Poor Level Research Articles

Description of Adolescent Knowledge Level About the Effect of Smoking on Dental and Oral Health in Kp. Cipadati Kabupaten Bandung

Smoking is dangerous for health. Smoking is a habit that is often done by people, both at the age of teenagers and adults. Factors behind smoking habits in adolescence are the lack of knowledge of adolescents about the dangers of smoking for health, including dental and oral health. This study aims to determine the level of knowledge of adolescent smokers about the impact of smoking on dental and oral health in Kp. Cipadati RT.03 RW.03 Cinunuk Village, Bandung Regency. This type of research is descriptive by distributing questionnaires. The number of respondents in this study were 32 teenage boys aged 13 to 19 years who smoked and lived in Kp. Cipadati RT.03 RW.01 Cinunuk Village, Bandung Regency.
 The results of the study from 32 respondents, showed the level of knowledge of adolescents about the effect of smoking on dental and oral health in Kp. Cipadati RT.03 RW.01 Cinunuk Village, Bandung Regency, 50.0% of respondents are in the category of a good level of knowledge, and for knowledge of adolescent smoking prevention efforts for dental and oral health, 40.6% of respondents are in the category of poor knowledge level. Conclusion: the level of knowledge of adolescents is good, but preventive efforts for adolescent smokers are still lacking.

Correlates of Oral Health Conditions and Oral Health Literacy Among a Sample of Patients With Cardiovascular Disease: A Cross-sectional Study

Background: Oral health literacy (OHL) and dental health indicators in people with cardiovascular diseases (CVDs) are important health conditions that have been less investigated in this group of patients. The aim of the present study was to evaluate oral health conditions and OHL in adult patients with cardiovascular conditions who referred to dental clinics in southwest, Iran. Methods: This cross-sectional study was conducted in Ahvaz, Iran in 2021-2022. The oral and dental health status and literacy of 302 people were investigated, and data were collected using a standard questionnaire about OHL (with dimensions of comprehension and calculation ability), as well as demographic and medical information. Then, the patients were clinically examined by a dentist to determine oral health indicators (Decayed, missing, and filled teeth: DMFT) and oral health index (OHI-S). Finally, data were analyzed using SPSS, version 22. Results: The mean DMFT was 11.06±3.55. According to the OHI-S, 124 (41.1%), 75 (24.8%), and 103 (34.1%) people were categorized in mean, good, and poor oral health levels, respectively. Pearson’s correlation coefficient demonstrated a direct, strong, and significant relationship between age and DMFT and OHI (r=0.702, r=0.678 P<0.001). The relationship between understanding ability and DMFT and OHI was inversely correlated (r=-0.389, r=-0.278, P<0.001), and the relationship between calculation ability and OHI, as well as between calculation ability and DMFT was inverse and significant ((r=-0.572, P<0.001) and r=-0.429, P<0.001, respectively). Conclusion: The results showed that there is a relationship between OHL and OHI in people with CVD, although it is not in a favorable condition. As a result, the design, implementation, and evaluation of oral health education programs for patients with CVD are highly recommended, and it is imperative that oral and dental health be carefully monitored in these patients.

Knowledge Regarding Ebola Virus Disease among Nursing Students

Background: Ebola virus disease (EVD) is an acute, viral and fatal illness among humans and other primates. It can be transmitted from wild animals to human and could spread from human to human. The objective of the study was to assess the knowledge regarding Ebola Virus Disease among the nursing students.
 Method: A cross sectional analytical study design was conducted among the nursing students to assess the knowledge regarding Ebola Virus Disease among the nursing students of Bharatpur, Chitwan. A total of 138 nursing students were selected by using the enumerative sampling method. Data were collected by using semi structured self-administered questionnaire. Data was entered and analyzed by using SPSS-20.
 Result: In the study, out of 138 respondents, majority of respondents were in age group of 21-25 years (51.4%) and while least 0.7% were in age group of 26-30years. Regarding ethnicity, highest percentage of the respondents were Brahmin/Chhetri covering 67.4%. Regarding the level of knowledge on Ebola virus disease, 77.5% had poor knowledge and 22.5% had good knowledge. There was statistically significant relationship between the level of knowledge regarding Ebola virus disease and types of family (p<0.031).
 Conclusion: Based on the finding of the study, it is concluded that majority of the respondents had poor level of knowledge regarding Ebola Virus disease. So, the study recommends the need of effective awareness programme for the nursing students that could bring more awareness as a whole in good level.

A study to assess the effectiveness of Self-instructional Module on knowledge regarding ABG among student nurses in selected college of city

Arterial blood gas analysis is a basic and useful laboratory test for the critical care of patient. ABG is an essential investigation for assessing clinical oxygenation and acid base status in critically ill patient, providing information about ventilation, oxygenation and acid base status, the three closely and interrelated physiological parameters that maintain pH homeostasis. Among student Nurses in selected college of city. An arterial blood Gas (ABG) tests explicitly blood taken from an artery ABG analysis assesses a patient’s partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2). The objectives of study were to assess existing level of knowledge regarding ABG analysis among the students nurses in selected college, Assess the post test knowledge regarding the ABG analysis among the student nurses in selected college, to assess the effectiveness of SIM on ABG analysis among the students nurses in Selected college, to find out the association between post-test levels of knowledge with selected Demographic level. A structured questionnaire to collect the knowledge score was use for data collection and the analysis was done with the help of inferential and descriptive statistics. The data collection was done from 60 samples from basic BSc nursing 3rd year students. The pre test shows 26.67% of the nursing student had poor level of knowledge score, 58.33% had average and 15% had good level of knowledge score. The post test shows 5% nursing student had average level of knowledge score 35% had good and 60% of nursing student have excellent level of knowledge score. The calculated t value is 15.07 are much higher than the tabulated value at 5% level of significance. Hence it is statistically interpreted that the self-instructional module on knowledge regarding ABG analysis among nursing students was effective

Survei tingkat kebugaran jasmani atlet remaja akademi basket rookie

Physical fitness also has a strong relationship with talent and health. Achievement in athletics correlates with other types of success, including other criteria such as physical fitness. This study aims to determine the level of physical fitness of young athletes at the Klaten rookie basketball academy. This descriptive research uses a survey approach. 20 basketball players. Tests and measurements are used in the data collection method. Indonesian Physical Fitness Test (TKJI) for the 16-19 year age group. Descriptive statistical analysis research using percentages is a method of data analysis. The results showed that young athletes had a moderate level of physical fitness, with 0 people (0%) having a poor level of physical fitness, 1 person (5%) having a low level of physical fitness, 9 people (45%) having a moderate level of physical fitness , and 0 people (0%) have a very good level of physical fitness. The conclusion is that most of the young athletes have a level of physical fitness which is included in the very good group, with 10 participants (or 50%) having the highest frequency in this field.

Internalised stigma among people with mental illness in Africa, pooled effect estimates and subgroup analysis on each domain: systematic review and meta-analysis

BackgroundInternalisation of stigma occurs when people with a stigmatised attribute, such as a mental illness, supress negative but accepted societal attitudes. However, as far as is known, there is no comprehensive picture of the prevalence of and factors associated with, internalised stigma among people living with mental illness in Africa. This systematic review and meta-analysis provide new knowledge by examining the evidence on the prevalence of internalised stigma and associated factors among people living with mental illness in Africa.MethodsUsing the population, intervention, comparison, outcome, and type of study (PICOT) approach, PubMed, Scopus, MEDLINE, PsycINFO, CINAHL, ScienceDirect, and Google Scholar were searched using a structured search comprising terms associated with mental health, mental illness, internalised stigma, and a list of all African countries. To evaluate paper quality, the Joanna Briggs Institute Quality Appraisal Checklist was used. Subgroup analysis with country and diagnosis was tested using a random-effect model, and bias was checked using a funnel plot and an inspection of Egger’s regression test. A p-value, OR and 95% CI was used to demonstrate an association.ResultsThe pooled prevalence of internalised stigma was 29.05% (25.42,32.68: I2 = 59.0%, p ≤ 0.001). In the subgroup analysis by country, Ethiopia had the highest prevalence of internalised stigma at 31.80(27.76,35.84: I2 = 25.6%, p ≤ 0.208), followed by Egypt at 31.26(13.15,49.36: I2 = 81.6%, p ≤ 0.02), and Nigeria at 24.31(17.94,30.67: I2 = 62.8%, p ≤ 0.02). Based on domains of internalised stigma, pooled prevalence was stigma resistance: 37.07%, alienation: 35.85%, experience of discrimination: 31.61%, social withdrawal: 30.81% and stereotype: 26.10%. Experiencing psychotic symptoms (1.42(0.45,2.38)), single marital status (2.78(1.49,4.06)), suicidal ideation (2.32(1.14,3.49)), drug nonadherence (1.5(-0.84,4.00)), poor social support (6.69(3.53,9.85)), being unemployed (2.68(1.71,3.65)), and being unable to read and write (3.56(2.26,4.85)) were identified as risk factors for internalised stigma.ConclusionsInternalised stigma is common among people suffering from mental illnesses in Africa. This review determined that 29% of the sample population had elevated internalised stigma scores, and there were variations by country. People experiencing mental illness who have a single marital status, suicidal behaviours, poor social support, unemployed and have poor literacy levels were at a higher risk of internalised stigma. The finding points to populations that require support to address internalised stigma and improve the mental health outcomes.

Medical Student Perceptions of Sociocultural Issues in Healthcare: A Multisite Study of Medical Spanish Education

Theory Cultural competence and humility are core elements of medical education in a diverse society. Language is inseparable from culture, as language informs, indexes, frames, and encodes both culture and worldview. Spanish is the most common non-English language taught in U.S. medical schools, yet medical Spanish courses tend to artificially separate language from culture. It is unknown to what extent medical Spanish courses advance students’ sociocultural knowledge or patient care skills. Hypotheses Based on current predominant pedagogy, medical Spanish classes may not adequately integrate sociocultural issues relevant to Hispanic/Latinx health. We hypothesized that students who completed a medical Spanish course would not demonstrate significant gains in sociocultural skills following the educational intervention. Method An interprofessional team developed a sociocultural questionnaire, and 15 medical schools invited their students to complete the questionnaire before and after completing a medical Spanish course. Of participating schools, 12 implemented a standardized medical Spanish course and three served as control sites. Survey data were analyzed regarding: (1) perceived sociocultural competence (recognition of common cultural beliefs, recognition of culturally normative non-verbal cues, gestures, and social behaviors, ability to address sociocultural issues in healthcare context, and knowledge of health disparities); (2) application of sociocultural knowledge; and (3) demographic factors and self-rated language proficiency (Poor, Fair, Good, Very Good, or Excellent) on the Interagency Language Roundtable scale for healthcare (ILR-H). Results Overall, 610 students participated in sociocultural questionnaire between January 2020 and January 2022. After the course, participants reported an increased understanding of cultural aspects of communication with Spanish-speaking patients and the ability to apply sociocultural knowledge to patient care (all p < 0.001). When analyzed by demographic factors, students who identified as Hispanic/Latinx or as heritage speakers of Spanish tended to report increased sociocultural knowledge/skills following the course. When examined by Spanish proficiency, preliminary trends showed that students at both ILR-H Poor and Excellent levels did not demonstrate gains in sociocultural knowledge or ability to apply sociocultural skills. Students at sites with a standardized course were likely to improve sociocultural skills in mental health conversations (p < 0.001) while students at control sites were not (p = 0.05). Conclusions Medical Spanish educators may benefit from additional guidance on teaching sociocultural aspects of communication. Our findings support that students at ILR-H levels of Fair, Good, and Very Good are particularly well-suited for gaining sociocultural skills in current medical Spanish courses. Future studies should explore potential metrics to evaluate cultural humility/competence within actual interactions with patients.

Physical Activity and Fitness Levels of Individuals With Ataxia: A Cross-Sectional Study

ObjectiveTo investigate physical activity levels of individuals with ataxia and correlate fitness to ataxia severity. DesignAn observational study SettingAn outpatient ataxia clinic in a large, tertiary, urban hospital in the US. ParticipantsIndividuals with cerebellar ataxia (N=42). InterventionNot applicable. Main Outcome MeasureParticipants were classified as sedentary or physically active using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Maximal oxygen consumption (V̇o2max) as an indicator of fitness level was measured, and ataxia severity was determined by the Scale for the Assessment and Rating of Ataxia (SARA). Mixed effect models were used to correlate ataxia severity to fitness levels. ResultsMost participants (28 out of 42) lived sedentary lifestyles, and these individuals had poor fitness levels (only 67.3% of their predicted measure). The main barriers to physical activity included lack of energy, lack of time, and fear of falling. There were no differences in age, sex, disease type, disease duration, ataxia severity, fatigue level, and medication use between sedentary and active groups. Measures of V̇o2max, maximal work, maximal heart rate, and anerobic threshold demonstrated statistically significant differences between groups whereas maximal respiratory rate and expired ventilation/carbon dioxide production were similar between groups. When adjusting for age, sex, functional mobility status, and disease duration, ataxia severity was inversely correlated with fitness level in the sedentary group. There was no relationship between ataxia severity and fitness level in the 14 individuals who were physically active. ConclusionsLower fitness levels were associated with more ataxia symptoms in the sedentary group. This relationship was not seen in individuals who were more active. Given the poor health outcomes associated with low fitness, physical activity should be encouraged in this population.

Risk and protective factors associated with mental health status in an Italian sample of students during the fourth wave of COVID-19 pandemic

BackgroundIt is well known that the COVID-19 pandemic has caused a global health crisis, especially for young people. However, most studies were conducted during the first waves of the pandemic. Few Italian studies specifically attempted to broadly assess young people’s mental health status during the fourth wave of the pandemic.MethodsThis study aimed at evaluating the mental health status among a group of Italian adolescents and young adults during the fourth wave of the COVID-19 pandemic. 11,839 high school students and 15,000 university students (age range 14–25) were asked to complete a multidimensional online survey, of which 7,146 (26,6%) agreed to participate. The survey also included standardized measures for depression, anxiety, anger, somatic symptoms, resilience, loneliness and post-traumatic growth. Two separate clusters were identified through cluster analysis. Random forest, classification tree and logistic regressions analyses were applied to identify factors associated to a good or a poor level of mental health and, thus, to define students’ mental health profiles.ResultsOverall, the students in our sample showed high levels of psychopathology. The clustering methods performed identified two separate clusters reflecting groups of students with different psychological features, that we further defined as "poor mental health" and "good mental health". The random forest and the logistic regressions found that the most discriminating variables among those two groups were: UCLA Loneliness Scale score, self-harm behaviors, Connor-Davidson Resilience Scale-10 score, satisfaction with family relationships, Fear of COVID-19 Scale score, gender and binge eating behaviors. The classification tree analysis identified students’ profiles, showing that, globally, poor mental health was defined by higher scores of loneliness and self-harm, followed by being of female gender, presenting binge eating behaviors and, finally, having unsatisfying family relationships.ConclusionsThe results of this study confirmed the major psychological distress caused by the COVID-19 pandemic in a large sample of Italian students, and provided further insights regarding those factors associated with a good or poor mental health status. Our findings suggest the importance of implementing programs targeting aspects that have been found to be associated to a good mental health.

The Relationship between Critical Thinking and Gender in Second Language Learning

This study investigated the relationship between critical thinking and gender in second language learning. To do this, thirty students who participated in a TOEFL preparation course at Shokouh English language institute, Mashhad, Iran, were selected as the participants. Limbach, Waugh, and Duran’s model of critical thinking was used as a guiding framework for teaching critical skills to the participants over the course of ten sessions. The model involved five steps: (a) determining and discovering learning objectives; (b) teaching through questioning; (c) practicing before assessing; (d) reviewing, refining and improving; and (e) providing feedback. To examine the development of critical thinking skills among the participants, a critical thinking questionnaire was designed. Results of the data analysis revealed a poor level of critical thinking among the learners, and showed that males and females were not significantly different from each other in applying critical thinking skills.

Interest in Rhinoplasty and Awareness of Postoperative Complications Among Female High School Students in Riyadh, Saudi Arabia.

Background Rhinoplasty and revision rhinoplasty are facial cosmetic operations that have potentially profound psychological implications for an individual.In recent years, rhinoplasty has increased internationally because of body dysmorphic disorders but also social media influence. As with any surgery, rhinoplasty carries risks, and the aim of this study was to explore female high school students' interest in rhinoplasty and their awareness about its postoperative complications in Riyadh, Saudi Arabia. Methods We employed a cross-sectional design for the study, which included 413 female high school students aged 14 to 17 years. Participants signed a consent form, and data were collected through an online survey from September to November 2022. A validated questionnaire tested for reliability was used. The level of knowledge and interest in rhinoplasty was compared with the socio-demographic characteristics of the female students using the chi-squared test. A p-value of 0.05 was considered statistically significant. Results A total of 413 female high school students responded to our survey, and 135 completed questionnaires were received. Nearly half (48.7%) of the students were happy about the current form of their nose. Among the students, 74.3% would not consider undergoing rhinoplasty, and the most common reason was satisfaction with their nose (69.4%). Those who did intend to undergo rhinoplasty (25.7%) were primarily interested in improving their appearance (74.5%). The total mean knowledge score was 6.01 (SD 3.27) out of 12 points, with 61.7% classified as having poor knowledge levels, and the rest (38.3%) were considered as having good awareness. Conclusions In our perception, the number of teenagers wanting rhinoplasty is increasing. Questions about their knowledge level, attitude, and perspective regarding the procedure should be important considerations for the surgeon.

Assessing safe and personalised maternity and neonatal care through a pandemic: a case study of outcomes and experiences in two trusts in England using the ASPIRE COVID-19 framework

BackgroundThe COVID-19 pandemic has resulted in profound and far-reaching impacts on maternal and newborn care and outcomes. As part of the ASPIRE COVID-19 project, we describe processes and outcome measures relating to safe and personalised maternity care in England which we map against a pre-developed ASPIRE framework to establish the potential impact of the COVID-19 pandemic for two UK trusts.MethodsWe undertook a mixed-methods system-wide case study using quantitative routinely collected data and qualitative data from two Trusts and their service users from 2019 to 2021 (start and completion dates varied by available data). We mapped findings to our prior ASPIRE conceptual framework that explains pathways for the impact of COVID-19 on safe and personalised care.ResultsThe ASPIRE framework enabled us to develop a comprehensive, systems-level understanding of the impact of the pandemic on service delivery, user experience and staff wellbeing, and place it within the context of pre-existing challenges.Maternity services experienced some impacts on core service coverage, though not on Trust level clinical health outcomes (with the possible exception of readmissions in one Trust). Both users and staff found some pandemic-driven changes challenging such as remote or reduced antenatal and community postnatal contacts, and restrictions on companionship. Other key changes included an increased need for mental health support, changes in the availability and uptake of home birth services and changes in induction procedures. Many emergency adaptations persisted at the end of data collection. Differences between the trusts indicate complex change pathways. Staff reported some removal of bureaucracy, which allowed greater flexibility.During the first wave of COVID-19 staffing numbers increased, resolving some pre-pandemic shortages: however, by October 2021 they declined markedly. Trying to maintain the quality and availability of services had marked negative consequences for personnel. Timely routine clinical and staffing data were not always available and personalised care and user and staff experiences were poorly captured.ConclusionsThe COVID-19 crisis magnified pre-pandemic problems and in particular, poor staffing levels. Maintaining services took a significant toll on staff wellbeing. There is some evidence that these pressures are continuing. There was marked variation in Trust responses. Lack of accessible and timely data at Trust and national levels hampered rapid insights. The ASPIRE COVID-19 framework could be useful for modelling the impact of future crises on routine care.

Properties and application of pectinase obtained from Galactomyces candidum using pectin extracted from mango peels as a carbon source

Enzyme instability, poor levels of activity, low substrate specificity, and cost, limit the use of pectinase in the juice industry as well as in galacturonic acid production. Therefore, this research explored the properties of low-cost Galactomyces candidum pectinase with high heat and pH stability capable of degrading mango pectin. Pectinase was produced from Galactomyces candidum on the second day in a submerged fermentation broth supplemented with beef-extract, yeast-extract, and mango pectin at a pH of 5.0. The crude enzyme had a specific activity of 31.34 U/mg. After gel filtration, the specific activity and molecular weight of the enzyme were 39.96U/mg and 26 kDa, respectively. The enzyme's optimal pH and temperature were 5.5 and 50 °C, respectively. The maximum velocity (Vmax) and Michaelis constant (KM) of the enzyme were 73.53 μmol/min and 1.49 mg/ml. The activation effect of some metal ions on the enzyme was in the following order Mn2+˃Ca2+˃K+˃Fe2+> Co2+> Na+˃Zn2+> Mg2+˃Cu2+. Galactomyces candidum pectinase retained more than 70% of its original activity after incubation for 120 min at all the pH tested. Also, over 80% of the enzyme's original activity was retained after incubation for 120 min at 50 and 60 °C, while at 70 °C, 50% of its initial activity was retained. In addition, over 70% of the enzyme's initial activity was lost at 80 °C after incubation for 120 min. Spectral studies on the clarification of mango fruit juice showed that both crude and purified Galactomyces candidum pectinase were able to clarify mango juice, suggesting the enzyme's potential in the beverage industry.

Knowledge And Practice on Prevention and Control of Dengue Among Homemaker in Bharatpur Metropolitan, Chitwan

Background: Dengue is a viral infection transmitted to humans through the bite of infected mosquitoes. The dengue virus (DENV) is one of the mosquito-borne viral diseases in the world today. Two main arthropod vectors are responsi-ble for transmission of dengue viruses: Aedes aegypti and Aedes albopictus. The Aedes aegypti mosquito is the main vector for the spread of dengue fever.&#x0D; Methods: An analytical cross-sectional study was conducted among home makers of Bharatpur. Data was analyzed using descriptive and inferential statistical tools in SPSS-20. p-value &lt;0.05 was considered as statistically significant.&#x0D; Results: In this study 60.0% have Fair level of knowledge 39.8% have poor level of knowledge. There was no good practice. The majority of respondents 78.6% show Good level of practice and minority 22.4% showed poor level of practice.&#x0D; Conclusions: We can conclude that majority of the respondents had fair knowledge regarding dengue. Despite of the fair knowledge level, the majority of the respondent had good practices such as use of mosquito net, covering house-hold containers, covering water tank, invert the water holding containers.

Diet and exercise are a fundamental part of comprehensive care for type 2 diabetes.

Diet and exercise are a fundamental part of comprehensive care for type 2 diabetes.

Factors Associated with Postpartum Care during the Fourth Stage of Labor in Nepal: A Hospital-based Cross-sectional Study

Postnatal care is an important part of maternal and neonatal care, and life-threatening complications can occur during the postpartum period. Empirical information on the level of postpartum care services is generally scarce in Nepal. Key elements of postpartum care during the fourth stage of labor include providing proper nutrition, promoting breastfeeding, and helping the mother manage any physical discomforts or challenges that may arise. This study investigated the level of postpartum care services delivered during the fourth stage of labor in a tertiary-level hospital in the Chitwan district of Nepal. A descriptive cross-sectional hospital-based study was conducted among 148 women admitted for vaginal delivery. A set of structured observation checklists was developed and finalized based on the WHO Recommended Interventions for Improving Maternal and Newborn Health: Integrated Management of Pregnancy and Childbirth. The structured observation checklist had twenty-two items, including twelve critical steps. A good level of care was valid with a score of ≥ 90% based on total items, including all twelve critical steps of care, and a poor level of care was valid with a score &lt;90%. The purpose of the study was explained to and written informed consent was obtained from all respondents. Ethical approval was received from the Institutional Review Committee of Chitwan Medical College. One third (33.8%) of the women received a good level of postpartum care services. Women’s residence (&lt;em&gt;p&lt;/em&gt; = .021), number of pregnancies (&lt;em&gt;p&lt;/em&gt; =.002), and number of antenatal visits (&lt;em&gt;p&lt;/em&gt; =.029) were significantly associated with the level of postpartum care during the fourth stage of labor. Going forward, it will be important for Nepal to enhance the capacity of clinicians or nurses to provide postpartum care as per WHO guidelines.

The Rationale Behind the Design Decisions in an Augmented Reality Mobile eHealth Exergame to Increase Physical Activity for Inactive Older People With Heart Failure.

Physical activity is important for everyone to maintain and improve health, especially for people with chronic diseases. Mobile exergaming has the potential to increase physical activity and to specifically reach people with poor activity levels. However, commercial mobile exergames are not specially designed for older people with chronic illnesses such as heart failure. The primary aim of this viewpoint is to describe the underlying reasoning guiding the design choices made in developing a mobile exergame, Heart Farming, tailored specifically for sedentary older people diagnosed with heart failure. The goal of the exergame is to increase physical activity levels by increasing the daily walking duration of patients with heart failure by at least 10 minutes. The rationale guiding the design decisions of the mobile exergame is grounded in the thoughtful integration of gamification strategies tailored for application in cardiovascular care. This integration is achieved through applying gamification components, gamification elements, and gamification principles. The Heart Farming mobile exergame is about helping a farmer take care of and expand a virtual farm, with these activities taking place while the patient walks in the real world. The exergame can be adapted to individual preferences and physical condition regarding where, how, when, and how much to play and walk. The exergame is developed using augmented reality so it can be played both indoors and outdoors. Augmented reality technology is used to track the patients' movement in the real world and to interpret that movement into events in the exergame rather than to augment the mobile user interface.

The risk of incident depression when assessed with the Lifestyle and Well-Being Index

ObjectivesNovel findings indicate links between unhealthy lifestyles and depression based on active inflammatory processes. Thus, identifying participants with poor habits could reveal differences in trends of incident depression. This study aimed to examine the association between an objective lifestyle assessment, as measured by the Lifestyle and Well-Being Index (LWB-I), and incident depression in healthy participants of a Spanish cohort. Study designThis was a longitudinal analysis of a subsample of 10,063 participants from the Seguimiento Universidad de Navarra cohort study. MethodsGroup comparisons and Cox proportional hazard models were conducted using the LWB-I, which categorizes the sample into groups with healthy and unhealthy lifestyles and well-being. The main outcome was incident depression as well as secondary outcomes. ResultsThose classified to the transition category of LWB-I were associated with a hazard ratio of 0.67 (95% confidence interval: 0.52–0.87), and those in the excellent category showed a hazard ratio of 0.44 (95% confidence interval: 0.33–0.58), which in both groups reflects a significantly lower risk of incident depression compared with the group including those classified in the poor LWB-I level. Moreover, the available sensitivity analyses concerning time of depression diagnosis or antidepressant treatment further supported the role of nutrition and physical activity on incident depression. Interestingly, throughout the follow-up, incident depression was inversely related to healthier daily habits as measured by the LWB-I. ConclusionsA global assessment of lifestyles such as the LWB-I provides valuable insight into the complex relationship between lifestyle factors and their link to depression risk.

The Potential Use of Sex Robots in Adults with Autistic Spectrum Disorders: A Theoretical Framework

Although the importance of the sexual sphere for the health of all human beings has been recognized at an international level, often this is underestimated when it comes to disabilities and even more to intellectual disabilities. In fact, the idea that subjects with intellectual disabilities are not aware of their bodies and of their wishes in the sexual and emotional field is still widespread in our society, in such a way that they are considered as children in need of constant supervision. Moreover, further hints of criticism that can be raised are about the poor level of sexual education that is dedicated to these subjects, both by family members and by therapists. The last decades have been characterized by a considerable growth in the technological sector and many new instruments have been successfully used in the field of healthcare of weak or disabled subjects. A particularly fruitful branch has been robotics which, in subjects with autistic spectrum disorders (ASD), has revealed itself as an excellent support to stimulate communication and develop social skills. As in recent years the field of robotics has also been characterized by a strong interest in the sphere of sexuality, building and implementing what we now define as sex robots or sexbots, it could be interesting to start a debate on the potential that these new generation artificial agents could have in the field of care of subjects with ASD. These robots, possessing a technology based on stimulating verbal and nonverbal interaction, could be useful for an education that is not only sexual but also psycho-emotional in subjects with ASD.

#3662 FREQUENCY OF INR TESTING IN HEMODIALYSIS PATIENTS ON VITAMIN K ANTAGONISTS: A RETROSPECTIVE STUDY

Abstract Background and Aims Despite the rising of direct oral anticoagulant agents’ use in the general population, vitamin K antagonists (VKA) are still used in hemodialysis (HD) French patients with atrial fibrillation. These HD patients on VKA have also poor levels of time in therapeutic range. It is recommended generally to follow patients with monthly INR, however there is lack of such evidence in HD. This study aims to analyze the frequency of INR testing needed in HD patients. Method This is a retrospective study of all patients treated with VKA in three French dialysis units between 1st January and 31st December 2022. Patients are followed with weekly INR. Variables collected included over twelve months the number of INR tests, their percentage within target, above target and below target, and number of VKA dose adjustment. Bleedings, transfusions, thrombotic events and antibiotic use were recorded. Linear regression analysis evaluated factors associated with number of VKA dose adjustment per year. This study was conducted in concordance with the Declaration of Helsinki 1975. Results Out of 160 HD patients, 45 (28.1%) were on VKA for paroxysmal or chronic atrial fibrillation. Their characteristics are summarized in Table 1. A total of 2609 INR tests were performed over a year with a mean of 57.9±18.6 per patient. The median number of VKA dose adjustment per year was 11 (8, 13). A significant correlation was found between the number of antibiotics and number of VKA dose adjustment (Spearman Rho = 0.360, p = 0.015). In univariate regression analysis, factors associated with higher numbers of dose adjustment were diabetes, sevelamer and blood flow (Table 2). Bleeding was not significantly different between those with high versus low VKA dose adjustment. Conclusion In this study, 22% of tests led to VKA dose adjustment. Patients with diabetes, on sevelamer, treated with antibiotics and with lower serum albumin needed frequent INR testing more than once monthly. These results could be helpful in contexts with limited resources.