Pretreatment Assessment Research Articles

Comparative Evaluation of Low-level Laser Therapy and Intralesional Injection in OSMF Patients: A Quasi-randomized Trial.

The aim of the present study was to compare the effectiveness of low-level laser therapy and intralesional injection in oral submucous fibrosis (OSMF) patients. The present study comprised of 52 grade II OSMF patients aged between 20 and 60 years. A pretreatment assessment was done for each patients. And 52 patients were divided into two groups (26 patients in each group). Group I received intralesional injections, and group II received low-level laser therapy (LLLT). The intralesional injection group received 0.5 mL 1500 I.U. Hyaluronidase with 2 mL dexamethasone biweekly for a month. The LLLT group underwent sessions of 0.1 watt laser only once for 3 cycles, each lasting 1 minute with 5-minute intervals. Evaluation of overall accessibility, burning sensation and mouth opening was done for both the treatment modalities on 0, 3rd, 7th and 15th day. All data were recorded and statistically analyzed. On comparison of burning sensation in intralesional Injection group, at baseline, the mean value was 4.00 ± 0.84 and it reduced to 1.19 ± 0.40 while in LLLT group from 4.15 ± 0.96 at baseline, it reduced to 2.65 ± 0.68 at the end of 15 days, respectively. On comparison of mouth opening in intralesional Injection group, at baseline, the mean value was 21.73 ± 1.56 and it increased to 32.53 ± 0.97 while in LLLT group from 22.70 ± 2.17 at baseline, it increased to 24.50 ± 1.31 at the end of 15 days, respectively. There was a statistically significant difference found between the two groups. The present study concluded that intralesional injections are more effective in treating grade II OSMF compared with LLLT. Several different treatment options are available to treat OSMF, including medical approaches, surgical management, and physiotherapy. One of the important therapeutic modalities is intralesional injection therapy with corticosteroids as they reduce inflammation and immunosuppression while hyaluronidase increases tissue permeability. How to cite this article: Pattnayak A, Das A, Rana P, et al. Comparative Evaluation of Low-level Laser Therapy and Intralesional Injection in OSMF Patients: A Quasi-randomized Trial. J Contemp Dent Pract 2024;25(8):745-750.

Enhancing Resurrection Practices for Unusable General Inventory Items in Hospital Settings

Background: Effective patient care in hospitals relies on the proper functioning of medical equipment. Malfunctioning general inventory items, such as patient beds, wheelchairs, and saline stands, pose significant challenges to hospital operations and patient care. D.G.H. Negombo needs help maintaining these items due to limited financial resources and inadequate technical expertise.Objective: To improve the resurrection practices of selected unusable general inventory items at D.G.H. Negombo.Methodology: This cross-sectional descriptive study was conducted from August 1, 2022, to November 15, 2023, and involved three phases: pre-intervention (assessment), intervention (implementation), and post-intervention (evaluation). Data collection methods included key informant interviews (K.I.I.), self-administered questionnaires (S.A.Q.), and desk reviews. The study targeted general inventory items marked for condemnation and included unit heads and maintenance technicians in its scope.Results: Pre-intervention assessments identified key issues such as inadequate technical skills, poor coordination, and insufficient infrastructure. Interventions implemented included skill development workshops, improved documentation practices, and enhanced communication strategies. Post-intervention evaluations demonstrated significant improvements in repair times, resource availability, and satisfaction among unit heads. Notably, 78% of wheelchairs, 79% of patient trolleys, and 76% of patient beds were successfully resurrected.Conclusions: The interventions enhanced the resurrection of unusable general inventory items, extended equipment lifespans, and achieved substantial cost savings.

Onsite training-mentoring intervention improves data quality: an implementation research

BackgroundThe quality of health data is not satisfactory in Low and Middle Income Countries (LMICs). Haramaya University, in collaboration with Ministry of Health and Regional Health Bureau, conducted an implementation research in selected public health facilities and administrative units. This research was aimed to test the onsite training-mentoring (OTM) intervention and adaptation of the implementation strategy to improve the routine health information system (RHIS) data quality in the context of public health sector.MethodsAn interrupted time series design with an onsite training-mentoring intervention was used to improve data quality in public health sector of Jigjiga Woreda, eastern Ethiopia from July 2021 to June 2022. Both the pre and post intervention assessments data were collected by experienced and trained public health professionals using interviewer guided self-administered interview, record review and observation data collection techniques. Data were analyzed using descriptive, bivariate, and multivariate logistic models to identify predictors of data quality.ResultsThe overall data accuracy was increased from 88.12% before to 95.0% after intervention; and it was above 90% in all the facilities. The overall data content completeness was increased from 75.75% to 89.9%, though it varied among the facilities. The timeliness and report completeness were 100% in all the facilities. The odds of those health workers who had poor knowledge were less likely to ensure data quality (AOR = 0.39; 95%CI: 0.19, 0.83) than their counterparts.ConclusionsThe intervention was brought substantial changes of data quality in the study setting. Knowledge of the workers towards data quality is a crucial factor to ensure data quality in the sector. Thus, collective efforts is required to continue this tested intervention to ensure the quality of the routine health information system in the lower levels of the sector.

Modified dialectical behavior therapy–informed transdiagnostic intervention for emotional disorders: protocol for a randomized controlled trial

BackgroundAnxiety and depressive disorders, characterized by high incidence and functional impairments, are emotional disorders with shared etiological and maintenance mechanisms. Dialectical behavior therapy (DBT) is a promising approach for the transdiagnostic treatment of emotional disorders. Developing a brief DBT intervention can facilitate the adoption of evidence-based therapy.MethodsThis protocol is for a 3-year single-blinded, two-arm randomized controlled trial. Individuals with depressive or anxiety disorder will be randomly allocated to a modified DBT–informed transdiagnostic psychotherapy group or a treatment-as-usual group. The intervention group will receive DBT individual therapy for 15 weeks. Power analyses revealed that the cohort should include a minimum of 250 participants. Preintervention, postintervention, and follow-up (after 3 months) assessments will be conducted. Primary outcomes will be severities of depression and anxiety rated by blind assessors. Intent-to-treat and per-protocol analyses will be conducted using the hierarchical linear model. Effect sizes will be estimated using Cohen’s d.ResultTo the best of our knowledge, the proposed study will be the first randomized controlled trial to evaluate the efficacy of a modified DBT intervention in managing transdiagnostic emotional disorders in Chinese individuals.ConclusionThis intervention is expected to improve clinical outcomes, daily functioning, and quality of life. The trial will enrich the empirical evidence for transdiagnostic interventions, facilitating the implementation of evidence-based therapy and reducing the high prevalence and challenges (e.g., disability) of emotional disorders in the Chinese population.Trial registration numberNCT05989451

Cleaning and Disinfection of Surfaces in a COVID-19 Respiratory Syndrome Unit: A Quasi-Experimental Study

Objective: This study aimed to assess the impact of an educational intervention on the cleaning and disinfection processes within a respiratory syndrome unit, serving as a designated facility for COVID-19 patients. Methods: A quasi-experimental design was employed, incorporating a pre-intervention and postintervention assessment. The evaluation of surfaces involved various monitoring techniques, including Adenosine Triphosphate (ATP) testing, colony-forming unit analysis, and visual inspections. All statistical analyses were conducted at a significance level of 5% (p < 0.05). Results: Following the implementation of the educational intervention, a notable reduction in surface contamination rates was observed. Significant improvements were noted for specific surfaces when utilizing the ATP testing method, including benchtops (p = 0.030), mattresses (p = 0.014), doorknobs (p = 0.014), and armchairs (p = 0.014). Furthermore, a decrease in the total count of aerobic bacteria was observed for benchtops (p = 0.014), mattresses (p = 0.014), and doorknobs (p = 0.014). Visual inspection results also indicated enhancements, with approval rates for benchtops, armchairs, and mattresses rising from 0% before the intervention to 37.5% afterward. Conclusion: The findings of this study demonstrate substantial improvements in approval rates following the implementation of the educational intervention. Additionally, this research provides valuable insights for the development of ongoing educational initiatives for the healthcare team, incorporating evaluation and feedback mechanisms as well as updates to cleaning and disinfection protocols.

Effects of Plyometric Training on Running Biomechanics and Jumping Ability of U14 Athletes.

Cardiel-Sánchez, S, Rubio-Peirotén, A, Molina-Molina, A, García-Cebadera Gómez, C, Almenar-Arasanz, A, Ráfales-Perucha, A, Roche-Seruendo, LE, and Cartón-Llorente, A. Effects of plyometric training on running biomechanics and jumping ability of U14 athletes. J Strength Cond Res 38(11): e656-e663, 2024-Children under the age of 14 years (U14) are particularly susceptible to musculoskeletal disorders because of growth spurts. Plyometric training has been shown to be beneficial for both injury reduction and performance enhancement. The aim of this study was to evaluate the effects of plyometric training on the jumping ability and running biomechanics of U14 track-and-field athletes. A single-blind randomized controlled trial was conducted. Thirty-five (18 female and 17 male) U14 athletes (age: 12.5 ± 1.2 years; height: 152.3 ± 7.7 cm; body mass: 47.3 ± 6.9 kg) were randomized into experimental and control groups. All subjects completed their usual training for 4 weeks, and those in the intervention group added a low-volume plyometric program twice a week. Preintervention and postintervention assessments included a countermovement jump (CMJ) to determine maximum jump height, 10-second repeated jumps to assess reactive strength index (RSI), and a 3-minute run at 12 km·h -1 to analyze running kinematics contact time, flight time, step length (SL), step frequency (SF), mean power output, vertical spring stiffness, and leg spring stiffness (LSS). The results revealed no main effect of time for any of the variables. A group-by-time interaction was found for RSI ( p = 0.045) in the intervention group, whereas a significant increase in LSS was also found after the intervention ( p = 0.031). However, no changes in CMJ height or other running parameters were observed. The significance level for the study was set at ρ ≤ 0.05. Plyometric-jump training may improve the stretch-shortening cycle in U14 athletes by increasing RSI and LSS. Athletes and coaches in running-related sports should be aware of these short-term effects when aiming to optimize the energy storage and release mechanism.

Effect of chloramine T and chlorhexidine in reducing gingivitis in patients admitted to a reference hospital for cardiopulmonary care: a randomized, controlled clinical trial.

The aim of this study is to evaluate the effect of Chloramine T in reducing gingivitis in hospitalized patients, in addition to providing an alternative to the use of Chlorhexidine. A randomized, triple-blind, placebo controlled clinical trial was performed with 45 volunteers presenting with gingivitis, using the Löe Gingival Index (LGI). Patients were randomly allocated into one of three groups: (G1): Chloramine T 0.2%; (G2): Chlorhexidine 0.12% and (G3): distilled water. After five days, the control group (G3) remained without relevant differences in relation to the first pre-treatment assessment, while the groups tested with chlorhexidine and chloramine T showed improvement in the LGI (p < 0.05). After ten days, G3 maintained the results of the previous assessments, G1 repeated the five-day assessment and G2 obtained a statistically significant difference, with a better result in relation to the previous assessment (p < 0.05). After fifteen days, G3 showed no differences in relation to the other assessments, G1 had a statistically significant difference, showing better performance in relation to the previous assessment and G2 continued the gradual improvement it had been showing in the LGI (p < 0.05). Chloramine T and Chlorhexidine present similar results in the treatment of gingivitis, when evaluated by probing by the LGI, and Chloramine T can be used effectively, without causing the adverse effects inherent to prolonged use of chlorhexidine. Importance of oral hygiene for patients admitted to hospitals with the use of adjuvant substances that do not present adverse effects such as chlorhexidine, which is considered the gold standard, seeking to provide better clinical protocols.

Therapeutic alliance and suicidal ideation in brief cognitive behavioral therapy for outpatients

ObjectiveThe therapeutic alliance is central to psychotherapy. However, research on the relationship between alliance and suicidality is scarce. We examined whether pretreatment suicidality is associated with an impaired alliance formation in brief cognitive behavioral therapy (CBT) and whether the therapeutic alliance is associated with change in suicidal ideation (difference between pretreatment and posttreatment assessment).MethodsN = 643 outpatients (64% female; age: M[SD] = 37.09[13.15], range: 18–73 years), received 12 sessions of manual-based short-term CBT for primary diagnosis treatment. Using self-report questionnaires, suicidal ideation and behavior were assessed before and after therapy, patient-rated therapeutic alliance was assessed after the fourth session and posttreatment. We performed correlation analyses and two hierarchical linear regressions, unadjusted and adjusted for possible confounding variables (age, gender, lifetime suicide attempts and depression).ResultsPretreatment suicidal ideation was not predictive of the quality of the early alliance. In addition, the therapeutic alliance was not predictive of change in suicidal ideation.ConclusionsIn the outpatient setting, no association was found between therapeutic alliance and suicidality. Future studies should investigate therapeutic alliance as a predictor of prospective suicidal behavior in different clinical settings.

Promotion of breastfeeding in Italian Maternity Hospitals: a pre-intervention study

BackgroundIn Italy, exclusive breastfeeding (EBF) rates at hospital discharge range unsatisfactorily between 20–97%.MethodsIn 2023, the Project for Hospital Policy on Breastfeeding (HPB) has been launched to promote breastfeeding in Italian Maternity Hospitals (MHs) as a joint initiative of the Italian Scientific Societies involved in perinatal care together with the National Midwife (FNOPO) and Nurse (FNOPI) Boards and with Vivere Onlus, a family association. The HBP Project has been designed as an uncontrolled before-after study to increase EBF rate at hospital discharge in the population of healthy, term infant with a normal weight at birth following an intervention bundle comprising: 1) Establishment of a local hospital Working Group; 2) Adoption of a hospital policy; 3) Implementation of breastfeeding monitoring; 4) Training for perinatal care professionals; 5) Enhanced implementation of the practices of skin-to-skin contact (SSC) and mother-baby rooming-in; 6) Development/Improvement of perinatal care protocols.ResultsWe report the pre-intervention assessment of 89 out of the 111 enrolled MHs (80.2%) at the beginning of the Project (Time 1 or T1). Almost all MHs (96.6%) have a multi-professional Breastfeeding Working Group, while a hospital policy on breastfeeding is available only in 48.2%. Moreover, only 56.2% of the 9,777 perinatal health workers have been trained in breastfeeding. Over a 1-month period, SSC has been practiced in the delivery room by 76.9% of 6,304 term healthy newborn infants and rooming-in by 83.4% of 6,735 healthy term newborns of normal weight at birth. Over a 4-month period, 69.1% of 33,367 healthy term newborns of normal birth weight were exclusively breastfed at hospital discharge. Noticeably, EBF rate of MHs ranges from 4% up to 100%, the second quartile being 73%.ConclusionAt T1 of the HPB Project, breastfeeding rates at hospital discharge for healthy, term infants with a normal weight at birth appear to be suboptimal among Italians MHs. Particularly, the range of EBF rates among participating centers is wide, with 50% of the MHs having EBF rate lower than 73%. Therefore, the ongoing HPB Project might represent not only an opportunity to increase the initiation of breastfeeding and to improve quality of health care in the whole study group of MHs, but possibly also to level differences between centers.

A Classroom Intervention of Enhancing Namibian Preservice Science Teachers’ Conceptual Understanding of Properties of Waves Through Mnemonics

This quantitative classroom intervention study investigated the effectiveness of using mnemonics to enhance preservice teachers’ conceptual understanding of the topic of wave properties in physics. The study involved a sample of 30 final-year undergraduate preservice teachers enrolled in the Bachelor of Education Honours, Senior Primary with specializations in Natural Science and Health Education at Dorado Campus of The International University of Management in Namibia. The primary objective was to assess the impact of a targeted mnemonic-based instructional intervention on their ability to comprehend and apply key physics concepts related to wave properties. Initially, participants’ baseline understanding of these concepts was evaluated through pre-intervention assessments, which provided a measure of their existing knowledge. A structured mnemonic-based teaching intervention was then implemented over a specified period, designed to facilitate improved understanding of wave properties. Following the intervention, post-assessment evaluations were conducted to compare and measure changes in the participants’ conceptual understanding of the subject matter. This comparative analysis aimed to identify any significant improvements resulting from the mnemonic-based instruction. The findings indicated that there were notable improvements in the participants’ conceptual grasp of wave properties after the mnemonic-based intervention. Additionally, the study collected and analyzed participants’ feedback regarding the use of mnemonics, offering insights into their perceptions of the technique’s effectiveness as a pedagogical tool for learning complex scientific concepts. This research contributes to the broader field of physics concepts by providing evidence-based strategies to enhance the preparation of preservice teachers, particularly in physics education. Ultimately, the results of this study have the potential to inform and improve teaching practices, fostering more effective and engaging educational experiences in future science classrooms.

AML in the Elderly - When less may be more.

We herein assess the distinct biological and clinical features of AML in older patients. We emphasize the importance of pre-treatment assessment to individualize care but note the changing treatment paradigm from intensive towards non-intensive therapy. Geriatric assessments and genetic data provide predictive information that guides treatment. During the past decade the FDA approved at least nine new targeted therapies, mostly small molecule inhibitors, in AML patients of all ages. These agents have created novel therapeutic options for this poorly chemo tolerant population whose AML tends to be intrinsically resistant to such therapy. Older AML patients may now be treated with less toxic therapy that provides similar, if not superior, efficacy compared with conventional chemotherapy. Although TP53 mutant AML remains a particular unmet need, additional novel agents on the horizon provide hope for improving outcomes for older adults with AML.

Abbreviated fixed-interval interventions promote self-control in rats

Impulsive choice, defined as choices of a smaller-sooner reward over a larger-later reward, can be reduced by time-based interventions that expose rats to delayed rewards. These interventions improve temporal processing concurrent with reducing impulsive choice. Exposure to delayed reinforcement has produced improvements in self-control after 30 sessions of intervention exposure (Renda et al., 2021). Experiment 1 of the present study used a pre-/post-test design to investigate a range of intervention exposures (6, 15, 30, and 45 sessions), including shorter exposures that have not previously been examined. Peak-interval timing was also assessed to determine whether different intervention exposures would improve temporal processing. All intervention exposures, including the abbreviated intervention, reduced impulsive choice, and improved temporal processing. Experiment 2 showed that the 6-session intervention improved self-control relative to a no-delay control, further strengthening the proposal that an abbreviated intervention may be sufficient to reduce impulsive choice. Moreover, improvements in peak-interval timing were observed in groups receiving a pre-intervention impulsive choice assessment, suggesting that exposure to the impulsive choice task may improve temporal processing.

Otolaryngology Simulation Curriculum Development and Evaluation for Medical Education in Rwanda.

This study aimed to assess the feasibility and acceptability of a new low-cost otolaryngology simulation training curriculum for medical students in Rwanda. Given the limited access to hands-on training and equipment in low-middle-income countries, building confidence in performing basic otolaryngology skills is vital for all medical students, especially where all graduates initially serve in primary care before specializing. Preintervention and postintervention assessments of simulation training. Conducted at the University of Global Health Equity in Rwanda. The simulation program comprised 3 primary components: (1) a low-cost, moderate-fidelity model for cricothyrotomy and tracheostomy practice, (2) a low-cost, low-fidelity ear model for foreign body and cerumen removal, and a high-fidelity manikin for practicing, (3) epistaxis management, and (4) nasal foreign body removal. Students underwent pretest and posttest assessments measuring their knowledge, experience, perceived skill, and confidence in performing these procedures. A survey collected feedback on the program. A total of 29 medical students participated in the simulation program, integrated into a 1-week otolaryngology "boot camp" preceding a 3-week clerkship rotation. All models were created using basic, locally available materials, at a total cost of $1.02 for cricothyrotomy and $0.20 for foreign body models. Knowledge and perceived confidence increased for all 3 simulations. All students found the simulations useful, enjoyable, and anticipated using these skills in future training. The study's results demonstrated that the low-cost otolaryngology simulation was well-received and enhanced knowledge, interest, and confidence in performing basic otolaryngology skills across all simulations.

Developing a GeoGebra-Based Teaching Module on Quadrilateral Area and Perimeter to Enhance Seventh-Grade Students' Critical Thinking Skills

Objective: Seventh-grade students often need help to grasp the concepts of area and perimeter, particularly when applied to real-world problems requiring critical thinking. This difficulty highlights a need for engaging and effective teaching resources beyond traditional methods. Method: This study employed a Research and Development (R&amp;D) approach using the ADDIE model to design, develop, and evaluate a GeoGebra-based teaching module explicitly targeting the area and perimeter of quadrilaterals. The module, designed to foster critical thinking, underwent rigorous validation by media and material experts before being tested for practicality and effectiveness with seventh-grade students. Result: The GeoGebra-based teaching module was valid and practical, receiving high scores from expert evaluations and user feedback. More importantly, the module's implementation positively impacted students' critical thinking skills related to area and perimeter, as evidenced by significant improvement between their pre-intervention and post-intervention assessments. Novelty: This study provides valuable evidence for the efficacy of GeoGebra-based teaching modules in significantly improving critical thinking skills within a specific mathematical context. It addresses a critical gap in existing educational resources by offering a validated, practical, and effective tool that can be adapted to elevate mathematical understanding and cognitive skills in middle school education

Psychological Improvement of People with Substance Addiction through a Self-Esteem Workshop

Addictions undermine the quality of life of individuals and their families. They generally lead to misadjustment that affects many areas (psychological, family, social, and occupational) and, in the most severe cases, can end in helplessness, loneliness, or early death. The self-esteem of the person with addictions tends to be reduced and this limits their chances of recovery. Through this research, we tried to test the effect of a self-esteem workshop on 58 people with addictions to different substances. A self-esteem workshop was carried out with people who were part of a therapeutic community belonging to the province of Pontevedra (Spain). Several working groups were established and received sessions over a period of two and a half months. Participation was voluntary and the anonymity and confidentiality of the participants were guaranteed. To assess self-esteem, the Coopersmith Self-Esteem Scale Short Form, or Form B, was used at the beginning and at the end of the workshop. The results confirm the existence of statistically significant differences in the Self-Esteem Scale in relation to the pre-treatment and post-treatment assessments: F(1) = 106.44, p = 0.000, η2 = 0.655. The self-esteem workshop resulted in a significant change in this construct and contributed to the psychological improvement of people with addictions.

Repeated prefrontal tDCS for improving mental health and cognitive deficits in multiple sclerosis: a randomized, double-blind, parallel-group study

BackgroundMultiple Sclerosis (MS) is an autoimmune disease associated with physical disability, psychological impairment, and cognitive dysfunctions. Consequently, the disease burden is substantial, and treatment choices are limited. In this randomized, double-blind study, we conducted repeated prefrontal electrical stimulation in 40 patients with MS to evaluate mental health variables (quality of life, sleep difficulties, psychological distress) and cognitive dysfunctions (psychomotor speed, working memory, attention/vigilance), marking it as the third largest sample size tDCS research conducted in MS to date.MethodsThe patients were randomly assigned (block randomization method) to two groups of sham (n = 20), or 1.5-mA (n = 20) transcranial direct current stimulation (tDCS) targeting the left dorsolateral prefrontal cortex (F3) and right frontopolar cortex (Fp2) with anodal and cathodal stimulation respectively (electrode size: 25 cm2). The treatment included 10 sessions of 20 min of stimulation delivered every other day. Outcome measures were MS quality of life, sleep quality, psychological distress, and performance on a neuropsychological test battery dedicated to cognitive dysfunctions in MS (psychomotor speed, working memory, and attention). All outcome measures were evaluated at the pre-intervention and post-intervention assessments. Both patients and technicians delivering the stimulation were unaware of the type of stimulation being used.ResultsRepeated prefrontal real tDCS significantly improved quality of life and reduced sleep difficulties and psychological distress compared to the sham group. It, furthermore, improved psychomotor speed, attention, and vigilance compared to the sham protocol. Improvement in mental health outcome variables and cognitive outperformance were interrelated and could predict each other.ConclusionsRepeated prefrontal and frontopolar tDCS ameliorates secondary clinical symptoms related to mental health and results in beneficial cognitive effects in patients with MS. These results support applying prefrontal tDCS in larger trials for improving mental health and cognitive dysfunctions in MS.Trial registrationClinicalTrials.gov Identifier: NCT06401928.

The Live Well intervention: Promoting healthy lifestyles during routine older people's mental healthcare.

Lifestyle is an important determinant of health. The Live Well intervention allows mental health clinicians to address lifestyle during routine mental health encounters. Clinicians were taught how to encourage consumers to learn more about lifestyle and health; consider their own lifestyle and health using a self-rated health and wellness questionnaire (HAWQ) and helped them decide which out of six health domains (physical, mental and social activity, healthy eating, mental wellbeing and positive thinking) should be improved in small, sustainable steps using a SMART (specific, measurable, achievable, relevant and timed) goal-setting template. Out of 65 enrolled consumers, 52 completed pre-intervention, 6-week and 12-week post-assessment assessments. There were improvements in all self-rated health domains except for heathy eating. At 12-week, consumers also recorded significant satisfaction with the Live Well program, goal achievement and wellbeing. Clinicians' feedback was positive about using this intervention with their consumers. Live Well is a feasible and effective way to engage consumers on positive lifestyle changes in routine mental health care encounters.

Ocular Complication in Facial Aesthetic Laser and Light Treatments: A Comprehensive Review.

The increasing popularity of laser- and light-based esthetic treatments for facial rejuvenation has raised concerns regarding ocular safety. Although these procedures are generally considered safe and effective, there is a growing body of evidence highlighting the potential for ocular complications. This review aims to systematically analyze the types and mechanisms of ocular injuries associated with such treatments, as well as to evaluate preventive measures and management strategies. A comprehensive literature search was conducted using databases including MEDLINE, PubMed and Ovid for relevant studies published on clinical trials, diagnosis and treatment. Some papers were further reviewed using a double-blinding approach, varying sample sizes, control usage, randomization usage and objective endpoint measurements. All studies were classified according to the Oxford Centre for evidence-based medicine evidence hierarchy. Our review identified several types of ocular complications associated with facial laser or light treatments, including but not limited to conjunctival burns, corneal damage, retinal phototoxicity, and transient vision disturbances. The incidence of these complications varies significantly depending on the type of laser or light source employed, treatment parameters, and the anatomical proximity of the eyes to the treatment area. Factors such as inadequate protective measures, patient movement during the procedure, and the operator's experience were found to contribute to the risk of ocular injury. Strategies such as the use of appropriate eye protection, careful patient positioning, and thorough pre-treatment assessments were highlighted as essential preventive measures. Ocular complications, though rare, represent a significant risk in facial esthetic laser and light treatments. This review underscores the importance of awareness among practitioners regarding the potential ocular hazards and the implementation of robust safety protocols. Future research is needed to establish standardized guidelines to minimize risks and enhance patient safety in esthetic dermatological practices. Continued education and improved protective strategies will be essential in safeguarding ocular health as the field of esthetic treatments continues to evolve. This comprehensive review serves as an essential resource for practitioners, informing them of ocular risks, management options, and the need for vigilance to mitigate complications in clinical practice.

Effects of a career education classroom course on high school students' career management competencies and career orientation in Hungary

AbstractSeveral researchers have highlighted the need to strengthen school-based career education in Hungary. After reviewing the international literature on similar programs, this study reports on the impact of an innovative, multi-method career education course. It aimed to support Hungarian high school (ISCED 344) students in grades 10–11 in making decisions on further education and career choices, and in dealing with related uncertainties and difficulties, mainly through developing career management competence. Using a quasi-experimental design, the intervention group of 92 students showed significantly better results on half of the 20 career orientation variables assessed six months after the end of the intervention of 12 three-quarter-hour sessions, with low effect sizes compared to the pre-intervention assessment, and the 96-student control group. In addition to a self-developed questionnaire, the CDDQ Career Decision-Making Difficulties Questionnaire; and the CFI Career Factors Inventory were used. The effectiveness of the intervention was independent of factors such as gender, age, academic performance, and parental education. The study concludes with the suggestion that an enhanced version of the course could be an officially recommended supplementary career education program in Hungarian high schools.

Liver-related aspects of valoctocogene roxaparvovec gene therapy for hemophilia A: expert guidance for clinical practice

AbstractAdeno-associated virus–based gene therapy (valoctocogene roxaparvovec) is an attractive treatment for hemophilia A. Careful clinical management is required to minimize the risk of hepatotoxicity, including assessment of baseline liver condition to determine treatment eligibility and monitoring liver function after gene therapy. This article describes recommendations (developed by a group of hemophilia experts) on hepatic function monitoring before and after gene therapy. To prevent harmful liver-related effects, gene therapy is contraindicated in patients with uncontrolled liver infections, autoimmune hepatitis, liver stiffness ≥8 kPa, or cirrhosis. Before using gene therapy in patients with liver steatosis or other liver disorders, the risk of liver damage should be considered using a highly individualized approach. Treatment is not recommended in patients with abnormal liver enzymes, including alanine aminotransferase (ALT) at any level above the upper limit of normal (ULN). Therefore, pretreatment assessment of liver health should include laboratory tests, abdominal ultrasound, and liver stiffness measurements by transient elastography (TE). In the first year after therapy, ALT levels should be monitored 1 to 2 times per week to detect elevations ≥1.5× ULN, which may require immunosuppressant therapy. Patients with ALT elevation should receive prednisone 60 mg/d for 2 weeks, followed by stepwise tapering when ALT returns to baseline. ALT monitoring should continue long term (every 3-6 months), along with abdominal ultrasound (every 6 months) and TE (yearly) evaluations. When patients with good liver health are selected for treatment and closely monitored thereafter, ALT elevations can be promptly treated and are expected to resolve without long-term hepatic sequelae.