Individual Approach Research Articles

Instruments validated in Brazil for assessing oral health literacy in adolescents: an integrative literature review

Adolescence is a stage of life where there are major physical and biological transformations concomitant with psychological and social ones, which occur with the development of sexuality and which influence the human being's personality and other aspects of life. Health literacy (HL) can be understood as an individual's ability to access, understand, evaluate and put into practice basic health information. Adolescent oral health literacy (OHL) is an area that is little explored, despite the importance of this formative stage in the individual approach to healthy lifestyles and behaviors. The objective of this study was to carry out an integrative literature review on research instruments validated in Brazil for OHL among adolescents. The search strategy was carried out in August 2023, with a broad search for studies that assessed OHL in adolescents, in the Virtual Health Library (VHL), US National Library of Medicine (PubMed) and Scientific Electronic databases. Library Online (Scielo). The keywords used were “health literacy” and “oral health” and “adolescents”. Inclusion criteria: free full texts; only: articles, books and documents, clinical trials, meta-analyses, controlled and randomized trials, analyzes and systematic reviews; without limitations of date or language. Exclusion criteria: studies without the three descriptors present in the text simultaneously, theses and monographs, abstracts, letters to the editor. 47 articles were found in VHL, 118 in PubMed and 13 in Scielo. Nineteen articles were analyzed and presented according to: author, title, year of publication, type of study, objectives, sample size and age group, sample recruitment, data collection tool, limitations and health outcomes. The only research instrument on adolescent OHL validated in Brazil was the BREALD-30 questionnaire, a Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry, which measures literacy through word recognition. An important research gap in this field was revealed.

AN EVALUATION OF THE OBESITY PHENOMENON IN THE CONTEXT OF SOCIAL WORK THEORIES

Obesity is a disease that negatively affects millions of people worldwide. This disease, which causes many people to experience physical, psychological, emotional, social and economic problems in terms of its consequences, is one of the most discussed diseases both in the world and in our country in recent years. Millions of people apply to obesity diagnosis and treatment centers in the world and in our country every year for treatment. It is very important to evaluate this disease, which has various treatment methods, not only from a medical perspective and to understand not only its medical consequences but also its biopsychosocial consequences.
 
 Social work is a profession and discipline that aims to understand the biopsychosocial aspects of problems and diseases and to make a holistic planning, intervention and evaluation with an individual approach in the environment. The phenomenon of obesity is a public health problem where various applications can be made for individuals, families and society experiencing this phenomenon. In this study, it is aimed to make an evaluation of social work theories towards the obesity phenomenon in order to give more space to obesity in the social work profession. Practices in the social work profession are based on theoretical foundations. Some of these theoretical approaches that guide practices are discussed in this review study. These are biopsychosocial approach, ecological approach, system approach and empowerment approach.

Information Support for Tutors in Higher Education Institutions

The relevance. Today, the influence of the tutor on the formation of consciousness and the success of students’ studies plays an important role. A tutor in his professional activity is one of the closest advisers, sometimes even a friend and assistant of a student, such a person helps the student to overcome problems and difficulties. It is the ability of the tutor’s individual approach that makes it possible to prevent problems that may arise for the student. However, the tutor does not always have enough information support for high-quality and efficient performance of his work. Therefore, the use of modern computer technologies in the tutor’s work is quite relevant and necessary.
 The purpose of the paper is to create information support for improving the tutor’s work.
 The methodology consists in developing and applying a clear plan that will help divide the main task into detailed subtasks. For this purpose, the work uses a functional model of the tutor’s information provision process to facilitate student adaptation.
 Conclusions. The tutor’s information support is an important component that affects the success and efficiency of the tutor’s work, as well as for the successful educational, scientific and social activities of students. The development of such an information resource for the tutor provides him with all the information about the opportunities and activities in which the student can be involved, and the student, in turn, is given the opportunity to find a mentor with whom it will be easy and simple for him to work.

ABOUT THE IMPORTANCE AND BENEFITS OF EVENT MARKETING

In today's environment, where consumers have a wide range of information available to them, it is important for companies to use more effective and flexible approaches to the market. Modern information technology helps the marketer to be closer to the buyer than in the past and to understand the customer's needs and desires well. In addition, marketers need to have a good understanding of the capabilities and benefits of different marketing communication tools and media channels. In today's competitive environment, it is becoming increasingly important for companies to use incentives that are better suited to today's targeted strategies. Effective marketing communications play an important role in a company's success in the marketplace. It is important in creating an impression of the company and its brands. Events help companies to achieve this goal. The purpose of this paper is to summarise and present the main benefits that companies can achieve through the intelligent use of events. Events are used by many companies to impress other people. And companies can gain their favour by making a great impression on the public. Thus, event marketing influences consumer attitudes towards different brands, consumer behaviour and stimulates purchases. An important question is when and how special events will be implemented. Their proper planning, organisation and execution will bring the company high recognition and economic benefits. Methodology. Secondary data was used in the course of writing this article. Modern scientific works of scientists and researchers were studied, and information was searched for using Internet sources. The paper examines modern forms of event marketing, individual approaches to work in this area and aspects of its development. Research results. Based on various reliable sources of information, a clear picture of the current situation in Georgia in this area was created. It has been found that companies do not use measures with the frequency that would bring them high results. They use only certain approaches. The paper examines the conceptual aspects of event marketing, analyses the definitions and opinions of various scientists and specialists in this area. Practical implications. The article discusses the risks and problems associated with the implementation of events, and presents a number of conclusions and recommendations to improve the efficiency of the use of events.

Analysis of the Learning Process of Computer Programming Logic in an 8-Year-Old Elementary School Student at Home through the Scratch Program

This paper presents a study guide and an analysis of its use in the computer programming learning process of an 8-year-old elementary school student through the Scratch program. The research’s objective is to explore and understand how this individual student approaches learning programming skills and tackles challenges within the Scratch environment. An individual case study approach was adopted at home, combining qualitative and quantitative methods to gain a comprehensive insight into the student’s learning process. The study was conducted without grant support, and the researcher actively participated as an educator and observer in the student’s learning sessions. Performance was assessed, and a semi-structured interview was conducted to inquire about the student’s experiences, motivations, and interests regarding programming in Scratch, as well as their feelings after the training. Additionally, the student’s activities during programming sessions were meticulously recorded, and projects created in Scratch were analyzed to assess progress and understanding of concepts. The findings of this research have the potential to contribute to the field of programming education and provide valuable insights into how young elementary school-aged individuals can acquire computer and programming skills in an interactive environment such as Scratch. The results obtained demonstrate that using the proposed guide to introduce elementary school students to programming at home, with parents acting as educators, is feasible. Therefore, it helps facilitate access to this knowledge, which is currently limited for many individuals in an official educational setting.

Retrospective analysis of scientific and psychological concepts of domestic violence

It is emphasised that in connection with the full-scale war of the russian federation against Ukraine, new risk factors for the increase in domestic violence have emerged, among which the most significant are fear, uncertainty; a sense of helplessness and confusion; socio-economic instability and job loss; forced displacement and loss of a safe environment and established interpersonal space; disruption of family dynamics and relationships; increased alcohol and drug use; easy access to various types of weapons; and the emergence of post-traumatic stress syndrome.
 It is noted that modern science considers domestic violence through the prism of existing approaches that explain the causes of its occurrence and peculiarities of its course.
 The first approach, the socio-cultural approach, focuses on the analysis of social structures, cultural norms and values of society as factors of domestic violence. It focuses on the impact of social factors and structures, as well as family relationships, on the management of the atmosphere of violence. The approach sees the main cause of domestic violence and violence against women as the so-called male dominance in social relations, the lack of gender equality, and the existence of established patriarchal norms that contribute to violence.
 The next individual psychological approach considers concepts that explain violence by human nature and focuses on the study of the personality traits of the perpetrator and the victim. Proponents of this approach emphasise that there are certain innate inclinations and instincts that push people to violence.
 Representatives of the systemic-family approach focus on the study of interaction, communication dynamics, conflict resolution processes in the family and ways of reconciliation that exist between its members. Violence is caused by various physical, moral, aesthetic, and economic constraints. According to scientists, violence is associated with the use of deliberate physical, psychological, financial and material pressure on a person, as most cases of domestic violence intersect with psychological pressure and exploitation.
 Representatives of the sociological approach note that violence is a general social phenomenon and it is a consequence of the clash of various interests manifested at different levels of its development, i.e. violence is socioculturally determined.
 The most widely accepted today is the ecological theory of violence, which explains domestic violence by considering the problem from different aspects through the prism of the mutual influence of four systems on human development: microsystem, mesosystem, exosystem, macrosystem.
 Therefore, despite the war, it is necessary to continue work on prevention and appropriate response to domestic violence, and understanding the essence and content of existing theoretical concepts of violence is one of the components of countering this phenomenon.

Pathophysiology of Pre-Eclampsia-Two Theories of the Development of the Disease.

Pre-eclampsia (PE) continues to be a leading cause of maternal and fetal mortality and morbidity. While substantial progress has been made in understanding the pathomechanisms of PE, the pathophysiology of the disease is still not fully understood. While the "two-stage model" of the development of PE is the most widely accepted theory, stating that the placenta is the main source of the disease, there are some other pathophysiological models of PE. Among these other theories, the one considering heart dysfunction as serving as the primary cause of PE seems to be gaining increasing prominence. In this review, we aim to elucidate these two divergent concepts concerning the development of PE. Despite some differences in their proposed pathomechanisms, both theories share vital pathophysiological elements in common. A central and critical component in both models is impaired placental perfusion, which appears to be a crucial phenomenon in PE. A comprehensive understanding of the different pathomechanisms involved in PE may be helpful in clinical practice, prompting a more individual approach to care of patients with PE.

Regional brain activity of resting-state fMRI and auditory oddball ERP with multimodal approach in individuals with internet gaming disorder.

Resting-state brain activity may be associated with the ability to perform tasks; however, a multimodal approach involving resting-state functional magnetic resonance imaging (fMRI) and event-related potentials (ERPs) has not been widely used to investigate addictive disorders. We explored resting-state fMRI and auditory oddball ERP values from 26 with internet gaming disorder (IGD) patients and 27 age- and intelligence quotient-matched healthy controls (HCs). To assess the characteristics of resting-state fMRI, we calculated regional homogeneity (ReHo), amplitude of low-frequency fluctuation (ALFF), and fractional amplitude of low-frequency fluctuation (fALFF); we also calculated the P3 component of the ERPs. Compared with HCs, the individuals with IGD exhibited significant decreases in ReHo and fALFF values in the left inferior occipital gyrus, increased ReHo and ALFF values in the right precuneus, increased ALFF in the left superior frontal gyrus, and lower P3 amplitudes in the midline centro-parietal area during the auditory ERP task. Furthermore, the regional activity of resting-state fMRI in the right inferior temporal gyrus and the occipital regions were positively correlated with the P3 amplitudes in IGD patients, whereas ReHo values of the left hippocampus and the right amygdala were negatively correlated with P3. Our results suggest that IGD patients have difficulty interacting effectively with cognitive function and sensory processing, although its interpretations need some cautions. The findings in this study will broaden the overall understanding of the neurobiological mechanisms that underlie IGD pathophysiology.

Подходы к управлению информационной инфраструктурой предприятия на основе интеграции моделей качества и дизайна программного обеспечения

The article discusses approaches to forming and managing the enterprise’s information infrastructure. The choice of approaches to the information infrastructure formation and management should be based on a comprehensive analysis of the organization’s needs, its goals and resources, and should be adapted to the organization’s specific conditions and requirements. It is noted that the successful management of an enterprise’s information infrastructure doesn’t only require the right approach, but also competence and experience in the field of IT management. Regardless of the chosen approach, the efficiency of the infrastructure depends on using modern technologies and management methods, as well as taking into account the specifics of the company’s activities. To ensure the management process effectiveness, it is necessary to apply modern tools and methods, such as management process automation, data monitoring and analysis, risk management and information security. The article discusses various approaches to managing the enterprise’s information infrastructure, such as the ITIL standard, COBIT and SWEBOK. It is stated that an effective solution for enterprises is an individual approach that allows considering various quality models and KPIs. The importance of using modern technologies and methods of information infrastructure management to improve the efficiency of business processes, to ensure information security and confidentiality, as well as to reduce the cost of its processing and storage is emphasized.

Diminished Returns of Higher Parental Education on Cognition for Black Adults in Middle and Later Life.

Mounting evidence suggests that the protective effects of one's own higher socioeconomic status (SES) on health are diminished among minoritized racial/ethnic groups in the United States. This study extends this area of research to childhood SES and cognition in middle and later life, focusing on the protective effects of higher parental education among non-Hispanic Black and White adults. Harmonizing data from individuals ages 50 and older across the Health and Retirement Study, the Study of Midlife in the United States, and the National Social Life, Health, and Aging Project, we examine whether associations between parental education and two measures of cognition (episodic memory and global cognition) are moderated by racialized identity (non-Hispanic White or Black) using a random-effects individual participant data meta-analysis approach. Findings indicated a small, but robust, protective effect of higher parental education on both episodic memory and global cognition among adults identified as White. Among adults identified as Black, there was no association between parental education and either cognitive outcome. This study provides evidence that the protective effect of higher parental education on cognition is not the same across racialized populations, consistent with the theory of Minority Diminished Returns. As scholars continue calls for life-course-oriented efforts to reduce racialized cognitive disparities, it is important to consider early-life risk and protective factors in the context of racism.

Tenor timbre images in the Giacomo Puccini’s operas: the experience of systematisation

The relevance of the article. An essential requirement for a musician-performer of any specialty is a deep understanding of the stylistics of the works performed, based on an analysis of the artistic and figurative foundations of the musical language. For opera singers, an important factor of professional level is knowledge of the basics of opera drama, the style of the era, possession of appropriate means of vocal expressiveness. Addressing the chosen topic determines the relevance and scientific novelty of the issues of this article, in which arias for tenor in the operas of Giacomo Puccini are considered systematically for the first time, in the context of the evolution of the composer's work. The main purpose of the article was to determine the criteria and implement the systematization of tenor arias in Giacomo Puccini's operas through the prism of their dramatic role in the focus of imagery, genre-stylistic and form-creating features, for further typology of the role of "Puccini's voice" — the tenor-spinto. The research methodology is based on the methods of complex-historical, typological, structural-functional and comparative analysis, which allows us to understand the individual approach of Giacomo Puccini to the creation of his "own musical theater", the dramaturgy of the image of an operatic character, and to determine the criteria for the systematization of operatic arias of the tenor role.
 Results and conclusions. The tenor timbre corresponds as much as possible to Puccini's "vision" of a theatrical character, so almost every opera has a main character with this type of voice. The tenor-spinto (lyrical-dramatic tenor) attracts the composer's special attention, which testifies to the composer's clear imagination of a certain timbre-image as a carrier of artistic and meaningful meaning. Aria, as a fragment of an opera that focuses the attention of the listener on the image of the hero and the voice of the performer, in the history of opera-drama has always created a dilemma between the need for continuous action and its stopping in solo episodes of the performers. Puccini's ability to combine thorough musical development with fixation on dramatically important moments is a special feature of his author's vision. The article proposes a systematization of tenor arias in Puccini's operas according to their place in the action of the play. Two large groups are distinguished: musical portraits of the hero and arias of spiritual elevation (the culminating episode of the character's development, often the climax of the opera). The criteria for the systematization of tenor arias are defined: artistic content (differentiation according to the emotional and figurative criterion); compositional and structural features (identification of common and individual features of the construction of musical forms); the predominant type of means of vocal expressiveness (features of Puchchin's melodism). This approach allows the performer to better understand the principles of Puccini's thinking as a playwright. A deep understanding of the stylistic principles of the composer's work, the stylistics of the author's writing, gives the singer the opportunity to create his own performance interpretation, which evokes a response from the audience and becomes a real artistic asset. Further research in the proposed scientific field will contribute to the expansion of ideas about the author's theater of Giacomo Puccini, will help to better understand the principles of Puccini's thinking as a playwright and the degree of his innovation.

Advances in machine intelligence-driven virtual screening approaches for big-data.

Virtual screening (VS) is an integral and ever-evolving domain of drug discovery framework. The VS is traditionally classified into ligand-based (LB) and structure-based (SB) approaches. Machine intelligence or artificial intelligence has wide applications in the drug discovery domain to reduce time and resource consumption. In combination with machine intelligence algorithms, VS has emerged into revolutionarily progressive technology that learns within robust decision orders for data curation and hit molecule screening from large VS libraries in minutes or hours. The exponential growth of chemical and biological data has evolved as "big-data" in the public domain demands modern and advanced machine intelligence-driven VS approaches to screen hit molecules from ultra-large VS libraries. VS has evolved from an individual approach (LB and SB) to integrated LB and SB techniques to explore various ligand and target protein aspects for the enhanced rate of appropriate hit molecule prediction. Current trends demand advanced and intelligent solutions to handle enormous data in drug discovery domain for screening and optimizing hits or lead with fewer or no false positive hits. Following the big-data drift and tremendous growth in computational architecture, we presented this review. Here, the article categorized and emphasized individual VS techniques, detailed literature presented for machine learning implementation, modern machine intelligence approaches, and limitations and deliberated the future prospects.

IS HOME HOSPICE THE “GREAT EQUALIZER?”—ADDRESSING EQUALITY AND EQUITY DURING THE COVID-19 PANDEMIC

Abstract COVID-19 illuminated many of the inequities that exist in the current healthcare system, especially for those who are most vulnerable and facing the end of life. Social determinants of health (SDOH) directly and indirectly influence access to the quality of care received by patients enrolled on the hospice benefit. We interviewed 20 interdisciplinary providers (nurses, managers, administrators, physicians, medical directors, social workers, and clergy) between September 2022 and January 2023 from three healthcare organizations that provided hospice care to older adults and their caregivers in NYC regarding their perceptions of the impact of SDOH on the delivery of hospice care during the pandemic. We then conducted rapid analysis of their responses. Findings emerged around three salient themes: 1. “I provide equal care to everyone” (Some providers recognize SDOH result in inequities within hospice, whereas others perceive hospice as an equalizer of care); 2. “They’re going to kill us” (Describing barriers that challenge hospice enrollment and continued access to care); and 3. “We’ve got to do better” (Addressing inequity through organizational and community programs that address barriers and improve access to hospice). Overall, we learned that SDOH must be addressed in a proactive rather than a reactive way to ensure hospice access. Systemic, rather than individual approaches were needed to overcome existing barriers exacerbated by the pandemic. To this end we will discuss lessons learned and strategies for program development and equitable delivery of home hospice care.

DIMINISHED RETURNS OF PARENTAL EDUCATION ON COGNITION: EVIDENCE FROM THREE POPULATION STUDIES IN THE US

Abstract Mounting evidence suggests that the protective effects of one’s own higher socioeconomic status (SES) on health is diminished among minoritized racial/ethnic groups in the United States (U.S.) with respect to outcomes such as mortality, hospitalization and mental health. Extending this area of research to childhood SES and later life outcomes, this study examines whether the protective effects of higher parental education on cognition is diminished among Black adults relative to their non-Hispanic White peers. Using data from the Health and Retirement Study, the Midlife in the U.S. Study, and the National Social Life, Health and Aging Project, I examine whether associations between parental education and two measures of cognition (episodic memory and global cognition) are moderated by race (non-Hispanic White or Black) using a random-effects individual participant data meta-analysis approach. I find evidence for a small, but robust, protective effect of higher parental education on both episodic memory and global cognition among White adults. Among Black adults, there was no association between parental education and neither episodic memory nor global cognition. This study provides evidence that the protective effect of higher parental education on cognition is not the same across racialized populations, consistent with the theory of Minority Diminished Returns. As scholars continue calls for life course-oriented efforts to reduce racialized cognitive disparities, it is important to consider early-life risk and protective factors in the context of structural racism.

Perceived trauma nursing core competency, interprofessional collaborative competency, and associated barriers among regional trauma center nurses

IntroductionAs key members of interprofessional teams working in complex settings, nurses in trauma centers require trauma nursing core competency. PurposeThis study sought to determine the levels and relationships of the perceived importance and performance of trauma nursing core competency, as well as the interprofessional collaborative competency and associated barriers among Korean regional trauma center nurses. MethodsThis cross-sectional, descriptive, and correlational survey involved a convenience sample of 190 Korean trauma center nurses. Data were collected using a web-based self-reporting questionnaire about the perceived importance and performance of trauma nursing core competency, as well as the interprofessional collaborative competency and associated barriers. Data were analyzed using descriptive statistics, Pearson’s correlation, and multiple regression (Enter method) analyses. ResultsThe perceived performance and importance of interprofessional collaborative competency, the perceived importance of trauma nursing core competency, and the perceived barriers to resources, training, competency, and interest significantly affected trauma nursing core competency performance, accounting for 64.5 % of the variance. ConclusionsTraining programs are needed to improve the core and interprofessional collaborative competencies of trauma nurses. Individual, team, and organizational approaches are essential to addressing the perceived barriers. The effects of training programs on the core competency of trauma nurses should be validated.

Phenotypes and treatment outcomes in idiopathic pulmonary arterial hypertension patients with comorbidities.

Idiopathic pulmonary arterial hypertension (IPAH) is often diagnosed in elderly patients with many comorbidities. Whereas a clear treatment strategy and risk assessment is recommended for patients with rare classical IPAH, monotherapy with phosphodiesterase type 5 inhibitors or endothelin receptor antagonists followed by regular follow-up and individualised therapy should be used for patients with many cardiopulmonary comorbidities. Here, we focus on these patients with IPAH and comorbidities, present a review of the literature with a focus on recently published work and summarise factors that may help to provide guidance for individualised treatment approaches in such patients.

Optimal Bell's Palsy Treatment: Steroids, Antivirals, and a Timely and Personalized Approach.

The optimal treatment approach for patients with Bell's palsy, a condition characterized by acute facial nerve palsy, remains unclear. The present study was designed to provide insights into the most effective treatment strategies, whether steroids alone or steroids plus antiviral agents, as well as the optimal timing of treatment initiation. To investigate the impact of treatment modalities and timing on the recovery rates of Bell's palsy patients and to assess the roles of individual factors. This retrospective analysis included 1504 patients with Bell's palsy who visited Kyung Hee University Hospital. Patients were divided based on the treatment modality (steroid monotherapy vs. combined steroid and antiviral therapy) and the timing of treatment initiation (≤72 vs. >72 h). The primary outcome was the recovery rate, as assessed by the House-Brackmann (HB) grade. Secondary outcomes included factors such as age, electroneurography (ENoG) and electromyography (EMG) results, and comorbid conditions. A combined comparison of patients treated with steroids plus antivirals and steroids alone, stratified by treatment start time, showed that recovery rates were highest in patients who received steroid monotherapy initiated within 72 h (OR 2.36; p < 0.05). Patients with severe Bell's palsy tended to benefit more from combined therapy when treatment was initiated within 72 h. The recovery rate was higher in patients who received steroid monotherapy than combined therapy (86.32% vs. 79.25%, p < 0.05). Initiating treatment beyond 72 h was associated with a higher recovery rate than starting treatment within 72 h (85.69% vs. 76.92%, p < 0.05). An evaluation of the factors affecting recovery showed that patients aged 20 to 39 years had a higher recovery rate than other age groups (OR 1.47; p < 0.05). Fairly predictive EMG results were associated with significantly higher recovery rates (OR 3.52; p < 0.05). These findings underscore the importance of individualized treatment approaches in Bell's palsy management. Steroid monotherapy remains effective, although combined treatment may have potential advantages, especially in patients with more severe disease. The best treatment results were achieved when steroid treatment was administered within 72 h. Our results suggest that there may be more flexibility in the application of the 72 h treatment period if we consider the time of treatment initiation alone, but this should take into account patient behavior patterns and the limitations of retrospective analysis. Further research is warranted to validate these findings and refine treatment recommendations for patients with Bell's palsy.

THE ROLE OF NURSES IN DISORDERS OF CONSCIOUSNESS: ​IMPLEMENTATION OF SENSORY STIMULATION IN THE NEURO-ICU

Abstract In the Neuro Intensive Care Unit (Neuro-ICU), patients with Disorders of Consciousness (DoC) often experience sensory deprivation. DoC, resulting from brain damage, encompasses varying degrees of wakefulness and awareness, ranging from coma to vegetative state and minimally conscious state. Research highlights a concerning trend in the Neuro-ICU, where older adults with DoC are more susceptible to mortality compared to their younger counterparts. This study emphasizes the indispensable role of nurses in effectively managing DoC within the Neuro-ICU, particularly through the thoughtful application of sensory stimulation interventions. Sensory stimulation is a promising approach that engages patients’ various senses—touch, sight, sound, and smell, aiming to awaken awareness and cognitive responses in DoC patients. By fostering neural activity, sensory stimulation holds the potential to contribute to their recovery. Importantly, these techniques can be customized to each patient’s specific condition and responses, and nurses, due to their continuous patient interactions, are uniquely positioned to administer these interventions at the bedside. Recognizing this vital role, evidence-based strategies are proposed, encompassing thorough literature analysis, assessment of nurses’ attitudes, and exploration of potential interventions within the Neuro-ICU setting. This research highlights the significant impact nursing can have on elevating patient outcomes. It demonstrates how evidence-based interventions like sensory stimulation can be seamlessly woven into patient care, providing a valuable and holistic approach for individuals grappling with the intricate challenges presented by DoC.

Individual approach to metastatic colorectal cancer treatment (clinical cases)

Two patients with metastatic colorectal cancer underwent R0 large bowel resection followed by surgery liver and lungs metastases, retroperitoneal lymph nodes and post-op chemotherapy. The total follow-up period of the first patient was currently 12 years, the recurrence-free period was 5 years. In the second patient, stabilization of the disease was observed for 12 years, and the total follow-up period – 18.5 years. An integrated treatment approach to metastatic CRC with active surgery for removable distant metastases or perioperative use of the most effective drug therapy for potentially resectable metastases can control the disease even with an aggressive course.

FURTHER EVALUATION OF A MODIFIED VERSION OF THE HOSPICE PHILOSOPHY SCALE: A DIFFERENTIAL ITEM FUNCTIONING ANALYSIS

Abstract The hospice philosophy of care (HPOC) is a set of values applicable to all interdisciplinary group members that drives organizational and individual approaches to hospice care. As the only established measure of HPOC attitudes, we aimed to extend previous exploratory psychometric evaluation of the eight-item Hospice Philosophy Scale (HPS-8). An interdisciplinary convenience sample of 481 hospice clinicians participated in this cross-sectional study. Participants were recruited through hospice and palliative care membership associations representing the core members of the Medicare Hospice Benefit-designated hospice interdisciplinary group (physicians, nurses, social workers, chaplains). After examining uniformity through confirmatory factor analysis, we tested HPS-8 items for differential item functioning (DIF) by professional discipline using multiple indicators, multiple causes models. We compared models via nested chi-square difference tests. Our final model assessed uniform DIF for the HPS-8 factor, controlling for DIF-indicated items. We also assessed internal consistency reliability. After correlating errors for two similarly worded items, global fit indices met prevailing thresholds, χ²(19)=55.18, p&amp;lt;.001 (RMSEA=.06, SRMR=.03, CFI=.98, TLI=.97). The uniform DIF model indicated two items with DIF. Chaplains endorsed the need for mental and spiritual preparation for death more than physicians (β=0.21, p&amp;lt;.001). Nurses endorsed involving patients and families in deciding treatments and services more than physicians (β=0.21, p=.006). Despite statistically significant DIF on these items, statistically significant differences among professions were not observed at the factor level (p&amp;gt;.50 for all). Composite reliability estimates satisfied internal consistency thresholds (CR=.76). Results support the HPS-8’s use as a valid and reliable measure for assessing HPOC in hospice clinicians.