Pre Intervention Research Articles

Nursing Care for Postpartum Mothers with Indications of Sectio Caesarea Against Lack of Knowledge About Breastfeeding Techniques at RPKK Koja Regional General Hospital, DKI Jakarta Province

The aim of this study was to determine mothers' knowledge about correct breastfeeding techniques for postpartum mothers with Sectio caesaria at the Koja Regional General Hospital, DKI Jakarta Province. This research method uses an observation sheet with a pre and post intervention design. Measurements were carried out on 3 respondents. This research was conducted at the Koja Regional General Hospital, DKI Jakarta Province. Data collection was carried out for 3 days. The sample in this study was postpartum mothers post caesarean section. The variable in this research is conducting health education about correct breastfeeding techniques. Analysis using an observation sheet is used to see knowledge of the breastfeeding techniques used. The results of this study show that by carrying out correct breastfeeding techniques, post-cesarean section mothers will understand and know the correct attachment position and breastfeeding technique so that complications of pain and blisters on the nipples do not occur. The more active the mother is in breastfeeding, the faster the mother will understand.

A Daily Checklist Method Increases Documentation of Code Status in Trauma Patients.

While insufficient code status documentation (CSD) is a longstanding challenge, all patients deserve the opportunity to participate in decision-making regarding code status, especially trauma patients with an unpredictable course. Prior interventions to increase CSD relied on reminder systems. We hypothesize that introducing a daily checklist will increase CSD for patients in the trauma ICU. This quality improvement study examined the efficacy of a twice-daily checklist for improving CSD in trauma patients at a level I trauma center. A pre-intervention (PRE) and post-intervention (POST) daily census characterized the percentage of patients with CSD (primary outcome), time-to-code status (TTCS, secondary outcome) documentation, and information about patients who were discharged with no code status (DNCS, secondary outcome). Of 213 PRE and 207 POST, daily census CSD for all patients increased from a median of 50.0% PRE to 64.4% POST (P < .05). Time-to-code status was halved (PRE: 25.30h, POST: 12.71h, P < .05). Code status documentation within 12h increased from 41.8% PRE to 60.9% POST (P < .05). Overall, the percentage of patients with CSD during their hospitalization increased 20% (PRE: 63.8%, POST: 83.6%, P < .05). Discharged with no code status patients decreased 20% (PRE: 35.2%, POST: 15.5%, P < .05). Including code status in a daily checklist involving key aspects of care for trauma patients is an effective method for improving code status documentation. Capturing code status for more patients in trauma allows us to provide patient-centered, goal-concordant care.

The effects of upper cervical spine manual therapy on central sensitization and brainstem auditory evoked potentials in subjects with migraine and neck pain

BackgroundMigraine is an important disease due to its impact on global health. Due to association of neck pain with migraine, manual therapy (MT) often used in management. The aim of this study was to evaluate the effects of upper cervical spine MT on specific mechanisms including central sensitization (CS) and brainstem auditory evoked potentials (BAEPs) in subjects with migraine and neck pain. Methods30 subjects with migraine and neck pain (30 female, mean age 43.10 ± 8.13) were randomly assigned to a medication plus MT (MedMT) group, a medication plus sham manual therapy (sham MT) group, and a medication alone (Med) group. CS was evaluated using the Central Sensitization Inventory (CSI) and BAEP determined electrophysiologically in all subjects pre and post intervention. Subjects in MedMT and sham MT groups received either 4 sessions of MT or sham MT. All subjects received medication. ResultsSubjects in MedMT group had a significant reduction in CSI score (P < 0.05) compare to the other 2 groups. For BAEPs, MedMT and sham MT groups had significantly decreased wave V latency on the right side (P < 0.05) compared to Med group. DiscussionManual therapy plus medication may have beneficial effects in people with migraine and neck pain by normalizing central sensitization levels. Additionally, upper cervical manual therapy or sham manual therapy have demonstrable neurophysiological effects reflected by changes in the auditory transmission pathways in the brainstem. Further research is required to investigate the mechanisms of action of MT in migraine.

School staff delivery of a solution focused intervention to support pupils' behaviour

AbstractA single case experimental design with multiple baselines was employed to explore the relationship between a solution focused intervention delivered by school staff and the externalising behaviour of four primary school pupils. The intervention took place over four to five sessions, which were delivered by non‐specialist school staff with the use of training, supervision, and a manual. Observations of a specific positive behaviour were carried out both before and during the intervention, which were then analysed through visual and statistical analysis. A pre and post intervention questionnaire measure of pupils’ externalising behaviour was collected. For each participant, one videoed session was used to explore the fidelity of the intervention to the manual. Analysis of observations of behaviour showed a significant increase in a specific positive behaviour for three of four participants. A measure of pupils’ externalising behaviour showed a significant reduction for two of the eight questionnaires collected. Video analysis suggested variation of fidelity across participants. This research provides tentative support for specific outcomes from a solution focused intervention, when delivered by non‐psychologists who are provided with appropriate support. It has also been found that non‐specialist school staff practitioners were able to deliver the intervention through applying elements from a manual to have a positive impact on a specific behaviour for three of four participants. There is a need for further high quality research to establish the effectiveness of solution focused interventions when delivered by non‐specialists with the use of consistent intervention and outcome measures.

Implementing a ward-level intervention to improve nursing handover communication with a focus on bedside handover-A qualitative study.

To improve the effectiveness of nursing clinical handover through a qualitative, tailored communication intervention. A multisite before and after intervention using qualitative ethnography combined with discourse analysis of nursing handover interactions. We implemented a tailored ward-based intervention to redesign nursing handover practice with co-constructed recommendations for organisational and cultural change on seven wards across three affiliated metropolitan hospitals between February 2020 and November 2022. The intervention was informed by pre-implementation interviews and focus groups with nursing, medical and allied health staff and patients (n = 151) and observed and/or audio-recorded handover events (n = 233). Post-intervention we conducted interviews and focus groups (n = 79) and observed and/or audio-recorded handover events (n = 129) to qualitatively evaluate impact. Our translational approach resulted in substantial changes post-intervention. Nurses conducted more shift-to-shift handovers at the bedside, with greater patient interaction and better structured and more comprehensive information transfer, supported by revised handover documentation. Redesigned group handovers were focused and efficient, communicating critical patient information. Contextualised training combined with changes to ward-level systemic factors impeding communication results in improved nursing handovers. Practice change requires strong executive leadership and project governance, combined with effective ward-level leadership, collaboration and mentoring. The speed and degree of change post-intervention demonstrates the power of interdisciplinary collaborative research between hospital executive, ward leadership and communication specialists. Nurses are more likely to conduct efficient group handovers and informative, patient-centred bedside handovers in line with policy when they understand the value of handover and have practical strategies to support communication. Communication training should be combined with broader ward-level changes to handover practice tailored to the ward context. A multilevel approach results in more effective practice change. We adhered to the COREQ guidelines. We interviewed patients on study wards pre and post intervention.

Abstract 997: Bringing the first prehabilitation program to American Indian cancer patients

Abstract Purpose. American Indian/Alaska Native (AI/AN) people have the worst cancer survival rates of any US racial group, are underrepresented in clinical trials and research, and have never been recruited for participation in any published prehabilitation (prehab) intervention conducted prior to cancer surgery. Description of Procedure. We are collaborating with tribal partners to design the first prehab translational clinical trial for AI patients diagnosed with obesity-related cancer, to be implemented prior to surgical resection of the tumor. Program components have been developed with community input through semi-structured interviews and guidance from the sponsoring tribal health facility, the San Carlos Apache Healthcare Corporation. Patients preparing for cancer surgery will engage in a 3-week multimodal intervention that entails home-based exercise, supervised fitness sessions, promotion of anti-inflammatory foods, and health education materials adapted for and by community members. Serum and tissue biomarkers, as well as lifestyle behavioral measures, will be compared pre and post intervention to assess responsiveness. In respect of tribal sovereignty, the experimental procedure includes protocol refinement and approval by the tribal health facility’s IRB and tribal council. Summary of Data. Our qualitative data reveal AI cancer survivors from the partnering tribal community have high interest in prehab and attest they would have participated if offered (100%). Their consensus feedback fashioned the specifics of the prehab translational clinical trial: 30 minutes daily walking, 60 minutes supervised resistance training twice weekly, 2 ounces walnut consumption daily, nutrition counseling, transportation assistance, and education/encouragement from staff and peers. Biospecimen sampling can be a sensitive topic for AI audiences, which we addressed early and found 75% of the interviewed survivors agreed to biospecimen collection without stipulation; this increased to 100% support once the rationale for biospecimens was explained. Conclusions: Published prehab studies in other populations administered for 3-5 weeks between diagnosis and surgery have shown improvements in functional capacity, attenuation of surgery-induced losses, alterations of inflammatory biomarkers, and patient safety. Our community-informed prehab translational clinical trial for AI patients is the first of its kind, and anticipated to demonstrate feasibility, patient acceptability, behavioral changes in lifestyle, and the potential to modulate inflammatory biomarkers. Citation Format: Jennifer Erdrich, Adriena Hernandez, Jennifer W. Bea, Cynthia A. Thomson. Bringing the first prehabilitation program to American Indian cancer patients [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 997.

Immediate Effect of Physiotherapist-demonstrated Action Observation with Execution for Improving Upper Extremity Motor Function in Stroke: a Pre-post Pilot Study.

Video-demonstrated action-observation-execution is an effective intervention for motor re-learning in stroke rehabilitation. But customization of video for each task repeatedly questions its feasibility within limited resources, particularly for daily routine practice and in community settings. Physiotherapist-demonstrated action-observation-execution is a practical intervention based on the principle of observation and consecutive repetitions of observed real, live movements. The main objective of this study was to investigate the immediate effect of Physiotherapist-demonstrated action-observation-execution in upper extremity motor training in stroke. Individuals with stroke were screened and 5 eligible participants were recruited. The research was a pre-post. A single session of Physiotherapist-demonstrated action-observation-execution was administered. A functional "Drinking" task was subdivided into simpler acts and trained. Pre and post intervention assessment of movement time using five hand-and-arm items of Nepali Wolf Motor Function Test were carried out. Global recovery was assessed in the form of Visual Analogue Scale. Paired t-test provided statistically significant difference in total movement time (mean difference=5.04 seconds, standard deviation=1.92, p=0.004) with larger effect size (0.95) indicating impressive improvement in movement time with the training. Substantial difference in global recovery score was noted (mean difference=17.40, standard deviation=3.65, p<0.0001, effect size=1.00) signifying the increased confidence and improved performance of upper extremity post treatment. The findings indicated that Physiotherapist-demonstrated action-observation-execution could be a feasible intervention to train motor functions in participants with stroke. Large-scale studies are recommended to establish the effectiveness of the intervention.

Neural correlates of bilateral proprioception and adaptation with training.

Bilateral proprioception includes the ability to sense the position and motion of one hand relative to the other, without looking. This sensory ability allows us to perform daily activities seamlessly, and its impairment is observed in various neurological disorders such as cerebral palsy and stroke. It can undergo experience-dependent plasticity, as seen in trained piano players. If its neural correlates were better understood, it would provide a useful assay and target for neurorehabilitation for people with impaired proprioception. We designed a non-invasive electroencephalography-based paradigm to assess the neural features relevant to proprioception, especially focusing on bilateral proprioception, i.e., assessing the limb distance from the body with the other limb. We compared it with a movement-only task, with and without the visibility of the target hand. Additionally, we explored proprioceptive accuracy during the tasks. We tested eleven Controls and nine Skilled musicians to assess whether sensorimotor event-related spectral perturbations in μ (8-12Hz) and low-β (12-18Hz) rhythms differ in people with musical instrument training, which intrinsically involves a bilateral proprioceptive component, or when new sensor modalities are added to the task. The Skilled group showed significantly reduced μ and low-β suppression in bilateral tasks compared to movement-only, a significative difference relative to Controls. This may be explained by reduced top-down control due to intensive training, despite this, proprioceptive errors were not smaller for this group. Target visibility significantly reduced proprioceptive error in Controls, while no change was observed in the Skilled group. During visual tasks, Controls exhibited significant μ and low-β power reversals, with significant differences relative to proprioceptive-only tasks compared to the Skilled group-possibly due to reduced uncertainty and top-down control. These results provide support for sensorimotor μ and low-β suppression as potential neuromarkers for assessing proprioceptive ability. The identification of these features is significant as they could be used to quantify altered proprioceptive neural processing in skill and movement disorders. This in turn can be useful as an assay for pre and post sensory-motor intervention research.

Utility of Kent's Repertory in the treatment of candidiasis: An open labelled, Single arm, interventional clinical trial

ABSTRACT&#x0D; Background: Candidiasis is the most significant opportunistic infection impacting the Quality of life. Objective: This study assess the effectiveness of individualized homoeopathy (IH) in centesimal scale selected from the Kent’s repertory in cases of Candidiasis. Methods: This is open – label, prospective, Single-arm, non-randomized, non-controlled clinical trial of pre-post comparison design was conducted at the Repertory outpatient department (OPD) of National Institute of Homoeopathy, Kolkata, India. Result: Calculated t29 value is 8.04 OR 9.17 by using NRS and MCAQ scoring scale and on referring t-table at degree of freedom 29, it is found that the t-value is 2.05 at p=0.05. However our calculated value 8.04 or 9.17 is &gt; 2.05 (t at p=0.05). As the calculated t-value is greater than the table value at α = 0.05 . So the result is significant at p ≤ 0.05. There is statically significant improvement in pre and post intervention status of patients enrolled in this clinical study. Conclusion: This study provides a positive trend to support the effect of IH (Individualized Homoeopathy) selected on the basis of principal of Kent’s repertory in patients with different variety of candidiasis and warrants further evaluation in RCT (Randomized control trial) with higher sample size.

Exploring the experiences of a person with dementia and their spouse who attended a telehealth music therapy programme: Two case examples from Ireland

ABSTRACT Introduction There is an increased need for accessible psychosocial interventions that support both people with dementia and their spouses. Recent research demonstrates the benefits of music therapy and caregiver-delivered music therapy for this population. This paper contributes to the emerging evidence base on telehealth music therapy for people with dementia outside of a COVID-19 era when in-person services were available. Method This exploratory phenomenological study explores the experiences of two couples who attended a six-week telehealth music therapy programme via two detailed case examples. Online semi-structured interviews with each couple were conducted pre and post intervention and analysed using Interpretative Phenomenological Analysis. Results Three shared themes emerged from the data analysis including (1) social isolation and lack of confidence linked to dementia diagnosis is worsened in rural locations, (2) song singing and song writing enables us to revisit happy memories, and (3) telehealth delivery increases access due to geographical location. The findings are presented in a narrative case study format to provide rich detailed descriptions of the music therapy programme and to illuminate the experiences of the participants. Discussion In both examples, telehealth delivery expanded access to music therapy (which was otherwise unavailable) and stimulated reminiscence which in turn encouraged meaningful engagement between the couple. The delivery of music therapy via telehealth, alongside in-person delivery, has the potential to expand access to music therapy to those who may not have access to or are no longer able to attend community support services due to geographical location, increased cognitive decline or reduced mobility. The successful delivery of telehealth music therapy is dependent on several factors including digital literacy, access to appropriate technological devices, caregiver support and level of cognitive decline.

Stewardship: it's going viral

Historically, antimicrobial stewardship (AMS) has considered the judicious use of antibiotics. AMS is widely adopted across Europe and the US; recently antifungal AMS is gaining momentum but antiviral AMS has been little described. Here we describe the introduction of AMS virology reviews at University Hospitals Birmingham (UHBFT); a novel concept and an opportunity to broaden the beneficial aspects of AMS to virology, termed anti-viral stewardship (AVS). In June 2022, a UK supply issue with aciclovir injection (ACV IV) was announced. In order to review and preserve parenteral ACV for those in greatest need, UHBFT pharmacist and virologists implemented a specialist review for patients prescribed more than 48 hours of treatment. This review initially lasted 10 weeks and data was collected on the advice offered, whether it was accepted, and time required completing the review. AVS rounds halved IV ACV consumption, compared to pre or post intervention levels, with more than half of patients advised to stop or switch to oral therapy. Diagnostics and sampling guidance was offered in one quarter of reviews, whilst the remaining interventions were more stewardship focused. In almost all cases stewardship advice was readily accepted by clinical teams. Due to positive feedback from clinicians and its effective management of supply, the anti-viral stewardship (AVS) programme was re-introduced in June 2023. Antiviral AMS rounds provide an opportunity to optimise sampling, diagnosis and improve patient management. Introduction of regular AVS at UHBFT are now well established and plan to be implemented in other hospitals.

A structured, journal-led peer-review mentoring program enhances peer review training

BackgroundPeer review is essential to the advancement of knowledge. However, training on how to conduct peer review is limited, unorganized, and not well studied. Thus, we sought to determine if a structured mentored peer-review program improved peer review training as measured by multiple quantitative and qualitative assessments.MethodsThis pre-post intervention study enrolled 55 mentees across 5 cohorts from 2020 to 2023. Each cohort completed pre-program evaluations, participated in 2 mentored reviews, and completed post-program evaluations over 6 months. Mentors and mentees completed pre-program demographic and review experience questionnaires. Outcome measures included (1) total and sub-scores on the modified Review Quality Index (mRQI) applied to the same pre-selected research manuscript reviewed by mentees both pre and post intervention, (2) mentee self-perceived comfort with and understanding of the review process using a custom questionnaire, and (3) mentor satisfaction surveys. Pre- and post-program measures were compared using the Wilcoxon signed-rank test.ResultsPost-program total modified RQI score (median (IQR) = 31 (26.3–35.8)) was higher than pre-program total score (26.6 (19.7–29.7)) for the 42 mentees who completed both pre- and post-program reviews. Mentees reported improved perception of review (median (IQR) pre = 4 (3–4), post = 5 (4–5)) and editorial processes (pre = 3 (2–4), post = 4 (4–5)) as well as self-perceived confidence in completing an independent review of both scientific (median (IQR) pre = 2 (2–3), post = 4 (4–4)) and non-scientific (pre = 3 (2–4), post = 4 (4–5)) manuscripts following program participation. p < 0.0001 for all scores noted. Mentors reported high scores for enjoyment (median (range) 5/5 (3–5)) and interest in repeat participation (5/5 (2–5)).ConclusionsA 6-month structured mentored-review program including 2 mentored reviews improves peer review training as measured by the modified RQI as well as participant self-perceived understanding of publication science with high mentor satisfaction.

Effectiveness of slow deep breathing therapy on lowering blood pressure in hypertensive patients: A case study

Introduction: Hypertension is a cerebral vascular disorder in the form of narrowing of cerebral blood vessels, resulting in reduced oxygen and nutrient supply to the brain. It is characterized by an increase in systolic blood pressure &gt;140 mmHg and diastolic pressure &gt;90 mmHg. Non-pharmacological management is needed to be applied in lowering blood pressure. Slow deep breathing therapy exercises are done by breathing long and deep breaths slowly can stimulate the secretion of endorphins neurotransmitters in the autonomic nervous system which has an effect on decreasing the work of sympathetic nerves, increasing the work of parasympathetic nerves whose effects can affect heart rate to be slow and also vasodilation occurs in blood vessels. Objective: To lower blood pressure in hypertensive patients by using slow deep breathing exercises. Methods: The method used in this study used a case study with pre and post intervention, patients were given slow deep breathing exercises by breathing in through the nose for 3 seconds until they felt that the stomach expanded then held their breath for 3 seconds, then exhaled slowly through the mouth for 6 seconds, and repeated all steps for 15 minutes. Results: Obtained results of a decrease in blood pressure in patients after being given slow deep breathing exercises. Conclusion: Slow deep breathing therapy exercises with appropriate methods and procedures can be an alternative to lower blood pressure in hypertensive patients

Effectiveness of range of motion therapy to improve muscle strength in postoperative limb fracture patients

Intoduction: A fracture or fracture is a separation or tear in bone continuity caused by trauma. Fracture fixation surgery is one of the procedures in handling fractures. However, there are still many short-term and long-term complications that can be experienced by patients, one of which is a decrease in range of motion which results in a decrease in muscle strength. Range Of Motion (ROM) is one of the therapies that can be done to improve and maintain the perfection of the ability to move joints completely and to increase muscle time and tone. Objective: To increase muscle strength in postoperative limb fracture patients can apply Range of Motion therapy. Methods: The method used in this study uses case studies with pre and post intervention. Range of Motion therapy is carried out 2 times a day in 3 consecutive days starting from the second day postoperatively. The patient was given ROM therapy on the second day postoperatively passively. On the third and fourth postoperative days, patients are asked to do ROM actively as taught on the first day. Results: Results showed that there was an increase in muscle strength in patients postoperative limb fractures after Range of Motion therapy. Conclusion: Range of motion therapy with appropriate procedures and performed routinely can improve muscle strength and daily activities in patients with postoperative limb fractures.

The Effect of Yoga Exercises on Reducing Stress Levels in Premenopouse Women

Premenopausal syndrome causes symptom physical and psychological. Disturbance psychology in general occurs in women transition is worry. One of possible efforts done that is do yoga exercises. Know the influence of yoga exercise on decline stress levels in women pre menopause in the Village Potatoes Subdistrict Toroh Grobogan Regency. Research design pre-experimental, with design one-group pre-posttest design. Samples required as many as 33 people with random sampling technique. Data collection using pre and post intervention questionnaires. Data analysis used the paired t test. The average stress level before yoga exercise was 17.97 with standard deviation 1.36. The minimum score is 15, meanwhile score maximum namely 21. The average stress level after yoga exercise is 10.72 with standard deviation 1.97. The minimum score is 7, meanwhile score maximum namely 15. Paired sample t-test obtained a p value of 0.000 (&lt; 0.05), meaning There is the influence of yoga exercise on stress levels in women pre menopause. The influence of yoga exercise on stress levels in women pre menopause in the Village Potatoes Subdistrict Toroh Grobogan Regency.

Farmer’s understanding and adoption of agricultural practices in southern part of India

India is fulfilling the consumption requirement of its pulses and oilseeds largely through importing. Andhra Pradesh is a leading state in the country, significantly contributes to the production of these crops. Low yield of pulses and groundnuts in India should be addressed through adoption of proven technological interventions along with enhancing farmers knowledge. The present study aimed to determine the differences in knowledge of Sustainable Agricultural Practices (SAPs) and adoption of improved agricultural practices (IAPs) among farmers at the baseline and endline phase of the study. The association of possible factors such as age, gender, education, farm experience, mass media, social participation, risk orientation, innovativeness with knowledge and adoption of Sustainable agricultural practices was evaluated. The study also examined the result of the technological intervention on crop yield at pre and post intervention. The study included 240 farmers with poor pulse and groundnut yield from villages of Andhra Pradesh with inadequate technological developments. At biotech intervention phase, farmers received training, field demonstration etc. The results revealed that at endline, 80% of farmers had knowledge of SAPs (compared to 48% at baseline) and the adoption rate of IAPs was 50% (compared to 3% at baseline). Factors such as mass media, social participation, risk orientation showed significant reduced risk on farmers with high knowledge of SAPs and with complete adoption of IAPs. The average yield per hectare of pulses during baseline was found to be 403.5 kg/ha ± 128.4 while during endline it was 601.25 kg/ha ± 206.8 (p-value = 0.001). The average yield per hectare of groundnut during baseline was found to be 983.75 kg/ha ± 444.9 and during endline it was 1216.78 kg/ha ± 473.9 (p-value = 0.000). Innovative technological interventions and capacity building of farmers increased yield of crops in Andhra Pradesh.

Acute effect of dry needling on trunk kinematics and balance of patients with non-specific low back pain

BackgroundLimited knowledge exists about the effectiveness of dry needling (DN) concerning the torso kinematics in patients with non-specific low back pain (NS-LBP). Acute effects of DN in NS-LBP patients from a functional perspective were investigated. MethodsSixteen NS-LBP patients and 11 healthy individuals (HG) were examined. NS-LBP patients received a single session of DN at the lumbar region. Baseline and immediate post-treatment measurements during flexion-extension and lateral bending of the trunk were conducted for the NS-LBP patients. HG were measured only at baseline to be used as a reference of NS-LBP patients' initial condition. Algometry was applied in NS-LBP patients. Centre of pressure, range of motion of the trunk and its’ derivatives were obtained. FindingsHG performed significantly faster, smoother and with greater mobility in the performed tasks compared to the pre intervention measurements of the NS-LBP patients. For the NS-LBP patients, significant greater angular velocity in frontal plane and significant lower jerk in the sagittal plane were demonstrated post intervention. DN alleviated pain tolerance significantly at the L5 level. Regarding the effectiveness of the DN upon spine kinematics, their derivatives were more sensitive. InterpretationIt appeared that the pathological type of torso movement was acutely affected by DN. NS-LBP patients showcased smoother movement immediately after the intervention and better control as imprinted in the higher derivative of motion although range of motion did not improve. This quantitative variable may not be subjected to acute effects of DN but rather need additional time and training to be improved.

Socio-Emotional Skills in The Academic Performance of Portuguese Basic Education Students (Emotional Intelligence Program)

Socio-emotional skills are a central element to face the problems of daily life and relate to others, becoming an essential capacity of the human being, developed educationally. We carried out a hybrid/mixed research (pre-pandemic period academic year 2019-20), modality of action research, having applied an intervention program to develop education for emotions, social skills and emotional intelligence in Portuguese children from 2 classes of the 4th grade elementary school, in order to improve their school performance and relationships between peers (educational environment). The conceptual framework was based on the analysis of the content of a range of studies on emotions, in the psych pedagogical scope, with emphasis on Salovey, Caruso and Mayer and Fernández Berrocal. The data collection techniques were as follows: sociometrist test friendship to the class (pre and post intervention); semi-structured interview with 2 teachers; participant observation; Intervention Program (7 sessions); focus-group; field notes. All ethical and legal rules were complied with in the procedures. The triangulations of the data obtained confirmed the improvement of (self) knowledge of emotions by the students, their social/emotional skills in the school performance of class and the relationships of friendship between them. We proposed socio-educational intervention guidelines to improve coexistence, with the involvement of the family and partners of the school and the emotional intelligence.

Three-dimensional printed models for multidisciplinary flexible nasopharyngoscopy training

Objective: To assess the effectiveness of a three-dimensional (3-D) printed head and neck model printed from our residency’s small 3D printer for the medical education and training of residents in nasopharyngoscopy. Study design: Survey based study. Setting: Resident education classroom. Methods: Computed tomography images were used to create an anatomically accurate 3-D printed model of the head and neck region. Participants took a pre-training and post-training surveys with an intervention incorporating didactic instruction by fellowship trained Otolaryngologist on how to perform nasopharyngoscopy. Participants Nasopharyngoscopy (FNP) attempts on the model were video recorded, timed and scored by a blinded reviewer with a predefined rubric. Changes in scores and timing of the procedure were evaluated. Results: Twenty-three participants from a single institution Emergency Medicine residency program completed the intervention. There were roughly equal proportions of senior, junior and intern residents. Thirty percent of participants were female. Sixty five percent of residents improved the overall time (in seconds) to identify anatomic landmarks and complete FNP. The participants had a statistically significant improvement in comfortability of performing FNP when comparing pre and post intervention. Conclusion: With increased use of nasopharyngoscopy not only by Otolaryngologist, 3D models of are beneficial to training other specialties less familiar with head and neck anatomy, in a low-pressure environment. Having the basic skills of nasopharyngoscopy will assist in the development of other procedures such as nasotracheal intubation, head/ neck/airway evaluation, etc. for the Emergency Room Department. This can assist in the efficiency of evaluation and treatment of head and neck conditions.

Laboratory reflex testing strategy for the early identification of primary care patients with multiple myeloma

ObjectivesOur objective was to shorten the screen for multiple myeloma (MM), through reflex testing. Design and MethodsThe clinical laboratory in the public University Hospital of San Juan (Alicante, Spain), serves 234,551 inhabitants. Through an intervention agreed with general practitioners, the Laboratory Information System (LIS) automatically registered serum immunoglobulins (Ig) when serum total proteins (STP) > 80 g/L for the first time in primary care patients. When concomitantly one Ig presented a value above and one below its reference interval, the LIS automatically registered a serum protein electrophoresis (SPEP). When a monoclonal peak in SPEP, immunofixation electrophoresis (IFE) for the typification of monoclonal bands (MB) was performed. If MB were present, a comment in the report explained the intervention. The number of additionally registered Ig, SPEP, IFE, and new diagnosis of MM were counted. The number of days elapsed from the report of elevated STP result to the final MM diagnosis was also counted as median and interquartile range (IQR), and compared to a pre intervention period. Results2071 cases of hyperproteinemia were identified, and had 91 a monoclonal peak, confirmed by IFE. In 35 patients it was a new finding, and 9 were diagnosed with MM, 3 Waldestrom macroglobulinemia, 2 lymphoplasmacytic lymphoma and 21 monoclonal gammopathy of undetermined significance. The number of days elapsed from hyperproteinemia to diagnosis was lower in the intervention period (21.5 vs 119.4) (P < 0.01). As our results show, in addition to shortening the time to diagnosis, an increased rate of detection of plasma cell disorders was observed when using our algorithm. ConclusionsThe above laboratory interventions agreed with clinicians, making use of laboratory technology resulted in early identification of MM.