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Brown, Menna, Noelle O'Neill, Hugo van Woerden, Parisa Eslambolchilar, Matt Jones, and Ann John. "Gamification and Adherence to Web-Based Mental Health Interventions: A Systematic Review." JMIR Mental Health 3, no. 3 (August 24, 2016): e39. http://dx.doi.org/10.2196/mental.5710.
Повний текст джерелаАнотація:
Background Adherence to effective Web-based interventions for common mental disorders (CMDs) and well-being remains a critical issue, with clear potential to increase effectiveness. Continued identification and examination of “active” technological components within Web-based interventions has been called for. Gamification is the use of game design elements and features in nongame contexts. Health and lifestyle interventions have implemented a variety of game features in their design in an effort to encourage engagement and increase program adherence. The potential influence of gamification on program adherence has not been examined in the context of Web-based interventions designed to manage CMDs and well-being. Objective This study seeks to review the literature to examine whether gaming features predict or influence reported rates of program adherence in Web-based interventions designed to manage CMDs and well-being. Methods A systematic review was conducted of peer-reviewed randomized controlled trials (RCTs) designed to manage CMDs or well-being and incorporated gamification features. Seven electronic databases were searched. Results A total of 61 RCTs met the inclusion criteria and 47 different intervention programs were identified. The majority were designed to manage depression using cognitive behavioral therapy. Eight of 10 popular gamification features reviewed were in use. The majority of studies utilized only one gamification feature (n=58) with a maximum of three features. The most commonly used feature was story/theme. Levels and game leaders were not used in this context. No studies explicitly examined the role of gamification features on program adherence. Usage data were not commonly reported. Interventions intended to be 10 weeks in duration had higher mean adherence than those intended to be 6 or 8 weeks in duration. Conclusions Gamification features have been incorporated into the design of interventions designed to treat CMD and well-being. Further research is needed to improve understanding of gamification features on adherence and engagement in order to inform the design of future Web-based health interventions in which adherence to treatment is of concern. Conclusions were limited by varied reporting of adherence and usage data.
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Segal, R., C. Zwaal, E. Green, J. R. Tomasone, A. Loblaw, T. Petrella, and The Exercise for People With Cancer Guideline Development Group. "Exercise for people with cancer: a clinical practice guideline." Current Oncology 24, no. 1 (February 28, 2017): 40. http://dx.doi.org/10.3747/co.24.3376.
Повний текст джерелаАнотація:
Background Development of this guideline was undertaken by the Exercise for People with Cancer Guideline Development Group, a group organized by Cancer Care Ontario’s Program in Evidence-Based Care (pebc). The purpose of the guideline was to provide guidance for clinicians with respect to exercise for patients living with cancer, focusing on the benefits of specific types of exercise, recommendations about screening requirements for new referrals, and safety concerns.Methods Consistent with the pebc’s standardized approach, a systematic search was conducted for existing guidelines, and systematic literature searches were performed in medline and embase for both systematic reviews and primary literature. Content and methodology experts performed an internal review, which was followed by an external review by targeted experts and intended users.Results The search identified three guidelines, eighteen systematic reviews, and twenty-nine randomized controlled trials with relevance to the topic. The present guideline provides recommendations for the duration, frequency, and intensity of exercise appropriate for people living with cancer. It also provides recommendations for pre-exercise assessment, safety concerns, and delivery models.Conclusions There is sufficient evidence to show that exercise provides benefits in quality of life and muscular and aerobic fitness for people with cancer both during and after treatment, and that it does not cause harm. The present guideline is intended to support the Canadian Society for Exercise Physiology’s Canadian physical activity guidelines. The recommendations are intended for clinicians and institutions treating cancer patients in Ontario, and for policymakers and program planners involved in the delivery of exercise programs for cancer patients.
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Oliffe, John L., Nick Black, Jeffrey Yiu, Ryan K. Flannigan, Donald R. McCreary, and S. Larry Goldenberg. "Mapping Canadian Men’s Recent and Intended Health Behavior Changes Through the Don’t Change Much Electronic Health Program." Journal of Medical Internet Research 22, no. 5 (May 15, 2020): e16174. http://dx.doi.org/10.2196/16174.
Повний текст джерелаАнотація:
Background Although evaluation studies confirm the strong potential of men’s electronic health (eHealth) programs, there have been calls to more fully understand acceptability, engagement, and behavior change to guide future work. Relatedly, mapping of behavior changes using health promotion theories including the transtheoretical model (or stages of change) has been recommended to build a translatable empirical base to advance design and evaluation considerations for men’s eHealth programs. Objective This study aimed to use a benchmark sample as a reference group to map the recent and intended health behavior changes in Canadian men who use the Don’t Change Much (DCM) eHealth program. The hypothesis being tested was that increased exposure to DCM would be positively associated with men’s recent and intended health behavior changes. Methods DCM users (n=863) were sampled for demographic data and self-reported recent and intended health behavior changes. Respondents also reported their usage (frequency and duration) for each of the 3 DCM components (web, newsletter, and social media) and were allocated to limited exposure (257/863, 29.8%), low exposure (431/863, 49.9%), and high exposure (175/863, 20.3%) subgroups. A benchmark sample (n=2000), comprising respondents who had not accessed DCM provided a reference group. Bivariate analysis of recent and intended health behavior changes and DCM exposure levels were used to compute the strength of association between the independent variables (exposure levels) and the 10 categorical dependent variables (recent and intended health behavior changes). Binary logistic regression models were computed for each of the 10 recent and intended health behavior changes. Linear regression was used to model the association between the number of recent and intended changes and the level of exposure to DCM. Results Compared with the benchmark reference group, DCM high-exposure respondents had significantly increased odds for 9 of the 10 health behavior changes, with the largest effect size observed for Changed diet or Improved eating habits (odds ratio [OR] 5.628, 95% CI 3.932-8.055). High-exposure respondents also had significantly increased odds for 9 intended health changes, with the largest effect sizes observed for Reduce stress level (OR 4.282, 95% CI 3.086-5.941). Moderate effect size (goodness of fit) was observed for increased total number of recent (F12,2850=25.52; P.001; adjusted R2=.093) and intended health behavior changes (F12,2850=36.30; P.001; adjusted R2=.129) among high-exposure respondents. Conclusions DCM respondents contrasted the predominately precontemplative benchmark sample mapping across the contemplative, preparation, and action stages of the transtheoretical health behavior change model. Almost 10% of variation in the recent and 13% of variation in the intended health behavior changes can be explained by DCM exposure and demographic factors, indicating the acceptability of this men’s eHealth resource.
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Vassileva-Decheva, D., and Cv Sokolov. "A Physiotherapy Program for Recovery of the Ankle/Foot Complex after Surgery to Correct a Cartilage Defect (Osteochondritis Dissecans) for Implementation in the Period of Home Recovery." Acta Medica Bulgarica 44, no. 1 (May 1, 2017): 30–34. http://dx.doi.org/10.1515/amb-2017-0005.
Повний текст джерелаАнотація:
Abstract The aim of this study is to build a suitable physiotherapy program for recovery of patients undergoing surgery in combination with platelet-rich plasma (PRP) therapy of the ankle joint, intended for implementation in the period of home treatment. This delineation of physiotherapy program contains an aim, the tasks set for realization of the aim and the used physiotherapy means. It is developed for the period of home treatment from postoperative week 2 (days 8-15) to the postoperative week 8 (days 56-63), the period that is very important for the normal recovery of the ankle/foot complex. The physiotherapy program is arranged into weeks and each of them contains the used physiotherapy means, the exercise duration and the therapeutic effect.
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Brigandi, Carla B. "Fidelity of Implementation for an Evidence-Based Enrichment Practice." Journal of Advanced Academics 30, no. 3 (July 11, 2019): 268–97. http://dx.doi.org/10.1177/1932202x19862686.
Повний текст джерелаАнотація:
Children with gifts and talents benefit from participation in programs grounded in research-based models. Implementation fidelity, however, is a potential moderator of intended benefits. The purpose of this study was to examine one teacher’s fidelity of implementation for Type III Enrichment, an evidence-based gifted education practice and component of Renzulli’s Enrichment Triad Model and Renzulli and Reis’s Schoolwide Enrichment Model. Findings indicated the gifted education teacher implemented Type III Enrichment with fidelity; she adhered to recommended structures and processes, which she skillfully implemented, and student participants were responsive and engaged in the learning process. Audience impact was adversely affected by duration of the one-semester program. In addition, findings indicated the teacher supplemented recommended processes and these supplemental activities influenced student engagement in positive ways.
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Balbim, Guilherme M., Susan Aguinaga, Isabela G. Marques, Jacqueline Guzman, David X. Marquez, and Priscilla Vasquez. "MIDDLE-AGED AND OLDER LATINOS’ SATISFACTION OF BAILAMOS LATIN DANCE PROGRAM." Innovation in Aging 3, Supplement_1 (November 2019): S714. http://dx.doi.org/10.1093/geroni/igz038.2620.
Повний текст джерелаАнотація:
Abstract Older Latinos engage in low levels of leisure-time physical activity (LTPA). Dance is a culturally appropriate activity which can be used to increase LTPA levels. We examined middle-aged and older Latinos’ satisfaction with the revised BAILAMOS Latin dance program. Healthy and low actives middle-aged and older Latinos (Mage = 64.89±7.08) were randomized to a 4-month dance program (n=167) or health education (n=166). The dance program consisted of four Latin dance styles (Merengue, Bachata, Cha Cha Cha, and Salsa). Classes were held twice a week for one hour. A total of 113 participants completed the program. Participants completed a program evaluation about the 4-months program regarding time, duration, settings, instructor, and overall satisfaction. Items were evaluated on a 1 (strongly disagree/very bad) to 4 (strongly agree/excellent) Likert agreement scale. A total of 73 participants evaluated the 4-month dance program. Participants evaluated the program adequacy agreeing or strongly agreeing as far: time, duration and setting (96-98%); instructor’s enthusiasm, quality of instructions, and eager to help (96-100%); dance program’s progression and enjoyment (93-96%); difficulty level (59%). Participants reported they intended to keep dancing by themselves (93%) and would recommend the program to friends and family (98%). Many participants (88%) reported feeling physically excellent or good as a result of the program, 95% found the program excellent or good, and 100% thought the program was worth their time. Overall, the BAILAMOS program evaluation demonstrated high participants’ acceptability and satisfaction. Those results can promote sustained LTPA and provide initial evidence to translation into community settings.
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Owens, Ed, and Richard Santner. "Integration of a Shoreline Response Program (SRP) and SCAT." International Oil Spill Conference Proceedings 2021, no. 1 (May 1, 2021): 679374. http://dx.doi.org/10.7901/2169-3358-2021.1.679374.
Повний текст джерелаАнотація:
ABSTRACT The Shoreline Response Program (SRP) is an adjustment within an Incident Management System (IMS) intended to improve current practices. An SRP builds on the recognized strengths of an IMS-based organization and of a SCAT program that utilizes an integrated and focused approach to streamline and better coordinate the decision and planning processes and the operational implementation activities. An SRP is an extension of the traditional SCAT program but with a broader focuses on strategic and tactical planning to minimize the short- and long-term impacts of oil on shorelines, the efforts and costs involved in a shoreline response, and the volumes of waste that would be generated. The inclusion of an SRP concept in drills, exercises and preparedness training can directly improve the ability to respond quickly and effectively during the initial response phase. Not implementing an SRP at the very outset of a spill response, when typically the best opportunities exist for the removal of bulk oil, can have significant long-term consequences. Shifting an emphasis on management and physical resources from, often only partially successful, on-water activities to onshore shoreline activities when oil can be picked up more rapidly and effectively can significantly reduce i) the footprint of the response, ii) the duration and scale of the shoreline operation, iii) the exposure of shore zone resources to the oil, and so accelerate environmental recovery, and iv) waste generation.
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S., Ondimu, Raude J.M, and Wanjala G. "PERSONAL COMPUTER-BASED CONTROL AND MONITORIBG SYSTEM FOR BIODIESEL ALGAE PHOTOBIOREACTOR." Journal of Engineering in Agriculture and the Environment 5, no. 1 (September 30, 2019): 10. http://dx.doi.org/10.37017/jeae.v5i1.50.
Повний текст джерелаАнотація:
Growing of Algae for biodiesel production has gained popularity in recent times. This is becausebiodiesel from algae has an economic advantage over other oil crops. The oil content that can beextracted from microalgae biomass depends on the culture conditions and microalgae species. Thismeans that besides selecting the best microalgae species, it is also necessary to ensure and maintain thebest culture conditions for optimal biodiesel production. Optimum algae growth conditions can be bestbe provided by a Controlled Environment Bioproduction System (CEBS) for the algae called as photo-bioreactor (PBR). This paper reports design and fabrication of a PC based control system for a PBRproduction system for algae being developed at the School of Biosystems and EnvironmentalEngineering (SoBEE) in Jomo Kenyatta University of Agriculture and Technology (JKUAT) in Kenya.The control system is intended to ensure that optimum PH, temperature, nutrients content; lightintensity/duration and salinity of growth medium for algae are maintained. The paper covers the designand fabrication of the PC control and monitoring system. The control and monitoring system consists ofa computer program and a microcontroller connected to sensors and actuators. The computer program(master) provides the graphical user interface (GUI) consisting of control buttons and means for realtime data logging and analysis as well as real-time simulation of PBR activities. It is available inexecutable file that can be run in any windows OS computer. The microcontroller program (slave)provides the means for connecting sensors and is used to measure as well as monitor the conditions inthe PBR tanks. Communication between the computer program and the microcontroller is achievedthrough the universal serial bus (USB). The control system consists of both open and closed loopsystems. The open loop system is used to control the light duration at predetermined intervals of time.The closed loop system is used to control the nutrient concentration, light intensity, PH and oxygen:carbon dioxide ratio.
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Howell, Peter, Stevie Sackin, and Kazan Glenn. "Development of a Two-Stage Procedure for the Automatic Recognition of Dysfluencies in the Speech of Children Who Stutter." Journal of Speech, Language, and Hearing Research 40, no. 5 (October 1997): 1073–84. http://dx.doi.org/10.1044/jslhr.4005.1073.
Повний текст джерелаАнотація:
This program of work is intended to develop automatic recognition procedures to locate and assess stuttered dysfluencies. This and the following article together, develop and test recognizers for repetitions and prolongations. The automatic recognizers classify the speech in two stages: In the first, the speech is segmented, and, in the second, the segments are categorized. The units that are segmented are words. Here assessments by human judges on the speech of 12 children who stutter are described using a corresponding procedure. The accuracy of word boundary placement across judges, categorization of the words as fluent, repetition or prolongation, and duration of the different fluency categories are reported. These measures allow reliable instances of repetitions and prolongations to be selected for training and assessing the recognizers in the subsequent paper.
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Ziesler, Pamela S., Douglas B. Rideout, and Robin Reich. "Modelling conditional burn probability patterns for large wildland fires." International Journal of Wildland Fire 22, no. 5 (2013): 579. http://dx.doi.org/10.1071/wf11185.
Повний текст джерелаАнотація:
We present a technique for modelling conditional burn probability patterns in two dimensions for large wildland fires. The intended use for the model is strategic program planning when information about future fire weather and event durations is unavailable and estimates of the average probabilistic shape and extent of large fires on a landscape are needed. To model average conditional burn probability patterns, we organised historical fire data from Yellowstone National Park, USA, into a set of grids; one grid per fire. We captured various spatial relationships inherent in the gridded data through use of geometric variables in the main model and by incorporating an autoregressive covariance structure. The final model had ‘good’ predictive ability with an AUC of 0.81 (1.0 is perfect prediction) and the estimated coefficients are consistent with theory and reflect how fires usually behave on the study site landscape. This technique produces a predictive model with finer detail than most landscape-wide models of burn probability and it has advantages over simulation methods for strategic planning because it does not require multiple runs of spread simulation models or information on fire duration.
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Suzman, Daniel L., Paul Gustav Kluetz, Amy E. McKee, Ashley Flynn Ward, Leigh Jessica Marcus, Sandra J. Casak, and Richard Pazdur. "Characteristics of breakthrough therapy designation requests (BTDRs) submitted to the Office of Hematology and Oncology Products (OHOP), FDA." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): e18236-e18236. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.e18236.
Повний текст джерелаАнотація:
e18236 Background: Breakthrough therapy designation is an FDA program intended to expedite the development of drugs and biologics that provide preliminary clinical evidence of a substantial improvement over existing therapies. The factors needed to demonstrate this improvement in oncologic therapies have not been well-described. Methods: We reviewed the characteristics of BTDRs submitted to OHOP from program initiation to the present. Results: From November 2013 through July 2016, there were 134 BTDRs for 96 drugs submitted to OHOP, not including 14 BTDRs intended for benign hematologic or supportive care indications. The most common drug mechanisms of action (MoA) were tyrosine kinase inhibitor (TKI) (37; 28%), immunotherapy (24; 18%), and targeted antibodies (21; 16%). Of the 134 BTDRs, 56 (42%) were granted. BTDRs were granted most frequently for TKIs (22; 59%) and immunotherapy (14; 58%) and were rarely granted for cytotoxic (1; 10%) or endocrine (0) therapies. BTDRs based on randomized trials were more frequently granted than those based on single-arm trials (49% vs 39%), as were BTDRs based on OS versus ORR or PFS (57% vs 41%). In BTDRs based on single-arm trials, the median number of patients was higher in those granted versus denied or withdrawn (41 vs 26 patients). Among BTDRs granted based on ORR in solid tumors, the ORR ranged from 24% to 94%, reflecting variation in available therapies, MoA, toxicity, and durability of response. Conclusions: The likelihood of a successful BTDR increases with randomized trial design and larger sample size. Additional considerations include MoA, duration of ORR, and choice of endpoint. [Table: see text]
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Witt, Sadie M., Shelby Stults, Emma Rieves, Kevin Emerson, and Daniel L. Mendoza. "Findings from a Pilot Light-Emitting Diode (LED) Bulb Exchange Program at a Neighborhood Scale." Sustainability 11, no. 14 (July 22, 2019): 3965. http://dx.doi.org/10.3390/su11143965.
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In the United States, 44% of low-income households struggle to pay their utility bills, affecting their ability to afford necessities such as food and health expenses. There is a high demand for, but low availability of, energy efficiency services in underserved neighborhoods, creating an opportunity for community-based programs to fill this inherent gap. This pilot project aims to bring energy savings and education to a uniquely targeted portion of Salt Lake City, UT, through the exchange of light-emitting diode bulbs and examines its feasibility in addressing energy insecurity at larger scales. Through the 8-month project duration, 1432 bulbs were exchanged at 23 events reaching 181 households in low-income areas that, through a year of use, were estimated to save residents approximately $18,219 in electricity bills, reducing CO2 emissions from power plants by 122 metric tons. Since this pilot reached less than 1% of households, we extrapolated a reach of 2%, 5%, and 7.5%, and found substantial potential decreases in power plant emissions and financial savings. Ongoing expansion efforts include more direct engagement with trusted members of the targeted communities and stronger attempts to engage participants in energy efficiency education as our project encountered some difficulties in reaching the intended population.
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Teepe, Gisbert Wilhelm, Tobias Kowatsch, Felix Patricius Hans, and Leo Benning. "Preliminary Use and Outcome Data of a Digital Home Exercise Program for Back, Hip, and Knee Pain: Retrospective Observational Study With a Time Series and Matched Analysis." JMIR mHealth and uHealth 10, no. 12 (December 2, 2022): e38649. http://dx.doi.org/10.2196/38649.
Повний текст джерелаАнотація:
Background Musculoskeletal conditions are among the main contributors to the global burden of disease. International guidelines consider patient education and movement exercises as the preferred therapeutic option for unspecific and degenerative musculoskeletal conditions. Innovative and decentralized therapeutic means are required to provide access to and availability of such care to meet the increasing therapeutic demand for this spectrum of conditions. Objective This retrospective observational study of preliminary use and outcome data explores the clinical outcomes of Vivira (hereafter referred to as “program”), a smartphone-based program for unspecific and degenerative pain in the back, hip, and knee before it received regulatory approval for use in the German statutory health insurance system. Methods An incomplete matched block design was employed to assess pain score changes over the intended 12-week duration of the program. Post hoc analyses were performed. In addition, a matched comparison of self-reported functional scores and adherence rates is presented. Results A total of 2517 participants met the inclusion criteria and provided sufficient data to be included in the analyses. Overall, initial self-reported pain scores decreased significantly from an average of 5.19 out of 10 (SD 1.96) to an average of 3.35 out of 10 (SD 2.38) after 12 weeks. Post hoc analyses indicate a particularly emphasized pain score reduction over the early use phases. Additionally, participants with back pain showed significant improvements in strength and mobility scores, whereas participants with hip or knee pain demonstrated significant improvements in their coordination scores. Across all pain areas and pain durations, a high yet expected attrition rate could be observed. Conclusions This observational study provides the first insights into the clinical outcomes of an exercise program for unspecific and degenerative back, hip, and knee pain. Furthermore, it demonstrates a potential secondary benefit of improved functionality (ie, strength, mobility, coordination). However, as this study lacks confirmatory power, further research is required to substantiate the clinical outcomes of the program assessed. Trial Registration German Clinical Trials Register DRKS00021785; https://drks.de/search/en/trial/DRKS00021785
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Asmara, I. P. S., D. Kristianto, M. A. Mustaghfirin, Y. Praharsi, Adianto, A. Z. Arfianto, and C. A. Firmansyah. "Development of the Elements of Tugboat Handling for Berthing and Unberthing of Container Ships." IOP Conference Series: Earth and Environmental Science 1081, no. 1 (September 1, 2022): 012015. http://dx.doi.org/10.1088/1755-1315/1081/1/012015.
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Abstract This paper provides a study on the procedure of tugboat handling for berthing and unberthing of container ships in the Port of Surabaya Container Terminal. The elements of the tugboat assistance consisted of time series of the percentage of tugboats’ power, the direction of the tug’s force, and the duration. This study developed a manoeuvring simulation program using the mathematical manoeuvring group (MMG) model to determine the handling elements to achieve the intended trajectory properly. The model considered the surging force, swaying force, and yawing moment of tugs, as well as the disturbances of current, wind, and wave. The planning trajectory is determined based on berthing and unberthing passages derived from the automatic identification system (AIS) data. The elements resulting in the berthing speed and berthing angle complied with the Permanent International Association of Navigation Congresses (PIANC).
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Requelo-Rodríguez, Inmaculada, Aurora Castro-Méndez, Ana María Jiménez-Cebrián, María Luisa González-Elena, Inmaculada C. Palomo-Toucedo, and Manuel Pabón-Carrasco. "Assessment of Selected Spatio-Temporal Gait Parameters on Subjects with Pronated Foot Posture on the Basis of Measurements Using OptoGait. A Case-Control Study." Sensors 21, no. 8 (April 16, 2021): 2805. http://dx.doi.org/10.3390/s21082805.
Повний текст джерелаАнотація:
Walking is part of daily life and in asymptomatic subjects it is relatively easy. The physiology of walking is complex and when this complex control system fails, the risk of falls increases. As a result, gait disorders have a major impact on the older adult population and have increased in frequency as a result of population aging. Therefore, the OptoGait sensor is intended to identify gait imbalances in pronating feet to try to prevent falling and injury by compensating for it with treatments that normalize such alteration. This study is intended to assess whether spatiotemporal alterations occur in the gait cycle in a young pronating population (cases) compared to a control group (non-pronating patients) analyzed with OptoGait. Method: a total of n = 142 participants consisting of n = 70 cases (pronators) and n = 72 healthy controls were studied by means of a 30 s treadmill program with a system of 96 OptoGait LED sensors. Results: Significant differences were found between the two groups and both feet in stride length and stride time, gait cycle duration and gait cadence (in all cases p < 0.05). Conclusions: pronating foot posture alters normal gait patterns measured by OptoGait; this finding presents imbalance in gait as an underlying factor. Prevention of this alteration could be considered in relation to its relationship to the risk of falling in future investigations.
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Sato, Toshihiko, and Hideo Ambo. "367 A sleep hygiene and relaxation training program after the Great East Japan Earthquake: What aspects of sleep could be improved?" Sleep 44, Supplement_2 (May 1, 2021): A146. http://dx.doi.org/10.1093/sleep/zsab072.366.
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Abstract Introduction After a natural disaster, the incidence of sleep difficulties tends to increase. Specifically, the prevalence of suspected insomnia was reported to have increased among disaster victims after the Great East Japan Earthquake of March 11, 2011. In a previous study, we have reported that education on sleep hygiene and relaxation training was effective in improving nighttime sleep in students of universities in Sendai city after the earthquake of March 2011. According to analyses of subscale scores of the Pittsburgh Sleep Quality Index (PSQI), the present study aimed to determine what aspects of sleep difficulties were successfully improved. Methods University undergraduates and graduates who reported having sleep difficulties were asked to respond to a questionnaire including the PSQI thrice, before attending a 90-min lecture on sleep hygiene and relaxation training, and a month and three months after attending the program. All participants who reported the total PSQI score of the cutoff point (6) or more were divided into two groups based on their PSQI scores before the program, that attending the course and that not attending it, that is, the “waiting list” group. Results The “attending” group exhibited a decrease in the total PSQI score in the first month after attending the program, and the score in this group reduced further three months later; Nine of twenty (45.0%) attending participants reported the score of less than 6 after a month, while only three of seventeen (17.6%) wait-list participants did. The PSQI subscale scores reported by the nine successful attending participants indicated a significant decrease in the subscale scores on subjective sleep quality, sleep latency, sleep duration, and sleep disturbance from before the program to one month later. Conclusion These results suggest that the short course on sleep hygiene and relaxation training intended for university students was effective, and about a half of the attended participants reported the PSQI score of less than the PSQI cutoff score one month later. This substantial effect would be mainly based on the improvement of their subjective sleep quality, latency, duration, and disturbance. Support (if any) This study was supported by a research grant from the Japanese Psychological Association, Tokyo, Japan.
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Meyer, Ulrike, and Elke Schuch. "Diary-Writing as a Tool for Monitoring and Assessing - Intercultural Learning and Cultural Intelligence." European Journal of Language and Literature 7, no. 1 (January 21, 2017): 85. http://dx.doi.org/10.26417/ejls.v7i1.p85-95.
Повний текст джерелаАнотація:
This paper outlines a research project which is being conducted in the edu¬cational context of an international Master program: In 2001, an interdisci¬plinary and cohort-based Master program entitled “International Manage¬ment and Intercultural Communication/GlobalMBA” was founded, which is currently offered by a four-university consortium that includes the follow¬ing: Technische Hochschule Köln (TH Köln), Cologne, Germany, the Fac¬ulty of Management at the University of Warsaw (UW), Poland, Dongbei University of Finance and Economics (DUFE) in Dalian, China, and the Coggin College of Business at the University of North Florida (UNF) in Jacksonville, USA. During the program´s 15-month duration, a multina¬tional cohort of 25-30 students recruited from each of the four universi¬ties studies together for one semester at each university. Much of the coursework and assignments as well as the final Master thesis are written in multinational groups of three to four students, thus requiring the students to permanently prove their teamwork skills. Besides, given the in-built mobility and multinational cohort-based structure of the program, the students are continuously exposed to a variety of different cultural experi¬ences and encounters. The program´s curriculum includes management-oriented courses as well as courses on the theory and practice of intercul¬tural communication. In one of these latter modules called Applied Inter¬cultural Communication, which is taught in every location and has a strong country-specific perspective, students are required to produce reflective dia¬ries describing their cultural experiences. The research project presented here started in 2013 and is based on a qualitative analysis of students´ diary entries written during a time span of 15 months as part of the course requirements for this particular module. The project is intended to serve two main purposes:
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Faraldo-Valles, Maria-Jose, Leonor Varela-Lema, and Monica Perez-Rios. "PP69 Supporting Decision Making: A Health Technology Assessment Training Proposal for Decision Makers." International Journal of Technology Assessment in Health Care 38, S1 (December 2022): S62. http://dx.doi.org/10.1017/s026646232200201x.
Повний текст джерелаАнотація:
IntroductionHealth technology assessment (HTA) reports are complex technical documents that address multiple aspects of the incorporation of a technology into the healthcare system applying complicated methodologies coming from different disciplines. The purpose of HTA is to support decision makers, who should have an adequate level of training to fully understand these assessments. However, most HTA education programs and courses are intended for HTA doers and there is a lack of practical guidance training aimed at preparing health managers or policy makers in HTA. The objective is to describe an HTA training program developed for decision makers of the three levels (health care administration, hospital management and clinical practice).MethodsThe education program has been designed through a collaboration between the Public Health Department of the Faculty of Medicine of the University of Santiago de Compostela (USC) and the Galician Health Technology Assessment Agency that belongs to the Spanish HTA Bodies Network. The duration of the course is 200 hours and the methodology will be distance learning, through the virtual classroom of the USC. The teaching collaborators come from the academic field and the HTA area.ResultsThe course will cover the legal, clinical and organizational framework in which the HTA is developed in Spain and in Europe; and will approach the methodology used in HTA. The course is structured in six modules: (i) Research, development and regulation of health technologies; (ii) Role of HTA as a decision support tool; (iii) HTA Methodology; (iv) Health information systems (including use of real world data); (v) Incorporation of HTA into society (stakeholders); (vi) Future challenges (personalized medicine and e-health).ConclusionsA specific training about HTA from a practical approach not theoretical could be of interest for different stakeholders involved in the decision-making process across the health systems. This type of educational program will allow decision makers to have a good understanding of the wide range of information they handle.
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Saleh, Isa, Muhammad Ahnaf Dzikrulloh, and Ahmad Habibul Muiz. "Model Program Khutbah Jumat Di Masjid Al-Ikhlash Surabaya: Perspektif Manajemen Operasi." Masjiduna : Junal Ilmiah Stidki Ar-Rahmah 2, no. 1 (June 30, 2019): 25. http://dx.doi.org/10.52833/masjiduna.v2i1.49.
Повний текст джерелаАнотація:
ABSTRACTThis research is intended to describe the program management sermon Friday at the Al-Ikhlash mosque, Tanjung Perak in Surabaya in Ecstasy. The goal in this study was describe the idea in search management program comes in Mosque Al-Ikhlash Tanjung Perak Surabaya in Ecstasy, described the selection process khatib, describes the design introduction, describes the implementation of the trial and described the shape of the design eventually. This study uses qualitative methods with the descriptive approach. This research uses data collection techniques in the form of in-depth interviews, observation and documentation. Program management ' preaching Friday at Mosque Al-Ikhlash of Tanjung Perak Surabaya Aware include: the Groove, the duration of the sermon, the criteria of khatib, theme, schedule khatib, SOP appearance khatib and infrastructure repair facility that supports the sermon Friday. Advice for all administrators that are in Al-Ikhlash mosque in Surabaya, to always provide service properly to the jama'ah, through the care facilities in Mosque Al-Ikhlash, choose a quality khatib-khatib, to performing at home and feel comfortable when the worship in the Mosque of Al-Ikhlash. ABSTRAKPenelitian ini dimaksudkan untuk menggambarkan manajemen program khutbah Jum’at di Masjid Al-Ikhlash Tanjung Sadari Perak Surabaya. Tujuan dalam penelitian ini adalah menggambarkan pencarian gagasan dalam manajemen program khutbah di Masjid Al-Ikhlash Tanjung Sadari Perak Surabaya, menggambarkan proses seleksi khatib, menggambarkan design pendahuluan, menggambarkan pelaksanaan uji coba dan menggambarkan bentuk design akhirnya. Penelitian ini menggunakan metode kualitatif dengan pendekatan deskriptif. Penelitian ini menggunakan teknik pengumpulan data berupa wawancara mendalam, observasi dan dokumentasi. Manajemen Program khutbah Jum’at di Masjid Al-Ikhlash Tanjung Sadari Perak Surabaya meliputi: alur, durasi khutbah, kriteria khatib, tema, jadwal khatib, SOP penampilan khatib dan sarana prasana yang mendukung khutbah Jum’at. Saran bagi segenap pengurus yang ada di Masjid Al-Ikhlash Surabaya, agar selalu memberikan pelayanan dengan baik kepada para jama’ah, melalui perawatan fasilitas yang ada di Masjid Al-Ikhlash, memilih khatib-khatib yang berkualitas, agar jama’ah betah dan merasa nyaman ketika beribadah di Masjid Al-Ikhlash.
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Pignataro, Rose M., Matthew J. Gurka, Dina L. Jones, Ruth E. Kershner, Patricia J. Ohtake, William T. Stauber, and Anne K. Swisher. "Tobacco Cessation Counseling Training in US Entry-Level Physical Therapist Education Curricula: Prevalence, Content, and Associated Factors." Physical Therapy 94, no. 9 (September 1, 2014): 1294–305. http://dx.doi.org/10.2522/ptj.20130245.
Повний текст джерелаАнотація:
BackgroundThe US Public Health Service (USPHS) recommends tobacco cessation counseling (TCC) training for all health care professionals. Within physical therapist practice, smoking can have adverse effects on treatment outcomes in all body systems. In addition, people with physical disabilities have a higher smoking prevalence than the general population, creating a strong need for tobacco cessation among physical therapy clientele. Therefore, TCC training is an important component of entry-level physical therapist education.ObjectiveThe aims of this study were: (1) to determine need for TCC training within entry-level physical therapist education and (2) to identify potential barriers to implementation of USPHS guidelines in the academic environment.DesignA descriptive cross-sectional survey was conducted.MethodsDirectors or academic coordinators of clinical education from entry-level physical therapist programs (N=204) were surveyed using an online instrument designed specifically for this study. Data regarding program and faculty characteristics, tobacco-related training content, and faculty opinions toward TCC in both physical therapist practice and education were analyzed descriptively.ResultsThe response rate was 71%. A majority (60%) of programs indicated inclusion of tobacco-related training, most commonly 1 to 2 hours in duration, and of these programs, 40% trained students in the implementation of USPHS clinical guidelines for TCC.LimitationsData analyses were constrained by limited or missing data in some areas. A single faculty member completed the survey for each program.ConclusionsThere is a need for TCC training in entry-level physical therapist education. Inclusion may be facilitated by addressing perceived barriers toward TCC as a component of physical therapist practice and promoting the relevance of TCC as it relates to intended outcomes of physical therapy interventions.
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Al Shareef, Haneen J., Adnan Al Harbi, Yasser Alatawi, Ahmed Aljabri, Mohammed A. Al-Ghanmi, Mohammed S. Alzahrani, Majed Ahmed Algarni, et al. "Evaluate the Effectiveness of Outpatient Parenteral Antimicrobial Therapy (OPAT) Program in Saudi Arabia: A Retrospective Study." Antibiotics 11, no. 4 (March 24, 2022): 441. http://dx.doi.org/10.3390/antibiotics11040441.
Повний текст джерелаАнотація:
(1) Background: Outpatient parenteral antibiotic therapy (OPAT) is a well-established and cost-effective measure that improves the efficient use of healthcare resources and increases bed availability. Only limited published data is available to illustrate OPAT implementation and outcomes in Saudi Arabia. The main objective of this study was to evaluate the effectiveness of OPAT in a tertiary center in Saudi Arabia. (2) Methods: In this retrospective study, clinical charts of enrolled patients were reviewed in a tertiary care center from the initial month of November 2017 to March 2020. All admitted patients with a central line and who enrolled in the OPAT of the hospital during this study period were included. The primary outcome was the 30-days readmission rate of OPAT patients. Secondary outcomes were factors associated with OPAT failure. Descriptive analysis of the data was used to express the results. (3) Results: We enrolled 90 patients; 54 (60%) were male; the mean age was 55.16 (±17.7) years old. The mean duration of the antimicrobial treatment was 21.9 (+24.6) days. All patients completed the intended course of therapy. Ertapenem was the most frequently used antimicrobial (43%), followed by vancomycin (11.2%). Urinary tract infections (UTIs) are some of the most common bacterial infections in 25 patients (26.9%), followed by osteomyelitis in 16 patients (17.2%). Extended-spectrum beta-lactamase E.coli was the highest common isolated microorganism (44.9%), followed by methicillin-resistant Staphylococcus aureus MRSA (16.9%). The readmission to the hospital during therapy was required for 12 patients (13.3%). Shifting from hospital care to OPAT care resulted in cost savings of 18 million SAR in the overall assessment period and avoided a total of 1984 patient days of hospitalization. (4) Conclusion: The findings have shown that OPAT therapy was effective with minimum hospital readmissions and therapy complications. OPAT programs can reduce healthcare costs and should be integrated into practice.
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Taha, Rbab, Sagar Kothari, Farid Foroutan, Melissa Gitman, Vikas Gupta, Tram Nguyen, and Coleman Rotstein. "Implementation of a Routine Screening Program for Latent Tuberculosis Infection among Patients with Acute Leukemia at a Canadian Cancer Center." Current Oncology 29, no. 12 (November 29, 2022): 9325–34. http://dx.doi.org/10.3390/curroncol29120731.
Повний текст джерелаАнотація:
Background: Screening for latent tuberculosis infection (LTBI) in patients with hematological malignancy is recommended because of their increased risk of tuberculosis (TB). We assessed the utility of tuberculin skin test (TST) screening in patients with acute leukemia and subsequent outcomes of LTBI treatment. Methods: We retrospectively evaluated patients ≥16 years of age with acute leukemia from 2013–2014 with a TST planted and read prior to the initiation of antineoplastic chemotherapy treatment. Demographics, clinical information and treatment outcomes of LTBI therapy were compared between patients with positive TST (≥10 mm induration) and negative TST. Results: A total of 389 patients with acute leukemia were included in the cohort. Of them, 37/389 (9.5%) had a positive TST. Only 3.4% (8/235) of individuals originating from North and South America as well as the Caribbean were TST positive, while 21% (20/95) of individuals from Asia were TST positive. Diagnostic imaging findings consistent with prior tuberculosis infection were higher in TST positive patients compared to TST negative ones (29.7% versus 9.4%, p < 0.0001). Furthermore, 31/38 patients (81.6%) who were TST positive received LTBI therapy, which was well tolerated. There was no significant difference in overall survival among those who received LTBI therapy compared to those who did not. No patients developed active TB. Conclusions: Universal screening with TST may be of low yield in individuals with acute leukemia unless patients originate from a TB endemic country. When therapy for LTBI is prescribed, patients with acute leukemia do not experience drug-induced liver toxicity and are likely to complete the intended duration of therapy, thus preventing the development of active tuberculosis.
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Shmakov, I. A., and V. I. Jordan. "Computer 3D-simulation of the temperature and diffusion kinetics of SHS in the closest packing of Ni@Al “core-shell” mesocells for modes with variable values of the key ignition parameters." Journal of Physics: Conference Series 2142, no. 1 (December 1, 2021): 012015. http://dx.doi.org/10.1088/1742-6596/2142/1/012015.
Повний текст джерелаАнотація:
Abstract The paper presents the results of computer 3D-simulation of the temperature and diffusion kinetics of SHS in a test model cluster of Ni-Al particles for modes with variable values of the key parameters of the SHS combustion wave ignition. The key parameters for the SHS combustion wave ignition were chosen as follows: the initial temperature for preliminary heating of the Ni-Al particles mixture, the ignition temperature of the combustion wave in the mixture of Ni-Al particles, the duration of the action of the heat pulse until the combustion wave ignition, and the thickness of the ignited layer in the mixture of particles. A program has been created to generate a test model cluster in the form of the closest ball packing of the Ni@Al “core-shell” mesocells (CBP-structure cluster of the Ni@Al “core-shell” mesocells). Using such a CBP-structure cluster, was continued a testing of created software package intended for 3D-simulation of SHS macrokinetics in a heterogeneous particle mixture, taking into account parallel MPI-calculations. In addition, the value ranges of the key parameters of the SHS combustion wave ignition for which the simulation results are in adequate agreement with the experimental data are determined as the parameters of the program model for SHS-simulation. The results of computational experiments have shown that diffusion kinetics is interrelated with temperature kinetics, and in mesocells with different locations within the CBP-structure cluster, the formation of intermetallic phases occurs inhomogeneously.
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Weng, Wei-Chien, and Yu-Cheng Lin. "Development of Detection Equipment for a Polymerase Chain Reaction with a Loop-Mediated Isothermal Amplification Reaction." Journal of Nanomaterials 2021 (March 29, 2021): 1–9. http://dx.doi.org/10.1155/2021/5513772.
Повний текст джерелаАнотація:
In this research, low-cost detection equipment intended to carry out a polymerase chain reaction (PCR) through a loop-mediated isothermal amplification (LAMP) reaction is presented. We designed the internal structure with SolidWorks and AutoCAD. The equipment comprised a Raspberry Pi development board, a temperature control module, and a fluorescent optical detection module. The main program, temperature control, florescent signal processing, signal analysis, and screen display were programmed with Java. We applied the digital temperature controller module to obtain precise temperature control of the equipment. The experimental results showed that the heating rate of the testing equipment could reach 65°C within 4 minutes and could be accurately controlled to within 1°C. The duration of the LAMP PCR experiment was found to be significantly shorter than that of the conventional PCR. The results also revealed that with LAMP PCR, the temperature could be accurately controlled within a specific range, and the designed heating tasks could be completed within 15 minutes to one hour, depending on the specimen. The equipment could also correctly read both the positive and negative reactions with fluorescent signals. Thus, the proposed LAMP PCR detection equipment is more sensitive, more stable, and more cost-effective than other conventional alternatives and can be used in numerous clinical applications.
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Vivoni, Enrique R., and Kevin T. Richards. "Integrated use of GIS-based field sampling and modeling for hydrologic and water quality studies." Journal of Hydroinformatics 7, no. 4 (October 1, 2005): 235–50. http://dx.doi.org/10.2166/hydro.2005.0021.
Повний текст джерелаАнотація:
Enhancements to traditional catchment-scale water quality assessments can be realized by leveraging geographical information systems (GIS) for both field data collection and hydrologic and water quality (H/WQ) modeling. In this study, we describe a GIS-based data collection system for geo-referenced environmental sampling utilizing mobile, wireless and Internet technologies. Furthermore, sampled field data is combined with historical measurements within a GIS-based semi-distributed watershed model for simulating water quantity and quality in a large regional catchment. The GIS-based sampling and modeling system is intended to streamline water quality assessments as compared to current practices. We describe an application and field study in the Williams River, New South Wales, Australia designed to assess the impacts of point and non-point source pollution on water quality. Historical data were utilized for calibrating and validating the Hydrologic Simulation Program – Fortran (HSPF) with the BASINS GIS interface over the 1988–2000 period. Results from the study indicate that short-duration, spatially extensive field campaigns provide useful data for enhancing modeling studies based on historical measurements at sparse sites. In addition, the study suggests that the conjunctive use of data collection and modeling is a step towards real-time integration of field data in hydrologic and water quality modeling efforts.
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Taylor, C. W., J. Crowley, S. K. Williamson, T. P. Miller, S. A. Taylor, T. G. Giri, R. L. Stephens, and R. B. Livingston. "Treatment of small-cell lung cancer with an alternating chemotherapy regimen given at weekly intervals: a Southwest Oncology Group pilot study." Journal of Clinical Oncology 8, no. 11 (November 1990): 1811–17. http://dx.doi.org/10.1200/jco.1990.8.11.1811.
Повний текст джерелаАнотація:
We designed an intensive, weekly treatment regimen for patients with small-cell lung cancer (SCLC) using six of the most active chemotherapeutic agents for this disease (doxorubicin [DOX], cyclophosphamide [CTX], vincristine [VCR], etoposide [VP-16], cisplatin [CDDP], and methotrexate [MTX]). The goal of this program was to gain rapid, repetitive exposure to multiple, active drugs. Treatment was administered weekly for a total of 16 weeks. Seventy-six SCLC patients (limited disease, 34; extensive disease, 42) were treated. The overall complete plus partial response rate was 82%. Complete response rates of 47% and 38% were observed in patients with limited (LD) and extensive disease (ED), respectively. The median survivals for patients with LD and ED were 16.6 and 11.4 months, respectively. Toxicities were tolerable and were primarily hematologic. Twenty-six patients had one or more transient life-threatening toxicities, but only one patient developed a fatal toxicity. Eighty-four percent of the patients received 80% or greater of the intended protocol dosages over the entire 16-week treatment period. We conclude that this intensive, short-duration treatment regimen is at least as good as other "standard" regimens, and we are encouraged aged by the complete response rate and median survival in patients with ED SCLC.
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Newcomer, Lee N., Stacey DaCosta Byfield, Benjamin Chastek, Stephanie Korrer, Thomas Horstman, and Jennifer Malin. "Describing the value of the most common first line NSCLC regimens in a real world setting." Journal of Clinical Oncology 35, no. 15_suppl (May 20, 2017): 9046. http://dx.doi.org/10.1200/jco.2017.35.15_suppl.9046.
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9046 Background: We aim to describe clinical and economic outcomes of common chemotherapy regimens for first line therapy of metastatic non-small cell lung cancer (mNSCLC).The data are intended to help clinicians and patients understand the real world results for patients like themselves. Methods: This retrospective analysis used clinical data obtained from a prior authorization (PA) program for chemotherapy linked with administrative claims data from 6/1/2015 to 5/31/2016 from a large national managed care organization. Clinical data included cancer type, stage at diagnosis, biomarkers, treatment line and evidence of progression/relapse. Eligible patients were commercially insured members with a PA request for commonly used NCCN recommended regimens for first line therapy of mNSCLC. Outcomes, including duration of therapy, % of patients hospitalized and total cost of care were tracked from first claim for chemotherapy until end of treatment due to discontinuation, death or start of a second line, with remaining patients censored at 5/31/2016 or end of enrollment. Results: Of 830 mNSCLC patients, 498 (60%) completed first line therapy during the study period. 345 initiated one of the following: Carbo/cisplatin + pemetrexed (CA), Carbo/cisplatin + paclitaxel (CP), Carbo/cisplatin + bevacizumab + pemetrexed (CBA), nivolumab (N), and docetaxal (D). Outcomes are summarized in the Table. Conclusions: Patients treated with the five most commonly prescribed first line therapies for mNSCLC have much shorter duration of therapies (52-76 days) than reported in published clinical trials with a significant risk of hospitalization (18% -30%) and at substantial cost ($34,971 - $108,100). These data are an important consideration for the patient and clinician making treatment decisions in routine clinical practice and will become more valuable as the database grows over time. [Table: see text]
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Batman, Samantha, Madan Kumar Piya, Sandhya Chapagain Acharya, Poonam Lama, Binod Aryal, Maya Neupane, Shashwat Pariyar, et al. "Cervical cancer prevention program in Nepal: A comprehensive "train the trainer" approach." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): 5530. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.5530.
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5530 Background: Cervical cancer is the leading cause of cancer and cancer-related deaths among women in Nepal, due in part to a lack of access to screening and limited medical providers trained to diagnose and treat women with preinvasive cervical disease. Cancer Care Nepal has partnered with The University of Texas MD Anderson Cancer Center (MD Anderson) and the American Society of Clinical Oncology (ASCO) to implement a ‘train the trainer’ (TOT) program to teach visual inspection with acetic acid (VIA), colposcopy, cervical biopsy, cryotherapy, thermal ablation, and loop electrosurgical excision procedure (LEEP). Methods: An initial cervical cancer prevention course was held in Kathmandu, Nepal in November 2019, supported by ASCO and with faculty from Civil Service Hospital, Bhaktapur Cancer Hospital, and National Academy of Medical Sciences and MD Anderson. As a continuation of this program, a TOT course was implemented for local specialists from five participating institutions throughout Nepal to learn how to deliver these trainings. Each participating institution then holds their own local course for nurses and doctors in their region. The training is complemented with monthly Project ECHO (Extension for Community Healthcare Outcomes) telementoring videoconferences. Results: The program was launched in November 2021. To date, two TOT training courses (2-day duration) have been held for clinicians from the 5 participating regions. Due to COVID-19 pandemic travel restrictions, didactic lectures were held virtually with MD Anderson and ASCO staff and included epidemiology of cervical cancer, screening guidelines, colposcopy, and treatment of cervical dysplasia. This was followed by hands-on training using simulation models to teach VIA, colposcopy, ablation and LEEP, led by the Nepalese faculty who had participated in the 2019 course. There were 41 participants in total (23 in the first course and 18 in the second course), including 21 gynecologists, 4 gynecologic oncologists, 1 medical oncologist, 1 general practitioner, and 14 nurses. 39 participants (73%) completed both the pre- and post- survey results. 86% of respondents from the first course and 100% of respondents from the second course reported that they intended to change their practice as a result of knowledge gained from the course. In addition, Cancer Care Nepal became a new hub for Project ECHO and held its first session in January 2022, with 20 participants representing two regions. The specialists from each of the 5 participating sites will be holding local courses for doctors and nurses in their respective regions throughout 2022. Conclusions: Our work shows that the TOT strategy can widen the reach of training in cervical cancer prevention in Nepal. Despite travel restrictions during the COVID-19 pandemic, global health training and mentoring can continue, though they require adaptions and use of virtual platforms.
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Batman, Samantha, Madan Kumar Piya, Sandhya Chapagain Acharya, Poonam Lama, Binod Aryal, Maya Neupane, Shashwat Pariyar, et al. "Cervical cancer prevention program in Nepal: A comprehensive "train the trainer" approach." Journal of Clinical Oncology 40, no. 16_suppl (June 1, 2022): 5530. http://dx.doi.org/10.1200/jco.2022.40.16_suppl.5530.
Повний текст джерелаАнотація:
5530 Background: Cervical cancer is the leading cause of cancer and cancer-related deaths among women in Nepal, due in part to a lack of access to screening and limited medical providers trained to diagnose and treat women with preinvasive cervical disease. Cancer Care Nepal has partnered with The University of Texas MD Anderson Cancer Center (MD Anderson) and the American Society of Clinical Oncology (ASCO) to implement a ‘train the trainer’ (TOT) program to teach visual inspection with acetic acid (VIA), colposcopy, cervical biopsy, cryotherapy, thermal ablation, and loop electrosurgical excision procedure (LEEP). Methods: An initial cervical cancer prevention course was held in Kathmandu, Nepal in November 2019, supported by ASCO and with faculty from Civil Service Hospital, Bhaktapur Cancer Hospital, and National Academy of Medical Sciences and MD Anderson. As a continuation of this program, a TOT course was implemented for local specialists from five participating institutions throughout Nepal to learn how to deliver these trainings. Each participating institution then holds their own local course for nurses and doctors in their region. The training is complemented with monthly Project ECHO (Extension for Community Healthcare Outcomes) telementoring videoconferences. Results: The program was launched in November 2021. To date, two TOT training courses (2-day duration) have been held for clinicians from the 5 participating regions. Due to COVID-19 pandemic travel restrictions, didactic lectures were held virtually with MD Anderson and ASCO staff and included epidemiology of cervical cancer, screening guidelines, colposcopy, and treatment of cervical dysplasia. This was followed by hands-on training using simulation models to teach VIA, colposcopy, ablation and LEEP, led by the Nepalese faculty who had participated in the 2019 course. There were 41 participants in total (23 in the first course and 18 in the second course), including 21 gynecologists, 4 gynecologic oncologists, 1 medical oncologist, 1 general practitioner, and 14 nurses. 39 participants (73%) completed both the pre- and post- survey results. 86% of respondents from the first course and 100% of respondents from the second course reported that they intended to change their practice as a result of knowledge gained from the course. In addition, Cancer Care Nepal became a new hub for Project ECHO and held its first session in January 2022, with 20 participants representing two regions. The specialists from each of the 5 participating sites will be holding local courses for doctors and nurses in their respective regions throughout 2022. Conclusions: Our work shows that the TOT strategy can widen the reach of training in cervical cancer prevention in Nepal. Despite travel restrictions during the COVID-19 pandemic, global health training and mentoring can continue, though they require adaptions and use of virtual platforms.
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Guz, Ol'ga. "Experience and effectiveness of practice-oriented training of voluntary people’s guard members based at the organizations of MIA of Russia." Vestnik of the St. Petersburg University of the Ministry of Internal Affairs of Russia 2021, no. 2 (July 8, 2021): 158–65. http://dx.doi.org/10.35750/2071-8284-2021-2-158-165.
Повний текст джерелаАнотація:
The relevance of the subject matter of the article is determined by the increasing spread of volunteering in our country, in particular, the formation of voluntary people’s guards that are intended to assist all state authorities includinglaw enforcement agencies. The legal basis for cooperation between the police and the public is fixed in the corresponding statutory documents. The performanceof voluntary people’s patrol depends considerably on the level oflegal, moral and psychological competenceof its members allowing to interact withlaw enforcement officers. Vigilantesshould understand the specifics of human rights practices and law enforcement activities.
The decrees of the Ministry of Internal Affairs of Russia define the procedure ofvigilante groupstraining, but their implementation requires the development of policy and methodological documentation.
The article presents the analysis of the existing practice of vigilantes training atlaw enforcement agencies, and identifies deficiencies and contradictions in thelevel of their expertise. The article discusses the specific features of such training: its short-term duration, as well as the heterogeneous composition of thevigilante groups as to age and profession. The authorpresents experience in implementing specially developed program forvigilantestraining that is unique both in content and in methods used. The content is presented on the basis of classification of representative tasksthat have to be solved by voluntary people’s patrol in joint activities with police officers. These tasks formed the basis for the three training modules reviewed in the article («Minors», «Foreigners», «Maintenance of order»).
Practice-oriented training methods include analysis of real situations that are presented in the classroom in various aspects and forms. Test and situational materials developedon their basis can be used in the process of training as well as for monitoring the effectiveness of the work performed. In conclusionthe author presentsthe analysis of the effectiveness of the suggested training program for vigilante groupas compared to the control group.
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Riehle, A., and J. Requin. "Monkey primary motor and premotor cortex: single-cell activity related to prior information about direction and extent of an intended movement." Journal of Neurophysiology 61, no. 3 (March 1, 1989): 534–49. http://dx.doi.org/10.1152/jn.1989.61.3.534.
Повний текст джерелаАнотація:
1. This study was devoted to the neuronal processes underlying the construction of the motor program. Two monkeys were trained in a choice reaction time task to perform precise wrist flexion and extension movements of small and large extent. During a trial, the first visual signal, the preparatory signal (PS), informed the animal completely, partially, or not at all about direction and/or extent of the forthcoming movement. After a constant waiting period, a second visual signal, the response signal (RS), was illuminated calling for execution of the requested movement. 2. Reaction time (RT) and movement time (MT) measurements during the training as well as the recording sessions revealed that providing prior information about movement parameters strongly affected RT, but only slightly affected MT. Reaction time decreased in relation to the amount (number of movement parameters precued) and the type of prior information. Providing information about movement direction shortened RT much more than providing information about movement extent. Behavioral data support a parametric conception of motor programming, i.e., that the programming of the different movement parameters results from assembling separate processes of different duration. These results are compatible with the model in which programming processes are serially and hierachically ordered, movement direction being processed before movement extent. 3. Single-cell recording techniques were used to study neuronal activity of the primary motor (MI) and the premotor (PM) cortex, contralateral to the active arm. The activity of 155 neurons of MI and 158 neurons of PM was recorded during performance of the task. Of these 313 neurons, only 14 neurons did not change their activity during execution of the task. Two hundred and seven neurons whose activity changes were related to movement direction and/or movement extent have been selected for the further study. They were classified into three main groups: 1) execution-related neurons (49 in MI, 27 in PM), 2) preparation- and execution-related neurons (48 in MI, 54 in PM), and 3) preparation-related neurons (8 in MI, 21 in PM). 4. Directionally selective, execution-related neurons were found to be more frequently located within MI (81/105, 77.1%) than within PM (55/102, 53.9%), whereas directionally selective, preparation-related neurons appeared tobe more frequently located within PM (47/102, 46.1%) than within MI (24/105, 22.9%).(ABSTRACT TRUNCATED AT 400 WORDS)
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Stevens, Leigh, and John Wardrop. "OIL SPILL MONITORING HANDBOOK." International Oil Spill Conference Proceedings 2005, no. 1 (May 1, 2005): 937–41. http://dx.doi.org/10.7901/2169-3358-2005-1-937.
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ABSTRACT This paper describes afield handbook jointly prepared for the New Zealand (NZ) Maritime Safety Authority (MSA) and Australian MSA (AMSA) to help plan the scope, scale, and design of oil spill monitoring programs. A two-class monitoring nomenclature is used to classify monitoring according to its underlying purpose. Type I (Operational) Monitoring: provides information of direct relevance to spill response operations, i.e. information needed to plan or execute response or cleanup strategies. Type II (Scientific) Monitoring: relates to non-response objectives, i.e. short and long term environmental damage assessments (including recovery), purely scientific studies, and all post spill monitoring activities. The two-class monitoring nomenclature recognizes the very different objectives of Type I and Type II monitoring, and the methods, scope, and degree of scientific rigour required for each. These in turn, have a significant bearing on the cost of the monitoring, and who will pay for it. Currently, Type I monitoring costs are recovered in NZ and Australia from the spiller (or insurer) alongside other operational response costs. The handbook, formatted as a field pocket guide, provides specific guidance as to what may be considered “necessary” and “reasonable” Type I monitoring, as well as presenting guidelines for defining study objectives, spatial boundaries, monitoring parameters, sampling and assessment methods, study duration, logistics, design constraints (and solutions), resources, and termination criteria. Type II monitoring programs are usually not integral to the response, and funding is less well defined, so Type II monitoring is not specifically addressed in the Handbook. However, many of the Type I guidelines are also relevant for Type II studies. The Handbook is intended to provide responders with sufficient guidance to determine the type of information necessary for an operational spill response, and an overview of the methods commonly used to collect the information needed to reach defensible spill response decisions in an appropriate time frame, and with an acceptable level of accuracy. The Handbook is supported by a Background Paper describing the key issues to be considered in establishing a monitoring program.
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Melín-Aldana, Héctor, Barbara Carter, and Debra Sciortino. "Documentation of Surgical Specimens Using Digital Video Technology." Archives of Pathology & Laboratory Medicine 130, no. 9 (September 1, 2006): 1335–38. http://dx.doi.org/10.5858/2006-130-1335-dossud.
Повний текст джерелаАнотація:
Abstract Context.—Digital technology is commonly used for documentation of specimens in anatomic pathology and has been mainly limited to still photographs. Technologic innovations, such as digital video, provide additional, in some cases better, options for documentation. Objective.—To demonstrate the applicability of digital video to the documentation of surgical specimens. Design.—A Canon Elura MC40 digital camcorder was used, and the unedited movies were transferred to a Macintosh PowerBook G4 computer. Both the camcorder and specimens were hand-held during filming. The movies were edited using the software iMovie. Annotations and histologic photographs may be easily incorporated into movies when editing, if desired. Results.—The finished movies are best viewed in computers which contain the free program QuickTime Player. Movies may also be incorporated onto DVDs, for viewing in standard DVD players or appropriately equipped computers. The final movies are on average 2 minutes in duration, with a file size between 2 and 400 megabytes, depending on the intended use. Because of file size, distribution is more practical via CD or DVD, but movies may be compressed for distribution through the Internet (e-mail, Web sites) or through internal hospital networks. Conclusions.—Digital video is a practical, easy, and affordable methodology for specimen documentation, permitting a better 3-dimensional understanding of the specimens. Discussions with colleagues, student education, presentation at conferences, and other educational activities can be enhanced with the implementation of digital video technology.
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Kazazyan, V. T., A. P. Malykhin, E. F. Vaitsetskaya, N. M. Dneprovskaya, I. E. Rubin, and N. A. Tetereva. "Preliminary analysis of the possibility of using REMIX fuel in VVER-1200 reactors of the Belarusian NPP." Proceedings of the National Academy of Sciences of Belarus, Physical-Technical Series 67, no. 1 (April 7, 2022): 57–64. http://dx.doi.org/10.29235/1561-8358-2022-67-1-57-64.
Повний текст джерелаАнотація:
The transition from conventional uranium to regenerated fuel, which uses reprocessed spent fuel and enriched natural uranium, improves fuel efficiency and reduces the amount of spent nuclear fuel (SNF). Based on the analysis of published materials concerning mainly the fuel cycles of the VVER-1000 reactor, it was concluded that the most suitable in the conditions of the Republic of Belarus is the use of REMIX fuel. To confirm this conclusion in relation to the VVER-1200 reactors of the Belarusian NPP, computational studies were carried out within the framework of the State program “Scienceintensive technologies and equipment” for 2021–2025, subprogram 3 “Scientific support for the effective and safe operation of the Belarusian nuclear power plant and promising directions for the development of nuclear energy”. The characteristics of a 12-month fuel cycle with multiple recycling (reuse of fuel) according to the REMIX technology with 19.75 % enrichment of added uranium and maintaining the design capacity and duration of the campaign have been obtained. The share of SNF that is not returned to the reactor is 12.8 % (for a cycle with uranium fuel – 100 %); the fraction of waste intended for disposal or long-term storage, respectively, decreases by 8 times, and the specific consumption of natural uranium is reduced from 202 g/(MW·day) for uranium fuel to 159 g/(MW·day) for REMIX fuel. The results obtained can be taken into account when developing a fuel use strategy at the Belarusian NPP.
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Dhungana, Adhish, Sutham Nanthamongkolchai, and Supachai Pitikultang. "Factors Related to Intention to Undergo Female Sterilization Among Married Women in Rural Kathmandu, Nepal." Nepal Journal of Epidemiology 6, no. 1 (March 31, 2016): 539–47. http://dx.doi.org/10.3126/nje.v6i1.14736.
Повний текст джерелаАнотація:
Background: Sterilization is most widely used fertility regulation method in Nepal. However, prevalence of uptake of female sterilization in central hilly region is less than the national average. The objective of the study was to explore the number and factors related to intention of married women to undergo female sterilization in rural Kathmandu which lies within central hilly region. Materials and Methods: This is a community based cross-sectional survey research conducted in rural area of Kathmandu valley. Two hundred and forty currently married women with at least one child of any age were interviewed using a structured pre-tested questionnaire.Results: More than four-fifth of the respondents intended to undergo sterilization. Almost two-third of them wanted to limit their family size by taking this option. More than one-third of women not-intending to undergo sterilization feared weakness after sterilization. Age of the respondents, duration of marriage, and number of living children were significantly associated with intention to undergo sterilization. 15-24 years age group were six times more likely to have the intention for sterilization (OR 6.79, CI 2.28-20.19) compared to age 35 years and above group. Mothers with less than 3 living children are about three times more likely to have the intention to undergo sterilization (OR 2.87, CI 1.3-6.33) compared to women with more than 2 living children. Women married for 6 to 10 years were three times more likely to have the intention (OR 3.0, CI 1.09-8.27). However, gender of the living children was not associated with intention to undergo sterilization.Conclusion: There were significant numbers of women intending to undergo sterilization. Age of the mother, number of living children and the duration of marriage were found to be significantly influencing the intention to undergo sterilization. However, as intention refers to future plan, the respondents’ intention may change over time. The national family planning program also needs to identify the key factors in accepting the sterilization and target these women to increase utilization.
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Thompson, Aliza, Kevin Carroll, Lesley A. Inker, Jürgen Floege, Vlado Perkovic, Sonia Boyer-Suavet, Rupert W. Major, et al. "Proteinuria Reduction as a Surrogate End Point in Trials of IgA Nephropathy." Clinical Journal of the American Society of Nephrology 14, no. 3 (January 11, 2019): 469–81. http://dx.doi.org/10.2215/cjn.08600718.
Повний текст джерелаАнотація:
IgA nephropathy (IgAN) is an important cause of ESKD for which there are no approved therapies. A challenge for evaluating treatments for IgAN is the usual long time course for progression to ESKD. The aim of this Kidney Health Initiative project was to identify surrogate end points that could serve as reliable predictors of a treatment’s effect on long-term kidney outcomes in IgAN and be used as a basis for approval. Proteinuria was identified as the most widely recognized and well studied risk factor for progression to ESKD in IgAN. The workgroup performed a critical review of the data on proteinuria reduction as a surrogate end point for a treatment’s effect on progression to ESKD in IgAN. Epidemiologic data indicate a strong and consistent relationship between the level and duration of proteinuria and loss of kidney function. Trial-level analyses of data from 13 controlled trials also show an association between treatment effects on percent reduction of proteinuria and treatment effects on a composite of time to doubling of serum creatinine, ESKD, or death. We conclude that data support the use of proteinuria reduction as a reasonably likely surrogate end point for a treatment’s effect on progression to ESKD in IgAN. In the United States, reasonably likely surrogate end points can be used as a basis for accelerated approval of therapies intended to treat serious or life-threatening conditions, such as IgAN. The clinical benefit of products approved under this program would need to be verified in a postmarketing confirmatory trial.
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Renegar, D. Abigail, Paul Schuler, and Nicholas Turner. "CORAL TOXICITY RESEARCH FOR DETERMINING THRESHOLDS FOR DISPERSANTUSE-NEBA CALCULATIONS." International Oil Spill Conference Proceedings 2017, no. 1 (May 1, 2017): 1267–86. http://dx.doi.org/10.7901/2169-3358-2017.1.1267.
Повний текст джерелаАнотація:
ABSTRACT (#2017-136) The use of dispersants in close proximity to coral communities is generally not recommended, although Net Environmental Benefit Analysis (NEBA) of various response methods and priorities may override this principle. The NEBA calculation for use of dispersants near corals is a function of the relative effects of dissolved components of crude oil (alone) and components of chemically enhanced (dispersed) oil in the water column on corals. This is best determined by examining the toxicity (concentration and duration of exposure) of oil and dispersed oil to corals at the individual/organism and cellular levels. Unfortunately, this is a little studied area and very little coral toxicity information exists. This paper describes ongoing multi-year research being conducted at Nova Southeastern University Oceanographic Center to fill the coral toxicity information gap and determine toxicity thresholds for individual corals. The research program was designed with inputs from an oversight committee and a broad group of collaborators from the response industry and toxicology communities. The output of the of the study is intended to be compatible with current and emerging predictive models such as NOAA’s Chemical Aquatic Fate and Effects (CAFÉ) database, which is used to estimate the fate and effects of thousands of chemicals, oils, and dispersants. An overview of previous and current research on hydrocarbon toxicity to corals will be presented, along with proposed guidelines for effective toxicity testing which conforms to standardized protocols and aids in comparison of results between studies and extrapolation to actual spills.
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Liem, Robert I., Sophie Lanzkron, Thomas D. Coates, Laura DeCastro, Ankit A. Desai, Kenneth I. Ataga, Robyn T. Cohen, et al. "American Society of Hematology 2019 guidelines for sickle cell disease: cardiopulmonary and kidney disease." Blood Advances 3, no. 23 (December 3, 2019): 3867–97. http://dx.doi.org/10.1182/bloodadvances.2019000916.
Повний текст джерелаАнотація:
Abstract Background: Prevention and management of end-organ disease represent major challenges facing providers of children and adults with sickle cell disease (SCD). Uncertainty and variability in the screening, diagnosis, and management of cardiopulmonary and renal complications in SCD lead to varying outcomes for affected individuals. Objective: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in their decisions about screening, diagnosis, and management of cardiopulmonary and renal complications of SCD. Methods: ASH formed a multidisciplinary guideline panel that included 2 patient representatives and was balanced to minimize potential bias from conflicts of interest. The Mayo Evidence-Based Practice Research Program supported the guideline development process, including performing systematic evidence reviews up to September 2017. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, including GRADE evidence-to-decision frameworks, to assess evidence and make recommendations, which were subject to public comment. Results: The panel agreed on 10 recommendations for screening, diagnosis, and management of cardiopulmonary and renal complications of SCD. Recommendations related to anticoagulation duration for adults with SCD and venous thromboembolism were also developed. Conclusions: Most recommendations were conditional due to a paucity of direct, high-quality evidence for outcomes of interest. Future research was identified, including the need for prospective studies to better understand the natural history of cardiopulmonary and renal disease, their relationship to patient-important outcomes, and optimal management.
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Gunawan, Esther Carissa, Lucky Permana, Ni Putu Ratna Sukma Dewi, Rivel Andreas Arthaprasasta, Satiananda Adisantika, and Glisera Agri Ariyan. "Pengaruh Pemberlakuan Standard Operating Procedure terhadap Keberlangsungan Usaha Mikro Kecil Menengah “Windu Sari Putri”." Jurnal Pemberdayaan Masyarakat Indonesia 2, no. 1 (June 30, 2020): 39–57. http://dx.doi.org/10.21632/jpmi.2.1.39-57.
Повний текст джерелаАнотація:
This research is based on an observation towards a micro business name “Windu Sari Putri” which produces cistik andjinten and is in a condition in which they are producing in a large volume but is lacking in terms of proper organized system especially in terms of production. This research article is intended to explore the changes after the implementation of standard operating procedures (SOP) as a way to manage the production process, other than the SOP itself some programs is also conducted to rearrange the placements of workstations, manage the hygiene procedures, and replace all the equipments required for production in order to maximize the application of SOP. The proposed SOP controls the production process from the production arrangements, making thedough, rolling and slicing the dough, firing up the firewood, frying the dough, and packaging the finished products. This research article will mainly focus on the implementation of the SOP itself on controlling the internal production process and how it affects the sustainability of the business. This research has found that there is a decrease in the work duration and increase in productivity, alsothe heightened sense of production hygiene.AbstrakPenelitian ini dilatarbelakangi oleh observasi penulis terhadap usaha mikro “Windu Sari Putri” yang memproduksi cistik dan jinten, dan kondisi dimana volume produksinya yang besar namun kurang terorganisir dengan baik di berbagai aspek terutama produksi. Artikel penelitian ini bertujuan untuk menggambarkan perubahan yang terjadi setelah pemberlakuan standard operating procedure (SOP) sebagai sarana pengatur proses produksi, selain SOP beberapa program kerja untuk menata ulang tata letak, prosedur kebersihan, dan mengganti peralatan juga dilaksanakan untuk memaksimalkan pengaplikasian SOP. SOP yang dirumuskan akan mengatur proses produksi dari penyiapan produksi, pembuatan adonan, penggilingan dan pengirisan adonan, pembakaran kayu, penggorengan adonan, dan pengemasan. Penelitian ini hanya akan fokus kepada pemberlakuan SOP dalam mengatur proses produksi internal dalam usaha dan pengaruhnya terhadap keberlangsungan usaha. Capaian dari penelitian ini adalah penurunan durasi produksi dan peningkatan produktivitas dalam proses produksi serta kesadaran yang meningkat terhadap kebersihan produksi
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Rodriguez, J., M. A. Rodriguez, L. Fayad, P. McLaughlin, F. Swan, A. Sarris, J. Romaguera, B. Andersson, F. Cabanillas, and F. B. Hagemeister. "ASHAP: A Regimen for Cytoreduction of Refractory or Recurrent Hodgkin’s Disease." Blood 93, no. 11 (June 1, 1999): 3632–36. http://dx.doi.org/10.1182/blood.v93.11.3632.
Повний текст джерелаАнотація:
Abstract Patients with Hodgkin’s disease, which is either refractory or recurs after frontline chemotherapy with MOPP (mechlorethamine, vincristine, procarbazine, and prednisone), ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), or both regimens, generally have a poor prognosis. High-dose chemotherapy with autologous marrow or stem cell rescue (ABMT) is now a widely used salvage strategy in these patients. In this study, our objective was to determine the response rate to ASHAP (Adriamycin = doxorubicin, Solumedrol = methylprednisolone, High-dose Ara-C = cytosine arabinoside, and Platinum = cisplatinum), in a group of patients with Hodgkin’s disease with such poor risk characteristics. The treatment was intended as a brief tumor reducing program before ABMT. Fifty-six patients with diagnosed relapsed or primary refractory Hodgkin’s disease underwent this treatment. The program consisted of the administration of two cycles of ASHAP chemotherapy (doxorubicin 10 mg/m2/d intravenous (IV) continuous infusion (CI) over 24 hours, days 1 to 4; methylprednisolone 500 mg/d IV over 15 minutes daily for 5 days; cisplatinum 25 mg/m2/d IV CI over 24 hours, days 1 to 4; cytosine arabinoside 1.5 g/m2/d IV over 2 hours on day 5). After two courses of ASHAP the patients were evaluated for response, including a gallium scan test. Patients with progressive disease were taken off the study. Those with responding or stable disease received a third course of ASHAP, followed by consolidative treatment with ABMT. There were 19 complete responses (34% CR), 20 partial responses (36% PR), and 17 treatment failures, including 8 with minor responses and 9 with disease progression. Thus, in total there were 39 responses out of 56 patients (CR + PR = 70%). Myelosuppression was the main toxicity. There were no deaths due to toxicity. At this time, 23 patients are alive. There were 31 deaths due to disease progression and 2 due to other causes. The initial response to ASHAP before subsequent ABMT consolidation treatment correlated with survival. All 17 patients in whom ASHAP failed to achieve a response have died. The presence of B symptoms at relapse, and a duration of response to the last regimen of ≤6 months, predicted a poor response to ASHAP. A short program of treatment with ASHAP is an effective tumor debulking approach in patients previously treated with both or either ABVD and MOPP, before ABMT.
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Rodriguez, J., M. A. Rodriguez, L. Fayad, P. McLaughlin, F. Swan, A. Sarris, J. Romaguera, B. Andersson, F. Cabanillas, and F. B. Hagemeister. "ASHAP: A Regimen for Cytoreduction of Refractory or Recurrent Hodgkin’s Disease." Blood 93, no. 11 (June 1, 1999): 3632–36. http://dx.doi.org/10.1182/blood.v93.11.3632.411k13_3632_3636.
Повний текст джерелаАнотація:
Patients with Hodgkin’s disease, which is either refractory or recurs after frontline chemotherapy with MOPP (mechlorethamine, vincristine, procarbazine, and prednisone), ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine), or both regimens, generally have a poor prognosis. High-dose chemotherapy with autologous marrow or stem cell rescue (ABMT) is now a widely used salvage strategy in these patients. In this study, our objective was to determine the response rate to ASHAP (Adriamycin = doxorubicin, Solumedrol = methylprednisolone, High-dose Ara-C = cytosine arabinoside, and Platinum = cisplatinum), in a group of patients with Hodgkin’s disease with such poor risk characteristics. The treatment was intended as a brief tumor reducing program before ABMT. Fifty-six patients with diagnosed relapsed or primary refractory Hodgkin’s disease underwent this treatment. The program consisted of the administration of two cycles of ASHAP chemotherapy (doxorubicin 10 mg/m2/d intravenous (IV) continuous infusion (CI) over 24 hours, days 1 to 4; methylprednisolone 500 mg/d IV over 15 minutes daily for 5 days; cisplatinum 25 mg/m2/d IV CI over 24 hours, days 1 to 4; cytosine arabinoside 1.5 g/m2/d IV over 2 hours on day 5). After two courses of ASHAP the patients were evaluated for response, including a gallium scan test. Patients with progressive disease were taken off the study. Those with responding or stable disease received a third course of ASHAP, followed by consolidative treatment with ABMT. There were 19 complete responses (34% CR), 20 partial responses (36% PR), and 17 treatment failures, including 8 with minor responses and 9 with disease progression. Thus, in total there were 39 responses out of 56 patients (CR + PR = 70%). Myelosuppression was the main toxicity. There were no deaths due to toxicity. At this time, 23 patients are alive. There were 31 deaths due to disease progression and 2 due to other causes. The initial response to ASHAP before subsequent ABMT consolidation treatment correlated with survival. All 17 patients in whom ASHAP failed to achieve a response have died. The presence of B symptoms at relapse, and a duration of response to the last regimen of ≤6 months, predicted a poor response to ASHAP. A short program of treatment with ASHAP is an effective tumor debulking approach in patients previously treated with both or either ABVD and MOPP, before ABMT.
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Tagare, Rosemarie D., Joshua A. McDonald, Brandon Tritle, Karen Fong, Michael G. Newman, Laura Certain, and Russell J. Benefield. "608. Continuous Infusion Vancomycin Is Not Associated with Improved Safety in an Outpatient Parenteral Antimicrobial Therapy Program." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S406—S407. http://dx.doi.org/10.1093/ofid/ofab466.806.
Повний текст джерелаАнотація:
Abstract Background Continuous infusion (CI) vancomycin has been reported to be associated with improved safety outcomes compared to intermittent infusion (II) in the outpatient parenteral antimicrobial therapy (OPAT) setting. Based on this our institution implemented a quality improvement intervention to discharge more patients on CI vancomycin aiming to improve vancomycin safety in our OPAT program. Methods This single-center, pre-/post-intervention, quasi-experimental study evaluated adult patients who received vancomycin for a minimum 7-day intended duration of therapy after discharge, were discharged to home health or a skilled nursing facility, and had a follow-up visit with an infectious diseases provider. Outcomes included discontinuation due to acute kidney injury (AKI) or due to any adverse drug event (ADE), time to AKI or ADE, and unplanned 30-day readmissions and were compared between the pre-intervention (11/25/2018 to 7/5/2020) and post-intervention (7/6/2020 to 3/31/2021) periods. Adverse events were defined as premature discontinuation of vancomycin with documentation of a suspected adverse event. Results Of the 445 patients included, 102 patients received CI vancomycin. Demographic characteristics were generally similar between time periods, although more patients discharged to home health were included during the post-intervention period. CI vancomycin use was higher after the intervention (42% vs 11%, P < 0.0001). Discontinuation due to AKI (7% vs 8%, P = 0.68) or any ADE (16% vs 18%, P = 0.65) occurred just as frequently post-implementation. Unplanned 30-day readmission was higher post-intervention (21% vs 12%, P = 0.02). When comparing patients receiving CI and II vancomycin, discontinuation rates due to AKI (10% with CI vs 7% with II, P = 0.35) and any ADE (17% with CI vs 17% with II, P = 0.85) were similar. Time to AKI (median 21 days with CI vs 16 days with II, P = 0.26) and any ADE (median 22 days vs 22 days, P = 0.55) were also similar. There was a trend toward a significantly higher unplanned 30-day readmission rate with use of CI compared to II (22% vs 14%, P = 0.07). Control Charts These control charts show the variation over time of the proportion of patients A. utilizing CI vancomycin, B. experiencing any adverse drug reaction, C. experiencing acute kidney injury, and D. being readmitted within 30 days. Upper and lower control limits are depicted by red lines, and the mean is depicted by a green line. Conclusion We found no safety advantages when using CI instead of II vancomycin in the outpatient setting. The potentially higher readmission rate observed with CI vancomycin will be investigated further. Disclosures Russell J. Benefield, PharmD, Paratek Pharmaceuticals (Grant/Research Support)
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Barbosa, Cecilia E., Saba W. Masho, Kellie E. Carlyle, and Maghboeba Mosavel. "Factors Distinguishing Positive Deviance Among Low-Income African American Women: A Qualitative Study on Infant Feeding." Journal of Human Lactation 33, no. 2 (November 24, 2016): 368–78. http://dx.doi.org/10.1177/0890334416673048.
Повний текст джерелаАнотація:
Background: Positive deviant individuals practice beneficial behaviors in spite of having qualities characterizing them as high risk for unhealthy behaviors. Objective: This study aimed to identify and understand factors distinguishing low-income African American women who breastfeed the longest (positive deviants) from those who breastfeed for a shorter duration or do not breastfeed. Methods: Seven mini-focus groups on infant-feeding attitudes and experiences were conducted with 25 low-income African American women, grouped by infant-feeding practice. Positive deviants, who had breastfed for 4 months or more, were compared with formula-feeding participants who had only formula fed their babies and short-term breastfeeding participants who had breastfed for 3 months or less. Results: Positive deviant women had more schooling, higher income, breastfeeding intention, positive breastfeeding and unfavorable formula-feeding attitudes, higher self-efficacy, positive hospital and Special Supplemental Nutrition Program for Women, Infants, and Children experiences, more exclusive breastfeeding, and greater comfort breastfeeding in public. Short-term breastfeeding women varied in breastfeeding intention and self-efficacy, seemed to receive insufficient professional breastfeeding support, and supplemented breastfeeding with formula. Some showed ambivalence, concern with unhealthy behaviors, and discomfort with breastfeeding in public. Formula-feeding women intended to formula feed, feared breastfeeding, thought their behaviors were incompatible with breastfeeding, were comfortable with and found formula convenient, and received strong support to formula feed. Conclusion: Tapping into the strengths of positive deviants; tailoring interventions to levels of general and breastfeeding self-efficacy; increasing social, institutional, and community supports; and removing inappropriate formula promotion may offer promising strategies to increase breastfeeding among low-income African American women.
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Sutandi, Sutandi, Resista Vikaliana, and Yusup Rachmat Hidayat. "Strategi Peningkatan Kinerja UMKM melalui “UMKM Naik Kelas” Pada UMKM di Kecamatan Cempaka Putih Jakarta Pusat." Jurnal Komunitas : Jurnal Pengabdian kepada Masyarakat 2, no. 2 (February 3, 2020): 159–63. http://dx.doi.org/10.31334/jks.v2i2.739.
Повний текст джерелаАнотація:
In Indonesia, SMEs have a strategic role and a very large contribution to the national economy by contributing 53.3% of total GDP (Gross Domestic Product). The number of SMEs in Indonesia reaches around 56.2 million units and is capable of absorbing 97.2% of the total workforce. Based on data from the Central Statistics Agency (BPS) the growth of online-based trading business has increased in the last 10 years, to 26 million or up 17% and followed by the number of SMEs reaching more than 55 million units, but many challenges must be faced by SMEs in facing MEA.The form of community service activity training is titled: "UMKM Grades Up with the subtitles Training on Inventory Management, Marketing Go Online, and Preparation of Simple Financial Statements and MSME Tax Socialization".This year 2019 is the second year of the implementation of this community service program. This year, the response of community service partners, in this case 10 Assisted Culinary MSMEs around the campus, Cempaka Putih Jakarta, were very enthusiastic. This can be seen from the spirit of curiosity (many questions) about the material of socialization and the seriousness of the training that was given. The UMKM Actors asked for the continuation of this training, in the form of assistance / consultation for the development of the UMKM.The driving factors of the UMKM Graduation Class activities are the enthusiasm or high motivation of the SMEs. While the obstacle to the implementation of this program is the lack of duration of training, in terms of frequency. Another difficulty is the limited time of the UMKM Actors, because they have to take care of the UMKM business processes that are still running.Based on the results and outcomes achieved in 2019 community service titled MSMEs Graduating Classes, then for 2020 it is planned to hold: mentoring MSME business processes, so that MSMEs truly advance in class. The intended grade is that there is progress in management, so that it has implications for increasing MSME income. To facilitate the assistance for MSME business development, a MSME staging or clustering will be conducted in Cempaka Putih District.
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Sutandi, Sutandi, Resista Vikaliana, Yusup Rachmat Hidayat, and Yuli Evitha. "Strategi Peningkatan Kinerja UMKM melalui “UMKM Naik Kelas” Pada UMKM di Kecamatan Cempaka Putih Jakarta Pusa." Jurnal Komunitas : Jurnal Pengabdian kepada Masyarakat 2, no. 2 (January 31, 2020): 159–63. http://dx.doi.org/10.31334/jks.v2i2.740.
Повний текст джерелаАнотація:
n Indonesia, SMEs have a strategic role and a very large contribution to the national economy by contributing 53.3% of total GDP (Gross Domestic Product). The number of SMEs in Indonesia reaches around 56.2 million units and is capable of absorbing 97.2% of the total workforce. Based on data from the Central Statistics Agency (BPS) the growth of online-based trading business has increased in the last 10 years, to 26 million or up 17% and followed by the number of SMEs reaching more than 55 million units, but many challenges must be faced by SMEs in facing MEA. The form of community service activity training is titled: "UMKM Grades Up with the subtitles Training on Inventory Management, Marketing Go Online, and Preparation of Simple Financial Statements and MSME Tax Socialization". This year 2019 is the second year of the implementation of this community service program. This year, the response of community service partners, in this case 10 Assisted Culinary MSMEs around the campus, Cempaka Putih Jakarta, were very enthusiastic. This can be seen from the spirit of curiosity (many questions) about the material of socialization and the seriousness of the training that was given. The UMKM Actors asked for the continuation of this training, in the form of assistance / consultation for the development of the UMKM. The driving factors of the UMKM Graduation Class activities are the enthusiasm or high motivation of the SMEs. While the obstacle to the implementation of this program is the lack of duration of training, in terms of frequency. Another difficulty is the limited time of the UMKM Actors, because they have to take care of the UMKM business processes that are still running. Based on the results and outcomes achieved in 2019 community service titled MSMEs Graduating Classes, then for 2020 it is planned to hold: mentoring MSME business processes, so that MSMEs truly advance in class. The intended grade is that there is progress in management, so that it has implications for increasing MSME income. To facilitate the assistance for MSME business development, a MSME staging or clustering will be conducted in Cempaka Putih District.
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Kim, Kyong-Jee, Yeon Ji Lee, Mi Jin Lee, and Young Hyo Kim. "e-Learning for enhancement of medical student performance at the Objective Structured Clinical Examination (OSCE)." PLOS ONE 16, no. 7 (July 1, 2021): e0253860. http://dx.doi.org/10.1371/journal.pone.0253860.
Повний текст джерелаАнотація:
This study aimed to investigate the impact of student e-learning on the development of clinical competencies. The study participants were 3rd year students (n = 43) at a private mid-sized medical school located in a South Korean suburb on a four-year medical program. Educational intervention was implemented to enhance student clinical performance. Students engaged in learning activities that intended to promote their self-directed learning abilities and clinical performances using e-learning resources. Intervention was conducted for the duration of six months during the 3rd year and its effectiveness was investigated by comparing student performances in OSCEs in a pre- and post- comparison format and also by comparing them with national scores. In addition, student perceptions of the impact of e-learning on their OSCE performances were assessed using a questionnaire, which included 36 items that elicited student perceptions of their experiences of e-learning and readiness for e-learning. Student OSCE scores improved significantly after educational intervention in all domains of clinical competencies assessed and for total scores (p < 0.001). Furthermore, students achieved higher OSCE scores than national average scores in the post-test, whereas they had performed lower than national average scores in the pre-test. Students showed neutral or slightly positive responses to the effectiveness of e-learning, and their perceptions of e-learning were not associated with their e-learning readiness scores. The study shows student OSCE performance improved significantly after educational intervention, which indicate the effectiveness of e-learning to support student learning of clinical performance. Despite significant improvements in student OSCE scores after e-learning, their perceptions of its effectiveness were neutral. Furthermore, student perceptions of e-learning were not associated with their readiness for it. Suggestions are made to help students use e-learning more effectively to enhance their clinical competencies.
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Beng, Jap Tji, and Sri Tiatri. "Efforts in Reducing the Urge of Using Gadgets among Vocational High School Students." MITRA: Jurnal Pemberdayaan Masyarakat 4, no. 1 (May 6, 2020): 101–8. http://dx.doi.org/10.25170/mitra.v4i1.1108.
Повний текст джерелаАнотація:
The role of vocational high schools in producing reliable workforce is highly expected. Gadgets are one of the tools used by vocational high school students in their daily lives. Gadgets can help in the learning process. However, there are indications that students tend to overuse gadgets. This overuse has caused problems, for example, in their social relationship. Efforts to reduce the use of gadgets are therefore needed so that the students are able to improve their skills in building a social relationship. This community service activity was intended to reduce the urge to use gadgets by students in their daily lives. The activity was divided into two parts. The first part included discussion with the principal and a teacher and the second part discussion with students. The participants of the activity were the school principal, a teacher, and 36 students of the vocational high school in Belitung. Interactive group discussions were used as the method in this program. In addition, a questionnaire was used to obtain a description of students’ experiences and their opinions about the time of using gadgets. The activity resulted in the decision made by the principal and the teacher to implement a plan to reduce the urge of using gadgets by students while at school. Students also tended to agree on reducing the urge to use gadgets. However, the maximum duration of time per day for students to be able to use gadgets still needed further discussion, because students inclined to disagree with the limit of three hours per day. From this activity it was concluded that the interactive discussions among researcher, principal, teacher, and students could reduce the urge to use gadgets by students while at school.
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Dhungana, Adhish, Sutham Nanthamongkolchai, and Supachai Pitikultang. "Factors Related to Intention to Undergo Female Sterilization Among Married Women in Rural Kathmandu, Nepal." Nepal Journal of Epidemiology 6, no. 1 (March 31, 2016): 539. http://dx.doi.org/10.3126/nje.v1i1.14736.
Повний текст джерелаАнотація:
<p><strong><em>Background:</em></strong> Sterilization is most widely used fertility regulation method in Nepal. However, prevalence of uptake of female sterilization in central hilly region is less than the national average. The objective of the study was to explore the number and factors related to intention of married women to undergo female sterilization in rural Kathmandu which lies within central hilly region. </p><p><strong><em>Materials and Methods:</em></strong> This is a community based cross-sectional survey research conducted in rural area of Kathmandu valley. Two hundred and forty currently married women with at least one child of any age were interviewed using a structured pre-tested questionnaire.</p><p><strong><em>Results:</em></strong> More than four-fifth of the respondents intended to undergo sterilization. Almost two-third of them wanted to limit their family size by taking this option. More than one-third of women not-intending to undergo sterilization feared weakness after sterilization. Age of the respondents, duration of marriage, and number of living children were significantly associated with intention to undergo sterilization. 15-24 years age group were six times more likely to have the intention for sterilization (OR 6.79, CI 2.28-20.19) compared to age 35 years and above group. Mothers with less than 3 living children are about three times more likely to have the intention to undergo sterilization (OR 2.87, CI 1.3-6.33) compared to women with more than 2 living children. Women married for 6 to 10 years were three times more likely to have the intention (OR 3.0, CI 1.09-8.27). However, gender of the living children was not associated with intention to undergo sterilization.</p><p><strong><em>Conclusion:</em></strong><strong> </strong>There were significant numbers of women intending to undergo sterilization. Age of the mother, number of living children and the duration of marriage were found to be significantly influencing the intention to undergo sterilization. However, as intention refers to future plan, the respondents’ intention may change over time. The national family planning program also needs to identify the key factors in accepting the sterilization and target these women to increase utilization.</p>
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van Bellen, Bonno, Martin Prins, Luke Bamber, Maria Wang, and Anthonie WA Lensing. "Reduction in Initial Length of Stay with Rivaroxaban Single-Drug Regimen versus LMWH-VKA Standard of Care: Findings from the EINSTEIN Trial Program." Blood 120, no. 21 (November 16, 2012): 3419. http://dx.doi.org/10.1182/blood.v120.21.3419.3419.
Повний текст джерелаАнотація:
Abstract Abstract 3419 Background The current standard of care for the treatment of symptomatic deep vein thrombosis (DVT) and pulmonary embolism (PE) is parenteral low molecular weight heparin (LMWH) or fondaparinux, overlapping with and followed by a vitamin K antagonist (VKA). According to guidelines, parenteral treatment should be discontinued only when patients have reached a stable level of anticoagulation with a VKA; defined as 2 consecutive measurements of international normalized ratio (INR) >2.0 at least 24 hours apart. Compared with the previous standard of care, continuous infusion of unfractionated heparin, LMWH has made outpatient treatment feasible and lowered the treatment burden for patients, while reducing healthcare system costs. However, based on local practice or initial severity of disease many patients, especially those with PE, are still hospitalized, with discharge delayed until parenteral treatment can be discontinued. Rivaroxaban is an oral anticoagulant that produces stable levels of anticoagulation without the need for dose adjustments or routine coagulation monitoring for acute or long-term treatment. With its oral mode of administration and without the need for parenteral bridging therapy, rivaroxaban has the potential to allow discharge based on a patient's clinical condition without the additional requirement of achieving adequate oral anticoagulation levels, thereby further reducing healthcare costs and increasing convenience for patients. Aims We investigated the potential of rivaroxaban to reduce the length of initial hospitalization and the proportion of patients hospitalized, using data from the EINSTEIN DVT and EINSTEIN PE studies. Methods The EINSTEIN DVT and EINSTEIN PE studies were large, open-label, randomized, non-inferiority phase III trials comparing oral rivaroxaban (15 mg twice daily for 3 weeks, followed by 20 mg once daily) with dose-adjusted subcutaneous enoxaparin (1.0 mg/kg twice daily) overlapping with, and followed by, warfarin or acenocoumarol (INR 2.0–3.0). There were no instructions in the protocols of the studies with regard to hospital admission and/or discharge, which were left to the judgment of the attending physician. Length of hospital stay was evaluated from investigator records of dates of admission and discharge. All analyses were carried out in the intention-to-treat population using the van Elteren test, a stratified non-parametric test of significance, stratified by intended treatment duration. Analyses were exploratory with no adjustments for multiplicity. Results In the EINSTEIN DVT trial, 1781 of 3449 (52%) patients were hospitalized for the qualifying event, with similar proportions in each treatment arm (Table). However, the median length of hospital stay was significantly shorter in the rivaroxaban arm compared with the enoxaparin/VKA arm (5.0 vs 8.0 days; p<0.0001). In the EINSTEIN PE trial, 4328 of 4832 (90%) patients were hospitalized, with similar proportions in each treatment arm. Again, the median length of hospital stay was significantly shorter in patients receiving rivaroxaban than in patients receiving enoxaparin/VKA (6.0 vs 7.0 days; p<0.0001). Conclusion These results indicate that a single-drug anticoagulation regimen using rivaroxaban significantly reduces the length of hospital stay for patients admitted for DVT and/or PE, relative to standard of care. This has the potential to reduce the treatment burden for patients and healthcare systems. Disclosures: van Bellen: Bayer Brazil: Membership on an entity's Board of Directors or advisory committees. Prins:Bayer Healthcare: Consultancy, Honoraria. Bamber:Bayer Healthcare: Employment. Wang:Bayer Healthcare: Employment. Lensing:Bayer Healthcare: Employment.
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Cui, Zhixin, Ke Liu, and Huicui Meng. "Associations between Conventional and Emerging Indicators of Dietary Carbohydrate Quality and New-Onset Type 2 Diabetes Mellitus in Chinese Adults." Current Developments in Nutrition 6, Supplement_1 (June 2022): 896. http://dx.doi.org/10.1093/cdn/nzac067.016.
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Abstract Objectives Our aim was to investigate the associations between dietary GI, CF and CQI and new-onset T2DM risk among Chinese adult. Methods Dietary glycemic index (GI), carbohydrate to fiber ratio (CF) and carbohydrate quality index (CQI) are conventional and emerging indicators for carbohydrate quality, respectively. Their associations with new-onset type 2 diabetes mellitus (T2DM) risk in Chinese adults remain unclear. We aimed to investigate the associations between dietary GI, CF and CQI and new-onset T2DM risk among Chinese adults. This prospective cohort study included 14,440 adults from the China Health and Nutrition Survey without cardiometabolic diseases at baseline. The associations between dietary GI, CF and CQI and T2DM risk were assessed using Cox proportional hazard regression analysis and dose–response relationships were explored using restricted cubic spline and threshold analyses. Results After a median follow-up duration of 9 years, a total of 1061 incident T2DM cases were identified. In fully adjusted models, higher dietary GI values were associated with reduced risk of T2DM, especially for Q4 (Q4 vs Q1: HR = 0.51; 95% CI: 0.38, 0.70; P-trend = 0.013), while CF and CQI were not significantly associated with incident T2DM. There were significant effect modifications of the association between dietary GI and T2DM risk by region and amount of carbohydrate intake (both P-interaction < 0.050). RCS analyses demonstrated significant non-linear trends of the associations between dietary GI and CF and T2DM risk (both P-overall < 0.001, P-nonlinear = 0.001), and threshold analyses showed that T2DM risk decreased and reached the bottom when dietary GI was 74.5 (73.4, 75.6) and CF was 27.3 (25.1, 29.6) (both P-log likelihood ratio < 0.001). Conclusions There were U-shaped relationships between dietary GI and CF and T2DM risk, indicating both dietary GI and CF should be controlled in a moderate range for T2DM prevention in Chinese adults. Further studies are required to confirm whether these indicators should be incorporated into dietary guidelines and Nutrient Facts panel labeling intended to help reduce T2DM risk in Chinese population. Funding Sources This study was funded by Shenzhen Science and Technology Program and the National Natural Science Foundation of China.