Mean Improvement In Score Research Articles

Non-Ablative Fractional 1940-nm Diode Laser for Skin Resurfacing and Treatment of Benign Pigmented Lesions.

The non-ablative 1940-nm laser induces controlled thermal damage at superficial depths without ablating the epidermis. We evaluated a new 1940-nm fractional diode laser for improving pigmentation and skin texture. Participants with mild to severe benign pigmented lesions received up to three laser treatments. Blinded evaluation of randomized pretreatment versus 1-month posttreatment photos was conducted by three independent dermatologists to identify the correct posttreatment image and assess pigmentation on a 5-point scale (0 = 0% improvement, 4 = 75%-100% improvement) and skin texture improvement. Fifty-four subjects (50 females; Fitzpatrick skin types I-IV) with pigmented lesions on the face or body underwent a total of 172 treatments. Blinded evaluation of 45 photography sets resulted in a 91% success rate of correct identification of posttreatment photos with a mean pigmentation improvement score of 2.0 (p < 0.05) and improvement in skin texture for 62% of treated areas. Mild to moderate edema (70%) and erythema (88%) were observed immediately posttreatment. Trace melasma recurrence in three subjects and one case of mild rash resolved during the study. Non-ablative fractional 1940-nm diode laser skin resurfacing is safe and effective at improving overall skin quality and treating pigmentation after 2-3 treatments. Long-term follow-up of clinical outcome is warranted.

Effect of Group Work on Students’ Performance in Mathematics at Elementary Level in District Larkana

This research investigates the effect of group work on students’ learning in mathematics at the elementary level in District Larkana. Given the concern over declining performance in mathematics, the study aims to enhance academic outcomes through cooperative learning strategies. A pre-test and post-test experimental design was implemented with fifty randomly selected sixth-grade students at a government girls' high school. Data were collected through structured questionnaires assessing knowledge, understanding, and application in alignment with Bloom's taxonomy. The findings revealed a significant positive effect of group work on student performance, evidenced by improved mean scores in understanding mathematical concepts and problem-solving abilities. For example, students’ post-test scores in the Application domain improved by 14.8%. These results support the hypothesis that collaborative learning methods can effectively enhance academic performance in mathematics. The study underscores the necessity of integrating group work into elementary education to foster student engagement and improve learning outcomes in mathematics. This study’s findings have practical implications for policymakers and curriculum designers aiming to enhance education quality through innovative teaching practices.

Efficacy and Safety of 730-nm Picosecond Laser for the Treatment of Acquired Bilateral Nevus of Ota-like Macules.

The effectiveness and safety of 730-nm picosecond laser for treating acquired bilateral nevus of Ota-like macules remain uncertain. This study aims to evaluate the potential benefits and risks of using the 730-nm picosecond laser for ABNOM removal. This is a retrospective review of patients who were presented to the clinic between January 2020 and January 2024 for the treatment of ABNOM with 730-nm picosecond laser alone. The efficacy of the laser was assessed based on the Quartile Improvement Scale, using high-resolution photographs evaluated by blinded dermatologists. A total of 72 Chinese participants with Fitzpatrick skin types III to IV were included in the study. The overall effective rate of the treatment was 75%, achieved after an average of 2.42 ± 0.75 sessions. A subgroup analysis of 41 patients who completed 3 treatment sessions showed statistically significant differences in outcomes across the sessions. The mean improvement scores for sessions 1, 2, and 3 were 1.63 ± 1.04, 2.66 ± 1.22, and 3.29 ± 1.17, respectively (p < .01). No cases of hypopigmentation were observed. The incidence of postinflammatory hyperpigmentation was 5.56%. The 730-nm picosecond laser is a safe and effective treatment for ABNOM in Chinese patients.

The Impact of a Randomized Community-Based Intervention on the Awareness of Women Residing in Lebanon Toward Breast Cancer, Cervical Cancer, and Intimate Hygiene.

Women's health represents an integral component of public health. With breast cancer being the first worldwide and cervical cancer the fourth most common cancer among women, and while habits of intimate hygiene remain mediocre, it is crucial to address these issues. We aimed to evaluate the efficacy of a community-based intervention on the knowledge and preventive measures (K&P) of women toward breast cancer, cervical cancer, and intimate hygiene. This longitudinal multicentric prospective interventional study was conducted on women residing in Lebanon aged 18-83 years old. The awareness sessions took place either in person or online to address these three topics, covering the eight governorates of Lebanon. Our sample included women both from the general population and from Order of Malta Lebanon (OML)'s centers and mobile medical units. A stratified randomized sampling method was implemented using age and governorates. Women were interviewed before (pre-test) and after (post-test) the awareness session. The K&P score and the improvement post-intervention were represented in a function of all the study variables. A p ˂ 0.05 was found statistically significant. A total of 657 women, with the majority being nonsmokers and having a bachelor's degree as their highest level of education, completed surveys before and after the intervention, showcasing a significant overall K&P mean score improvement of 50.48% in the pre- vs. post-test (an average score of 22.01 ± 5.95 over 38 (57.93% of correct answers) vs. 33.12 ± 3.41 over 38 (89.58% of correct answers), respectively, p < 0.001). A significant difference was also noted between pre- and post-test (p < 0.001) in each of the three topics individually, with improvements of 52.39% for breast cancer, 60.00% for cervical cancer, and 22.27% for intimate hygiene. National awareness campaigns are key to shedding light on breast and cervical cancer matters and improving women's reproductive health and intimate hygiene in Lebanon. Addressing the knowledge gaps and promoting early screening and healthy habits through national public health policies can empower women to protect their health and well-being.

Comparing the efficacy of intra-articular injection of Platelet Rich Plasma (PRP) with corticosteroids (CS) in patients with chronic zygapophyseal joint low back pain confirmed by double intra-articular diagnostic blocks: A triple-blinded randomized multicentric controlled trial with a 6-month follow-up

ObjectiveTo compare the safety and effectiveness in improving function and reducing pain of autologous PRP to corticosteroid (CS) zygapophyseal (Z-joint) intra-articular (IA) injections at six months for patients with chronic osteoarthritis Z-joint mediated low back pain (LBP). DesignProspective triple-blinded multicentric randomized controlled trial. MethodsFifty participants with radiological signs of Z-joint OA and chronic Z-joint mediated LBP confirmed by a ≥80 % pain improvement after two IA local anesthetic injections were randomized into PRP and CS groups, using a 1:1 ratio. Participants completed questionnaires at baseline, and at 1-, 3- and 6-month post-treatment, with adverse effect data collected at 1 month. Function (Oswestry disability index (ODI)), pain (Numeric Rating Scale (NRS)), treatment satisfaction (modified MacNab criteria), and quality of life (Short Form survey 36 (SF-36)) were assessed at each follow-up. The primary outcome was the percentage of participants improving their function (ODI score) above the minimal clinically important difference (MCID) of 17 points. The secondary outcomes were the percentage of participants with a >50 % NRS improvement, satisfaction to treatment and mean score improvement. Proportions were compared between groups using a chi-square test. Mean scores were compared using a two-way ANOVA or the nonparametric Brunner & Langer test. ResultsBoth groups were similar at baseline, no major adverse effects occurred, and no participants were lost at follow-up. The proportion of participants improving their ODI scores above the MCID, the proportion of participants with a >50 % NRS improvement, and mean ODI scores were significantly different between groups in favor of PRP at 6 months. Modified MacNab satisfaction scale, NRS and SF36 mean scores were not statistically different between groups, but all followed the same pattern: the CS groups had a greater improvement a one month, both groups were equivalent at three months and the PRP group had a greater improvement at six months. ConclusionThis first triple-blinded multicentric RCT demonstrates the safety of PRP IA Z-joint injections and its superiority in improving pain and function at six months post-treatment compared to CS for patients with chronic OA Z-joint mediated LBP. To perform a blinded control study, two intra-articular treatments were compared. However, knowing that radiofrequency neurotomy (RFN) of the medial branch diagnosed by branch blocks has been standard of care for pain originating from Z-joints, further studies comparing PRP to RFN are still needed. Clinicaltrials gov registry numberNCT05188820.

Development of Augmented Reality media in polyhedral space-building lessons to improve the mathematical reasoning ability

Technology plays a crucial role in education, particularly in supporting teachers with interactive media to enhance students' mathematical reasoning skills in flat-sided geometry material. This study aims to improve students' mathematical reasoning skills by developing and utilizing valid, practical, and effective augmented reality (AR) media for flat-sided geometry. The research follows the ADDIE development model. The validity test results of the developed media show a validity score of 81.79% for media and 78.33% for material, indicating high validity. The practicality analysis, based on student response questionnaires, yields a score of 79.08%, categorized as practical. The effectiveness analysis, derived from pretest and posttest data using the Paired Sample T-test, reveals a significance value of 0.000, indicating a significant improvement in students' mean scores. Additionally, the N-Gain score of 0.64 falls into the moderate category, confirming the media's effectiveness in enhancing mathematical reasoning skills. In conclusion, the augmented reality learning media for flat-sided geometry material is valid, practical, and effective in improving students' mathematical reasoning abilities. It is recommended that future researchers further develop innovative products to enhance the quality of learning experiences.

비교과 프로그램 연계 모의수업 시연의 효과 분석: 예비유아교사의 전공만족도, 교수기술, 음악 교수효능감 및 교수내용지식을 중심으로

Objectives This study aims to investigate the effectiveness of mock classroom demonstrations linked to extracurricular programs for pre-service early childhood teachers, focusing on major satisfaction, teaching skills, music teaching self-efficacy, and pedagogical content knowledge. Methods For this purpose, a study was conducted with 42 students (experimental group) from University A and 38 students (comparison group) from University B, both located in the Chungcheong region, who were enrolled in an early childhood music education course. Normality and trends were examined using SPSS 23.0, and the effectiveness was analyzed using independent samples t-tests and paired samples t-tests. Results The main findings are as follows: Firstly, the experimental group demonstrated an improvement in post-test mean scores compared to their pre-test scores. In the comparison group, although some sub-factors showed improvement in post-test mean scores compared to pre-test scores, most scores decreased. Normality was confirmed, and homogeneity between the experimental and comparison groups was established. Secondly, the pre-test and post-test comparison within the experimental group indicated that post-test mean scores were significantly higher than pre-test mean scores across all factors. Conversely, the comparison group did not show statistically significant differences between pre-test and post-test scores. Comparison between the experimental and comparison groups revealed that the experimental group achieved significantly higher scores than the comparison group. Conclusions The study results verified the effectiveness of integrating extracurricular programs into field-linked classes to enhance the overall understanding of majors among incoming students. Accordingly, the study aims to propose activation strategies for theoretical and practical courses through a tailored approach to integrating extracurricular programs.

Exercise Interventions and Intelligence in Children and Adolescents: A Meta-Analysis.

Mixed evidence exists on whether physical exercise interventions influence intelligence measures in children and adolescents. To determine the effect of exercise interventions on intelligence in children and adolescents. Relevant articles were identified in PubMed, Web of Science, PsycINFO, and Scopus (until February 22, 2024). Randomized controlled trials assessing the effects of exercise interventions on intelligence in youth (≤19 years). A random-effects meta-analysis was performed for intelligence measures reported in ≥3 studies. Subanalyses examined the moderating effect of variables such as participants' intelligence quotient (IQ), age, or intervention duration. Fourteen randomized controlled trials (n = 3203 participants; age range = 5-14 years) were included. Exercise interventions significantly improved general intelligence compared with control groups (standardized mean difference = 0.54, 95% confidence interval [CI] = 0.11-0.97, P = .01), which corresponded to a mean improvement in the IQ score of 4.0 points (95% CI = 1.44-6.64, P = .01). Significant benefits of exercise interventions were also observed for fluid intelligence (standard mean difference = 0.20, 95% CI = 0.06-0.34, P = .006). Crystallized intelligence could not be meta-analyzed because of a lack of studies. Subanalyses revealed similar benefits in participants with low/borderline versus normal IQ, children versus adolescents, and interventions with different durations. The heterogeneity observed in the characteristics of the exercise interventions and the populations included can be a potential confounding factor. Exercise interventions are associated with improvements in intelligence (including both general and fluid intelligence) in youth.

Reverse Shoulder Arthroplasty in the Setting of Massive Proximal Humeral Bone Loss: A Systematic Review

Massive proximal humeral bone loss (PHBL) poses a technical challenge during reverse shoulder arthroplasty (RSA). Surgical treatment strategies include allograft-prosthetic composite (APC) reconstructions, endoprostheses, and other reverse shoulder arthroplasty constructs, however, there is a paucity of literature summarizing the outcomes and complications unique to this complex patient population. This study aimed to systematically review the literature to evaluate (1) patient-reported outcome measures (PROMs), (2) functional outcomes, and (3) complications according to surgical treatment strategy for patients with massive PHBL who undergo primary or revision shoulder arthroplasty. A systematic review of the PubMed/MEDLINE, Embase, and Cochrane databases was performed to identify studies reporting clinical outcomes and complications of reverse shoulder arthroplasty in patients with significant PHBL. Methodological quality was assessed for included studies. PROMs, radiographic outcomes, and postoperative functional outcomes were collected. Eleven studies evaluating clinical outcomes and complications of reverse shoulder arthroplasty in the setting of PHBL comprising 277 patients were included for review. The mean age was 66 years (range, 60-79 years). American Shoulder and Elbow Surgeons (ASES) score, Visual Analog Scale (VAS), and range of motion (ROM) were the most common outcomes collected, and patients exhibited significant improvements in mean scores postoperatively. Of the types of prostheses reported, there were 155 reverse shoulder arthroplasty (RSA) with allograft-prosthetic composite (APC) reconstructions, 48 proximal humeral replacement (PHR) endoprostheses, 41 RSA, 15 custom RSA, and 2 RSA with fibular strut allografts. The overall pooled complication rate was 30.1% (82/272) with revision/reoperation as the most common complication at 21% (57/272). The overall complication rate for RSA-APC reconstructions was 51% (79/155). The overall complication rate for PHR endoprostheses was 64.6% (31/48). Revision/reoperation rates were the most complication for both RSA-APC and PHR endoprostheses with rates of 20% and 31.3%, respectively. Treatment by APC reconstruction is the most common surgical technique described in the setting of massive PHBL. While shoulder arthroplasty can yield acceptable results for patients with substantial PHBL, such patients are at increased risk for complications and revision surgery.

Adaptation and feasibility of the Swedish Promoting Resilience in Stress Management intervention targeting adolescents and young adults newly diagnosed with cancer.

To describe the adaptation and feasibility of the Swedish version of the Promoting Resilience in Stress Management (PRISM) intervention among adolescents and young adults (AYAs) newly diagnosed with cancer. PRISM is a 5-session, manualized program designed to strengthen AYAs individual resources for managing stress by promoting resilience skills: stress-management, goal-setting, cognitive reframing and meaning-making. It is delivered 1:1 by an interventionist via video-visits. PRISM was developed in the US and adapted for a Swedish population. A feasibility study was conducted looking at recruitment, retention, acceptability of the intervention (evaluation survey and exit interviews) and pre- and post- exploratory psychosocial outcome measures (resilience, global health, emotional functioning and rehabilitation needs). Participants were recruited from a comprehensive cancer center in Sweden. Of the 31 eligible individuals (16-30 years), 20 (65%) agreed to participate and 11 (55%) completed PRISM. Eighty-six percent (6/7) of the participants who completed the evaluation survey thought that the order of the modules and the content were "very good or good". The AYAs that participated in the exit interviews expressed that the programme contributed new knowledge and for some confirmed previous knowledge, which was valuable both during and after participation. The role of the interventionist was stressed as important to support participants through the programme. Suggestions for the future included making PRISM more personalized. Exploratory quantitative analyses suggested improved mean scores regarding resilience, global health and emotional functioning from pre- to post-intervention. This study suggests that participating in PRISM has the potential to guide AYAs during the initial period after a cancer diagnosis. Further work to make PRISM more personalized might increase AYAs' interest in, and completion of, PRISM.

Jiving and Utilizing Gamification Activities in Science (JUGAS): An Intervention in Improving Grade 11 Students’ Conceptual Understanding

This action research explores the effectiveness of Project JUGAS in enhancing Grade 11 HUMSS students' understanding of Earth and Life Science. Using an explanatory sequential design, the study assessed pretest and posttest scores of students engaged in gamification activities—cabbage relay, geologic crossword puzzles, science mystery stations, and impromptu speech spinners—over four weeks. Results show a significant improvement in mean scores (p=0.00***) with a large effect size (d=0.92). Qualitative analysis identified six key themes: fun and interactive, engaging and motivating, challenging, collaborative, mastery of learning, and progression with rewards. The joint display confirmed that these qualitative themes support the quantitative data, demonstrating Project JUGAS's effectiveness as a pedagogical strategy.

Technique “without bone tunnels” (Micheli–Kocher) in anterior cruciate ligament reconstruction in growing patients. Surgical details and our experience with 19 cases

BackgroundGiven the boom in sports in school age, its intensity and the increase in sports in females, we are experiencing a boom in sports injuries characteristic of “adults” in growing patients, the anterior cruciate ligament being an injury with possible serious consequences. MethodsTo show the surgical technique “without bone tunnels” by Micheli–Kocher in anterior cruciate ligament reconstruction in growing patients based on our results in 20 patients. ResultsSince 2017 we have performed the technique “without bone tunnels” by Micheli–Kocher in 30 patients, 20 of whom have been followed up for more than 2 years. In our study, we have observed a return to previous sports activity in more than 90% of the patients, with only one patient undergoing reoperation due to a new rupture of the plasty. The results on the IKDC scales show an improvement in mean score from 42 points preoperatively to 84 postoperatively and on the Lysholm scale from 48 preoperatively to 94 postoperatively. ConclusionsThe technique “without bone tunnels” by Micheli–Kocher is a technique indicated in patients under 12 years of age and Tanner stage 2 or less. It is a technique of moderate complexity with excellent results in recovery from previous sports activity and knee stability.

Effect of repetitive transcranial magnetic stimulation on trigeminal-mediated headshaking in 17 horses.

Trigeminal-mediated headshaking is a neuropathic facial pain condition in horses. No treatment has been entirely successful. Repetitive transcranial magnetic stimulation (rTMS) is used in human medicine as a treatment for various neuropathic pain conditions, and good results have been achieved in cases of trigeminal neuralgia. Apply rTMS to horses with trigeminal-mediated headshaking (TMHS) and to evaluate tolerability, application of the setting, and success rate. Seventeen horses with nonseasonal signs of TMHS. Other underlying causes of headshaking were ruled out. The rTMS was performed under standing sedation on 5 consecutive days applying 3 sets of 500 stimulations each, with a stimulation strength of 5 Hz. Horses were evaluated on Day 1 (t0) and Day 5 (t1) of the treatment and 2 (t2) and 4 weeks (t3) afterwards using a special scoring system. The rTMS was well tolerated. Headshaking signs during exercise were decreased by 70% (Day 5; t1). Four weeks after rTMS, signs were still decreased (mean reduction of 50%) during exercise. Improvement of mean resting and exercise scores was significant (P < .05) and effect sizes between pretreatment and all time points after treatment (t1, t2, t3) were large (>±0.8). Repetitive transcranial magnetic stimulation may be a promising treatment for neuropathic pain and headshaking in affected horses. Pain-free periods after treatment differ individually, and repeated treatment may be necessary. More studies should be performed to determine ideal settings for horses.

The effects of a symptom management program on symptom experience and physical function in Thai adults with chronic obstructive pulmonary disease: A single-blind randomized controlled trial study.

Adults with Chronic Obstructive Pulmonary Disease (COPD) experience a range of unpleasant symptoms, including fatigue, dyspnea, sleep disturbances, anxiety, and depression, that are interrelated and impact one another. Developing a program to handle simultaneous symptoms poses challenges but offers advantages for adults with COPD in efficiently managing symptoms. This study aimed to determine the effects of a symptom management program on symptom experience and physical function in Thai adults with COPD. A randomized controlled trial (RCT) with a Repeated Measures design was performed. One hundred and two participants were allocated randomly to either the control group (n = 51) or the experimental group (n = 51). The experimental group received eight weeks of the symptom management program and usual care, while the control care group received only usual care. Data were collected from January 2023 to August 2023 at baseline, 4th weeks, and 8th weeks using the demographic data, the modified Medical Research Council (mMRC), the Pittsburgh Sleep Quality Index (PSQI), the Multidimensional Assessment of Fatigue (MAF), the Hospital Anxiety and Depression Assessment Scale (HADS), the COPD Assessment Test (CAT), and 6-Minute Walk Distance (6-MWD). The hypotheses were analyzed using Repeated Measures Multivariate Analysis of Variance (MANOVA). The symptom management program significantly impacted the experimental group's symptom experience and physical function at Weeks 4 and 8 (F = 5.257, p <0.001). There were significantly improved mean scores for the mMRC, MAF, 6MWD, and CAT (p <0.001, p <0.05). No statistically significant differences were observed in the PSQI, HADS-Anxiety, and HADS-Depression over time. Implementing a symptom management program can help patients with COPD efficiently manage their symptoms. In clinical settings, nurses should integrate this program into routine nursing care to enhance the quality of life for patients suffering from COPD. The program can help patients preserve physical functionality while reducing dependence on family and society. Thai Clinical Trials Registry (TCTR20230111006).

Prospective Research Comparing Different Trochanteric Fracture Fixation Techniques.

Aim Evaluation and comparison of various methods of trochanteric fracture fixation. Methods This study was conducted prospectively at the Orthopaedics Department of Dr. D Y Patil Medical College and Research Centre. The study spanned 18 months and involved 100 patientstreated in the outpatient and the emergency department. Patients who fulfilled that specific criteria were selected for this study and the appropriate surgical intervention for each group was determined through radiological examination. Results Of the 100 patients, 55 (55%) were male and 45 (45%) females. Patients in our collection ranged from 20 to 90 years old. Proximal Femoral Nail (PFN), Dynamic Hip Screw (DHS ), and Proximal Femoral Locking Compression Plate (PFLCP ) groups averaged 56, 58, and 64 years old, respectively. The most common cause of intertrochanteric fracture was domestic falls (60%), followed by road traffic accidents (35%). The Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification rated 40 individuals (40%) as stable and 60 as unstable. Most patients in our study had unstable A3 fractures. PFN patients had 16 A3 fractures. In DHS, 32 patients suffered A3 fractures. Twelve PFLCP patients suffered A3 fractures. The smallest group had A1 fractures. Six PFN patients suffered A1 fractures. Two DHS patients had A1 fractures. Two PFLCP patients suffered A1 fractures. PFN group mean scores improved significantly after one and three months in this study. At six months, the PFN group had a significant mean score improvement. Conclusion PFN results ranged from satisfactory to excellent, offering numerous advantages over other methods such as DHS and PFLCP. The benefits of PFN include a shorter lever arm, fracture site compression, and enhanced rotational stability, which contribute to a lower chance of mechanical failure. Additionally, patients treated with PFN typically experience shorter hospital stays, earlier mobilization, less blood loss, shorter surgery times, faster rehabilitation, and quicker bone healing, making PFN a highly effective treatment option for certain fractures.

Subcision with platelet-rich plasma and microneedling versus subcision with saline and micro-needling in posttraumatic scars.

In treating post-traumatic scars, this study compared the safety and effectiveness of combined subcision with saline and microneedling versus combined subcision with platelet-rich plasma and microneedling. Combined subcision with saline and microneedling or combined subcision with platelet-rich plasma and microneedling were used to treat 36 consecutive individuals with post-traumatic scarring. The Modified Manchester score was used to assess texture change, pigmentation, and surface distortion changes. Each change was given a score between 1 and 4. A lower score (range: 3-12) indicates a better result. The mean of the three individual scores was determined. For best outcomes, each patient needed four treatment sessions for each scar, with a one-month follow-up period following the final treatment. The three variables in group B had mean scores of 1.4 ± 0.5, 2 ± 0.8, and 2.2 ± 0.9, respectively, for texture change, pigmentation, and surface distortion. With a mean score of 1.4 ± 0.5, texture change had the best response out of the three variables we evaluated. The investigator determined that the mean improvement score for patients in group B's overall appearance was 5.61 ± 1.19. The study has shown that the combination of subcision with platelet-rich plasma, and microneedling appears to be a promising treatment for posttraumatic scars due to its low risk and high efficacy. Our findings suggest that this is a safe method for treating posttraumatic scars, with few side effects and a low chance of recurrence. 04-2023-300279. NCT06135480.

Implementing a process-based reflective teacher training course through situational role play, video, and scenario evidence and its effects on EFL teacher candidates’ perceptions of caring and reflective practices

ABSTRACT The current study examined the teacher candidates’ perceptions of ways a process-based reflective teacher training course-especially those focused on bumpy moments in the classroom, through situational role plays, video reflections, and scenarios- could assist them in their reflective and caring practices. In this regard, a sample of 45 pre-service teacher candidates enrolled at a teacher education university in Iran partook in the study and filled in the reflective and caring practices questionnaire before and after the treatment. Moreover, three teacher candidates were offered to keep reflective journals about the procedure based on their observations. Furthermore, pre- and post-phase interview was conducted with 15 participants. The results of this study revealed that the participants across all three intervention groups experienced improvement as a result of engaging in the teacher training course. The scenario group had the highest mean, followed by the video group; the role play group showed the least amount of improvement in reflective questionnaire mean score of all the treatment groups. The implication is that the process-oriented reflective teacher training course through situational role-play, video-based reflection, and scenario-based reflection can make teacher candidates more cautious about the caring and reflective aspects of their teaching.

The immunization questionnaire for understanding unwellness (TIQUU): Fun learning about vaccination using an innovative storytelling approach

BackgroundVaccination is a pivotal tool in public health. In LMICs like Pakistan, challenges hinder high immunization rates. This study addresses gaps in vaccination knowledge among school children through innovative educational interventions. The study aims to enhance vaccination awareness and contribute to health education discourse. MethodologyThis quasi-experimental study was conducted in 4 private schools in Karachi, Pakistan, from February to May 2021. Children aged 8–12 years in grades 2–5 were enrolled. An interactive discussion on vaccine safety and immunization was conducted using a bilingual pictorial storybook. Group-I experienced traditional Urdu book reading, while Group-II engaged with a digital animated video in English. A pre-test was conducted to assess baseline knowledge about immunization followed by an interactive discussion and immediately a post-test. Test scores were analyzed using paired sample t-test using Stata 17.0 version. ResultsThe study enrolled 400 students in Karachi, Pakistan. Both groups exhibited significant knowledge shifts regarding vaccine-related topics. Group-I (Analog Urdu) showed changes in understanding sickness reasons, vaccine timing, newborn protection, sports injury response, and memory impact. Group-II (Digital English) displayed shifts in illness understanding, recommended actions, injection and vaccine knowledge, safety perceptions, measles prevention, and management during sports injury. A statistically significant improvement in mean scores was observed. ConclusionAs a proactive and early strategy to alleviate the societal burden of under-immunization, cost-effective educational interventions can be integrated into school curricula. Our approach through bilingual pictorial storybooks and animated videos has been proven effective and helps one grasp immunization's importance.

Impact of Prehospital Ultrasound Training on Simulated Paramedic Clinical Decision-Making.

When used appropriately, focused limited-scope ultrasound exams could potentially provide paramedics with accurate and actionable diagnostic information to guide prehospital decision-making. In this study we aimed to investigate the impact of a 13-hour prehospital ultrasound training course on the simulated clinical decision-making of paramedics as well as their ultrasound skills, knowledge, and self-confidence. We evaluated the ultrasound competence of 31 participants using post-course written and practical assessments. Written clinical decision scenarios were administered pre- and post-training. Post-training scenarios included an uninterpreted ultrasound clip to aid decision-making. Scenarios included extended focused assessment with sonography in trauma, pulmonary exam, and focused echocardiography combined with carotid pulse check exams. Correct answers to scenarios were defined as those selected by a veteran emergency physician. Participants also indicated their confidence in each of their decisions using a Likert scale. Training yielded a statistically significant increase in both mean scenario score (35.5% absolute increase) and mean participant self-confidence (15.8% relative increase), across all exam/decision types assessed (P ≤ 0.001). The focused pulmonary exam yielded the largest increase in both mean score improvement (59.7% absolute increase) and paramedic confidence in their decisions (28.6% increase). Trained paramedics can perform focused ultrasound exams and accurately interpret and apply actionable exam findings in the context of written scenarios. Analysis through our model characterized the theoretical clinical yield of each prehospital ultrasound exam and demonstrated how each exam may provide improved decision accuracy in several specific simulated clinical contexts. These results provide support for growing evidence that focused limited-scope ultrasound may be an effective prehospital diagnostic tool in the hands of trained paramedics.

Trofinetide for the treatment of Rett syndrome: Results from the open-label extension LILAC study

Trofinetide was approved for the treatment of Rett syndrome based on the results of the phase 3, randomized, placebo-controlled, 12-week LAVENDER study. Rett syndrome is a chronic disorder requiring long-term treatment. We report the efficacy and safety results of LILAC, a 40-week, open-label extension study of LAVENDER. Females with Rett syndrome aged 5-21 years received open-label treatment with trofinetide for 40weeks. The primary endpoint was long-term safety of trofinetide; secondary endpoints included the change from baseline at week 40 in the Rett Syndrome Behaviour Questionnaire score and the Clinical Global Impression-Improvement score at week 40. Overall, 154 participants were enrolled and treated with trofinetide in LILAC. The most common adverse events in LILAC were diarrhea (74.7%), vomiting (28.6%), and COVID-19 (11.0%). Diarrhea wasthe most common adverse event leading to treatment withdrawal (21.4%). The Rett Syndrome Behaviour Questionnaire mean score (standard error) improvement from the LAVENDER baseline to week 40 in LILAC was -7.3 (1.62) and -7.0 (1.61) for participants treated with trofinetide and placebo in LAVENDER, respectively. Mean Clinical Global Impression-Improvement scores (standard error) at week 40 rated from the LILAC baseline were 3.1 (0.11) and 3.2 (0.14) for participants treated with trofinetide and placebo in LAVENDER, respectively. Treatment with trofinetide for ≤40weeks continued to improve symptoms of Rett syndrome. Trofinetide had a similar safety profile in LILAC as in LAVENDER. The study was supported by Acadia Pharmaceuticals Inc. (San Diego, CA, USA). This trial was registered at ClinicalTrials.gov (NCT04279314).