Follow-up In Group Research Articles

An overview of the Swiss Neonatal Network & Follow-up Group (SwissNeoNet)

: The Swiss Neonatal Network & Follow-up Group (SwissNeoNet) started as a paper based standardized data collection for very preterm born infants in 1995 for the purpose of research. It has since evolved into a sophisticated online medical registry with the chief aim of improving the quality of medical care for high-risk newborn infants through research, education and collaborative audit. In support of its aim, it collects primary hospitalization and neurodevelopmental follow-up data of various cohorts of newborns from all level III neonatal intensive care units (NICUs) and all peripheral intermediate care level IIB neonatal units (NUs) in Switzerland. It coordinates clinical, epidemiological and health-services research that provide orientation for Swiss neonatologists on how their performance compares with that of other networks, how different approaches in practices without clear evidence base associate with outcome, or how processes and outcomes evolve longitudinally. Its research also allowed former very preterm born children to express their own perception of their quality of life. SwissNeoNet closely monitors and compares NICUs and NUs and provides the infrastructure for quality improvement collaboratives. All units jointly and openly compare their performance and identify potential for changing clinical practices which has led to several local improvement projects as well as revisions of national treatment recommendations. To collaborate in research, to acquire benchmarks, and to serve as a benchmark, SwissNeoNet is actively engaged in several national and international collaborations. Receiving no governmental support, SwissNeoNet struggles with a limited budget to continuously operate a multifaceted, complex network with an electronically advanced, security sensitive infrastructure. Nevertheless, it plans expanding by connecting closer to the families and ultimately the former very preterm born children in the near future: building a patient reported outcome measure (PROM) repository and thus learning more about the parental/patient perspective will benefit clinical research, qualitative research, quality assessment, long-term follow-up recruitment and may even pave the way to later expand into citizen science and personalized health care.

Internet follow-up can improve the compliance of sublingual immunotherapy in children with allergic rhinitis: a retrospective cohort study.

Sublingual immunotherapy (SLIT) is an effective approach for treating allergic rhinitis in children. Although the curative effect of SLIT is significant, the compliance of patients is poor because of the long treatment time. How to improve patients' compliance with SLIT is an important clinical problem faced by otolaryngology clinicians. At present, there are few studies on SLIT compliance. The present study aimed to analyze the related factors affecting SLIT compliance in children with allergic rhinitis (AR). In total, 153 patients with AR who received SLIT were selected as the study objects. Seventeen patients were excluded from this study.The patients' demographic, follow-up methods, complications efficacy, compliance data, etc. were collected, and all patients were followed-up regularly. Patients were considered to have poor compliance when they stop taking medication of SLIT. Univariate and multivariable regression analyses were performed to analyze the independent factors influencing SLIT compliance. The odds ratios (ORs) and 95% confidence intervals (CIs) were computed by logistic regression. A total of 136 patients were enrolled in this study. The baseline clinical factors of the two groups of follow-up methods were balanced and comparable. Among these, 35 patients (25.7%) ceased SLIT. There was a significant difference in compliance between the Internet follow-up group and the traditional follow-up group (P<0.001). Univariate logistic regression analysis showed that SLIT compliance was significantly related to residence (P<0.001), the caregiver's education level (P<0.001), follow-up methods (P<0.001), and whether the patient also had asthma (P<0.002). In the multivariate regression analysis, it was found that the follow-up methods (OR =7.60, 95% CI: 2.20-26.21, P=0.001) and caregiver's education level (OR =8.54, 95% CI: 3.04-23.95, P<0.001) were independent factors influencing SLIT compliance after adjusting for residence and whether the patient also had asthma. Our study found that the follow-up methods and the education level of caregivers were independent factors affecting SLIT compliance in children with AR. This study suggested that we should use the Internet follow-up method for children treated with SLIT in the future, and provides a basis for how to improve the compliance of SLIT in children with AR.

Efficacy of Peripheral Nerve Stimulation with a High Frequency Electromagnetic Coupled (HF-EMC) Powered Implanted Receiver in Treating Different Pain Targets/Neuralgias.

Chronic pain is a significant global public health problem. Peripheral nerve stimulation (PNS) has been gaining popularity in recent years as it is effective, safe and less invasive than surgery for the treatment of chronic pain. The authors aimed to document and share a collection of patient-reported pain scores before and after implanting a percutaneous PNS lead/s with an external wireless generator at various target nerves. The authors designed a retrospective study, reviewing electronic medical records. Statistical analysis was performed using SPSS 26; p-value ≤ 0.05 was considered significant. The mean baseline pain scores of 57 patients have reduced significantly after the procedure at different follow-up durations. Target nerves included genicular nerves, superior cluneal nerves, posterior tibial nerve ± sural nerve, middle cluneal nerves, radial and ulnar nerves and right common peroneal nerve. In the one-month follow-up group, mean pain score was reduced from 7.44 ± 1.48 pre-procedure to 1.6 ± 1.49, from 7.42 ± 1.5 pre-procedure to 1.6 ± 1.5 7.42 at 3 months, from 7.52 ± 1.5 to 1.72 ± 1.57 at 6 months, from 7.41 ± 1.53 to 1.7 ± 1.55 at 9 months, from 7.41 ± 1.58 to 1.76 ± 1.63 at 12 months, from 7.38 ± 1.59 to 1.69 ± 1.56 at 15 months and from 7.5 ± 1.7 to 1.45 ± 1.57 at 24 months (p ≤ 0.001). Patients also reported significant reduction in morphine milliequivalent, pre-procedure MME 47.75 ± 452.5 to 37.92 ± 43.51 at 6 months (p = 0.002, N = 57), pre-procedure MME 42.72 ± 43.19 to 30.38 ± 41.62 at 12 months (p = 0.003, N = 42), and pre-procedure MME 41.2 ± 46.12 to 21.19 ± 40.88 at 24 months (p ≤ 0.001, N = 27). The only complications occurred post procedure with 2 patients receiving an explant and 1 patient receiving a lead migration. PNS has been shown to be safe and effective in treating chronic pain at different sites with sustained pain relief for up to 24 months. This study is unique in providing long-term follow-up data.

Standard follow-up after curative surgery for advanced gastric cancer: secondary analysis of a multicentre randomized clinical trial (KLASS-02).

The benefit of regular follow-up after curative resection for gastric cancer is controversial as there is no evidence that it will improve survival. This study assessed whether regular follow-up leads to improved survival in patients after surgery for gastric cancer. A secondary analysis was undertaken of patients who participated in an RCT of laparoscopic versus open distal gastrectomy for advanced gastric cancer between November 2011 and April 2015. Depending on whether patients were compliant with the initial trial follow-up protocol or not, they were analysed as having had either regular or irregular follow-up. Clinicopathological characteristics, recurrence patterns, detection, treatments, and survival were compared between the groups. The regular and irregular follow-up groups comprised 712 and 263 patients respectively. Disease recurrence within 36 months was more common in the regular group than in the irregular group (17.0 versus 11.4 per cent; P = 0.041). Recurrence patterns did not differ between the groups. The 3-year recurrence-free survival rate was worse in the regular than in the irregular group (81.2 versus 86.5 per cent; P = 0.031). However, the 5-year overall survival rate was comparable (84.5 versus 87.5 per cent respectively; P = 0.160). Multivariable analysis revealed that type of follow-up was not an independent factor affecting 5-year overall survival. Regular follow-up after radical gastrectomy was not associated with improved overall survival.

"You have to strive very hard to prove yourself": experiences of Black nursing students in a Western Canadian province.

This study explored the experiences of Black students in two western Canadian undergraduate nursing programs. Using a qualitative focused ethnography design grounded in critical race theory and intersectionality, participants were recruited using purposive and snowball sampling. Data were collected through individual interviews, and a follow-up focus group. Data were analyzed using collaborative-thematic analysis team approaches. n=18 current and former students participated. Five themes emerged: systemic racism in nursing, precarious immigrant context, mental health/well-being concerns, coping mechanisms, and suggestions for improvement. An improved understanding of Black student experiences can inform their recruitment and retention. Supporting Black students' success can potentially improve equity, diversity, and inclusivity in nursing education programs and/or their representation in the Canadian nursing workforce. The presence of a diverse nursing profession is imperative to meet the needs to provide more quality and culturally competent services to diverse population.

A lower energy intake contributes to a better cardiometabolic profile in adolescence: Data from the EPITeen cohort

Caloric restriction has been associated with improved cardiometabolic health. Available data in humans are commonly based on short follow-up periods, specific diets, or population groups. We hypothesized that participants of a population-based cohort (Epidemiological Health Investigation of Teenagers in Porto) with a dietary pattern characterized by a lower energy intake during adolescence have a better cardiometabolic profile in adolescence and young adulthood than other dietary patterns. At aged 13 and 21 year evaluations, diet, anthropometric, and cardiometabolic measures were assessed. Diet was assessed through a food frequency questionnaire and, at 13 years, summarized in dietary patterns identified by cluster analysis. The lower intake dietary pattern included 40% of the participants. The energy intake misreport was estimated using the Goldberg method. Analysis of variance and analysis of covariance were used to compare cardiometabolic risk factors according to dietary patterns. The mean energy intake was 2394 and 2242 Kcal/d for the total sample at aged 13 years (n=962) and 21 years (n=862), respectively. Those belonging to the lower intake dietary pattern showed a 25% and 5% lower energy intake, respectively. In the cross-sectional analysis at aged 13, adolescents belonging to the lower intake dietary pattern presented lower glucose, insulin, triglycerides, and blood pressure values after adjusting for body mass index and parents' education level. Among the plausible reporters, differences were only statistically significant for glucose and systolic blood pressure. Our data support that a dietary pattern characterized by a lower energy intake may contribute to a better cardiometabolic profile in adolescents. However, no significant effect was found in young adulthood.

Snakes and ladders: A qualitative study understanding the active ingredients of social interaction around the use of audit and feedback.

Explore characteristics of the facilitator, group, and interaction that influence whether a group discussion about data leads to the identification of a clearly specified action plan. Peer-facilitated group discussions among primary care physicians were carried out and recorded. A follow-up focus group was conducted with peer facilitators to explore which aspects of the discussion promoted action planning. Qualitative data was analyzed using an inductive-deductive thematic analysis approach using the conceptual model developed by Cooke et al. Group discussions were coded case-specifically and then analyzed to identify which themes influenced action planning as it relates to performance improvement. Physicians were more likely to interact with practice-level data and explore actions for performance improvement when the group facilitator focused the discussion on action planning. Only one of the three sites (Site C) converged on an action plan following the peer-facilitated group discussion. At Site A, physicians shared skepticism of the data, were defensive about performance, and explained performance as a product of factors beyond their control. Site B identified several potential actions but had trouble focusing on a single indicator or deciding between physician- and group-level actions. None of the groups discussed variation in physician-level performance indicators, or how physician actions might contribute to the reported outcomes. Peer facilitators can support data interpretation and practice change; however their success depends on their personal beliefs about the data and their ability to identify and leverage change cues that arise in conversation. Further research is needed to understand how to create a psychologically safe environment that welcomes open discussion of physician variation.

Engaging boys in menstrual hygiene management (MHM) interventions in Bangladeshi schools: a pilot study to assess acceptability and feasibility

AbstractEducating boys about puberty and menstruation has been hypothesized to aid in reducing menstrual stigma and negative attitudes about menstruation. We developed and piloted a school-based intervention for girls and boys to increase knowledge about puberty and foster a more supportive environment for menstruating schoolgirls. In this sub-study, we conducted 24 formative in-depth interviews and four group vignette exercises for schoolboys to develop the intervention package. We then carried out pre- and postintervention surveys and conducted four follow-up focus group discussions to determine the feasibility, acceptability, and effects of the intervention package among schoolboys and to develop recommendations for scale up. During the formative phase, boys reported minimal knowledge concerning puberty but felt puberty education was vital for all. Following the intervention, boys' awareness of menstruation increased compared to baseline [PD: 15%; 95% confidence interval (CI): 2, 29]. The reported comfort level of discussing puberty-related issues in a school club or with friends also increased [PD: 13%; 95% CI: 2, 24]. In focus groups, boys reported finding the sessions helpful and informative. Engagement of schoolboys, combined with well-delivered intervention materials and social and behavior change communication interventions is feasible and can contribute to a more supportive and girl-friendly environment in schools.

The Unique Lived Experiences of LGBQ Athletes: A Collegiate Women’s Rugby Club Team as an Inclusive & Empowering Community

ABSTRACT There is ongoing debate regarding the culture of competitive women’s sports. On one hand, women who participate in sports are viewed as adhering to and reinforcing heteronormative stereotypes and hegemonic masculinity. Conversely, women’s sports are viewed as an inherently supportive environment for those involved. The current study explored the latter phenomena, specifically related to factors that promote an inclusive and empowering community for LGBTQ+ women. Eleven individual semi-structured interviews and one follow-up focus group with six participants were conducted with women from a collegiate women’s rugby club team. All participants described their sexual identities as Lesbian, Gay, Bisexual, and/or Queer (LGBQ). A reflexive thematic analysis was used to analyze the data collectively. Participants described their collegiate rugby team as being one of their first encounters with a safe and inclusive LGBTQ+ environment. Membership on the team also was viewed as an important experience that helped participants come to terms with their sexual identity. Specifically, findings indicate the supportive actions of teammates, an inclusive team culture, and unique factors related to the sport of rugby helped promote an inclusive and empowering community for LGBTQ+ women. Indeed, from a critical positive youth development perspective, social justice life skills (e.g., allyship) provided actionable behaviors that promote an inclusive and empowering community for LGBTQ+ women. However, future research must seek to understand the lived experiences of all women’s rugby participants, particularly transgender and athletes of color.

Borderline personality disorder in young adults: features of psychopathology and patterns of course

To identify the psychopathological features of borderline personality disorder (BPD) in adolescence, determine the trajectory of its further course, and develop criteria for differential diagnosis. Clinical/psychopathological and psychometric methods were used to study 143 patients. The patients were divided into two groups: a clinical group - 73 patients, who were inpatients or outpatients in the clinical departments of the Mental Health Research Center (MHRC) in 2019-2022, and a follow-up group - 70 patients who were inpatients or outpatients in the MHRC clinic in 2006-2010. The structure of BPD in adolescence was clinically heterogeneous, which allowed distinguishing three typological varieties: with phenomena of «affective storm», which was characterized by the dominance of affective disorders, including after completion of adolescence, with some stabilization of personality structure (type I); with the dominance of addictive patterns of the type of «adrenalinomania», in which one of the key positions was occupied by craving impairments, with a constant need to search for new extreme hobbies, the use of psychoactive substances, which persisted after the end of adolescence (type II); with the predominance of «cognitive dissociation», which was characterized by the most polymorphic picture of disorders, with the predominance of self-identification disorders with dissociative disorders that retain their severity after the end of adolescence (type III). An integrative assessment of outcomes showed that rather favorable results (47.37%) (χ2=23.37, p=0.001) prevailed at type I, type II was characterized by rather unfavorable (59.26%) and unfavorable results (22.22%) (χ2=12.75, p=0.013) and type III by rather unfavorable (79.17%) and unfavorable (8.33%) outcomes (χ2=16.75, p=0.002). In the nosological evaluation of the follow-up group, 80.0% of patients were diagnosed with BPD, in the rest of the patients there was a change in diagnosis: in 14.3% for schizotypal disorder, in 5.7% for an attack-like form of schizophrenia (χ2=13.8, p=0.008; χ2=14.5, p=0.006). BPD in adolescence was confirmed in the majority of cases in adulthood. The results confirm that the typological variants of BPD are of prognostic value and can serve to further develop therapeutic and socio-rehabilitation measures.

Whole Blood Titanium Concentration after Limb Salvage Surgery with Three-Dimensional-Printed Ti6Al4V Implants.

Three-dimensional (3D)-printed customized implants can be fabricated and utilized for all bones with massive bone defects. The main safety issues with 3D-printed implants made of Ti6Al4V alloy are related to the release of metal debris and residual powder. In this study, we investigated the perioperative titanium concentrations in whole blood and peri-implant fluid samples of patients who underwent limb salvage surgery with a 3D-printed Ti6Al4V implant. Nineteen patients who underwent limb salvage surgery with 3D-printed Ti6Al4V implants were divided into two groups: the serial samples group and the follow-up group. To observe metal distribution and clearance in the body, serial samples of blood and peri-implant fluid from the surgical drain were prospectively collected for five patients in the serial samples group. For the remaining 14 patients who were followed up for more than a year, blood samples were collected only once. In the serial samples group, the mean baseline titanium concentration was 0.78 µg/L (range, 0.1-2.2 µg/L): 3 patients showed peak concentration before the third postoperative month, while 2 patients still showed an increasing pattern at this point. Total titanium mass in the surgical drain showed a wash-out phenomenon in a week, with a significant uniform decrease (p = 0.04). In 14 patients in the follow-up group, the mean titanium concentration in the whole blood was 10.8 µg/L (range, 0.3-36.6 µg/L). For the 14 patients with a long-term follow-up, the aluminum and vanadium concentrations were all negligible. Whole blood titanium concentrations were higher after surgery using 3D-printed implants than after that using conventional orthopedic implants, but markedly lower than in patients with implant failure. None of the patients developed serious clinical adverse effects during follow-up.

Effectiveness of a school-based health education program to improve the symptoms of premenstrual syndrome in high school girls in Ilam.

The premenstrual syndrome happens periodically and affects both the individual and family. The aim of this study was to determine the effect of the health education program on reducing premenstrual syndrome in high school girls in Ilam. This experimental study was conducted in girls' high schools in Ilam, in 2017-2018. In total, 120 students were enrolled in the study (intervention group = 61 and control group = 59) and selected through convenience sampling. In this study, a standard Premenstrual Symptoms Screening Tool (PSST) was used to diagnose students with premenstrual syndrome or Premenstrual Dysphoric Disorder (PMDD). The educational program for the intervention group was held in four sessions of 30 min for 4 consecutive weeks. The obtained data were analyzed by the SPSS statistical software at a significance level of less than 0.05. The results showed a significant difference in the proportion of cases with moderate and severe PMS and PMDD between intervention and control groups in follow-up (P < 0.001). However, these proportions were not significantly different between the two groups in the baseline. According to the results, the educational program can be recommended as an effective intervention for girls with moderate-to-severe premenstrual symptoms and premenstrual dysphoric disorder.

Combined PCL and PLC Reconstruction Improves Residual Laxity in PCL Injury Patients with Posterolateral Knee Laxity Less Than Grade III.

To compare the short-term clinical and radiologic outcomes of combined posterior cruciate ligament (PCL) and posterolateral complex (PLC) reconstruction to those of isolated PCL reconstruction (PCLR) for patients with posterolateral knee laxity less than grade III. We retrospectively reviewed 49 patients (51 knees) who underwent PCLR between January 2008 and December 2015. Patients with a minimum follow-up of 24 months were included and divided into two groups (group A, isolated PCLR; group B, combined PCL and PLC reconstruction). Clinical outcomes were evaluated as the International Knee Documentation Committee (IKDC) subjective, Lysholm, and Tegner activity scale scores. Radiologic outcomes were also assessed using the side-to-side differences in posterior tibial translation via stress radiographs. A total of 30 cases were analyzed. There were no significant differences in the Lysholm and Tegner activity scale scores between the two groups preoperatively and at the final follow-up. However, group B showed a higher IKDC subjective score compared to group A at the final follow-up (group A, 72.8±8.9; group B, 77.7±10.1; p<0.05). Regarding the radiologic outcomes, group B also showed a significantly less side-to-side difference in posterior tibial translation compared to group A at the final follow-up (group A, 4.8±2.3 mm; group B, 3.8±2.1 mm; p<0.05). Combined PCL and PLC reconstruction resulted in improved clinical and radiologic outcomes than isolated PCLR in patients who have less than grade III posterolateral laxity of the knee. In cases of PCL rupture with ambiguous PLC injury, combined PCL and PLC reconstruction may help to improve posterior residual laxity of the knee.

Evaluation of an Online Decision Aid for Selection of Contraceptive Methods.

Knowledge gaps in contraceptives led to their low adoption rates and misuse in young women. The existing online contraception decision aids missed certain decision factors deemed important to college-aged women and did not consistently provide clear and accurate recommendations. To address the needs of young women and the limitations in current tools, we developed a prototype contraception decision aid, My Contraceptive Choice (MCC). This article reports an evaluation study of the MCC tool. We conducted a mixed methods study: (1) to assess MCC's usefulness and usability through an online survey and a follow-up focus group, and (2) to provide a quantitative examination on the recommendations generated by MCC to match with individual user's needs and preferences through simulated test cases. The survey of 150 college-aged women showed very positive responses (reflecting personal preferences, 75%; helping people learn more about birth control methods, 88%; easy to navigate, 91%). The follow-up focus group of 10 survey participants reconfirmed most findings from the survey and provided detailed feedback on certain system functions, such as the inclusion of an important decision factor of weight gain and the efficient hybrid design to integrate the customized recommendations with the side-by-side comparison of all contraceptive methods. Simulated test cases showed that the MCC tool achieved an accuracy of 72% in addressing user preferences and an accuracy of 72% in satisfying user needs, which were significantly better than the existing Planned Parenthood tool. The initial evaluations suggest that the MCC tool has achieved good levels of usefulness, usability, and appropriate recommendations to address user needs and preferences. Future research is required to assess the performance of the MCC tool in naturalistic settings and to examine the generalizability of the findings to other user populations.

The effectiveness of McMaster model on anxiety and self-control of women on the verge of divorce

Aim: The aim of this study was to determine the effectiveness of McMaster model on anxiety and self-control of women on the verge of divorce. Method: The present study was a quasi-experimental with pre-test and post-test with a two-month control and follow-up group; The statistical population of the present study was women referring to counseling centers in District 6 of Tehran in 2020. After screening with the Zung Anxiety Questionnaire (1971), 30 women were selected by convenience sampling method in the experimental group of McMaster model (n = 15) and control group (n = 15) were randomly replaced. The experimental group underwent the intervention of McMaster model (2007) for eight sessions of 90 minutes and the control group did not receive any intervention. The research instruments were Zung Anxiety Inventory (1971) and Tangney, Bamster and Boone (2004) Self-Control Questionnaire and the data were analyzed using repeated measures mixed variance analysis. Results: The results showed the effect of Maxmaster model intervention on anxiety score (F = 5.25, P = 0.030) and self-control (F = 8.56, P = 0.007) and the stability of this effect in the follow-up stage. Conclusion: The results of the study suggest evidence that the McMaster model is an appropriate method to increase self-control and also reduce anxiety in women on the verge of divorce.

Comparing the effectiveness of teaching cognitive and metacognitive strategies on academic buoyancy

Background and Aim: The present research was designed and implemented to compare the effectiveness of teaching cognitive learning strategies and metacognitive learning strategies on the academic buoyancy of Tehran students in the academic year 2020-21. Methods: The current research was conducted as a quasi-experimental study with a pre-test and post-test along with a control and follow-up group. The research population included students who were studying in Tehran in 2021; A random sampling method was used to select the sample. They were replaced in the test 1 and test 2 groups and the control group. First, the pre-test was performed for all three groups, then one training group was taught cognitive learning strategies and the other experimental group was taught metacognitive learning strategies; However, there was no intervention in the control group, and at the end, a post-test was taken from all three groups. The questionnaire used in the research was the Academic Buoyancy Questionnaire by Martin and Marsh (2008). To analyze the data, the method of mixed variance analysis was used. Results: The interaction of stages with the experimental group was effective in three stages of measurement in academic monitoring (F=8.78, P=0.001). Conclusion: The results showed that according to the average scores of the pre-test and post-test and comparing them with the control group, the academic buoyancy of the students has increased; Also, a follow-up test was taken after one month, in which the post-test changes remained stable and stable.

Comparing the effectiveness of multisensory stimulation and cognitive rehabilitation on mental state, memory and sleep disorder in elderly women with cognitive impairments

Aim: The present study was conducted with the aim of comparing the effectiveness of multisensory stimulation and cognitive rehabilitation on mental state, clinical memory and sleep disorder in elderly women with cognitive impairments. Methods: The current research was conducted as a semi-experimental pre-test-post-test type with control and follow-up groups. The statistical population consisted of 30 elderly women referring to nursing homes in Tehran, who were divided into two experimental and control groups by a simple random method. To collect data from Folstein mental state questionnaires (1975), Wechsler Bluber clinical memory questionnaire (1939), Petersburg Boyce et al. sleep quality questionnaire (1989) and cognitive deficits questionnaire (national surveys standard of the Ministry of Health and Iran Statistics Center) used. The data was analyzed using SPSS-21 software and mixed analysis of variance tests. Results: According to the results of multisensory stimulation and cognitive rehabilitation, it improves mental status (F=28.58, P&lt;0.001), clinical memory (F=20.27, P&lt;0.001), and sleep disorder (F=12.43, P&lt;0.001) has a significant effect in the elderly with cognitive defects (P&lt;0.01). The effectiveness of cognitive rehabilitation is greater compared to multisensory stimulation on the mental state and clinical memory of the elderly (P&lt;0.01); However, the effectiveness of multisensory stimulation on the sleep disorder of the elderly is more than the effectiveness of cognitive rehabilitation (P&lt;0.01). Conclusion: This method can be used to improve the cognitive ability and, as a result, the quality of life of the elderly independently and together with clinical and subclinical cognitive treatments.

REX SHUNT IN CHILDREN: COULD DYSFUNCTION BE PROGNOSED? A RETROSPECTIVE ANALYSIS.

The aim: To analyze retrospectively our experience of Rex shunt in children with symptomatic portal hypertension, its effect on hypersplenism regression and varices eradication, assess shunt survival and investigate risk factors, that could lead to shunt dysfunction and thrombosis. Materials and methods: 24 children (16 males, 8 females) ,with portal hypertension included into the study. All surgeries were performed within single center in a period from January 2010 to March 2022. Follow up period was 6.75±1.19 years. Results: Age at diagnosis was 5.39±0.64 years. 5 (20.8%) had umbilical catheter in anamnesis. 16 (66.7%) manifested bleeding episodes as the first sign of portal hypertension. 9 (37.5%) of children manifested severe hypersplenism. Age at Rex shunting was 7.5±0.7 years. In 7 (31.8%) cases Rex shunt thrombosis occurred. 1 successful thrombectomy and 6 splenorenal shunting were performed. Kaplan-Meyer analysis showed Rex shunt survival 0.670 (95%CI 0.420-0.831). Logistic regression model indicated thrombocytes count (p=0.0423) and cytopenia (p=0.0272) as factors that could influence shunt thrombosis. Follow-up group included 18 patients. Spleen volume regression became significant by 1 p/o year p<0,05, thrombocytes significant increasement reached in 1 p/o months (p<0.01), varices involution was achieved by 1 p/o year (p<0,001). Conclusions: Rex shunt effectiveness in study group was 70.9%., shunt survival assessed 0.670 (95%CI 0.420-0.831). Rex shunt was effective in bleeding prophylaxis in all patients of follow up group. Preoperative thrombocytes count (p=0.0423) and cytopenia (p=0.0272) were detected as factors that could influence shunt thrombosis, that is to be considered in RS preoperative period and require following studies.

Comparing the effectiveness of group dialectical behavior therapy with group schema therapy on emotional dysregulation in women with coronary heart disease

The present study aimed to compare the effectiveness of group dialectical behavior therapy with group schema therapy on emotional dysregulation in women with coronary heart disease. The present study method was quasi-experimental and the design used in this research was a pre-test-post-test design with control and follow-up groups. The statistical population of this research included married women aged 35 to 50 with coronary heart disease who visited Azadi Vascular Hospital in Tehran in 2022. Three groups were randomly grouped using the available sampling method: 15 subjects in the first group, 15 in the second group, and another 15 subjects in the control group. In order to carry out regular treatment sessions, an 8-session dialectical behavior therapy protocol and an 8-session schema therapy protocol were developed and implemented. Gratz and Roemer (2004) Difficulty in Emotional Regulation have been used to collect data. In order to statistically analyze the data, analysis of variance with repeated measurements and Bonferroni's post hoc test were used by SPSS software. The results of Bonferroni's post hoc test showed that there is a difference between the effectiveness of group dialectical behavior therapy and group schema therapy on emotional dysregulation in women with coronary heart disease from the pre-test stage, to the post-test and follow-up (p&lt;0.05); Compared to group schema therapy, dialectical behavioral therapy has a greater effect in reducing emotional dysregulation in women with coronary heart disease from the pre-test stage to the post-test and follow-up

Comparison of the effectiveness of compassionate mind-based therapy and dialectical behavior therapy on cognitive deficits, emotional processing defects and impulsivity of adolescent soldiers aged 18 to 20 years with high-risk behaviors

Background and Aim: High-risk behaviors are behaviors that increase the likelihood of physical, psychological and social disastrous consequences for the individual. The aim of this study was to compare the effectiveness of compassionate mind therapy and dialectical behavior therapy on cognitive deficits, emotional processing defects and impulsivity of adolescent soldiers aged 18 to 20 years with high-risk behaviors. Methods: The method of the present study was quasi-experimental with a pretest-posttest design with a follow-up group. The statistical population of this study included all adolescent soldiers aged 18 to 20 years who referred to Valiasr Medical Center in Tehran in 2020. The sample selection process in the present study consisted of two stages: The first stage was done by purposeful sampling method of high-risk behaviors questionnaire to screen soldiers referred to Valiasr Medical Center in Tehran and among those who received a score higher than the screening method 50 people were selected based on the completion of the consent form for participation in the research as well as the inclusion and exclusion criteria of 45 people (15 people in the first experimental group, 15 people in the second experimental group and 15 people in the control) and specialized in 3 groups at random. To collect data, Iranian adolescents' risk questionnaires, cognitive deficits, Toronto Alexithymia scale, and Impulsivity Scale were used. Results: A pairwise comparison between the two treatment groups showed that cognitive deficits in the two treatment groups of compassion (I-J=7.20; P&lt;0.01) and dialectical behavior therapy (I-J=8.66; P&lt;0.01), Was significant from pre-test to post-test in contrast to control group (I-J=1.56; P&lt;0.05); Also, the study of emotional processing deficits shows that only the dialectical behavior therapy group (I-J=12.73; P&lt;0.01) was significant from pre-test to post-test. Also, the study of impulsivity in treatment groups shows that only compassion treatment was effective in reducing impulsivity (I-J=7.66; P&lt;0.01). Conclusion: According to the findings of the present study, it seems that with compassionate practice and increasing positive emotions, a person's behavioral-intellectual treasury expands, which can it provided the basis for problem-solving and the reduction of conflicts between intrapersonal and interpersonal emotions, thereby reducing impulsivity and risky behaviors.