5-point Scale Research Articles

Cross-cultural adaptation of the Czech version of the core outcome measures index for low back and neck pain.

The Core Outcome Measures Index (COMI) is a short, multidimensional instrument translated into several languages that covers five domains recommended in the assessment of outcome in patients with low-back and neck pain. The purpose of this study was to cross-culturally adapt the COMI from English to Czech language and to test the face and construct validity and reproducibility of its results in patients with low-back and neck pain. Participants (n = 125) were included from primary and secondary care. The participants reported moderate pain and disability levels. All participants filled in the COMI forms before and after surgery. Descriptive statistics, Wilcoxon paired test, Crombach's alpha, principal component analysis and information entropy calculation were used. The instrument was successfully forward and back-translated. It can be seen that the questionnaire applied as part of our intervention study produces answers with a sufficient degree of variability and with a satisfactory degree of representation of extreme values. It can be also seen that the questionnaire can diagnose an objectively occurring change associated with the surgeon within the intervention procedure. Our other findings support the idea of ​​a possible reduction in the number of questions that measure the same latent variable. Our investigations also showed that it is possible to reduce the range of the point scale of the perception of pain to 5 degrees of intensity and thus unify the range with the other questions. The Czech COMI shows acceptable properties and is thus suitable to use as a short instrument for measuring important domains in patients with low-back and neck pain.

Consensus palliative care referral criteria for people with chronic obstructive pulmonary disease

ObjectivePeople with advanced chronic obstructive pulmonary disease (COPD) have substantial palliative care needs, but uncertainty exists around appropriate identification of patients for palliative care referral.We conducted a Delphi study of...

Important Notes for Preventing Entrapment of Distal Filter-based Embolic Protection Device in Carotid Artery Stenting.

Failure to retrieve a distal filter-based embolic protection device (EPD) is a potential complication of carotid artery stenting. This may be caused by trapping of the proximal marker of the EPD within the stent tip marker. Maintaining an adequate distance between the two can prevent this. We examined the behavior of several stent-filter-based EPD combinations, focusing on their propensity to become trapped or disengage in vitro. Four physicians subjectively rated the force required to result in trapping using a 5-point scale. Moreover, the force required to disengage trapped devices was evaluated. The Casper stent-Spider FX EPD combination was difficult to disengage when entrapment occurred, which suggested that this phenomenon tended to occur with this combination. The stent tip marker of the closed-cell stents advanced as they shortened, which may be a unique feature of closed-cell stents. Although trapping is uncommon, it can cause serious complications. To prevent these complications, device characteristics should be well understood before they are used in patients.

팀티칭 보육교사의 교육과정운영 자율성과 동료교사의 사회적지지가 놀이지원역량에 미치는 영향

Objectives The purpose of this study is to examine the effect of team teaching childcare teachers' curriculum operation autonomy and fellow teachers' social support on play support competency. Methods To this end, a survey was conducted among 307 childcare teachers currently operating team-teaching classes at childcare centers in the Busan and Gyeongnam regions. The collected data were analyzed using SPSS 24.0, employing descriptive statistics, correlation analysis, and multiple regression analysis. Results First, team teaching childcare teachers' curriculum management autonomy averaged 4.09 on a 5-point scale, the social support from fellow teachers averaged 4.02, and the ability to support play averaged 4.16. Second, it was found that there are significant correlations between team teaching childcare teachers' curriculum operation autonomy, fellow teachers' social support, overall play support competency, and all its sub-factors. Third, the curriculum operation autonomy of team teaching childcare teachers and fellow teachers' social support explained 49.1% of cognitive competency, 44.1% of affective competency, and 57.7% of practical competency, which are sub-factors of play support competency. Common factors affecting these sub-factors included a child-centered play environment and interactions, collaboration and participation with families and the community, flexible daily routines, and evaluative support, with evaluative support being the most explanatory. Conclusions The meaningful play environment and interactions, along with reflective self-assessment by educators and recognition and praise from peers, indicate the potential for enhancing the play support capabilities of childcare teachers. Therefore, efforts to analyze and support the team-teaching environment of childcare teachers implementing revised educational curricula are necessary to enhance their play support capabilities.

Patient-reported data on the severity of Von Willebrand disease.

The severity of Von Willebrand disease (VWD) is currently based on laboratory phenotype. However, little is known about the severity of the patient's experience with the disease. The most recent VWD guidelines highlight the need for patient-reported outcomes (PROs) in VWD. The study aimed to investigate the patient-perspective on VWD severity and to identify key factors that determine the severity of disease experienced by patients. Patients participated in a nationwide cross-sectional study on VWD in the Netherlands (WiN-study). Patients filled in a questionnaire containing questions on the experienced severity of VWD (4-point scale), bleeding score (BS) and quality of life (QoL). We included 736 patients, median age of 41.0 years (IQR 23.0-55.0) and 59.5% were women. A total of 443 had type 1, 269 type 2 and 24 type 3 VWD. Self-reported severity of VWD was categorized as severe (n=52), moderate (n=171), mild (n=393) or negligible (n=120). Classification by historically lowest FVIII:C levels<0.20 IU/mL as a proxy for severe VWD aligned with patient-reported severity classification with a 72% accuracy. Type 3 VWD (OR=4.02, 95%CI: 1.72-9.45), higher BS (OR=1.09, 95%CI: 1.06-1.11), female sex (OR=1.36, 95%CI: 1.01-1.83), haemostatic treatment in the year preceding study inclusion (OR=1.53, 95%CI: 1.10-2.13) and historically lowest VWF:Act levels (OR=0.26, 95%CI: 0.07-1.00) were independent determinants of patient-reported severity. This study shows that patient-reported data provide novel insights into the determinants of experienced disease severity. Our findings highlight the need for studies on PROs with validated questionnaires to assess the burden of VWD.

Ultrasound-guided Genicular Nerve Block in Patients Undergoing Knee Arthroscopy: A Randomized Controlled Trial

This study was to investigate the efficacy of ultrasound-guided genicular nerve block for patients who underwent knee arthroscopy. Patients were randomized into two groups: 1. nerve block group: ultrasound-guided genicular nerve block (superomedial, superolateral and inferomedial genicular nerve, 2-ml 0.5% ropivacaine each nerve.) prior to the general anesthesia, 2. control group: no intervention prior to the general anesthesia. The measurements were pain severity at 3,6, 12, 24, 48, and 72 hours after surgery at rest and at activity(Pain severity was primary outcome at 3 hours after surgery at rest); the time for first ambulation; straight leg raise; mechanical pain threshold of the block areas; time of the surgery, anesthesia and extubation; the use of analgesics in the perioperative period and 72 hours after the surgery; the number of patients awakening from pain on the first two nights after the surgery; the length of hospital stay; postoperative adverse effects. The pain severity was performed by VAS (A 10-point visual analogue scale, 0 points painless, 10 points severe pain) and median (interquartile range; IQR). A total of 70 patients (median age: 53 y, 32 men; 35 per group) were included. Compared to the control group, the nerve block group had a lower pain VAS score at rest (2[2-2] vs. 3[2-4], P&lt;0.01) at 3 hours, and lower pain VAS score at rest persisted for 24 hours and activity persisted for 12 hours after the surgery, also had lower intraoperative dosage of sufentanil (20±4.8 vs. 28.5±5.1 mg; P&lt;0.001), lower requirement for analgesics for pain and lower PONV (postoperative nausea and vomiting) throughout the 72-hour observation period. There were no significant difference for the incidence of postoperative adverse effects and straight leg raise. In conclusion, ultrasound-guided genicular nerve block could reduce the pain severity after knee arthroscopy and decrease the use of intraoperative sufentanil without affecting motor function.

Effect of preoperative oral carbohydrate on the postoperative recovery quality of patients undergoing daytime oral surgery: a randomized controlled trial

BackgroundPreoperative oral carbohydrate intake can improve the postoperative recovery of fasting patients in many kinds of surgeries; however, the effect of carbohydrates on patients undergoing daytime oral surgery is still unclear. This study was designed to evaluate the effect of preoperative oral carbohydrate intake on the quality of recovery of patients undergoing daytime oral surgery using the quality of recovery-15 (QoR-15) questionnaire.MethodsNinety-two patients scheduled for daytime oral surgery were randomly allocated to the midnight fasting group (F group, n = 45) or the carbohydrate-Outfast loading group (O group, n = 47). Participants in the F group fasted from midnight the day before surgery. Patients in the O group also fasted but received the Outfast drink (4 ml/kg) 2–3 h before the induction of anesthesia. QoR-15 questionnaire, patient well-being, and satisfaction were assessed before anesthesia induction and 24 h after surgery. Perioperative blood glucose, postoperative exhaust time, and adverse events were also recorded.ResultsThe QoR-15 scores were significantly higher in the O group than in the F group preoperatively and postoperatively. Seven parameters representing patient well-being evaluated on a numeric rating scale (NRS, 0–10) were lower in the O group than in the F group postoperatively, except for the hunger and sleep quality scores. Patient satisfaction scores on a 5-point scale were higher in the O group than in the F group preoperatively and postoperatively. Meanwhile, the postoperative exhaust time was significantly shorter in the O group compared to the F group, while there were no significant differences in blood glucose concentrations between two groups.ConclusionsPreoperative oral carbohydrate intake could improve postoperative recovery quality, well-being, and satisfaction of patients undergoing daytime oral surgery 24 h after surgery, and may serve as a treatment option for patients undergoing daytime oral surgery.Trial registrationThis trial was registered in the Chinese Clinical Trial Registry (ChiCTR2100053753) on 28/11/2021.

Methodological Variations to Explore Conflicting Results in the Existing Literature of Masking Smile Judgment.

Although a smile can serve as an expression of genuine happiness, it can also be generated to conceal negative emotions. The traces of negative emotion present in these types of smiles can produce micro-expressions, subtle movements of the facial muscles manifested in the upper or lower half of the face. Studies examining the judgment of smiles masking negative emotions have mostly employed dichotomous rating measures, while also assuming that dichotomous categorization of a smile as happy or not is synonymous with judgments of the smile's authenticity. The aim of the two studies was to explore the judgment of enjoyment and masking smiles using unipolar and bipolar continuous rating measures and examine differences in the judgment when instruction varied between judgments of happiness and authenticity. In Experiment 1, participants rated smiles on 7-point scales on perceived happiness and authenticity. In Experiment 2, participants rated the smiles on bipolar 7-point scales between happiness and a negative emotion label. In both studies, similar patterns were observed: faces with traces of fear were rated significantly less happy/authentic and those with traces of anger in the brows were rated significantly happier/more authentic. Regarding varied instruction type, no effect was found for the two instruction types, indicating that participants perceive and judge enjoyment and masking smiles similarly according to these two instructions. Additionally, the use of bipolar scales with dimensions between a negative emotion label and happiness were not consistently effective in influencing the judgement of the masking smile.

Development of quality indicators for hypertension management at the primary health care level in South Africa.

Despite many quality initiatives at the primary health care (PHC) level, little is known about the actual quality of care of patients diagnosed with hypertension in South Africa. This study aimed to develop quality indicators for hypertension management at the PHC level to improve the quality of care and patient outcomes. The RAND/UCLA Appropriateness Method, comprising two rounds, was used to develop clear, appropriate, and feasible evidence-based quality indicators for hypertension. In Round 1, a 9-point scale was used by a panel of 11 members to rate clarity and appropriateness of 102 hypertension quality indicator statements, grouped under 9 dimensions of quality hypertension management, using an online MS Excel® spreadsheet. In Round 2, 9 of the same panellists discussed all indicators and rated their appropriateness and feasibility during a remote online, interactive face-to-face MS Teams® meeting. Statements rated ≥7-9 with agreement were defined as either appropriate or feasible. The panel rated 46 hypertension quality indicator statements ≥7-9 with agreement for the appropriate and feasible measurement of the management of hypertension: monitoring (n = 16), review (n = 5), lifestyle advice (n = 9), tests (n = 7), intermediate outcomes (n = 6), referrals (n = 2) and practice/facility structures (n = 1). No indicator statements were rated both appropriate and feasible for measuring blood pressure levels and treatment. If applied, these indicators would improve monitoring and management of patients with hypertension, patient outcomes, and data quality in South Africa and result in more efficient use of scarce resources. This study can be replicable for improving care of other non-communicable diseases across Africa.

Limited utility of subendometrial enhancement in assessing the interface between the endometrium and myometrium

This study was conducted to re-evaluate the utility of subendometrial enhancement (SEE) in assessing the interface between the endometrium and myometrium. In total, 110 women who underwent pelvic magnetic resonance imaging (MRI) for non-endometrial gynecologic diseases were enrolled in this prospective study. Two radiologists independently assessed the presence or absence of subendometrial enhancement (SEE) on dynamic contrast-enhanced (CE) MRI. A subgroup analysis was performed to evaluate the impact of menstrual status on the detection of SEE. Identified areas of SEE were rated using a 4-point Likert scale to determine their reliability in assessing the interface between the endometrium and myometrium. SEE was identified in 44.5% (49/110) of cases by radiologist 1 and in 39.1% (43/110) by radiologist 2. A subgroup analysis indicated no significant differences in the detection of SEE based on menstrual status. The identified areas of SEE were deemed reliable for assessing the interface between the endometrium and myometrium in 24.5% (12/49) of the cases evaluated by radiologist 1 and in 32.6% (14/43) of those evaluated by radiologist 2. Among the 110 women studied, reliable areas of SEE for assessing the interface between the endometrium and myometrium were observed in 10.9% (n = 12) by radiologist 1 and 12.7% (n = 14) by radiologist 2. The evaluation of SEE using dynamic CE MRI may be limited in its ability to assess the interface between the endometrium and myometrium.

Function-based risk reduction intervention for lifestyle-related disorders among inactive 40-year-old people: a pilot randomised controlled trial

Background Interventions for preventing or reducing the development of lifestyle-related disorders should be investigated as these conditions are becoming increasingly prevalent and having large effects on quality of life and life expectancy globally. The aim of this pilot study was to prepare for a full-scale randomised controlled trial by evaluating the short-term changes resulting from a function-based preventive intervention aimed at lifestyle-related disorders on a small group of physically inactive 40-year-old people. Change in objectively measured physical activity, functional capacity according to a risk profile, and goal attainment were main outcomes.MethodsParticipants (n = 27) underwent functional examinations including tests of fitness, strength, mobility, balance, and posture as well as standard medical examinations including weight measures, blood pressure and blood tests and were randomised to two groups. The intervention group (n = 15) received feedback from all the examinations and lifestyle counselling based on a functional profile. The control group (n = 12) received feedback only from the standard medical examination. Follow-up was at 3–4 months. Changes in physical activity measured with accelerometers, functional levels on the functional profile, goal attainment and subjective assessments of health-related quality of life, motivation, function, and physical activity were examined, as were standard medical parameters.ResultsChange in mean time in moderate or more intense physical activity was 9 min higher in the intervention group (95% confidence interval -6.35, 24.51) and change in sedentary time was 42 min lower (-95.24, 11.32). The intervention group showed a higher increase in motivation for change 1.58 on 10-point scale (0.20, 2.97) and indicated more improvement on the functional risk levels concerning fitness (-0.06, 0.90). Correlation between objectively measured and self-assessed physical activity and function increased after the intervention. Most participants in the intervention group achieved some or all of their goals.ConclusionsThis small-scale pilot intervention with functional examinations and lifestyle counselling showed positive tendencies for change in short-term physical activity level. It seemed to lead to better understanding of personal functional capacity and increased motivation for lifestyle changes. Setting and fulfilling meaningful goals for lifestyle-related changes seemed to influence levels on the functional profile in positive directions. Research on larger and more diverse populations will be necessary to better understand the implications of the intervention.Trial registrationClinicalTrials.gov: NCT05535296 first posted on 10/09/2022.

Organizational health literacy in German hospitals: a cross-sectional survey among hospital managers

BackgroundOrganizational health literacy (OHL) describes conditions and measures in healthcare institutions to enable patients to make good health-related decisions. By providing easy access to and appropriate communication of understandable information to use and navigate the facility, healthcare organizations can contribute to strengthening patients’ health literacy and self-management. The extent of OHL implementation in German hospitals remains largely unknown. This study aims to fill this gap in our knowledge by investigating OHL-related activities reported by hospital managers.MethodsBetween November and December 2022, we conducted a national online survey among medical, nursing and administrative hospital managers with hospitals that operate more than 50 beds. The data were collected via the health literate health care organization ten item questionnaire (HLHO-10) and supplemented by sociodemographic questions and an open-ended question. We applied variance and correlation analyses to investigate the data.ResultsOf 3,301 invited hospital managers, 371 participated in the survey (response rate 11%). The overall mean score for HLHO-10 was 4.6 (SD = 1.1) on a 7-point Likert scale, indicating a moderate level of OHL implementation. Hospital managers stated that hospitals concentrate on helping patients find their way around and communicating the costs of treatment transparently and clearly; conversely, that active patient participation in the design and evaluation of health information is rare in care settings, and that health information is seldom provided to patients through a range of media. For the practical implementation of the OHL, most hospital managers mentioned activities regarding communication standards, such as providing information materials.ConclusionsGiven their unique position as hubs of human interaction, hospitals provide an ideal opportunity to promote the adoption of OHL. By actively involving patients, hospitals can better tailor their approaches to meet patient needs and preferences. Compared to studies from oncology centres in Germany and 20 Italian hospitals, the average HLHO-10 score of this study is lower. While some aspects of OHL are already embedded in inpatient care, it is imperative that OHL is thoroughly embedded in the hospitals’ organizational culture and plays a fundamental role in the daily operations of the institution. This could be done, for instance, by more explicitly addressing the topic of health literacy in staff communication training.

Agri-Preneurial Resilience and Success: The Correlation and Demographic Characteristics of Smallholders in South Africa

The incentives and subsidies needed to stimulate growth, resilience, and success in agri-preneurial businesses will only be realized through numerous interventions as agri-preneurship contributes significantly to sustainable agricultural development in South Africa. This study provided a novel insight into agri-preneurial resilience and success and evidenced the hypothesis that there is no significant positive correlation between agri-preneurial resilience, farm success, and selected demographic characteristics of smallholders. We surveyed a total of 200 agri-preneurs who were willing and able to participate in this study. This study used a structured questionnaire that was divided into the following sections: (i) demographic information; (ii) agri-preneurial resilience; and (iii) agri-preneurial success. Descriptive statistics and a regression analysis were employed to articulate responses. Four distinct models were employed to ascertain the goodness of fitness and the hypothesis, and assess the relationship between success, resilience, and selected demographic characteristics of agri-preneurs. To determine resilience, the Connor–Davidson Resilience Scale (CD-RISC) with 10 items was used because the CD-RISC justifies the best psychometric characteristics that portrays the levels of resilience amongst agri-preneurs. In measuring success, the scale items were graduated and ranked on a 5-point scale from 1 to 5. The reliability of the scale was also tested, and α = 0.93 was obtained. This study obtained a Cronbach alpha value of 0.96, indicating optimum reliability. Additionally, we ran a factor analysis to certify the reliability of the variable, which gave one factor from the four items. Significant positive correlations were found between gender, age, education, income, household size, diversification, and agri-preneurial resilience and success. This study concluded that most of the selected demographic characteristics were predictors of agri-preneurial resilience and success. However, demographic variables may be influenced by numerous factors given the heterogeneity of agri-preneurs in the study area.

Dynamic contrast-enhanced MRA of the aorta using a Golden-angle RAdial Sparse Parallel (GRASP) sequence: comparison with conventional time-resolved cartesian MRA (TWIST).

To compare the application of two contrast-enhanced time-resolved magnetic resonance angiography sequences on an aortic disease patient cohort: the conventional Cartesian-sampling-based, Time-resolved angiography With Interleaved Stochastic Trajectories (TWIST) sequence, and the radial-sampling-based Golden-angle RAdial Sparse Parallel (GRASP) sequence. TWIST is highly sensitive to patient movement, which can lead to blurring and reduced sharpness of vascular structures, particularly in dynamic regions like the aorta. Such motion artifacts can compromise diagnostic accuracy. Radial-sampling-based techniques are less sensitive to motion than cartesian sampling and are expected to improve the image quality in body parts subjected to motion. 30 patients (60.9 ± 16.1y.o.) with various aortic diseases underwent a 1.5T magnetic resonance angiography examination. Assessment of image quality in the ascending aorta (AA), descending aorta (DA), and abdominal aorta (AbA) on a 4-point Likert scale (1 = excellent, 4 = non-diagnostic) as well as max. aortic diameters (Dmax) were performed. T-test and multilevel mixed-effect proportional-odds models were used for the image analysis. GRASP offered superior depiction of vascular structures in terms of vascular contrast for qualitative analysis(TWIST, reader 1: 1.6 ± 0.5; reader 2: 1.9 ± 0.4; reader 3: 1.1 ± 0.4; GRASP, reader 1: 1.5 ± 0.5; reader 2: 1.4 ± 0.5; reader 3: 1.0 ± 0.2) and vessel sharpness for qualitative (TWIST, reader 1: 1.9 ± 0.6; reader 2: 1.6 ± 0.6; reader 3: 2.0 ± 0.3; GRASP, reader 1: 1.4 ± 0.6; reader 2: 1.2 ± 0.4; reader 3: 1.3 ± 0.6) and quantitative analysis (TWIST, AA = 0.12 ± 0.04, DA = 0.12 ± 0.03, AbA = 0.11 ± 0.03; GRASP, AA = 0.20 ± 0.05, DA = 0.22 ± 0.06, AbA=0.20 ± 0.05). Streaking artefacts of GRASP were more visible compared to TWIST (TWIST, reader 1: 2.2 ± 0.6; reader 2: 1.9 ± 0.3; reader 3: 2.0 ± 0.5; GRASP, reader 1: 2.6 ± 0.6; reader 2: 2.3 ± 0.5; reader 3: 2.8 ± 0.6).Aortic Dmax comparison among the sequence showed no clinical relevance. GRASP outperformed TWIST in SNR, vessel sharpness, and reduction in image blurring; streaking artefacts were stronger with GRASP, but did not affect diagnostic image quality.

Increasing Student Interest in Learning through the Implementation of the K-Nearest Neighbor Algorithm in Classifying Learning Preferences at SMAN 1 Kraksaan

This research examines the effectiveness of implementing the K-Nearest Neighbor (KNN) algorithm in classifying student learning preferences and its impact on increasing interest in learning at SMAN 1 Kraksaan. The main aim of the research is to optimize learning methods through personalization based on individual student preferences. The study involved 560 students of SMAN 1 Kraksaan, with data including variables of age, gender, academic grades, daily study time, attendance and participation in class. The KNN algorithm is used to classify students' learning preferences into visual, auditory, kinesthetic, and reading/writing categories. The learning method is then adjusted based on the results of this classification. The results show that the KNN algorithm is able to classify student learning preferences with an accuracy of 80.36%. After implementing personalized learning methods, there was a significant increase in students' interest in learning, with an average increase of 1.76 points on a 10-point scale. Paired t-test analysis showed a statistically significant difference between interest in learning before and after intervention (p &lt; 0.0001). This research concludes that the implementation of the KNN algorithm in classifying learning preferences can help increase students' interest in learning effectively. These findings emphasize the importance of personalization in education and demonstrate the potential of integrating machine learning in the pedagogical process to improve learning outcomes.

Over-employment and the success of combining work and parenthood

Purpose: is to determine the impact of working week length on satisfaction with work-children balance in a gender context.Methods: the empirical data are based on a structured survey of employed Russians raising children under 14 (N = 1449), the final sample size of 826 respondents. The authors’ online survey technology was used. The success of work-children balance was rated on a 10-point scale. Mean satisfaction with work-children balance as a function of parents' working hours was analysed using Mann-Whitney U-test and z-test.Results: sociological assessments show high overemployment among parents of minor children: 56.5% of working fathers and 33.1% of working mothers work over 40 hours a week. The statistical significance of the average estimates of the differentiation of "time for children" satisfaction between overemployed, underemployed and standardly employed parents by working hours revealed gender specificity. Working fathers show no significant difference in the estimated proportions, although overemployed male respondents are 1.6 times less likely to rate the success of their work-children balance as high. Among women, there is a direct correlation: the longer the working week, the lower the average assessment of the success of work-children balance. Women with two or more children of different ages (0–6; 7–14) are the least satisfied with their work-children balance.Conclusions and Relevance: working hours exceeding the normative standards of the RF Labour Code negatively impact women's parental well-being and impede the multi-child parenting as a national demographic goal. It is important to develop mechanisms to encourage employers to reduce overtime for women raising children under 14.

A Non-Surgical Wearable Option for Bone Conduction Hearing Implants: A Comparative Study with Conventional Bone Conduction Hearing Aids Mounted on Eyeglasses.

This study aimed to compare the audiological benefits of a non-implantable wearable option for a bone conduction (BC) implant mounted on an arch (SoundArc) to those of traditional BC hearing aids (HAs) mounted on eyeglasses (BCHAs) in patients with moderate to severe conductive or mixed hearing loss. A preliminary cross-sectional observational prospective cohort study was conducted in the Tertiary Audiological Department, University Hospital. Fourteen adults with conductive or mixed hearing loss (PTA at 0.5-1-2-4 KHz = 67 ± 15 dB HL) who had been wearing conventional BCHAs mounted on eyeglasses for at least 3 years and had declined surgical implantation of a bone conduction hearing implant (BCHI) were included in the study. Unaided and aided pure-tone air conduction (AC) and bone conduction (BC) thresholds, as well as speech tests in quiet and noise, were recorded at baseline and in two different settings: with a BCHI mounted on SoundArc® and with their own BCHAs mounted on eyeglasses using two couplers. Participants completed questionnaires in both conditions, including the International Inventory for Hearing Aids (IOI-HA), the Hearing Handicap Inventory for Adults/Elderly (HHIA/E), the Speech, Spatial, and Qualities of Hearing Scale (SSQ), a 10-point visual analog scale (VAS), and the Fatigue Impact Scale (FIS). A significant functional gain was observed in both settings (p = 0.0001). Better speech perception in quiet and noise was observed with SoundArc compared to conventional BCHAs on eyeglasses (improvements in word repetition scores in noise: +19.3 at SNR +10 dB, p = 0.002; +12.1 at SNR 0 dB, p = 0.006; and +11.4 at SNR -10 dB, p = 0.002). No significant differences were found in IOI-HA, FIS, and HHIA/E scores. However, significantly better SSQ scores were reported for SoundArc in all domains (p = 0.0038). Although patients were accustomed to using BCHAs mounted on eyeglasses, the bone conduction wearable option of the BCHI (SoundArc) proved to be a viable alternative for adult patients with conductive or mixed hearing loss who are unable or unwilling to undergo BCHI surgery.

Design and Pilot Implementation of an ECHO Module to Facilitate Treatment of Hepatitis C Virus Infection During Pregnancy

Abstract Background Pregnant patients are largely excluded from Hepatitis C virus (HCV) research and treatment. Studies show that pregnant patients want to discuss treatment while providers feel they lack the knowledge and training for these discussions. To bridge this gap, we designed an ECHO module about management of HCV in pregnancy and infancy. Methods Content experts from pediatric infectious diseases, hepatology, maternal-fetal medicine, bioethics and members of ECHO-Chicago discussed: prior data, potential topics, target audience and scheduling of sessions. We held 8 one-hour sessions with 20-30 minutes of didactics and 30-40 minutes of solicited case discussion. Participants included those who participated in prior ECHO training and prenatal providers in local and regional practices. A 7-point Likert scale pre- and post-training survey was administered to assess metrics of self-efficacy for management of HCV in pregnancy and childhood. Results The sessions were conducted from May to June 2023 on the following topics: HCV screening; HCV pathophysiology/clinical presentations; staging fibrosis in HCV; HCV Treatment in non-pregnant patients; harm reduction; clinical considerations of HCV in pregnancy; shared decision-making for HCV treatment in pregnancy; and HCV screening in infants &amp; treatment for children. Fourteen participants completed pre- and post-surveys. In the pre-survey, participants had low ratings of self-efficacy (average 3.0). In the post-survey (Table 1), participants reported dramatic increases in all areas (average 5.2, increase of 2.2) with the largest in the following areas: “Ability to discuss and manage timing of hepatitis C treatment in a pregnant person”, average 5.1, increase of 3; “Ability to identify suitable pregnant candidates for treatment for Hepatitis C”, average 5.2, increase of 2.7. For context, a 1-point increase in self-efficacy is considered meaningful. All respondents reported increased ability to address HCV in a preconception, pregnant, postpartum, or neonatal population. Conclusion As pivotal studies of pan-genotypic antivirals indicate efficacy and safety during pregnancy, this ECHO module could be distributed to support providers who are discussing therapy initiation. Table 1: Average Change in Self-Efficacy between Pre- &amp; Post-Series Surveys

ANALYSIS OF ECOTOURISM AND DISASTER MITIGATION DATA AT THE KUALA LANGSA MANGROVE FOREST BY USING THE ANALYTIC HIERARCHY PROCESS

The problem in the management of a public area is to determine aspects that contribute most as its best practices. This paper explores the contributions of the Kuala Langsa Mangrove Forest located in Langsa City, Aceh Province, for ecotourism and disaster mitigation. This research was intended to analyze the aspects of forest management that has successfully reformed dry coast into an ecotourism site. The Analytic Hierarchy Process (AHP) as a multicriteria decision making method was used to analyze the best indicators data. This method was selected as the suitable method since it utilizes the objectivity of mathematics in comparing some subjective criteria to obtain the best indicators. The implementation of the AHP method consists of three stages: the development of the criteria’s hierarchy table; the development of pairwise matrix related to the intention of giving weights for the criterion’s elements; the logical concistency verification of the matrix. Indicators were written on a five point scale related to a value judgement. The results of the research show that as an ecotourism site, the activities of the mangrove forest are motivated and based on the existing rules which attract people to become interested. The role of the local government has resulted: developed the programs according to the existing mangrove management law that reached 67% among other law related indicators; budget allocation priority by self-generating which get priority of 59% among budget indicators; oriented on the increasing of fishermen, obtained 49% of economical function elements; encouraged the involvement and partnership of the local resources around the mangrove forest which reached 31% among other programs offered and sustainability approach by considering ecological functions aspect. For physical contribution for disaster mitigation, the largest dissipation is given by Rhizophora mucronata due to its height compared to the other types.

Anatomical theater or full digitization? Students' assessment and preferences in the field of anatomy teaching.

For many years, teaching of anatomy has been based on traditional forms of teaching, but innovative solutions are currently being implemented on a large scale around the world. The COVID-19 pandemic and distance learning have influenced the development of new technologies in teaching. The study was conducted among medical students who studied anatomy in the year preceding the analysis when the restrictions related to the pandemic had been lifted. The questionnaire contained 10 questions with YES/NO answers and a modified 10-point Likert scale. The data was subjected to statistical analysis performed in R studio using the R programming language. 650 respondents were included in the analysis. Students assessed the modernization of anatomy departments to be unsatisfactory - on a 10-point scale, the most common answer was 2 - the average was 2.69. At the same time, they assessed the accessibility of knowledge as acceptable - median 6, with an average of 5.58. 75.38% of respondents did not use virtual reality technology, 75.69% did not use a 3D printing. 92.5% did not work with a virtual anatomical table. The vast majority of students claim that new technologies will be useful in their future clinical practice. New technologies are still rarely used in the teaching of anatomy, despite an increasing availability of such solutions and the conviction of students about the validity of implementing innovations in their future clinical practice. It seems reasonable to enable cooperation between the traditional forms of learning and the modern ones.