High Satisfaction Research Articles

Feasibility study of a parent-driven intervention for youth with Down syndrome.

Children with Down syndrome present with behavioural and emotional difficulties, including noncompliance, rule-breaking, emotion dysregulation and delays in executive functioning. Few behavioural interventions have been designed specifically for children with Down syndrome. The Research Units in Behavioral Intervention (RUBI) Parent Training for Disruptive Behaviors is a structured empirically supported parent training programme developed for caregivers of children with autism. This feasibility trial explored the feasibility and acceptability of an abbreviated RUBI intervention with caregivers of children with Down syndrome and identified promising outcome measures to target in future larger clinical trials. A double-blind randomised feasibility pilot clinical trial allocated participants to a behavioural intervention (BEH) or educational (EDU) group. BEH and EDU consisted of five individual sessions over the course of 5 to 8weeks. Measures were administered to 20 caregivers and their youth with Down syndrome at three time points. Both BEH and EDU were rated as feasible with high parental adherence and acceptable with high treatment satisfaction. Both BEH and EDU demonstrated decreased externalising behaviours, irritability and hyperactivity and improved behavioural regulation in executive functioning over time. No impact was noted on caregiver functioning. The feasibility trial has strong findings regarding feasibility and satisfaction and has promising findings regarding the selection of measures for future trials testing an adapted RUBI programme and an education programme to reduce behavioural challenges in children with Down syndrome. Larger scale clinical trials are needed to confirm promising findings of these feasible treatments.

Career Impact of Palliative Care Fellowship Training for Nurse Practitioners.

Background: Postgraduate fellowship training for nurse practitioners (NP) in palliative care can ameliorate workforce shortages; however, currently there are few NP fellowships and little evidence about outcomes, such as retention in hospice and palliative nursing, job satisfaction, or professional contributions. Objective: To describe the impact of palliative care fellowship training on the careers of NP alumni. Methods: A survey was electronically distributed to all NP alumni of an interprofessional palliative care fellowship since adult and pediatric nursing cohorts were added (2009-2022). Results: Most respondents still worked in hospice and/or palliative care; a majority of them engaged in professional activities beyond clinical work and reported high career satisfaction. Alumni endorsed multiple benefits of postgraduate fellowship except for post-fellowship compensation. Conclusions: NP palliative care fellowship alumni reported multiple career benefits including job satisfaction, professional accomplishment, and ongoing employment at their training institutions.

The use of biologics in patients suffering from chronic rhinosinusitis with nasal polyps - a 4-year real life observation.

Antibody therapy for chronic rhinosinusitis with nasal polyps (CRSwNP) has been established in Germany since 2019. With limited long-term data on biologic treatment for CRSwNP, we conducted a comprehensive evaluation of our 4-year data. This monocentric study aims to assess the real-world effects of this treatment on clinical course, quality of life, treatment adherence, biologic switching, dual therapy, and comorbidities. We retrospectively analysed biologic therapy data in patients with severe chronic rhinosinusitis with nasal polyps. 191 patients with CRSwNP treated with Dupilumab, Mepolizumab, or Omalizumab were observed for up to 4 years in a real-life setting. We observed clear symptom improvements with few side effects. No loss of efficacy or tolerability was noted during the 4-year period. Patients reported high satisfaction compared to previous therapies, with overall improved quality of life. Revision surgery or oral steroid use during biologic therapy was rare. Some patients prolonged injection intervals or discontinued steroid nasal spray. Biologic switching occurred infrequently due to side effects or inadequate response and was generally well tolerated. Many patients reported additional positive effects such as asthma or allergy symptom improvement and reduced medication intake. In summary, this study confirms the potency and tolerability of biologics for CRSwNP treatment, with sustained efficacy over 4 years. Biologic switching is a viable option for inadequate response or intolerable side effects. Therapy positively impacts Th2 comorbidities, corticosteroid requirements, surgery need, and overall compliance remains high. Project No.: 22-0802. Registry name: Biologika bei Patient*innen mit chronischer Sinusitis mit Nasenpolypen.

Long-term Outcomes of Poly-4-Hydroxybutyrate (P4HB) in Aesthetic Breast Surgery.

Over the past decade, the use of poly-4-hydroxybutyrate (P4HB) in aesthetic breast surgery has grown in popularity. Published data on long-term outcomes, however, is scarce. The purpose of this study was to assess long-term outcomes when using P4HB in various aesthetic breast procedures. A retrospective review of all patients undergoing breast procedures with P4HB performed by the senior author (WPA) between July 2012 and March 2022. All patients with greater than one year of follow-up were evaluated, including demographics, surgical indications, complications, secondary procedures, and patient satisfaction. A Kruskal-Wallis test was performed to assess the stability of satisfaction over time. A total of 248 patients were evaluated. The mean follow-up length was 2.9 years (range, 1-9.3y). The most common surgical indication was breast ptosis, which comprised 68 percent (n=167) of patients. The overall complication rate was 8.0 percent (n=20), with an unplanned reoperation rate of 2.8 percent (n=7). Across the entire study population, the mean satisfaction score was 3.42 out of 4. When satisfaction scores were compared to follow-up length, Kruskal-Wallis test demonstrated no statistical differences (H = 18.2, p = 0.89, df = 2), suggesting stability of satisfaction over time. This study presents the senior author's entire experience with P4HB across a wide range of aesthetic breast procedures. With an average follow-up length of almost 3 years, P4HB appears to be both a safe and effective tool to support soft tissue in aesthetic breast surgery. Further, high patient satisfaction appears stable.

Comprehensive Assessment of Labiaplasty Techniques and Tools, Satisfaction Rates, and Risk Factors: A Systematic Review and Meta-analysis.

Various surgical techniques have been devised for the surgical cosmetic enhancement of female outer genitalia. The selection of an optimal method should be based on satisfaction rates and safety; however, a comprehensive, contemporary systematic assessment of these factors in has been limited in the literature. Our aim was to conduct a comprehensive systematic review and meta-analysis to evaluate the overall satisfaction rates and risk factors associated with various labiaplasty techniques and tools. The authors performed a systematic literature search in three medical databases: PubMed, Elsevier and Cochrane Library (CENTRAL) with the closing date of October 2023. Original articles with quantitative satisfaction rates and frequencies of most common complications (hematoma, dehiscence, swelling, bleeding and infection) were included. Systematic search provided a total of 3954 records. After selection and review of the articles, 86 eligible, peer-reviewed studies were identified, of which 53 provided quantitative data. High overall satisfaction rate was found for all methods (Prop: 94%; CI: 93-95%), with highest satisfaction for deepithelization (Prop: 97%; CI: 85%-99%). Complications were generally rare, with elevated incidences for some techniques (wedge resection - dehiscence: Prop: 8%; CI: 5%-13% and composite reduction - swelling: Prop: 13%; CI: 2%-54%). Scalpel has significantly higher incidence of complications than laser, namely for bleeding, swelling and hematoma. Labiaplasty can be considered a generally effective approach to outer female genitalia beautification, with low associated risks. Surgeons must tailor their approach to the patients' needs and anatomy to achieve maximal satisfaction, given the differences in the frequency of complications for each method.

Integration of Lipofilling with Blepharoplasty to Optimize Periorbital Rejuvenation: A Retrospective Study

Background: Surgical blepharoplasty has traditionally been used to rejuvenate the periorbita by removing excess tissue. While this often enhances appearance, it does not address the volume loss associated with aging. Hyaluronic acid (HA) fillers have been used to address volume loss; however, issues such as the Tyndall effect, chronic edema, and the cost of repeated injections make them less than ideal. Advances in contemporary surgery have made autologous fat a natural alternative for filling volume loss in the periorbita. Fat grafting, whether using macrofat, microfat, or nanofat, can provide excellent results, but a separate procedure is required to harvest the fat from the patient. Objectives: The aim of this study was to analyze and describe complications and patient satisfaction by comparing blepharoplasty alone with blepharoplasty combined with lipofilling. Methods: A retrospective review of a single surgeon's private practice cases was performed on 45 consecutive patients who underwent surgical blepharoplasty alone and 64 patients who had surgical blepharoplasty combined with lipofilling from 2002 to 2021. Complications, pain scores, and patient satisfaction reports were assessed. Results: Upon comparing the blepharoplasty alone group to the blepharoplasty with lipofilling group, the 109 patients did not differ significantly in age. Both groups were predominantly female. There were no major complications, only minor ones, and though the blepharoplasty alone group had a higher complication rate, this was not statistically significant. Lipofilling added approximately 30 minutes to the 60-minute blepharoplasty procedure, but pain scores were higher in the combination group. However, pain dissipated quickly and, while statistically significant, was not clinically significant. Patient satisfaction with the additional lipofilling was high, which resulted in lipofilling being added to all blepharoplasty procedures. Conclusions: Traditional surgical blepharoplasty can be combined with fat grafting techniques to address tissue loss and descent. Lipofilling integrated with blepharoplasty is a safe procedure. It is well tolerated by patients and provides high satisfaction with good aesthetic outcomes. The use of autologous fat offers an economical and effective advantage for patients.

Management of urinary incontinence in girls with congenital pouch colon.

This study describes the management of urinary incontinence (UI) in eight girls with congenital pouch colon (CPC) associated with anorectal malformation (ARM). From 2013 to 2015, six girls with CPC and UI underwent bladder neck reconstruction (BNR). Four girls had complete UI (CUI) and two girls partial UI (PUI). From 2019 to 2023, four girls, including two with failed BNR, underwent bladder neck closure (BNC) and augmentation cystoplasty (AC) with a continent stoma. Subtypes of CPC were Complete CPC (n = 7) and Incomplete CPC (n = 1). All girls had a double vagina; short, wide urethra; and reduced bladder capacity with an open, incompetent bladder neck (BNI). During BNR, a neourethra was constructed from a 1.5-2cm-wide and 1.5-3-cm-long trigonal strip. During BNC, AC was performed using a 20cm ileal segment (n = 3) and by a colonic pouch segment, preserved during earlier colorraphy (n = 1). Continent stoma included a Monti's channel (n = 3) and appendicovesicostomy (n = 1). BNR produced moderate improvement of UI (n = 2), while UI was still very severe (n = 4). During BNC, intraoperative complications included iatrogenic vaginal tears (n = 4). Early complications included partial dehiscence of the ileocystoplasty (n = 1), partial adhesive small bowel obstruction (n = 1), and difficulty in stomal catheterization with prolonged drainage from the pelvic drain (n = 1). Late complications included unilateral grade II vesicoureteric reflux (n = 2) and vesicovaginal fistula (VVF) (n = 2) needing trans-vaginal closure in one girl. Urinary stones (n = 2) with stomal leakage of urine in one girl needed open cystolithotomy twice (n = 1), and endoscopic lithotripsy (n = 1). At follow-up, all patients have high overall satisfaction with the procedure and their continence status. BNC with AC and a catheterizable stoma satisfactorily achieves continence in girls with CPC and UI, vastly improving quality of life. If lower urinary tract (LUT) anatomy is favorable, BNR with/without AC can be the initial surgical procedure. BNC should be the primary procedure in girls with unfavorable LUT anatomy and for failed BNR. IV.

Disease severity in moderate‐to‐severe plaque psoriasis: Results from the Belgian REDISCOVER study

AbstractBackgroundIn the Belgian DISCOVER study, conducted in 2011–2012 before the advent of the IL‐17 and IL‐23 Inhibitors, significant undertreatment of patients with plaque psoriasis was reported.ObjectivesThe present study aimed to re‐evaluate the real‐world clinical management and quality of care of moderate‐to‐severe plaque psoriasis patients treated with systemic treatment for at least 24 weeks in clinical practice in Belgium.MethodsThis cross‐sectional and retrospective chart review (REDISCOVER) was conducted in 2021–2022 in private practices and hospitals in Belgium. Patient data were collected during one single visit and included assessments of psoriasis severity (Psoriasis Area Severity Index [PASI], Body Surface Area [BSA], Pruritus VAS scale) and Health‐Related Quality of Life (Dermatology Life Quality Index [DLQI]) and other selected criteria of the Belgian treat‐to‐target (T2T) outcome set.ResultsOf the 306 patients included in the study, 81.4% received treatment with biologicals and 18.6% with traditional systemics, that is, methotrexate or apremilast. IL‐23 Inhibitors (33.7%) and methotrexate (10.8%) were the most prescribed biologicals and traditional systemic, respectively. Between the time of treatment initiation and enrolment, the average PASI and BSA scores decreased, indicating treatment benefits. PASI scores were lower in patients treated with biologicals versus patients treated with traditional systemics. Full achievement of the two Belgian T2T guidelines dimensions was observed in 51% of the patients. Nonetheless, patients were generally satisfied with their treatment (96.1%) and physicians evaluated the treatment as adequate for most patients (87.3%).ConclusionsCompared to 10 years ago, a demonstrable improvement in care of moderate‐to‐severe psoriasis patients was observed in Belgium. This was reflected by substantial achievement of the current treatment goals and high treatment satisfaction by both patients and physicians. While one out of five patients is not achieving targeted goals, and is not treated with a biological, it seems there is still room for improvement.

Dorsal Metatarsal Closed Wedge Osteotomy in the Treatment of Freiberg's Disease: A Prospective Observational Study.

The aim of this study was to prospectively evaluate the clinical and radiological results of dorsal metatarsal closed wedge osteotomy and headless screw fixation in the surgical treatment of Freiberg's disease.Thirty-four patients who were treated with dorsal metatarsal closed wedge osteotomy (DMCWO) for Freiberg's disease between February 2018 and March 2022 were included in the study. Patients were staged according to the classification system described by Smillie. Clinical outcomes were evaluated using the American Orthopedic Foot and Ankle Society's (AOFAS) lesser metatarsophalangeal-interphalangeal scale, the visual analog scale (VAS), the range of motion (ROM) of the metatarsophalangeal (MTP) joint, and a subjective patient satisfaction questionnaire. For radiological evaluation, the amount of preoperative shortening of the involved metatarsal, the amount of metatarsal shortening developed after osteotomy, and radiological recovery times were recorded.Thirty-two (94.1%) of the patients were female, and two (5.9%) were male. The average postoperative follow-up period for patients was 33.7 months (range: 24 months to 41 months). The mean AOFAS scores increased from 53.24 to 86.26 (p<0.01). The mean VAS scores decreased from 8.59 to 1.79, and it was observed that the patients' pain improved significantly (p<0.01). The mean ROM of the MTP joint increased from 48.76 degrees to 70.76 degrees (p<0.01). An average of 2.5mm (range 1mm to 4.1mm) of shortening of the metatarsal length developed postoperatively (p<0.01). Arthrosis developed in 1 case (2.9%), and transfer metatarsalgia developed in 2 cases (5.8%).DMCWO is an effective treatment for both the early and advanced stages of symptomatic Freiberg's disease, leading to high patient satisfaction.

Integration of Family Navigation into ECHO Autism for Pediatric Primary Care in Underserved Communities.

Children with autism from underserved communities face complex system-, provider-, and family-level barriers to accessing timely diagnosis and early intervention. The current study evaluated the preliminary effects and feasibility of a new program (ECHO Autism LINKS) that integrated pediatric primary care provider (PCP) training with family navigation (FN) to bridge the gaps between screening, referral, and service access. Three cohorts of PCPs (n = 42) participated in the program, which consisted of 60-minute sessions delivered by Zoom twice per month for 12 months. Each session included didactics, case-based learning, and collaborative discussion with participants and an interdisciplinary team of experts. Family navigators were members of the expert team and provided FN services to families referred by PCP participants. Program attendance and engagement were strong, with 40 cases presented and 258 families referred for FN services, most of whom (83%) needed help accessing and connecting with services, and 13% required ongoing support due to complex needs. PCPs demonstrated significant improvements in self-efficacy in providing best-practice care for children with autism, reported high satisfaction, and observed improved knowledge and practice as a result of the program. The results of this initial pilot provide support for the feasibility, acceptability, and preliminary efficacy of the ECHO Autism LINKS program. The model holds promise in addressing complex barriers to healthcare access by providing both PCPs and families with the knowledge and support they need. Future research is needed to evaluate the efficacy and effectiveness of the program in improving child and family outcomes.

Effectiveness of A Multi-modal Strategy to Reduce External Ventricular Drain Associated Infection: A Quasi-experimental Study

BackgroundInfection is a serious complication in neurosurgical patients who undergo external ventricular drain (EVD) insertion and is associated with high morbidity and mortality. MethodsWe conducted a quasi-experimental study in patients who underwent EVD insertion to evaluate the impact of a strategy to reduce the incidence of external ventricular drain associated infections (EVDAIs). The study was divided into 2 periods; (1) the pre-intervention period when techniques for EVD insertion and maintenance were up to the discretion of the neurosurgeons and (2) the post-intervention after implementation of a multi-modal strategy (cefazolin prophylaxis, preoperative chlorhexidine showers, application of postoperative chlorhexidine-impregnated dressing, limited manipulation of the EVD, and meticulous EVD management). The primary outcome was the incidence rate of EVDAIs; secondary outcomes included in-hospital mortality rate and the hospital length of stay. ResultsIn total, 135 patients were included. The incidence rate of EVDAIs was significantly reduced in the post-intervention period (5.6 cases/1,000 EVD-days) compared with the pre-intervention period (18.2 cases/1,000 EVD-days; P=0.026). There were no differences in all secondary outcomes analyzed. This multi-modal strategy was associated with high satisfaction among healthcare personnel. ConclusionsImplementation of a multi-modal strategy was associated with a reduction in the incidence of EVDAIs. This was in line with our goal of promoting a new culture of safety despite being in a resource-limited setting.

Evaluation of the Therapeutic Effect of Preventive External Application of Traditional Chinese Medicine Gel Combined with Psychological Care in Tumor Patients with Radiation Dermatitis

Radiation dermatitis (RD) caused by radiation therapy has brought pain to patients. Therefore, we aim to investigate the efficacy of preventive external application of Traditional Chinese medicine (TCM) gel in conjunction with psychological care for the prevention of RD in patients with malignant tumors. A total of 130 patients who underwent radiotherapy in our hospital from January 2021 to December 2022 were selected as the research objects. The patients were divided into two groups based on their nursing modes: the conventional group received TCM gel treatment for Radiation Therapy Oncology Group (RTOG) grade II skin damage, while the combination group received preventive external application of TCM gel before radiotherapy along with psychological care support. The incidence of RD, quality of life, negative emotional changes, and satisfaction with nursing care were recorded and compared between the two groups. Our results demonstrated a significant reduction in the incidence of RTOG grade III–IV skin damage, an obvious improvement in patient’s quality of life and negative emotions, and a higher satisfaction in the combination group compared to the conventional group (P &lt; 0.05). In conclusion, this study suggests that the preventive external application of traditional Chinese medicine combined with psychological care during radiotherapy holds significant potential in preventing RD in patients with malignant tumors. Furthermore, it is proposed that the observed efficacy of the Chinese medicine gel in preventing radiation dermatitis may be attributed to its anti-inflammatory properties, primarily mediated by key active ingredients such as berberine and obacunone.

Long-term functional success and robust implant survival in lateral unicompartmental knee arthroplasty: A case series with a mean follow-up of twenty two and a halfyears.

Lateral unicompartmental knee arthroplasty (UKA) is an accepted treatment option in cases of end-stage lateral osteoarthritis. While lateral UKA has many proposed advantages compared to total knee arthroplasty, its technical challenges and relatively small number of cases make this an uncommon procedure. The aim of this study was to report the survivorship and functional outcomes beyond 20years of follow-up of isolated UKA. Between January 1988 and October 2003, 54 lateral UKAs were performed in a single center. The fitted prosthesis was a fixed plate and cemented polyethylene (PE). All patients had isolated lateral tibiofemoral osteoarthritis, including five open meniscectomies, three arthroscopies, and three open reductions of lateral tibial plateau fractures. Patients with a minimum of 20years of follow-up were included in the final analysis. Of the 54 UKA, 22 died before reaching the minimum follow-up period and four were lost to follow-up. Twenty-eight were included in the final analysis. Among them, 21 patients remained alive and an additional seven were deceased after 20years. The mean age at the last follow-up was 84.8 ± 11.9years with a mean follow-up duration of 22.5 ± 2.1years. Of the 28 knees, eight underwent revision surgery (5 for the progression of osteoarthritis; 2 for aseptic loosening; 1 for PE wear). Kaplan-Meier survival analysis revealed a survival rate at 20 and 25years of 72.3% (CI 59.1; 88.6). The average time to revision was 14.9 ± 4.9years. At the last follow-up, the mean function Knee Society Score (KSS) was 41.5 ± 32.9 and the mean objective KSS score was 79.4 ± 9.7. In the unrevised population, 94.7% of patients (n = 18) reported being satisfied or very satisfied with the surgery. Lateral UKA remains a viable treatment option for patients with isolated lateral tibiofemoral osteoarthritis, providing satisfactory 20-year implant survivorship and high patient satisfaction.

Exploring the Efficacy of a Remote Strategy-Based Intervention for People With Multiple Sclerosis With Everyday Memory Impairments: A Pilot Study.

This pilot study evaluates a remote strategy-based intervention for individuals with multiple sclerosis who experience everyday memory impairments. The intervention can potentially inform cognitive rehabilitation for this population. To investigate the feasibility and efficacy of an intervention (TELE-Self-GEN) to determine whether it can alleviate everyday memory impairments of individuals with multiple sclerosis. Pretest-posttest. Community. Ten adults with multiple sclerosis. Six synchronous treatment sessions were delivered online via Zoom. The treatment protocol embedded a memory strategy (self-generated learning) within a metacognitive framework, including self-awareness and self-management strategies. The treatment emphasizes when and how self-generation should be used. Measurements assessed feasibility and participants' satisfaction with the intervention and its delivery method, as well as memory, everyday memory, and functional performance. Participants expressed high satisfaction with the virtual treatment, highlighting its convenience as a key factor. Treatment resulted in improvements in memory performance, perceived memory ability in daily life, and functional performance. Results provide initial proof of concept in the utilization of a remotely delivered, strategy-based treatment approach to improve memory performance and functional abilities. The pilot data support a larger randomized clinical trial of the TELE-self-GEN. Plain-Language Summary: The results of this pilot study highlight the promising potential of TELE-self-GEN for people with multiple sclerosis (MS), who face memory challenges every day. This remotely delivered, strategy-based occupational therapy treatment approach, TELE-self-GEN, has the potential to significantly improve functional memory. The study participants reported improvements in their memory performance, perceived memory ability in daily life, and functional performance. These encouraging results serve as a foundation for more extensive clinical trials using TELE-self-GEN for people with MS.

치위생과 학생들의 성격유형에 따른 전공만족도

Objectives: It is to understand the personality characteristics of students through the results of MBTI personality type and major satisfaction of dental hygiene students and provide basic data for student guidance and counseling Methods: From December 4, 2003 to March 29, 2024, 305 students enrolled in the dental hygiene department were conducted. For the data analysis of this study, the SPSS version 27.0 (IBM Crop, Armonk, USA) statistical program was used. Results: 1. The distribution of individual preference indicators was more introverted (I), sensory (S), sensory (F), and cognitive (P) 2. The MBTI personality types appeared in the order of ISFP, ISTP, ISFJ, and INFP, ESTJ. 3. The personality type by function was the highest in the sensory (S)-emotional type (F), and the personality type by temperament was the highest in the sensory (S)-perception type (P) 4. In terms of major satisfaction according to preference trends, students in introversion (I), sensory (S), thinking (T), and judgment (J) had high major satisfaction, and major satisfaction by personality type was in the order of ESTP, ISTJ, ISFJ, and ESFP, and major satisfaction of ST by function and SJ by temperament was the highest. Conclusions: Through the above results, it is expected that the MBTI personality type of students will be actively utilized to provide basic data on student guidance and counseling for students who may not adapt to the department.

Advanced hybrid closed loop (artificial pancreas) and carbohydrate count in type 1 diabetes

BACKGROUND: Postprandial Glucose Excursion (PPGE) control is one of the goals of diabetes therapy. Patients should count meal carbohydrates but it is often inaccurate. Automated Advanced Hybrid Closed Loop (AHCL) systems may overcome carbohydrate count mistakes and aid to improve PPGE control. OBJECTIVE: To evaluate the effect of switching from manual Sensor Augmented Pump (SAP) to AHCL on PPGE in Type 1 Diabetic (T1D) subjects. METHODS: In 15 T1D patients using manual SAP, the Area Under the Curve (AUC) after breakfast, lunch and dinner was calculated for two weeks before (T0), immediately (T1) and 3 months (T2) after switching to 780 G AHCL system. Total Daily Dose (TDD), Time Above/Below/In Range (TAR, TBR, TIR), BMI, A1c, lipid profile and Treatment Satisfaction Questionnaire (DTSQ) were considered. RESULTS: A significant reduction in AUC was observed for breakfast and dinner at T2 and for lunch and dinner at T1. TIR increased, while TAR and TBR reduced significantly from T0 to T1 and T2. For A1c, BMI and plasma lipids no statistically significant differences were observed, although A1c decreased from 7.2% to 6.8%. TDD increased significantly, due to the automatic correction boluses. DTSQ score at T2 was 33 (range 32–34, max 36). CONCLUSIONS: After switching to AHCL, PPGE decreased rapidly by automatic correction boluses, without weight gain. Meal management simplification and glucose control improvement were associated with high satisfaction scores.

Demographics and job satisfaction as predictors of mental well-being of Filipino teachers

Teachers worldwide have had to change how they work because of the COVID-19 health crisis. These work changes and pandemic challenges have affected teachers in one way or another. There is a need to investigate teachers' welfare and how contented they are with their jobs two years after the onset of the pandemic and nationwide lockdown. This study examined the factors predicting the subjective mental well-being of teachers in the Philippines. Using a cross-sectional study design, the survey responses of 218 Filipino teachers were analyzed. Data were gathered electronically using the demographic profile form, a short version of the Warwick–Edinburgh Mental Well-being Scale, and the Short Index of Job Satisfaction. Results indicated that the majority of teachers had average to high job satisfaction and average subjective mental well-being. Regression analysis revealed that the type of school employed, residence, and job satisfaction were significant predictors of the mental well-being of teachers. This study affirms that certain demographic variables and satisfaction at work exert a positive influence on the mental health of teachers. Continuously making improvements in the working conditions of teachers and devising ways to enhance their well-being are vital.

Subtalar arthroereisis with metallic implant is a safe and effective treatment for pediatric patients with symptomatic flexible flatfeet. A 10-year clinical and radiographic follow-up

BackgroundSubtalar arthroereisis (SA) is an increasingly applied minimally invasive approach for flexible flat foot (FFF) not responsive to conservative treatment. This study aimed at evaluating the long-term clinical and radiographic outcomes of SA in pediatric patients with symptomatic FFF. MethodsThirty-seven patients (11.9 ± 1.6yy) underwent SA (74 feet), with outcomes assessed after a mean 10-year follow-up. Pain, quality of life, foot functionality, and alignment were evaluated using validated tools and radiographic parameters, calculated on weightbearing x-rays pre- and post-operatively. ResultsClinical outcomes reached excellent postoperative results (FFI: 9.1, AOFAS: 94.5) with a low 0.9 NRS pain (p < 0.01) and a 92 % satisfaction. All radiographic parameters improved significantly towards normal values: CP 17.5 ± 3.9, MA 4.3 ± 5.8, TCA 42.8 ± 6.2, TNCA 21.1 ± 8.5, TNU% 26.6 ± 8.4 (all p < 0.01). ConclusionsSA with a metallic endosinotarsal device provided significant long-term clinical and radiographic improvements, with low complication rates and high patient satisfaction, supporting its efficacy as a treatment option for pediatric symptomatic FFF. Level of evidenceIV

Pengaruh Motivasi Kerja, Quality Of Work Life, Dan Kepuasan Kerja Terhadap Kinerja Guru MAN Kota Malang

Optimal human resource management is a form of MAN's goal in carrying out its activities effectively and efficiently. The importance of teacher motivation, fulfilling the quality of work life in the work environment, and teachers feeling satisfied at work is a form of effort to optimize the potential and level of productivity of MAN's teacher resources. This type of research is a literature study, a theoretical study that describes the fulfillment of work motivation, quality of work life, and high job satisfaction that teachers have in a straight line according to MAN's expected work results.

Evaluating the Efficacy of Reconstruction: Systematic Review of Six-Strand Hamstring Autografts for Anterior Cruciate Ligament Reconstruction: Biomechanical and Clinical Outcomes

Introduction: Anterior Cruciate Ligament (ACL) injuries are a major concern in orthopedics, particularly affecting active individuals and often necessitating surgery. The incidence of ACL injuries is rising, especially in women, comprising half of knee joint injuries. These injuries, common in sports with pivoting actions, can lead to long-term joint issues like osteoarthritis. Advances in surgical methods and understanding of postoperative recovery are crucial for improving patient outcomes, with considerations for graft size, material, and reconstruction technique critical in the rehabilitation process. Material and Methods: A systematic review was conducted by searching PubMed, MEDLINE, and SCOPUS for studies from 2009 to 10 February 2024, focusing on “six-strand hamstring graft” outcomes in ACL reconstruction. Inclusion criteria were English publications on 6HS autografts’ biomechanical and clinical outcomes. Excluded were non-specific, BTB, or hybrid studies, and non-research articles. Out of 347 records, 9 were analyzed after rigorous screening and quality assessment. This review, emphasizing six-strand hamstring autografts, enriches orthopedic knowledge, particularly for ACL surgery. Results: This review evaluated studies on six-strand hamstring (6HS) autografts for ACL reconstruction, encompassing prospective, retrospective, and cadaveric studies with subjects ranging from 12 to 413. Findings indicate that 6HS autografts enhance knee stability and increase graft diameter, correlating with reduced graft failure rates and improved clinical outcomes, including high patient satisfaction and low re-injury rates. Rehabilitation varied, with recovery times quicker due to larger graft sizes, and most studies reported low complication rates, underscoring 6HS autografts’ efficacy in ACL surgery. Conclusions: Performing 6HS autografts in ACL reconstruction reveals that they offer improved knee stability and graft diameter, leading to better clinical outcomes. These autografts are associated with high patient satisfaction and low re-injury rates, suggesting their effectiveness in mimicking native ACL function and enhancing rehabilitation. However, research limitations highlight the need for further long-term, comprehensive studies.