Intensive Sessions Research Articles

Prohibited Olympic Medalist with PIEZO1 VUS Who Claims Innocence

Competitive athletes are often exposed to extreme physiological loading, resulting in over excessive mechanotransduction during their acute intensive training sessions and competitions. Individual differences in their genetics often affect how they cope with these challenges, as reflected in their high performances. Olympic Medalists are prohibited from providing atypical values in the Hematological Module of the Athlete Biological Passport. Since there was no aphysiological result and the Athlete maintained his innocence, a whole genome sequence analysis was carried out on him and his parents, with the primary focus on the PIEZO ion channels encoding gene. PIEZO1 is known to participate in homeostatic regulation even on a whole-body level, including the regulation of physical performance, circulatory longevity of red blood cells and cell fate determination of mesenchymal stem cells in relation to hydrostatic pressure. However, PIEZO2 was found to be the principal mechanosensory ion channel for proprioception. These regulatory mechanisms play a pivotal role in mechanotransduction and intensive exercise moments. Interestingly, two variances of uncertain significance of PIEZO1 were found that may explain the atypical values of the Athlete. Furthermore, two additional variances in SDC2, the syndcan-2 encoding gene, were identified in trans position that may influence the crosstalk between PIEZO2 and PIEZO1, with more likely relevance to the detected atypical values. After all, based on the found variances of PIEZO1 and syndecan-2, it cannot be ruled out that these VUS variants may have caused or impacted the exhibited outlier findings of the ABP Hematological Module of the Athlete.

Fundamentals of leadership development: a randomized pilot study to evaluate implementation of a leadership curriculum for diversity, equity, and inclusion.

The Fundamentals of Leadership Development (FLD) Curriculum was created to increase integration of diversity, equity, and inclusion (DEI) in leadership skills. The pilot FLD course was utilized 1) evaluate short-term impact of the curriculum, and 2) evaluate optimal delivery methods of curricular interventions on diversity in a leadership context in a randomized fashion. After IRB approval, the pilot FLD course was opened to all SAGES Committee members for enrollment. All participants had access to the same online modules and discussion forum, but were randomized either to a 4-week longitudinal or 2-day intensive didactic session. Participants were asked to assess the curricular content after each online module and provide overall course feedback on all sessions. This data was collected along with leadership experience, course participation, and course completion data. A total of 79 participants registered for the FLD course, with 55 (69.7%) of participants completing the course. Of those that registered, 46 (58.2%) self-identified as underrepresented in medicine, 32 (40.5%) self-identified with she/her/hers pronouns, and 45 (57.0%) held an institutional leadership position. Fifty-nine (74.6%) participants were willing to be randomized. Course engagement was higher in the intensive course with 64.1% and 48.7% participation over days 1 and 2, respectively. In the longitudinal course, participation dropped off every week from 70%, 47.5%, 35%, and 27.5%, throughout the 4-week course. Participants who accessed the online modules spent a median time of 3h and 34min.User confidence after completion of each individual module were "somewhat confident" and "completely confident" for almost all survey respondents on a 5-tier Likert scale. The pilot FLD course appealed to SAGES members in leadership roles and who identified as. URiM. Course engagement was higher in the intensive course. Long-term behavior changes after course completion will need to be assessed with additional qualitative interviews. (300/300 words).

The Role of Bio-Inspired Soft Robotic Gloves in Stroke Rehabilitation: A Comprehensive Analytical Review

Stroke is a leading cause of long-term disability, with many survivors experiencing impaired motor function. Traditional rehabilitation methods often face limitations in achieving full functional recovery. In recent years, bio-inspired soft robotic gloves have emerged as a promising solution for enhancing stroke rehabilitation, mimicking the natural movement and adaptability of biological systems. This paper provides a comprehensive analytical review of bio-inspired soft robotic gloves designed for stroke rehabilitation, focusing on their development, fabrication methods and therapeutic applications. The primary objective of this review is to evaluate the role of bio-inspired designs in the creation of soft robotic gloves and assess their effectiveness in facilitating motor recovery post-stroke. A systematic analysis of existing literature is conducted, exploring various fabrication techniques, including soft material integration, actuators and sensors, as well as the application of these gloves in clinical and therapeutic settings. Findings from this review reveal that bio-inspired soft robotic gloves show significant potential in improving patient outcomes by enhancing finger and hand movement through assisted motor control. These devices offer advantages in terms of comfort, flexibility and adaptability, allowing for prolonged and intensive rehabilitation sessions. However, limitations remain, such as the high cost of fabrication, challenges in achieving precise motor control and the lack of large-scale clinical trials to validate long-term efficacy. The research has several implications: (1) Theoretical: advancing the understanding of bio-inspired design principles in soft robotics; (2) Methodological: highlighting fabrication techniques that enhance glove performance and user adaptability. This review offers original value by consolidating and analysing recent developments in bio-inspired soft robotic gloves, contributing to both the academic literature and practical applications in stroke rehabilitation. It emphasizes the necessity of future research to address current limitations, especially in optimizing performance and reducing production costs, while enhancing patient outcomes.

Report- Towards a sustainable mobility | Green and blue infrastructures among the Finiq municipality

Finiq is a village located in the homonymous Municipality, which is part of the District of Vlorë. This Municipality has been the subject of the 8th International Workshop of Tirana (9th - 20th January 2023). The workshop, “Re-Inventing Phoeniciae (Finiq): New Intersections of Tradition, Innovation, Landscapes and Tourism”, had the aim to address, from different point of view, the problems of “identity”, “shrinking” and “isolation” of this area. The workshop unfolded in two distinct phases. Initially, attendees engaged in a series of enlightening lectures delving into various aspects of Albanian culture, complemented by captivating case studies crafted by both professors and students from Polis University. Additionally, an insightful site-visit to the Municipality of Finiq provided firsthand exposure to real- world applications. Subsequently, the focus shifted to intensive working sessions, where PhD students were grouped into four specialised teams, each tasked with addressing a specific domain: Infrastructures and Facilities, Environmental Systems, Landscapes and Heritage, and Settlements, Public Spaces and Dwellings. Our team, dedicated to scrutinising infrastructural and facility concerns within the Municipality, boasted a diverse array of expertise spanning architecture, urban planning, civil engineering, and mechanical engineering. This diverse blend of skills fostered a rich exchange of perspectives, allowing for a comprehensive analysis and exploration of potential solutions. Through collaborative efforts, this workshop aimed to endeavoured to reimagine Finiq by proposing innovative infrastructural and facility enhancements across various scales, thereby contributing to the holistic revitalisation of the region.

The Evolvement of Session Design From Junior Age to Senior Peak Performance in World-Class Cross-Country Skiers.

To compare designs of training sessions applied by world-class cross-countryskiers during their most successful junior and senior season. Retrospective analysis of self-reported training characteristics (ie,training form, intensity, and exercise mode) among 8 male and 7 female world-class cross-country skiers was conducted. Total number of sessions (441 [71] vs 519 [34], P < .001, large effect) and mean duration (1.5 [0.1]h vs 1.7 [0.1]h, P < .001, moderate effect) increased from junior to senior age. More double-session days were performed at senior age (124 [50] vs 197 [29]d, P < .001, large). The number (310 [64] vs 393 [64], P < .001, large effect) and duration (1.3 [0.1]h vs 1.5 [0.1]h, P < .001, moderate effect) of low-intensity training sessions increased from junior to senior age. Regarding intensive training, most emphasis was put on high-intensity training sessions lasting 20 to 39minutes with <5-minute intervals at junior age, while 40 to 59minutes ofmoderate-intensity training with 5- to 9-minute intervals was predominant at senior age. More MIXED (combined moderate- and high-intensity) sessions (9 [7] vs 14 [7], P = .023, moderate effect) and longer races (0.5 [0.1]h vs 0.6 [0.1]h, P = 0.29, moderate effect) compensated for fewer high-intensity training sessions at senior age (36 [17] vs 25 [10], P = .027, moderate effect). Duration of strength-training sessions increased significantly (0.6 [0.1] vs 0.8 [0.2]h, P = 0.30, moderate effect), while other training forms remained unchanged. World-class cross-country skiers increased their training volume from junior to senior age primarily by more and longer low-intensity training sessions and more often training twice per day. Concurrently, the most frequent intensive sessions were modified from high- to moderate-intensity training, lasted longer, and contained longer intervals.

Effects of a Training Program to Improve Co-Teaching and Collaboration Skills for In-Service Teachers of Special and General Education

Although co-teaching is increasingly recognized as a valuable approach in inclusive education, comprehensive studies that examine the impact of targeted professional development on enhancing teachers’ capabilities in this area are lacking. The limited research on this topic fails to provide clear evidence of the effectiveness of such training programs and their potential benefits for special education and general education teachers. Addressing this issue, this study investigates the effectiveness of a proposed professional development training program designed to elevate co-teaching and collaboration skills among in-service teachers. A one-group quasi-experimental design was used, and a convenience sampling of 32 female teachers, comprising 16 special education and 16 general education teachers, participated in the program consisting of 14 intensive sessions. Pre- and post-intervention assessments, comprising a co-teaching test and a collaboration skills scale, were administered. Results demonstrate significant benefits of the training program, with participants showcasing improved performance in the co-teaching post-test and collaboration scale. Special education teachers notably outperformed their general education counterparts in co-teaching skills. However, the analysis did not reveal any statistically significant differences between teachers of students with learning disabilities and teachers of general education regarding their performance on the collaboration skills scale. The study concludes with recommendations and future research directions, offering insights to further advance co-teaching practices and collaboration skills among educators.

Factors associated with completion of intensive adherence counseling among people living with HIV at a large referral hospital in Uganda: a retrospective analysis

BackgroundAmong people living with HIV(PHIV) with unsuppressed viral load after six or more months of anti-retroviral therapy (ART), three intensive adherence counseling sessions (IAC) sessions are recommended. However, there is limited information about IAC completion rates. We investigated the factors associated with IAC completion among PLHIV with an unsuppressed viral load on first and second-line ART in mid-western Uganda.MethodsIn this retrospective review of medical records, we abstracted routine HIV data between January 2018 and September 2019 at the Fort Portal Regional Hospital. IAC completion was the primary outcome measured as the receipt of ≥ 3 consecutive good ART adherence scores of ≥ 95.0% during the IAC sessions, spaced one month apart within three months. The modified Poisson regression analysis with robust standard errors was used to determine factors associated with the outcome, reported as risk ratio (RR) and 95% confidence interval (CI).ResultsWe studied 420 participants of whom 204 (48.6%) were aged 20–39 years (mean age, 33.6 ± 13.3 years) and 243 (57.9%) were female. 282 (67.1%) participants completed their IAC sessions. Secondary or higher levels of education (Adjusted RR (aRR) 0.79, 95% CI 0.64–0.98), no follow-up for IAC (aRR 0.76, 95% CI 0.67–0.87), malnutrition (aRR 0.65, 95% CI 0.43–0.99) were associated with a lower likelihood of IAC completion while being in a separated/widowed or divorced relationship (aRR 1.23, 95% CI 1.01–1.49) was associated with a higher likelihood of IAC completion.ConclusionsWe found a low IAC completion rate compared to the desired target of 100%. Nutritional support for malnourished PLHIV receiving IAC, follow-ups, and targeted health education on the importance of IAC are needed to improve the IAC completion rate.

The issue of energy metabolism featues of athletes specializing in virous types of gymnastics

This study examines research conducted by both domestic and international scholars on the training processes of gymnasts across various disciplines. The primary objective is to identify the characteristics of bioenergetic support influencing gymnastic performance. Contemporary research suggests that an athlete's physical capacity is contingent upon several factors, including the nature of motor activity performed during training drills, age, gender, and competitive experience. Statistical analysis demonstrates that drill duration in men's artistic gymnastics ranges from 5 seconds (vault) to 70 seconds (floor exercise), while women's routines vary between 5 seconds (vault) and 90 seconds (balance beam and floor exercise). Callisthenic drills require significantly more time, with duration ranging from 90 seconds (individual events) to 150 seconds (group events). Gymnastic training encompasses a wide age range, typically from 4 to 20 years, most commonly between 9 and 16 years. Notably, many female gymnasts reach their competitive peak during their mid-to-late teens, while males typically peak around 20 years old. The research indicates a proportional increase in training duration and intensity alongside age and competitive level. Studies investigating energy consumption in male artistic gymnasts reveal the highest consumption during floor exercises, followed by vault, still rings, horizontal bar, and parallel bars. Similarly, floor exercise consumes the most energy in women's artistic gymnastics, followed by bars, balance beam, and vault. Furthermore, research suggests that anaerobic energy support dominates during vault, pommel horse, parallel bars, and still rings exercises, while aerobic mechanisms underpin floor exercises and callisthenics. Notably, oxidative metabolism appears to have minimal direct impact on competitive callisthenic performance but plays a crucial role in glycogen conservation during extended, intensive training sessions for elite female gymnasts.

Pemanfaatan Artificial Intelligence (AI) Pada Penyusunan Aksi Nyata Paltform Merdeka Mengajar di SDN 02 Medalkrisna

This training program is designed to enhance the competency of elementary school teachers in developing practical actions on the Merdeka Mengajar Platform (PMM) by utilizing Artificial Intelligence (AI) technology. Through the use of Turnitin for plagiarism checks and Gamma for document preparation, the program aims to ensure that the work produced is original and well-structured. The training involves teachers in intensive sessions that include the introduction and use of Turnitin to detect plagiarism, as well as Gamma to assist in preparing practical action documents that meet Kemendikbud's validation standards. The results of the training show a significant improvement in teachers' ability to produce creative, innovative, and compliant practical actions according to the assessment criteria. Teachers participating in this program can produce more professional and plagiarism-free documents, thanks to the constructive feedback from AI. Furthermore, the resulting practical action documents have a clear and attractive structure, facilitating the validation process. This program also encourages the formation of a learning community among teachers, where they share best practices and support continuous improvement. Thus, this training program not only enhances teachers' digital competence but also contributes to the overall improvement of education quality. The use of AI in education becomes an important step in preparing teachers to face challenges in the digital era.

PENGELOLAAN SDM UMKM DI ERA DIGITAL PADA PULAU HARAPAN, KEPULAUAN SERIBU

Effective and adaptive management of Human Resources (HR) to the development of digital technology is the key to the success of Micro, Small, and Medium Enterprises (MSMEs) in the modern era. Harapan Island, one of the islands in the Thousand Islands, DKI Jakarta, has great economic potential, especially from the MSME sector. However, limitations in human resource management and the use of digital technology are the main challenges for the growth and sustainability of MSMEs in this region. This community service activity aims to increase the capacity of MSME human resource management on Harapan Island through the application of digital technology. This program includes training and assistance in the use of digital tools for human resource management, the development of basic digital skills for MSME actors, and increasing digital literacy among MSME workers. The methodology used includes workshops, intensive training sessions, and direct mentoring in the field. It is hoped that through this program, MSMEs on Harapan Island can optimize their human resource management, improve operational efficiency, and expand market reach through digital technology. In addition, this program also aims to build awareness and better understanding of the importance of digitalization in business management. Thus, MSMEs on Harapan Island can develop better and contribute more significantly to the local economy and the welfare of the local community.

A Young Man with Polydipsia and Severe Hyponatremia-Successful Management with Mere Fluid Restriction: A Case Report on Psychogenic Primary Polydipsia

Polydipsia as a result of an obsessive-compulsive disorder may cause polyuria and serious consequences like severe forms of electrolyte imbalance. This case report explores the rare occurrence of psychogenic primary polydipsia resulting in severe hyponatremia in a 29-year-old man presenting with excessive thirst, compulsive water intake, and extreme lethargy owing to serum hypo-osmolarity and hyponatremia. After the exclusion of organic conditions like diabetes mellitus, diabetes insipidus, hypercalcemia and, chronic kidney disease, intervention comprising of intensive counseling sessions, fluid restriction and slow normal saline infusion smoothly alleviated his presenting problems. Psychiatric management was contemplated to attain sustainable results.

Assistance in Developing Market Economics Teaching Modules for Teachers at the Indonesian School Davao, Philippines

This international community service program aims to enhance teachers' skills in developing market economics teaching modules at the Indonesian School in Davao, Philippines. The program includes a series of workshops and intensive mentoring sessions for teachers, focusing on developing market economics teaching materials that align with the curriculum and local context. The approach involves problem identification, preparation, and coordination, activity socialization, implementation through online and offline mentoring, group discussions, and ongoing evaluation to ensure that the knowledge and skills acquired can be effectively applied. The program results significantly improve teachers' ability to design innovative and relevant teaching modules and an increased understanding of market economics concepts. Other positive impacts include establishing a more robust collaborative network between educators in both countries and enhancing the quality of economics education at the Indonesian School in Davao, Philippines. The program has successfully created a more interactive and engaging learning environment for students.

Analisis Kemampuan Guru dalam Menangani Masalah dalam Belajar Mengajar di SMK Swasta Bandung Percut Sei Tuan

Although it is hoped that school children are able to deal with learning situations well, in reality students often experience obstacles in the teaching and learning process, which shows a gap between expectations and educational reality. This research focuses on a teacher from the Bandung Percut Sei Tuan Private Vocational High School (SMK). The aim of this research is to identify and understand the problems faced by teachers in teaching and the approaches used to overcome these obstacles through in-depth and open interviews. Interviews were conducted in the teacher's work space, with the aim of creating an environment that supports and encourages teachers to share experiences and their thoughts openly. The interview guide consisted of five questions designed to explore the main challenges in teaching, conflict resolution strategies, and the teacher's ways of dealing with students' low interest or difficulty in following lessons. The teacher identified major challenges such as lazy attitude towards studying, tendency to sleep, and high interest in playing among students. In facing this challenge, teachers adopt a flexible approach by providing short breaks between intensive learning sessions to maintain students' energy and focus. In terms of conflict resolution, teachers emphasize the importance of patience and self-control, as well as providing positive reinforcement for desired behavior. Teachers also emphasize the need to treat students with compassion and emotional attention, seeing them as biological children who must be cared for and guided with care. In addition, teachers realize the importance of collaborating with parents to support students' holistic development. The research results show that the main challenges faced by teachers in teaching at the Bandung Percut Sei Tuan Private Vocational School can be overcome through a flexible approach, positive reinforcement, and deep emotional attention. This approach is believed to create an inclusive and supportive learning environment, which in turn can improve students' emotional well-being and academic achievement. This research provides important insights for educators in developing effective strategies to overcome obstacles in the teaching and learning process

Dietary perception and knowledge among cardiac patients visiting tertiary care hospital outpatient department (OPD).

To appraise the dietary perception and knowledge of cardiac patients visiting Outpatient department of a tertiary care hospital. A cross sectional study of 466 patients attending cardiac outdoor clinic at a tertiary care cardiac hospital in Rawalpindi, Pakistan were selected through convenient sampling from January to April 2021. Patients included in the study were above 18 years of age and had a cardiac disease. A structured questionnaire in English and Urdu was drafted with questions related to patient demographics, dietary perception and knowledge. Among 466 patients, 60% (n=280) were males and 40% (n=186) were females whereas 14% (n=66) of the patients were uneducated and 15% (n=68) had completed postgraduate education. In this study 23% (n=106) of the participants used internet to search nutrition related information and 72 % (n=339) of the patients consider their lifestyle to be healthy. Majority (n=261, 56%) of the patients had no idea regarding sodium consumption. 46% (n=215) of the patients had no knowledge regarding the effects of bakery items on cardiac health. Dietary Knowledge plays a predominant role in the management of cardiac disease. The study concluded that cardiac patients had inadequate knowledge regarding dietary intake in cardiac disease and has high prevalence of dietary myths and misconceptions. Strategic plan including nutritional awareness program and intensive counseling sessions should be designed to increase dietary knowledge of cardiac patients.

Peningkatan Keterampilan Penulisan Karya Ilmiah melalui Penggunaan Sitasi Mendeley

This community service aims to enhance the academic writing skills of students, particularly those in the early semesters of college, through the utilization of article citations from national and international journals with the assistance of Mendeley. The community service method involves intensive training sessions on Mendeley for early semester students at Bhinneka PGRI University Tulungagung. This training consists of preparation, implementation, and evaluation stages. The results of the community service indicate that Mendeley training is effective in improving efficiency and accuracy in article citations as well as overall reference management skills. With this training, it is expected that students can produce quality academic papers with accurate and structured citation approaches.

Short all-out isokinetic cycling exercises of 90 and 15 s unlock exercise-induced hypoalgesia.

Acute physical activity leads to exercise-induced hypoalgesia (EIH). However, to what degree it can be induced by very short but highly intensive exercise is largely unknown. This study aims to investigate the effects of two different short all-out isokinetic exercise sessions on EIH. Twenty young male participants underwent three different interventions (90, 15 s all-out isokinetic cycling, respectively, and control) after an individualized low-intensity warm-up in a randomized-controlled-crossover design. Before (pre), after warm-up (post 1) as well as immediately post-intervention (post 2) pain sensitivity was measured employing pressure pain thresholds (PPT; in N) at the elbow, knee and ankle joints as well as the sternum and forehead. Performance parameters (e.g. lactate, perceived exertion, heart rate) were documented. A 'time' × 'intervention' × 'body site' interaction effect (p < 0.001, η2 partial = 0.110) was observed for PPT. Both isokinetic interventions resulted in EIH at all body sites, even after ruling out any warm-up effects, while effects were larger for 90 s (maximum increase of 25.7 ± 11.7 N) compared to 15 s (maximum increase of 19.3 ± 18.9 N), and control (maximum increase of 8.0 ± 6.1 N). Compared to control, 15 s also resulted in hypoalgesic effects and differences were not observed at all sites. In this study, 90 s resulted in higher lactate, subjective exhaustion and heart rate levels compared to 15 s and control (p < 0.001), while higher values were also observed for 15 s compared to control. Global EIH assessed immediately after exercise can be induced by short highly intensive exercises. The effects are greater when the subjective and the objective exertion are higher as induced by the 90 s intervention. This study investigates the potential for brief, highly intensive exercise sessions to induce exercise-induced hypoalgesia (EIH). The research demonstrates that EIH can indeed be triggered by such short workouts, with greater effects observed during a 90 s session compared to a 15 s one, most likely due to higher subjective and objective exertion. These findings offer insights into the potential for extremely brief but intense exercises to alleviate pain, impacting exercise recommendations and pain management strategies.

Ketamine enhanced ECT in refractory recurrent depression.

IntroductionRecurrent Depressive Disorder is a chronic condition that significantly impacts the quality of life. Despite various treatment options, some patients face severe and treatment-resistant relapses. This case is related to research on ketamine in Electroconvulsive Therapy (ECT) for RDD. One study highlighted the efficacy and safety of ketamine compared to other anaesthetic agents in ECT for major depression. Additionally, another study explored subanesthetic doses of ketamine before each ECT session to improve therapeutic outcomes and sleep quality in patients with major depressive disorder.ObjectivesTo present a clinical case of a patient with Recurrent Depressive Disorder (RDD) who improved following a change in the Electroconvulsive Therapy (ECT) protocol using ketamine as an anaesthetic inducer.Methods We examined the patient’s medical records, including her medical history, previous treatments, and therapeutic responses.ResultsA 65-year-old childless woman with a history of stroke, bilateral carotid atheromatosis, and hypothyroidism suffered from RDD. Despite multiple prior treatments and ECT, she experienced a severe depressive relapse. Eight intensive ECT sessions were administered, with observed memory lapses. Due to the lack of response, the anaesthetic inducer etomidate was replaced with ketamine, resulting in a positive response. The patient continued pharmacological treatment with improved mood, but recent and evident memory alterations persisted, possibly related to anterograde amnesia.Conclusions This case highlights the complexity of RDD in patients with comorbidities and treatment-resistant relapses. The change in the ECT protocol using ketamine was effective, emphasizing the importance of alternative therapeutic approaches in refractory cases. The successful treatment of RDD in this patient using ketamine in ECT underscores the need for personalized therapeutic options in treatment-resistant patients. These scientific resources reinforce the relevance of exploring therapeutic alternatives in contemporary clinical practice. We need more research to understand the underlying mechanisms and how this approach could be enhanced in similar cases.Disclosure of InterestNone Declared

Анализ доказательной базы эффективности моделей ранней помощи DIRFloortime и ESDM. Часть 2. Модель ESDM

&lt;p style="text-align: justify;"&gt;&lt;strong&gt;Objectives&lt;/strong&gt;. Describing empirically proven algorithms of the Early Start Denver Model (ESDM) is a relevant task to compare variants of the model practically presented in the correctional space and the empirically proven variant. The basic empirical studies of the effectiveness of the ESDM model are analyzed.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Methods&lt;/strong&gt;. The review considers 9 English-language sources, 5 articles in Russian, and a textbook on the Denver Early Intervention Model, which describe evaluations mainly in the format of randomized and controlled trials of the effectiveness of the ESDM model.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Results.&amp;nbsp;&lt;/strong&gt;The results of the analysis of the cited studies indicate a significantly greater effectiveness of the ESDM approach for children with autism spectrum disorders (ASD) compared to standard available care options on such parameters as: receptive and expressive speech, socialization, daily living skills, communication, motor skills, reduction of the main symptoms of autism, and reduction of parental stress.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Conclusions&lt;/strong&gt;. The basic evidence-based applications of the ESDM model are described, which include: writing an individualized care plan, intensive sessions with the child for approximately 15 hours per week, regular parent training, independent interaction with children for approximately 2&amp;mdash;3 hours per day, and age of onset of care between 18 and 30 months. The conclusion has been made that the Early Start Denver Model (EDSM) is appropriate for working with early age children showing signs of ASD.&lt;/p&gt;

Designing an operational research TB training program in Zambia

&lt;sec&gt;&lt;title&gt;BACKGROUND&lt;/title&gt;The USAID-funded Eradicate TB Project (ETB) partnered with the National Tuberculosis and Leprosy Control Program (NTLP) to establish an operational research (OR) training program in order to generate local evidence to enhance TB care in Zambia.&lt;/sec&gt;&lt;sec&gt;&lt;title&gt;METHOD&lt;/title&gt;Between 2017 and 2021, healthcare workers (HCWs) from district teams underwent two 10-day intensive training sessions. The program evolved to include a competitive application process and an additional primer workshop on developing feasible research questions.&lt;/sec&gt;&lt;sec&gt;&lt;title&gt;RESULTS&lt;/title&gt;Of the 36 enrollees in the OR training program, 26 (72.2%) completed it, leading to nine OR studies that informed interventions for TB care improvement. Notable achievements include reduced TB mortality, increased pediatric notifications, and enhanced sputum courier systems, with all studies disseminated at national and international conferences, four submitted to peer-reviewed journals, of which three were published. Two studies were replicated by the NTLP at provincial and national levels.&lt;/sec&gt;&lt;sec&gt;&lt;title&gt;CONCLUSIONS&lt;/title&gt;Integrating OR training into TB initiatives is feasible and beneficial. The program's phased execution and adaptive strategies provide valuable insights for similar settings, although challenges in sustainability of mentorship and funding persist. This success underscores the importance of continuous OR capacity strengthening among HCWs in Zambia.&lt;/sec&gt;

Socio-demographic factors & adherence of newly diagnosed pulmonary tuberculosis patients to the newly introduced daily regimen: A hospital survey based follow up study

IntroductionPoor adherence to anti-tuberculosis medication is a major barrier to its global control. Patient adherence to the standard anti-TB therapy (ATT) in developing countries has been estimated to be as low as 40%. Multiple factors influencing adherence to treatment are:Economic and structural factors such as homelessness, unemployment and poverty; patient related factors like ethnicity, gender, age, knowledge about TB, cultural belief systems, mental state etc. Aims & objectivesThis study was planned with the aim to study the association between various socio-demographic factors with level of adherence to the daily regimen amongst newly diagnosed pulmonary TB patients at a tertiary care hospital in metropolitan city of Maharashtra. Additionally, we tried to determine the type of non-adherence along with reasons for it. Methodology: An interview based pre-tested and validated questionnaire was developed & used as data collection tool. Total 181 newly diagnosed, FDC naïve, drug sensitive pulmonary TB patients from DOT center of a tertiary care hospital were enrolled & interviewed for sociodemographic, treatment & adherence details. They were followed up at 2nd & 6th month of their treatment, i.e., IP & CP follow up. Their Nikshay portal data & TB treatment cards were accessed for information on treatment adherence. ResultsOut of 181 patients, 110 (60.8%) were found to be adherent whereas 71 (39.2%) were found to be non-adherent. Among those non-adherent, 64 (90.9%) had treatment gaps (intermittent missed doses) & 7 (9.9%) showed discontinuation of treatment. Majority of these patients reported personal obligations & starting to feel better as the main reason for non-adherence (p < 0.0001). The sociodemographic factors that had significant impact on level of adherence were patients’ age (p = 0.013); level of education (p = 0.035); family size (p = 0.018); family history of TB (p = 0.0001) & current smoking habit (p = 0.025). ConclusionIt is evident from the study that socio-demographic factors do have a major impact on patients’ levels of adherence to treatment. Family history of TB as well as sputum conversion at end of treatment/CP have been identified as independent risk factors among pulmonary TB patients who are non-adherent to treatment. Thus, ensuring robust availability of DBT & intensive tobacco cessation sessions for all diagnosed patients as well as strengthening system for making prophylaxis available for household & close contacts of patients can help in reducing impact of socio-demographic factors & improving adherence levels. RecommendationsIn-patient care option specifically during IP; regular dietary counseling to improve nutrition & help reduce drug side effects & use of alternate adherence technologies like facility-based DOT or Video Observed Therapy (VOT) wherever feasible can help to improve adherence levels for TB patients from all walks of life.