Measurement Tools Research Articles

Validation and application of caged Z-DEVD-aminoluciferin bioluminescence for assessment of apoptosis of wild type and TLR2-deficient mice after ischemic stroke

Programmed cell death or apoptosis is a critically important mechanism of tissue remodeling and regulates conditions such as cancer, neurodegeneration or stroke. The aim of this research article was to assess the caged Z-DEVD-aminoluciferin substrate for in vivo monitoring of apoptosis after ischemic stroke in TLR2-deficient mice and their TLR2-expressing counterparts. Postischemic inflammation is a significant contributor to ischemic injury development and apoptosis, and it is modified by the TLR2 receptor. Caged Z-DEVD-aminoluciferin is made available for bioluminescence enzymatic reaction by cleavage with activated caspase-3, and therefore it is assumed to be capable of reporting and measuring apoptosis.Apoptosis was investigated for 28 days after stroke in mice which ubiquitously expressed the firefly luciferase transgene. Middle cerebral artery occlusion was performed to achieve ischemic injury, which was followed with magnetic resonance imaging. The scope of apoptosis was determined by bioluminescence with caged Z-DEVD-aminoluciferin, immunofluorescence with activated caspase-3, flow cytometry with annexin-V and TUNEL assay.The linearity of Z-DEVD-aminoluciferin substrate dose effect was shown in the murine brain. Z-DEVD-aminoluciferin was validated as a good tool for monitoring apoptosis following adequate adjustment. By utilizing bioluminescence of Z-DEVD-aminoluciferin after ischemic stroke it was shown that TLR2-deficient mice had lower post-stroke apoptosis than TLR2-expressing wild type mice. In conclusion, Z-DEVD-aminoluciferin could be a valuable tool for apoptosis measurement in living mice.

Integrate between information systems engineering and software engineering theories for successful quality engineering measurement of software: Valid instrument pre-results

An extensive number of instruments and systems assessment tools are weak and not good enough in the appraisal of systems’ quality engineer success measurement. Thus, the comprehension of systems’ success is very serious. One of the purposes of this research topic is to develop a successful, novel, validated instrument for measuring system quality success based on the integration between theories of information systems (Seddon and DeLone & McLean) and software engineering theory (ISO 25010). To ensure the quality of the instrument before use, eight academic experts have validated. The reason for expanding the number of experts to eight is to accurately build and evaluate the instrument because this instrument is the first one erring. After expert validation done successfully, researchers started the process of instrument pre-test. Pre-test verification and validation results done by test the instrument of 74 users. The results of the statistical testing were perfect. The Composite reliability proposed value is 0.7, The average variance extracted value is 0.5. Cronbach’s alpha is higher than 0.7. The value of Spearman’s reliable rhea is >0.6. Results approved that this instrument is strong and perfect to be used as a valid tool for system success measurement.

Antipsychotic agents in anxiety disorders: An umbrella review.

Although not approved for the treatment of anxiety disorders (except trifluoperazine) there is ongoing off-label, unapproved use of first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs) for anxiety disorders. There have been systematic reviews and meta-analyses on the use of antipsychotics in anxiety disorders, most of which focused on SGAs. The specific aims of this umbrella review are to: (1) Evaluate the evidence of efficacy of FGAs and SGAs in anxiety disorders as an adjunctive treatment to traditional antidepressant treatments and other nonantipsychotic medications; (2) Compare monotherapy with antipsychotics to first-line treatments for anxiety disorders in terms of effectiveness, risks, and side effects. The review protocol is registered on PROSPERO (CRD42021237436). An initial search was undertaken to identify systematic reviews and meta-analyses from inception until 2020, with an updated search completed August 2021 and January 2023. The searches were conducted in PubMed, MEDLINE (Ovid), EMBASE (Ovid), APA PsycInfo (Ovid), CINAHL Complete (EBSCOhost), and the Cochrane Library through hand searches of references of included articles. Review quality was measured using the AMSTAR-2 (A MeaSurement Tool to Assess Systematic Reviews) scale. The original and updated searches yielded 1796 and 3744 articles respectively, of which 45 were eligible. After final review, 25 systematic reviews and meta-analyses were included in the analysis. Most of the systematic reviews and meta-analyses were deemed low-quality through AMSTAR-2 with only one review being deemed high-quality. In evaluating the monotherapies with antipsychotics compared with first-line treatments for anxiety disorder there was insufficient evidence due to flawed study designs (such as problems with randomization) and small sample sizes within studies. There was limited evidence suggesting efficacy of antipsychotic agents in anxiety disorders other than quetiapine in generalized anxiety disorder (GAD). This umbrella review indicates a lack of high-quality studies of antipsychotics in anxiety disorders outside of the use of quetiapine in GAD. Although potentially effective for anxiety disorders, FGAs and SGAs may have risks and side effects that outweigh their efficacy, although there were limited data. Further long-term and larger-scale studies of antipsychotics in anxiety disorders are needed.

Validation of the Chinese version of the diabetes health profile to predict the impact of mobile health education on quality of life in type 2 diabetes patients.

The Diabetes Health Profile (DHP18), initially created in the United Kingdom, currently lacks a Chinese version. This study endeavors to authenticate the Chinese adaptation of the DHP18 and assess the influence of mobile health (mHealth) education intervention on the quality of life of individuals living with diabetes. The study included 470 Type 2 diabetes Mellitus (T2DM) patients (204 men, 266 women), spanning an age range of 19-79 years, with an average age of 54 ± 12.40 years. Data analysis employed Jamovie and Mplus software. Moreover, test-retest reliability was evaluated in 52 hospitalized T2DM patients through two repeated measurements taken 4 weeks apart. The Chinese version DHP18 scale exhibited high reliability, evidenced by a Cronbach's alpha of 0.88, and coefficient of test-retest reliability of 0.84. Individual subscales also demonstrated strong reliability, ranging from 0.76 to 0.84, with test-retest reliability spanning from 0.71 to 0.74. Confirmatory Factor Analysis (CFA) employing a three-factor structure (χ2 = 294.69, GFI = 0.92, TLI = 0.91, RMSEA = 0.05, SRMR = 0.06) validated the scale's construct validity. Notably, there was a statistically significant difference (p < 0.05) in the quality of life between Type 2 diabetes patients using mHealth education intervention and those without mHealth education intervention. Mediation analysis revealed that Appraisal of Diabetes (ADS) and Self-Management Efficacy (SED) mediated the effects of Psychological Distress (PD) and Behavior Adherence (BA) on quality of life, both significant direct and indirect effects (p < 0.001). In addition, Dietary Abstinence (DE) displayed significant overall impact (β = -0.13, p < 0.001) and indirect influence (β = -0.10, p < 0.01) on diabetic patients' quality of life, though lacking a significant direct effect (β = -0.03, p = 0.38). The Chinese version of the Diabetes Health Profile Scale meets stringent psychometric standards and stands as an appropriate measurement tool for Chinese T2DM patients, maintaining comparable results to the original scale's structure. The mHealth education intervention yielded a notably positive impact on the quality of life among T2DM patients. Mediation analysis revealed that the three dimensions of the DHP were mediated by Appraisal of Diabetes and Diabetes Self-Management Efficacy, partially mediated by Psychological Distress and Behavior Adherence, and fully mediated by Dietary Abstinence, providing insight into the positive effects of the mHealth model on the quality of life of diabetic patients.

Evaluation of the German Version of the Keratoconus Outcomes Research Questionnaire.

To translate, validate, and evaluate the psychometric properties of the German version of Keratoconus Outcomes Research Questionnaire (KORQ). This prospective study included 3 phases. In phase 1, the KORQ was translated in a standardized way; in phase 2, Rasch validation was performed; in phase 3, the validated questionnaire was evaluated in a separate patient cohort. All patients answered the German KORQ. Scheimpflug imaging (Pentacam) and optical coherence tomography scans (MS-39) were conducted. Corneal imaging measurements were correlated with patient-reported outcome measures. After standardized translation, 100 patients self-administered the German KORQ. Rasch analysis was conducted for psychometric testing of the KORQ. Based on the results of the Rasch analysis, the original German version of the KORQ was modified and any items showing a misfit were excluded. This resulted in a new shortened version of the KORQ, which was evaluated in 30 patients. The revised German KORQ met the criteria of Rasch analysis and showed excellent internal consistency reliability and convergent validity. The correlation between the KORQ score and various clinical measurements was examined using Spearman correlation. A significant moderate correlation was observed between the D (r = 0.237; P = 0.006) and K max (r = 0.162; P = 0.065) values of Pentacam. Inverse correlations were observed for thinnest pachymetry measured with MS-39 (r = -0.167; P = 0.058) and best corrected visual acuity (r = -0.210; P = 0.016). The shortened German KORQ met the assumptions of the Rasch model and displayed satisfactory psychometric properties. The German KORQ could be adopted as a powerful patient-reported outcome measures tool for German-speaking patients with keratoconus in the future.

Analysis of Employee Work Quality Using Statistical Process Control and Compliance with Standard Operating Procedures (Study in the Merchandise Inspection Department of the Foodhall Senayan City)

The objective of this research is to evaluate the effectiveness of employee performance in implementing Standard Operating Procedures (SOP) within the Merchandise Inspection/Receiving Department at The Foodhall Senayan City. This research is of a qualitative descriptive nature, with a focus on Statistical Process Control (SPC) as a measurement instrument. It employs the Implementation of Seven Key Elements in SOP, covering efficiency, consistency, error minimization, problem-solving, and defensive limitations. Five individuals participated in this research: Branch Manager, Receiving Supervisor, and three Receiving Staff members. Data collection techniques were based on direct observation, interviews, and documents used as references for the receiving staff's work procedures. In this study, the author used Statistical Process Control (SPC) on Attribute Control Charts, specifically using P-charts as a measurement tool for Quality Control checks on goods. The Implementation of Seven Key Elements in SOP was used to deepen the investigation into problem-solving that could not be explained using numerical data. Based on the analysis results using Statistical Process Control (SPC) for the current period, the average reversal rate is 0.02, indicating proximity to the Lower Control Limit (LCL) of 0 or zero defects. Meanwhile, regarding the usage of the Implementation of Seven Key Elements in SOP in the Merchandise Inspection/Receiving Department at The Foodhall Senayan City, it is evident that in the implementation of these seven key elements, there are still some shortcomings. These deficiencies include error minimization, process mapping, employee protection, and defensive limitations.

Platelet-rich Plasma Superiority over Hyaluronic Acid as a Conservative Treatment for Early Knee Osteoarthritis: A Systematic Review

AIM:This study aimed to perform a systematic review (SR) of SR to elucidate prior findings regarding favorable outcomes between platelet-rich plasma (PRP) and hyaluronic acid (HA) injections for early knee osteoarthritis (KOA). MATERIALS AND METHODS: We conducted a thorough literature search adhering to the Preferred Reporting Items for SR and Meta-analyses only for SRs from PubMed, ScienceDirect, and Google Scholar from 2020 to 2023. The inclusion and exclusion criteria were determined using the population, intervention, comparison, outcome, and study design model. A measurement tool to assess SR-2 was used to grade the included SRs. Two researchers independently searched, extracted, and assessed the risk of bias in the included studies. Cohen’s kappa coefficient was used to calculate the inter-observer disparities in study eligibility and risk of bias. The corrected covered area (CCA) metric addressed the overlap issue with the original studies. RESULTS: One SR yielded high methodological quality whereas three SRs yielded moderate methodological quality. The overall CCA among the four SRs was 30.77%, and all SRs used the Western Ontario and McMaster Universities Osteoarthritis Index score as a patient-reported outcome (PRO) and revealed that the PRP group improved more than the HA group. One SR used the Tegner score as a PRO and found no distinction between the PRP and HA groups. The incidence of substantial pain was lower in the PRP group than in the HA group. One SR reported considerably lower local pain post-injection in the HA groups. Overall, three SRs showed that PRP yielded better outcomes than the HA, and one showed that PRP showed advantages over HA injections for knee pain at 6 and 12 months; however, the clinical outcomes were not different. CONCLUSION: Our findings supported the superiority of PRP over HA as a long-term alternative therapy for early-stage KOA.

Examination of Modern Strategies of Instructing Patients for Radiation Protection in the Nuclear Medicine Department

Background: In every nuclear medicine center, there are places where people are exposed to more radiation than in other areas. To reduce the radiation exposure of employees and patients referring to these centers, it is necessary to observe special precautions to reduce the amount of dose received by different people, especially in the case of women of reproductive age. This study aimed to educate patients and companions to reduce the harmful effects of ionizing radiation. Methods: In this study, a questionnaire was used as the measurement tool. It contained demographic information and questions related to the evaluation of the quality of education, the level of awareness of patients and their companions, and also their level of satisfaction with the educational facilities of the center. The sample size included 193 patients who had been referred to the Gamma Scan department of Farshchian hospital. The data collected were analyzed using SPSS 19 software. For validity and reliability, the obtained information was analyzed with the help of mean, frequency, and percentage for qualitative variables. Results: The results of this study showed no significant correlation between knowledge level and gender (P=0.178). However, there was a direct relationship between the two variables of knowledge and level of education which is statistically significant (P=0.001). Conclusion: Measurements and statistical studies showed that in the nuclear medicine department of Farshchian Heart Hospital in Hamedan, the level of awareness of patients regarding radiation protection is weak and needs to be improved.

Primary data on symptom burden and quality of life among elderly patients at risk of dying during unplanned admissions to an NHS hospital: a cohort study using EuroQoL and the integrated palliative care outcome scale.

Older people account heavily for palliative care needs at the population level and are growing in number as the population ages. There is relatively little high-quality data on symptom burden and quality of life, since these data are not routinely collected, and this group are under-recruited in primary research. It is unclear which measurement tools are best suited to capture burdens and experience. We recruited a cohort of 221 patients aged 75 + years with poor prognosis who had an unplanned admission via the emergency department in a large urban hospital in England between 2019 and 2020. Risk of dying was assessed using the CriSTAL tool. We collected primary data and combined these with routine health records. Baseline clinical data and patient reported quality of life outcomes were collected on admission and reassessed within the first 72h of presentation using two established tools: EQ-5D-5L, EQ-VAS and the Integrated Palliative Outcomes Scale (IPOS). Completion rate was 68% (n = 151) and 33.1% were known to have died during admission or within 6 months post-discharge. The vast majority (84.8%) reported severe difficulties with at least one dimension of EQ-5D-5L at baseline and improvements in EQ-VAS observed at reassessment in 51.7%. The baseline IPOS revealed 78.2% of patients rating seven or more items as moderate, severe or overwhelming, but a significant reduction (-3.6, p < 0.001) in overall physical symptom severity and prevalence was also apparent. No significant differences were noted in emotional symptoms or changes in communication/practical issues. IPOS total score at follow up was positively associated with age, having comorbidities (Charlson index score > = 1) and negatively associated with baseline IPOS and CriSTAL scores. Older people with poor prognosis admitted to hospital have very high symptom burden compared to population norms, though some improvement following assessment was observed on all measures. These data provide valuable descriptive information on quality of life among a priority population in practice and policy and can be used in future research to identify suitable interventions and model their effects.

Fuzzy Testing Method of Process Incapability Index

The process capability index is a tool for quality measurement and analysis widely used in the industry. It is also a good tool for the sales department to communicate with customers. Although the value of the process capability index can be affected by the accuracy and precision of the process, the index itself cannot be differentiated. Therefore, the process incapability index is directly divided into two items, accuracy and precision, based on the expected value of the Taguchi process loss function. In fact, accuracy and precision are two important reference items for improving the manufacturing process. Thus, the process incapability index is good for evaluating process quality. The process incapability index contains two unknown parameters, so it needs to be estimated with sample data. Since point estimates are subject to misjudgment incurred by the inaccuracy of sampling, and since modern businesses are in the era of rapid response, the size of sampling usually tends to be small. A number of studies have suggested that a fuzzy testing method built on the confidence interval be adopted at this time because it integrates experts and the experience accumulated in the past. In addition to a decrease in the possibility of misjudgment resulting from sampling error, this method can improve the test accuracy. Therefore, based on the confidence interval of the process incapability index, we proposed the fuzzy testing method to assess whether the process capability can attain a necessary level of quality. If the quality level fails to meet the requirement, then an improvement must be made. If the quality level exceeds the requirement, then it is equivalent to excess quality, and a resource transfer must be considered to reduce costs.

Systematic review and analysis of self-efficacy in sun protection measurement instruments.

The objective of this study was toidentify and appraise available sun protection self-efficacy instruments and synthesize information. A systematic search of electronic databases from 2005 to 2023 included PubMed, CINAHL, Embase and PsycINFO . While instruments have been developed to evaluate sun-protective behaviors and self-efficacy separately, sun-protection self-efficacy instruments have yet to be widely studied. Self-efficacy is an essential antecedent to performing health-related behaviors or practices that can promote or hinder the health of individuals and groups. Studies randomized control trials or descriptive studies that used self-efficacy measurement tools to evaluate behaviors, intentions, and sun protection knowledge were included in this review. Sun protection surveys that targeted providers or parents and non-English articles were excluded. Data were extracted by one independent researcher. Fifteen studies met the inclusion criterion and included 10 scales of self-efficacy in sun protection. Study design and purpose, and the instrument's validity and reliability statistics, including Cronbach's alphas, were extracted. The two-factor self-efficacy in sun protection scale was the most common measure for primary prevention, with acceptable reliability and validity. However, other instruments also showed reliable psychometric properties, especially measures of sunscreen self-efficacy. More research in self-efficacy measurement is warranted to examine specific populations and determine the appropriate constructs of self-efficacy. It is crucial to design evidence-based interventions that affect self-efficacy, are measured by a reliable, valid instrument, and have the potential to increase sun-protective and screening behaviors.

Integrating environmental monitoring and bird attack prevention in fish farming: a combined solution for improved pond management

Fish farming plays a pivotal role in meeting the ever-increasing global demand for fish and seafood. Yet, fish farmers face formidable challenges in maintaining ideal water conditions and safeguarding their stock from avian predators. This research introduces a comprehensive solution that harnesses IoT technology, real-time monitoring, and bird deterrent mechanisms to heighten the efficiency of fish farming. Through IoT sensors, critical water parameters like temperature, pH, turbidity, and more are continuously monitored, providing real-time data accessible via an intuitive web application and SMS alerts. Motion detection, using passive inferred (PIR) based sensors, activates a water-spraying mechanism to repel birds and safeguard fish, thus eliminating the necessity for expensive and potentially harmful net enclosures. Our experiments underscore the system’s precision, with a mere 0.40 °C average temperature difference compared to traditional measurement tools. This integrated approach not only enhances sustainability and productivity but also reduces manual labour, minimizes losses, and preserves the environment, rendering fish farming more efficient and economically viable.

Efficacy and safety of ozone therapy for knee osteoarthritis: an umbrella review of systematic reviews.

The objective of this study is to evaluate the effectiveness and safety of ozone therapy (OT) in the treatment of knee osteoarthritis (KOA), which is the most common form of the disease. We analysed systematic reviews (SRs) of randomised controlled trials (RCTs) using the "A MeaSurement Tool to Assess systematic Reviews" (AMSTAR2) instrument to evaluate their quality. We developed a narrative synthesis report with eight SRs (15 RCTs/3,685 patients) to summarise the findings. The AMSTAR2 analysis indicated that all reviews had critically low confidence ratings. Statistically significant effects in pain reduction using OT compared to placebo groups were reported in three SRs. OT was shown to be comparable to other therapies in one SR and not superior in the other five. Six SRs highlighted the need for additional RCTs with improved methodological quality to confirm the efficacy of OT for KOA. SRs found fewer consistent effects for improving joint function. Regarding safety, seven SRs reported a low prevalence of minor adverse events linked with OT. Finally, this umbrella review highlights the beneficial effects and safety of OT in the treatment of KOA, particularly in pain control. The low methodological quality of RCTs and SRs limits the possibility of drawing conclusions on the effectiveness of the procedure in comparison to other therapies. Ensure adequate compliance with guidelines such as Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and AMSTAR2 has the ability to improve the quality of SRs in this area.

Efficacy of microchips and 3D sensors for orthodontic force measurement: A systematic review of invitro studies.

To evaluate the efficacy of microchips and 3D microsensors in the measurement of orthodontic forces. Through September 2023, comprehensive searches were conducted on PubMed/MEDLINE, SCOPUS and SCIELO without restrictions. After removing duplicate entries and applying the eligibility criteria, 23 studies were included for analysis. All the studies were conducted invitro, and slightly more than half of them were centred on evaluating orthodontic forces exerted by aligners. Eight utilized microchips as measurement tools, while the remaining studies made use of 3D microsensors for their assessments. In the context of fixed appliances, key findings included a high level of agreement in 3-dimensional orthodontic force detection between simulation results and actual applied forces. Incorporating critical force-moment combinations during smart bracket calibration reduced measurement errors for most components. Translational tooth movement revealed a moment-to-force ratio, aligning with the bracket's centre of resistance. The primary findings in relation to aligners revealed several significant factors affecting the forces exerted by them. Notably, the foil thickness and staging were found to have a considerable impact on these forces, with optimal force transmission occurring at a layer height of 150 μm. Furthermore, the type of material used in 3D-printing aligners influenced the force levels, with attachments proving effective in generating extrusive forces. Deliberate adjustments in aligner thickness were observed to alter the forces and moments generated. Microchips and 3D sensors provide precise and quantitative measurements of orthodontic forces in invitro studies, enabling accurate monitoring and control of tooth movement.

Cochlear measurement in computed tomography and magnetic resonance imaging data sets by the Otoplan measurement tool: a retrospective comparative study.

Using Otoplan software, it is possible to measure the cochlea before cochlear implant surgery. Until now, computed tomography (CT) of the cochlea has been necessary for this purpose. The aim of this study was to find out whether measuring the cochlea with magnetic resonance imaging (MRI) using Otoplan is possible with the same accuracy. The cochlea of 44 patients of the local cochlear implant centre was measured by Otoplan using high-resolution CT-bone and MRI images, and the determined lengths were compared. No significant difference was found between the cochlear lengths measured, regardless of whether the length measurement was based on a CT or an MRI data set. For the determination of cochlear length prior to cochlear implant surgery, MRI images are just as suitable as CT images, therefore CT is not mandatory for length measurement by Otoplan, which could reduce the patient's radiation exposure.

Evaluating short- and long-term investment strategies: development and validation of the investment strategies scale (ISS)

PurposeIn response to the growing importance of understanding individual investment strategies, the present study aimed to develop a new scale for measuring both the short- and long-term investment strategies of individuals.Design/methodology/approachThe study assessed the psychometric properties of the investment strategies scale (ISS) using data collected from 1428 individual investors. In the initial study, an exploratory factor analysis (EFA) was conducted to investigate the factor structure of the proposed scale (N = 700). The EFA results yielded a two-factor structure, and Cronbach’s alpha values for short- and long-term investment strategies were 0.90 and 0.88, respectively. A confirmatory factor analysis was performed to validate the factor structure of the scale in the second study (N = 728).FindingsThe results demonstrated that the two-factor model fit the data well. In the third study, the correlation between Hofstede’s long-term orientation and the two dimensions of the scale was investigated. The results indicated that long-term investment strategies significantly predict long-term orientation, thus confirming the concurrent validity of the scale.Research implicationsThese findings demonstrate that the proposed ISS is a reliable and valid instrument for measuring individuals’ short- and long-term investment strategies, contributing to a deeper understanding of investment decision-making processes.Originality/valueThis study introduces a novel measurement tool—ISS—specifically designed to comprehensively assess both short- and long-term investment strategies among individual investors.

SOCIODYNAMICS OF SOCIAL ENTREPRENEURSHIP IN UZBEKISTAN AND INTRODUCING THE SOCIAL ENTREPRENEURSHIP DEVELOPMENT INDEX (SED Index) IN COMMUNITIES

Based on sociological researches conducted by the author this article provides a comprehensive analysis of the current state of social entrepreneurship in Uzbekistan, a relatively new and evolving phenomenon within the country. Through a thorough examination of the existing landscape, the author evaluates the level of development, challenges, and opportunities for social entrepreneurship in Uzbekistan. By proposing an algorithmic framework for its future growth and development, the article offers valuable insights and recommendations to foster a flourishing social entrepreneurship ecosystem in Uzbekistan. analyzes some methodologies to quantify the level of social entrepreneurship development within regions, followed by the proposal of a potential Social Entrepreneurship Development Index (SED Index) as an exemplary measurement tool. KEYWORDS: social entrepreneurship, sociodynamics of social entrepreneurship in Uzbekistan, resources for the development of social entrepreneurship, algorithm of developing social entrepreneurship in Uzbekistan, measuring the level of social entrepreneurship development within regions, Social Entrepreneurship Development Index (SED Index)

Identifying and Evaluating Young Children with Developmental Central Hypotonia: An Overview of Systematic Reviews and Tools.

Children with developmental central hypotonia have reduced muscle tone secondary to non-progressive damage to the brain or brainstem. Children may have transient delays, mild or global functional impairments, and the lack of a clear understanding of this diagnosis makes evaluating appropriate interventions challenging. This overview aimed to systematically describe the best available evidence for tools to identify and evaluate children with developmental central hypotonia aged 2 months to 6 years. A systematic review of systematic reviews or syntheses was conducted with electronic searches in PubMed, Medline, CINAHL, Scopus, Cochrane Database of Systematic Reviews, Google Scholar, and PEDro and supplemented with hand-searching. Methodological quality and risk-of-bias were evaluated, and included reviews and tools were compared and contrasted. Three systematic reviews, an evidence-based clinical assessment algorithm, three measurement protocols, and two additional measurement tools were identified. For children aged 2 months to 2 years, the Hammersmith Infant Neurological Examination has the strongest measurement properties and contains a subset of items that may be useful for quantifying the severity of hypotonia. For children aged 2-6 years, a clinical algorithm and individual tools provide guidance. Further research is required to develop and validate all evaluative tools for children with developmental central hypotonia.

Strategies to Improve Therapeutic Adherence in Polymedicated Patients over 65 Years: A Systematic Review and Meta-Analysis.

Part of the population over 65 years of age suffer from several pathologies and are therefore polymedicated. In this systematic review and metanalysis, we aimed to determine the efficacy of several strategies developed to improve adherence to pharmacological treatment in polymedicated elderly people. Web Of Science, PubMed and the Cochrane Library were searched until 2 January 2024. In total, 17 of the 1508 articles found evaluated the efficacy of interventions to improve adherence to medication in polymedicated elderly patients. Methodological quality and the risk of bias were rated using the Cochrane risk of bias tool. Open Meta Analyst® software was used to create forest plots of the meta-analysis. In 11 of the 17 studies, an improvement in adherence was observed through the use of different measurement tools and sometimes in combination. The most frequently used strategy was using instructions and counselling, always in combination, in a single strategy used to improve adherence; one involved the use of medication packs and the other patient follow-up. In both cases, the results in improving adherence were positive. Five studies using follow-up interventions via visits and phone calls showed improved adherence on the Morisky Green scale compared to those where usual care was received [OR = 1.900; 95% CI = 1.104-3.270] (p = 0.021). There is a high degree of heterogeneity in the studies analyzed, both in the interventions used and in the measurement tools for improving adherence to treatment. Therefore, we cannot make conclusions about the most efficacious strategy to improve medication adherence in polymedicated elderly patients until more evidence of single-intervention strategies is available.

Activities of Daily Living in Patients with Chronic Obstructive Pulmonary Disease: A Hybrid Concept Analysis

Background: Limitations of activities of daily living (ADLs) are well-known in chronic obstructive pulmonary disease (COPD) patients. However, a lack of consensus regarding the concept of ADL in COPD patients causes problems in their measurement. This study was conducted to clarify and conceptualize the concept of ADLs in COPD. Methods: The hybrid model of concept analysis consisting of a literature review phase, a fieldwork phase, and an analytical phase was applied. In the first phase, an extensive literature review was performed by searching the accredited databases for relevant articles published within 2000-2022. In the second phase, 18 in-depth interviews with COPD patients were carried out in Tehran, Iran. Field observational notes were transcribed verbatim, and qualitative content analysis was performed. In the analytical phase, attributes of ADLs were derived from the previous two phases. Results: Based on the attributes derived from the final analytical phase, ADLs in COPD patients are complex and multifactorial and are affected by dyspnea and factors influencing it. The pattern of daily activities, communication, and self-care in COPD patients changes toward living normally and independently. Conclusions: The concept analysis of ADLs in COPD patients revealed some key attributes. The results might be useful for designing nursing models, developing theories and measurement tools, and increasing the capacity to perform ADLs in COPD patients.