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Osteoarthritis is a rheumatic disease characterized by degeneration and decay of cartilage in the joints. As the disease worsens, the joint space narrows causing numbness and pain, which often impairs movement. In addition to pharmacological therapy, low-intensity laser (LILT), high-intensity laser (HILT) and exercise are used to treat osteoarthritis (OA) of the knee. HILT is a new modality in our country and the experience from its application is small, especially in the treatment of OA of the knee. Aim of the paper was to compare the effect of HILT with LILT in the treatment of OA of the knee. Material and methods: This was a randomized comparative unilateral blind study involving 72 patients divided into two groups. The first group was treated with HILT, the second group treated with LILT. Outcome measure was the visual analogue scale (VAS) for pain, which was made on the first and tenth day of treatment. Statistical significance was defined as p, Остеоартритисот е ревматолошко заболување кое се карактеризирасо дегенерација и распаѓање на 'рскавицата во зглобовите. Со влошување на болеста, зглобниот простор се стеснува предизвикувајќи вкочанетост и болка, што често го нарушува движењето. Освен фармаколошка терапија, во лекувањето на остеоартитисот (ОА) на коленото се применува нискоинтензивен ласер (НИЛТ), високоинтензивен ласер (ВИЛТ) и вежби. ВИЛТ е нов модалитет во нашата земја и искуството од неговата примена е мало, особено во лекувањето на ОА на коленото. Цел на трудот е да се спореди ефектот на ВИЛТ во однос на НИЛТ во лекувањето на болката кај остеоратитис на коленото. Материјал и методи: Рандомизирано, компаративно, еднострано слепо истражување во кое учествуваа 72 пациенти поделени во две групи. Првата група беше лекувана со ВИЛT, а втората група со НИЛТ. Како мерка за исход беше користена визуелно аналогна скала (ВАС) за болка, која беше направена на првиот и десеттиот ден од лекувањето. За статистичка значајност беше земено р

Mario Kasovi&cacute;,1,2 Andro Štefan,1 Lovro Štefan1– 3 1Faculty of Kinesiology, Department of General and Applied Kinesiology, University of Zagreb, Zagreb, 10 000, Croatia; 2Faculty of Sports Studies, Department of Sport Motorics and Methodology in Kinanthropology, Masaryk University, Brno, 625 00, Czech Republic; 3Faculty of Science, Department of Recruitment and Examination (RECETOX), Masaryk University, Brno, 625 00, Czech RepublicCorrespondence: Lovro ŠtefanFaculty of Kinesiology, Department of General and Applied Kinesiology, University of Zagreb, Zagreb, 10 000, CroatiaTel +385-9891-77-060Email lovro.stefan1510@gmail.comPurpose: To examine the associations between gait speed and sleep quality in first-year university students, according to gender.Methods: In this cross-sectional study, we recruited 193 first-year university students [mean age±standard deviation (SD): 19.6± 1.1 years; mean height: 178.0± 10.5 cm; mean weight: 74.0± 11.0 kg; 26.9% women). Sleep quality was assessed using the Pittsburgh Sleep Quality questionnaire, with a lower score indicating “better” sleep quality. Gait speed was measured using the Zebris pressure platform. The associations were examined with generalized linear models and multiple regression analysis.Results: In the unadjusted model, faster participants had significantly “better” sleep quality (β=− 3.15, 95% CI − 3.82 to − 2.47, p< 0.001). When the model was adjusted for sex, age, body-mass index, self-rated health, smoking status, and psychological distress, faster participants remained having “better” sleep quality (β=− 2.88, 95% CI − 3.53 to − 2.22, p< 0.001).Conclusion: This study shows that sleep quality can be predicted by gait speed in the first-year university students.Keywords: youth, biomechanics, sleep, relationship

Introduction. Patients considered for radical surgery for lung cancer need a functional evaluation to identify those at increased risk of postoperative complications. Material and methods. We performed an analysis of clinical data of 1214 patients who underwent a single lobectomy for lung cancer. To assess the risk of complications, we used the chronic obstructive pulmonary disease assessment test (CAT). Results. 254 pulmonary and 51 cardiovascular complications occurred in 216 (17.8%) patients. In 204 patients with a CAT score ≥12 complications occurred more often than in patients with a lower score (26.5% vs. 16.0%; p < 0.001). Conclusions. In patients undergoing lobectomy for lung cancer, pulmonary complications occurred much more frequently than cardiovascular complications. Patients with a CAT score ≥12 had a higher rate of postoperative complications as compared to those with a lower score.

Dynamic information networks, containing evolving nodes and links, exist in various applications. For example, in a Facebook network, nodes represent users, links represent friendship, and users often form different groups. Over time, some users will leave some groups. Thus, for both users and groups, it’s meaningful to predict which users would leave which groups. Existing studies consider that a user is more likely to leave if most of his/her friends leave. However, in reality, the low-degree nodes usually make up the majority of all nodes and there exist some users with very few friends but keeping staying in a group. Therefore, it might lead to precision loss if only neighborhood information is utilized, but previous work ignored this. To improve prediction precision, we firstly introduce novel definitions of a group’s activeness and a user’s own activeness respectively. Then we propose the group-combined activeness score of each user so that a user with a lower score would be more possible to leave. After that, we present an unsupervised prediction algorithm to continuously predict group members’ departure behaviors in a dynamic information network. Experiments on several real datasets show the effectiveness, efficiency and superiority of our algorithm compared with the state-of-the-art competitors.

Purpose: This study aimed to examine the differences in scores of the Attitude to Patient Safety Questionnaire (APSQ) by medical students before and after the outbreak of COVID-19.Methods: In total, 97 and 118 medical students completed patient safety courses at Yonsei University Wonju College of Medicine in 2019 and 2020, respectively. In 2019, the course was conducted using traditional learning in the classroom, whereas, in 2020, most of the classes were conducted using non-face-to-face learning methods.Results: In 2019 and 2020, 49 and 53 students responded to the APSQ. Only one item “Patients are not really aware of how safe their care is” had a lower score in 2020 than in 2019.Conclusion: Although the total APSQ score did not differ between 2019 and 2020, the students in 2020 might have a poor understanding of the role of patients in medical errors.

The potentially complex relationship between sleep and physical activity has been characterized as difficult to answer. This study was to determine the relationship between Physical Activity (PA) and Sleep Quality (SQ) among community dwelling older adults in Idi-Araba, Lagos-State. A cross-sectional study of older adults aged 55 years and above. The participants’ PA level and SQ were measured using the Physical Activity Scale for the Elderly (PASE) and Pittsburgh Sleep Quality Index (PSQI) respectively. The data was summarised using mean, frequency and percentage. Spearman Correlation, Mann-Whitney, Kruskal-Wallis and chi-square test were also employed. Level of significance was set at p ?0.05. Majority of the older adults (62%) reported poor sleep quality. There was a significant relationship between PA and SQ among the participants, higher level of physical activity correlated with a lower score on the sleep quality. Age had significant influence on PA as there was a decline in PA with increasing age, though gender had no significant influence on PA. Age and gender had no significant influence on SQ. Older adults should be encouraged to participate in more physical activity to improve their sleep. Key words: Sleep quality, physical activity, older adults.

Introducción: La pandemia puede generar compromiso en la salud mental, especialmente del personal de salud expuesto directamente al virus. La Otorrinolaringología es una de las especialidades con mayor riesgo de exposición y contagio por SARS-CoV-2. Objetivo: Evaluar la salud mental en los otorrinolaringólogos de Hispanoamérica ante la actual pandemia COVID-19. Diseño: Estudio de corte transversal. Métodos: Se evaluaron variables socioeconómico/demográficas en otorrinolaringólogos y su asociación con las escalas PHQ-9 y GAD-7. Resultados: Se estudiaron 256 otorrinolaringólogos de Hispanoamérica. La escala PHQ-9 presentó una media de 5.45 (DE 4.22). La escala GAD-7 presentó una media de 4.55 (DE 3.457). La prevalencia de depresión mayor y ansiedad fue de 14.8% y 7%, respectivamente. En el análisis multivariado, los otorrinolaringólogos a los que se les ha realizado prueba con hisopado nasofaríngeo tienen una predicción significativa para presentar una puntuación alta en la escala PHQ-9 (p = .027). En la puntuación de la escala GAD-7, los individuos con mayor edad tienen una predicción significativa de menor puntuación en la escala (p = .002). Los otorrinolaringólogos con más años de experiencia (p = .037) y aquellos que les han realizado prueba de RT-PCR con hisopado nasofaríngeo para SARS-CoV-2, tienen una predicción significativa para presentar una puntuación alta en la escala GAD-7 (p = .027). Conclusión: La exposición a la prueba de hisopado nasofaríngeo para el diagnóstico de COVID-19 fue la única variable independiente que se asoció con aumento de las puntuaciones en las escalas GAD-7 y PHQ-9.

BACKGROUND: We aimed to investigate whether the degree of transverse sinus stenosis (TSS) on magnetic resonance venography (MRV) can predict visual outcomes in patients with idiopathic intracranial hypertension (IIH). METHODS: A chart review identified IIH patients followed for at least 6 months. Mean deviation (MD) on visual field (VF) testing at initial and last follow-up visits, best corrected visual acuity (BCVA), patients’ age, body mass index, and lumbar puncture opening pressure were recorded. MRV was used to grade TSS on a scale of 0–8 using the grading scheme proposed by Farb et al., whereby a lower score indicates a greater degree of stenosis. Linear regression analysis was used to test for association between above variables and MD on VF, including change in MD over time. RESULTS: 44 female patients were followed for a median of 26 months. All patients had unilateral or bilateral TSS on MRV. The median TSS score was 3/8. The median BCVA was 0.06 logMAR at baseline. The median VF MD was −3.02 dB at baseline and −1.96 dB at final follow-up. There was no significant association between the degree of TSS and either baseline MD (P-value = 0.34) or the change in MD on VF over the course of follow-up (P-value = 0.54). Baseline BCVA (P = 0.045) and baseline MD (P

The radiological findings of COVID-19 are well-described, including its evolution. In an earlier report of admission chest radiographs of patients with COVID-19, we anecdotally noted relative sparing of the left upper zone (LUZ). We subsequently aimed to describe the main chest radiograph findings in another cohort, focusing on zonal predominance. The admission chest radiographs of 111 patients with CO­VID-19 pneumonia requiring intensive care admission were reviewed by 2 thoracic radiologists and categorized according to the predominant pattern into either ground-glass opacities (GGOs), alveolar infiltrates and/or consolidation, or reticular and/or nodular infiltrates or an equal combination of both, and the extent of disease involvement of each of the zones using a modified Radiologic Assessment of Lung Edema (RALE) score. Parenchymal changes were detected in all. In total, 106 radiographs showed GGOs, alveolar infiltrates, and/or consolidation, and 5 had a combination of reticular/nodular infiltrates as well as GGOs, alveolar infiltrates, and/or consolidation. The LUZ had a significant lower grading score than the right upper zone: 1 versus 2 (p < 0.001). Likewise, the upper zones had a significant lower score than the mid and lower zones (p < 0.001). Our findings confirmed the relative sparing of the LUZ in severe COVID-19 pneumonia.

This study aimed to scrutinize whether Turkish EFL instructors have feared selves while teaching English in their clasess, while speaking in front of public, and in their relationships with their students and colleagues. The participants comprised a total number of 38 Turkish EFL instructors at Selcuk University, Konya and PhD candidates at Hacettepe University, Ankara, Turkey in 2015-2016 academic year. The participants were selected via purposive sampling model on voluntary basis. The data were collected using a questionnaire consisting of 37 items and 5 sub dimensions based on a 5-point Likert scale. The results showed that the participant EFL instructors whose ages were in between 31-35 and between 36-40; and those whose ages were 40+ showed significant difference (p

Background: Adolescence is a transition from childhood to adulthood, along with physical and emotional changes. One significant difference is physical appearance. Adolescents tend to be afraid of negative evaluations from others for their physical appearance or social physique anxiety. Objective: This study aimed to determine the social physique anxiety in female adolescents at Bandung Middle School. Methods: This study's method was a descriptive quantitative method using a total population technique with a sample of 331 female high school students in Bandung Middle School. The measurement instrument that was used in this study was SPAS-C (Social Physique Anxiety for Children). Analysis of the data was conducted using the average score of social physique anxiety and was presented as a percentage. Result: This study showed that most respondents had a lower score than social physique anxiety average score with a several 176 respondents (53.2%), in comparison 155 respondents (46.8%) had a higher score than social physique anxiety average score. Based on the study results, comparing the number of respondents who had a lower score than the social physique anxiety average score with the number of respondents who had a higher score than the social physique anxiety average score did not significantly differ. Conclusions: Preventive solutions for social physique prevention are essential. Schools can make a consultation schedule or use an online consultation system and work with community health centers to provide health education and knowledge about social physique anxiety and the influencing factors and its prevention.

Quality of life (QoL) typically improves with a parathyroidectomy (PTx) in cases of primary hyperparathyroidism (PHPT), but the effect of surgery on QoL is not yet fully understood. This study evaluated the impact of PTx on health-related QoL (HRQoL). Patients who underwent PTx for PHPT between January 2016 and December 2019 were asked to complete the 36-Item Short Form Health Survey (SF-36) and the Primary Hyperparathyroidism Quality of Life (PHPQoL) questionnaire before surgery and 1 year later. A 5-point Likert scale was used: negative responses received a lower score and positive responses scored high. Forty-one of 50 patients completed the questionnaires before and 12 months after the surgery. The median patient age was 64 years (min-max: 32-83 years). In the study group, 33 were female, and 8 were male. The SF-36 results indicated that significant improvements had been observed in all 8 domains a year after surgery, particularly in the physical functioning and role, general health, energy, and mental health scales. The PHPQoL scores also improved significantly after PTx (p < 0.05). The improvement in the physical and mental health components was 50% and 76%, respectively. In conclusion, this study demonstrated that PTx for PHPT improved QoL.

The experiment was conducted at Horticulture Farm of Agriculture and Forestry University, Rampur, Nepal during the November 2016 to March 2018 for two consecutive years to assess the characteristics on postharvest quality of late season cauliflower varieties. The experiment was laid in a Randomized Complete Block Design (RCBD) with the eleven late season cauliflower varieties viz., Freedom, Titan, Ravella, Amazing, Artica, Bishop, Casper, Indam 9803, NS 106, Snow Mystique, and Snowball 16, each replicated with four times. Significantly higher TSS value of 5.7º Brix was produced by Snowball 16 than other varieties. Considerably higher vitamin C of 49 mg/100 g was found in Amazing than other varieties. Significantly lower physiological loss in weight of 5.3%, 9.6% and 15.6% was found in Artica at three, six and nine days after harvesting, respectively. Higher score for the taste of curd was 8.8 in Snowball 16 followed by Amazing while lower score for taste of the curd was 4.8 in Indam 9803 variety. The attractive color and more compact curd score of 8.4 was found in both Titan and Artica than other varieties. Therefore, it can be concluded that Snowball 16 and Amazing varieties were the best open pollinated varieties for taste of the curd and composition of chemical constitutes. Bishop, Snow Mystique, NS 106, Artica and Titan varieties were other probable hybrid varieties based on their overall postharvest characteristics.

Introduction: M.B.B.S. (Bachelor of Medicine, Bachelor of Surgery) is a challenging period for personal, academic & professional growth of a student. Resilience, the ability to regain original strengths after facing stressful situation is important while dealing with the challenges during M.B.B.S. course. Type of coping can affect resilience. This study aims to assess the resilience in M.B.B.S. students and find the correlation with coping. Materials and Methods: A cross-sectional study was carried out on consecutively selected 250 M.B.B.S. students. Participants were interviewed with self-reporting questionnaires. Data was collected using semi-structured proforma, resilience scale and mechanisms of coping scale. Statistical analysis was done using mean, standard deviation, chi square test, t test, Pearson’s correlation, regression analysis and ANOVA wherever needed. Result : Mean resilience score was 5.02 with no significant gender differences. Resilience score was significantly higher in first & second year students and interns. Students with higher resilience score were using problem solving as a major coping. Participants with very good relationship with their family, colleagues and teachers were significantly more resilient. Those having addiction of any sort had significantly low score on resilience and problem solving coping. Participants requiring longer time to come out of stressful situation had lower score on resilience. Participants facing a stressful life situation had significantly less score on problem solving. Conclusion: Resilience is positively influenced by problem solving, better relationship with others & less academic stress. It is negatively influenced by emotion based coping, exposure to stressful situation, need of longer time to recover, addiction and higher academic stress. Keywords : Resilience, Coping, M.B.B.S. students

Studies have been performed to determine the relationship between assessment of linear udder traits and lifetime of cows. Experiments were carried out in the herd of breeding farm AF "Mayak" Zolotonosha district of Cherkasy region on the number of cows of Ukrainian Red-and-White (URW) and Black-and-White (UBW) dairy breeds. Estimation of cows firstborn by conformation type was carried out according to the method of linear classification. It was found that cows with higher estimates for condition of udder morphological traits have a longer lifetime compared to animals rated lower score. The difference between cows, rated at one and nine score for trait of the front udder part attachment, was very significant and amounted 939 (URW) and 710 (UBW) days. The difference between the lowest and highest estimates on the basis of height rear udder parts attachment was 687 (URW) and 878 (UBW) days. Animals with an assessment for udder central ligament development below the average (1.4 score) were used from 1675 to 1832 (URW) and from 1535 to 1810 (UBW) days according to estimated breeds. Cows with an assessment of nine score differed by higher lifetime - 2377 days, exceeding cows with the lowest score at 702 days (URW) and 2322 days with reliable excess on 785 days (UBW). The difference between the average lifetime of cows estimated at nine score and with assessment of one score for udder depth was 618 days in cows URW and in UBW - 762 days. It has been proven that cows were used longer in the herd with estimates for front teats position from five to nine score, and a significant decrease in lifetime of cows began with an estimate for this trait from three to one score. Thus, assessment of cows Ukrainian Red-and-White and Black-and-White dairy breeds by the method of linear classification confirmed that the desired development of udder morphological traits was the key to long lifetime cows in modern technological conditions of milk production.

The purpose of this study was to determine how dual-task (DT) effect on gait differs among adolescents with different fitness and health profiles. The gait performances of 365 adolescents aged 13–14 years were assessed at single and DT walking. The proportional changes in gait parameters from single to dual were regressed against gender, body mass index (BMIz), three components of MABC-2 (balance, aiming &catching and manual dexterity), group (high vs low motor competence), body strength, physical fitness level using multiple regression analyses; and gender and four items of balance subtest of MABC-2 in the secondary analysis. The analyses showed that being female was associated with greater reduction in gait speed and stride length and an increase in double support time and step time; and having lower score in balance was related to greater reduction in gait speed, and cadence, and an increase in step time. Only zig-zag hopping item of the balance subtest was associated with DT effect on gait speed and stride length. No significant relationships were found between DT effect on gait and the rest of the predictors. Females and adolescents with lower level of balance function may be at higher risk of having DT deficit during walking.

Roux-en-Y gastric bypass (RYGB) has emerged as the most effective treatment in reversing insulin resistance in patients with type 2 diabetes mellitus (T2DM). A number of models and statistical tools have been proposed to predict patients likely to experience diabetes remission post-RYGB. The purpose of our study was to evaluate the preoperative accuracy of DiaRem score in predicting T2DM remission at 1 year of follow-up in a retrospective analysis of diabetic morbidly obese patients who underwent RYGB. One hundred and forty-three patients underwent RYGB between January 2018 and December 2018. We conducted a retrospective analysis in 55 patients (38.46%) with T2DM with 1 year of follow-up. DiaRem score was calculated, and patients were stratified in five groups. At a 1-year follow-up, we found a higher proportion of patients with T2DM remission in the lower score group compared to a lower proportion of patients with remission in the higher score group. We derived a DiaRem cut-off score of 6.5 that had high sensitivity and specificity to predict T2DM remission preoperatively. We found a significant decrease in BMI and HbA1C values post-operatively at 1 year following RYGB. DiaRem score is an easy to determine score based on basic clinical parameters that could identify patients with T2DM who would achieve maximal benefit in terms of remission after bariatric surgery. The development of a suitable scoring tool would be clinically useful as it would enable clinicians to better triage patients for RYGB.

مستخلص: هدفت الدراسة إلى معرفة ديناميات الشخصية، کالحوافز والحاجات والمشاعر والصراعات والعقد النفسية والتخيلات لدى الحالات الطرفية على مقياس القدرة للتفکير الابداعي من خلال تطبيق اختبار تفهم الموضوع ( التات )، وتم تحديد عينة الدراسة باختيار الحالة الأولى لحصولها على درجة أعلى، والحالة الثانية لحصولها على درجة أقل على مقياس التفکير الإبداعي، وذلک بالنسبة للعينة الکلية لغرض تطبيق الدراسة الإکلينيکية ومعرفة جوهر ديناميات الشخصية لکلى الحالتين الطرفيتين: باستخدام المقابلة الکلينيکية ذات رؤوس الموضوعات الهادية. وتبين من خلال نتاج الدراسة أن اختبار تفهم الموضوع (T.A.T ) من حيث التحليل الکمي والکيفي والدلالات الإکلينيکية لعناصره، ذو فائدة کلينيکية في معرفة ديناميات الشخصية وتحقيق الفهم الأفضل للحالة. Abstract The study aimed to know the dynamics of personality, such as the motives, needs, feelings, conflicts, psychological complexes, and fantasies of the peripheral cases on the scale of the creative thinking through the application of the Thematic apperception Test(TAT), and the study sample was determined by choosing the first case for obtaining a higher score, and the second case for obtaining a lower score On the creative thinking scale, for the total sample for the purpose of applying the clinical study and knowing the essence of the personality dynamics for the two terminal states: using the clinical interview with guiding topic headings. It was found through the results of the study that the Subject Understanding Test (T.A.T) in terms of quantitative and qualitative analysis and the clinical indications of its elements is of clinical benefit in knowing the dynamics of personality and achieving a better understanding of the situation.

Objectives Migraine is a neurological disorder causing unbearable pain. Dietary approach is proposed as a preventive way of reducing the severity of migraine headaches. The present study aimed to examine the association between MIND diet and migraine headaches. Results We found that participants with higher score of MIND diet compared to those with lower score, were less likely to have severe headaches (OR = 0.64; 95% CI 0.45, 0.91; P = 0.01). Moreover, our results showed an inversed correlation between mind diet score and duration (β = − 0.14, 95% CI − 1.42, − 0.14, P = 0.04) and frequency of headaches (β = − 0.13, 95% CI − 0.99, − 0.07, P = 0.03).

Objectives: This study aims to evaluate an online media production called ‘the Alzheimer Experience’ (AlzExp), which was developed to raise public awareness and enhance knowledge and understanding of dementia. Method: Before and after watching AlzExp, all visitors of AlzExp (February–June 2012) were asked to complete questionnaires on demographics, knowledge about dementia, attitude towards people with dementia (person-centeredness) and the use of AlzExp. McNemar's chi-squared test, multivariate linear regression analysis and paired t-tests were used to analyze change in knowledge, predictors for change in person-centered attitude and differences between subgroups in change in person-centered attitude. Results: Participants in this study (n = 213) were mostly professionals and working with people with dementia, or had someone with dementia among their acquaintances. An increase of person-centered attitude between pre- and posttest was predicted by age, having a professional or personal relationship with someone with dementia, person-centeredness at pre-test and time spent in AlzExp. Professionals had a more person-centered attitude after watching AlzExp, as did younger people, those who spent more time in AlzExp and those who had a lower score at pre-test. Conclusion: The beneficial impact of AlzExp found in this study was modest and in particular present for people who deal with people with dementia (professionally or personally). More insight is needed in the effects of tools aimed at raising public awareness and enhancing knowledge and understanding of dementia to tackle stigmatization associated with dementia and, thereby, improving the quality of life of people with dementia and their caregivers.

Introduction: The quality of care affects patients’ satisfaction. To provide high quality care, nurses face ethical challenges in daily practice. Moral sensitivity is the first phase in moral implementation. This study aimed to determine the relationship between nurses’ moral sensitivity and patients’ satisfaction in medical wards. Methods: In descriptive correlational study 198 nurses and 198 patients in 17 medical wards filled out the Moral Sensitivity Questionnaire (MSQ) and Patient Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ), respectively. Nurses were sampled by the census method. For each nurse, a patient was selected randomly from the same ward. Data were analyzed using SPSS version 13. Results: The highest scores were in the dimensions of “relational orientation” and “following the rules”, and the lowest scores were in the dimensions of “autonomy” and “experiencing moral conflicts”. The highest level of patients’ satisfaction was with “nurses’ professional performance” 3.98 (1.09), and the lowest level was with “nurses’ routine work” 2.69 (1.22). There was no significant relationship between the mean of patient satisfaction and moral sensitivity of nurses. Conclusion: Considering that nurses had a higher score in dimension of “following the rules” and a lower score in dimension of “autonomy”, it seems ethical performance in the real situation is not merely due to the nurses’ moral sensitivity and it seems the complexity of the organization causes nurses face difficulties in making decisions related to clinical practice; therefore, policy makers in the health system should be able to identify barriers.

Objectives:\ud The objective of this cross‐sectional, observational study was to investigate performance of activities of daily living in patients with myotonic dystrophy type 1 (DM1).\ud \ud Materials and Methods:\ud Adults with genetically confirmed DM1 were recruited from Newcastle University (Newcastle upon Tyne, UK) and University College London Hospitals NHS Foundation Trust (London, UK). Data on activities of daily living were recorded through the DM1‐ActivC (scale scores range between 0 and 100, where a higher/lower score indicates a higher/lower ability).\ud \ud Results:\ud Our sample comprised 192 patients with DM1 (mean age: 46 years; 51% female). Patients reported most difficulties with running, carrying and putting down heavy objects, and standing on one leg, and least difficulties with eating soup, washing upper body, and taking a shower. Irrespective of the disease duration (mean: 20 years), most patients were able to perform basic and instrumental activities of daily living (eg personal hygiene and grooming, showering, eating, cleaning and shopping), with the exception of functional mobility/transfer tasks (eg walking uphill and running). The mean DM1‐ActivC total score was estimated at 71 (95% CI: 68‐74). Estimated progenitor cytosine‐thymine‐guanine repeat length and age explained 27% of the variance in DM1‐ActivC total scores (P < .001).\ud \ud Conclusions:\ud We show that DM1 impairs performance of activities of daily living, in particular those requiring a high degree of muscle strength, stability and coordination. Yet, across the evolution of the disease, the majority of patients will still be able to independently perform most basic and instrumental activities of daily living.

SIGNIFICANCE Tear osmolarity has been reported as one of the best diagnostic tests for dry eye disease and its management. Contact lens wear is thought to influence tear homeostasis. Understanding how regular wear of contact lenses and their type affect tear osmolarity is important. PURPOSE The purpose of this study was to assess changes in tear osmolarity and ocular symptoms over a period of 12 months following refitting contact lens wearers with daily disposable contact lenses. METHODS Fifty subjects aged (mean ± SD) 26 ± 4 years were refitted with either silicone-hydrogel (delefilcon A, SiHy, n = 34) or hydrogel (omafilcon A, Hy, n = 16) daily disposable soft contact lenses. Study included seven visits: baseline measurements without contact lenses; two visits for contact lens fit and selection; follow-up measurements after 3, 6, and 12 months of contact lens wear; and a post-study visit without contact lenses. Lens type selection was based on a set of objective measurements. Subjects were instructed to follow strict wearing rules. Impedance-based osmometer was used to collect samples from the lower tear meniscuses. The Ocular Surface Disease Index (OSDI) and the eight-item Contact Lens Dry Eye Questionnaire were used to assess subject-reported ocular symptoms and contact lens discomfort, respectively. RESULTS Downward trend of tear osmolarity was noted over the time course of study. Statistically significant differences were noted in tear osmolarity (Friedman test, χ = 21.91 [P < .001], and χ = 13.89 [P = .003]) for the right and left eyes, respectively. A statistically significant decrease in tear osmolarity was apparent only for initially symptomatic subjects (for OSDI ≥13: χ = 26.25, P < .001; for OSDI

Objectives: To determine the impact of erythema nodosum leprosum (ENL) on health-related quality of life (HRQoL) of persons affected by leprosy compared to individuals without ENL using the Medical Outcomes Study: 36-Item Short Form Survey (SF-36). Methods: Individuals with a diagnosis of leprosy completed the Bengali version of the SF-36. The responses to the items of the surveys were coded, summed and transformed into a score for each of the eight domains. A lower score reflects a worse HRQoL. Results: 290 individuals with a median age of 32 years (Range 14–82) participated. Individuals with ENL and those with isolated neuritis had significantly lower mean scores in all domains compared with individuals without reaction or neuritis except the domain of physical functioning in those with ENL. Conclusions: This study demonstrates an association of reduced HRQoL with ENL compared to individuals without reaction or neuritis.

This systematic review aims to evaluate the efficacy of cognitive and behavioral interventions for improving fall-related psychological concerns. A systematic search yielded eight randomized controlled trials eligible for inclusion. All studies compared a cognitive and behavioral intervention with a control. The meta-analysis showed that cognitive and behavioral treatments had beneficial effects on fear of falling outcomes (lower score better) immediately after treatment (random-effects standardized mean difference [SMD]: −0.3, 95% confidence interval [CI] [−0.50, −0.10]) and at the longer term follow-up (random-effects SMD: −0.29, 95% CI [−0.49, −0.09]). Cognitive and behavioral treatments also showed a positive effect on falls efficacy outcomes (higher score better) immediately after treatment (fixed-effects SMD: 0.19, 95% CI [0.04, 0.34]) and over the longer term (fixed-effects SMD: 0.13, 95% CI [−0.00, 0.25]). However, the clinical significance of these effects on fear of falling and falls efficacy was unclear. Further work is required with best-practice comparators over a longer follow-up period.

Background: Ovarian cancer has the highest mortality rate among all gynecological cancers. However, early detection of the disease could improve patients' outcomes. This could be achieved by satisfying knowledge about the risk factors and symptoms of ovarian cancer. Thus, this study aimed to investigate the level of knowledge of Saudi women about the symptoms and risk factors of ovarian cancer. Methodology: A cross-sectional observational survey was carried out among literate females aged 18 years and above, in Saudi Arabia, using an online self-developed questionnaire that was distributed via a link to Google forms. Only completed surveys were included in the analysis. Results: A total of 473 females responded to this survey. Women who were proactive in talking with their doctors showed a significantly higher score (p value < 0.001). Participants who did not talk to their doctors about ovarian cancer showed a significantly lower score (p value < 0.001). Also, 89.8% of the females mentioned that they did not discuss ovarian cancer with their doctors on any previous visits, where 41.3% of the respondents mentioned that they did not believe that they were in danger, and 5.6% of the females mentioned that their doctors were too busy to talk with them. Conclusion: A poor level of knowledge, poor practices, and behavior toward ovarian cancer among females was observed in Saudi Arabia. Further studies are required to explore the reasons behind this poor knowledge about ovarian cancer.

ObjectiveTo assess the impact of COVID-19 second wave on quality of life (QoL) of Brazilian medical students.MethodsThe data from 210 medical students were collected through a web-based survey between February and March 2021. We assessed information about sociodemographic characteristics, health conditions, electronics tools-related to physical activity (PA-eTool), and health-associated QoL. Multiple linear regression was performed to identify the potential QoL predictors.ResultsThe psychological domain was the most affected, showing lower score during COVID-19 second wave. Being male was a positive predictor in the physical health domain. Spending too much time indoors and sexual minority-group membership were associated with lower perception on psychological well-being. Personal benefit from having PA-eTool accessed and higher income were positively associated with psychological and environmental domains, respectively, and in the overall QoL.ConclusionsPsychological well-being impairment is a long-term negative impact among Brazilian medical students during COVID-19. By evidencing that students’ QoL has been worsened in this global crisis, supportive interventions provided by community and universities are required to aid those vulnerable students facing mental health or QoL impairment.

Background This study aimed to investigate the prevalence of and the factors associated with the regular use of complementary therapies for Taiwanese patients with systemic lupus erythematosus (SLE). Methods In this cross-sectional study, 351 patients with SLE were consecutively recruited from a regional hospital in southern Taiwan from April to August 2019. Demographic and clinical information, including the use of different types of complementary therapies, was ascertained using a self-constructed questionnaire. Disease-specific quality of life was measured using the Lupus Quality of Life (LupusQoL) questionnaire. SLE disease activity was assessed using the rheumatologist-scored Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K). Factors associated with the regular use of complementary therapies were evaluated using multiple logistic regression analyses. Results Of the 351 patients with SLE, 90.3% were female, and 60.1% were ≥ 40 years of age. The prevalence of the regular use of any type of complementary therapy was 85.5%. The five most popular types of complementary therapy used were (1) fitness walking or strolling, (2) Buddhist prayer or attending temple, (3) vitamin consumption, (4) calcium supplementation, and (5) fish oil supplementation. Multiple logistic regression analyses revealed that the significant and independent factors associated with the regular use of complementary therapies in patients with SLE were age ≥ 40 years (adjusted odds ratio [aOR] 2.76, p = 0.013), nonoverweight or nonobesity (aOR 0.29, p = 0.004), engagement in vigorous exercise in the past year (aOR 4.62, p = 0.002), a lower SLEDAI-2 K score (aOR 0.90, p = 0.029), and a lower score in the physical health domain of the LupusQoL (aOR 0.57, p = 0.001). Conclusions A high prevalence of complementary therapy use in Taiwanese patients with SLE was observed. Rheumatologists should routinely ask patients about their use of supplements to minimize the risk of interaction with medical therapy.

This research evaluated the properties of cured chicken breasts of broiler chicken with different marketing ages (28, 30, 32, and 34 day). The water contents in the proximate compositions of the samples tended to decrease with increasing marketing age, while the protein content increased. The samples’ uncooked and cooked pH values, WHC, and cooking yield increased with increasing marketing age, however, the WHC and cooking yield were not significantly different between the 32 and 34 day samples (p &gt, 0.05). In the case of the color, the 34 day samples were significantly lower in terms of lightness, but significantly higher in redness and yellowness compared to the other samples (p &lt, 0.05). Although the shear forces of the 28–32 day samples were not significantly different (p &gt, 0.05), those of the 28 and 30 day samples were significantly lower than those of the 34 day sample (p &lt, 0.05). Furthermore, the aromatic profile (determined by principal component analysis) of the 34 day sample differed from that of the 28–32 day samples. Flavor evaluation of the cooked 30 and 32 day samples showed significant differences compared to the 28 and 34 day samples (p &lt, 0.05), and the texture evaluation showed that the 34 day sample obtained a significantly lower score than the 28 day sample (p &lt, 0.05). Overall, these results suggest that the current broiler marketing age of 32 day results in suitable quality properties for broiler cured chicken breast.

This study aimed to evaluate the general quality of life (QoL) of Brazilian vegetarians. A cross-sectional study was conducted with Brazilian vegetarian adults (18 years old and above). Individuals were recruited to participate in a nationwide online survey that comprised the WHOQOL-BREF as well as sociodemographic and characterization questions related to vegetarianism. The WHOQOL-BREF is composed of 24 items which are divided into four domains (domain 1: physical health, domain 2: psychological well-being, domain 3: social relationships, and domain 4: environment), plus two general items which were analyzed separately, totaling 26 items. The answers from the questionnaire were converted into scores with a 0–100 scale range, with separate analyses for each domain. Results were compared among groups based on the different characteristics of the vegetarian population. A total of 4375 individuals completed the survey. General average score results were 74.67 (domain 1), 66.71 (domain 2), 63.66 (domain 3) and 65.76 (domain 4). Vegans showed better scores when compared to the other vegetarians, except in domain four, where the statistical difference was observed only for semi-vegetarians (lower score). Individuals adopting a vegetarian diet for longer (&gt, 1 year) showed better results for domains one and two, with no difference for the other domains. Having close people also adopting a vegetarian diet positively influenced the results for all domains. On the other hand, it was not possible to distinguish any clear influence of the motivation for adopting a vegetarian diet on the scores’ results. Adopting a vegetarian diet does not have detrimental effects on one’s QoL. In fact, the more plant-based the diet, and the longer it was adopted, the better the results were.

Instant foods are now a part of Indian cuisine making cooking easier for households and encouraging entrepreneurs into the market who can add variety. Dosa is a common breakfast item which is made from rice and black gram in the ratio of 70:30 respectively and an approach was made to standardize the fermentation timings. The fermentation time of rice and black gram considered for standardization were 6, 12, 18, 24, 30, 36 and 42 hours at a constant temperature of 30 °C. The best fermentation time was selected based on sensory scores of different attributes like appearance, sourness, flavour, texture, taste and overall acceptance. The results showed that 12 hours of fermentation obtained highest scores for all sensory attributes that include appearance with 7.75, texture with 7.44, flavour with 7.50, taste with 7.63 and overall acceptance 7.69. The batter received lower score for sourness as the increase in time increased the sourness. Therefore, 12 hours of fermentation was found optimum to give best dosa batter.

Objective To analyse the profile of Family Doctors who gain access to positions, both to the general quota, as well those reserved for teaching tutors of Family and Community Medicine, by means of a relocation competition. Material and methods A descriptive observational study was conducted in which 2 comparison groups were established: A Non-Teaching group that did not include Family Doctors who did not request or gain access to tutor positions, and a Teaching group with those that gained access to positions reserved for tutors. The information was obtained from the marks of the relocation competition carried out in Galicia in 2018. A total of 426 General Practitioners that entered the examination were included, of which 301 were female (70.7%) and 125 (29.3%) males. The variables were the obtaining of a position reserved for tutor, gender, and the merits considered in the competition: professional experience, training, scientific publications, and Galician language. The non-parametric statistics tests of Mann-Whitney and Kruskal-Wallis were used, after checking for non-normal distribution. Results Statistically significant differences were found in the distribution by gender in favour of males in the Teaching group compared to the Non-Teaching group (P < .01). The Teaching group obtained better results in training and publications. The females obtained statistically significant results in their favour in the training variable, and the males in experience. Conclusions For the choice of teaching places in relocation interviews and examinations, publications and training had an important weighting; but, taking the gender perspective into account, a lower percentage of women had gained access to teaching positions due to having lower score in the experience category.

To assess neuropsychological performance among workers at a paint factory in Mexico City.During 2004 and 2005 we assessed the neuropsychological performance of 208 workers who were exposed to organic solvents at a paint factory, mainly toluene and xylene. We categorized workers into low and high exposure groups using a cumulative index for toluene, based on times spent in different tasks. We evaluated cognitive and motor functions with 13 neuropsychological tests.We found lower attention, longer time to complete the test β=5.5 (R2=12.3%), and a lower score in the motor-cognitive test β=-15.7 (R2=19.5%) in the high exposure group through multiple linear regression model analysis, with adjustment for age and education.Our results are similar to the ones reported in the literature, but the effects are less severe, probably due to lower exposure to organic solvents.Evaluar el desempeño neuropsicológico de los trabajadores de una fábrica de pintura en la Ciudad de México.Se evaluó el desempeño neuropsicológico de 208 trabajadores expuestos a disolventes orgánicos, principalmente tolueno y xileno, en una fábrica de pintura en la Ciudad de México durante 2004 y 2005. Se categorizaron en grupos de baja y alta exposición con un índice acumulado de tolueno con base en el tiempo empleado por actividad. Se evaluaron funciones motoras y cognitivas con 13 pruebas neuropsicológicas.Se registró un tiempo más largo para completar la prueba β=5.5 (R2=12.3%) y una puntuación baja en la prueba motor-cognitiva de β=- 15.7 (R2=19.5%) en el grupo de alta exposición en los modelos de regresión lineal múltiple, ajustados por confusores.Los presentes resultados son similares a los reportados en la literatura, aunque los efectos son menos graves, probablemente debido a la baja exposición.

This study examined the relationships between social media usage, acculturation and psychological well-being through a survey with 121 Chinese in New Zealand. The results showed that (1) higher use frequency of social media popular in New Zealand (NZ social media) was associated with higher score on identification with New Zealand (NZI) and lower score on identification with China (CNI), (2) the relationship between the use frequency of social media popular in CN (CN social media) and CNI or NZI was not statistically significant, (3) the use frequency of CN social media and NZ social media were significantly and positively correlated. (4) Both CNI and NZI were positively related to Happiness, but had no significant relationship with Depression, (5) the relationship between NZ social media use and Happiness was positively mediated by NZI. Implications for working with Chinese migrants and for future research were discussed.

There are many factors which contribute to a successful sports career in football. One of the most important ones is players’ comprehensive preparation which consists of motor, technico-tactical and psychical components. The study focuses on a selected psychical aspect and more precisely on the temperamental features that describe and explain relationship between a man and environment.The aim of the study was to determine and compare the level of highly qualified young footballers’ temperamental properties in relation to those of the average people of the same age. The subject of the research was 31 players of the Lech Poznań club (Polish champions U-17 from 2016). The research was carried out using the EAS-D questionnaire which consists of five scales: dissatisfaction, fear, anger, activity and sociability.In the conducted study, there was a statistically significant differentiation of the results between the respondents and the average people at the level of two temperamental traits such as fear (a lower score in football players) and activity (a higher score in tested football players compared to the average people of the same age).

This paper aimed at finding out and describe deeply the students’ writing skill and their mastery on descriptive and recount texts. This was a descriptive research type. There were 22 students at class VIII of Junior High School 2 Sintoga as respondents of the research. Writing tests on descriptive and recount texts were used to collect the data. The data were classified into excellent, good, fair, poor, and very poor by using Jacob’ theory and calculated the data on percentage by using formula Sudijono. It was found that the students got fair skill for both mean score of students based on component writing descriptive and recount texts (57.18 and 58.1). For the each component of genres, they got lower score on content, organization of text, vocabulary, and language use. On descriptive text, there were 16 students’ mastery on generic structure for beginning stage and 8 students for developing stage. Meanwhile, for generic structure of recount text 10 students were mastery on generic structure for beginning stage, 11 students for developing stage, and 1 student for consolidating stage. Most of students made the mistakes in orientation and events. Some students who did not give the information of the place (where), time (where), and the reason (why) clearly in the orientation. In the events, some students wrote their experience unchronologicaly. It is concluded that the students’ mastery on writing descriptive and recount texts are fair category. It implies that the students should improve their writing skill through building writing habit and English teacher should be able to find out effective techniques and strategies in teaching writing skills.

Objectives The purposeof this study was to evaluate the diagnostic accuracy of transthoracic ultrasound in patients with bronchiectasis and compare it with high-resolution computed tomography (HRCT) chest. Patients and methods Sixty-one patients with bronchiectasis underwent transthoracic ultrasound. Radiological severity of bronchiectasis was assessed using a modified Reiff score (number of lobes involved in six lobes multiplied by the degree of bronchial dilatation) (tubular=1, varicose=2, cystic=3). Transthoracic findings were compared with that of the HRCT and pulmonary function tests. Results Two patterns of sonographic abnormalities were detected: B-line pattern and c-profile (consolidation) pattern. The first was detected in 42 (68.8%) patients and the later was detected in seven (11.1%) patients. Twelve (19.7%) patients had normal sonographic examination. There was significant positive correlation between severity of bronchiectasis by the modified Reiff score pattern. The highest score correlated with the c-profile pattern and the lower score correlated with the B-line pattern (P≤0.001), while patients with very low score (≤20) had normal examination. There was a negative correlation between HRCT score, ultrasound pattern, and Partial pressure of oxygen tension (PO2) (P≤0.001). Conclusion Bronchiectasis can be assessed by chest ultrasound; pattern of sonography is correlated to the radiological severity and functional impairment of the disease.

Background: The loss of functional capacity (FC) by the elderly compromises autonomy and interferes with quality of life (QL). Objective: To evaluate the FC score and the QL of elderly people living in a community and to assess the influence of age and gender on FC and QL. Methodology: Quantitative, exploratory, descriptive research of an applied nature. Sixty-seven elderly people were cared for during the consultations scheduled in a family health unit. A sociodemographic and health data form, basic activities of daily living (BADL), instrumental activities of daily living (IADL) and QL evaluation instruments were used. Results: For the BADL, there was a lower score only for continence (54; 80.6%). The majority are independent (63; 94%) for IADL, mean QL score was 16.1 ± 1.9. There was a significant correlation between the variables age and BADL and between IADL and QL. Males obtained a higher mean score (μ = 26.26) for FC, and for QL, there was no significant difference (p > 0.05). Conclusion: Age and gender were associated with FC and QL of the elderly

Objectives To test 9 + screening batterie's intra-rater reliability, to provide indicative data of elite handball players, and to analyze difference between age, playing positions and level of play. Design Descriptive study. Setting Icelandic elite male handball players. Participants 182 elite male handball players. Main outcome measures Nine + screening battery. Results Reliability test: Intra-class correlation for the total score was 0.95. The correlation of each of the test factors varied from 0.63 to 0.91. The mean total score was 22.3 ± 2.9 (95%CI 16.7–28.1), with no difference in total score comparing players age or level of play. Goalkeepers displayed a higher total score than other players (F3,151 = 5.75, p = 0.001). Junior players had a lower score than senior players in tests measuring abdominal strength and core stability; Test 5; │2(3, 182) = 41.5, p Conclusions The 9+ intra-rater reliability was acceptable for the total score and individual tests. Age-related differences were provided in many individual tests.

Introduction/Objective Presbycusis, elderly hearing loss, is a progressive, bilateral sensoryneural hearing loss characterized by reduced sensitivity of hearing and understanding speech in a noisy environment, thereby impairing communication and inducing anxiety. The objective was to examine the impact of hearing amplification on subjective hearing disability assessment and anxiety in people with presbycusis. Method Sample consisted of 120 respondents aged 47-85 with presbycusis, 60 subjects with and 60 subjects with no auditory amplification. The standardized Hearing Handicap Inventory for the Elderly and the Spielberger State Trait Anxiety Inventory were used in the study. Results In subjects with hearing amplification, test/retest has no statistical significance in the STAI and HHIE scales and subscales, except the HHIE-S (p = 0.004) with a lower score on the retest. Respondents in whom hearing amplification was performed during the year was statistically significant in HHIE (p = 0.016), HHIE-S (p = 0.004) and STAI-S (p = 0.029) which speaks of favorable effect of hearing amplification. In the group with no hearing amplification, statistical significance was observed in relation to the HHIE scores (p = 0.002), HHIE-E (p = 0.000), STAI (p = 0.000), STAI-S (p = 0.001) and STAI-T (p = 0.001) and it was noticed that anxiety, loss of emotional contacts, and more pronounced degree of hearing impairment were the result of unassisted hearing rehabilitation. Conclusion Audiological practice should include tests for assessment of hearing disability and anxiety in order to preserve health in later life. Uvod/Cilj Presbiakuzija, staračka nagluvost, jeste progresivni, bilateralni senzorineuralni gubitak sluha koji karakteriše smanjena osetljivost sluha i razumevanja govora u bučnoj sredini, čime narušava komunikaciju i značajno utiče na ispoljavanje anksioznosti. Cilj rada je bio ispitati uticaj slušne amplifikacije na ispoljavanje slušne onesposobljenosti i anksioznosti kod osoba sa presbiakuzijom. Metode Uzorak su činila 120 ispitanika oba pola, starosti 47-85 godina sa presbiakuzijom, 60 ispitanika sa slušnom amplifikacijom i 60 bez sprovedene amplifikacije. U istraživanju su korišćene standardizovane skale Hearing Handicap Inventory for the Elderly i Spielberger State Trait Anxiety Inventory za procenu prisustva anksioznosti. Rezultati Kod ispitanika sa slušnom amplifikacijom test/retest nema statističke značajnosti u rezultatima skala i podskala STAI i HHIE, sem HHIE-S (p = 0,004) sa manjim rezultatom na retestu. Kod ispitanika kod kojih je tokom godine sprovedena slušna amplifikacija zapažena je statistički značajna razlika u HHIE (p = 0,016), HHIE-S (p = 0,004) i STAI-S (p = 0,029), što govori o povoljnom uticaju slušne amplifikacije. U grupi bez slušne amplifikacije zapažena je statistička značajnost u odnosu na rezultate HHIE (p = 0,002), HHIE-E (p = 0,000), STAI (p = 0,000), STAI-S (p = 0,001) i STAI-T (p = 0,001) i zapaženo je da su anksioznost, gubitak emocionalnih kontakata i izraženiji stepen slušne onesposobljenosti posledica nesprovedene slušne rehabilitacije. Zaključak U audiološku praksu bi trebalo uvesti testove za procenu slušne onesposobljenosti i anksioznosti u cilju očuvanja zdravlja u kasnijem životnom dobu.

Introduction: Amyotrophic lateral sclerosis (ALS) is a rare, fatal and progressive neurodegenerative disease which begins due to selective damage to motor neurons. The disease begins as spinal (spinal cervical, spinal lumbosacral and spinal thoracic form) and bulbar form. The diagnosis is set by using revised El Escorial criteria. Aim: Aims of the paper were determining demographic characteristics of ALS patients, category of the disease and functional disability of patients using Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R). Material and methods: In this cross-sectional study, medical histories of ALS patients, which were diagnosed at the Clinic of Neurology of the University Clinical Center of the Republic of Srpska, were examined. Demographic characteristics, initial form of the disease, category of disease (using revised El Escorial criteria), functional disability (using ALSFRS-R) and dia-gnostic delay were analyzed. Results: This study included 30 patients, 20 (67%) were male, 10 (33%) were female. The ALS began at 57 ± 12 years, and average diagnostic delay was 10 months. The disease started as a spinal form in 26 (87%) patients, out of which 13 (43%) had spinal cervical, 12 (40%) spinal lumbosacral and 1 (3%) spinal thoracic form of disease. The initial bulbar form was reported in 4 (13%) patients. The average ALSFRS-R score was 33,5. Patients with a spinal lumbosacral form of the disease had statistically significant lower score of ALSFRS-R (p = 0.048) which indicates bigger functional motoric disablement, compared to other forms of disease. Low values of ALSFRS-R are correlated with more accurate diagnosis, according to the revised El Escorial criteria. Conclusion: Results of this study showed that ALS is more frequent and occurs earlier in men. The disease most commonly started as spinal cervical form. Patients with spinal lumbo-sacral form of the disease had significantly lower values of ALSFRS-R which indicates a faster progression of the disease. As patients acquire lower ALSFRS-R scores and greater disability, they progress to the definite ALS category.

The foaming properties of milk manufactured under different conditions were investigated using a Dynamic Foam Analyzer 100. The sensory characteristics of foamed milk were evaluated by descriptive analysis by means of a trained panel. Milk homogenized at 25 MPa had significantly smaller bubble size and higher foam stability than milk homogenized at 7 MPa. Foamed milk prepared from milk homogenized at 25 MPa had significantly higher sensory evaluation scores for ‘fineness’, ‘smoothness’, ‘elasticity’, and ‘body’, and a significantly lower score for ‘meltability’ compared to foamed milk prepared from milk homogenized at 7 MPa. Milk heated at 120 °C had a significantly smaller bubble size than milk heated at 140 °C. Foamed milk prepared from milk heated at 120 °C had a significantly higher score for ‘sweetness’ than did foamed milk prepared from milk heated at 140 °C. In addition, milk heated using infusion-type pasteurizer had a significantly smaller bubble size compered to milk heated using a plate-type pasteurizer. Foamed milk prepared from milk heated using an infusion-type pasteurizer had significantly higher scores for ‘fineness’ and ‘smoothness’, and a significantly lower score for ‘cooked-flavor’ compared to foamed milk prepared from milk heated using a plate-type pasteurizer.

People's emotional appearance differs due to national, cultural, geographical and educational backgrounds. Few studies have examined the impact of odors to regulate negative emotion for the Asian. In this research, we evaluate EEG signals to demonstrate the impact of odors to regulate negative emotion for Asians. The results show that, during the tension, both FA groups witness a significant increase and beta wave average power spectrum (T8) experienced a slight reduction caused by lavender odor. However, both citrus and peppermint odors cause a significant increase in FA groups and beta wave average power spectrum (T7 and T8). During the depression, the citrus and mint odors cause a more significant increase in positive FA and beta wave average power spectrum (T7) , while the lavender treatment has no significant effect. For the tension-anxiety (T/A) and depression-dejection (D/D), both FA groups get a lower score after odor treatment but not all reach a statistical significance. Both EEG and POMS data suggests that lavender odor produces a higher valance and a lower arousal which indicates that the lavender odor has a better effect on relieving tension. While the citrus and mint odors produce a higher valance and arousal of emotion which indicates that these two odors have a greater effect on mitigating depression.

Previous studies have been limited by not directly comparing the quality of public and private CHCs using a standardized patient method (SP). This study aims to evaluate and compare the quality of the primary care provided by public and private CHCs using a standardized patient method in urban China. We recruited 12 standardized patients from the local community presenting fixed cases (unstable angina and asthma), including 492 interactions between physicians and standardized patients across 63 CHCs in Xi’an, China. We measured the quality of primary care on seven criteria: (1) adherence to checklists, (2) correct diagnosis, (3) correct treatment, (4) number of unnecessary exams and drugs, (5) diagnosis time, (6) expense of visit, (7) patient-centered communication. Significant quality differences were observed between public CHCs and private CHCs. Private CHC physicians performed 4.73 percentage points lower of recommended questions and exams in the checklist. Compared with private CHCs, public CHC providers were more likely to give a higher proportion of correct diagnosis and correct treatment. Private CHCs provided 1.42 fewer items of unnecessary exams and provided 0.32 more items of unnecessary drugs. Private CHC physicians received a 9.31 lower score in patient-centered communication. There is significant quality inequality in different primary care models. Public CHC physicians might provide a higher quality of service. Creating a comprehensive, flexible, and integrated health care system should be considered an effective approach towards optimizing the management of CHC models.

Purpose Transanal single-stage endorectal pull-through (TERPT) procedure for patients with Hirschsprung disease (HD) has favorable outcomes, with a lower complication rate. Nevertheless, various degrees of bowel dysfunction and fecal incontinence can persist for a long time in some patients. The aim of this study was to assess the mid- and long-term outcomes of TERPT performed during the infantile period after the completion of toilet training. Methods We retrospectively reviewed 82 patients aged ≥4 years who underwent TERPT during the infantile period after the pathological diagnosis of HD between 2001 and 2013. Functional outcomes were investigated according to the answers of the Bowel Function Score (BFS) questionnaire, a previously validated 7-item questionnaire about bowel habits. Normal values were obtained in a previous study on BFS for children in Western countries, and a one-sample t-test was used for statistical analysis. Results Overall, BFS was similar in all investigated age groups. On comparing fecal soiling and social problems between the HD and normal populations, a lower score at an early age in patients with HD was noted; however, the scores became similar when the patients were 7 years of age. Stool frequency decreased continuously but was not significantly different between the 2 groups. Conclusion The functional outcomes of TERPT performed during the infantile period, after completing toilet training, were similar to that of the normal population. In most cases, uncomfortable symptoms were diminished and functions improved with age.

PURPOSE: To develop a protocol for abdominal imaging on a prototype 0.55 T scanner and to benchmark the image quality against conventional 1.5 T exam. METHODS: In this prospective IRB-approved HIPAA-compliant study, 10 healthy volunteers were recruited and imaged. A commercial MRI system was modified to operate at 0.55 T (LF) with two different gradient performance levels. Each subject underwent non-contrast abdominal examinations on the 0.55 T scanner utilizing higher gradients (LF-High), lower adjusted gradients (LF-Adjusted), and a conventional 1.5 T scanner. The following pulse sequences were optimized: fat-saturated T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and Dixon T1-weighted imaging (T1WI). Three readers independently evaluated image quality in a blinded fashion on a 5-point Likert scale, with a score of 1 being non-diagnostic and 5 being excellent. An exact paired sample Wilcoxon signed-rank test was used to compare the image quality. RESULTS: Diagnostic image quality (overall image quality score ≥ 3) was achieved at LF in all subjects for T2WI, DWI, and T1WI with no more than one unit lower score than 1.5 T. The mean difference in overall image quality score was not significantly different between LF-High and LF-Adjusted for T2WI (95% CI − 0.44 to 0.44; p = 0.98), DWI (95% CI − 0.43 to 0.36; p = 0.92), and for T1 in- and out-of-phase imaging (95%C I − 0.36 to 0.27; p = 0.91) or T1 fat-sat (water only) images (95% CI − 0.24 to 0.18; p = 1.0). CONCLUSION: Diagnostic abdominal MRI can be performed on a prototype 0.55 T scanner, either with conventional or with reduced gradient performance, within an acquisition time of 10 min or less.

Objective: Multiple relapses over time are common in both affective and non-affective psychotic disorders. Characterizing the temporal nature of these relapses may be crucial to understanding the underlying neurobiology of relapse.Materials and Methods: Anonymized records of patients with affective and non-affective psychotic disorders were collected from SA Mental Health Data Universe and retrospectively analyzed. To characterize the temporal characteristic of their relapses, a relapse trend score was computed using a symbolic series-based approach. A higher score suggests that relapse follows a trend and a lower score suggests relapses are random. Regression models were built to investigate if this score was significantly different between affective and non-affective psychotic disorders.Results: Logistic regression models showed a significant group difference in relapse trend score between the patient groups. For example, in patients who were hospitalized six or more times, relapse score in affective disorders were 2.6 times higher than non-affective psychotic disorders [OR 2.6, 95% CI (1.8–3.7), p < 0.001].Discussion: The results imply that the odds of a patient with affective disorder exhibiting a predictable trend in time to relapse were much higher than a patient with recurrent non-affective psychotic disorder. In other words, within recurrent non-affective psychosis group, time to relapse is random.Conclusion: This study is an initial attempt to develop a longitudinal trajectory-based approach to investigate relapse trend differences in mental health patients. Further investigations using this approach may reflect differences in underlying biological processes between illnesses.

Aim: It has been suggested that adolescents diagnosed with ADHD have an unhealthier diet compared to their peers without ADHD. The association between chemosensation (smell and taste) and dietary patterns remains unknown. The aim is to investigate unhealthy food preferences and food neophobic behaviour among adolescents diagnosed with ADHD. Additionally, it is to investigate the relationship between dietary patterns and chemosensory function. Methods: We enrolled 36 adolescents with and without ADHD to complete a food item and a food neophobia questionnaire and to undergo chemosensory testing. Results: Adolescents with ADHD performed significantly worse on both chemosensory tests compared to the non-ADHD group. No difference in food preferences nor food neophobia was found between the two groups. Conclusion: Adolescents with ADHD have a lower score on chemosensory tests compared to their peers, suggesting impaired chemosensory function. No differences in dietary preferences nor food neophobia were seen between the two groups.

En el ambiente altamente tecnológico y visual en el que se desarrolla el proceso educativo, constituye una necesidad fundamental desarrollar la competencia visual de los educadores, pues así se garantiza que adquieran las habilidades para el manejo efectivo de la información visual. Este artículo presenta el resultado de un estudio piloto realizado con educadores de una institución educativa que fueron parte de un proceso formativo donde se plantea desarrollar 6 competencias, las cuales promueven en conjunto el desarrollo la competencia visual. En este diseño cuasi experimental pretest postest de un solo grupo, se aplicó un muestreo no probabilístico por conveniencia. En la muestra participaron 43 educadores, cuyo desempeño fue evaluado mediante un test de 45 preguntas. Los resultados del pretest y postest de cada competencia se analizaron y se presentan por separado. Después de realizar el análisis descriptivo de las variables, el estudio de normalidad y el contraste para muestras relacionadas, se observa que hay diferencias estadísticamente significativas en el puntaje de las competencias 1, 2, 5 y 6. Sin embargo, se evidencia un retroceso en el puntaje de la competencia 3 y ninguna diferencia en la media de la competencia 4. Educational process takes place in a highly technological and visual environment, so it is a fundamental need to develop the educator’s visual competency because this ensures they acquire the skills to manage the visual information effectively. This article reports the results of a pilot study that was conducted with educators of one educational institution who attended a training process to develop 6 competencies, which together promote the development of visual competency. In this quasi-experimental one-group pretest-posttest design, a convenience sampling method was applied. The sample consisted of 43 educators, whose performance was assessed through a test of 45 questions. The pretest and posttest data of each competence were analyzed and reported separately. The descriptive statistics of the variables, the normality test, and the parametric and non-parametric hypothesis tests show that there are statistically significant differences in the scores of competencies 1, 2, 5, and 6. However, findings indicate that there is a lower score in the posttest of competence 3, and the mean of competence 4 is the same in the pretest and the posttest

Body concerns and stress-related disorders are increasing in the younger population in a wide range of nations. Studies find links between both self-worth, exercise dependence, and self-esteem in relation to stress, but few have considered all three variables in relation to one another. The present study explored whether the co-appearance of high levels of psychological distress, and low levels of self-esteem may be a vulnerability factor for developing exercise dependence by studying the links between self-esteem, psychological stress, and exercise dependence. A standardized cross-sectional questionnaire was completed by 203 regular exercisers attending two gyms (mean age: 35.9 years). The variables self-esteem, psychological distress, and exercise dependence were all significantly correlated with each other, even after weekly exercise amount, age, and gender had been accounted for. Those who exercised for more than 9 h per week had a significantly higher score on stress and exercise dependence symptoms, and a lower score on self-esteem compared with the remaining groups. One could hypothesize that low self-esteem is a vulnerability factor and high psychological stress a maintenance factor for an exercise-dependent person. It is argued that more focus should be directed toward the negative consequences of excessive exercise.