx.doi.org/10.1136/bmjopen-2022-060994.

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ObjectiveTo estimate continuous positive airway pressure (CPAP) length of treatment effect on survival of hospitalised COVID-19 patients in a medium-sized UK Hospital, and how this effect changes according to the patient’s comorbidity and COVID-19 route of acquisition (community or nosocomial) during the two waves in 2020.SettingThe acute inpatient unit in Wrightington, Wigan and Leigh Teaching Hospitals National Health Service (NHS) Foundation Trust (WWL), a medium-sized NHS Trust in north-west of England.DesignRetrospective cohort of all confirmed COVID-19 patients admitted in WWL during 2020.Participants1830 patients (568 first wave, 1262 s wave) with antigen confirmed COVID-19 disease and severe acute respiratory syndrome admitted between 17 March 2020 (first confirmed COVID-19 case) and 31 December 2020.Outcome measureCOVID-19 survival rate in all patients and survival rate in potentially hospital-acquired COVID-19 (PHA) patients were modelled using a predictor set which include comorbidities (eg, obesity, diabetes, chronic ischaemic heart disease (IHD), chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD)), wave, age, sex and care home residency, and interventions (remdesivir, dexamethasone, CPAP, intensive care unit (ICU), intubation). Secondary outcome measure was CPAP length, which was modelled using the same predictors of the survival rate.ResultsMortality rate in the second wave was significantly lower than in the first wave (43.4% vs 28.1%, p<0.001), although for PHA COVID-19 patients mortality did not reduce, remaining at very high levels independently of wave and CPAP length. For all cohort, statistical modelling identified CPAP length (HR 95% CI 0.86 to 0.96) and women (HR 95% CI 0.71 to 0.81) were associated with improved survival, while being older age (HR 95% CI 1.02 to 1.03) admitted from care homes (HR 95% CI 2.22 to 2.39), IHD (HR 95% CI 1.13 to 1.24), CKD (HR 95% CI 1.14 to 1.25), obesity (HR 95% CI 1.18 to 1.28) and COPD-emphysema (HR 95% CI 1.18 to 1.57) were associated with reduced survival. Despite the detrimental effect of comorbidities, patients with CKD (95% CI 16% to 30% improvement in survival), IHD (95% CI 1% to 10% improvement in survival) and asthma (95% CI 8% to 30% improvement in survival) benefitted most from CPAP length, while no significant survival difference was found for obese and patients with diabetes.ConclusionsThe experience of an Acute Trust during the COVID-19 outbreak of 2020 is documented and indicates the importance of care home and hospitals in disease acquisition. Death rates fell between the first and second wave only for community-acquired COVID-19 patients. The fall was associated to CPAP length, especially for some comorbidities. While uncovering some risk and protective factors of mortality in COVID-19 studies, the study also unravels how little is known about PHA COVID-19 and the interaction between CPAP and some comorbidities.
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Morrone, Kerry A., Deepti Kalluri, Jennifer G. Davila, Gifty Edusei, Basirat Shoberu, Janna Rosario, Lisa M. Figueiredo, et al. "Decreased Hospital Readmissions for Vaso Occlusive Crisis with Implementation of a Sickle Cell Pain Action Plan (SPAP)." Blood 130, Suppl_1 (December 7, 2017): 867. http://dx.doi.org/10.1182/blood.v130.suppl_1.867.867.

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Abstract Background: Vaso occlusive crisis (VOC) is the most common reason for hospital admissions and emergency room visits in sickle cell disease (SCD). Education of patients, caregivers, and the healthcare team are a key factor in reducing readmission rates following hospitalization for children with VOC. There is a paucity of data on parental understanding of pain medications on hospital discharge, a confusing and intense time for families. This quality improvement (QI) project addresses provider and patient/parent knowledge gaps by incorporating a sickle cell pain action plan (SPAP) into the discharge process. Objectives: The global aim was to decrease the 7 and 30-day readmission rates for VOC by 15% in a pediatric sickle cell population in one year. A multi-disciplinary team initiated a QI project at a single institution between April 2016 and May 2017. Methods: The key drivers comprised of pharmacy, nursing, pediatric residents, patient representatives and pediatric hematologists. The SPAP was modeled on the success of the asthma action plan and helps distinguish patients degree of pain, with specific medical instructions for treatment. PDSA cycles included implementation of the SPAP with medication teaching at bedside, nursing teaching with SPAP during admission and pharmacy consults. The QI leader performed monthly educational modules to the house staff, pharmacists and nursing, and sent weekly email reminders to leaders of the inpatient team. Monthly run charts were created to assess 7 and 30- day readmissions. There are 14 months of data reported to capture both 7 and 30-day readmissions in the total study period. Readmissions were compared monthly to the year prior to implementation of the SPAP. Process measures were the number of documented pharmacy consults, documented SPAPs in the chart and surveys (5 point Likert scale) on patients understanding of their medications post discharge. Results: There were 230 admissions for VOC the 12 months prior to implementation of the SPAP and 293 VOC admissions during the study period. Thirty-day readmission rates from April-July 2016 had a 36% reduction compared to 2015 data. The rise in readmissions during August, November and December of 2016 prompted implementation of new team champions and reeducation of staff, and subsequent months had reduction in readmissions. The cumulative decrease at completion of the project was an 18% reduction in thirty-day readmission rates and 13% reduction in 7-day readmission rates, whether or not there was a documented SPAP. Patients that had a documented SPAP in their chart (n=33) had a 65% reduction in thirty-day readmissions and 22% reduction in seven-day readmissions. Of the patients/parents surveyed (n=20 pre-implementation, n=34 post implementation) 91% and 74% strongly agreed they knew which pain medications to administer and how to escalate care compared to 56% and 47% prior to the project. Ninety percent of the surveyed families agreed that the SPAP: helped them understand their pain medications, remember medication names, was easy to understand and would be used again in the future. Pareto charts showed the following barriers to implementation of the QI intervention: pharmacy consults not performed due to lack of adequate staffing, SPAP documentation lacking despite a pharmacy consult being requested, and difficulties of staff adjusting to a new electronic medical record. Conclusion: VOC readmission rates can be decreased by using a teaching tool to enforce medication understanding upon discharge. The SPAP was highly accepted in our patient population and empowered patients and families to treat their pain crisis at home once discharged. Disclosures No relevant conflicts of interest to declare.
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Abd Ali, Mustafa N., Ahmed H. Jasim, Abdulrasool N. Nassr, and Monqith A. Kaddish. "Forced vital capacity (FVC), peaked expiratory flow rate (PEFR), are additional parameters in the assessment of the reversibility test." Journal of the Faculty of Medicine Baghdad 60, no. 1 (April 1, 2018): 24–27. http://dx.doi.org/10.32007/jfacmedbagdad.v60i1.35.

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Background: Spirometry is an important test performed in patients expect to have airway obstruction, assessment of intense reaction to inhalers (the trial of reversibility of airway blockade) is a normally utilized technique in clinical and academic studies. The consequences of this test are utilized to take choices on treatment, consideration, exclusion from diagnosis and other research think about, and for analytic marking [asthma versus chronic obstructive airway disease (COPD)]. Usually, the (FEV1) or (FVC) standards before and after giving of the bronchodilator are compared and the adjustment is processed to distinguish variations from the norm in lung volumes and air flow.Objective: The aim of this study was to investigate the effectiveness of FVC and PEFR as further constraints to evaluate bronchodilator reaction in asthmatic peoples with severe or moderate airflow blockade.Patients and methods: This study is cross sectional study performed in Baghdad teaching hospital where one hundred patient were enrolled in this study patients were detected with asthma and confirm airway blockade according to (GINA) guide lines. The pulmonary function for all members was investigated with a convenient spirometer (spiro-lab3 Spirometer) as stated by those measures from claiming American thoracic particular social order, The mean and standard deviation results of the predicted% values pulmonary function test were also used for comparisons were measured by t-test. A p-value of ≤ 0.05 considered to be significant statistically.Results: The post bronchodilator (post –BD) results of FVC, PEFR are greater than pre- bronchodilator where are statistically significant P value = 0.00. the amount of the changes of FVC post (BD) was more than 400ml from pre (BD) and the amount of the changes of PEFR post (BD) more than 1000ml from the pre (BD) both were p-value = 0.00.Conclusion: The asthmatic patients with moderate and severe airway obstruction, we observed that FVC and PEFR is a valuable important limit to FEV1 to evaluate reversibility reactionKeyword: forced vital capacity(FVC), peaked expiratory flow rate (PEFR), spirometry and forced expiratory volume in 1st second (FEV1). السعة الحيويه القصوى ومعدل الجريان الزفيري الاعلى وصفات اضافية في تقييم اختبار المعاكسه القصبيه أ.د. مصطفى نعمه عبد علي احمد حسين جاسم عبد الرسول نوري نصر منقذ عبد المحسن كاظم الخلاصه : خلفية البحث : ان جهاز قياس التنفس هو وسيله لقياس تضيق المجاري الهوائية ومدى استجابتها لموسع القصبات عند التشخيص للحالات السريريه , وفي تحديد نوع العلاج , وفي التمييز بين الربو القصبي وانسداد القصبات المزمن . في هذا البحث تم قياس السعة الحيويه القصوى والحجم الزفيري الاعلى في الثانيه وذلك قبل وبعد اعطاء موسع القصبات وقياس الفرق في الحالات الطبيعيه لحجوم الرئه وجريان الهواء فيها . هدف البحث : استخدام عنصر السعة الحيويه القصوى وعنصر معدل الجريان الزفيري الاعلى كعوامل اضافية لتقييم اختبار توسع القصبات في مرضىالربو القصبي ذوي تضيق القصبات المتوسط والشديد. المرضى وطرق العمل:اجريت دراسه مقطعيه في مستشفى بغداد التعليمي على 100 مريض يعانون من الربو مع تضيق المجاري الهوائية حسب التصنيف العالمي (GINA) , وقد اجريت لهم وظائف الرئه . تم استخدام اختبار - testt و p – value على مستوى معنويه اقل او يساوي 0.05. النتائج : اظهرت نتائج السعة الحيويه ومعدل الجريان الزفيري الاعلى بعد اعطاء موسع القصبات هي اكبر من قبل اعطائه مع قيمة p- value تساوي صفر .كما ان معدل التغيير للسعة الحيويه بعد اعطاء موسع القصبات كانت اكثر من 400ml من قبل اعطاء موسع القصبات . وقد بلغ معدل التغيير في الجريان الزفيري الاعلى بعد اعطاء موسع القصبات اكثر من 1000ml بالمقارنة ما قبل اعطاء موسع القصبات , وكانت p- value تساوي صفر . الاستنتاج : في هذا البحث ,كانت السعة الحيويه القصوى ومعدل الجريان الزفيري الاعلى لمرضى الربو القصبي ذات قيمه مهمه لدعم الحجم الزفيري الاقصى في الثانية الاولى لتقييم تفاعل المعاكسة لتوسع القصبات . مفتاح الكلمات : السعه الحيوية القصوى , معدل الجريان الزفيري الاعلى , جهاز قياس التنفس , لحجم الزفيري الاقصى في الثانية الاولى
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Suwahono, Suwahono, and Dwi Mawanti. "Using Environmentally Friendly Media (Happy Body) in Early Childhood Science: Human Body Parts Lesson." JPUD - Jurnal Pendidikan Usia Dini 13, no. 2 (December 5, 2019): 281–95. http://dx.doi.org/10.21009/jpud.132.06.

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The knowledge of the science of human body parts for early childhood is very important so that children have the ability to recognize and support the cleanliness and health of members of the body, as well as so that they recognize their identity. In addition, introducing environmentally friendly material for early childhood teachers to enrich learning media. This study aims to improve student learning outcomes in science using environmentally friendly media. The topic raised in this search was about recognizing body parts and their benefits and treatments. This type of research is action research. Respondents involved 19 early childhood students. The results showed that there was an increase in subjects' understanding of swallowing extremities and treatment 60% in the pre-cycle phase, 80% in the first cycle and 93% in the second cycle. The findings show that the use of happy body media has a positive effect on limb recognition. Further research is recommended on environmentally friendly media and ways of introducing limbs to early childhood through media or strategies suitable for the millennial era. Keywords: Media (Happy Body), Early Childhood Science, Human Body Parts References: Anagnou, E., & Fragoulis, I. (2014). The contribution of mentoring and action research to teachers’ professional development in the context of informal learning. Review of European Studies, 6(1), 133–142. Belsky, J., Steinberg, L., & Draper, P. (1991). Childhood experience, interpersonal development, and reproductive strategy: An evolutionary theory of socialization. Child Development, 62(4), 647. Black, M. M., & Hurley, K. M. (2016). Early child development programmes: further evidence for action. The Lancet Global Health, 4(8), e505–e506. Blok, H., Fukkink, R., Gebhardt, E., & Leseman, P. (2005). The relevance of delivery mode and other programme characteristics for the effectiveness of early childhood intervention. 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S., White, L. J., & Greenfield, D. B. (2018). Approaches to learning and science education in Head Start: Examining bidirectionality. Early Childhood Research Quarterly, 44, 34–42. https://doi.org/10.1016/j.ecresq.2018.02.013 Carr, W. (2006). Philosophy, methodology and action research. Journal of Philosophy of Education, 40(4), 421–435. Colker, L. J. (2008). Twelve characteristics of effective early childhood teachers. YC Young Children, 63(2). Cook, C., Goodman, N. D., & Schulz, L. E. (2011). Where science starts: Spontaneous experiments in preschoolers’ exploratory play. Cognition, 120(3), 341– 349. Dewi Kurnia, H. Z. (2017). Pentingnya Media Pembelajaran. Jurnal Pendidikan Anak Usia Dini, 1 No.1, 81–96. Gelman, R., & Brenneman, K. (2004). Science learning pathways for young children. Early Childhood Research Quarterly, 19(1), 150–158. Gersick, C. J. (1988). Time and transition in work teams: Toward a new model of group development. Academy of Management Journal, 31(1), 9–41. Gopnik, A., Meltzoff, A. N., & Kuhl, P. K. (1999). The scientist in the crib: Mind, brains, and how children learn. New York, NY: William Morrow & Company. Guo, Y., Wang, S., Hall, A. H., Breit-Smith, A., & Busch, J. (2016). The Effects of Science Instruction on Young Children’s Vocabulary Learning: A Research Synthesis. Early Childhood Education Journal, 44(4), 359–367. https://doi.org/10.1007/s10643-015-0721-6 Hadders-Algra, M. (2019). Interactive media use and early childhood development. Jornal de Pediatria, (xx), 1–3. https://doi.org/10.1016/j.jped.2019.05.001 Han, S., Capraro, R., & Capraro, M. M. (2015). How Science, Technology, Engineering, and Mathematics (Stem) Project-Based Learning (Pbl) Affects High, Middle, and Low Achievers Differently: the Impact of Student Factors on Achievement. International Journal of Science and Mathematics Education, 13(5), 1089–1113. https://doi.org/10.1007/s10763-014-9526-0 Harris, P. L., & Kavanaugh, R. D. (1993). Young children’s understanding of pretense. Monographs of the Society for Research in Child Development, 58(1), 1–92. Hayati, H. S., Myrnawati, C. H., & Asmawi, M. (2017). Effect of Traditional Games, Learning Motivation And Learning Style On Childhoods Gross Motor Skills. International Journal of Education and Research, 5(7). Hedefalk, M., Almqvist, J., & Östman, L. (2015). Education for sustainable development in early childhood education: a review of the research literature. Environmental Education Research, 21(7), 975–990. https://doi.org/10.1080/13504622.2014.971716 Herakleioti, E., & Pantidos, P. (2016). The Contribution of the Human Body in Young Children’s Explanations About Shadow Formation. Research in Science Education, 46(1), 21–42. https://doi.org/10.1007/s11165-014-9458-2 İlin, G., Kutlu, Ö., & Kutluay, A. (2013). An Action Research: Using Videos for Teaching Grammar in an ESP Class. Procedia - Social and Behavioral Sciences. https://doi.org/https://doi.org/10.1016/j.sbspro.2013.01.065 Jennifer M. Zosh, Emily J. Hopkins, Hanne Jensen, Claire Liu, Dave Neale, Kathy Hirsh-Pasek, S. L. S. and D. W. (2017). Learning through play : a review of the evidence. Kagan, J., Reznick, J. S., & Snidman, N. (1987). The physiology and psychology of behavioral inhibition in children. Child Development, 1459–1473. Kemmis, S., & Taggart, M. (2002). The action research planner. Victoria: Dearcin University Press. Lebel, C., & Beaulieu, C. (2011). Longitudinal development of human brain wiring continues from childhood into adulthood. Journal of Neuroscience, 31(30), 10937–10947. Luna, B., Garver, K. E., Urban, T. A., Lazar, N. A., & Sweeney, J. A. (2004). Maturation of cognitive processes from late childhood to adulthood. Child Development, 75(5), 1357–1372. Nayfeld, I., Brenneman, K., & Gelman, R. (2011). 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Hoit, G., C. Hinkewich, J. Tiao, V. Porgo, L. Moore, L. Moore, J. Tiao, et al. "Trauma Association of Canada (TAC) Annual Scientific Meeting. The Westin Whistler Resort & Spa, Whistler, BC, Thursday, Apr. 11 to Saturday, Apr. 13, 2013Testing the reliability of tools for pediatric trauma teamwork evaluation in a North American high-resource simulation settingThe association of etomidate with mortality in trauma patientsDefinition of isolated hip fractures as an exclusion criterion in trauma centre performance evaluations: a systematic reviewEstimation of acute care hospitalization costs for trauma hospital performance evaluation: a systematic reviewHospital length of stay following admission for traumatic injury in Canada: a multicentre cohort studyPredictors of hospital length of stay following traumatic injury: a multicentre cohort studyInfluence of the heterogeneity in definitions of an isolated hip fracture used as an exclusion criterion in trauma centre performance evaluations: a multicentre cohort studyPediatric trauma, advocacy skills and medical studentsCompliance with the prescribed packed red blood cell, fresh frozen plasma and platelet ratio for the trauma transfusion pathway at a level 1 trauma centreEarly fixed-wing aircraft activation for major trauma in remote areasDevelopment of a national, multi-disciplinary trauma crisis resource management curriculum: results from the pilot courseThe management of blunt hepatic trauma in the age of angioembolization: a single centre experienceEarly predictors of in-hospital mortality in adult trauma patientsThe impact of open tibial fracture on health service utilization in the year preceding and following injuryA systematic review and meta-analysis of the efficacy of red blood cell transfusion in the trauma populationSources of support for paramedics managing work-related stress in a Canadian EMS service responding to multisystem trauma patientsAnalysis of prehospital treatment of pain in the multisystem trauma patient at a community level 2 trauma centreIncreased mortality associated with placement of central lines during trauma resuscitationChronic pain after serious injury — identifying high risk patientsEpidemiology of in-hospital trauma deaths in a Brazilian university teaching hospitalIncreased suicidality following major trauma: a population-based studyDevelopment of a population-wide record linkage system to support trauma researchInduction of hmgb1 by increased gut permeability mediates acute lung injury in a hemorrhagic shock and resuscitation mouse modelPatients who sustain gunshot pelvic fractures are at increased risk for deep abscess formation: aggravated by rectal injuryAre we transfusing more with conservative management of isolated blunt splenic injury? A retrospective studyMotorcycle clothesline injury prevention: Experimental test of a protective deviceA prospective analysis of compliance with a massive transfusion protocol - activation alone is not enoughAn evaluation of diagnostic modalities in penetrating injuries to the cardiac box: Is there a role for routine echocardiography in the setting of negative pericardial FAST?Achievement of pediatric national quality indicators — an institutional report cardProcess mapping trauma care in 2 regional health authorities in British Columbia: a tool to assist trauma sys tem design and evaluationPatient safety checklist for emergency intubation: a systematic reviewA standardized flow sheet improves pediatric trauma documentationMassive transfusion in pediatric trauma: a 5-year retrospective reviewIs more better: Does a more intensive physiotherapy program result in accelerated recovery for trauma patients?Trauma care: not just for surgeons. Initial impact of implementing a dedicated multidisciplinary trauma team on severely injured patientsThe role of postmortem autopsy in modern trauma care: Do we still need them?Prototype cervical spine traction device for reduction stabilization and transport of nondistraction type cervical spine injuriesGoing beyond organ preservation: a 12-year review of the beneficial effects of a nonoperative management algorithm for splenic traumaAssessing the construct validity of a global disability measure in adult trauma registry patientsThe mactrauma TTL assessment tool: developing a novel tool for assessing performance of trauma traineesA quality improvement approach to developing a standardized reporting format of ct findings in blunt splenic injuriesOutcomes in geriatric trauma: what really mattersFresh whole blood is not better than component therapy (FFP:RBC) in hemorrhagic shock: a thromboelastometric study in a small animal modelFactors affecting mortality of chest trauma patients: a prospective studyLong-term pain prevalence and health related quality of life outcomes for patients enrolled in a ketamine versus morphine for prehospital traumatic pain randomized controlled trialDescribing pain following trauma: predictors of persistent pain and pain prevalenceManagement strategies for hemorrhage due to pelvic trauma: a survey of Canadian general surgeonsMajor trauma follow-up clinic: Patient perception of recovery following severe traumaLost opportunities to enhance trauma practice: culture of interprofessional education and sharing among emergency staffPrehospital airway management in major trauma and traumatic brain injury by critical care paramedicsImproving patient selection for angiography and identifying risk of rebleeding after angioembolization in the nonoperative management of high grade splenic injuriesFactors predicting the need for angioembolization in solid organ injuryProthrombin complex concentrates use in traumatic brain injury patients on oral anticoagulants is effective despite underutilizationThe right treatment at the right time in the right place: early results and associations from the introduction of an all-inclusive provincial trauma care systemA multicentre study of patient experiences with acute and postacute injury carePopulation burden of major trauma: Has introduction of an organized trauma system made a difference?Long-term functional and return to work outcomes following blunt major trauma in Victoria, AustraliaSurgical dilemma in major burns victim: heterotopic ossification of the tempromandibular jointWhich radiological modality to choose in a unique penetrating neck injury: a differing opinionThe Advanced Trauma Life Support (ATLS) program in CanadaThe Rural Trauma Team Development Course (RTTDC) in Pakistan: Is there a role?Novel deployment of BC mobile medical unit for coverage of BMX world cup sporting eventIncidence and prevalence of intra-abdominal hypertension and abdominal compartment syndrome in critically ill adults: a systematic review and meta-analysisRisk factors for intra-abdominal hypertension and abdominal compartment syndrome in critically ill or injured adults: a systematic review and meta-analysisA comparison of quality improvement practices at adult and pediatric trauma centresInternational trauma centre survey to evaluate content validity, usability and feasibility of quality indicatorsLong-term functional recovery following decompressive craniectomy for severe traumatic brain injuryMorbidity and mortality associated with free falls from a height among teenage patients: a 5-year review from a level 1 trauma centreA comparison of adverse events between trauma patients and general surgery patients in a level 1 trauma centreProcoagulation, anticoagulation and fibrinolysis in severely bleeding trauma patients: a laboratorial characterization of the early trauma coagulopathyThe use of mobile technology to facilitate surveillance and improve injury outcome in sport and physical activityIntegrated knowledge translation for injury quality improvement: a partnership between researchers and knowledge usersThe impact of a prevention project in trauma with young and their learningIntraosseus vascular access in adult trauma patients: a systematic reviewThematic analysis of patient reported experiences with acute and post-acute injury careAn evaluation of a world health organization trauma care checklist quality improvement pilot programProspective validation of the modified pediatric trauma triage toolThe 16-year evolution of a Canadian level 1 trauma centre: growing up, growing out, and the impact of a booming economyA 20-year review of trauma related literature: What have we done and where are we going?Management of traumatic flail chest: a systematic review of the literatureOperative versus nonoperative management of flail chestEmergency department performance of a clinically indicated and technically successful emergency department thoracotomy and pericardiotomy with minimal equipment in a New Zealand institution without specialized surgical backupBritish Columbia’s mobile medical unit — an emergency health care support resourceRoutine versus ad hoc screening for acute stress: Who would benefit and what are the opportunities for trauma care?A geographical analysis of the Early Development Instrument (EDI) and childhood injuryDevelopment of a pediatric spinal cord injury nursing course“Kids die in driveways” — an injury prevention campaignEpidemiology of traumatic spine injuries in childrenA collaborative approach to reducing injuries in New Brunswick: acute care and injury preventionImpact of changes to a provincial field trauma triage tool in New BrunswickEnsuring quality of field trauma triage in New BrunswickBenefits of a provincial trauma transfer referral system: beyond the numbersThe field trauma triage landscape in New BrunswickImpact of the Rural Trauma Team Development Course (RTTDC) on trauma transfer intervals in a provincial, inclusive trauma systemTrauma and stress: a critical dynamics study of burnout in trauma centre healthcare professionalsUltrasound-guided pediatric forearm fracture reduction with sedation in the emergency departmentBlock first, opiates later? The use of the fascia iliaca block for patients with hip fractures in the emergency department: a systematic reviewRural trauma systems — demographic and survival analysis of remote traumas transferred from northern QuebecSimulation in trauma ultrasound trainingIncidence of clinically significant intra-abdominal injuries in stable blunt trauma patientsWake up: head injury management around the clockDamage control laparotomy for combat casualties in forward surgical facilitiesDetection of soft tissue foreign bodies by nurse practitioner performed ultrasoundAntihypertensive medications and walking devices are associated with falls from standingThe transfer process: perspectives of transferring physiciansDevelopment of a rodent model for the study of abdominal compartment syndromeClinical efficacy of routine repeat head computed tomography in pediatric traumatic brain injuryEarly warning scores (EWS) in trauma: assessing the “effectiveness” of interventions by a rural ground transport service in the interior of British ColumbiaAccuracy of trauma patient transfer documentation in BCPostoperative echocardiogram after penetrating cardiac injuries: a retrospective studyLoss to follow-up in trauma studies comparing operative methods: a systematic reviewWhat matters where and to whom: a survey of experts on the Canadian pediatric trauma systemA quality initiative to enhance pain management for trauma patients: baseline attitudes of practitionersComparison of rotational thromboelastometry (ROTEM) values in massive and nonmassive transfusion patientsMild traumatic brain injury defined by GCS: Is it really mild?The CMAC videolaryngosocpe is superior to the glidescope for the intubation of trauma patients: a prospective analysisInjury patterns and outcome of urban versus suburban major traumaA cost-effective, readily accessible technique for progressive abdominal closureEvolution and impact of the use of pan-CT scan in a tertiary urban trauma centre: a 4-year auditAdditional and repeated CT scan in interfacilities trauma transfers: room for standardizationPediatric trauma in situ simulation facilitates identification and resolution of system issuesHospital code orange plan: there’s an app for thatDiaphragmatic rupture from blunt trauma: an NTDB studyEarly closure of open abdomen using component separation techniqueSurgical fixation versus nonoperative management of flail chest: a meta-analysisIntegration of intraoperative angiography as part of damage control surgery in major traumaMass casualty preparedness of regional trauma systems: recommendations for an evaluative frameworkDiagnostic peritoneal aspirate: An obsolete diagnostic modality?Blunt hollow viscus injury: the frequency and consequences of delayed diagnosis in the era of selective nonoperative managementEnding “double jeopardy:” the diagnostic impact of cardiac ultrasound and chest radiography on operative sequencing in penetrating thoracoabdominal traumaAre trauma patients with hyperfibrinolysis diagnosed by rotem salvageable?The risk of cardiac injury after penetrating thoracic trauma: Which is the better predictor, hemodynamic status or pericardial window?The online Concussion Awareness Training Toolkit for health practitioners (CATT): a new resource for recognizing, treating, and managing concussionThe prevention of concussion and brain injury in child and youth team sportsRandomized controlled trial of an early rehabilitation intervention to improve return to work Rates following road traumaPhone call follow-upPericardiocentesis in trauma: a systematic review." Canadian Journal of Surgery 56, no. 2 Suppl (April 2013): S1—S42. http://dx.doi.org/10.1503/cjs.005813.

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Hadia, Rajesh, Priyesha Bhatt, Anadisharan Panchal, Anjali Gandhi, Trupal Rathod, Dhaval Joshi, Sunil Baile, Rajesh Maheshwari, Stani Ajay, and Hemraj Singh Rajput. "An Observational Study on Drug Utilization Pattern in Asthma and Chronic Obstructive Pulmonary Disease in Tertiary Care Teaching Hospital." Journal of Pharmaceutical Research International, August 5, 2021, 187–98. http://dx.doi.org/10.9734/jpri/2021/v33i40a32234.

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Background: Obstructive airway diseases such as asthma and COPD are defined as a decreased capacity to get air through the conducting airways and out of the lungs. Objective: To study the drug utilization pattern in asthma and chronic obstructive pulmonary disease, determine irrationally (does not comply with prescription) drug usage, and whether they were prescribed following the standard treatment guidelines. Methodology: A total of 150 patients of either sex aged 18 years and above having asthma and/or COPD were included in the study. The medical records of patients were checked and information was recorded. The prescriptions were analyzed for drug utilization patterns. The newly diagnosed patients were followed up and medication adherence was determined after 1 month. Results: Out of all 150 patients there were 103 male and 47 female patients. 54 patients were having asthma, 89 patients COPD, and 7 patients asthma COPD overlap. The majority of the patient were prescribed 1 to 3 drugs per prescription. Inhaled corticosteroids were the highest prescribed drug class. The most commonly prescribed drug combination was budesonide + formoterol. The majority of the patients have poorly adhered to the treatment. Conclusion: Study data highlights that very few drug interactions were identified between prescribed medications. The drugs and their combinations were prescribed according to the standard guidelines GOLD (Global Initiative for Chronic Obstructive Lung Disease) and GINA (Global Initiative for Asthma).
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Hadia, Rajesh, Azrin Shaikh, Twinkle Ajay, Elizabeth Philip, Dhaval Joshi, Trupal Rathod, Arti Shah, and Hemraj Singh Rajput. "A Cross-sectional Observational Study on Pharmacoeconomic Burden of Asthma in a Tertiary Care Teaching Hospital." Journal of Pharmaceutical Research International, July 15, 2021, 292–301. http://dx.doi.org/10.9734/jpri/2021/v33i37a32011.

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Background: Asthma remains one of the most common chronic respiratory diseases. Even with significant advancement in the diagnosis and management of asthma, its control remains suboptimal. As the overall health expenditures are escalating, the healthcare community has become more sensitive to the concept of Pharmacoeconomic. Objective: We aimed to assess the healthcare cost; economic burden associated with the management of asthma. Methodology: A Prospective Observational Study was conducted in a Hospital of Vadodara, Gujarat, India with the sample of 120 patients. Patient’s data, financial data and the healthcare cost were collected while interviewing the patient. The healthcare costs included were direct medical cost, direct non-medical cost, and indirect cost. Result: The average costs per asthmatic patient per month with severe, moderate and mild asthma were found to be USD 65.27, USD 50.89, and USD 48.85, respectively. The average overall cost with or without co-morbidity were calculated as USD 56 and USD 38, respectively. Out of USD 53.6, the average direct medical cost was USD 29.6, the average direct non-medical cost was USD 17.4, and the average total indirect cost was USD 6.6. The mean total cost for inpatient was calculated to be USD 105.12 and for outpatient it was USD 56.09. The 43% of the population had burden of illness less than 30% and 40% of the population had burden of illness between 60-80%. Only 6.6% of population had more than 80% of Pharmacoeconomic burden of asthma. Conclusion: In our study, it was concluded that the patients with severe asthma and/or co-morbidity have higher treatment cost. Out of the overall cost, the maximum cost borne by the patient was the direct medical cost. The hospitalization increased the total health care cost by about 47%. The 43% of the population has less than 30% of burden of asthma while only 6.67% of population had more than 80% of burden of asthma.
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Almusawi, Zuhair M., Haidar AN Abood, and Aqeel M. Alfadhil. "A Comparative Study of Salbutamol Nebulizer versus Salbutamol plus Budesonide Nebulizer in the Treatment of Children with Acute Asthma Exacerbation." International Journal of Research in Pharmaceutical Sciences 9, SPL1 (April 16, 2018). http://dx.doi.org/10.26452/ijrps.v9ispl1.1410.

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Asthma is a common chronic illness of childhood and represents the leading cause of childhood morbidity as measured by school absence,emergency department visit,and hospitalization. Budesonide is an inhaled corticosteroid used as controller agent and recently introduced as an adjuvant treatment in acute attacks of asthma.To evaluate the effect of combination of budesonide plus salbutamol nebulizer versus salbutamol nebulizer monotherapy in children with acute attack of asthma. A randomized double blind standard control clinical study was done in Karbala teaching hospital for children from1st of November 2015 to the end of November 2016 on patients aged 1-12 years presented to emergency department with mild to moderate acute attack of asthma. The patients randomly divided into salbutamol group (50) patients and salbutamol plus budesonide group (50) patients. For each patient the severity of asthma attack was determined by pulmonary index score (PIS) before initiation of treatment,then assessment done each 30 minutes up to 90 minute to detect the decrement in severity of attack and response to treatment. There was significant reduction in PIS (p<0.05) for both group of patients treated with salbutamol and salbutamol plus Budesonide and after 30, 60 minutes as compare with their baseline score. After 30 minutes from ER admission patients who were treated with combination of salbutamol plus budesonide had significantly lower PISs than those treated with salbutamol alone. At end of 90 minute there were 28 patients from salbutamol group and only 14 patients from combination group with significant difference in number of patient between groups (p<0.05). The mean duration of stay in E.R was significantly shorter (p<0.05) in patients treated with nebulized salbutamol +budesonide. The addition of nebulized budesonide to salbutamol significantly lower the PIS and shorten the duration of stay in emergency department in asthmatic children with acute attack.
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SWAMI, NARENDRA KUMAR, JIGNESH KUMAR, RASHMI BHUJADE, and ANIL SINGH BAGHEL. "AN OBSERVATIONAL STUDY TO ASSESS THE ADVERSE DRUG REACTION OF ANTI-ASTHMATIC DRUGS AMONG ADULTS IN WESTERN RAJASTHAN." Asian Journal of Pharmaceutical and Clinical Research, March 14, 2022, 106–9. http://dx.doi.org/10.22159/ajpcr.2022.v15i4.44273.

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Background: Asthma is one of the most common chronic illness worldwide. For prevention of exacerbations, patients of bronchial asthma are kept on long-term treatment that is why they are amenable for adverse drug reactions (ADRs). The study was planned to monitor ADRs with intervention of anti-asthmatic drugs in adults visited in medicine outpatient or admitted in inpatient department of a tertiary care teaching hospital. Methods: A cross-sectional study was conducted among 340 asthma patients in collaboration with Department of Medicine for duration of 12 months. Information of patients was collected with the help of semi-structured case record form ADRs along with interventions given that were also recorded. Results: Data analysis was done with the help of SPSS version20.0. Fisher exact test was applied. A total of 340 patients were enrolled in the study. The highest numbers of ADRs were observed with Salbutamol (34.78%). The highest ADRs were noted with Beta2 agonists class of drugs. The main ADRs noted were headache followed by tremors and oral thrush. Statistically significant association was found between presence of ADRs and severity of asthma. Conclusion: Identifying any possible connection between a presenting complaint and drug used is crucial to reduce the risk of ADRs in the future. Appropriate monitoring of ADRs is a key for this. Reduction in ADRs will improve the compliance of patient and ultimately their clinical outcome.
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Gunasekara, Sumali, Thanushika Ranawaka, Dilan Chathuranga, Upekshi Kankanamge, and Aindralal Balasuriya. "Importance of Following Proper Inhalation Techniques and Awareness Regarding Asthma among Clinical Patients." Journal of Complementary and Alternative Medical Research, August 14, 2021, 1–13. http://dx.doi.org/10.9734/jocamr/2021/v15i330266.

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Aims: Asthma is one of the biggest health burdens on the Sri Lankan population. Achievement of treatment goals isdetermined mainlythrough pharmacological management. The main objective of this study was to evaluate the patient inhaler handling techniques and their awareness regarding their disease condition, as well as to find out how an educational intervention effects patients‘ inhaler handling techniques. Study Design: A Prospective cross sectional study used. Place and Duration of Study: National Hospital for Respiratory Diseases, Welisara and Colombo South Teaching Hospital, Kalubowila between June 2017 to August 2017. Methodology: Clinically diagnosed asthma patients were randomly divided into Control and Test groups. Control comprised 94 patients and the test comprised 93 patients. Their baseline knowledge about asthma and inhaler-using technique were assessed in 1st month by using an interviewer-administered questionnaire and checklist respectively. The test group was given both information leaflet and verbal instructions. Again, all the participants were assessed for the inhaler techniques on their next clinic day by using the same questionnaire and the checklist. Results: After the educational intervention, there was a statistically significant improvement in the test group, in the adherence to the nine steps, including critical steps, regarding all 3 device types (PMDI, DPI, and PMDI with Spacer) in the 2nd-month visit. (at P =.05) When considering awareness about asthma in the total population, most participants were knowledgeable regarding asthma. Conclusion: We observed gaps in knowledge between current practice and what is expected in patients with asthma regarding their inhaler therapy. This might be due to the quality of instructions delivered by health care providers being insufficient and them lacking the time to observe patients individually for the inhaler techniques. Awareness regarding asthma and inhalation techniques can be raised by using information leaflets as well as through verbal counseling.
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Fardan, Zeinh Hussein, Abdulbari Ahmed Alzahrani, Sara Abdullah Althumairy, Hana Saeed Al Malih, Shahad Awad AlQahtani, Wijdan Saleh Quraishi, Hasnaa Abdullah Althumairy, Fajr Abdulhadi Alnaami, and Wafaa Sulaiman Alhifzi. "Knowledge of school teachers regarding Asthma in Aseer region of Saudi Arabia." World Family Medicine Journal /Middle East Journal of Family Medicine 19, no. 10 (October 2021). http://dx.doi.org/10.5742/mewfm.2021.94151.

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Background: Asthma is a leading cause of impairment, high health-care costs and poor quality of life for those who suffer from it. Asthma is the most prevalent chronic medical illness that schoolteachers must deal with in their students, impacting more than 10% of them. Teachers may be required to supervise inhaler administration and determine the necessity for additional treatment in acute attacks. Asthma prevalence varies greatly over the world, ranging from 1 to 20% for both children and adults. Methods: The data for this cross-sectional study was acquired using a specially designed questionnaire. The questionnaire includes demographic questions as well as questions about asthma awareness and knowledge. After collection of data, it was coded and entered in the SPSS ver.20 software for analyses descriptive statistics (mean standard deviation, frequencies and percentages were computed), to measure the significance differences t test and chi-square test was used at 5% level of significance. Data was collected from the teachers of Aseer region of KSA. Ethical approval was obtained from King Khalid University, Saudi Arabia. The study duration was from January-2021 to April-2021. Results: Out of a total 759 respondents, the mean (S.D.) of the respondents were 31.6(12.8). 14.2% were male while 85.8% were females. The Cronbach alpha of the questionnaire was 0.79. We have observed that age and education have a significant impact over the prevalence of Asthma awareness. Conclusion: We should train our teachers by conducting series of seminars, webinars and workshops. We will also incorporate training the trainer sessions for teaching staff to enhance their skills to deal with asthma. Key words: Asthma, diseases, teacher, knowledge, awareness
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Kim, Jin Sun, Nader Hashweh, Hannah Li, Salik Choudhary, Sadashiv Santosh, and Edward Charbek. "Effectiveness of one-on-one coaching in improving pressurized metered dose inhaler (pMDI) technique among COPD patients: a prospective clinical study." BMC Pulmonary Medicine 21, no. 1 (August 16, 2021). http://dx.doi.org/10.1186/s12890-021-01627-y.

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Abstract Background Incorrect use of inhalers among asthma and COPD patients is very prevalent. Yet, no single intervention is considered standard of care. We aimed to conduct a COPD-specific investigation of active one-on-one coaching as the educational intervention to improve pressurized metered dose inhaler (pMDI) technique and COPD symptoms management. Methods COPD patients who have pMDI in their treatment regimen were enrolled in this prospective study using the Global Initiative for Chronic Obstructive Lung Disease criteria. After rapid cognitive screen, inhaler technique was assessed and an active one-on-one coaching was provided utilizing the 12-step American Thoracic Society instructions. Patients’ inhaler technique was assessed and scored again at their regular follow-up visits. Results One hundred and one patients participated in the study. The percentage of pMDI misuse decreased from 43.5% pre-teaching to 12.9% post-teaching (binomial test p value < 0.001). The mean number of errors decreased from 3.1 errors pre-teaching to 1.7 errors post-teaching (paired t-test p value < 0.001). The number needed to treat was 3.3 patients to prevent one misuse. Patients with an impaired cognitive function were more likely to have inhaler misuse in general and less likely to improve their technique when provided training. Conclusions This study reveals that many COPD patients have incorrect pMDI techniques that can be improved with a short training in the clinic. Trial Registration: Not applicable.
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Nyantakyi, Richardson Adjei, Perditer Okyere, Edward Appiah Boateng, Isaac Okyere, Francis Adjei Osei, Samuel Frimpong Odoom, Frank Micah, and Joseph Attakorah. "Factors influencing knowledge levels among hypertensive patients receiving treatment at the Komfo Anokye Teaching Hospital in Kumasi, Ghana: a cross-sectional study." African Journal of Current Medical Research 4, no. 1 (August 2, 2020). http://dx.doi.org/10.31191/afrijcmr.v4i1.52.

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Background Basic knowledge about hypertension and its treatment can have a positive impact on high blood pressure control reducing cardiovascular morbidity and mortality. This study aimed at assessing the knowledge levels and to determine the factors that influenced knowledge levels among hypertensive patients receiving treatment at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. Methods A cross-sectional study was conducted at the outpatient hypertensive clinic of KATH between April and May 2019. Three hundred and ninety-seven (397) hypertensive patients aged 18 years and above who had been diagnosed with hypertension for at least six months and currently taking at least one antihypertensive drug completed a self-administered questionnaire. The questionnaire consisted of basic socio-demographic profile, patient-related information on hypertension and its treatment and knowledge on hypertension. The Hypertension Knowledge-Level Scale (HK-L) was used to determine the level of knowledge among patients receiving treatment at the Komfo Anokye Teaching Hospital (KATH), Kumasi. Results Out of the 397 patients, 199 (50.1%) had high knowledge level on hypertension and its treatment. Binary logistic regression analysis was conducted for hypertension knowledge level. Respondents with a junior level of education, paid for their antihypertensive drugs by themselves, had asthma as a comorbidity and took non-prescribed drugs had a significant association with knowledge level on hypertension and its treatment. Conclusion Knowledge about hypertension in hypertensive patients is moderate and therefore much effort should be made in educating and involving them in the condition to help them gain control over the disease and improve adherence rates.
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Parthasarathi, Ashwaghosha, Sachith Srinivas, Jayaraj Biligere Siddaiah, and Padukudru Anand Mahesh. "Local Adverse Drug Reactions In Ambulatory Asthma Patients Treated With Inhaled Corticosteroids: An Experience From A South Indian Teaching Hospital." Current Respiratory Medicine Reviews 18 (May 1, 2022). http://dx.doi.org/10.2174/1573398x18666220501124708.

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Background: Inhaled corticosteroids (ICS) have an essential and established role in the treatment of asthma. Both systemic and local adverse effects may accompany the long-term use of ICS. Systemic adverse drug reactions (ADRs) of ICS are well established. However, there is a paucity of information on local ADRs, especially in the Indian population. Objectives: To determine the prevalence, severity, predictability, and preventability of local ADRs to ICS and their associated risk factors. Methods: Patients with asthma who need ICS were enrolled. Study patients were interviewed with open-ended questions to assess local ADRs to ICS at baseline and each follow-up visit, once a month for three months. Causality (Naranjo’s algorithm and WHO scale), severity (Hartwig SCf scale), predictability (based on the frequency of occurrence of ADR and history of drug exposure), and preventability (Schumock and Thornton criteria) of local ADRs were assessed. Bivariate analysis and subsequently multivariate logistic regression were used to identify the risk factors for local ADRs to ICS. Results: A total of 243 patients (134 female) were included in the study. A total of 74 local ADRs were observed in 59 patients (prevalence 24.3%). The most common local ADRs were feeling of thirst (14.8%) followed by cough during inhalation (8.6%) and taste disturbance (4.5%). All ADRs were predictable and mild in severity. Preventability assessment found 85.1% of local ADRs as ‘probably preventable’. Two out of five patients who had ADR’s reduced or skipped doses because of the discomfort, despite their physician’s recommendation to continue their regular dose of ICS. Age >41 years, use of MDI without spacer, and use of budesonide were identified as the risk factors for developing ADRs to ICS. Conclusion: Local ADRs to ICS were observed in approximately one in four patients with asthma. Two out of five patients who had ADRs reduced or skipped doses because of it. Strategies to prevent local ADRs to ICS should focus on patients aged >41 years, receiving budesonide, using MDI without a spacer, and is dose-dependent. We need to establish standards on the best practices for preventing ADRs, such as identifying the most suited device or ICS that is best tolerated by the individual patient, identifying the least ICS dose that maintains ideal asthma control.
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"Effect of Curcumin Supplement on Pulmonary Functions, Total and Differential White Blood Cell Count, Serum Level of Leptin and Body Mass Index in a Sample of Iraqi Patients with Chronic Bronchial Asthma." Al Mustansiriyah Journal of Pharmaceutical Sciences, May 1, 2019, 47–58. http://dx.doi.org/10.32947/ajps.19.02.00403.

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Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation together with increased oxidative stress that lead to clinical symptoms of asthma. Obesity is a known risk factor of asthma as the obesity is correlated with systemic inflammation and airway restriction. Curcumin, a natural product derived from the rhizomes of Curcuma longa (Turmeric), has a wide range of beneficial properties including anti-inflammatory and weight reducing agent. This study was designed to evaluate the effect of curcumin as supplement therapy on the pulmonary function, total and differential white blood cell count and metabolic status of chronic bronchial asthmatic patients. It is a prospective randomized controlled interventional study carried out on 40 patients visiting Al-Yarmouk teaching hospital and conducted from October 2017 to April 2018. The patients were allocated into group1; include 17 asthmatic patients assigned to receive conventional therapy for asthma alone, and group 2; include 23 asthmatic patients assigned to receive conventional therapy for asthma plus 750 mg curcumin capsule twice daily for two months. Results revealed significant improvement in forced expiratory volume in one second (FEV1) and the ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) in group 2 patients after two months(P<0.01). The total white blood cell count didn’t show any difference after treatment except decrease in neutrophil count after curcumin supplement (p< 0.05). The leptin level and body mass index present with no significant difference in both groups after two months (p >0.05).
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Tesfaye, Behailu Terefe, Mihret Terefe Tessema, Mengist Awoke Yizengaw, and Dula Dessalegn Bosho. "Potentially inappropriate medication use among older adult patients on follow-up at the chronic care clinic of a specialized teaching hospital in Ethiopia. A cross-sectional study." BMC Geriatrics 21, no. 1 (October 7, 2021). http://dx.doi.org/10.1186/s12877-021-02463-9.

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Abstract Background Older adult patients are prone to potentially inappropriate medication use (PIMU); its use has been associated with multiple adverse consequences. As a result, it is crucial to determine the magnitude and factors associated with PIMU. The present study was mainly aimed to determine and assess the magnitude and predictors of potentially inappropriate medication use in older adult patients on follow-up at the chronic care clinic of Jimma medical center. Methods A retrospective cross-sectional study was conducted involving 219 patients aged 65 years and above on treatment follow-up. Data was collected using a checklist. The 2019 updated American Geriatric Society (AGS) Beers Criteria® and Screening Tool of Older People’s Potentially Inappropriate Prescriptions criteria and Screening Tool to Alert Doctors to Right Treatment (STOPP/START) criteria (version 2) were employed to assess PIMU. SPSS IBM (v22) was used for data entry and analysis. Categorical variables were described using frequency and percentage, whereas continuous variables were described using mean with standard deviation (SD) or median with interquartile range (IQR). Logistic regression was conducted to identify predictors of PIMU. Results The average number of medications prescribed per patient was 4.0 (IQR = 2.0). At least one PIMU was identified in 182 (83.1%) and 99 (45.2%) patients, based on Beers and STOPP criteria, respectively. Additionally, potential prescription omission (PPO) was observed in 24 (10.9%) patients. The risk of Beers PIMU was increased with age [AOR = 1.21, p < 0.001], hypertension [AOR = 4.17, p < 0.001], and polypharmacy [AOR = 14.10, p < 0.001], while a decrease in the risk was noted in patients with a diagnosis of ischemic stroke [AOR = 0.133, p = 0.01] and asthma [AOR = 0.03, p < 0.001]. Using STOPP criteria, hypertension [AOR = 2.10, p = 0.04], diabetes mellitus [AOR = 2.26, p = 0.04], ischemic heart disease [AOR = 2.84, p = 0.04], peripheral neuropathy [AOR = 10.61, p < 0.001], and polypharmacy [AOR = 6.10, p < 0.001] significantly increased the risk of PIMU. Conclusions Regardless of the screening tool used to assess, the present study revealed PIMU in the large proportion of the participants. Multiple medication use and certain disease condition had increased the probability of PIMU. Hence, it is imperative to use screening tools for reviewing medications prescribed in older adult patients to ensure safety of medication therapy.
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Aremu, Shuaib Kayode, Tayo Ibrahim, Azeez Oyemomi Ibrahim, and Popoola Tomilayo Ajoke. "Correlation of Features of Allergic Rhinitis and Allergic Conjunctivitis with Treatment Modalities." Journal of Advances in Medicine and Medical Research, April 27, 2019, 1–10. http://dx.doi.org/10.9734/jammr/2019/v29i830111.

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Introduction: Allergic Rhinitis (AR) is a chronic, symptomatic allergic disorder of the nose that is usually caused by IgE-mediated inflammatory response following exposure to an allergen. The allergen could be in the form of dust, pollen, flower, animal dander, mold, cold, food allergens or insect. Clinically, AR occurs when there are recurrent nasal symptoms which are reversible either spontaneously or with medication in the preceding one year. Such symptoms include at least two of the following; excessive sneezing, running nose, nasal itching, nasal discharge, nasal congestion or obstruction. Previous studies have linked AR to be co-existed with another form of allergic disorders including AC, Atopic dermatitis and Allergic Asthma. This study is aimed at assessing the feature of AR patients with coexistent AC as well as evaluating the effectiveness of the treatments offered to them. Objectives: The study was aimed at finding the correlation between the nasal and eye features in a patient who has co-existing allergic rhinitis and allergic conjunctivitis. Methodology: This was a cross-sectional descriptive study conducted between August 2018 and November 2019 among 38 patients who presented to ENT and Ophthalmology departments of Federal Teaching Hospital Ido-Ekiti, Ekiti State, Southwestern Nigeria and was diagnosed with both allergic rhinitis and allergic conjunctivitis. Relevant data obtained were analyzed using SPSS version 20. P ≤ 0.05 was taken as significant. Results: The patients’ age range between 8 and 81 years with a median age of 33 years. The majority were less than 45 years (63.2%) with the male to female ratio of almost. Eye pain, itching, and redness account for 97.4% of all the eye features, while the presence of Cobblestone-like papillae is the least and accounted for 5%. Nasal itching (92.1%) was the commonest nasal symptom. Sleep disturbance was found to be the most common among those with eye itching (29.7%). Conclusion: This research was conducted to correlate the features of allergic rhinitis with those of conjunctivitis and common management and preventive measures offered to the patients seen in our clinics. The majority of the patients were less than 45 years with almost equal sex ratio. Eye pain, itching, and redness account for the majority of all the eye features, while the presence of Cobblestone-like papillae is the least eye feature. Nasal itching was the commonest nasal symptom and this was seen in the majority of the patients with eye symptoms.
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Wood, Beatrice L., Sarah B. Woods, Sourav Sengupta, and Turya Nair. "The Biobehavioral Family Model: An Evidence-Based Approach to Biopsychosocial Research, Residency Training, and Patient Care." Frontiers in Psychiatry 12 (October 5, 2021). http://dx.doi.org/10.3389/fpsyt.2021.725045.

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Engel's biopsychosocial model, based in systems theory, assumes the reciprocal influence of biological, psychological, and social factors on one another and on mental and physical health. However, the model's application to scientific study is limited by its lack of specificity, thus constraining its implementation in training and healthcare environments. The Biobehavioral Family Model (BBFM) is one model that can facilitate specification and integration of biopsychosocial conceptualization and treatment of illness. The model identifies specific pathways by which family relationships (i.e., family emotional climate) impact disease activity, through psychobiological mechanisms (i.e., biobehavioral reactivity). Furthermore, it is capable of identifying positive and negative effects of family process in the same model, and can be applied across cultural contexts. The BBFM has been applied to the study of child health outcomes, including pediatric asthma, and adult health, including for underserved primary care patients, minoritized samples, and persons with chronic pain, for example. The BBFM also serves as a guide for training and clinical practice; two such applications are presented, including the use of the BBFM in family medicine residency and child and adolescent psychiatry fellowship programs. Specific teaching and clinical approaches derived from the BBFM are described in both contexts, including the use of didactic lecture, patient interview guides, assessment protocol, and family-oriented care. Future directions for the application of the BBFM include incorporating temporal dynamics and developmental trajectories in the model, extending testable theory of family and individual resilience, examining causes of health disparities, and developing family-based prevention and intervention efforts to ameliorate contributing factors to disease. Ultimately, research and successful applications of the BBFM could inform policy to improve the lives of families, and provide additional support for the value of a biopsychosocial approach to medicine.
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"Romanian Congress of Physical and Rehabilitation Medicine and Balneology, Galați, 4-6 September 2019 - Congress Abstracts." Balneo Research Journal 10, Vol.10, No.3 (September 3, 2019): 321–432. http://dx.doi.org/10.12680/balneo.2019.276.

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Scientific Program Oral Presentations Authors Title Abstract CONSTANTIN MUNTEANU, Mihail HOTETEU, Diana MUNTEANU, Gabriela DOGARU - 12 minutes PERSPECTIVES OF BALNEOLOGY - INTERNATIONAL DATA INPUTS, NATIONAL OUTPUTS Link L1 UMBERTO SOLIMENE - 14 minutes CLIMATE AND HEALTH: A NEW CHALLENGE FOR AN OLD SCIENCE Link L2 Zeki KARAGÜLLE - 14 minutes BALNEOLOGICAL TREATMENTS WITH NATURAL HYDROGEN SULFIDE (H2S) Waters Link L3 Constantin Florin Dragan, Liliana Padure, Gelu Onose - 12 minutes SPECIFIC ADVANCED QUANTIFICATIONS ON THE RELATIONSHIP BETWEEN THE ANGULATION OF THE MAIN SCOLIOTIC CURVE AND LEG SWING IN THE GAIT PHASES, IN CHILDREN AND ADOLESCENTS WITH AND WITHOUT POSTURAL TREATMENT Link L4 Irina ALBADI, Camelia CIOBOTARU, Andreea-Alexandra LUPU, Ionela BALASA, Claudiu FATU, Enghin SACHIR, Gelu ONOSE - 12 minutes A MULTIMODAL APPROACHES TO MANAGE REHABILITATION THERAPY OF DISFUNCTIONALS ASPECTS TO A PACIENT WITH GOUT, MIELLITUS DIABETES, ATRIAL FIBRILATION AND MIDDLE CEREBRAL ARTERY STROKE Link L5 ELENA RAEVSCHI - 12 minutes PREVENTION CONSIDERATIONS IN Cardiovascular Diseases regarding the premature mortality reduction Link L6 ANIȘOARA CIMIL - 12 minutes THE EFFECTIVENESS OF THE REHABILITATION PROGRAMME ACCORDING TO THE ETIOPATHOGENESIS OF PROSTHETIC JOINT PATHOLOGY Link L7 TRAIAN -VIRGILIU SURDU, Monica SURDU, Olga SURDU - 10 minutes FOURTH INDUSTRIAL REVOLUTION (INDUSTRY 4.0) AND MODERN THERMAL MEDICINE (THERME 4.0) IN XXIST CENTURY Link L8 Gabriela DOGARU, Akos MOLNAR, Marieta MOTRICALA - 10 minutes EFFECTS OF CARBONATED MINERAL WATER AND MOFETTE IN BĂILE TUŞNAD IN EXPERIMENTALLY INDUCED ISCHEMIC HEART DISEASE Link L9 Q & A – 12 minutes Authors Title Abstract Aurelian Anghelescu, Valentin Deaconu, Catalina Axente,Elena Constantin, Gelu Onose - 12 minutes THERAPEUTIC DIFFICULTIES IN A YOUNG PATIENT WITH MULTIDRUG RESISTANT EPILEPSY (NEEDING VAGAL NERVE ELECTROSTIMULATION), SEQUELAE AFTER CONGENITAL VASCULAR CEREBRAL MALFORMATION, WITH CHRONIC GAIT IMPAIRMENTS AND RECENT TRAUMATIC BRAIN COMPLICATION Link L10 Luminița NIRLU, Alexandru G. STAVRICĂ, Laura Georgiana Popescu, Ana Carmen Albeșteanu, Ali-Osman Saglam, Gelu Onose - 12 minutes DIAGNOSTIC PARTICULARITIES AND MULTIMODAL THERAPEUTIC AND REHABILITATION APPROACHES TO A COMPLEX CASE OF POST ISCHEMIC STROKE WITH DYSPHAGIA AND DYSPHONIA, ASSOCIATING MILLARD-GUBLER AND WALLENBERG SYNDROMES - CASE REPORT Link L11 Cristina Octaviana DAIA, Croitoru Stefana, Mariana Axente, Gelu ONOSE - 14 minutes IONTOPHORESIS AND LASER APPLICATIONS IN FACIAL NERVE PALSY Link L12 Doina Maria MOLDOVAN, Gabriela DOGARU - 12 minutes SPLINTING VERSUS SURGICAL TREATMENT IN MALLET FINGER Link L13 Doina Maria MOLDOVAN, Gabriela DOGARU - 12 minutes EARLY REHABILITATION IN PATIENT AFTER TREATMENT FOR DISTAL RADIUS FRACTURE Link L14 Liliana PADURE, Raluca PETCU, Anca Irina GRIGORIU - 12 minutes THE IMPACT OF MULTIFACTORIAL GAIT ANALYSIS ON THE DIAGNOSIS AND REHABILITATION OF CHILDREN WITH WALKING DISORDERS Link L15 Valerica Creanga-Zarnescu, Ana-Maria Fatu, Mihaela Lungu, Violeta Sapira, Anamaria Ciubara - 12 minutes REHABILITATION POSSIBILITIES OF APHASIC PATIENT Link L16 Cristina DAIA, Simona SCHEK, Stefana CROITORU, Alina GHERGHICEANU, Gelu ONOSE - 12 minutes FAVORABLE REHABILITATION RESULTS ON A PATIENT WITH SEVERE LEFT HEMIPLEGIA AFTER AN INTRAPARENCHYMAL HEMATOMA Link L17 Elena VIZITIU, Mihai CONSTANTINESCU, Sînziana Călina SILIȘTEANU - 12 minutes THE ROLE OF THERAPEUTIC SWIMMING IN THE PROPHYLAXIS OF SCOLIOSIS IN THE "C" LEFT IN CHILDREN DURING THE PREPUBERTAL PERIOD Link L18 Q & A – 12 minutes Authors Title Abstract Alexandru G. STAVRICĂ, Luminiţa Nirlu, Laura Georgiana Popescu, Ana Carmen Albeşteanu, Gelu ONOSE - 12 minutes DIAGNOSTIC AND THERAPEUTIC APPROACHES IN REHABILITATION CORRELATED TO A CASE OF TETRAPARESIS (WITH PREDOMINANCE OF PARAPARESIS) AFTER SEVERE CCT - BIFRONTO - BASAL AND BITEMPORAL CONTUSION. Link L19 Ana Maria Bumbea, Otilia Rogoveanu, Carmen,Albu Rodica Traistaru, Catalin,Bostina, Bogdan Stefan Bumbea, Roxana Dumitrascu, Borcan Madalina MANAGEMENT OF SPASTICITY IN NEUROLOGICAL PATIENTS Link L20 Laura Georgiana Popescu, Luminița Nirlu, Ana Carmen Albeșteanu, Ali Osman Saglam, Gelu Onose - 12 minutes PARTICULARITIES OF COMPLEX THERAPEUTICALLY-REHABILITATIVE MANAGEMENT, STEPWISE, IN A PATIENT WITH POST-CCT PSYCHO-COGNITIVE IMPAIRMENT IN A LARGE POLYTRAMATIC CONTEXT - CASE REPORT Link L21 Adrian MELNIC, Oleg PASCAL - 12 minutes DEVELOPING STRATEGIES TO ADDRESS COMORBIDITY IN STROKE REHABILITATION. Link L22 Dorin-Gheorghe TRIFF, Simona POP - 12 minutes MONOGENIC DISEASES WITH MUSCULO ARTICULAR LAXITY. DIAGNOSTIC CRITERIA AND PRINCIPLES OF RECOVERY THERAPY Link L23 Catalin Ionite, Dragos Arotaritei, Mihai Ilea, Mariana Rotariu - 12 minutes THE USE OF ELASTIC BANDS IN THE RECOVERY OF ANKLE SPRAINS Link L24 Mariana Rotariu, Marius Turnea, Calin Corciova, Catalin Ionite - 12 minutes THE EFFECTS OF CUBE THERAPY IN THE RECOVERY OF THE ARTHROSIS HAND IN GERIATRICS Link L25 Cristian Ştefan LIUŞNEA - 12 minutes FITNESS AND WELLNESS. CONCEPTUAL DELIMITATIONS Link L26 Adriana LUPU - 12 minutes NSAID THERAPY OF MUSCULOSKELETAL PAINS AND ITS PARTICULARITIES IN THE PATIENTS SUFFERING FROM CARDIOVASCULAR DISORDERS Link L27 Q & A – 12 minutes Authors Title Abstract Mihaela MANDU, Cristinel Dumitru BADIU, Raluca PETCU, Cosmin OPREA, Gelu ONOSE - 12 minutes CLINICAL-EVOLUTIVE PARTICULARITIES AND A MULTIMODAL THERAPEUTIC-REHABILITATIVE, AS WELL AS THROUGH CONNECTED CARES, APPROACH, IN A CASE OF HEMIPLEGIA AFTER ISCHEMIC CARDIO-EMBOLIC STROKE WITHIN A POLYPATHOLOGICAL CONTEXT Link L28 Ana Carmen Albesteanu, Laura Georgiana Popescu, Luminița Nirlu, Ali Osman Saglam, Gelu Onose - 12 minutes MULTIMODAL - REHABILITATIVE THERAPEUTICAL APPROACHES IN A COMPLEX OF PATHOLOGY INCLUDING POSSIBLY EVOLVING DISCARIOTIC TYPE - CASE REPORT Link L29 Liliana PADURE, Cristian Adam, Laura Fierbinteanu - 12 minutes ATTACHMENT - PROGNOSTIC FACTOR IN MEDICAL RECOVERY Link L30 Prof. Alexandru Vlad Ciurea - 20 minutes MOTILITY OR MORBIDITY IN NEUROSURGERY Link L31 Valerica CREANGA-ZARNESCU, Ana-Maria FATU, Anamaria CIUBARA, Violeta SAPIRA,Aurelia ROMILA, Mihaela LUNGU - 12 minutes EXERCISES PROGRAM AND REHABILITATION IN PARKINSON’S DISEASE Link L32 Irina VERINCEANU,Alice MUNTEANU, Andreea STOICA, Stefan ISPAS - 12 minutes THE CARDIAC REHABILITATION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION Link L33 Marius Turnea, Catalin Ionite, Mihai Ilea, Dragos Arotaritei - 12 minutes STATISTICAL ANALYSIS OF PHYSIOTHERAPEUTIC MEANS USED IN THE RECOVERY OF MUSCLE INJURIES IN ATHLETES Link L34 Mihaiela CHICU, Eugen BITERE - 10 minutes THE ROLE OF IL1β IN CARTILAGINOUS DISTRUCTION IN RHEUMATOID ARTHRITIS Link L35 Mihaiela CHICU, Eugen BITERE - 10 minutes THE ROLE OF THE INFLAMMASOMS IN THE PATHOGENESIS OF INFLAMMATORY REACTION Link L36 Q & A – 8 minutes Authors Title Abstract Prof. Dr. Gelu Onose, (Keynote Speaker) Vlad Ciobanu, Corina Sporea - 20 minutes A TOPICAL SYSTEMATIC LITERATURE REVIEW AND REAPPRAISAL ON ESSAYS TOWARDS SYSTEMATIZING CLINICAL ASSESSMENT INSTRUMENTS USED TO EVALUATE NEURO-functional deficits after spinal cord injuries, mainly in adults, including through the ICF(-DH) conceptual framework Link L37 Diana-Elena SERBAN, Aurelian ANGHELESCU, Elena CONSTANTIN, Gelu ONOSE - 12 minutes THE ACQUISITION OF SELF-DEFENSE TECHNIQUES AND PROCEDURES AGAINST THE ACT OF AGGRESSION IN THE PACIENT WITH PARAPLEGIA, WHEEL-CHAIR INDEPENDENT Link L38 Aurelian Anghelescu, Elena Constantin, Anca Sanda Mihaescu, Gelu Onose - 12 minutes “PREVENTION IS CURE, EDUCATION IS ESSENTIAL” - RESPONSIBLE IMPLICATION OF YOUNG PEOPLE IN EDUCATIONAL AND PROPHYLACTIC ACTIONS AGAINST ACCIDENTAL CERVICAL SPINAL CORD INJURY AND SEVERE DISABILITIES BY DIVING IN UNVERIFIED WATERS. Link L39 Alexandra SPORICI, Irina ANGHEL, Lapadat MAGDALENA, Gelu ONOSE - 12 minutes RECOVERABLE RESULTS AT A PATIENT WITH AIS/FRANKEL D INCOMPLETE TETRAPLEGIA / POST SPINAL CORD INJURY BY FALLING FROM A HEIGHT, ON AN ANKYLOSING SPONDYLITIS BACKGROUND Link L40 Ioana ANDONE, Carmen CHIPĂRUȘ, Andreea FRUNZA, Aura SPÎNU, Simona STOICA, Liliana ONOSE, George PATRASCU, Gelu ONOSE -12 minutes CLINICAL, PARACLINICAL ASPECTS AND COMPLEX THERAPEUTICAL APPROACHES IN A PATIENT WITH INCOMPLETE PARAPLEGIA, POST THORACIC MENIGIOMA SURGICALLY TREATED, IN NEUROFIBROMATOSIS CONTEXT Link L41 Cristina Octaviana DAIA, Alina-Elena Gherghiceanu, Helene Ivan, Gelu ONOSE - 12 minutes RESEARCH ON NEUROREHABILITATION RESULTS IN VERTEBRO-MEDULLARY POST-TRAUMATIC CONDITIONS ASSOCIATING FRACTURES, IN A POLITRAMATIC CONTEXT Link L42 Ali-Osman Saglam, Alexandru G. Stavrica, Ana Carmen Albeşteanu, Laura Georgiana Popescu, Luminita Nirlu, Gelu Onose - 12 minutes MEDICAL-REHABILITATION ENDEAVORS, CARE INTERVENTIONS AND CONNOTATIONS OF A MEDICO-SOCIAL TYPE, IN A COMPLEX POLYPATHOLOGICAL CASE: PARAPLEGIA, SPONDYLODISCITIS, KIDNEY FAILURE IN THE HAEMODIALYSIS STAGE AND BILATERAL NEPHROSTOMIES AFTER SURGICALY TREATTED BLADDER NEOPLASM. Link L43 Sorina Petrușan-Dunca, Liviu Lazăr, Tiberiu-Dorin Corha - 12 minutes INDICATIONS AND LIMITIS OF REHABILITATION TREATMENT FOR LUMBAR DISCOPATHY IN PREGNACY Link L44 Q & A – 8 minutes Authors Title Abstract Elena Silvia SHELBY, Mihaela AXENTE, Liliana PĂDURE - 12 minutes CHARCOT MARIE TOOTH DISEASE. CASE PRESENTATION. 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Souto Figueroa, Antonio Freire Magariños RESEARCH - SURVEY TO 142 THERMALIST WHO HAVE PERFORMED A THERMAL CURE AT THE BATHS OF BAÑOS DE MOLGAS (OURENSE) AND AUGAS SANTAS (LUGO) - GALICIA – SPAIN Link L53 Q & A – 12 minutes Authors Title Abstract Irina Ionica - 12 minutes ACUPUNCTURE IN REHABILITATION - A GENERAL VIEW Link L54 Denisa COAJĂ, Gabriela DOGARU - 12 minutes THE HEALTH BENEFITS OF FINNISH SAUNA BATHING Link L55 Otilia ROGOVEANU, Florin GHERGHINA , Rodica TRAISTARU - 12 minutes SPINA BIFIDA – FUNCTIONAL REHABILITATION METHODS IN CHILDREN Link L56 Mihaela DUTESCU, Raluca OLTEAN, Petru NENADICI - 12 minutes GEOAGIU BAI RESORT - OUR EXPERIENCE OF MEDICAL REHABILITATION TREATMENT Link L57 Dumitru MIHĂILĂ, SILISTEANU Sinziana Calina, ȚICULEANU Mihaela (Ciurlică) - 12 minutes THE METEOROLOGICAL COMPLEX AND THE HUMAN PATHOLOGY. CASE STUDY – SUCEAVA COUNTY Link L58 Mariana VARODI, Gabriela DOGARU - 12 minutes EFFICACY OF NATURAL THERAPEUTIC FACTORS FROM OCNA SIBIULUI SPA RESORT IN GONARTHROSIS Link L59 Boróka-Panna GÁSPÁR, Gabriela DOGARU - 12 minutes BONE HYDRATION AND MINERAL WATERS Link L60 CALIN BOCHIS, LIVIU LAZAR, HORAȚIU URECHESCU, CARMEN NISTOR-CSEPPENTO, FELICIA CIOARA, NICOLETA PASCALAU, ALIN BOCHIS , DIANA IOVANOVICI - 12 minutes CORRELATION OF VAS PAIN SCORE WITH FUNCTION AT THE PACIENTS WITH TEMPOROMANDIBULAR OSTEOARTHRITIS Link L61 Marian Romeo CALIN, Ileana RADULESCU, Mihaela Antonina CALIN, Elena Roxana ALMASAN - 12 minutes RADIOMETRIC ASSESSMENT OF PELOID AND SALT WATER USED FOR THERAPY AND BALNEARY TRATAMENT FROM TECHIRGHIOL LAKE, ROMANIA Link L62 Q & A – 12 minutes Authors Title Abstract Cristina PETRESCU - 12 minutes EFFICACY NATURAL THERAPEUTIC FACTORS FROM BAILE GOVORA IN BRONCHIAL ASTHMA Link L63 PARASCHIVA POSTOLACHE - 12 minutes PULMONARY REHABILITATION SAVES LIVES AND IMPROVES LIFE Link L64 DOINA-CLEMENTINA COJOCARU, PARASCHIVA POSTOLACHE - 12 minutes ASSESSMENT OF DYSPNEA IN PULMONARY REHABILITATION PRACTICE Link L65 PARASCHIVA POSTOLACHE, CRISTINA LACATUSI - 12 minutes HELIOTHERAPY, CLIMATOTHERAPY AND PATIENTS WITH RESPIRATORY DISEASES Link L66 CONSTANTIN MUNTEANU, DIANA MUNTEANU, MIHAIL HOTETEU - 12 minutes BIOLOGICAL INSIGHTS OF SPELEOTHERAPY Link L67 PARASCHIVA POSTOLACHE, CRISTINA LACATUSI, DOINA-CLEMENTINA COJOCARU - 12 minutes AEROSOLS AND BREATHING Link L68 PARASCHIVA POSTOLACHE, MADALINA ZEBEGA - 12 minutes RESPIRATORY MUSCLE TRAINING AND RESPIRATORY REHABILITATION Link L69 CRISTI FRENȚ, GEORGETA MAIORESCU - 12 minutes DEVELOPMENTS AND INVOLUTIONS OF TOURISM IN THE SPA RESORTS IN ROMANIA AND THE CASE STUDY FOR LACUL SĂRAT RESORT Link L70 Dragos Arotaritei, Andrei Gheorghita, Mariana Rotariu, Marius Turnea - 12 minutes MATHEMATICAL MODEL OF SULPHUR ABSORPTION PROCESS, A POSSIBLE APPLICATION IN CURE WITH SULPHUROUS MINERAL WATER Link L71 Q & A – 12 minutes Authors Title Abstract Mihai Ciocanu, Anișoara Cimil - 12 minutes THE EFFICIENCY OF THE REHABILITATION SERVICE IN HOSPITAL CONDITIONS Link L72 Sinziana Calina SILIȘTEANU, Andrei Emanuel SILIȘTEANU - 12 minutes TRIAL ON THE WATER CONSUMPTION BY THE PERSONS IN THE GROUP AGED 19-30 YEARS Link L73 Liviu Lazăr, Florin Marcu, Felicia Cioară, Carmen Nistor Csepentö - 12 minutes MANAGEMENT OF SPECIAL ARTERIAL DISEASES Link L74 Mihaela-Carmen SUCEVEANU, Paul-Nicolae SUCEVEANU - 12 minutes EVOLUTION OF CARDIOVASCULAR RISK FACTORS AFTER MORE THAN 2 PERIODIC HOSPITALIZATIONS IN THE COVASNA HOSPITAL FOR CARDIOVASCULAR REHABILITATION Link L75 Mihaela DUTESCU, Adina TRAILA, Margit SERBAN, Emilia URSU, Dorina MIU, Ioana MALITA, Bianca CIRESAN - 12 minutes THE EFFICIENCY OF MEDICAL REHABILITATION TREATMENT IN PATIENTS WITH HEMOPHILIA AFTER SURGICAL ORTHOPEDIC INTERVENTIONS - THE EXPERIENCE OF "CRISTIAN SERBAN" BUZIAS CENTER Link L76 Dorin-Gheorghe TRIFF, Simona POP - 12 minutes PRECURSORS OF BALENOLOGY EDUCATION IN ROMANIA Link L77 Dr. Eugenia Dumitrescu, Dr. Carmen Enescu - 12 minutes ANTIALLERGIC PROCEDURES MOST COMMONLY USED IN PHYSICAL RECOVERY MEDICINE AND BALNEOLOGY Link L78 Mihail HOTETEU, Constantin MUNTEANU, Diana MUNTEANU, Gabriela DOGARU - 12 minutes PELOIDS - PERSPECTIVES ON RESEARCH AND FUTURE PLANS Link L79 Liliana Stanciu, Daniela Profir, Viorica Marin, Doinița Oprea, Elena Ionescu, Elena Almășan, Carmen Oprea - 12 minutes THE SCIENCE OF AGING WELL Link L80 Q & A – 12 minutes POSTER SESSION Authors Title Abstract Andra Pintilie, Liliana Pădure, Andrada Mirea, Corina Sporea Proprioceptive Functional Vibration Stimulation as therapeutic tool in spasticity management of jump gait pattern of spastic diplegic children with cerebral palsy Poster 1 Andra Pintilie, Liliana Pădure, Andrada Mirea, Corina Sporea Modern computerized techniques for gait’s functional evaluation through a specialized wireless inertial sensor – premise for orthopedic corrective shoes wear in children with gait disorders secondary to Cerebral Palsy Poster 2 Ana Maria PÂSLARU, Ana Maria FĂTU, Anamaria CIUBARĂ The role of medical recovery in oncology Poster 3 Maria Veronica MORCOV, Liliana PADURE, Cristian Gabriel MORCOV, Gelu ONOSE Exercises availed by sensor-based computer advanced devices: part of the interactive cognitive recovery – adjuvant of the therapy applied in the Centrul National Clinic de Recuperare Neuropsihomotorie Copii “Dr. N. 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49

Hughes, Karen Elizabeth. "Resilience, Agency and Resistance in the Storytelling Practice of Aunty Hilda Wilson (1911-2007), Ngarrindjeri Aboriginal Elder." M/C Journal 16, no. 5 (August 28, 2013). http://dx.doi.org/10.5204/mcj.714.

Full text
Abstract:
In this article I discuss a story told by the South Australian Ngarrindjeri Aboriginal elder, Aunty Hilda Wilson (nee Varcoe), about the time when, at not quite sixteen, she was sent from the Point Pearce Aboriginal Station to work in the Adelaide Hills, some 500 kilometres away, as a housekeeper for “one of Adelaide’s leading doctors”. Her secondment was part of a widespread practice in early and mid-twentieth century Australia of placing young Aboriginal women “of marriageable age” from missions and government reserves into domestic service. Consciously deploying Indigenous storytelling practices as pedagogy, Hilda Wilson recounted this episode in a number of distinct ways during the late 1990s and early 2000s. Across these iterations, each building on the other, she exhibited a personal resilience in her subjectivity, embedded in Indigenous knowledge systems of relationality, kin and work, which informed her agency and determination in a challenging situation in which she was both caring for a white socially-privileged family of five, while simultaneously grappling with the injustices of a state system of segregated indentured labour. Kirmayer and colleagues propose that “notions of resilience emerging from developmental psychology and psychiatry in recent years address the distinctive cultures, geographic and social settings, and histories of adversity of indigenous peoples”. Resilience is understood here as an ability to actively engage with traumatic change, involving the capacity to absorb stress and to transform in order to cope with it (Luthar et al.). Further to this, in an Indigenous context, Marion Kickett has found the capacity for resilience to be supported by three key factors: family connections, culture and belonging as well as notions of identity and history. In exploring the layers of this autobiographical story, I employ this extended psychological notion of resilience in both a domestic ambit as well as the broader social context for Indigenous people surviving a system of external domination. Additionally I consider the resilience Aunty Hilda demonstrates at a pivotal interlude between girlhood and womanhood within the trajectory of her overall long and productive life, and within an intergenerational history of resistance and accommodation. What is especially important about her storytelling is its refusal to be contained by the imaginary of the settler nation and its generic Aboriginal-female subject. She refuses victimhood while at the same time illuminating the mechanisms of injustice, hinting also at possibilities for alternative and more equitable relationships of family and work across cultural divides. Considered through this prism, resilience is, I suggest, also a quality firmly connected to ideas of Aboriginal cultural-sovereignty and standpoint and to, what Victoria Grieves has identified as, the Aboriginal knowledge value of sharing (25, 28, 45). Storytelling as Pedagogy The story I discuss was verbally recounted in a manner that Westphalen describes as “a continuation of Dreaming Stories”, functioning to educate and connect people and country (13-14). As MacGill et al. note, “the critical and transformative aspects of decolonising pedagogies emerge from storytelling and involve the gift of narrative and the enactment of reciprocity that occurs between the listener and the storyteller.” Hilda told me that as a child she was taught not to ask questions when listening to the stories of an Elder, and her own children were raised in this manner. Hilda's oldest daughter described this as a process involving patience, intrigue and surprise (Elva Wanganeen). Narratives unfold through nuance and repetition in a complexity of layers that can generate multiple levels of meaning over time. Circularity and recursivity underlie this pedagogy through which mnemonic devices are built so that stories become re-membered and inscribed on the body of the listener. When a perceived level of knowledge-transference has occurred, a narrator may elect to elaborate further, adding another detail that will often transform the story’s social, cultural, moral or political context. Such carefully chosen additional detail, however, might re-contextualise all that has gone before. As well as being embodied, stories are also emplaced, and thus most appropriately told in the Country where events occurred. (Here I use the Aboriginal English term “Country” which encompasses home, clan estate, and the powerful complex of spiritual, animate and inanimate forces that bind people and place.) Hilda Wilson’s following account of her first job as a housekeeper for “one of Adelaide’s leading doctors”, Dr Frank Swann, provides an illustration of how she expertly uses traditional narrative forms of incrementally structured knowledge transmission within a cross-cultural setting to tell a story that expresses practices of resilience as resistance and transformation at its core. A “White Doctor” Story: The First Layer Aunty Hilda first told me this story when we were winding along the South Eastern Freeway through the Adelaide hills between Murray Bridge and Mount Barker, in 1997, on our way home to Adelaide from a trip to Camp Coorong, the Ngarrindjeri cultural education centre co-founded by her granddaughter. She was then 86 years old. Ahead of us, the profile of Mt Lofty rose out of the plains and into view. The highest peak in the Mount Lofty ranges, Yurrebilla, as it is known to Kaurna Aboriginal people, or Mt Lofty, has been an affluent enclave of white settlement for Adelaide’s moneyed elite since early colonial times. Being in place, or in view of place, provided the appropriate opportunity for her to tell me the story. It belongs to a group of stories that during our initial period of working together changed little over time until one day two years later she an added contextual detail which turned it inside out. Hilda described the doctor’s spacious hill-top residence, and her responsibilities of caring for Dr Swann’s invalid wife (“an hysteric who couldn't do anything for herself”), their twin teenage boys (who attended private college in the city) along with another son and younger daughter living at home (pers. com. Hilda Wilson). Recalling the exhilaration of looking down over the sparkling lights of Adelaide at night from this position of apparent “privilege” on the summit, she related this undeniably as a success story, justifiably taking great pride in her achievements as a teenager, capable of stepping into the place of the non-Indigenous doctor's wife in running the large and demanding household. Successfully undertaking a wide range of duties employed in the care of a family, including the disabled mother, she is an active participant crucial to the lives of all in the household, including to the work of the doctor and the twin boys in private education. Hilda recalled that Mrs Swann was unable to eat without her assistance. As the oldest daughter of a large family Hilda had previously assisted in caring for her younger siblings. Told in this way, her account collapses social distinctions, delineating a shared social and physical space, drawing its analytic frame from an Indigenous ethos of subjectivity, relationality, reciprocity and care. Moreover Hilda’s narrative of domestic service demonstrates an assertion of agency that resists colonial and patriarchal hegemony and inverts the master/mistress-servant relationship, one she firmly eschews in favour of the self-affirming role of the lady of the house. (It stands in contrast to the abuse found in other accounts for example Read, Tucker, Kartinyeri. Often the key difference was a continuity of family connections and ongoing family support.) Indeed the home transformed into a largely feminised and cross-culturalised space in which she had considerable agency and responsibility when the doctor was absent. Hilda told me this story several times in much the same way during our frequent encounters over the next two years. Each telling revealed further details that fleshed a perspective gained from what Patricia Hill Collins terms an “epistemic privilege” via her “outsider-within status” of working within a white household, lending an understanding of its social mechanisms (12-15). She also stressed the extent of her duty of care in upholding the family’s well-being, despite the work at times being too burdensome. The Second Version: Coming to Terms with Intersecting Oppressions Later, as our relationship developed and deepened, when I began to record her life-narrative as part of my doctoral work, she added an unexpected detail that altered its context completely: It was all right except I slept outside in a tin shed and it was very cold at night. Mount Lofty, by far the coldest part of Adelaide, frequently experiences winter maximum temperatures of two or three degrees and often light snowfalls. This skilful reframing draws on Indigenous storytelling pedagogy and is expressly used to invite reflexivity, opening questions that move the listener from the personal to the public realm in which domestic service and the hegemony of the home are pivotal in coming to terms with the overlapping historical oppressions of class, gender, race and nation. Suddenly we witness her subjectivity starkly shift from one self-defined and allied with an equal power relationship – or even of dependency reversal cast as “de-facto doctor's wife” – to one diminished by inequity and power imbalance in the outsider-defined role of “mistreated servant”. The latter was signalled by the dramatic addition of a single signifying detail as a decoding device to a deeper layer of meaning. In this parallel stratum of the story, Hilda purposefully brings into relief the politics in which “the private domain of women's housework intersected with the public domain of governmental social engineering policies” (Haskins 4). As Aileen Moreton-Robinson points out, what for White Australia was cheap labour and a civilising mission, for Indigenous women constituted stolen children and slavery. Protection and then assimilation were government policies under which Indigenous women grew up. (96) Hilda was sent away from her family to work in 1927 by the universally-feared Sister Pearl McKenzie, a nurse who too-zealously (Katinyeri, Ngarrindjeri Calling, 23) oversaw the Chief Protector’s policies of “training” Aboriginal children from the South Australian missions in white homes once they reached fourteen (Haebich, 316—20). Indeed many prominent Adelaide hills’ families benefited from Aboriginal labour under this arrangement. Hilda explained her struggle with the immense cultural dislocation that removal into domestic service entailed, a removal her grandfather William Rankine had travelled from Raukkan to Government House to protest against less than a decade earlier (The Register December 21, 1923). This additional layer of story also illuminates Hilda’s capacity for resilience and persistence in finding a way forward through the challenge of her circumstances (Luthar et al.), drawing on her family networks and sense of personhood (Kickett). Hilda related that her father visited her at Mount Lofty twice, though briefly, on his way to shearing jobs in the south-east of the state. “He said it was no good me living like this,” she stated. Through his active intervention, reinforcement was requested and another teenager from Point Pearce, Hilda’s future husband’s cousin, Annie Sansbury, soon arrived to share the workload. But, Hilda explained, the onerous expectations coupled with the cultural segregation of retiring to the tin shed quickly became too much for Annie, who stayed only three months, leaving Hilda coping again alone, until her father applied additional pressure for a more suitable placement to be found for his daughter. In her next position, working for the family of a racehorse trainer, Hilda contentedly shared the bedroom with the small boy for whom she cared, and not long after returned to Point Pearce where she married Robert Wilson and began a family of her own. Gendered Resilience across Cultural Divides Hilda explicitly speaks into these spaces to educate me, because all but a few white women involved have remained silent about their complicity with state sanctioned practices which exploited Indigenous labour and removed children from their families through the policies of protection and assimilation. For Indigenous women, speaking out was often fraught with the danger of a deeper removal from family and Country, even of disappearance. Victoria Haskins writes extensively of two cases in New South Wales where young Aboriginal women whose protests concerning their brutal treatment at the hands of white employers, resulted in their wrongful and prolonged committal to mental health and other institutions (147-52, 228-39). In the indentured service of Indigenous women it is possible to see oppression operating through Eurocentric ideologies of race, class and gender, in which Indigenous women were assumed to take on, through displacement, the more oppressed role of white women in pre-second world war non-Aboriginal Australian society. The troubling silent shadow-figure of the “doctor’s wife” indeed provides a haunting symbol of - and also a forceful rebellion against – the docile upper middle-class white femininity of the inter-war era. Susan Bordo has argued that that “the hysteric” is archetypal of a discourse of ‘pathology as embodied protest’ in which the body may […] be viewed as a surface on which conventional constructions of femininity are exposed starkly to view in extreme or hyperliteral form. (20) Mrs Swann’s vulnerability contrasts markedly with the strength Hilda expresses in coping with a large family, emanating from a history of equitable gender relations characteristic of Ngarrindjeri society (Bell). The intersection of race and gender, as Marcia Langton contends “continues to require deconstruction to allow us to decolonise our consciousness” (54). From Hilda’s brief description one grasps a relationship resonant with that between the protagonists in Tracy Moffat's Night Cries, (a response to the overt maternalism in the film Jedda) in which the white mother finds herself utterly reliant on her “adopted” Aboriginal daughter at the end of her life (46-7). Resilience and Survival The different versions of story Hilda deploys, provide a pedagogical basis to understanding the broader socio-political framework of her overall life narrative in which an ability to draw on the cultural continuity of the past to transform the future forms an underlying dynamic. This demonstrated capacity to meet the challenging conditions thrown up by the settler-colonial state has its foundations in the connectivity and cultural strength sustained generationally in her family. Resilience moves from being individually to socially determined, as in Kickett’s model. During the onslaught of dispossession, following South Australia’s 1836 colonial invasion, Ngarrindjeri were left near-starving and decimated from introduced diseases. Pullume (c1808-1888), the rupuli (elected leader of the Ngarrindjeri Tendi, or parliament), Hilda’s third generation great-grandfather, decisively steered his people through the traumatic changes, eventually negotiating a middle-path after the Point McLeay Mission was established on Ngarrindjeri country in 1859 (Jenkin, 59). Pullume’s granddaughter, the accomplished, independent-thinking Ellen Sumner (1842—1925), played an influential educative role during Hilda’s youth. Like other Ngarrindjeri women in her lineage, Ellen Sumner was skilled in putari practice (female doctor) and midwifery culture that extended to a duty of care concerning women and children (teaching her “what to do and what not to do”), which I suggest is something Hilda herself drew from when working with the Swann family. Hilda’s mother and aunties continued aspects of the putari tradition, attending births and giving instruction to women in the community (Bell, 171, Hughes Grandmother, 52-4). As mentioned earlier, when the South Australian government moved to introduce The Training of Children Act (SA) Hilda’s maternal grandfather William Rankine campaigned vigorously against this, taking a petition to the SA Governor in December 1923 (Haebich, 315-19). As with Aunty Hilda, William Rankine used storytelling as a method to draw public attention to the inequities of his times in an interview with The Register which drew on his life-narrative (Hughes, My Grandmother, 61). Hilda’s father Wilfred Varcoe, a Barngarrla-Wirrungu man, almost a thousand kilometres away from his Poonindie birthplace, resisted assimilation by actively pursuing traditional knowledge networks using his mobility as a highly sought after shearer to link up with related Elders in the shearing camps, (and as we saw to inspect the conditions his daughter was working under at Mt Lofty). The period Hilda spent as a servant to white families to be trained in white ways was in fact only a brief interlude in a long life in which family connections, culture and belonging (Kickett) served as the backbone of her resilience and resistance. On returning to the Point Pearce Mission, Hilda successfully raised a large family and activated a range of community initiatives that fostered well-being. In the 1960s she moved to Adelaide, initially as the sole provider of her family (her husband later followed), to give her younger children better educational opportunities. Working with Aunty Gladys Elphick OBE through the Council of Aboriginal Women, she played a foundational role in assisting other Aboriginal women establish their families in the city (Mattingly et al., 154, Fisher). In Adelaide, Aunty Hilda became an influential, much loved Elder, living in good health to the age of ninety-six years. The ability to survive changing circumstances, to extend care over and over to her children and Elders along with qualities of leadership, determination, agency and resilience have passed down through her family, several of whom have become successful in public life. These include her great-grandson and former AFL football player, Michael O’Loughlin, her great-nephew Adam Goodes and her-grand-daughter, the cultural weaver Aunty Ellen Trevorrow. Arguably, resilience contributes to physical as well as cultural longevity, through caring for the self and others. Conclusion This story demonstrates how sociocultural dimensions of resilience are contextualised in practices of everyday lives. We see this in the way that Aunty Hilda Wilson’s self-narrated story resolutely defies attempts to know, subjugate and categorise, operating instead in accord with distinctively Aboriginal expressions of gender and kinship relations that constitute an Aboriginal sovereignty. Her storytelling activates a revision of collective history in ways that valorise Indigenous identity (Kirmayer et al.). Her narrative of agency and personal achievement, one that has sustained her through life, interacts with the larger narrative of state-endorsed exploitation, diffusing its power and exposing it to wider moral scrutiny. Resilience in this context is inextricably entwined with practices of cultural survival and resistance developed in response to the introduction of government policies and the encroachment of settlers and their world. We see resilience too operating across Hilda Wilson’s family history, and throughout her long life. The agency and strategies displayed suggest alternative realities and imagine other, usually more equitable, possible worlds. References Bell, Diane. Ngarrindjeri Wurruwarrin: A World That Is, Was and Will Be. Melbourne: Spinifex, 1998. Bordo, Susan. “The Body and the Reproduction of Femininity.” Writing on the Body: Female Embodiment and Feminist Theory. Eds. Katie Conboy, Nadia Medina, and Sarah Stanbury. New York: Columbia UP, 1997. 90-110. Collins, Patricia Hill. Black Feminist Thought. New York: Routledge, 2000. Fisher, Elizabeth M. "Elphick, Gladys (1904–1988)." Australian Dictionary of Biography. National Centre of Biography, Australian National University, 29 Sep. 2013. ‹http://adb.anu.edu.au/biography/elphick-gladys-12460/text22411>. Grieves, Victoria. Aboriginal Spirituality: Aboriginal Philosophy, The Basis of Aboriginal Social and Emotional Wellbeing, Melbourne University: Cooperative Research Centre for Aboriginal Health, 2009. Haebich, Anna. Broken Circles: The Fragmenting of Indigenous Families. Fremantle: Fremantle Arts Press, 2000. Haskins, Victoria. My One Bright Spot. London: Palgrave, 2005. Hughes, Karen. "My Grandmother on the Other Side of the Lake." PhD thesis, Department of Australian Studies and Department of History, Flinders University. Adelaide, 2009. ———. “Microhistories and Things That Matter.” Australian Feminist Studies 27.73 (2012): 269-278. ———. “I’d Grown Up as a Child amongst Natives.” Outskirts: Feminisms along the Edge 28 (2013). 29 Sep. 2013 ‹http://www.outskirts.arts.uwa.edu.au/volumes/volume-28/karen-hughes>. Jenkin, Graham. Conquest of the Ngarrindjeri. Adelaide: Rigby, 1979. Kartinyeri, Doris. Kick the Tin. Melbourne: Spinifex, 2000. Kartinyeri, Doreen. My Ngarrindjeri Calling, Adelaide: Wakefield, 2007. Kickett, Marion. “Examination of How a Culturally Appropriate Definition of Resilience Affects the Physical and Mental Health of Aboriginal People.” PhD thesis, Curtin University, 2012. Kirmayer, L.J., S. Dandeneau, E. Marshall, M.K. Phillips, K. Jenssen Williamson. “Rethinking Resilience from Indigenous Perspectives.” Canadian Journal of Psychiatry 56.2 (2011): 84-91. Luthar, S., D. Cicchetti, and B. Becker. “The Construct of Resilience: A Critical Evaluation and Guidelines for Future Work.” Child Development 71.3 (2000): 543-62. MacGill, Bindi, Julie Mathews, Ellen Trevorrow, Alice Abdulla, and Deb Rankine. “Ecology, Ontology, and Pedagogy at Camp Coorong,” M/C Journal 15.3 (2012). Mattingly, Christobel, and Ken Hampton. Survival in Our Own Land, Adelaide: Wakefield, 1988. Moreton-Robinson, Aileen. Talkin’ Up to the White Woman. St Lucia: UQP, 2000. Night Cries, A Rural Tragedy. Dir. Tracy Moffatt. Chili Films, 1990. Read, Peter. A Rape of the Soul So Profound. Crows Nest: Allen & Unwin, 2002. Tucker, Margaret. If Everyone Cared. Sydney: Ure Smith, 1977. Wanganeen, Elva. Personal Communication, 2000. Westphalen, Linda. An Anthropological and Literary Study of Two Aboriginal Women's Life Histories: The Impacts of Enforced Child Removal and Policies of Assimilation. New York: Mellen Press, 2011.
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Chavdarov, Anatoliy V. "Special Issue No. – 10, June, 2020 Journal > Special Issue > Special Issue No. – 10, June, 2020 > Page 5 “Quantative Methods in Modern Science” organized by Academic Paper Ltd, Russia MORPHOLOGICAL AND ANATOMICAL FEATURES OF THE GENUS GAGEA SALISB., GROWING IN THE EAST KAZAKHSTAN REGION Authors: Zhamal T. Igissinova,Almash A. Kitapbayeva,Anargul S. Sharipkhanova,Alexander L. Vorobyev,Svetlana F. Kolosova,Zhanat K. Idrisheva, DOI: https://doi.org/10.26782/jmcms.spl.10/2020.06.00041 Abstract: Due to ecological preferences among species of the genus GageaSalisb, many plants are qualified as rare and/or endangered. Therefore, the problem of rational use of natural resources, in particular protection of early spring plant species is very important. However, literary sources analysis only reveals data on the biology of species of this genus. The present research,conducted in the spring of 2017-2019, focuses on anatomical and morphological features of two Altai species: Gagealutea and Gagea minima; these features were studied, clarified and confirmed by drawings and photographs. The anatomical structure of the stem and leaf blade was studied in detail. The obtained research results will prove useful for studies of medicinal raw materials and honey plants. The aforementioned species are similar in morphological features, yet G. minima issmaller in size, and its shoots appear earlier than those of other species Keywords: Flora,gageas,Altai species,vegetative organs., Refference: I. Atlas of areas and resources of medicinal plants of Kazakhstan.Almaty, 2008. II. Baitenov M.S. Flora of Kazakhstan.Almaty: Ġylym, 2001. III. DanilevichV. G. ThegenusGageaSalisb. of WesternTienShan. PhD Thesis, St. Petersburg,1996. IV. EgeubaevaR.A., GemedzhievaN.G. The current state of stocks of medicinal plants in some mountain ecosystems of Kazakhstan.Proceedings of the international scientific conference ‘”Results and prospects for the development of botanical science in Kazakhstan’, 2002. V. Kotukhov Yu.A. New species of the genus Gagea (Liliaceae) from Southern Altai. Bot. Journal.1989;74(11). VI. KotukhovYu.A. ListofvascularplantsofKazakhstanAltai. Botan. Researches ofSiberiaandKazakhstan.2005;11. VII. KotukhovYu. The current state of populations of rare and endangered plants in Eastern Kazakhstan. Almaty: AST, 2009. VIII. Kotukhov Yu.A., DanilovaA.N., AnufrievaO.A. Synopsisoftheonions (AlliumL.) oftheKazakhstanAltai, Sauro-ManrakandtheZaisandepression. BotanicalstudiesofSiberiaandKazakhstan. 2011;17: 3-33. IX. Kotukhov, Yu.A., Baytulin, I.O. Rareandendangered, endemicandrelictelementsofthefloraofKazakhstanAltai. MaterialsoftheIntern. scientific-practical. conf. ‘Sustainablemanagementofprotectedareas’.Almaty: Ridder, 2010. X. Krasnoborov I.M. et al. The determinant of plants of the Republic of Altai. Novosibirsk: SB RAS, 2012. XI. Levichev I.G. On the species status of Gagea Rubicunda. Botanical Journal.1997;6:71-76. XII. Levichev I.G. A new species of the genus Gagea (Liliaceae). Botanical Journal. 2000;7: 186-189. XIII. Levichev I.G., Jangb Chang-gee, Seung Hwan Ohc, Lazkovd G.A.A new species of genus GageaSalisb.(Liliaceae) from Kyrgyz Republic (Western Tian Shan, Chatkal Range, Sary-Chelek Nature Reserve). Journal of Asia-Pacific Biodiversity.2019; 12: 341-343. XIV. Peterson A., Levichev I.G., Peterson J. Systematics of Gagea and Lloydia (Liliaceae) and infrageneric classification of Gagea based on molecular and morphological data. Molecular Phylogenetics and Evolution.2008; 46. XV. Peruzzi L., Peterson A., Tison J.-M., Peterson J. Phylogenetic relationships of GageaSalisb.(Liliaceae) in Italy, inferred from molecular and morphological data matrices. Plant Systematics and Evolution; 2008: 276. XVI. Rib R.D. Honey plants of Kazakhstan. Advertising Digest, 2013. XVII. Scherbakova L.I., Shirshikova N.A. Flora of medicinal plants in the vicinity of Ust-Kamenogorsk. Collection of materials of the scientific-practical conference ‘Unity of Education, Science and Innovation’. Ust-Kamenogorsk: EKSU, 2011. XVIII. syganovA.P. PrimrosesofEastKazakhstan. Ust-Kamenogorsk: EKSU, 2001. XIX. Tsyganov A.P. Flora and vegetation of the South Altai Tarbagatay. Berlin: LAP LAMBERT,2014. XX. Utyasheva, T.R., Berezovikov, N.N., Zinchenko, Yu.K. ProceedingsoftheMarkakolskStateNatureReserve. Ust-Kamenogorsk, 2009. XXI. Xinqi C, Turland NJ. Gagea. Flora of China.2000;24: 117-121. XXII. Zarrei M., Zarre S., Wilkin P., Rix E.M. Systematic revision of the genus GageaSalisb. (Liliaceae) in Iran.BotJourn Linn Soc.2007;154. XXIII. Zarrei M., Wilkin P., Ingroille M.J., Chase M.W. A revised infrageneric classification for GageaSalisb. (Tulipeae; Liliaceae): insights from DNA sequence and morphological data.Phytotaxa.2011:5. View | Download INFLUENCE OF SUCCESSION CROPPING ON ECONOMIC EFFICIENCY OF NO-TILL CROP ROTATIONS Authors: Victor K. Dridiger,Roman S. Stukalov,Rasul G. Gadzhiumarov,Anastasiya A. Voropaeva,Viktoriay A. Kolomytseva, DOI: https://doi.org/10.26782/jmcms.spl.10/2020.06.00042 Abstract: This study was aimed at examining the influence of succession cropping on the economic efficiency of no-till field crop rotations on the black earth in the zone of unstable moistening of the Stavropol krai. A long-term stationary experiment was conducted to examine for the purpose nine field crop rotation patterns different in the number of fields (four to six), set of crops, and their succession in crop rotation. The respective shares of legumes, oilseeds, and cereals in the cropping pattern were 17 to 33, 17 to 40, and 50 to 67 %. It has been established that in case of no-till field crop cultivation the economic efficiency of plant production depends on the set of crops and their succession in rotation. The most economically efficient type of crop rotation is the soya-winter wheat-peas-winter wheat-sunflower-corn six-field rotation with two fields of legumes: in this rotation 1 ha of crop rotation area yields 3 850 grain units per ha at a grain unit prime cost of 5.46 roubles; the plant production output return and profitability were 20,888 roubles per ha and 113 %, respectively. The high production profitabilities provided by the soya-winter wheat-sunflower four-field and the soya-winter-wheat-sunflower-corn-winter wheat five-field crop rotation are 108.7 and 106.2 %, respectively. The inclusion of winter wheat in crop rotation for two years in a row reduces the second winter wheat crop yield by 80 to 100 %, which means a certain reduction in the grain unit harvesting rate to 3.48-3.57 thousands per ha of rotation area and cuts the production profitability down to 84.4-92.3 %. This is why, no-till cropping should not include winter wheat for a second time Keywords: No-till technology,crop rotation,predecessor,yield,return,profitability, Refference: I Badakhova G. Kh. and Knutas A. V., Stavropol Krai: Modern Climate Conditions [Stavropol’skiykray: sovremennyyeklimaticheskiyeusloviya]. Stavropol: SUE Krai Communication Networks, 2007. II Cherkasov G. N. and Akimenko A. S. Scientific Basis of Modernization of Crop Rotations and Formation of Their Systems according to the Specializations of Farms in the Central Chernozem Region [Osnovy moderniz atsiisevooborotoviformirovaniyaikh sistem v sootvetstvii so spetsi-alizatsiyeykhozyaystvTsentral’nogoChernozem’ya]. Zemledelie. 2017; 4: 3-5. III Decree 330 of July 6, 2017 the Ministry of Agriculture of Russia “On Approving Coefficients of Converting to Agricultural Crops to Grain Units [Ob utverzhdeniikoeffitsiyentovperevoda v zernovyyee dinitsysel’s kokhozyaystvennykhkul’tur]. IV Dridiger V. K., About Methods of Research of No-Till Technology [O metodikeissledovaniytekhnologii No-till]//Achievements of Science and Technology of AIC (Dostizheniyanaukiitekhniki APK). 2016; 30 (4): 30-32. V Dridiger V. K. and Gadzhiumarov R. G. Growth, Development, and Productivity of Soya Beans Cultivated On No-Till Technology in the Zone of Unstable Moistening of Stavropol Region [Rost, razvitiyeiproduktivnost’ soiprivozdelyvaniipotekhnologii No-till v zone ne-ustoychivog ouvlazhneniyaStavropol’skogokraya]//Oil Crops RTBVNIIMK (Maslichnyyekul’turyNTBVNIIMK). 2018; 3 (175): 52–57. VI Dridiger V. K., Godunova E. I., Eroshenko F. V., Stukalov R. S., Gadzhiumarov, R. G., Effekt of No-till Technology on erosion resistance, the population of earthworms and humus content in soil (Vliyaniyetekhnologii No-till naprotivoerozionnuyuustoychivost’, populyatsiyudozhdevykhcherveyisoderzhaniyegumusa v pochve)//Research Journal of Pharmaceutical, Biological and Chemical Sciences. 2018; 9 (2): 766-770. VII Karabutov A. P., Solovichenko V. D., Nikitin V. V. et al., Reproduction of Soil Fertility, Productivity and Energy Efficiency of Crop Rotations [Vosproizvodstvoplodorodiyapochv, produktivnost’ ienergeticheskayaeffektivnost’ sevooborotov]. Zemledelie. 2019; 2: 3-7. VIII Kulintsev V. V., Dridiger V. K., Godunova E. I., Kovtun V. I., Zhukova M. P., Effekt of No-till Technology on The Available Moisture Content and Soil Density in The Crop Rotation [Vliyaniyetekhnologii No-till nasoderzhaniyedostupnoyvlagiiplotnost’ pochvy v sevoob-orote]// Research Journal of Pharmaceutical, Biological and Chemical Sciences. 2017; 8 (6): 795-99. IX Kulintsev V. V., Godunova E. I., Zhelnakova L. I. et al., Next-Gen Agriculture System for Stavropol Krai: Monograph [SistemazemledeliyanovogopokoleniyaStavropol’skogokraya: Monogtafiya]. Stavropol: AGRUS Publishers, Stavropol State Agrarian University, 2013. X Lessiter Frank, 29 reasons why many growers are harvesting higher no-till yields in their fields than some university scientists find in research plots//No-till Farmer. 2015; 44 (2): 8. XI Rodionova O. A. Reproduction and Exchange-Distributive Relations in Farming Entities [Vosproizvodstvoiobmenno-raspredelitel’nyyeotnosheniya v sel’skokhozyaystvennykhorganizatsiyakh]//Economy, Labour, and Control in Agriculture (Ekonomika, trud, upravleniye v sel’skomkhozyaystve). 2010; 1 (2): 24-27. XII Sandu I. S., Svobodin V. A., Nechaev V. I., Kosolapova M. V., and Fedorenko V. F., Agricultural Production Efficiency: Recommended Practices [Effektivnost’ sel’skokhozyaystvennogoproizvodstva (metodicheskiyerekomendatsii)]. Moscow: Rosinforagrotech, 2013. XIII Sotchenko V. S. Modern Corn Cultivation Technologies [Sovremennayatekhnologiyavozdelyvaniya]. Moscow: Rosagrokhim, 2009. View | Download DEVELOPMENT AND TESTING OF AUTONOMOUS PORTABLE SEISMOMETER DESIGNED FOR USE AT ULTRALOW TEMPERATURES IN ARCTIC ENVIRONMENT Authors: Mikhail A. Abaturov,Yuriy V. Sirotinskiy, DOI: https://doi.org/10.26782/jmcms.spl.10/2020.06.00043 Abstract: This paper is concerned with solving one of the issues of the general problem of designing geophysical equipment for the natural climatic environment of the Arctic. The relevance of the topic has to do with an increased global interest in this region. The paper is aimed at considering the basic principles of developing and the procedure of testing seismic instruments for use at ultralow climatic temperatures. In this paper the indicated issue is considered through the example of a seismic module designed for petroleum and gas exploration by passive seismoacoustic methods. The seismic module is a direct-burial portable unit of around 5 kg in weight, designed to continuously measure and record microseismic triaxial orthogonal (ZNE) noise in a range from 0.1 to 45 Hz during several days in autonomous mode. The functional chart of designing the seismic module was considered, and concrete conclusions were made for choosing the necessary components to meet the ultralow-temperature operational requirements. The conclusions made served for developing appropriate seismic module. In this case, the components and tools used included a SAFT MP 176065 xc low-temperature lithium cell, industrial-spec electronic component parts, a Zhaofeng Geophysical ZF-4.5 Chinese primary electrodynamic seismic sensor, housing seal parts made of frost-resistant silicone materials, and finely dispersed silica gel used as water-retaining sorbent to avoid condensation in the housing. The paper also describes a procedure of low-temperature collation tests at the lab using a New Brunswick Scientific freezing plant. The test results proved the operability of the developed equipment at ultralow temperatures down to -55°C. In addition, tests were conducted at low microseismic noises in the actual Arctic environment. The possibility to detect signals in a range from 1 to 10 Hz at the level close to the NLNM limit (the Peterson model) has been confirmed, which allows monitoring and exploring petroleum and gas deposits by passive methods. As revealed by this study, the suggested approaches are efficient in developing high-precision mobile seismic instruments for use at ultralow climatic temperatures. The solution of the considered instrumentation and methodical issues is of great practical significance as a constituent of the generic problem of Arctic exploration. Keywords: Seismic instrumentation,microseismic monitoring,Peterson model,geological exploration,temperature ratings,cooling test, Refference: I. AD797: Ultralow Distortion, Ultralow Noise Op Amp, Analog Devices, Inc., Data Sheet (Rev. K). Analog Devices, Inc. URL: https://www.analog.com/media/en/technical-documentation/data-sheets/AD797.pdf(Date of access September 2, 2019). II. Agafonov, V. M., Egorov, I. V., and Shabalina, A. S. Operating Principles and Technical Characteristics of a Small-Sized Molecular–Electronic Seismic Sensor with Negative Feedback [Printsipyraboty I tekhnicheskiyekharakteristikimalogabaritnogomolekulyarno-elektronnogoseysmodatchika s otritsatel’noyobratnoysvyaz’yu]. SeysmicheskiyePribory (Seismic Instruments). 2014; 50 (1): 1–8. DOI: 10.3103/S0747923914010022. III. Antonovskaya, G., Konechnaya, Ya.,Kremenetskaya, E., Asming, V., Kvaema, T., Schweitzer, J., Ringdal, F. Enhanced Earthquake Monitoring in the European Arctic. Polar Science. 2015; 1 (9): 158-167. IV. Anthony, R. E., Aster, R. C., Wiens, D., Nyblade, Andr., Anandakrishnan, Sr., Huerta, Audr., Winberry, J. P., Wilson, T., and Rowe, Ch. The Seismic Noise Environment of Antarctica. Seismological Research Letters. 2015; 86(1): 89-100. DOI: 10.1785/0220150005 V. Brincker, R., Lago, T. L., Andersen, P., and Ventura, C. Improving the Classical Geophone Sensor Element by Digital Correction. In Conference Proceedings: IMAC-XXIII: A Conference & Exposition on Structural Dynamics Society for Experimental Mechanics, 2005. URL: https://www.researchgate.net/publication/242452637_Improving_the_Classical_Geophone_Sensor_Element_by_Digital_Correction(Date of access September 2, 2019). VI. Bylaw 164 of the State Committee for Construction of the Russian Federation “On adopting amendments to SNiP 31-01-99 “Construction climatology”. URL: https://base.garant.ru/2322381/(Date of access September 2, 2019). VII. 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View | Download COMPARATIVE ANALYSIS OF RESULTS OF TREATMENT OF PATIENTS WITH FOOT PATHOLOGY WHO UNDERWENT WEIL OPEN OSTEOTOMY BY CLASSICAL METHOD AND WITHOUT STEOSYNTHESIS Authors: Yuriy V. Lartsev,Dmitrii A. Rasputin,Sergey D. Zuev-Ratnikov,Pavel V.Ryzhov,Dmitry S. Kudashev,Anton A. Bogdanov, DOI: https://doi.org/10.26782/jmcms.spl.10/2020.06.00044 Abstract: The article considers the problem of surgical correction of the second metatarsal bone length. The article analyzes the results of treatment of patients with excess length of the second metatarsal bones that underwent osteotomy with and without osteosynthesis. The results of treatment of patients who underwent metatarsal shortening due to classical Weil-osteotomy with and without osteosynthesis were analyzed. The first group consisted of 34 patients. They underwent classical Weil osteotomy. The second group included 44 patients in whomosteotomy of the second metatarsal bone were not by the screw. When studying the results of the treatment in the immediate postoperative period, weeks 6, 12, slightly better results were observed in patients of the first group, while one year after surgical treatment the results in both groups were comparable. One year after surgical treatment, there were 2.9% (1 patient) of unsatisfactory results in the first group and 4.5% (2 patients) in the second group. Considering the comparability of the results of treatment in remote postoperative period, the choice of concrete method remains with the operating surgeon. Keywords: Flat feet,hallux valgus,corrective osteotomy,metatarsal bones, Refference: I. A novel modification of the Stainsby procedure: surgical technique and clinical outcome [Text] / E. Concannon, R. MacNiocaill, R. Flavin [et al.] // Foot Ankle Surg. – 2014. – Dec., Vol. 20(4). – P. 262–267. II. Accurate determination of relative metatarsal protrusion with a small intermetatarsal angle: a novel simplified method [Text] / L. Osher, M.M. Blazer, S. Buck [et al.] // J. Foot Ankle Surg. – 2014. – Sep.-Oct., Vol. 53(5). – P. 548–556. III. Argerakis, N.G. The radiographic effects of the scarf bunionectomy on rearfoot alignment [Text] / N.G. Argerakis, L.Jr. Weil, L.S. Sr. Weil // Foot Ankle Spec. – 2015. – Apr., Vol. 8(2). – P. 89–94. IV. Bauer, T. Percutaneous forefoot surgery [Text] / T. Bauer // Orthop. Traumatol. Surg. Res. – 2014. – Feb., Vol. 100(1 Suppl.). – P. S191–S204. V. Biomechanical Evaluation of Custom Foot Orthoses for Hallux Valgus Deformity [Text] // J. Foot Ankle Surg. – 2015. – Sep.-Oct., Vol.54(5). – P. 852–855. VI. Chopra, S. Characterization of gait in female patients with moderate to severe hallux valgus deformity [Text] / S. Chopra, K. Moerenhout, X. Crevoisier // Clin. Biomech. (Bristol, Avon). – 2015. – Jul., Vol. 30(6). – P. 629–635. VII. Computer assisted planning and custom-made surgical guide for malunited pronation deformity after first metatarsophalangeal joint arthrodesis in rheumatoid arthritis: a case report [Text] / M. Hirao, S. Ikemoto, H. Tsuboi [et al.] // Comput. Aided Surg. – 2014. – Vol. 19(1-3). – P. 13–19. VIII. Correlation between static radiographic measurements and intersegmental angular measurements during gait using a multisegment foot model [Text] / D.Y. Lee, S.G. Seo, E.J. Kim [et al.] // Foot Ankle Int. – 2015. – Jan., Vol.36(1). – P. 1–10. IX. Correlative study between length of first metatarsal and transfer metatarsalgia after osteotomy of first metatarsal [Text]: [Article in Chinese] / F.Q. Zhang, B.Y. Pei, S.T. Wei [et al.] // Zhonghua Yi XueZaZhi. – 2013. – Nov. 19, Vol. 93(43). – P. 3441–3444. X. Dave, M.H. Forefoot Deformity in Rheumatoid Arthritis: A Comparison of Shod and Unshod Populations [Text] / M.H. Dave, L.W. Mason, K. Hariharan // Foot Ankle Spec. – 2015. – Oct., Vol. 8(5). – P. 378–383. XI. Does arthrodesis of the first metatarsophalangeal joint correct the intermetatarsal M1M2 angle? Analysis of a continuous series of 208 arthrodeses fixed with plates [Text] / F. Dalat, F. Cottalorda, M.H. Fessy [et al.] // Orthop. Traumatol. Surg. Res. – 2015. – Oct., Vol. 101(6). – P. 709–714. XII. Dynamic plantar pressure distribution after percutaneous hallux valgus correction using the Reverdin-Isham osteotomy [Text]: [Article in Spanish] / G. Rodríguez-Reyes, E. López-Gavito, A.I. Pérez-Sanpablo [et al.] // Rev. Invest. Clin. – 2014. – Jul., Vol. 66, Suppl. 1. – P. S79-S84. XIII. Efficacy of Bilateral Simultaneous Hallux Valgus Correction Compared to Unilateral [Text] / A.V. Boychenko, L.N. Solomin, S.G. Parfeyev [et al.] // Foot Ankle Int. – 2015. – Nov., Vol. 36(11). – P. 1339–1343. XIV. Endolog technique for correction of hallux valgus: a prospective study of 30 patients with 4-year follow-up [Text] / C. Biz, M. Corradin, I. Petretta [et al.] // J. OrthopSurg Res. – 2015. – Jul. 2, № 10. – P. 102. XV. First metatarsal proximal opening wedge osteotomy for correction of hallux valgus deformity: comparison of straight versus oblique osteotomy [Text] / S.H. Han, E.H. Park, J. Jo [et al.] // Yonsei Med. J. – 2015. – May, Vol. 56(3). – P. 744–752. XVI. Long-term outcome of joint-preserving surgery by combination metatarsal osteotomies for shortening for forefoot deformity in patients with rheumatoid arthritis [Text] / H. Niki, T. Hirano, Y. Akiyama [et al.] // Mod. Rheumatol. – 2015. – Sep., Vol. 25(5). – P. 683–638. XVII. Maceira, E. Transfer metatarsalgia post hallux valgus surgery [Text] / E. Maceira, M. Monteagudo // Foot Ankle Clin. – 2014. – Jun., Vol. 19(2). – P.285–307. XVIII. Nielson, D.L. Absorbable fixation in forefoot surgery: a viable alternative to metallic hardware [Text] / D.L. Nielson, N.J. Young, C.M. Zelen // Clin. Podiatr. Med. Surg. – 2013. – Jul., Vol. 30(3). – P. 283–293 XIX. Patient’s satisfaction after outpatient forefoot surgery: Study of 619 cases [Text] / A. Mouton, V. Le Strat, D. Medevielle [et al.] // Orthop. Traumatol. Surg. Res. – 2015. – Oct., Vol. 101(6 Suppl.). – P. S217–S220. XX. Preference of surgical procedure for the forefoot deformity in the rheumatoid arthritis patients–A prospective, randomized, internal controlled study [Text] / M. Tada, T. Koike, T. Okano [et al.] // Mod. Rheumatol. – 2015. – May., Vol. 25(3). – P.362–366. XXI. Redfern, D. Percutaneous Surgery of the Forefoot [Text] / D. Redfern, J. Vernois, B.P. Legré // Clin. Podiatr. Med. Surg. – 2015. – Jul., Vol. 32(3). – P. 291–332. XXII. Singh, D. Bullous pemphigoid after bilateral forefoot surgery [Text] / D. Singh, A. Swann // Foot Ankle Spec. – 2015. – Feb., Vol. 8(1). – P. 68–72. XXIII. Treatment of moderate hallux valgus by percutaneous, extra-articular reverse-L Chevron (PERC) osteotomy [Text] / J. Lucas y Hernandez, P. Golanó, S. Roshan-Zamir [et al.] // Bone Joint J. – 2016. – Mar., Vol. 98-B(3). – P. 365–373. XXIV. Weil, L.Jr. Scarf osteotomy for correction of hallux abducto valgus deformity [Text] / L.Jr. Weil, M. Bowen // Clin. Podiatr. Med. Surg. – 2014. – Apr., Vol.31(2). – P. 233–246. View | Download QUANTITATIVE ULTRASONOGRAPHY OF THE STOMACH AND SMALL INTESTINE IN HEALTHYDOGS Authors: Roman A. Tcygansky,Irina I. Nekrasova,Angelina N. Shulunova,Alexander I.Sidelnikov, DOI: https://doi.org/10.26782/jmcms.spl.10/2020.06.00045 Abstract: Purpose.To determine the quantitative echogenicity indicators (and their ratio) of the layers of stomach and small intestine wall in healthy dogs. Methods. A prospective 3-year study of 86 healthy dogs (aged 1-7 yrs) of different breeds and of both sexes. Echo homogeneity and echogenicity of the stomach and intestines wall were determined by the method of Silina, T.L., et al. (2010) in absolute values ​​of average brightness levels of ultrasound image pixels using the 8-bit scale with 256 shades of gray. Results. Quantitative echogenicity indicators of the stomach and the small intestine wall in dogs were determined. Based on the numerical values ​​characterizing echogenicity distribution in each layer of a separate structure of the digestive system, the coefficient of gastric echogenicity is determined as 1:2.4:1.1 (mucosa/submucosa/muscle layers, respectively), the coefficient of duodenum and jejunum echogenicity is determined as 1:3.5:2 and that of ileum is 1:1.8:1. Clinical significance. The echogenicity coefficient of the wall of the digestive system allows an objective assessment of the stomach and intestines wall and can serve as the basis for a quantitative assessment of echogenicity changes for various pathologies of the digestive system Keywords: Ultrasound (US),echogenicity,echogenicity coefficient,digestive system,dogs,stomach,intestines, Refference: I. Agut, A. Ultrasound examination of the small intestine in small animals // Veterinary focus. 2009.Vol. 19. No. 1. P. 20-29. II. Bull. 4.RF patent 2398513, IPC51A61B8 / 00 A61B8 / 14 (2006.01) A method for determining the homoechogeneity and the degree of echogenicity of an ultrasound image / T. Silina, S. S. Golubkov. – No. 2008149311/14; declared 12/16/2008; publ. 09/10/2010 III. Choi, M., Seo, M., Jung, J., Lee, K., Yoon, J., Chang, D., Park, RD. Evaluation of canine gastric motility with ultrasonography // J. of Veterinary Medical Science. – 2002. Vol. 64. – № 1. – P. 17-21. IV. Delaney, F., O’Brien, R.T., Waller, K.Ultrasound evaluation of small bowel thickness compared to weight in normal dogs // Veterinary Radiology and Ultrasound. 2003 Vol. 44, № 5. Р 577-580. V. Diana, A., Specchi, S., Toaldo, M.B., Chiocchetti, R., Laghi, A., Cipone, M. Contrast-enhanced ultrasonography of the small bowel in healthy cats // Veterinary Radiology and Ultrasound. – 2011. – Vol. 52, № 5. – Р. 555-559. VI. Garcia, D.A.A., Froes, T.R. Errors in abdominal ultrasonography in dogs and cats // J. of Small Animal Practice. – 2012. Vol. 53. – № 9. – P. 514-519. VII. Garcia, D.A.A., Froes, T.R. Importance of fasting in preparing dogs for abdominal ultrasound examination of specific organs // J. of Small Animal Practice. – 2014. Vol. 55. – № 12. – P. 630-634. VIII. Gaschen, L., Granger, L.A., Oubre, O., Shannon, D., Kearney, M., Gaschen, F. The effects of food intake and its fat composition on intestinal echogenicity in healthy dogs // Veterinary Radiology and Ultrasound. 2016. Vol. 57. № 5. P. 546-550 IX. Gaschen, L., Kircher, P., Stussi, A., Allenspach, K., Gaschen, F., Doherr, M., Grone, A. Comparison of ultrasonographic findings with clinical activity index (CIBDAI) and diagnosis in dogs with chronic enteropathies // Veterinary radiology and ultrasound. – 2008. – Vol. 49. – № 1. – Р. 56-64. X. Gil, E.M.U. Garcia, D.A.A. Froes, T.R. In utero development of the fetal intestine: Sonographic evaluation and correlation with gestational age and fetal maturity in dogs // Theriogenology. 2015. Vol. 84, №5. Р. 681-686. XI. Gladwin, N.E. Penninck, D.G., Webster, C.R.L. Ultrasonographic evaluation of the thickness of the wall layers in the intestinal tract of dogs // American Journal of Veterinary Research. 2014. Vol. 75, №4. Р. 349-353. XII. Gory, G., Rault, D.N., Gatel, L, Dally, C., Belli, P., Couturier, L., Cauvin, E. Ultrasonographic characteristics of the abdominal esophagus and cardia in dogs // Veterinary Radiology and Ultrasound. 2014. Vol. 55, № 5. P. 552-560. XIII. Günther, C.S. Lautenschläger, I.E., Scholz, V.B. Assessment of the inter- and intraobserver variability for sonographical measurement of intestinal wall thickness in dogs without gastrointestinal diseases | [Inter-und Intraobserver-Variabilitätbei der sonographischenBestimmung der Darmwanddicke von HundenohnegastrointestinaleErkrankungen] // Tierarztliche Praxis Ausgabe K: Kleintiere – Heimtiere. 2014. Vol. 42 №2. Р. 71-78. XIV. Hanazono, K., Fukumoto, S., Hirayama, K., Takashima, K., Yamane, Y., Natsuhori, M., Kadosawa, T., Uchide, T. Predicting Metastatic Potential of gastrointestinal stromal tumors in dog by ultrasonography // J. of Veterinary Medical Science. – 2012. Vol. 74. – № 11. – P. 1477-1482. XV. Heng, H.G., Lim, Ch.K., Miller, M.A., Broman, M.M.Prevalence and significance of an ultrasonographic colonic muscularishyperechoic band paralleling the serosal layer in dogs // Veterinary Radiology and Ultrasound. 2015. Vol. 56 № 6. P. 666-669. XVI. Ivančić, M., Mai, W. Qualitative and quantitative comparison of renal vs. hepatic ultrasonographic intensity in healthy dogs // Veterinary Radiology and Ultrasound. 2008. Vol. 49. № 4. Р. 368-373. XVII. Lamb, C.R., Mantis, P. Ultrasonographic features of intestinal intussusception in 10 dogs // J. of Small Animal Practice. – 2008. Vol. 39. – № 9. – P. 437-441. XVIII. Le Roux, A. B., Granger, L.A., Wakamatsu, N, Kearney, M.T., Gaschen, L.Ex vivo correlation of ultrasonographic small intestinal wall layering with histology in dogs // Veterinary Radiology and Ultrasound.2016. Vol. 57. № 5. P. 534-545. XIX. Nielsen, T. High-frequency ultrasound of Peyer’s patches in the small intestine of young cats / T. Nielsen [et al.] // Journal of Feline Medicine and Surgery. – 2015. – Vol. 18, № 4. – Р. 303-309. XX. PenninckD.G. Gastrointestinal tract. In Nyland T.G., Mattoon J.S. (eds): Small Animal Diagnostic Ultrasound. Philadelphia: WB Saunders. 2002, 2nd ed. Р. 207-230. XXI. PenninckD.G. Gastrointestinal tract. In: PenninckD.G.,d´Anjou M.A. Atlas of Small Animal Ultrasonography. Blackwell Publishing, Iowa. 2008. Р. 281-318. XXII. Penninck, D.G., Nyland, T.G., Kerr, L.Y., Fisher, P.E. Ultrasonographic evaluation of gastrointestinal diseases in small animals // Veterinary Radiology. 1990. Vol. 31. №3. P. 134-141. XXIII. Penninck, D.G.,Webster, C.R.L.,Keating, J.H. The sonographic appearance of intestinal mucosal fibrosis in cats // Veterinary Radiology and Ultrasound. – 2010. – Vol. 51, № 4. – Р. 458-461. XXIV. Pollard, R.E.,Johnson, E.G., Pesavento, P.A., Baker, T.W., Cannon, A.B., Kass, P.H., Marks, S.L. Effects of corn oil administered orally on conspicuity of ultrasonographic small intestinal lesions in dogs with lymphangiectasia // Veterinary Radiology and Ultrasound. 2013. Vol. 54. № 4. P. 390-397. XXV. Rault, D.N., Besso, J.G., Boulouha, L., Begon, D., Ruel, Y. Significance of a common extended mucosal interface observed in transverse small intestine sonograms // Veterinary Radiology and Ultrasound. 2004. Vol. 45. №2. Р. 177-179. XXVI. Sutherland-Smith, J., Penninck, D.G., Keating, J.H., Webster, C.R.L. Ultrasonographic intestinal hyperechoic mucosal striations in dogs are associated with lacteal dilation // Veterinary Radiology and Ultrasound. – 2007. Vol. 48. – № 1. – P. 51-57. View | Download EVALUATION OF ADAPTIVE POTENTIAL IN MEDICAL STUDENTS IN THE CONTEXT OF SEASONAL DYNAMICS Authors: Larisa A. Merdenova,Elena A. Takoeva,Marina I. Nartikoeva,Victoria A. Belyayeva,Fatima S. Datieva,Larisa R. Datieva, DOI: https://doi.org/10.26782/jmcms.spl.10/2020.06.00046 Abstract: The aim of this work was to assess the functional reserves of the body to quantify individual health; adaptation, psychophysiological characteristics of the health quality of medical students in different seasons of the year. When studying the temporal organization of physiological functions, the rhythm parameters of physiological functions were determined, followed by processing the results using the Cosinor Analysis program, which reveals rhythms with an unknown period for unequal observations, evaluates 5 parameters of sinusoidal rhythms (mesor, amplitude, acrophase, period, reliability). The essence of desynchronization is the mismatch of circadian rhythms among themselves or destruction of the rhythms architectonics (instability of acrophases or their disappearance). Desynchronization with respect to the rhythmic structure of the body is of a disregulatory nature, most pronounced in pathological desynchronization. High neurotism, increased anxiety reinforces the tendency to internal desynchronization, which increases with stress. During examination stress, students experience a decrease in the stability of the temporary organization of the biosystem and the tension of adaptive mechanisms develops, which affects attention, mental performance and the quality of adaptation to the educational process. Time is shortened and the amplitude of the “initial minute” decreases, personal and situational anxiety develops, and the level of psychophysiological adaptation decreases. The results of the work are priority because they can be used in assessing quality and level of health. Keywords: Desynchronosis,biorhythms,psycho-emotional stress,mesor,acrophase,amplitude,individual minute, Refference: I. Arendt, J., Middleton, B. Human seasonal and circadian studies in Antarctica (Halley, 75_S) – General and Comparative Endocrinology. 2017: 250-259. (http://dx.doi.org/10.1016/j.ygcen.2017.05.010). II. BalandinYu.P. A brief methodological guide on the use of the agro-industrial complex “Health Sources” / Yu.P. Balandin, V.S. Generalov, V.F. Shishlov. Ryazan, 2007. III. Buslovskaya L.K. Adaptation reactions in students at exam stress/ L.K. Buslovskaya, Yu.P. Ryzhkova. Scientific bulletin of Belgorod State University. Series: Natural Sciences. 2011;17(21):46-52. IV. Chutko L. S. Sindromjemocionalnogovygoranija – Klinicheskie I psihologicheskieaspekty./ L.S Chutko. Moscow: MEDpress-inform, 2013. V. Eroshina K., Paul Wilkinson, Martin Mackey. The role of environmental and social factors in the occurrence of diseases of the respiratory tract in children of primary school age in Moscow. Medicine. 2013:57-71. VI. Fagrell B. “Microcirculation of the Skin”. The physiology and pharmacology of the microcirculation. 2013:423. VII. Gurova O.A. Change in blood microcirculation in students throughout the day. New research. 2013; 2 (35):66-71. VIII. Khetagurova L.G. – Stress/Ed. L.G. Khetagurov. Vladikavkaz: Project-Press Publishing House, 2010. IX. Khetagurova L.G., Urumova L.T. et al. Stress (chronomedical aspects). International Journal of Experimental Education 2010; 12: 30-31. X. Khetagurova L.G., Salbiev K.D., Belyaev S.D., Datieva F.S., Kataeva M.R., Tagaeva I.R. Chronopathology (experimental and clinical aspects/ Ed. L.G. Khetagurov, K.D. Salbiev, S.D.Belyaev, F.S. Datiev, M.R. Kataev, I.R. Tagaev. Moscow: Science, 2004. XI. KlassinaS.Ya. Self-regulatory reactions in the microvasculature of the nail bed of fingers in person with psycho-emotional stress. Bulletin of new medical technologies, 2013; 2 (XX):408-412. XII. Kovtun O.P., Anufrieva E.V., Polushina L.G. Gender-age characteristics of the component composition of the body in overweight and obese schoolchildren. Medical Science and Education of the Urals. 2019; 3:139-145. XIII. Kuchieva M.B., Chaplygina E.V., Vartanova O.T., Aksenova O.A., Evtushenko A.V., Nor-Arevyan K.A., Elizarova E.S., Efremova E.N. A comparative analysis of the constitutional features of various generations of healthy young men and women in the Rostov Region. Modern problems of science and education. 2017; 5:50-59. XIV. Mathias Adamsson1, ThorbjörnLaike, Takeshi Morita – Annual variation in daily light expo-sure and circadian change of melatonin and cortisol consent rations at a northern latitude with large seasonal differences in photoperiod length – Journal of Physiological Anthropology. 2017; 36: 6 – 15. XV. Merdenova L.A., Tagaeva I.R., Takoeva E.A. Features of the study of biological rhythms in children. The results of fundamental and applied research in the field of natural and technical sciences. Materials of the International Scientific and Practical Conference. Belgorod, 2017, pp. 119-123. XVI. Ogarysheva N.V. The dynamics of mental performance as a criterion for adapting to the teaching load. Bulletin of the Samara Scientific Center of the Russian Academy of Sciences. 2014;16:5 (1): S.636-638. XVII. Pekmezovi T. Gene-environment interaction: A genetic-epidemiological approach. Journal of Medical Biochemistry. 2010;29:131-134. XVIII. Rapoport S.I., Chibisov S.M. Chronobiology and chronomedicine: history and prospects/Ed. S.M. Chibisov, S.I. Rapoport ,, M.L. Blagonravova. Chronobiology and Chronomedicine: Peoples’ Friendship University of Russia (RUDN) Press. Moscow, 2018. XIX. Roustit M., Cracowski J.L. “Non-invasive assessment of skin microvascular function in humans: an insight into methods” – Microcirculation 2012; 19 (1): 47-64. XX. Rud V.O., FisunYu.O. – References of the circadian desinchronosis in students. Ukrainian Bulletin of Psychoneurology. 2010; 18(2) (63): 74-77. XXI. Takoeva Z. A., Medoeva N. O., Berezova D. T., Merdenova L. A. et al. Long-term analysis of the results of chronomonitoring of the health of the population of North Ossetia; Vladikavkaz Medical and Biological Bulletin. 2011; 12(12,19): 32-38. XXII. Urumova L.T., Tagaeva I.R., Takoeva E.A., Datieva L.R. – The study of some health indicators of medical students in different periods of the year. Health and education in the XXI century. 2016; 18(4): 94-97. XXIII. Westman J. – Complex diseases. In: Medical genetics for the modern clinician. USA: Lippincott Williams & Wilkins, 2006. XXIV. Yadrischenskaya T.V. Circadian biorhythms of students and their importance in educational activities. Problems of higher education. Pacific State University Press. 2016; 2:176-178. View | Download TRIADIC COMPARATIVE ANALYSIS Authors: Stanislav A.Kudzh,Victor Ya. Tsvetkov, DOI: https://doi.org/10.26782/jmcms.spl.10/2020.06.00047 Abstract: The present study of comparison methods based on the triadic model introduces the following concepts: the relation of comparability and the relation of comparison, and object comparison and attributive comparison. The difference between active and passive qualitative comparison is shown, two triadic models of passive and active comparison and models for comparing two and three objects are described. Triadic comparison models are proposed as an alternative to dyadic comparison models. Comparison allows finding the common and the different; this approach is proposed for the analysis of the nomothetic and ideographic method of obtaining knowledge. The nomothetic method identifies and evaluates the general, while the ideographic method searches for unique in parameters and in combinations of parameters. Triadic comparison is used in systems and methods of argumentation, as well as in the analysis of consistency/inconsistency. Keywords: Comparative analysis,dyad,triad,triadic model,comparability relation,object comparison,attributive comparison,nomothetic method,ideographic method, Refference: I. AltafS., Aslam.M.Paired comparison analysis of the van Baarenmodel using Bayesian approach with noninformativeprior.Pakistan Journal of Statistics and Operation Research 8(2) (2012) 259{270. II. AmooreJ. E., VenstromD Correlations between stereochemical assessments and organoleptic analysis of odorous compounds. Olfaction and Taste (2016) 3{17. III. BarnesJ., KlingerR. Embedding projection for targeted cross-lingual sentiment: model comparisons and a real-world study. Journal of Artificial Intelligence Research 66 (2019) 691{742. doi.org/10.1613/jair.1.11561 IV. Castro-SchiloL., FerrerE.Comparison of nomothetic versus idiographic-oriented methods for making predictions about distal outcomes from time series data. Multivariate Behavioral Research 48(2) (2013) 175{207. V. De BonaG.et al. Classifying inconsistency measures using graphs. Journal of Artificial Intelligence Research 66 (2019) 937{987. VI. FideliR. La comparazione. Milano: Angeli, 1998. VII. GordonT. F., PrakkenH., WaltonD. The Carneades model of argument and burden of proof. Artificial Intelligence 10(15) (2007) 875{896. VIII. GrenzS.J. The social god and the relational self: A Triad theology of the imago Dei. Westminster: John Knox Press, 2001. IX. HermansH.J. M.On the integration of nomothetic and idiographic research methods in the study of personal meaning.Journal of Personality 56(4) (1988) 785{812. X. JamiesonK. G., NowakR. Active ranking using pairwise comparisons.Advances in Neural Information Processing Systems (2011) 2240{2248. XI. JongsmaC.Poythress’s triad logic: a review essay. Pro Rege 42(4) (2014) 6{15. XII. KärkkäinenV.M. Trinity and Religious Pluralism: The Doctrine of the Trinity in Christian Theology of Religions. London: Routledge, 2017. XIII. KudzhS. A., TsvetkovV.Ya. Triadic systems. Russian Technology Magazine 7(6) (2019) 74{882. XIV. NelsonK.E.Some observations from the perspective of the rare event cognitive comparison theory of language acquisition.Children’s Language 6 (1987) 289{331. XV. NiskanenA., WallnerJ., JärvisaloM.Synthesizing argumentation frameworks from examples. Journal of Artificial Intelligence Research 66 (2019) 503{554. XVI. PührerJ.Realizability of three-valued semantics for abstract dialectical frameworks.Artificial Intelligence 278 (2020) 103{198. XVII. SwansonG.Frameworks for comparative research: structural anthropology and the theory of action. In: Vallier, Ivan (Ed.). Comparative methods in sociology: essays on trends and applications.Berkeley: University of California Press, 1971 141{202. XVIII. TsvetkovV.Ya.Worldview model as the result of education.World Applied Sciences Journal 31(2) (2014) 211{215. XIX. TsvetkovV. Ya. Logical analysis and variable scales. Slavic Forum 4(22) (2018) 103{109. XX. Wang S. et al. Transit traffic analysis zone delineating method based on Thiessen polygon. Sustainability 6(4) (2014) 1821{1832. View | Download DEVELOPING TECHNOLOGY OF CREATING WEAR-RESISTANT CERAMIC COATING FOR ICE CYLINDER." JOURNAL OF MECHANICS OF CONTINUA AND MATHEMATICAL SCIENCES spl10, no. 1 (June 28, 2020). http://dx.doi.org/10.26782/jmcms.spl.10/2020.06.00048.

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