Independent Community Research Articles

A pilot study surveying the impact of pharmacist-led counseling on naloxone dispensing.

The purpose of this study was to evaluate the impact of pharmacist counseling on patients purchasing naloxone and to highlight reasons for naloxone purchase refusal. A multisite study that was conducted from September 15, 2022, to January 11, 2023. Independent community pharmacies. Fifty patients met inclusion criteria. Data collected included demographics, preintervention knowledge assessment, post-intervention naloxone purchase, and reasons for naloxone refusal. The primary outcome was naloxone purchase after pharmacist education intervention. The secondary outcome was reasons for naloxone purchase refusal. The primary outcome showed that 60 percent of patients purchased naloxone after pharmacist intervention. As a secondary outcome, the number of patients who refused to purchase naloxone was 20 percent, with the majority of patients expressing that naloxone was not necessary as a reason for refusal. More studies are needed in order to conclude the impact of pharmacist education on the increasing purchase of naloxone.

Strategi Komunikasi Komunitas Kutai Literasi dan Budaya Etam untuk Membangun Kesadaran Masyarakat dalam Belajar Bahasa Isyarat

This research aims to explain how the communication strategy of Kutai Literacy and Etam Culture Community to build public awareness in learning sign language and explain the supporting and inhibiting factors of Kutai Literacy and Etam Culture Community activities in building public awareness in learning sign language. Formulation of communication strategies with the stages of knowing the audience, compiling messages, determining methods and selecting the use of media using the Elaboration Likelihood Model. The research method used to understand this issue is descriptive qualitative aims to explain the phenomenon as deeply as possible. The results of this research conducted, researchers can draw conclusions on the communication strategy of the Kutai Literacy and Etam Culture Community to build public awareness in learning sign language. First, recognize the audience where Kaliya's audience is the general public and in social media are those who are friends with Kaliya's Instagram account. Second, composing the message in accordance with Kaliya's vision, mission and goal, which is to build inclusive education and help provide information accessibility to deaf or hard of hearing people. Third, determining the method in this case in delivering the message, Kutai Literacy and Etam Culture Community uses redundancy, persuasive, informative and educative. Fourth, the use of Kaliya media in delivering information directly through Car free day, socialization in the agency environment and Kaliya Goes to School and for indirect media is Instagram and Whatsapp. The Elaboration Lkelihood Model analysis of Kaliya on the Central line conveys a message that makes sense and is relevant to the Law and conveys the importance of learning sign language, on the peripheral line Kaliya tries to build a Positive Image and includes outstanding deaf figures in building public awareness. The supporting factors of Kaliya's activities are the support from government agencies and it is an independent community that is well known and the activities are rarely done. The inhibiting factor is the lack of human resources both from Kaliya members or volunteers and deaf friends who excel.

Accelerated Iron Corrosion by Microbial Consortia Enriched from Slime-like Precipitates from a Corroded Metal Apparatus Deployed in a Deep-sea Hydrothermal System.

Microbiologically influenced corrosion refers to the corrosion of metal materials caused or promoted by microorganisms. Although some novel iron-corrosive microorganisms have been discovered in various manmade and natural freshwater and seawater environments, microbiologically influenced corrosion in the deep sea has not been investigated in detail. In the present study, we collected slime-like precipitates composed of corrosion products and microbial communities from a geochemical reactor set on an artificial hydrothermal vent for 14.5 months, and conducted culture-dependent and -independent microbial community ana-lyses with corrosive activity measurements. After enrichment cultivation at 37, 50, and 70°C with zero-valent iron particles, some of the microbial consortia showed accelerated iron dissolution, which was approximately 10- to 50-fold higher than that of the abiotic control. In a comparative ana-lysis based on the corrosion acceleration ratio and amplicon sequencing of the 16S rRNA gene, three types of corrosion were estimated: the methanogen-induced type, methanogen-sulfate-reducing bacteria cooperative type, and sulfate-reducing Firmicutes-induced type. The methanogen-induced and methanogen-sulfate-reducing bacteria cooperative types were observed at 50°C, while the sulfate-reducing Firmicutes-induced type was noted at 37°C. The present results suggest the microbial components associated with microbiologically influenced corrosion in deep-sea hydrothermal systems, providing important insights for the development of future deep-sea resources with metal infrastructures.

Evaluation of potential drug-drug interactions of metformin using different software programs: A single-center retrospective study

Aim: Given that metformin is often recommended for the management of type 2 diabetes mellitus, it is clinically significant to consider the potential interactions between metformin and other medications. In this study, we aimed to identify potential drug-drug interactions associated with metformin by retrospectively analyzing the prescriptions of patients taking metformin. Materials and Methods: Metformin-containing prescription data of five independent community pharmacies in Konya province for the year 2023 were analyzed retrospectively. Medscape®, Drugs® and LexiComp® software programs were used to detect potential drug-drug interactions. As a result of power analysis with the G Power program, 400 patients were included in the study with an effect size of 0.25, type 1 error of 0.05 and confidence interval of 0.95. Kendall's W analysis was performed to determine the concordance between the software programs. Results: Kendall's W value indicating the agreement between Medscape®, Drugs® and LexiComp® software programs was calculated as 0.061. In terms of potential drug-drug interactions of metformin, the agreement between the software programs was observed to be slight. The highest agreement between the progrmas was observed between Medscape® and LexiComp® (Kappa coefficient=0.44). Conclusion: Since potential drug-drug interactions are common in prescriptions for patients taking metformin, these interactions should be carefully monitored. Clinicians should use multiple interaction programs to identify potential drug-drug interactions of metformin.

Pilot Study to Evaluate the Feasibility of a Patient Questionnaire for the Purpose of Investigating the Extent of Purchasing Antibiotics without a Prescription in a Rural Province in South Africa: Rationale and Implications

Abstract Introduction: There are concerns with rising rates of antimicrobial resistance (AMR) across countries with appreciable impact on morbidity, mortality and costs. Amongst low- and middle-income countries, a key driver of AMR is the excessive use of antibiotics in ambulatory care, with a critical area being the appreciable selling of antibiotics without a prescription often driven by patient demand and limited knowledge. There is currently conflicting evidence in South Africa regarding this practice. Consequently, there is a need to explore these critical issues amongst patients, especially in more rural areas of South Africa. A pilot study was undertaken to address this. Methods: A two-step descriptive approach was undertaken. This involved two questionnaires amongst patients exiting chain and independent community pharmacies followed by cognitive interviews. Results: Overall, 21 patients were approached for an interview, including 11 for Part 1 of the questionnaire with 3 declining, and 10 for Part 2, with 2 declining. Subsequently 8 patients completed each part of the questionnaire. On average, it took 2 min 13 s to complete both parts. 3 of the 5 patients being dispensed an antibiotic were dispensed one without a prescription, with all 3 patients exiting from independent pharmacies. Key reasons for self-purchasing included money and convenience. There was mixed knowledge regarding antibiotics and AMR amongst the 8 patients interviewed with Part 2. Overall, there was a satisfactory understanding of the Part 1 questions, although some modifications were suggested. Some participants had difficulty with fully understanding the questions in Part 2, with a number of suggestions made to improve this for the main study. Conclusion: There were concerns with the extent of purchasing antibiotics without a prescription in this pilot study as well as the knowledge of patients regarding antibiotics and AMR. Both areas need addressing and will be explored further in the main study.

Role of Community Pharmacist in Asthma Management: Knowledge, Attitudes and Practice.

To investigate knowledge, attitude, and practice of asthma management counseling and the perceived barriers by community pharmacists. This cross-sectional study was conducted on 416 community pharmacists using an online-based questionnaire. The questionnaire included five parts that assessed socio-demographics and medical references used to seek drug-related information, pharmacists' knowledge (7 items), attitudes (5 items), practice (22 items) and the barriers for the provision of asthma management counseling (10 items). Binary logistic regression was conducted to find the variables that were significantly and independently associated with knowledge, attitude and asthma management counseling practice. Increased years of experience was associated with decreased knowledge (OR = 0.918, 95% Cl (0.869:0.970), P = 0.002) and less positive attitude toward asthma management (OR = 0.876, 95% Cl. (0.821:0.935), P < 0.001), while working in independent community pharmacy (OR = 2.097, 95% Cl. (1.273:3.454), P = 0.004) and increased awareness of asthma management guidelines (OR = 1.60, 95% CI. (1.044:2.453), P = 0.031) increased the odds of being in the high knowledge group. In contrast, increasing the daily number of pharmacy visitors OR = 1.009, 95% Cl. (1.001:1.016), P = 0.024) and having a pharmacy degree (OR = 2.330, 95% Cl. (1.256:4.326), P = 0.007) increased the odds of having a positive attitude. Male pharmacists (OR = 0.553, 95% Cl. (0.350:0.873), P = 0.011) and having bachelor in pharmacy (OR = 0.354, 95% Cl. (0.179:0.700), P = 0.003) decreased the odds of being in the high practice group. On the other hand, increased awareness of asthma management guidelines tripled the odds of being in the high practice group (OR = 3.067, 95% Cl. (1.964:4.787), P < 0.001). The current study findings offer valuable insights into the gaps in knowledge, attitude, and practice of asthma management counseling among community pharmacists, as well as the barriers and factors that impede the provision of these services. These insights serve as a guide for developing future strategies aimed at enhancing the role of pharmacists in asthma care.

Liberty and Order: Legal Interests in China's Domestic Crime Legislation and Amendment

The family is an independent community, in which members have closer life ties and deeper subjective emotions than ordinary social members. The diversity of the internal relationships within the family and the different expressions of family ethics determine the pluralistic normative construction of criminal law when it intervenes in the family. However, with the transformation of the social structure, the function of the family has gradually declined. The traditional Chinese society's "family-oriented" ideology has fallen behind, and the past value judgment of "emphasizing order and disregarding freedom" does not conform to the social values of the people. Firstly, in terms of the configuration of penalties, the statutory penalties for domestic crimes are lighter than those for similar crimes, which conflicts with the increasing sense of equality, rights, and modern family concepts in society. Secondly, in the judicial practice process, the judicial organs ignore unfair interest arrangements, attach importance to outdated value judgments, overemphasize departmental interests, and infringe on the legitimate rights and interests of vulnerable groups. These behaviors all go against the values of ordinary people. This article takes the crimes of purchasing trafficked women and child abuse in traditional Chinese family crimes as examples, combined with current social trends and the transformation of traditional family values and order. Based on the unique and complex features of the protected legal interests in family crimes, it balances the values of order protection and human rights protection, faces up to the connotation and extension changes of domestic crimes in the new era, and establishes the family law theory of criminal law.

DESIGN NEEDS AND PERCEPTIONS OF OLDER ADULTS REGARDING SHARED-USE AUTOMATED VEHICLES

Abstract Many communities struggle to provide safe, accessible, and reliable transportation services for older adults due to high demand, rising costs, driver shortages, and other evolving challenges. Innovative transportation solutions are needed to support the current and future populations of older adults. Low-speed, shared-use, driverless shuttles present an exciting development in automated vehicle (AV) technology with potential to meet mobility needs of older adults in their community. Understanding older adults’ perceptions about and willingness to consider using these emerging modes of transportation is vital to realizing the full potential of these technologies. This presentation summarizes an in-person study conducted with 12 older (average: 66 +/- 4 years of age, range: 60 to 80 years) and 10 younger (average: 44 +/- 11 years) adults that evaluated a stationary, proof-of-concept shared-use AV retrofitted with accessibility features. We will present findings on perceptions regarding accessibility, safety, and willingness to use driverless AVs along with human factors design recommendations. While questionnaire-based studies have been the dominant approach to understanding older adults’ perceptions about shared-use AVs, in-person evaluations even with prototype AVs as described here, provide opportunities to identify goals, needs and preferences of older adults concerning usability and safety in early design stages, and through hands-on exploration help older adults develop good mental models, i.e., understand AV capabilities and limitations, towards building trust and acceptance for these emerging modes of transportation. Research and policy implications will be discussed towards enabling emerging driverless shared-use AV technologies that support safe and independent community mobility for older adults.

Survey of Georgia community pharmacists’ needs to engage in advanced community pharmacy services

BackgroundCommunity pharmacists improve health, reduce fragmentation in care, lower health costs, and improve health outcomes. In Georgia, pharmacists are able to enter collaborative drug therapy management protocols, such as hypertension management, with a collaborating physician, which may allow pharmacists to provide advanced community pharmacy services (ACPS), however few Georgia pharmacists have this licensure. No program(s) exist that empower pharmacists to successfully engage in ACPS across the state of Georgia nor trains pharmacists to successfully engage in collaborative practice. ObjectiveThe goal of this project was to explore community pharmacists’ perception, confidence, and engagement in ACPS and how this can improve access to care in Georgia. MethodsSix hundred one independent community pharmacists were sent an electronic survey May 13, 2022, with weekly email reminders through June 17, 2022. Results were analyzed with the independent sample t test. Thematic analysis was completed on open response survey questions. ResultsNinety responses were received (15% response rate). In the majority of survey outcomes, no differences were found in needs for success between rural versus urban pharmacists. Pharmacies with a smaller technician-to-pharmacists ≤2 (staffing) ratios identified billing for services as a higher priority need for success for them to confidently engage in ACPS (P = 0.012) while pharmacies with a higher technician-to-pharmacists >2 (staffing) ratio agreed a larger need was in optimization of current workflow to allow for advanced community pharmacy service incorporation (P = 0.034). All community pharmacists agreed they would require expansion in staffing and the qualities desired for additional hires to support ACPS include ambition, proficiency, and communication skills. ConclusionNumerous needs for success exist for community pharmacists to feel comfortable and confident to engage in ACPS. Addressing these needs may increase community pharmacist impact through increasing utilization of these services.

The impacts of relational organizing for health system and community collaboration: Early evidence from a rapid multisite qualitative study.

To understand the ways relational organizing practices impacted collaborations between independent or health system-affiliated community health clinics, public health offices, and community groups during the early COVID-19 pandemic. Between November 2020 and June 2021, we interviewed clinical and public health workers, clinic-based community organizers, and staff and volunteers at community organizations who participated in three COVID-19 response collaborations in the Northwestern United States. This was a qualitative study employing participatory and rapid data collection and analysis methods. Research team members invited key participants in organizing efforts to a semi-structured virtual interview conducted by an independent health services researcher. A sensemaking team that included project participants analyzed interview data using an iterative, thematic approach and conducted a ripple effect mapping exercise to supplement interview data. A total of 19 people contributed data for analysis. Analysis was guided by the underlying research questions: whether and how relational organizing practices contributed to successful collaboration, and what challenges were encountered. Relational organizing was perceived to contribute to multiple positive project outcomes, including greater self-efficacy in a time of crisis and enhanced sense of connection; these outcomes contributed to a sense of successful collaboration. Four mechanisms were identified that explained relational organizing's collaborative efficacy: (1) mobilizing existing relationships for rapid community engagement; (2) bringing concrete skills for enhancing trust among cross-sector partners; (3) recognizing and addressing power dynamics; and (4) creating vehicles for exercising collective community power. Lack of trust and unsurfaced power dynamics were perceived as common challenges to sustained collaboration, which relational organizing could sometimes mitigate. Our findings suggest relational organizing practices can be protective against common "pain points" faced by cross-sectoral partnerships, especially in times of crisis. Further piloting of clinic-based relational organizing is recommended, as is research on longer-term impacts.

주민자치조직의 지역공동체 의식에 관한 연구

Since the restoration of the self-governance system in 1995, Korea has been striving to stabilize the implementation of the local government system and expand local autonomy to overcome the limitations of representative democracy. In 1998, a local self-governance committee was established and operated to reflect the needs of residents through participation and communication at the town, village, and district levels, which are the basic units of local self-governance, but it did not achieve its purpose. Therefore, in 2010, a special law was enacted to expand the scope of resident participation, which was a limitation of resident autonomy committees. The purpose of the Act was to establish an efficient public service system by expanding residents' participation and restoring local traditional communities. This study sought to verify the effectiveness of the neighborhood association conversion policy by comparing the sense of community in neighborhoods that were converted to neighborhood associations and those that were not converted to neighborhood associations.&#x0D; Quantitative research was used as the research method, and the research model and hypotheses were derived through theoretical discussions on major factors such as residents' self-governance capacity as an independent variable and community consciousness as a dependent variable. A survey tool was utilized to measure residents' sense of community. Questionnaires were distributed to residents visiting 44 administrative wards in Goyang-si, Gyeonggi-do, and the collected questionnaires were analyzed using SPSS version 27.0. Descriptive statistics, analysis of variance, correlation, and multiple regression analysis were performed on the collected survey responses.&#x0D; The results of the study showed that there was no statistically significant difference in the level of residents' sense of community between neighborhood councils and neighborhood committees. This suggests that the policy of converting neighborhood committees into neighborhood associations had an unexpected effect, resulting in a policy error. In order to improve the sense of community and restore traditional neighborhoods, it is necessary to increase the level of residents' ‘local attachment’, ‘local identity’, and ‘sense of fulfillment’. It is also necessary to verify the professional competence of community council members to ensure their representation. In addition, it will be possible to overcome the limitations of representative democracy by solving local problems with residents through connecting with local resources and community organizations.

Optimalisasi Pemasaran Produk Melalui Penggunaan Digital Marketing Pada Produk Makanan Ringan Tumpi Di Desa Lerep Kabupaten Semarang

It is hoped that the community's creativity in managing Tumpi Snack Food Products MSMEs in Lerep Village, Semarang Regency will be able to become an independent and capable community in order to improve the community's economy to address the problem of poverty. According to researchers' opinions and observations, village community empowerment is closely related to community participation in implementing the work program. The roles carried out in mutual cooperation with the village government in order to empower the community through MSMEs include participatory cooperation with plans carried out according to existing regional potential, utilizing all village potential to maintain the sustainability of development areas and developing village potential so that the village community has power or empowerment of its population. This type of research is descriptive research. The approach used is a qualitative approach and a conceptual approach. The data source used is secondary data. Data analysis was carried out descriptively qualitatively. Conclusions were drawn using a deductive method, namely drawing conclusions from general to specific, especially those related to the research topic, namely Optimizing MSME Product Marketing Through the Use of Digital Marketing on Tumpi Snack Food Products in Lerep Village, Semarang Regency. This research resulted in findings that since it was declared as the souvenir center of the Lerep Tourism Village, Karang Bolo is synonymous with Tumpi and Tempe Kripik. Tumpi and tempe kripik are very attached to Karang Bolo village because Tumpi and tempeh kripik are snack foods produced by most of the residents. this hamlet. The process of making tempeh chips and various other chips in Karang Bolo village, from the initial stage to the final stage, is still done traditionally, including the frying method which still uses a wood-fired stove. It is hoped that the community's creativity in managing MSMEs will be able to become an independent and capable community in order to improve the community's economy to address the problem of poverty. According to researchers' opinions and observations, village community empowerment is closely related to community participation in implementing the work program. The roles carried out in mutual cooperation with the village government in order to empower the community through MSMEs include participatory cooperation with plans carried out according to existing regional potential, utilizing all village potential to maintain the sustainability of development areas and developing village potential so that the village community has power or empowerment of its population.

Empowerment of The Village Forest Management Institution Baharu through Optimizing the Utilization of Bamboo in Foramadiahi

The lack of public in using bamboo is due to the absence of a market and lack of public. Optimizing the use of bamboo can help society increase an economic household. The aim of carrying out service activities is to improve the skills and abilities of the village forest management institution or LPHD Baharu in using bamboo as a basic material for crafts and being able to understand the concept of an independent community economy. The activity was carried out at LPHD Baharu of Foramadiahi in Ternate, North Maluku. Activities were carried out with the LPHD forest farmers group in Foramadiahi. The method used is socialization and training to process bamboo into crafts that have marketable value. All stages of activities were carried out well and supported by community participation. Some of the uses of bamboo in Foramadiahi are as house fences, braces (gata-gata), and support poles (house building materials/concoctions). Apart from that, bamboo can also be processed into various crafts and weaves. It is hoped that these activities can provide knowledge and skills for the community to develop the potential of bamboo in Foramadiahi so that it can help the community become an independent sub-district.

Assessment of student pharmacist‐led academic detailing on independent community pharmacy naloxone orders

AbstractIntroductionAcademic detailing has been used as a preferential method to increase pharmacists' awareness of naloxone; however, its impact on actual dispensing rates is not well established.ObjectiveThe aim of this pilot study is to determine if a student‐led academic detailing on naloxone use and communication increased the amount of naloxone ordered from independent pharmacies in various geographic settings throughout Northeast Pennsylvania.MethodsThirty‐nine independent pharmacies which utilized a single wholesaler were randomized to receive an in‐person, student‐led training about naloxone use and communication. Students attended a train‐the‐trainer presentation to ensure a universal training was provided to all pharmacies. Students were provided with intranasal naloxone demonstration devices, handouts on effective communication, and talking points for each pharmacy visit. All academic detailing sessions were held live at each pharmacy during that pharmacy's regular business hours. Topics covered included appropriate naloxone use, what to expect after giving naloxone, and evidence‐based communication methods for engaging with patients about purchasing naloxone. Devices and handouts were left behind for pharmacists to use in daily practice. Naloxone and opioid shipping data for 3 months prior to and 3 months post‐intervention were compared.ResultsNaloxone ordered in the pre‐intervention period was 21 vs. 26 (intervention vs. control) (p = 0.59) and 31 vs. 29 post‐intervention (p = 0.25). There was no statistically significant difference in the number of pharmacies which ordered more naloxone pre vs. post‐intervention or in the total amount of opioids ordered pre vs. post‐intervention.ConclusionWhile pharmacies which received academic detailing did order more naloxone than pharmacies which did not, the difference did not rise to a level of statistical significance. As the population of this pilot study was small, expanding this approach to academic detailing to a larger population is warranted to possibly see more robust results.

The 5-STS is a prognostic factor of sub-acute stroke patients who will not become community walkers at discharge from rehabilitation.

The recovery of community ambulation is a common concern among individuals after stroke. (1) To develop a potential readily applicable prognostic model able to correctly discriminate stroke patients who will not become independent community walkers at discharge; (2) To investigate the effects of early reassessment during the first month of treatment on the prediction accuracy of this model. This was a prospective cohort study. A consecutive sample of 80 patients at ≤60 days poststroke were assessed at baseline of outpatient physical rehabilitation and reassessed one month later. Non-functional community ambulation was measured. Seventy-four patients were followed until discharge. Of these, 47 patients were non-functional community walkers at discharge. A prediction model based on baseline performance in the five repetition sit-to-stand [5-STS] test was able to discriminate those patients of the sample (Area-under-curve = 0.956), and again with data from reassessment (AUC = 0.952). A time of 21 s at baseline was a highly prognostic cut-off point for discrimination (sensitivity = 87.2% and 85.1%). The combined use of baseline and reassessment data improved sensitivity (98.1%)CONCLUSION:Early findings of the 5-STS among stroke patients is an independent prognostic factor associated with independent community walking at discharge. It could discriminate individuals who will not become community walkers at discharge.

Total Quality Management as Predictor of Artificial Intelligence Ensures Competitive Marketing

In the modern world Total Quality Management (TQM) respecting the past ensures the triumph of the future and Artificial Intelligence. Fulfilling the absence in the universal medical journal of multi-organ supportive therapy (MOST) replacement models of the central nervous system, immune and energy system functions, have been completed by describing extracorporeal and intracorporeal prosthetics of immune and energy system functions. Prosthetics, assistive support, and replacement of nervous system function contributed to the foundation of Artificial Intelligence (AI) and the creation of the robot as an intellect-technocrat combination. Using the Da Vinci robot with four arms, surgeons in Spain performed a lung transplant [3], relevant and timely also in the complications of COVID-19 SARS-CoV-2. As a result, the robot reduced the discrepancy between the predominance of the human and technocratic intellectual factors in the creation of the product useful to humanity. At the foundation of AI is TQM recognized by the scientific community of the modern world and in the context of alternative medicine models as a promoter of science. Thanks to the US development over 40 years of transgenic pig organ transplantation, as a model conceived in Moldova (1984), as an alternative to human donor organs. The prized TQM medicine is successfully assimilated by competitive marketing, in which AI is already included, with an essential social financial role. IA was supported by Antonio Guterres, Secretary General of the United Nations, Ursula von der Leyen, President of the European Commission. Thus AI has been considered at the level of the United Nations, the European Union, Japan, China and others. The head of the European Commission, Ursula von der Leyen from Great Britain at the First AI Safety Summit in the world, named 4 conditions for ensuring safety in the use of AI. 1) A thriving and independent scientific community equipped to evaluate AI systems, with funding and access to the best supercomputers; 2) Development of internationally recognized procedure and standards for AI safety testing. 3) A standard procedure whereby every significant incident caused by errors or misuse of AI is reported and accounted for. 4) Establishment of a reliable international notification system.

Are pharmacists on the front lines of the opioid epidemic? A cross-sectional study of the practices and competencies of community and hospital pharmacists in Punjab, Pakistan

IntroductionCountries are grappling with a rapidly worsening upsurge in the opioid-related overdose deaths, misuse and abuse. There is a dearth of data in Pakistan regarding the practices and competencies of...

Determinants of the resilience of mothers who have down syndrome children

Children as the fruit of a husband and wife's love bond are children whose presence is awaited. However, it is different from the presence of a child with Down syndrome, this will have a major influence on the family, especially the mother who is the closest figure to the child. This study aims to determine the resilience determinants of mothers who have children with Down syndrome at the Surabaya POTADS Foundation.This study used an analytical observational design with a cross sectional approach by distributing questionnaires. The number of participants involved in this study was 10 participants where all participants had met the criteria to become participants using purposive sampling technique. The variables in this study are individual factors, family factors, community factors, risk factors, resilience. The instrument used is a questionnaire using a closed ended type dicotomy. Data analysis used logistic regression statistical test. (1) Based on the results of the Simultaneous Test (F test), it is known that the calculated F value is 2,930 &lt; F table 4.53 or Sig is 0.135 &gt; 0.05, which means H_1 is rejected. This shows that the independent variables, namely individual, family, community and risk have no simultaneous effect on the dependent variable, namely resilience, (2) Based on the results of the Partial Test (T test) it is known that the influence of the four independent variables, namely individual, family, community and risk individually on the dependent variable, namely resilience, the Sig value is obtained. &gt; 0.05, so it can be concluded that the independent variable has no partial effect on the dependent variable. It can be concluded that there is no influence between independent variables (individual, family, community and risk) on the dependent variable (resilience) caused by several factors, namely low cognitive function, lack of coping strategies, low Locus of Control, negative self-concept and the absence of family support and low social skills.

Power Mobility, Supported Standing and Stepping Device Use in the First Two Years of Life: A Case Report of Twins Functioning at GMFCS V

Mobility experience has a positive impact on activity, participation, socialisation, language and cognition, but children with cerebral palsy (CP), Gross Motor Function Classification System (GMFCS) level V require assistive devices or assistance in all environments. Supported standing devices afford upright, weight-bearing positions to promote muscle, bone, joint and overall health. Supported stepping devices afford stepping and upright independent mobility, positively impacting self-esteem and participation, while power mobility is the only possibility for effective, independent community mobility. These devices and opportunities should be introduced at the age when children who are typically developing are pulling to stand, moving and exploring their environment. A detailed case description including lived experience and device use data is presented for female twins with dystonic tetraplegic CP born at 25 weeks gestational age and functioning at GMFCS level V. The feasibility of using power mobility, standing and stepping devices in home and community settings within the first two years is illustrated. The twins transitioned from spending 24 h in lying positions or being held in arms to spending more than 2 h daily in upright positions and having opportunities to move independently. Positioning and mobility devices can help to address all the F-words for child development: functioning, family, fitness, fun, friends and future.

Elevated emotion network connectivity is associated with fluctuations in depression.

Elevated emotion network connectivity is thought to leave people vulnerable to become and stay depressed. The mechanism through which this arises is however unclear. Here, we test the idea that the connectivity of emotion networks is associated with more extreme fluctuations in depression over time, rather than necessarily more severe depression. We gathered data from two independent samples of N = 155 paid students and N = 194 citizen scientists who rated their positive and negative emotions on a smartphone app twice a day and completed a weekly depression questionnaire for 8 wk. We constructed thousands of personalized emotion networks for each participant and tested whether connectivity was associated with severity of depression or its variance over 8 wk. Network connectivity was positively associated with baseline depression severity in citizen scientists, but not paid students. In contrast, 8-wk variance of depression was correlated with network connectivity in both samples. When controlling for depression variance, the association between connectivity and baseline depression severity in citizen scientists was no longer significant. We replicated these findings in an independent community sample (N = 519). We conclude that elevated network connectivity is associated with greater variability in depression symptoms. This variability only translates into increased severity in samples where depression is on average low and positively skewed, causing mean and variance to be more strongly correlated. These findings, although correlational, suggest that while emotional network connectivity could predispose individuals to severe depression, it could also be leveraged to bring about therapeutic improvements.