Comprehensive Treatment Program Research Articles

Application of Minimally Invasive Surgery-Multidisciplinary Team in Advanced and Recurrent Gynecological Cancers: 10-Year Exploration and Practice.

The treatment of advanced and recurrent gynecological cancers (ARGCs) remains more difficult evens. This assay aims to introduce the application of minimally invasive surgery-multidisciplinary team (MIS-MDT) as well as a comprehensive evaluation and treatment program of ARGC. The diagnosis and treatment model of MDT collaboration has become a new model of clinical cancer treatment. In my country, it is in the start-up and trial stage. Our team began to explore surgical treatment of recurrent gynecological cancers in 2011 and has been committed to MDT treatment of ARGC for more than 3 years. So far, 61 patients have completed MDT treatment (28 of them were advanced gynecological cancer patients, 33 of them were recurrent gynecological cancer patients). Among them, MDT involved 43 times in gastrointestinal surgery, 21 times in urology, 5 times in the department of intractable abdominal diseases, and 5 times in other departments. After surgery, 58 patients (95%) restarted adjuvant therapy such as radiotherapy and chemotherapy. In addition, 32 patients (52.5%) underwent genetic and molecular testing, of which 14 patients (23%) accepted targeted and immunotherapy based on the testing results. After MIS-MDT treatment, the median progression-free survival of these patients was >30 months, respectively. These patients have achieved good results after surgery of MDT. With continuous accumulation and summarization, we have systematically reviewed the diagnosis and treatment model of ARGC and guided clinical work as the model of Tongji Tenth Hospital (comprehensive evaluation and treatment).

Faktor Risiko Kejadian Malaria pada Masyarakat Wilayah Pertambangan: Literature Review

Globally, nearly 85% of malaria cases occur in nineteen Indian sub-Saharan African countries.Tropical and subtropical countries are endemic areas for this disease because they have a rainy season that provides a high availability of clean water, where vector mosquitoes can lay eggs and breed.. KForest activities such as agriculture, logging and gold mining are considered high risk occupations for exposure to malaria, this is because forest workers, especially miners and loggers, often spend weeks to months at work..This article uses a literature review approach with a cross-sectional study design. Articles are searched through electronic databases systematically onScience Direct, Malaria Journal, and PubMedpublished in the last 10 years and taken between the years (2013-2022) using the keywords (risk factorAND malaria AND “mine workers). Based on the results of data extraction from search engines of the Science Direct, Malaria Journal, and PubMed methods, there are 15 journals selected based on inclusion criteria. FactorsThe risk of malaria in mining area communities is age, gender, education, knowledge, behavior, attitudes, and environmental conditions.This study serves as a baseline for assessing the impacts of mining activities in relation to future vector control interventions.Malaria elimination efforts can be accelerated by targeting improvements in treatment practices, diagnosis, and reporting to private pharmacies, private clinics, and grocery stores. Programs should also seek to increase awareness and understanding of malaria among at-risk populations, in particular the importance of using preventive measures and following a comprehensive antimalarial treatment program.

Сomprehensive restorative treatment of posture disorders in children with connective tissue dysplasia

Aim is to develop a comprehensive program of restorative treatment of posture disorders in children against the background of connective tissue dysplasia. Materials and methods. Ninety children aged from 4 to 17 years were under observation. Of these, 60 patients with connective tissue dysplasia (CTD) were divided into an experimental group (30 children) and a comparison group (30 children). These CTD children were under medical supervision from 2010 to 2020. The reference group consisted of 30 conditionally healthy children of the same age. All children were comprehensively examined. All СTD patients during the entire period of dispensary observation underwent comprehensive restorative treatment using methods of physical therapy, swimming and teaching patients at the educational school “Posture Correction” for children. The data obtained were processed statistically. Results. Characteristic signs of hereditary disorders of connective tissue development were revealed in all CTD children. An increase in the concentration of oxyproline in the blood serum and an increase in urinary excretion of oxyproline and calcium were found. After 5 years from the start of rehabilitation measures, there was an increase in endurance of the back muscles, a minimum number of pathological manifestations, including arthritis, arthralgic syndromes, coccygodynia. Ten years later, at the age of 14 years, the children of the experimental group formed a good posture, a well-off muscular corset and a minimal number of complications. Patients of the comparison group during the observation process more often complained of a feeling of fatigue, prolonged, incurable pain in the thoracic and lumbar spine, weak muscle corset. Conclusion. If CTD signs are detected in children, long-term dispensary observation should be carried out in outpatient conditions with the inclusion of a set of exercises of physical therapy and other rehabilitation measures. With the initial CTD manifestations on the part of the spine, children should be recommended to use a back support or a semi-rigid corset for the duration of increased loads, lessons, and long training sessions.

Substance use and substance use disorders in Africa: An epidemiological approach to the review of existing literature.

The relationship between man and substances that have abuse potentials, and whose use has been associated with the development or progression of substance use disorders has continued to evolve in terms of geography, economic implications, and time. History shows that local plants with psychoactive constituents can get exported worldwide through global travel, commerce, or even conquest. Time and globalization also change people's relationship with substances of abuse; hence, an area that was initially alien to certain substances might evolve to becoming a trafficking hub, and then a destination. A case in point is Africa where a rapidly increasing prevalence of substance use/abuse and substance use disorder among adolescents and young adults is putting enormous strain on the economy, healthcare system, and society at large. However, there appears to be a paucity of scientific literature and data on the epidemiology, risk assessment, and contributing factors to substance use and the development of substance use disorders across Africa. In this narrative review, we examine extant literature (PubMed, Google scholar, Medline) for information on the prevalence, trends, and influencers of substance use and the development of substance use disorders. This is with a view of understanding the determinants of substance use and factors that influence the development of substance use disorders in the region, and how this information can be channeled towards developing a comprehensive intervention and treatment program.

Assessing Loneliness among Adults Receiving Outpatient Treatment with Medication for Opioid Use Disorder (MOUD).

Loneliness is a significant risk factor for substance use, however, impacts of treatments on loneliness are relatively unexplored. Living in a rural location is a greater risk factor for loneliness. This study examined data from a quasi-experimental study in rural Appalachia, comparing the effectiveness of Mindfulness-Based Relapse Prevention (MBRP) versus Treatment as Usual (TAU) among adults receiving MOUD in outpatient therapy. Our objective was to determine whether observed reductions in self-reported craving, anxiety, depression, and increased perceived mindfulness would also improve loneliness reports. Eighty participants (n = 35 MBRP; n = 45 TAU) were included in the analysis from a group-based Comprehensive Opioid Addiction Treatment program. Outcomes tracked included craving, anxiety, depression, mindfulness, and loneliness as measured by the Revised UCLA Loneliness Scale (R-UCLA). A linear mixed model ANOVA determined the significance of the treatments on changes in loneliness scores at baseline, 12 weeks, 24 weeks, and 36 weeks post-recruitment. Both groups reported significantly reduced loneliness over the course of the study (F = 16.07, p < 0.01), however there were no significant differences between groups. Loneliness was also significantly positively (p < 0.01) correlated with anxiety (0.66), depression (0.59), and craving (0.38), and significantly (p < 0.01) inversely correlated (−0.52) with mindfulness. Results suggest that participation in MOUD group-based outpatient therapy has the potential to diminish loneliness and associated poor psychological outcomes. Thus, it is possible that a more targeted intervention for loneliness would further diminish loneliness, which is important as loneliness is linked to risk for relapse.

Orthodontic status of children with cerebral palsy in Arkhangelsk

Relevance. Cerebral palsy (CP) is a common disease, which causes early disability in children and affects their dental status. The absence of malocclusion prevalence situational analysis precludes good planning of orthodontic care in the comprehensive rehabilitation of children and adolescents with CP. The study aimed to assess the orthodontic status in Arkhangelsk children and adolescents with primary, mixed and permanent dentition to ground the inclusion of an orthodontist in a multidisciplinary team. Materials and methods. In 2021, the study examined 110 children and adolescents aged 11 months to 17 years with confirmed CP undergoing treatment at the Arkhangelsk Multidisciplinary Rehabilitation Center. We performed an oral examination, interviewed parents (guardians) on bad habits in children and adolescents, objectively examined and assessed the orthodontic status and functional impairment (chewing, swallowing, breathing). Results. The prevalence of malocclusion in children and adolescents with CP is 100%. Malocclusion was detected in primary, mixed and permanent dentitions. We diagnosed distal occlusion (75.4%), open bite in primary teeth (66.6%), deep overbite in permanent dentition (60.1%), severe overjet (71.8%) and unilateral crossbite (3.6%). Conclusion. The results suggest reconsidering approaches to dental pathology prevention and treatment in spastic CP. Early diagnosis of initial malocclusion and customized preventive measures are essential in comprehensive treatment and prevention programs.

Influence of Comprehensive Lifestyle Intervention (LSI) Program on Health, Fatigue, and Quality of Life in Middle-Aged Women.

Middle age is one of the most important times in a woman's life, and it is a time when multiple changes occur that affect the body and health. The study aimed to investigate the efficacy of a comprehensive lifestyle intervention (LSI) program, including stress management, on middle-aged women's physical, physiological, and mental health. A total of 40 middle-aged women participated in a short-term LSI program, nutrition, exercise, and mental and physical management with various experiential activities. Physical measurements, biochemical indicators, stress hormones, chronic fatigue, and quality of life indicators were evaluated to interpret the clinical efficacy of the program. LSI program significantly improved satisfaction and quality of life in participants. Total chronic fatigue scores reduced significantly compared to scores before the start of the program. Moreover, fat mass and body fat were reduced without loss of muscle mass. Further, blood pressure and triglyceride levels significantly decreased after completing the LSI program. However, changes in stress hormone levels remained insignificant. Adoption of LSI in middle-aged women demonstrated positive implications of the program. LSI efficiently regulates body fat, fat mass, fatigue, hypertension, and triglyceride levels which play a critical role in determining the quality of life. Thus, the LSI program could spread healthy lifestyles among middle-aged women.

P385 Candida auris: a growing threat to global health

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Background and ObjectivesThe emerging pathogen, C. auris, has been associated with nosocomial outbreaks in recent times. The true scale of the problem is difficult to comprehend due to several issues with the identification of C. auris using both phenotypic and molecular techniques. Most commonly, these isolates have been misidentified as C. haemulonii. Biofilm formation is strongly suggested given its association with intensive care settings, especially in patients with CVCs and long-term urinary catheters. Many isolates of C. auris have also shown raised MICs to multiple classes of antifungal agents, raising the possibility of pan-drug resistance.ObjectiveTo study the demographic characteristics, risk factors, and outcomes in patients with C. auris infection.MethodologyThis is a retrospective study from a tertiary care hospital (JPNATC, AIIMS) including all patients from the time period of 2018-2022 that showed growth of C. auris in any site. C. auris was identified using conventional methods (pale-pink growth on chromogenic medium, no pseudohyphae on germ-tube test, growth in presence of 10% NaCl) and VITEK-2. To reduce the misidentification and the intertest variability, the results were confirmed with MALDI-TOF. The risk factors and other patient information were taken from the HIS. Statistical analysis was performed.ResultsDuring the study period, a total of 31 patients had a C. auris infection. The most common age group was 20-40 years (n = 11,44%) with a preponderance in males (n = 23,74%). A total of 74% of the infections were found in blood, which was the most common site of infection followed by urine (10%). The other sites were pus-from-wound (n = 2), groin, nailbeds, and CVP tip (n = 1). Most of the cases were ICU patients (86%). All the patients with candidemia due to C. auris (n = 17 100%) had CVC, had surgery within the past 30 days, and were on broad-spectrum antibiotics and TPN. 71% (n = 12) had a history of immunosuppression and 18% (n = 14) had a history of prior antifungal therapy. Although 100% (n = 17) had the presence of an indwelling urinary catheter, none of them had candiduria due to C. auris. No patient with C. auris infection had neutropenia. The median LOS was 34.5 days. Most of the isolates were resistant to fluconazole (n = 13,93%), amphotericin B (n = 13,93%), voriconazole (n = 6,55%), flucytosine (n = 10,71%). A total of 87% (n = 12,87%) of isolates were sensitive to caspofungin and micafungin by VITEK-2 (limitation of this study). In all, 28% (n = 7) of the patients died whereas 40% (n = 10) were discharged. A total of 75% patients had clearing of the persistent candidemia when treated with caspofungin whereas only 25% patients had clearing of the candidemia when treated with voriconazole.ConclusionMost cases of C. auris infection were found in critical patients with the most common presentation being candidemia. The risk factors are similar to any other Candida infection. C.auris is the leading antimicrobial-resistant fungi and poses an additional burden to the healthcare system. The fungus has a high crude-mortality rate and we are running out of treatment options. A comprehensive intervention program with ongoing surveillance and good AMR practices is the need of the hour to reduce the burden of this dangerous pathogen.

PERIODONTAL TISSUE MORPHOLOGY IN CHILDREN WITH ABNORMAL OCCLUSION AND CONNECTIVE TISSUE DYSPLASIA SYNDROME

The study involved an analysis of the data gum biopsies obtained through light microscopy and polarization microscopy in order to identify pathomorphological features and the collagen Type I &amp; Type III ratio in 56 children with occlusion issues, periodontal diseases and various undifferentiated connective tissue dysplasia (UCTD). 32 healthy children with intact periodontium served as a control group. For the histological examination of gum biopsies, the respective sections were stained with hematoxylin and eosin, while Picro-Sirius Red Stain Kit reagents were used to assess the Type I and Type III collagen distribution in the gum connective tissue. The image processing was performed in the ImageJ 1.47 software, while when analyzing the color histograms, the ratio of the red pixels (Type I collagen) and the green pixels (Type III collagen) was identified. The Type I/III collagen ratio (1.41±0.09) in children with chronic catarrhal gingivitis, occlusion issues and a “prominent” degree of UCTD was found to be significantly lower (p≤0.05) the similar ratio observed in patients with clinically healthy periodontium (2.01±0.09), as well as in patients with “mild” and “moderate” UCTD (1.63 ± 0.17) with homogeneous clinical and morphological dental manifestations. The effectiveness of the developed comprehensive dental treatment program for periodontal issues in children with abnormal occlusion associated with UCTD, including conservative anti-inflammatory treatment, pharmacological correction and orthodontic treatment, is justified by an increase in the amount of mature Type I collagen, a decrease in the developing immature Type III collagen, and inflammation in the periodontal tissues. A sufficient degree of maturity and differentiation of connective tissue was also achieved.

The Effect of a Comprehensive Life-Style Intervention Program of Diet and Exercise on Four Bone-Derived Proteins, FGF-23, Osteopontin, NGAL and Sclerostin, in Overweight or Obese Children and Adolescents.

The adipose and bone tissues demonstrate considerable interconnected endocrine function. In the present study, we determined the concentrations of fibroblast growth factor-23 (FGF-23), osteopontin, neutrophil gelatinase-associated lipocalin (NGAL) and sclerostin in 345 children and adolescents who were overweight or obese (mean age ± SD mean: 10.36 ± 0.16 years; 172 males, 173 females; 181 prepubertal; and 164 pubertal) before and after their participation in a comprehensive life-style intervention program of diet and exercise for one year. Following the one-year life-style interventions, there was a significant decrease in BMI (p < 0.01), FGF-23 (p < 0.05), osteopontin (p < 0.01) and NGAL (p < 0.01), and an increase in sclerostin (p < 0.01) concentrations. BMI z-score (b = 0.242, p < 0.05) and fat mass (b = 0.431, p < 0.05) were the best positive predictors and waist-to-height ratio (WHtR) (b = −0.344, p < 0.05) was the best negative predictor of the change of osteopontin. NGAL concentrations correlated positively with HbA1C (b = 0.326, p < 0.05), WHtR (b = 0.439, p < 0.05) and HOMA-IR (b = 0.401, p < 0.05), while BMI (b = 0.264, p < 0.05), fat mass (b = 1.207, p < 0.05), HDL (b = 0.359, p < 0.05) and waist circumference (b = 0.263, p < 0.05) were the best positive predictors of NGAL. These results indicate that FGF-23, osteopontin, NGAL and sclerostin are associated with being overweight or obese and are altered in relation to alterations in BMI. They also indicate a crosstalk between adipose tissue and bone tissue and may play a role as potential biomarkers of glucose metabolism. Further studies are required to delineate the physiological mechanisms underlying this association in children and adolescents.

Prevalence and risk factors of general and abdominal obesity and hypertension in rural and urban residents in Bangladesh: a cross-sectional study

BackgroundObesity and hypertension are global health concerns. Both are linked with increased risks of all-cause and cardiovascular mortality. Several early studies reported the prevalence of obesity and hypertension in Bangladeshi adults, but the associated factors in this country population are not clear yet. We aimed to estimate the prevalence and related risk factors of general and abdominal obesity and hypertension in rural and urban adults in Bangladesh.MethodsIn this cross-sectional study, data (n = 1410) was collected on rural (n = 626) and urban (n = 784) adults from eight divisional regions of Bangladesh. Both anthropometric and socio-demographic measurements were recorded in a standardized questionnaire form. General and abdominal obesity were defined based on WHO proposed cut-off values and hypertension was defined by SBP ≥ 140 mmHg and/or, DBP ≥ 90 mmHg and/or, intake of anti-hypertensive drugs at the time of data collection. Multivariable logistic regression analyses were performed to assess the relationship of general and abdominal obesity and hypertension with various factors.ResultsThe overall prevalence of general obesity, abdominal obesity and hypertension was 18.2, 41.9 and 30.9%, respectively. The women had a higher prevalence of general obesity (25.2%), abdominal obesity (56.1%) and hypertension (32.3%) compared to the men (12.2, 29.0, and 29.7%, respectively). The prevalence of both general and abdominal obesity was higher in urban participants (21.7 and 46.6%, respectively) than in the rural participants (13.8 and 35.1%, respectively), whereas, the rural participants had a higher prevalence of hypertension (35.1%) compared to the urban participants (27.5%). In geographical region comparison, the prevalence of general and abdominal obesity and hypertension were higher in participants enrolled from Dhaka (30.8%), Khulna (63.6%) and Mymensingh (43.5%) regions, respectively compared to other regions. In regression analysis, increased age, place of residence and less physical activity were positively associated with the increased risk of both types of obesity and hypertension. The analysis also showed a significant positive association between high BMI and an increased risk of hypertension.ConclusionThis study shows a high prevalence of obesity and hypertension in rural and urban adults. Increased age, inadequate physical activity and place of residence were significant determinants of general and abdominal obesity and hypertension. A comprehensive intervention program focusing on modifiable risk factors such as lifestyles and food habits is needed to increase awareness and prevent the burden of obesity and hypertension in the Bangladeshi population.

Principles of sanatorium-resort treatment of adult and pediatric patients who have undergone COVID-19

Spa treatment plays an important role in the recovery process of both adult and pediatric patients after a coronavirus infection. Currently, medical rehabilitation programs of this stage are being worked out and, as the accumulated data show, an integrated approach with the inclusion of various methods is more effective. Sanatorium-resort care for patients who have undergone COVID-19 is provided on a planned basis and is based on the principles of phasing, continuity and continuity between medical organizations. Treatment of patients with the consequences of a coronavirus infection in sanatorium conditions is carried out in the late recovery period at the III stage of rehabilitation care. The main advantage of spa treatment is the use of natural therapeutic factors: climate, landscape, balneo- and peloidotherapy. An important part of the comprehensive treatment program is the methods of physical rehabilitation, which should be selected individually, taking into account the functional reserves and patient tolerance. Also, the program of spa treatment includes diet therapy, according to indications, hardware physiotherapy, psychotherapy.

Peer victimization, environmental and psychological distress, and academic performance among children in China: A serial mediation model moderated by migrant status

BackgroundDespite robust evidence indicating the adverse academic, psychological, and school-related impacts of being victimized, the ways in which peer victimization indirectly affects children's academic performance by psychological and environmental distress remain poorly understood, especially in China. ObjectiveWe sought to investigate how peer victimization negatively impacts academic performance via the serial mediation effects of environmental and psychological distress among migrant versus non-migrant children in China. Participants and settingParticipants were selected by multistage stratified cluster sampling, and data were collected with a cross-sectional survey administered in Nanjing and Guangzhou, China. The sample included 1747 students in Grades 4 to 9 (boys = 54.7 %, mean age = 11.7 years). MethodsStructural equation modeling and group comparison analysis were conducted to examine the hypothesized model. ResultsChildren's experiences with peer victimization significantly affected their academic performance and in relationships partially mediated by environmental distress (i.e., perception of school safety), followed by psychological distress (i.e., anxiety) (95 % CI: [−0.010, −0.001], B = −0.005, p < .01). The serial mediation model applied to non-migrant children only (95 % CI: [−0.026, −0.001], B = −0.008, p < .05), however, whereas environmental distress exerted a single mediating effect on the association between peer victimization and academic performance among migrant children only (95 % CI: [−0.125, −0.044], B = −0.076, p < .001). ConclusionEnvironmental and psychological distress exerted serial mediating effect on the association between peer victimization and academic performance. School-based comprehensive intervention programs designed for migrant versus non-migrant children are recommended.

Elementary school comprehensive intervention and myopia development: the Wenzhou Epidemiology of Refraction Error Study.

To investigate the effects of school-based comprehensive intervention on myopia development in elementary school children. As a part of the Wenzhou Epidemiology of Refraction Error Study, there were 1524 participating elementary students (730 girls, 47.9%) in grades 1 to 3 from three campuses of one school, aged 7.3±0.9y, who were examined twice every year for a 2.5y follow up period. Comprehensive intervention and other reminders were given at school every semester for the intervention group. The control group did not receive comprehensive intervention and did not have reminders of it. There were 651 students in the intervention group [mean age 7.3±0.9y; 294 (45.2%) girls] and 737 students in the control group [mean age 7.2±0.9y; 346 (46.9%) girls]. Overall mean myopia progression during the 2.5y follow-up was -0.49±1.04 diopters (D) in the intervention group and -0.65±1.08 D in the control group (P=0.004). The majority that not get myopia at baseline spherical equivalent (SE≤-1.0 D). Their mean myopia progression during the 2.5y follow-up was -0.37±0.89 D in the intervention group and -0.51±0.93 D in the control group (27.5% reduction, P=0.009); Overall, mean axial length elongation was less in the intervention group (0.56±0.32 mm) than in the control group (0.61±0.38 mm, 10.5% reduction, P=0.009). The percentage of close reading distance (<30 cm) in the intervention group was less than in the control group (73.4% vs 76.2%, P<0.001), the percentage of everyday perform eye exercises in the intervention group was more than in the control group (27.8% vs 20.7%, P<0.001) 30mo later. The comprehensive intervention program at elementary school has a significant alleviating effect on myopia progression for children during the 2.5y follow-up, especially for those non-myopia at baseline.

Screening and assessment for post-acute COVID-19 syndrome (PACS), guidance by personal pilots and support with individual digital trainings within intersectoral care: a study protocol of a randomized controlled trial

BackgroundBecause the clinical patterns and symptoms that persist after a COVID-19 infection are diverse, a diagnosis of post-acute COVID-19 syndrome (PACS) is difficult to implement. The current research project therefore aims to evaluate the feasibility and the practicability of a comprehensive, interdisciplinary, and cross-sectoral treatment program consisting of a low-threshold online screening and holistic assessment for PACS. Furthermore, it aims to evaluate digital interventions and the use of so-called personal guides that may help to facilitate the recovery of PACS.MethodsThis German study consists of a low-threshold online screening for PACS where positively screened participants will be supported throughout by personal pilots. The personal pilots are aimed at empowering patients and helping them to navigate through the study and different treatment options. Patients will then be randomly assigned either to an intervention group (IG) or an active control group (ACG). The IG will receive a comprehensive assessment of physiological and psychological functioning to inform future treatment. The ACG does not receive the assessment but both groups will receive a treatment consisting of an individual digital treatment program (digital intervention platform and an intervention via a chatbot). This digital intervention is based on the needs identified during the assessment for participants in the IG. Compared to that, the ACG will receive a more common digital treatment program aiming to reduce PACS symptoms. Importantly, a third comparison group (CompG) will be recruited that does not receive any treatment. A propensity score matching will take place, ensuring comparability between the participants. Primary endpoints of the study are symptom reduction and return to work. Secondary outcomes comprise, for example, social participation and activities in daily life. Furthermore, the feasibility and applicability of the online screening tool, the holistic assessment, digital trainings, and personal pilots will be evaluated.DiscussionThis is one of the first large-scale studies to improve the diagnosis and the care of patients with PACS by means of empowerment. It is to be evaluated whether the methods utilized can be used for the German and international population.Trial registration ClinicalTrials.gov Identifier: NCT05238415; date of registration: February 14, 2022

Clinical Study of Mobile Application- (App-) Based Family-Centered Care (FCC) Model Combined with Comprehensive Iron Removal Treatment in Children with Severe Beta Thalassemia.

Methods A retrospective study was conducted on the clinical records of 148 children diagnosed with severe beta thalassemia who were admitted to our hospital between October 2018 and September 2021. The patients were separated into two groups, a control group and an intervention group, with 74 cases in each group, according to the various care approaches. The basic treatment regimen was given to all of the children: deferoxamine mesylate combined with deferiprone. During treatment, the control group received routine care, and the intervention group adopted the FCC model based on a mobile app. The quality of life scale for children and adolescents (QLSCA) score, the family assessment device (FAD) score, the exercise of self-care agency scale (ESCA) score, and the medication compliance scale score were compared between the two groups. Results The QLSCA score, ESCA score, and medication compliance scale score of the intervention group were significantly higher than those of the control group and showed a significant difference (intergroup effect: F = 198.400, 259.200, and 129.800, all P < 0.001). Scores in both groups increased over time (time effect: F = 19.350, 40.830, and 12.130, all P < 0.001), and there was an interaction effect between grouping and time (interaction effect: F = 3.937, 12.020, and 5.028). The P values were 0.020, <0.001, and 0.007. The FAD score of the intervention group was significantly lower than that of the control group (intergroup effect: F = 177.200, P < 0.001). The FAD scores of both groups decreased over time (time effect: F = 7.921, P = 0.005). There was an interaction effect between groups and time (interaction effect: F = 5.206, P = 0.006). Conclusion The application effect of the mobile app-based FCC model combined with the comprehensive iron removal treatment program in children with severe beta thalassemia is significant, which can significantly improve the quality of life, family function, self-care ability, and medication compliance of children, and has high clinical application value.

Voice Handicap Index in Iranian Rehabilitation Professors with and Without Vocal Complaints

Background: University professors are a group of professional voice users who report more voice problems than the general population, which may affect their quality of life. The World Health Organization defines health as a multidimensional concept: "A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." The Voice Handicap Index (VHI) can assess university professors' vocal health even before having a voice problem. Objectives: We aimed to study the Voice Handicap Index (VHI) in Iranian rehabilitation professors with and without vocal complaints. Methods: This cross-sectional online study enrolled 235 professors (100 men and 135 women) from Iranian rehabilitation colleges selected through stratified random sampling. The inclusion criterion was being a university professor. The assessment tools included VHI and a four-part questionnaire about vocal complaints. The Kolmogorov-Smirnov test checked the normality of quantitative data. The Mann-Whitney and chi-square tests compared the two groups. The data were analyzed by SPSS21 at a significance level of 0.05. Results: The rate of voice problems was significantly more in professors with vocal complaints (29.12%) than in those without complaints (9%), according to VHI30 (P &lt; 0.001). The mean VHI differences between the two groups, with and without vocal complaints, were significant in the scores of the total scale (P &lt; 0.000) and its subtests physical (P &lt; 0.000), emotional (P &lt; 0.000), and functional (P &lt; 0.002). Some information was also obtained about vocal complaints in professors, including the frequency of nine vocal complaints. The frequency of the complaints was 64.1% for vocal fatigue, 61.2% for hoarseness, 24.3% for pain, 16.5% for breathy voice, 15.5% for strain, 13.6% for monotone voice, 11.7% for pitch breaks, 5.8% for aphonia, 4.9% tremor in professors with vocal complaints, 78.64% for the effect of vocal complaints on communication, and 72.8% (acute) and 27.2% (chronic) for the duration of vocal complaints. Conclusions: Iranian university professors of rehabilitation science with vocal complaints had higher VHI scores than those without vocal complaints, which shows they may be apt to voice problems. Vocal fatigue was the most common voice complaint, and voice tremor was the least. Also, most reported complaints were acute that affected professors' communication. In future research, it seems necessary to design comprehensive prevention and treatment programs focusing on the vocal health of professors in rehabilitation colleges.

Effectiveness of a Public Transportation Intervention Program for Individuals With Autism Spectrum Disorder

Abstract Date Presented 04/02/2022 Transitional-age youth and young adults with autism spectrum disorder (ASD) often face transportation challenges that impede community participation. The purpose of this study was to examine the impact of a comprehensive peer support OT intervention program on the travel skills of individuals with ASD to increase community mobility. Primary Author and Speaker: Elizabeth Pfeiffer

IMPLEMENTATION OF BARANGAY JUSTICE SYSTEM AND COMMUNITY SATISFACTION IN THE MUNICIPALITY OF CALAUAN, LAGUNA: BASIS FOR INTERVENTION PROGRAM

The study determined the Level of Implementation of the Barangay Justice System and community satisfaction in the Municipality of Calauan. Through this objective, the study helped create an intervention program that will surely help in decongesting the court dockets and improve the mediation process in the Municipality of Calauan. This study was descriptive correlational that dealt with the relationship of relevant variables, particularly the Implementation of Barangay Justice and Community Satisfaction. It assessed the relationship between variables and a quantitative research design that used a self-made questionnaire which was answered by 255 respondents, specifically 10 members in the Lupon Tagapamayapa and 5 clients who filed a case in the Katarungang Pambarangay in all 17 Barangays of the Municipality. It collected quantifiable information and used a statistical test to analyze the data. Based on the findings of the study, the results made by the Lupon Tagapamayapa Members and its Constituents on the Implementation of the Barangay Justice System were all fully implemented. On the test of significant difference between the assessment of Lupon Tagapamayapa Members and its Constituents as regards the Implementation of Barangay Justice System were all greater than the level of significance at .05 concluded that there was no significant difference in the assessment of the respondents on the Level of Implementation of Barangay Justice System in the Municipality of Calauan, Laguna. An output was made after determining the least mean results in the study. A comprehensive Intervention Program that will help the Municipality of Calauan in Implementing the Barangay Justice System.

Клініко-терапевтичні особливості пацієнтів із шизотиповим розладом з обсесивно-компульсивною симптоматикою

Introduction. The prevalence of obsessive-compulsive symptoms in modern conditions of high stress and the lack of detailed recommendations for this category of patients determine the relevance of this publication. The emergence of suffering at a young age forms insufficiently adaptive behaviors and complicates the socialization of such persons. And the emergence of these symptoms within different etiological disorders requires the development of differentiated diagnostic and therapeutic approaches. Materials and methods. The study involved 69 outpatients with leading obsessive-compulsive disorder within schizotypal disorder (F21). The following methods were used: clinical-psychopathological, psychodiagnostic, clinical-follow-up and mathematical statistics. Patients were examined using psychodiagnostic techniques: clinical scale of obsessions and Yel-Brown compulsions (Y-BOCS - Obsessive-compulsive Scale); hospital anxiety and depression scale (HADS); quality of life scale (Chaban OS, 2008); multidimensional scale of perception of social support ("MSPSS" D. Zimet); questionnaire "Lifestyle Index" ("LSI" by R. Plutchik - G. Kellerman - H. R. Conte), method "Psychological diagnosis of coping behavior strategy" by R. Lazarus. Results. The clinical typology of these symptoms: type of avoidance, type of ambivalence and type of accumulation was studied by processing the clinical scale of obsessions and Yel-Brown compulsions (Y-BOCS) in patients with schizotypal disorder (F21). It was found that these symptoms were accompanied by anxiety and depressive symptoms only at the subclinical level, which indicates a lack of criticism of one’s condition. In patients with the leading obsessive-compulsive symptoms in schizotypal disorder, not quite mature variants of the protective structure are actualized, namely, substitution (62.3%), displacement (60.9%), regression (58%) and denial (26.1%). The leading coping strategies of such individuals are self-control (73.9%) and escape-avoidance (55.1%), which differs significantly from the strategies more often used by patients with ACS at the neurotic level. We have proposed a program of comprehensive treatment of this group of patients. Patients were divided into 2 groups, the first of which received a combined (differentiated psychopharmacological interventions and psychotherapy) option of therapy, and the second – only differentiated psychopharmacotherapy. The psychotherapeutic formulation was determined by different focus targets depending on the type of obsessive-compulsive symptoms and consisted of a combination of techniques of cognitive-behavioral therapy (CBT) and gestalt therapy (GT). The results of the follow-up study indicate the effective impact of the developed treatment and rehabilitation program on all components of the mental state and social functioning of patients with all types of obsessive-compulsive symptoms of subpsychotic level. Conclusions. The leading types of ACS in schizotypal disorder and features of psychosocial functioning in patients have been identified, which allowed to create a differentiated approach to the formation of a program of their comprehensive treatment and rehabilitation. Such persons need mandatory psychopharmacotherapy and differentiated psychotherapeutic intervention. The application of the program made it possible to improve the mental state and quality of life and achieve the optimal level of adaptation of patients in various spheres of life, increase periods of remission and prevent recurrence of the disorder.