Academic literature on the topic 'Oral medication Problems, exercises, etc'

This review presents the problems that arise when learning Tamil and the solutions for it, which is our mother tongue, and which has been a virgin language for a long time. Solutions to problems in learning can be found through oral training and error free writing training. Oral training should be given through different and flexible exercises. The speech of the linguist should be an example to eliminate the shortcomings of unedited speech. The difference in the duration of the writing of the characters and the place of birth of a word should be clearly stated through individual training and group training. Writing training plays an important role in providing error & free writing training. Being able to write without error is made possible by clear pronunciation, oral reading, relaxed writing, checking what is written, knowing the rules of grammar etc.

4608 Background: Oral therapies (angiogenesis inhibitors and mammalian target of rapamycin (mTOR) inhibitors) for renal cell carcinoma (RCC) have demonstrated significant improvements in progression-free survival but also possess toxicities. The objective of this study was to evaluate whether different toxicities of oral RCC therapies had equal importance to patients. Methods: US adults from the Kidney Cancer Association with a self-reported diagnosis of RCC completed a web-enabled survey. Respondents were asked to select the 3 most and 3 least troublesome toxicities from a list of 20 common RCC therapy toxicities. For each respondent, a value of 1 was assigned to each of the 3 most troublesome toxicities, a value of -1 was assigned to each of the 3 least troublesome toxicities, and a value of 0 was assigned to the remaining toxicities. A straight count method was applied to estimate the mean relative importance of each toxicity. Respondents also answered 10 treatment-choice questions, each of which included a pair of hypothetical RCC medication profiles described by survival, toxicities, and serious adverse events. Four toxicities including fatigue, mouth sores, hand-foot syndrome, and stomach problems were included in both exercises. Results: 264 of the 272 respondents completed the entire ranking exercise. Among the 20 toxicities, stomach problems was the most troublesome and was assigned an importance of 10. Changes in hair color was the least troublesome and was assigned an importance of 0. Patients ranked fatigue (8.2), mouth sores (7.7), hand-foot syndrome (6.6) by order of importance. When given choices among eliminating severe toxicities, fatigue was as important as stomach problems, both fatigue and stomach problems were more import than mouth sores, and mouth sores was more important than hand-foot syndrome; although not statistically significant. Conclusions: This statistical approach offers insight into those toxicities important to patients on chronic RCC therapies.

Relevance. The article presents an analysis of the key dental problems during the pandemic of the novel coronavirus infection (COVID-19), discussed on the platform of the interdisciplinary all-Russian online conference „Prevention of cross-infection at dental appointments in the context of the COVID-19 pandemic”. The high professional interest of dentists in the problems of high risk of transmission of infection at a dental appointment, the role of dental manifestations in the general symptom complex of COVID-19, the possibilities of testing saliva for SARS-CoV-2, the peculiarities of providing specific types of dental care in different periods of a pandemic, dental (hygienic) accompanying patients in outpatient and inpatient treatment, including in intensive care units. Based on the analysis of existing data on the immunopathogenesis of the disease, the main risk factors and routes of infection, the principles of systematization of COVID-associated diseases (conditions) of the oral cavity, the proposed approaches to their correction and treatment were discussed. Based on the results of our own observations and analysis of foreign publications, clinical variants of the manifestation of the disease (or its medication support) in the oral cavity have been analyzed. The important role of interdisciplinary approaches (dentists, healthcare organizers, epidemiologists, microbiologists, immunologists, etc.) to solving dental problems during a pandemic is emphasized. The role of modern IT-technologies, telemedicine and teledentistry in the implementation of educational and scientific-practical activities for the medical and dental community during a pandemic is highlighted.

Clinical reasoning is the specific cognitive process used by health care practitioners to formulate accurate diagnoses for complex patient problems and to set up and carry out effective care. Athletic training students and practitioners need to develop and display effective clinical reasoning skills in the assessment of injury and illness as a first step towards evidence-based functional outcomes. In addition to the proper storage of and access to appropriate biomedical knowledge, an equally important component of effective clinical reasoning is the ability to select and interpret various conclusions from the mounting quantity of evidence-based medicine (EBM) sources. In assessing injury and illness, this competency is particularly reliant upon experience, skill execution, and available evidence pertaining to the diagnostic accuracy and utility of various special tests and physical examination procedures. In order to both develop and assess the ability of our students to integrate EBM into their clinical reasoning processes, we have designed exercises and evaluations that pertain to evidence-based clinical decision making during oral practical examinations in our assessment of athletic injury labs. These integrated oral practical examinations are designed to challenge our students' thinking and clinical performance by providing select key features of orthopaedic case pattern presentations and asking students to pick the most fitting diagnostic tests to fit that particular case. Students must not only match the appropriate special/functional tests, etc, to the case's key features, but also choose and explain how useful the chosen tests are for the differential diagnosis process, relative to the best diagnostic evidence. This manuscript will present a brief theoretical framework for our model and will discuss the process we use to evaluate our students' ability to properly select, perform, and explain various orthopaedic examination skills and the relevant evidence available. Specific examples of oral practical exam modules are also provided for elucidation.

This article proposes the results of performed work, which aims are to prepare junior schoolchildren with severe speech disorders to solve arithmetic problems in speech therapy classes. Our previous research has found that children with severe speech disorders had difficulty solving arithmetic problems. In the process of preparing junior schoolchildren with severe speech disorders to solve arithmetic problems in speech therapy classes, we observed specific errors at the level of: pronunciation of sounds, words; sentence construction; text translation. To overcome them, we used correction tasks. They were offered to children to perform only when they saw in them a mistake of a certain type, and therefore did not include these tasks in the text of the lesson, and offered them as tips in the working mode. The duration of these correction tasks is 1-2 minutes. The purpose of their use is the awareness of children with severe speech disorders of mistakes and formation of their skills of independent control over their own speech. In order to overcome errors, we offered different tasks based on analytical systems: visual, auditory, tactile-kinesthetic, changing them each time. The final analysis of the features of speech therapy classes has shown that in order to overcome specific errors in oral and written speech among pupils with severe speech disorders during speech therapy classes was effective to use not only tasks for speech development, but also corrective exercises that were involved in different situations depending on the manifestation. In particular, to correct the phonetic side of speech, pupils with severe speech disorders were taught to focus on analytical systems: auditory – associating speech sounds with different sounds of the environment; tactile-kinesthetic – feeling vibration; visual – imagining the articulatory image and associating the sound of speech with visual support. In the future, based on the concise tips of a speech therapist (figurative, gestural, facial expressions, etc.) children were offered to correct mistakes. And when the tips were taken away, they were applied only when needed to individual pupils with severe speech disorders.

Background. The main problems of the postoperative period include organ dysfunction (“surgical stress”), morbidity due to hypothermia, pain, hyper- or hypovolemia, cognitive dysfunction, sleep disturbances, immobilization, semi-starvation, constipation, thromboembolism, anemia, postoperative delirium and more. A multimodal approach to optimizing enhanced recovery after surgery (ERAS) includes improving the preoperative period, reducing stress and pain, exercise, and switching to oral nutrition. These measures accelerate recovery and reduce morbidity. Objective. To describe the measures required for ERAS. Materials and methods. Analysis of literature sources on this issue. Results and discussion. The majority of postoperative complications are associated with the so-called surgical stress involving the release of stress hormones and the start of inflammatory cascades. The stress response is triggered not only directly as a result of surgery, but also as a result of the use of regional anesthesia and other medications. Mandatory prerequisites for ERAS include procedure-specific dynamic balanced analgesia, as well as patient blood management (PBM). The latter consists of hematopoiesis optimization, minimization of bleeding and blood loss, improvement of anemia tolerability. The presence of preoperative anemia before joint replacement significantly increases the number of complications in the 30-day period (Gu A. et al., 2020). Preoperative anemia also leads to the unfavorable consequences of other interventions, which underlines the need to detect and treat it early. An optimal infusion therapy with a positive water balance (1-1.5 L) is an integral component required for ERAS. Balanced solutions should be used; opinions on the use of colloids are contradictory. Venous thrombosis remains a significant problem, as immobilization is an important pathogenetic mechanism. The question of optimal prevention of this condition has not been clarified yet. In 40-50 % of cases after major surgery and in <5 % of cases after minor interventions, the patient develops postoperative orthostatic intolerance. The mechanisms of the latter are a decrease in sympathetic stimulation against the background of increased parasympathetic stimulation; the effects of opioids and inflammation are likely to play an additional role. Preventive methods have not been definitively established, α1-agonists (midodrine) and steroid hormones are likely to be effective. Unfortunately, for most of these problems, there is a gap between the available scientific evidence and the actual implementation of the recommended procedures. The ERAS Society has created recommendations for the management of patients, undergoing a number of surgical interventions (gastrectomy, esophagectomy, cesarean section, oncogynecological surgeries, etc.). For example, recommendations for colon interventions include no premedication and bowel preparation for surgery, use of middle thoracic anesthesia/analgesia, administration of short-acting anesthetics, avoidance of sodium and fluid overload, use of short incisions, absence of drainages, use of non-opioid oral analgesics and non-steroid anti-inflammatory drugs, stimulation of intestinal motility, early removal of catheters, oral nutrition in the perioperative period, control of surgery results and adherence to treatment. Knowledge of procedure-specific literature data and recommendations, multidisciplinary cooperation, monitoring, identification and sharing of methods that have economic advantages are necessary for the ERAS improvement. Outpatient surgery and one-day surgery are becoming more and more common. In a study by N.H. Azawi et al. (2016) 92 % of patients after laparoscopic nephrectomy were discharged home within <6 hours after surgery. Repeated hospitalizations of these patients were not recorded. In a study by G. Ploussard et al. (2020) 96 % of patients after robotic radical prostatectomy were discharged home on the day of surgery; 17 % required re-hospitalization. Early physical activity is an important component of rapid recovery after surgery. There is an inverse relationship between the number of steps per day and the severity of pain after a cesarean section. Despite a large body of literature on the subject, large-scale randomized trials and definitive procedure-specific recommendations are still lacking. This justifies the need for thorough pathophysiological studies and, once completed, randomized controlled or cohort studies. The objectives of these studies should include clear clarification of the pathophysiology of postoperative organ dysfunction, the introduction of a procedure-specific and evidence-based set of perioperative measures, monitoring of purely surgical and general medical consequences of surgeries, identifying areas for improvement and finding new treatment and prevention strategies. Conclusions. 1. Multimodal approach to ERAS optimization includes improvement of the preoperative period, reduction of stress and pain, physical activity, transition to oral nutrition, etc. 2. Procedure-specific dynamic balanced analgesia, PBM, optimal infusion therapy with a positive water balance are the mandatory prerequisites for ERAS. 3. For the majority of problems of the perioperative period, there is a gap between the available scientific evidence and the actual implementation of the recommended procedures. 4. New preclinical and clinical studies are needed to form definitive guidelines for the management of patients in the perioperative period.

Diabetic patients generally require life-long treatment and continuous follow up. In spite of their benefit of achieving glycemic control, there are many safety concerns with antidiabetic drugs such as gastrointestinal side effects, metabolic complications, central nervous system (CNS) symptoms, musculo-skeletal problems, genito-urinary disorders like UTI, development of peripheral oedema, weight gain etc. To highlight pattern of Adverse Drug Reactions with use of oral anti-diabetic drugs.All suspected Adverse Drug Reaction Reporting Form having any anti-diabetic drug as suspected cause of ADR were collected. The reported ADRs on the notification forms, after being confirmed by the physician-in-charge, were assessed for causality using WHO-UMC Causality Categories14, preventability using Modified-Schumock and Thornton scale15 and severity using Modified Hartwig and Siegel scale.: The data from the forms was presented in tabular form and data will be interpreted by using Microsoft Excel 365 software. Adverse drug reaction related to gastrointestinal system were most reported ADRs (41.31%). Among GI adverse events, nausea was mostly reported ADR and it was mostly associated with DPP-4 inhibitors. Hypoglycemia was most frequently observed in patients taking sulfonylureas. Causality assessment according to WHO-UMC criteria showed 61.68% ADRs had probable causality while 37.43% had possible causality and only 0.90% had certain causality. Most of the ADRs in our study were non-preventable (57.78%) & were of mild to moderate grade. Hypoglycemia continues to be major concern in patients taking anti-diabetic medications and sulfonylureas were commonest drugs responsible for it. As anti-diabetic medication is generally taken for lifetime, the risk of development of adverse effects related to concurrent related co-morbidities of patients shouldn’t be ignored while prescribing. The physician should report these adverse effects to ADR monitoring centre, so that proper signal could be generated for the welfare of the society.

Background and Aims: Asthma is a chronic disease that reduced quality of life. People with asthma are less active than their peers, leads the patient to become more and more sedentary. Asthma can cause postural changes in the spine, shoulder girdle, which is a good option to prevent and correct these changes. The use of complementary therapies along with medication for people with chronic asthma can help improve posture and rehabilitation of the respiratory system, so the use of hyperkyphosis curvature correction exercises strengthens the extensor muscles of the trunk, serratus, rhomboid, and middle trapezius. On the other hand, stretching exercises have increased the flexibility of the pectoralis muscles, which has corrected the deformity of the shoulder girdle and spine, which can reduce the angle of kyphosis and round shoulder [10,11]. The use of breathing exercises in addition to improving the quality of life can reduce pulmonary function and physiological effects on the airways to reduce irritability and inflammation to the extent that it reduces the use of bronchodilators [12]. Therefore, it seems that by using the right combination of corrective and breathing exercises, on the one hand, it is possible to overcome the long-term effects of asthma, which is muscular imbalance in the shoulder girdle and cervical and thoracic spine [13], and on the other hand, with correction. Posture can reduce these complications and improve lung function by modifying the chest posture. In addition to strengthening the main and auxiliary respiratory muscles, breathing exercises also help to expand the chest [14,15]. Therefore, the aim of this study was to investigate the effect of combined corrective and respiratory exercises at home on kyphosis angle and respiratory capacity in children with asthma. Materials and Methods: The present study was a Clinical trial study with a pretest-posttest design. For this purpose, 30 children with mild asthma living in Rasht, with the approval of a pediatric pulmonologist, were included in the study purposefully and voluntarily. Subjects were randomly divided into two experimental (15 people with mean age: 10.53 ± 2.09 years) and control groups (15 people with mean age: 11.40 ± 2.13 years). Inclusion criteria included age between 8 and 14 years, mild asthma and the desire of the subject and parents to participate in the study and exclusion criteria include: older and lower ages, severe or moderate asthma, severe asthma attacks and having Scoliosis and orthopedic problems, the unwillingness of the child or parents to participate in research, musculoskeletal disorders, the child with heart disease or any disease that is prohibited by the doctor from activity and exercise, as well as the exacerbation of asthma attacks following exercise It was a training program. To start and conduct this research process, the code of ethics (IR.GUMS.REC.1398.537) and the code of IRCT20160815029373N6 from Iran Clinical Trial Registration Center were received from the ethics committee of Guilan University of Medical Sciences. Also, in all stages of the research, the Helsinki Code of Ethics was followed. Measurement of dependent variables in both pre- and post-test stages including assessment of dorsal spinal curvature (kyphosis) using a flexible ruler, respiratory capacity using spirometry, anthropometric indices (width, depth and chest circumference using a bin the experimental group performed combined corrective and respiratory exercises for eight weeks. To analyze the results of this study, dependent-t test and covariance analysis were used at significance level of p<0.05. Results: The results of analysis of covariance showed that after controlling the effect of pre-test (covariate), there is a significant difference in the results of dorsal spine curvature and respiratory capacity (FEV1 and FVC / FEV1) in the post-test between the control and experimental groups. The difference results are as follows difference between the Thoracic spine curvature (P = 0.004), FEV1 (P=0/001) ، FEV1/FVC (P=0/02) and Anthropometric indices of the chest (P = 0.001). The results of correlated t-test show that combined corrective and respiratory exercises had a significant effect on the variables of dorsal spine curvature, respiratory capacity, width, depth and chest circumference of the subjects in the training group (p <0.05). In the control group, no significant difference was observed between pre-test and post-test scores of variable width, depth and chest circumference. Conclusion: The results of this study showed that the combination of corrective and respiratory exercises in addition to reducing the curvature of chest kyphosis can have a significant effect on improving respiratory capacity and increasing chest dilatation in children with chronic asthma. However, the posture of people with chronic asthma due to respiratory struggles and overuse of the main and secondary respiratory muscles and the pattern of oral respiration changes and increases the prevalence of hyperkyphosis [6]. According to the results, it seems, combined corrective and respiratory exercises can be a positive influence on the extensor muscles of the chest improves lung function and postural correction in children with asthma. Therefore, it is recommended to therapists, coaches and exercise teachers to use combined corrective and respiratory exercises to improve the physical, postural and respiratory factors of children with asthma. Keywords

The article examines the problems and methods of teaching russian spoken speech at a chinese university, taking into account the ethnocultural characteristics of the chinese audience and the specifics of the chinese student education system. A system of methods and approaches is justified, which contributes to the effective mastery of russian spoken speech. The article describes the features of the chinese audience, complicating the mastery of russian spoken speech in the RCT lesson. The principles and exercises proposed in the article contribute to the organization of such an educational process that will ensure the achievement of a high level of communicative competence of chinese students, the author considers certain didactic techniques that allow achieving a high level of formation of foreign-language communicative competence, neutralization of passion and psychological barrier («psychological counseling», debates, «brainstorming», «fun pictures», comic dialogues, thematic autostoritelling, «black box», «director himself», roleplaying games, «lexical physical education», etc.). The article notes that the main way to overcome this is to use means, methods and techniques in the process of training based on the pedagogical impact of humor, the use of which should become an integral component of the process of teaching chinese students of oral speech and be consistently implemented in all aspects of this process: in the speech behavior of the teacher, in the selection of didactic material, in the typology of the proposed tasks. The author justifies the concept of lessons in colloquial speech as an «encyclopedia of life» and the need to expand the outlook of students by providing them with new information from the field of «background knowledge», not only aimed at expanding the lexical base, but also containing interesting information about psychological and cultural phenomena.

Abstract Background: Prophylactic treatment allows patients with haemophilia (PWH) to live an approximately normal life. The majority of German PWH receive prophylaxis. The need of frequent weekly injections may impact negatively treatment adherence. This is the expected reason which might result in increased annual bleeding rate. Therefore there is a need for half-life extended products which will be launched end of this year in Germany. However, little is known about patients' perspectives on the use of new products with extended half-life and their willingness to switch to these products. Aim: The German patient organisation DHG is interested to better understand PWH's expectations and concerns towards these new products in order to adapt their support for the haemophilia community. Methods: The study consisted of two phases: 1) conduct of separate focus groups with adult haemophilia patients and parents of haemophilic children with respect to the new long-lasting products across Germany; 2) based on the focus group results construction of a questionnaire for a systematic postal survey among DHG members with haemophilia A or B (n=1,499). Results: The postal survey included questions concerning haemophilia, knowledge about half-life of actual factor concentrates (FC) and attitudes towards actual FC and open ended questions concerning the expectations towards new products and how therapy could be facilitated. The open ended questions should give the participants the chance to write down other aspects, problems, laments and other wishes. Several aspects could be mentioned by the same subject. Out of the sent 1,499 questionnaires 697 questionnaires were sent back; mainly from adult patients (n=518), 177 from parents of haemophilic children. Patients had haemophilia A (83.7%), in a severe form (77.8%), were on prophylaxis (61.4%), mostly three times a week (47.8%) and used recombinant products (57.8%). 14.1% have had an inhibitor. Open questions were answered by 462 respondents, at least 1 to maximum 5 aspects were mentioned. Open questions on the current situation ["facilitation of therapy"] (n=302): less packaging waste (n=129), no cooling required (n=61), sc injections/oral medication/nasal medication (n=54), better supplies like perfect injection needle etc. (n=27), prefilled syringe (n=25), diversity of package size (125 iU to 4000 iU) (n=24), support in home care therapy (n=17), simpler treatment documentation (n=9), improved logistic/delivery for home treatment (n=8). Open questions for future situation (n=160) ["expectations towards new long-lasting products"]: less injections (n=492), same safety/efficacy/compatibility (n=44), better quality of life (n=22), no fridge (n=16), treatment costs/reduction-no increase (n=15), higher trough level (n=9), smaller packaging (n=8), easier handling (n=8), and many more mentioned 1- 3 times. Conclusions: The answers to the open questions in this representative survey among German haemophilia patients and parents of children with haemophilia provide important additional information and insights in the unmet needs of haemophilia patients, which will help the German patient association and pharmaceutical companies to better inform patients about the new up-coming products taking patients needs into consideration. Disclosures Kalnins: SOBI: Consultancy. Miesbach:SOBI: Consultancy. von Mackensen:SOBI: Consultancy.

A condition for the effectiveness of sensory development of primary school students is a critical study of the pedagogical experience of its organization. The importance of solving this problem is caused by the fact that school practice lays the foundation of pedagogical science and must take into account both modern scientific achievements and requirements of regulatory state documents. The purpose of the study is to highlight the mass pedagogical experience of sensory development of primary school students. To achieve this goal, written and oral interviews with teachers (questionnaires, interviews, talks) and observation of professional activities were used. It has been revealed that teachers are aware of the meaning of sensory development and distinguish its leading areas – the forming of vision, hearing and touch of schoolchildren; identify students’ typical difficulties in distinguishing mixed colors, complex shapes of objects, sonorous, hissing and whistling consonants, as well as in reproducing the nuances of coloring of objects, the relationship between size and spatial arrangement, inclined and rounded elements of letters, sequence of sounds in an audible word. At the same time, teachers are poorly oriented in the program material of perceptual development, admit insufficient awareness of the laws of sensory processes, and want to know more about the latest techniques and technologies of their forming. Observation of the real educational process allowed to establish a wide range of didactic influences used by educators in order to form different types of students’ perception. Teachers organize studies of colored objects, correcting children's verbal designations of colors and their shades; suggest exercises for superimposing objects of different shapes and sizes (arranging by size, placing figures in given proportions, etc.); form students' ideas about speech sounds (observation of the work of speech organs, modeling the properties of sounds with conditional chips, analysis of the phonetic structure of words, etc.); provide perception of musical works, demonstrate sounds of musical instruments and singing voices, use symbols to record the gradations of sounds in pitch, duration and volume, encourage students to reproduce the properties of musical sounds in singing and rhythmic movements; create conditions for touching objects made of different materials. However, teachers do not pay enough attention to distinguishing and naming color nuances, three-dimensional geometric shapes, symbols of voicedness and voicelessness of consonants, comparison of musical sounds by timbre qualities, and verbal characteristics of tactile sensory impressions. The conducted research proves that the mass pedagogical experience ensures the implementation of program requirements for improving the sensory sphere of primary school students, but shows a lack of teachers’ awareness of children's sensory processes and unstable motivation to solve problems of developing students’ perception. The prospect for further scientific research is to study the program, educational and methodological resources of forming the processes of perception in primary school students.