P-value Research Articles

Factors of Lower Limb Prosthesis and Orthosis User's Satisfaction in Amhara National Regional State Rehabilitation Center, Ethiopia: An Institution-Based Cross-Sectional Study

Background: Prosthesis and orthosis are assistive devices used for different forms of cases. Lower limb prostheses and orthoses are very crucial to improve patient’s ability to walking, increased level of activity and participation to enhance their quality of life. However, there is limited knowledge of workplace variables that either satisfy or dissatisfy the prosthesis and orthosis users in the regional state, Ethiopia. Therefore, this study aimed to assess the satisfaction and associated factors among lower limb prosthesis and orthosis users in Amhara National Regional State Rehabilitation Center, Ethiopia. Methods: Institution based cross-sectional study was conducted from April 01 to May 30, 2019, at Amhara National Regional State Rehabilitation Center among lower limb prosthesis and orthosis users. Data were collected using a structured interviewer-administered questionnaire by the standardized assessment tool; Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0). The study included a total of 207 participants. Binary logistic regression analysis was performed. In the multivariable logistic regression analysis, p value < 0.05 and adjusted odds ratio (AOR) with 95% confidence interval (CI) were used to identify the associated factors. Results: The study revealed that 56.5% (95% CI: 49.9-63.3) of lower limb prosthesis and orthosis users were satisfied. Experiencing pain (AOR: 5.56, 95%CI: 2.68-11.52), living in the rural area (AOR: 3.52, 95%CI: 1.51-8.21), use of prosthesis and orthosis devices on an average less than 9 hours (AOR=0.30, 95% CI 0.11-0.80) and 9-12 hours in a day (AOR: 0.16, 95% CI: 0.07-0.38) were factors significantly associated with satisfaction. Conclusion: The magnitude of lower limb prosthesis and orthosis users’ satisfaction was found to be relatively low. Therefore, healthcare providers and managers of the rehabilitation center need to emphasize on status of the client’s device throughout patient care in the management of clients’ pain and use of devices on an average hour per day.

A framework for assessing glaucoma progression using structural and functional indices jointly.

PurposeWhile many tests and indices are available to identify glaucoma progression, using them in combinations may decrease overall specificity. The aim of this study was to develop a framework for assessing glaucoma progression using structural and functional indices jointly for a fixed specificity.MethodsThe study included 337 eyes of 207 patients with ocular hypertension or primary open-angle glaucoma selected from the Diagnostic Innovations in Glaucoma Study or the African Descent and Glaucoma Evaluation Study. All patients had at least 9 visits. Each visit had retinal nerve fiber layer thickness (RNFLT) and mean sensitivity from static automated perimetry (SAP MS) measured within a one-month window. Simple linear regression was applied to assess deterioration in each index for series of 5 to 9 visits. To identify progression using the two indices jointly, marginal significance levels set at a specificity of 95% were derived for two criteria: ANY (worsening on either RNFLT or SAP MS) and ALL (worsening on both RNFLT and SAP MS). Positive rate (percentage of eyes flagged as progressing) was determined individually for each index, as well as for the ANY and ALL criteria.ResultsCompared to SAP MS, RNFLT had higher positive rates (15% to 45%) for all series lengths. For the joint analyses, the positive rate was on average 12% higher for the ANY criterion compared to the ALL criterion. While RNFLT-alone had comparable positive rates and time-to-detection as the ANY criterion, each uniquely identified a subset of eyes (Kappa = 0.55 to 0.75).ConclusionsThis study provides a simple framework for assessing glaucoma progression with data from two tests jointly, without compromising specificity. This framework can be extended to include two or more parameters, can accommodate global or regional indices, and can eventually be used with novel parameters identified as predictive of glaucoma progression.

Risk Factors and Incidence of Venous Thromboembolism after Total Knee Replacement

Patients undergoing total knee arthroplasty can be at risk in developing venous thromboembolism. The etiology of venous thromboembolism after a total knee arthroplasty is multifactorial. The aim of this study is to present the risk factors and the incidence of venous thromboembolism among the 276 patients, who underwent a total of 348 knee arthroplasty treatments in the King Abdulaziz University Hospital. Three hundred (86.2%) patients had undergone unilateral total knee arthroplasty. Only 48 (13.8%) patients had simultaneous bilateral total knee arthroplasty. Their mean length of stays was 11.02 days. venous thromboembolism was present in eight patients (2.3%), either with symptomatic deep vein thrombosis (1.4%) or with pulmonary embolism (1.1%). One hundred twenty-five (35.9%) patients had diabetes, and six of them had developed venous thromboembolism (P-value: 0.020). The mean post-op mobilization (4.63 ± 3.5 days) was higher in cases with venous thromboembolism (P-value: 0.045). Factors, such as the patients’ age, history of venous thromboembolism, gender, history of cerebrovascular, obesity, operation time, and use of preoperative venous thromboembolism prophylaxis, showed no statistical significance with the incidence of venous thromboembolism in them. The result of our study are comparable to those reported in literature. Diabetes mellitus and delayed postoperative mobilization were the significant risk factors to the incidence of venous thromboembolism.

Confirmatory Factors to Nursing Practice for Patient Safety of Nurses in Kalasin Hospital, Kalasin Province, Thailand.

This cross-sectional research aimed to explore the associated factors with nursing practice for patient safety of nurses in Kalasin Hospital, Kalasin Province, Thailand. The 245 samples were randomized which using created questionnaires which was applied to collect their opinion. The results showed that level of nursing practice for patient safety was moderate level (average = 3.55, S.D. = 0.89) in addition to their experience in patient care, knowledge patient safety and safety culture skills was a significant relationship to practice of nursing professional skills with statistical significance (r = 0.625, p-value = 0.001). It was revealed that supporting system and resources sufficient for the top administrative level in hospital were significantly related to nursing practice and patient safety. Policy direction of the hospitals is becoming aware of the importance of transforming organizational culture in order to improve patient safety and nursing practice toward to safety culture as quality awareness in the organization.

Sleep Quality in Adolescents with Inflammatory Bowel Disease

Background: The incidence and prevalence of Inflammatory BowelDisease (IBD) in the U.S. is increasing. Because adequate sleep quality and duration play a role in the mental and physical wellbeingof children, this study aimed to determine the prevalence of sleep difficulties in our urban pediatric IBD cohort and evaluateassociations between sleep quality and disease severity. Methods: Patients completed the Pittsburgh Sleep Quality Index(PSQI) questionnaire during an office visit. Chart review provided demographic information, and Pediatric Crohn’s Disease ActivityIndex (PCDAI) and Pediatric Ulcerative Colitis Activity Index (PUCAI) scores were calculated from the day of the visit. Results: The prevalence of sleep problems was 33.54% (95%CI: 26.24% to 41.48%; p-value=0.02). PUCAI scores in children with sleep problems (PSQI mean 19.17 ± 20.43) were significantlyhigher than PUCAI scores in children without sleep problems. There was no association between total PSQI scores, classification of IBD,age, gender, ethnicity, steroid use, or disease duration. Conclusion: Our IBD cohort reported a 33% prevalence ofsleep disturbance symptoms. In the small group of patients withUlcerative Colitis (UC), there was a trend toward a greater degree ofsleep disturbances and a higher PUCAI score. Further investigationinto sleep disorders among children with IBD is warranted toprovide further insight into this issue. Additional evaluation of the differences between Crohn’s disease (CD) and ulcerative colitis asthey relate to sleep quality as well as studies implementing objectivesleep assessments, such as polysomnography or actigraphy, arewarranted as they may offer better understanding of the relationshipbetween pediatric IBD and sleep quality.

The Quality Improvement Information System for Surveillance and Monitoring for Patient Safety and Personal Safety in Kalasin Hospital, Kalasin Province, Thailand.

This mixed-method research aimed to evaluate in need assessments and develop an intervention model for quality improvement information system-QIIS for surveillance and monitoring Patient safety and Personals safety in Kalasin Hospital, Thailand. The process was divided into 3 phases, 1) Studies on needs assessments of patients and hospital staff-2P, 2) Develop the program and assessment 3) Program implementation and evaluation. The 245 participants were participated during October 2019 - Februarys 2020. A questionnaire and semi-structure interview by content analysis were applied to investigate on needs assessments and intervention evaluation were using checklist for observation. The results revealed that information alert from supportive technology especially in real-time were sophisticated improving and significantly increasing with the positively and satisfaction levels of the staff increasingly particularly in pre and post observation (p-value <0.05). The key success of QIIS was comprised as suddenly response and information alert system, for this reason their staff could be immediately responsive to problems as much as they affords.

Statistical Analysis of Air Pollutants Concentration and Health Information Related to Respiratory Disease Patients in Bangkok, Thailand.

Air pollution can lead to exposure to foreign particles, air that can be inhaled deep into the lungs and cardiovascular system, causing diseases such as stroke, heart disease, lung cancer, chronic obstructive pulmonary diseases, and respiratory infections. The Pearson's product moment correlation coefficient (r) was used to determine the strength of association between a pair of variables, to test the relationship between these variables and to test whether the association is greater than could be expected by chance. The linear regression between respiratory disease patients, PM10, and other air pollutants were used in this study. Among PM10 together with CO, O3, and NOx was statistically significant with P-value of <0.01 (r = .031, .307, .561; 95% CI = -.570-1.437, .275-.445, and .223-.289 respectively).

Cómo mejorar la comunicación de estadísticos inferenciales en ciencias de la salud

Las técnicas de inferencia estadística son esenciales para las ciencias de la salud. Gracias a estas herramientas estadísticas se pueden identificar, por ejemplo, factores de riesgo que afectan negativamente al estado de salud de las personas. Sin embargo, el proceso de comunicación científica y la relevancia de los hallazgos científicos pueden distorsionarse por el mal uso de estadísticos inferenciales como el p-valor o el factor de Bayes. En este trabajo proporcionamos siete directrices básicas que pretenden ayudar a interpretar y usar conjuntamente el pvalor clásico de un contraste de hipótesis en conjunción con los factores de Bayes. Aunque el factor de Bayes es menos conocido, y de introducción más reciente, que el p-valor es susceptible de ser utilizado superficial o erróneamente. Una comunicación más eficiente de los resultados de la investigación científica favorecería una mejor comprensión de estos y redundaría en mayores cotas de salud pública. Esperamos que estas directrices puedan ser de utilidad para personas de ciencia con poca experiencia, frente a la toma de decisiones políticas relacionadas con hallazgos científicos, en procesos editoriales y para el público en general.

Assessment of the Primary School Teachers' Knowledge, Attitude and Practice on Care of Children with Type 1 Diabetes at School in Taif Region, Saudi Arabia 2018

Background: Diabetes is a disorder of metabolism where the hormone insulin is deficient, ineffective or absent, resulting in abnormally high blood glucose levels and significant damage to the body's vascular system. The prevalence of type 1 diabetes for Unites States residents aged 0-19 years is 1.7 per 1000. Saudi Arabia is ranked the 7th globally in number of children with T1DM and the 5th regarding the incidence. The prevalence of type 1 diabetes mellitus in Saudi Arabian children and adolescents is 109.5 per 100,000. Diabetes mellitus (DM) is one of the most common chronic childhood diseases. Type 1 diabetes mellitus (T1DM) is the most common autoimmune endocrine disorder in childhood and adolescence1 with increasing incidence worldwide that varies according to race, country, and region. In the last decades, several studies reported a significant increase in T1DM cases in children up to 14 years old. Aim of the study: This study aimed to assess diabetes-related knowledge, attitudes and management practices among school teachers in order to determine their diabetes training needs and preparedness to provide adequate care for students with diabetes. Method: A cross sectional descriptive study was conducted at Taif primary schools teachers working in governmental schools in Saudi Arabia, in 2018. The researcher invited 411 teachers Systematic random by proportional allocated stratified technique to participate in the study. Results: Out of 411 teachers invited to participate in the study, returned completed questionnaire with a response rate of 100%. Their almost of the teachers (28.0%) were in the age group 45-50 years. All of them were males teachers (100.0%), the main source of information about DM cited by teachers was the mass media (67.9%) and Attitude of the teacher toward diabetes mellitus in the school children these study results show that is a significant relation between score and Attitude Negative where (93.2) where P-value=0.001. Conclusion: The results reveal that teachers have inadequate knowledge of some of the basic facts of diabetes and its treatment, a situation, which could have dangerous consequences for the child and complicate his or her schooling in a number of ways.coordinating these studies with the schools provided a way to reach a large number of teachers with a message for to prevent diabetes without singling any students out.

Association Between Number of Actionable Pharmacogenetic Variants and Length of Hospital Stay.

The goal of this study was to evaluate association between number of pharmacogenetic variants and length of hospital stay. Electronic medical records were combined with exome sequencing results in 450 hospitalized patients. De-identified data set was used to characterize urgent care utilization and to identify presence of 44 actionable pharmacogenetic variants according to the guidelines of the Clinical Pharmacogenetics Implementation Consortium. The average age was 58.03 ± 16.47 ranging from 20 to 91 years old, average number of pharmacogenetic variants was 61.22 ± 26.52 ranging from 20 to 169, and mean length of hospital stay was 6.50 ± 4.29 ranging between 1 and 42 days. After adjusting for patient socio-demographics and overall disease severity reflected by the Charlson comorbidity index, a significant association between mean length of stay and number of pharmacogenetic variants was found using generalized linear regression (p-value < 2.2e-16).

Risks of Lymphoma and Digestive Cancers in Patients with Celiac Disease: Cohort Study

BACKGROUND: The association between celiac disease (CD) and the development of various malignant tumors, in particular gastrointestinal cancers, has been reported by several studies. However, the close relative risks (Odds Ratio) of these complications compared to the population are still insufficiently known and estimates of the risk factors for the development of these complications in patients followed for CD remain controversial. Objective: To estimate the close relative risks of malignant complications in a cohort of patients with celiac disease compared to the Moroccan population and to determine the risk factors for the development of these complications. Methods: Our work is a retrospective, descriptive and analytical study, carried out within the Department of Medicine C of the CHU IBN SINA Mohammed V University of Rabat, over a period of 23 years - between 1995 and 2018 -, and on a basis of 284 cases of celiac disease, from which we have extracted a series of 16 cases of celiac disease with at least one malignant gastrointestinal complication. Using a case-control study, we were able to determine the risk of these complications compared to the general Moroccan population. Results: We gathered a population of 16 celiac patients with one or more malignant gastrointestinal complications, out of a total of 284 cases of CD, the prevalence was 5.6%. We found a significant increase in the risk of developing digestive malignancies during CD with an Odds Ratio (OR) of 46 (95% confidence interval [CI] 34–63) and p value <0.0001). This risk was higher during the period of per diagnosis, we also objectified a significant increase in risk of all types of cancers found in our series compared to those of control cases. The two risk factors for malignant complications found in our study are non-compliance with the gluten-free diet and delayed diagnosis. Conclusions: There is a significant increase in the risk of malignancy in patients diagnosed with CD. Particularly during the period of per diagnosis. This risk according to this cohort can be reduced by the good observance of the gluten-free diet and an early diagnosis in the face of the most severe symptoms of this pathology.

The Prevalence of Alcohol and Tobacco Use Associated Risk Factor of Noncommunicable Diseases in Si Sa Ket Province, Thailand.

Noncommunicable diseases (NCDs) were caused by risk factors also rising rapidly and killed more people. This study aimed to explore and determine the prevalence and distribution of alcohol and tobacco use as NCDs's risk factors. We used a cross-sectional survey on Health dataset between October 2013 and April 2017 of people who were 13 years old and older. This study was investigated included demographics, alcohol consumption and tobacco use. This study found risk of NCDs 49.07%, The majority of risk factor were men (50.2 %), age_group were 40-59 years old(24.4%), The most were men having diabetes mellitus family (43.0%), hypertension family (17.9 %), alcohol consumption (26.9%), tobacco use (19.0%), most of the women were high blood pressure (23.0%), high blood sugar level (33.3%), overweight and obesity (23.4%), waist was over (22.5%) and high total cholesterol (21.4%), alcohol consumption among the gender 37.8%, most were male (26.9%), age_group mostly 45-59 years old (19.3 %), married (23.1%), agricultural (29.7%), primary school (29.7%). The prevalence of risk factors, most risk factors was tobacco use in men (18.9%), OR 16.789, (95%CI, p-value</001), alcohol consumption were men (26.9%), OR 3.934 (95%CI, p-value<.001).

Grade - 8 Students’ Knowledge on the Impact of Human Activities on an Ecosystem Using Aftermath Wheel

This study determined the Grade 8 students’ knowledge on the impact of human activities on an ecosystem using teacher-made educational hands-on activity in the form of Aftermath Wheel. A pretest-posttest quasi-experimental design was conducted using an achievement test. Population sampling method was employed to choose the subjects of the study. There were 53 Grade 8 students form two classes of Burgos National High School in Cabarroguis, Quirino, Philippines. For the treatment, 23 students belongs to the control group (K to 12 module based lesson) and 30 students served as experimental group (Utilization of Aftermath Wheel). Data revealed that the mean scores of the control group in the pre-test was 11.91/30 (39.7%), and in the post-test was 12.74/30 (42.47%) while the mean scores of the experimental group in the pre-test was 12.8/30 (42.7%) and in the post-test was 14.07/30 (46.9%). Apparently, there is no significant difference in the pre-test and post-test scores in the control group while the post-test scores of the experimental group revealed significantly greater than their pre-test scores with a p-value of 0.013. It was found also that the post-test scores of the experimental group significantly greater than the post-test scores of the control group in the subtopic on ways of minimizing human impact, with a p-value of 0.028. And in the overall, data analysis revealed that there is no significant difference in the over-all post-test scores between the control group. Relatively, this study has demonstrated that the aftermath wheel can help in enhancing the knowledge of the grade 8 students on the impact of human activities on an ecosystem. Hence, the researcher recommended to use of the Aftermath Wheel as an alternative method to enhance the knowledge of the students on the impact of human activities in the ecosystem.

Value of shear-wave elastography of the liver and spleen for predicting the risk of esophageal - gastric varices and bleeding in patients with advanced schistosomiasis

To assess the value of shear-wave elastography (SWE) of the liver and spleen for predicting the risk of esophageal-gastric varices (EGV) and the bleeding from EGV (EGVB) in patients with advanced schistosomiasis. The medical records of 90 patients with definitive diagnosis of advanced schistosomiasis in Wuxi People's Hospital Affiliated to Nanjing Medical University from January 2017 through January 2020 were retrospectively reviewed. The severity of EGV was graded in the 90 patients with advanced schistosomiasis using gastroscopic findings as a golden standard. Then, the subjects were assigned to the non-EGV and EGV groups, and the low- and high-risk EGVB groups according to the grading. The SWE elastic moduli of the liver and spleen were measured and compared between groups. In addition, the receiver operating characteristic (ROC) curve was plotted, and the area under the ROC curve (AUC) was estimated to evaluate the diagnostic efficiency of the SWE elastic moduli of the liver and spleen for predicting the high risk of EGV and EGVB. The 90 patients with advanced schistosomiasis included 61 men and 29 women, and had a mean age of (74.3 ± 8.6) years (range, 62 to 83 years). If gastroscopic findings were employed as a golden standard, there were 32 cases with grade 0 (35.5%), 17 cases with grade 1 (18.9%), 15 cases with grade 2 (16.7%) and 26 cases with grade 3 EGV (28.9%). There were 32 cases in the non-EGV group (35.6%) and 58 cases in the EGV group (64.4%), and 41 cases in the high-risk EGV group (45.6%) and 49 cases in the low-risk EGV group (54.4%), respectively. The SWE elastic moduli of the liver and spleen were both significantly greater in the EGV group than in the non-EGV group (t = 5.73 and 7.26, both P values < 0.05). The SWE elastic moduli of the liver and spleen had AUCs of 0.70 and 0.75, optimal cut-off of 16.1 kPa and 22.6 kPa, sensitivities of 80.6% and 83.9% and specificities of 71.4% and 78.6% for the prediction of EGV, respectively. In addition, the SWE elastic moduli of the liver and spleen were significantly greater in the high-risk EGVB groups than in the low-risk EGVB group (t = 7.35 and 9.61, both P values < 0.05), and the SWE elastic moduli of the liver and spleen had AUCs of 0.68 and 0.71, optimal cut-off of 22.7 kPa and 33.8 kPa, sensitivities of 70.4% and 73.6% and specificities of 89.3% and 93.1% for the prediction of high-risk EGV, respectively. SWE is useful to predict the risk of EGV and EGVB in patients with advanced schistosomiasis.

THU0187 IMPACTS OF BODY MASS INDEX ON CLINICAL RESPONSE OF NOVEL SUBCUTANEOUS INFLIXIMAB (CT-P13 SC) IN PATIENTS WITH ACTIVE RHEUMATOID ARTHRITIS: 1-YEAR RESULTS FROM A PART 2 OF PHASE I/III RANDOMIZED CONTROLLED TRIAL

Background: In the post-hoc analysis of PLANETRA, a Phase III randomized controlled trial (RCT), no significant association was found between body mass index (BMI) and clinical responses in rheumatoid arthritis (RA) patients using weight-based intravenous (IV) infliximab (3 mg/kg every 8 weeks)1,2. Since the subcutaneous (SC) formulation of CT-P13 which was approved from EMA after demonstrating non-inferiority compared to CT-P13 IV is a fixed-dose of 120 mg biweekly, it is meaningful to evaluate the impact of BMI on clinical response of CT-P13 SC3,4. Objectives: This report is to investigate post-hoc impact of BMI on clinical responses of CT-P13 SC 120 mg in Part 2 of a Phase I/III RCT in active RA patients throughout the 1-year treatment period. Methods: A total of 165 patients who received at least one full dose of CT-P13 SC (after IV induction at Weeks 0 and 2) in the initial treatment stage before Week 30 and who had at least one efficacy evaluation result after Week 6 or thereafter were included in this analysis. Patients were categorized into 3 groups; under/normal weight ( Results: In the under/normal weight (n=63), overweight (n=61), and obesity (n=41) groups, the mean±SD of age (years) (48.7±14.00, 51.5±10.93, 53.8±10.62) and the mean±SD of RA duration (years) (6.4±6.00, 8.2±9.27, 5.4±4.72) were comparable. At baseline, the rates of high disease activity (90.5%, 90.2%, 87.8%; DAS28 [CRP]>5.1) were similar among the groups. All other baseline and disease characteristics including gender, race, and other disease activity parameters were also comparable among the groups. The rate of remission or LDA (Figure 1), the mean change from baseline of DAS28 (CRP) (-3.3, -3.1, -3.3 at Week 54), duration of LDA up to Week 54 (26.2, 29.2, 27.9 weeks), and the good or moderate EULAR responder rates (84.1%, 80.3%, 90.2% at Week 54) were all comparable among the groups and there were no statistically significant differences (p-value>0.05). The ACR responder rates were also comparable among the groups except for the ACR70 at Weeks 2 and 6 which were obtained following 2 IV infusions in the IV dose loading phase. Absolute value of Pearson correlation coefficient was below 0.06 between BMI at screening and mean change from baseline in DAS28 (CRP) during CT-P13 SC treatment from Weeks 14 to 54, indicating that correlation between two measurements was weak and was not statistically significant (p-value>0.05) (Figure 2). Conclusion: These post-hoc results showed that there was no impact of BMI on the clinical responses of CT-P13 SC 120 mg biweekly in RA patients. Therefore, CT-P13 SC 120 mg could be a reasonable therapeutic option regardless of BMI.

THU0131 LOCALISATION OF RHEUMATOID LUNG NODULES IN PATIENTS WITH RHEUMATOID ARTHRITIS-RELATED INTERSTITIAL LUNG DISEASE: RIGHT OR LEFT?

Background: The frequency of pulmonary rheumatoid nodules closely relates to the diagnostic modality and changes from Objectives: The aim of this study was to describe the general features and localisation of pulmonary rheumatoid nodules in RA-ILD patients followed up in a single tertiary center. Methods: During January 2010 and March 2019, 826 RA patients had lung computerized tomography (CT) in Hacettepe University. Three radiologists re-evaluated lung CTs and 156/826 (18.8%) patients with had RA-ILD. Pulmonary nodules suggesting pulmonary rheumatoid nodules were identified by radiologist from lung CTs. In addition to demographic, clinical and laboratory data; number of the pulmonary rheumatoid nodules, size and localisation of the biggest nodule – named as dominant nodule-, type of ILD (UIP, NSIP and isolated airway disease (AD)) were recorded. p value less than 0.05 was considered as statistically significant. Results: Of 156 patients, 68 (26, 38.2% male) patients (43.5%) had at least one pulmonary rheumatoid nodule. The mean (SD) follow-up duration was 167 (88) months for RA, and 72 (46) months for RA-ILD. Thirty patients had UIP (44.1%), 31 (45.6%) had NSIP and 7 (10.3%) had AD pattern. 35 (51.5%) of patients had exposed smoking (current or past). Rheumatoid factor and anti-CCP were positive in 60/68 (88.2%) and 33/45 (73.3%) patients, respectively. Median number of nodules was 3 (2-3). Median size of the dominant nodule was 6.8 (5.0-11.5) mm. While 41 (60.3%) of dominant nodules localised in right lung, 27 (39.7%) of dominant nodules localised in left lung (p=0.09). In addition, right inferior lobe (21, 39.9%) was the most common localisation and right middle lobe (7, 10.3%) was the least common localisation of dominant nodule (Figure 1). Conclusion: We found a high prevalence of pulmonary rheumatoid nodules in RA-ILD patients and right inferior lobe was the most common localization of dominant nodules. Prospective studies are needed to determine how the presence and localization of pulmonary rheumatoid nodules affect the RA-ILD disease process.

Bounding Attachment Dan Tingkat Stress Ibu Postpartum

ABSTRACT Background: The result of bounding attachment researched which have been done about the frequency of bounding attachment from thirty five (53) respondents, that is, bounding attachment of 27 respondents (50,9%) are good and 12 respondents (22,6%) are deficient. Based on the researched from thirty five (53) respondents about the distribution of stressful level in postpartum mothers, that is, 22 respondents (41,5%) are not stressful and 15 respondents (28,3%) are very stressful. Research Objectives: The relationship of bounding attachment with stressful level in postpartum mothers. Research Methods: The researched methods are using for this researched that is quantitative analysis in descriptive correlation methods with total sampling are thirty five (53) respondents. Research Results: Based on chi-quare test and the statistic p-value are 0,020, the results shown that p-value score in the relationship of bounding attachment with the stressful level for postpartum mothers are <0,05. Then there is relationship of bounding attachment with the stressful level for postpartum mothers. Conclusions and recommendations: The researched result shown that there is a significant relationship between bounding attachment with the stressful level for postpartum mothers at RW. 05 Pondok Rejeki, Kel. Kota Baru, Kec. Pasar Kemis, Kab. Tangerang, particularly recommendations are for postpartum mothers to motivate their self to do bounding attachment while having their baby birth.

Pengetahuan Dan Sikap Tentang HIV/AIDS Dan Upaya Pencegahan HIV/AIDS

ABSTRACT HIV / AIDS in adolescents is an important matter to consider, given the many behavioral problems adolescents are increasingly vulnerable to HIV / AIDS. The number of cases among adolescents against HIV / AIDS is caused by ignorance and indifference of adolescents. In Indonesia in 2018 HIV / AIDS was reported as many as 433 (84.2%). To determine the relationship between the level of knowledge about HIV / AIDS with HIV / AIDS prevention efforts in adolescents. The research is a type of quantitative research using a descriptive correlation design, a time approach using cross sectional, sampling techniques using simple random sampling. The sample in this study were 133 respondents. Data analysis used univariate analysis and bivariate analysis. Bivariate analysis using Chi Square test. Based on the Chi Square test there is a relationship between the level of knowledge about HIV / AIDS with HIV / AIDS prevention efforts in adolescents (P-value 0.004 <0.05) and there is a relationship between attitudes about HIV / AIDS with HIV / AIDS prevention efforts in adolescents (P -value 0.001 <0.05). Most respondents are well-informed, have a positive attitude, and take preventative measures. Students are expected to increase their knowledge by reading health books or accessing them through other information media so as to increase understanding of HIV / AIDS. Schools are expected to conduct health education programs or provide health information, one of which is about HIV / AIDS in order to increase knowledge and knowledge for students and facilitate library with more resources related to HIV / AIDS.

Capacitação de agentes comunitários de saúde para identificação de casos de tuberculose em uma unidade saúde da família

Objetivo: Capacitar os Agentes Comunitários de Saúde de uma ESF de Belém, para o reconhecimento de pacientes suspeitos de tuberculose. Métodos: Estudo quantitativo, descritivo, transversal e analítico, realizado em uma Estratégia de Saúde da Família (ESF) da cidade de Belém – PA. A aplicação do trabalho ocorreu em três momentos: aplicado o questionário como pré-teste, palestra sobre tuberculose ministrada pelas pesquisadoras e reaplicação do instrumento de coleta como pós-teste. As variáveis quantitativas foram avaliadas por meio do teste T-Student (p &lt; 0,05). Resultados: Na aplicação do pré-teste, evidenciou que todos os participantes possuem domínio nos eixos temáticos no que tange à definição, modo de transmissão, quadro clínico e prevenção da tuberculose. Nos demais tópicos, identificou-se uma discrepância no conhecimento prévio entre os participantes e os eixos com maior dificuldade de conhecimento foram relacionados ao tratamento diretamente observado (TDO) em 55,5% (n=5) e etiologia da TB com 44,4% (n=4). Os resultados obtidos no pós-teste constatam uma equivalência nos conhecimentos adquiridos possuindo significância estatística (p valor = 0,027, Média ± 1,77; DP ± 1.98). Conclusão: A maioria ACS da ESF estudada mesmo com relatos verbais de que possuiam muitas dúvidas em relação ao tema, os resultados desta intervenção são considerados satisfatórios.

Anxiety sensitivity dimensions in young individuals with at-risk-mental states.

Anxiety Sensitivity (AS) is a transdiagnostic risk factor involved in the development and maintenance of different psychopathological conditions including anxiety disorders and psychosis. It consists of Physical Concerns (e.g., the belief that palpitations lead to a cardiac arrest), Social Concerns (the belief that observable anxiety reactions will elicit social rejection), and Cognitive Concerns (the belief that cognitive difficulties lead to mental incapacitation). No study investigated whether specific AS dimensions are related to At-Risk Mental States (ARMS). This study compared AS dimensions between young individuals with ARMS, patients after a recently occurred First-Episode Psychosis (FEP) and matched community controls. Based on models of ARMS and previous evidence, it was hypothesized that ARMS individuals have higher physical, social and cognitive concerns than FEP patients and controls. Thirty individuals with ARMS and 30 with FEP and 30 controls recruited from the general population completed the Anxiety Sensitivity Index-3 (ASI-3) and Penn State Worry Questionnaire. ARMS and FEP individuals had higher scores than controls on ASI-3 Cognitive Concerns [F(2,87)= 11.48, p<.001]. Individuals with ARMS had higher ASI-3 Physical Concerns scores than FEP patients [F(2,87)= 5.10, p<.01] and at a marginal significance level than controls. No between-group difference was found on Social Concerns. Higher ASI-3 Physical Concerns scores [B = -.324, Wald’s χ2(1) = 8.29, p < .01] and psychiatric comorbidities [B = -2.726, Wald’s χ2(1) = 9.33, p < .01] were significantly related to ARMS than FEP. Higher ASI-3 Social Concerns scores were related to FEP, despite at a marginal significance level [B =.213, Wald’s χ2(1) = 3.79, p = .052]. Interventions for AS Cognitive/Physical Concerns could be incorporated in the treatment of ARMS. A replication of the findings is required. Future longitudinal studies should examine whether Cognitive Concerns predict development of FEP in ARMS to improve early detection and prevention strategies.