Higher Mean Rank Research Articles

The impact of synthetic bone grafting for tissue regeneration

Aims: This study aimed to examine the biological response of synthetic nanocomposite material on canine mandibular bone. Methods: Nine healthy adult male local breed dogs aged 12 to 18 months and weighing 10.2 to 15.2 kg were used in the study. Based on healing intervals of 1 and 2 months, the dogs were divided into 2 groups. Each group had 3 subgroups with 3 dogs each. The division was based on the grafting material used to fill the created defect: an empty defect (Control-ve), Beta-Tricalcium Phosphate, and nanocomposite (Beta-Tricalcium Phosphate and nanosilver 1%) . Surgery started after the dogs were anaesthetized. The surgical procedure began with a 5 cm parallel incision along the mandible’s lower posterior border. After exposing the periosteum, a three 5mm-diameter, 5-mmdeep critical-size holes were made, 5mm between each one. Each group’s grafting material had independent 3 holes. The defects were covered with resorbable collagen membranes followed by suturing of the mucoperiosteal flap. Results: Total densitometric analysis showed no significant differences between groups at 1-month intervals, with the nanocomposite group having a higher mean rank (165.66± 31.21) in comparison to other groups while at 2 months intervals that there was a highly significant difference between three groups as the P-value was (0.000) with the nanocomposite group having a higher mean rank (460.66± 26.40). Conclusions: In the current study, the use of nanocomposites improved osteoconductivity by accelerating new bone formation. Moreover, the encorporation of nanosilver enhanced growth factor activity. These attributes make nanocomposites a promising material for enhancing the bone healing process.

Hybrid operating room with ceiling mounted imaging system assisted pre-operative and intra-operative lung nodule localization for thoracoscopic resections: a 5-year case series

BackgroundVideo-assisted thoracoscopic (VATS) lung resections are increasingly popular and localization techniques are necessary to aid resection. We describe our experience with hybrid operating room (OR) cone-beam computed tomography (CT) assisted pre-operative and intra-operative lesion localization of lung nodules for VATS wedge resections, including our novel workflow using the hybrid OR cone-beam CT to re-evaluate patients who have undergone pre-operative localization for those who are unsuitable for intra-operative localization.MethodsRetrospective analysis of all consecutive patients with small (≤ 20 mm), deep (≥ 10 mm distance from pleura) and/or predominantly ground-glass nodules selected for lesion localization in the Interventional Radiology suite followed by re-evaluation with cone-beam CT in the hybrid OR (pre-operative), or in the hybrid OR alone (intra-operative), prior to intentional VATS wedge performed by a single surgeon at our centre from January 2017 to December 2021.Results30 patients with 36 nodules underwent localization. All nodules were successfully resected with a VATS wedge resection, although 10% of localizations had hookwire or coil dislodgement. The median effective radiation dose in the pre-operative group was 10.4 mSV including a median additional radiation exposure of 0.9 mSV in the hybrid OR for reconfirmation of hookwire or coil position prior to surgery (p = 0.87). The median effective radiation dose in the intra-operative group was 3.2 mSV with a higher mean rank than the intra-operative group, suggesting a higher radiation dose (p = 0.01).ConclusionsWe demonstrate that our multidisciplinary approach utilizing the hybrid OR is safe and effective. Intra-operative localization is associated with lower radiation doses. Routine use of cone-beam CT to confirm the position of the physical marker prior to surgery in the hybrid OR helps mitigate consequences of localization failure with only a modest increase in radiation exposure.

Effect of Hands-on Laboratory Experiment and Demonstration Teaching Techniques on Rwandan Secondary School Students’ Academic Performance in Solutions and Titration

The main objective of this intervention study was to investigate the effect of three teaching approaches, namely the traditional teaching method (TTM), a teacher-based demonstration experiment (TBDE) and a student hands-on experiment (SHE), on students’ academic performance. A total number of 324 senior five students studying chemistry as one of the main subjects in their combinations were selected from four provinces and Kigali city in Rwanda. The data were collected using a chemistry achievement test comprising 30 multiple-choice questions. This test was administered before and after teaching intervention to measure the effect of the three teaching approaches on students’ academic performance of solutions and titration. The Kruskal–Wallis test indicated that both SHE and TBDE had a higher mean rank after the intervention than the TTM group. The post-hoc test showed a statistically significant difference in the mean score of TTM vs. TBDE, as well as TTM vs. SHE. However, there was no significant statistical difference between the SHE vs TBDE groups. The results indicate that providing laboratory experiments through SHE or TBDE approaches significantly improved students’ academic performance of solutions and titration. Chemistry teachers are advised to use laboratory experiments provided either through SHE or TBDE as an effective remedial tool that could improve students’ performance in solutions and titration.

Differences of Local Students and Non-Local Students Independence

Independent students are inherently capable of self-management, not relying on emotional support from others, especially parents, able to make independent decisions, and possess a strong set of principles. Furthermore, the objectives of this research are as follows: 1) to determine the level of independence among local students at FKIP USK, 2) to determine the level of independence among non-local students at FKIP USK, 3) to identify the differences in independence between local and non- local students at FKIP USK. This research employs a quantitative approach with a comparative research design. The population of this study consists of active S1 FKIP USK students from the 2022 cohort, who come from outside the Aceh province and do not live with family members or relatives (for local students), as well as those who reside in and originate from Banda Aceh or live with their parents (for non-local students), totaling 425 students. The research sample comprises 133 FKIP USK students, with 60 local students and 73 non-local students, selected using a simple random sampling technique. Based on the research findings, it was known that the level of independence among local students predominantly falls into the high category (60%), while independence among non-local students predominantly falls into the moderate category (49%). The research results show an Asymp. Sig. (2-tailed) value of 0.026 ˂ 0.05, indicating that there was a difference in independence between local and non- local students at FKIP USK, as evidenced by the detailed mean rank values, with local students (75.18) having a higher mean rank than non-local students (60.27). Therefore, it can be concluded that the hypothesis in this research is accepted.

Relationship Between Serum Albumin Levels And Pulmonary Edema In Glomerulonephritis Patients

Background: Glomerulonephritis is an inflammatory disease of the glomerulus that causes changes in permeability, changes in kidney’s structure, and function of the glomerulus. Hypoalbuminemia in glomerulonephritis can decrease oncotic pressure resulting in extravasation of fluid into the interstitium. In severe hypoalbuminemia, extravasation of fluid can result in pulmonary edema. The subjective of this study was to analyze the correlation between serum albumin and the incidence of pulmonary edema by chest x-ray in patients with glomerulonephritis. Methods: The samples of this study were collected by purposive sampling using secondary data from the medical records of Dr. Kariadi Hospital in Semarang with a total of 46 subjects from January 2016-January 2021. The serum albumin was categorized as normal if serum albumin was >3,5 g/dL, mild hypoalbuminemia if serum albumin was 2.5-3.5 g/dL and severe hypoalbuminemia if serum albumin was <2.5 g/dL. Result: Mann Whitney test showed a significant relationship between between serum albumin and the incidence of pulmonary edema by chest x-ray in patients with glomerulonephritis (p = 0.016). A higher mean rank was found in patients with pulmonary edema compared to patients without pulmonary edema. Conclusion:There is a significant relationship between serum albumin and the incidence of pulmonary edema by chest x-ray in patients with glomerulonephritis. Patients with lower serum albumin have a greater tendency to develop pulmonary edema than patients with higher serum albumin.

Self-Regulation Processes in Patients with Alcohol Dependence (Pilot Study)

IntroductionThe first stage of the psychological intervention is related to diagnosticsObjectivesPurpose of the study was to explore features of mental self-regulation processes in patients with diagnosis “Mental and behavioral disorders due to use of alcohol”.MethodsThe study involved 39 male patients with alcohol dependence, the average age of 43.6 ± 6 years. The experimental group (20 patients) was taking part in in-patient rehabilitation program, the duration of rehabilitation ranged 4-6 months. The control group included 19 patients of the in-patient addiction treatment department, with average duration of treatment 21 days. To assess self-regulation processes, questionnaires “Style of behavior self-regulation” (Morosanova V.) and questionnaire of volitional self-control (Zverkov A., Eydman E.) were used. To compare differences between two independent groups Mann-Whitney U-test was usedResults There was a significant difference for the subscale “Persistence and perseverance” in “Volitional self-control” test (p≤0.05) for the control and experimental groups. Patients, involved in clinical rehabilitation program, have higher ranks comparing to patients got clinical treatment (22.2 and 17.7). The comparison of the results of the questionnaire “Style of behavior self-regulation” showed that there is a significant difference for subscales “Modeling of significant conditions” and “Independence” (p≤0.05); participants from the experimental group had higher mean rank in both cases.Conclusions Patients who took part in the long-term in-patient rehabilitation program had more stable motivation to achieve their goals, better self-regulation and activity planning skills, higher independence and self-confidence, they were less dependent on opinion of others. The identified features can be used in psychological programs aimed at improving planning skills, reducing behavioral rigidity, stabilizing self-esteem and improving adaptive capacity.DisclosureNo significant relationships.

Determinants of Prolonged Length of Stay among Patients with Road Traffic Injury at the Philippine General Hospital: A Retrospective Cohort Study

Introduction. Road traffic injuries are among the leading causes of preventable death, claiming around 7000 lives every year. Furthermore, road traffic can injure or disable thousands more every year in the Philippines.
 Objectives. This study determined the hospital length-of-stay patterns and risk factors for a prolonged length of stay in a tertiary hospital after road traffic injury.
 Methods. A retrospective cohort study was conducted to determine the determinants of the length of stay in the Philippine General Hospital (PGH) among road traffic injury victims for the year 2016. Length of stay was recorded according to the median. The other variables were cross-tabulated against the length of stay, and each of their crude odds ratios along with corresponding p-values were presented. Continuous variables were analyzed using Wilcoxon Mann-Whitney U-test. The predictor model for the determinants of prolonged length of stay in the hospital was built using forward selection. Likelihood-ratio test was used to compare the model with and without the exposure variable.
 Results. A total of 427 road traffic injury victims were admitted to the Philippine General Hospital in 2016. The mean age of the patients was 31.55 years (±14.97) with a median age of 29 years. The majority of patients were males (82.4%) and single (60.8%). Most patients were riding a motorcycle during the time of the accident (64.2%) while 20% were pedestrians. The majority of the victims were intoxicated (74.3%) and were not using helmets (57.1%) at the time of the accident. Most of the victims received first aid (69.2%) and the mean time of admission was 3.03 (±13.31) days while the median time to admission was 12 hours. Receiving first aid (p<0.01), availed services (p<0.01), and married civil status (p=0.04) were found to be strongly associated with length of hospital stay. Without controlling for any confounders, pay patients (OR = 3.46, 95% CI: 1.3, -9.87), elective patients (OR = 7.88, 95% CI: 2.64, 31.61), and those in non-trauma wards (OR=2.07, 95% CI: 1.29, 3.36) had higher odds for longer hospitalization stay. On the other hand, those who did not receive first aid (OR = 0.55, CI:0.35, 0.85) had lower odds for prolonged hospitalization. Those who suffered face injury and did not suffer external injuries had a higher mean rank, suggesting a longer length of hospital stay. On the other hand, upon controlling variables found to be associated with previous studies, those with low Glasgow coma scale (GCS) scores were 2.77 times (95% CI: 1.13, 6.91) more likely to stay longer in the hospital.
 Conclusion. The type of victim, mortality status, age, and sex were found to be important determinants of prolonged hospitalization. To lessen the number of fatalities and road trauma injuries, laws on road safety should be strictly and properly implemented. Shared responsibility of all road users is also important in improving the safe usage of roads.

Sustainability of integrated anaemia prevention activities implemented through non-government organizations and schools, and its effect on haemoglobin status of adolescent girls in urban slums of Pune, in Maharashtra, India.

Programmes for the prevention of iron deficiency anaemia among adolescent girls need sustainable inputs for maximum benefits. To assess the interventions sustained for anaemia prevention implemented through NGOs and schools. An intervention study followed longitudinally in three phases. Phase I comprised (a) needs assessment of the community and (b) capacity assessment of service providers through a cross-sectional survey in nine slums, through six NGOs and three schools. Based on needs assessment, an integrated intervention for anaemia prevention was provided for adolescent girls (n = 384) in the community. To ensure sustainability the capacity of stakeholders (n = 67) was built by providing training in the components of the integrated intervention and establishing linkages with the public health system. Refresher training was conducted during phase II (n = 69) for reinforcing and strengthening of activities introduced in phase I. In phase II and III continuations of activities by the NGOs and schools that were initiated in phase I were monitored. Sustainability of activities was measured using an index that comprised technical, programmatic, social, and financial indicators. The impact of sustained interventions was assessed by comparing the mean rank haemoglobin concentrations of centres with varying levels of coverage. Scores of sustainability indicators decreased from phase II to phase III. Organizations that showed > 50% coverage showed significantly higher mean rank haemoglobin (p = < 0.05) during phases II and III. There is a need to identify and address barriers that prevent sustainable interventions for anaemia control.

Attitude of nurses and midwives towards collaborative care with physicians in Jimma University medical center, Jimma, South West Ethiopia

BackgroundGood attitude on collaborative care between nurses and midwives with physicians is crucial for better team working. This further enables those vital health care professionals to provide quality and improved care for their clients.ObjectiveTo assess the attitude of nurses and midwives towards collaborative care with physicians in Jimma University medical center, Jimma, South West Ethiopia.MethodologyThe institution-based cross-sectional study was conducted from March 20 to April 8, 2019, using a semi-structured and standardized questionnaire. Study units were selected by simple random sampling using the lottery method. A total of 410 participants were included in the study. Data were entered into Epi data version 4.2 and exported to statistical packages for social sciences version 23 for cleaning and further analysis. Descriptive statistics were presented with tables, figures, and narratives. The level of significance was set at a p value of less than 0.05 in multivariable logistic regression.Results and conclusionMore than five out of ten, 234 (57.2%) of participants had a good (good attitude is defined in the operational definition section of methodology) attitude towards collaborative care with physicians, and the rest 175 (42.8%) poor attitude toward it. Participants had the highest median score in the shared education and teamwork (26.0) subscale and midwives were found to have higher mean rank scores compared to nurses. It was only in the nurse's/midwife's autonomy subscale that a statistically significant difference was found (Z = − 2.92, p value = 0.003). More generally, more than have of the participants had a good attitude on providing care collaboratively with physicians, though a significant proportion of nurses and midwives also rate collaborative care provision with physicians as poor.RecommendationsThe findings of this study suggested that interventions are needed to be taken to improve nurse's and midwife’s attitudes on the provision of collaborative care with physicians. Enhancement of shared education, cooperation rather than dominance and caring attitude are all vital. These all could in turn enhance the quality of care provided for clients.

A comparative evaluation of medicine package inserts for oral antidiabetic agents in Palestine

BackgroundPatient package inserts (PPIs) should provide accurate, sufficient, and clear information for patients as well as health care professionals. The goal of this study was to evaluate and compare the PPIs of local and imported anti-diabetic agents in the Palestinian market.MethodsEighteen leaflets were collected and analysed based on the completeness of 31 criteria using a scoring method, then the quantity of information was assessed by applying word counting of 17 headings and subheadings. Statistical comparisons of the word count for all products were performed using the Mann-Whitney U test with mean ranks. Then the mean ranks for differences in word counts were adjusted to calculate the fold-difference statistic by dividing the higher mean rank by the lower mean rank.ResultsIn general, the PPIs of imported agents scored better than local PPIs, but none of the inserts fulfilled the whole criteria. Thirteen out of thirty-one criteria were available in all products. None of these agents had provided any information about duration of use, instructions to convert tablets into liquids forms, pharmacokinetics, or shelf life. Moreover, mechanism of action and maximum dose were deficient in all local PPIs (0.0%), while they were included in 37.5 and 62.5% of imported PPIs, respectively. Furthermore, 90.0% of local PPIs lacked information about drug dose, 80.0% didn’t mention any instructions regarding effects on ability to drive or possibility of tablet splitting, and 60.0% didn’t involve orders about possibility of tablet crushing. Local PPIs provided inadequate and less detailed instructions regarding many aspects, since the estimated mean rank of local and imported PPIs demonstrated a range of difference from 1.04-fold for missing dose to 2.64-fold for warning and precautions.ConclusionsSignificant differences were being identified, with excellence being assigned to imported PPIs. So, it is worth suggesting some necessary modifications in PPI topography and sequence structure of local diabetic agents. Experts in Palestinian Ministry of Health should implement regulatory guidelines to improve the quality and quantity of information provided by local PPIs. This optimisation could become a step forward toward optimal health practice in our society.

English usage in daily life by Turkish students between 15–19 years of age: a scale development study

The purpose of this study is to develop a valid and reliable scale to assess the level of English usage in daily life by students between 15 and 19 years of age, and to compare these students’ scale scores according to their achievement levels in an English course. Five hundred and ninety-five participants were randomly selected from a universe. Exploratory factor analysis results indicate that the scale has a two-factor structure, which explains 50.1% of the total variance. Exploratory factor analysis is validated by confirmatory factor analysis (NNFI: 0.97; CFI: 0.97; GFI: 0.87; AGFI: 0.84; RMSEA: 0.07; and Standardized RMR: 0.05). Cronbach Alpha coefficients for Factor 1 and Factor 2 were calculated as 0.90 and 0.86, respectively. Test–retest reliability coefficient of the scale is at the expected level (r: 0.86, p<0.001). Item discrimination results indicate that the upper 27% of participants have higher mean rank scores for each item on the scale and on the two factors, and that this difference is significant at the 0.01 level. Results of the study show that students’ level of English usage in their daily life is low, and that the students who use more English in their daily life have a higher achievement level in the English course.

Use Behavioral Change Program to Decrease Hyperlipidemia and Hypertension in Primary Health Setting

This randomized controlled trial study aimed to determine the effectiveness of a behavioral change program for Thais with hyperlipidemia and hypertension. The program was based on self-care knowledge, self-care ability, blood lipid and blood pressure control. The study involved 98 purposively selected, patients with hyperlipidemia and hypertension receiving care at a hospital. Subjects were randomly assigned to either the experimental (n = 50) or control group (n = 48). Those in the experimental group received a 24-week behavioral change program and routine care, while those in the control group received only routine care. The behavioral change program consisted of group education sessions, wherein cognitive restructuring was used to increase the subjects’ knowledge about, and ability to carry out self-care for hyperlipidemia and hypertension. Data were collected via interview-administered questionnaires, blood lipid and blood pressure measurements, before and after participation in the program. Data were analyzed utilizing descriptive statistics; Chi-square; Mann- Whitney U test; and, independent t-test. Results indicated the experimental group, 24 weeks after completion of the program, had a significantly higher mean rank of self-care knowledge and self-care ability regarding medication-taking, dietary control, exercise, risk behavioral avoidance, as well as significantly lower mean blood lipid and blood pressure levels, than the control group. Findings suggest the program was effective in enhancing subjects’ knowledge regarding hyperlipidemia and hypertension, as well as control of their blood lipid and blood pressure.