Activity Values Research Articles

#3077 Activity and chronicity index as graft lost predictors in kidney transplant with antibody mediated rejection or isolated microvascular inflammation

Abstract Background and Aims Antibody mediated rejection (ABMR) is the major cause of graft lost in kidney transplant (KT) recipients. Banff classification considers active ABMR (aABMR) and chronic active ABMR (caAMBR) but does not consider isolated microvascular inflammation (iMVI). Considering histologic lesions in kidney biopsies (KB), activity (AI) and chronicity index (CI) have been developed. Only CI ≥4 has been associated to worse graft survival in ABMR, yet the prognostic value of AI and CI in iMVI is still unknown. Our aim was to evaluate chronicity and activity index as prognostic tools in ABMR and iMVI. Method Retrospective study of KT recipients (1987-2022) with KB (2013-2022) with ABMR (category 3, Banff’2019) [group 1] and iMVI [group 2]. We evaluated AI ([glomerulitis (g) + peritubular capillaritis (ptc), arteritis (v) + C4dscore] e CI ([interstitial fibrosis (ci), tubular atrophy (ct), chronic vasculopathy (cv), and 2xchronic glomerulopathy (2cg) scores)]). Our aim was to evaluate chronicity and activity index as prognostic tools in ABMR and iMVI. Results One hundred thirty-nine KT with aABMR (n=48) and caABMR (n=46) (group 1) and MVIi (n=45) (group 2). Graft loss along time of follow-up (35 [15-69] months) was higher in group 1 (41.5% vs 22.2%; p=0.02). AI was higher in group 1 (4 [3-4.5] vs. 2 [2-4]; p<0.001) and CI similar in both groups (4 [3-7] vs. 4 [4-6]; p=0.7). In the multivariate analysis CI (per unit increase) with HR 1.24 [1.09-1.42; p=0.001] and IA ≥4 in ABMR with HR 2.23 [1.08-4.58; p=0.029]. Death-censored graft survival was worse in IA. IA≥ 4 e IC ≥4 La supervivencia del injerto muerte-censurada fue peor en el grupo RH con IA≥ 4 e IC ≥4 (Fig. 1). Conclusion Our findings suggest that the activity index in ABMR and the chronicity index both in ABMR and iMVI are valuable prognostic tools.

Guided inquiry-based learning to enhance student engagement, confidence, and learning.

This study explores the impact of guided inquiry-based learning (IBL) on student engagement and performance in a dental hygiene program. The research was conducted with 36 dental hygiene students, focusing on enhancing student engagement using a guided IBL methodology that could ultimately lead to improved student performance and confidence. Delivered through two interventions, pre-, post-, and delayed post-tests evaluated student performance and confidence, while the ASPECT survey assessed student engagement. The interventions included a lecture (intervention #1) and a group-based IBL worksheet activity (intervention #2). Statistical analyses using analysis of variance (ANOVA) tested the impact of these interventions on student performance and confidence-adjusted scores. Results showed significant improvements in student performance and confidence following both interventions, with notably higher gains after the IBL activity. Analysis of ASPECT survey data revealed positive perceptions of engagement, emphasizing the importance of group dynamics, instructor roles, and the activity's value. Students reported enhanced understanding and engagement through group interactions and individual study. The study also highlighted the critical role of the instructor in facilitating and guiding the IBL activity. In conclusion, the study demonstrates that guided IBL strategies can significantly enhance student confidence and performance, suggesting a sustainable impact on learning outcomes. These findings underscore the importance of active, engaged learning methodologies in healthcare education, particularly in enhancing long-term retention and understanding of complex topics. The study advocates for integrating such strategies into academic curricula to foster deeper student engagement and improved educational experiences.

Effectiveness of Physical Activity in Geriatric Population to Decrease the Risk of Fall a Randomized Control Trial

Background: For elderly persons who are frail, effective fall prevention strategies are required. Our goal was to evaluate physical activity's value in preventing falls in older persons. Material and Methodology: The physiological profile evaluation was used to conduct a randomised control experiment on individuals aged sixty five and older who were categorised as pre-frail and had mild to moderate fall risk scores.A total of 54 participants were recruited in the study using allocation concealment. 54 participants were split into two groups at random i.e MPE (n = 27), control (n = 27). The three-day-per-week, 12-week intervention mainly concentrated on proprioception, muscular development, response time, and balancing training. The main finding was the assessment of fall risk using PPA twelve weeks after baseline and at a 24 week follow-up. Results: At weeks 12 and 24, there were significant changes between the MPE group and controls in the fall risk, proprioception, muscle strength, response speed, postural sway, and fear of falling scores. In addition, the MPE group's HRQOL had dramatically improved compared to controls. Practical Implication: by identifying and establishing effect of physical activity in geriatric population in reducing risk of fall, clinical phrophylatic and rehabilitation palns can be designed and implemented before hand to decrease the chances of fall iniuries and to facilitate the rehabilitation plan after the injury. Conclusion: The MPE programme significantly improved proprioception, response time, and postural sway in elderly people with pre-frailty, which decreased the risk of falls.The MPE programme is therefore advised for use in routine primary care for the geriatric population. Keywords: Fall, Geriatric, MPE, Physical Activity, risk of fall, pre-frail, multiple physical exercise, HRQOL, postural sway

A Standards-Based Checklist for Program Evaluation as Scholarly Activity.

Educators in graduate medical education (GME) regularly make decisions about adding, deleting, or revising some aspect of a curriculum, rotation, or other program activity. At the core of each decision is the activity's value to the learners, faculty, program, and sponsoring institution, and/or to meeting accreditation/licensure requirements. When these decisions are informed by systematic program evaluation, the results may be generalizable and have value to others in GME beyond their local worth. Yet how does an educator know if their work might be relevant to others or fulfill scholarship criteria? These are particularly vexing challenges for evaluation, as every program is local and has unique settings, trainees, faculty, and resources. Thus, disseminating evaluation as scholarship is a balancing act: staying true to the local nature of the program while addressing concerns of skeptics who may say, “That's not relevant…it wouldn't work here.”Applying standards of program evaluation can tip the balance toward becoming a scholarly activity. Other Rip Outs1,2 in this series outlined the American Evaluation Association (AEA) standards (accuracy, feasibility, integrity [ie, propriety], and utility)3 and suggested their application to program planning and implementation. Viewing these same standards in a checklist format can guide evaluation as a scholarly activity for authors and reviewers. Reminder: standards apply to evaluation, not to the project (eg, asking if the evaluation is feasible, not if the project is feasible). Standards and sample items include:As evaluators, readers, and editors, we like checklists ordered to match the standard introduction/aim, methods, results, discussion/conclusions (IMRD) framework. However, evaluation standards underpin the entire program evaluation endeavor; thus, one standard can—and often should—appear in multiple sections. See online supplementary data for the complete Evaluation as Scholarly Activity Checklist by AEA Standards.

Activity and Time Value of Public Passenger Transportation Users During the Covid-19 Pandemic in 2020 (Bus of Batik Solo Trans Corridor 4 in Surakarta)

The Covid-19 pandemic in 2020 has a significant impact on all countries' social and economic conditions, including Indonesia. It is fitting that social and economic changes also affect the transportation sector. The value of economic benefits in one public facility operation also depreciated due to the economic recession. One of the variables that can be reviewed is the time value of public passenger transportation users (AUP) to measure how much depreciation has occurred. This study specifically for travel is learning, using the bus mode Batik Solo Trans (BST) Corridor 4. Development of scenarios for questionnaires with stated preference methods, using the choice mode between motorbikes and AUP as an option, and the mode utility is approached with the equation multiple linear regression. The results of the analysis show that the time value of the user in the fleet is IDR 274.67 / hour for a distance of 8.35 km and the Time Value for a distance of 13.0 km = IDR 240.82 / hour with a Value of Activity (VoA) which is close to zero because the activity in the fleet has no financial value. This time value is considerably smaller than the AUP time value with the same intention of trip, studying, which was analyzed in 2015, which was IDR 4,708 / hour.

A lean view of lean

A lean view of lean

Does conducting activities while traveling reduce the value of time? Evidence from a within-subjects choice experiment

Many studies about conducting activities while traveling start from the hypothesis that conducting onboard activities reduces the value of time (VoT). However, surprisingly limited empirical evidence is provided for this hypothesis. The few studies that aim at providing this evidence face methodological problems in the sense that effects attributed to conducting onboard activities are confounded with differences between groups. This paper further develops and applies a solution for this problem proposed by Wardman and Lyons (2016). In essence, this method includes constructing a within-person choice experiment, which involves that the same respondents make choices in a context that enables conducting activities, as well as in a context that does not enable conducting activities. This method is applied in a study that collected data from 820 train travelers in the Netherlands. The results show that as expected, the VoT in the activity context is significantly lower than the VoT in the non-activity context, which thus supports the hypothesis. Reduction in VoT due to conducting onboard activities is around 30% for commuters, while leisure travelers who prefer to read lose almost half their VoT value. In addition, this paper discusses how the estimated VoT reduction values can be interpreted as the Value of Activity (VoA), which can be used for appraising investments aimed at reducing the disutility of travel other than by means of reducing travel time, such as improving Internet connections.

PROTOCOL: Personal Budgeting Interventions to Improve Health and Social Care Outcomes for People with a Disability: A Systematic Review

PROTOCOL: Personal Budgeting Interventions to Improve Health and Social Care Outcomes for People with a Disability: A Systematic Review

Evaluating the Potential Impact of Pharmacist Counseling on Medication Adherence Using a Simulation Activity

To evaluate the impact of counseling in a simulated medication adherence activity. Students were randomized into 2 groups: patient medication monograph only (PMMO) and patient medication monograph with counseling (PMMC). Both groups received a fictitious medication and monograph. Additionally, the PMMC group received brief counseling. A multiple-choice, paper-based survey instrument was used to evaluate simulated food-drug interactions, adherence, and perceptions regarding the activity's value and impact on understanding adherence challenges. Ninety-two students participated (PMMC, n=45; and PMMO, n=47). Overall, a significantly higher incidence of simulated food-drug interactions occurred in the PMMO group (30%) vs the PMMC group (22%) (p=0.02). Doses taken without simulated food-drug interactions were comparable: 46.2% (PMCC) vs 41.9% (PMMO) (p=0.19). The average number of missed doses were 3.2 (PMMC) vs 2.8 (PMMO) (p=0.55). Approximately 70% of the students found the activity to be valuable and 89% believed it helped them better understand adherence challenges. This activity demonstrated the challenges and important role of counseling in medication adherence.

A novel capacity and trust based service selection mechanism for collaborative decision making in CPS

Cyber-physical system (CPS) provides more powerful service through combining software service and physical device. It is an effective solution to organize various CPS services to realize collaborative decision making (CDM). In CPS, finding out the most competent participators for CDM sponsor is a core problem. To solve this problem, we propose a novel capacity and trust computation based CPS service selection mechanism in intelligent and automatic manners. It comprises three phases, including capacity evaluation, trust computation and negotiation selection. In the first phase, CDM sponsor describes formal semantic of decision task and computes the capacity evaluation values according to participator instructions. In the second phase, we design a novel trust computation method to calculate the values of activity trust, subjective belief, objective reputation, physical trust and recommended trust respectively. In the third phase, service selection is achieved through a negotiation mechanism according to capacity evaluation and trust computation.

Sentidos da pesquisa na prática profissional de enfermeiras assistenciais

The aim of this study was to analyze the meanings given to investigative research by nurse clinicians enrolled in a research support group. The interpretive anthropology theoretical frame was used along with an ethnographic case study. Data was collected through semi-structured individual and group interviews, document and statement analysis as well as field diary notes. The statements of 36 participants were analyzed interpretively identifying four categories: activity's value, researching is learning, the movements about the activity, the activity is hard work that demands personal effort. We understand that once research training initiative is supported by the organization and desired by the nurse, it becomes a scientific-pedagogical strategy for academic nursing formation with positive repercussions to care assistance.