Pretreatment Scores Research Articles

Down-Regulation of Tinnitus Negative Valence via Concurrent HD-tDCS and PEI Technique: A Pilot Study.

Around 30% of the general population experience subjective tinnitus, characterized by conscious attended awareness perception of sound without an external source. Clinical distress tinnitus is more than just experiencing a phantom sound, as it can be highly disruptive and debilitating, leading those affected to seek clinical help. Effective tinnitus treatments are crucial for psychological well-being, but our limited understanding of the underlying neural mechanisms and a lack of a universal cure necessitate further treatment development. In light of the neurofunctional tinnitus model predictions and transcranial electrical stimulation, we conducted an open-label, single-arm, pilot study that utilized high-definition transcranial direct current stimulation (HD-tDCS) concurrent with positive emotion induction (PEI) techniques for ten consecutive sessions to down-regulate tinnitus negative valence in patients with clinical distress tinnitus. We acquired resting-state functional magnetic resonance imaging scans of 12 tinnitus patients (7 females, mean age = 51.25 ± 12.90 years) before and after the intervention to examine resting-state functional connectivity (rsFC) alterations in specific seed regions. The results showed reduced rsFC at post-intervention between the attention and emotion processing regions as follows: (1) bilateral amygdala and left superior parietal lobule (SPL), (2) left amygdala and right SPL, (3) bilateral dorsolateral prefrontal cortex (dlPFC) and bilateral pregenual anterior cingulate cortex (pgACC), and (4) left dlPFC and bilateral pgACC (FWE corrected p < 0.05). Furthermore, the post-intervention tinnitus handicap inventory scores were significantly lower than the pre-intervention scores (p < 0.05). We concluded that concurrent HD-tDCS and PEI might be effective in reducing tinnitus negative valence, thus alleviating tinnitus distress.

307 Reducing Moral Distress in Burn/trauma Intensive Care Unit Nurses

Abstract Introduction There is minimal research regarding moral distress in Burn/Trauma intensive care unit (ICU) nurses compared to other nursing specialties. However, there is evidence that indicates there are high levels of moral distress in this nursing population which increases the risk for psychological or physical distress, burnout, and high nursing turnover. Identifying and utilizing an effective intervention, such as nursing huddles with clinical ethicists, can help reduce the impact of moral distress in this nursing population. Methods An evidenced-based practice project using the IOWA Model was conducted over a six week period on a ten bed Burn/Trauma ICU. Convenience sampling was utilized to capture a total of 24 registered nurses (RN) in the initial survey period. Each of the nurses (n=24) completed the Moral Distress Thermometer (MDT) and the Measure of Moral Distress for Healthcare Providers (MMD-HP) prior to signing up for a nursing huddle with the clinical ethicists. There were five nursing huddles conducted with clinical ethicists on Microsoft Teams over the span of four weeks. Each nurse that participated was required to complete the pre-intervention surveys prior to participating in the nursing huddles and also complete the post MDT evaluation. The MDT pre and post-intervention scores were compared to evaluate the impact of nursing huddles with clinical ethicists on moral distress among RNs working in a Burn/Trauma ICU. Results Out of the 24 RNs, 62.5% (n=15) completed the pre-intervention surveys, nursing huddles, and post-intervention surveys. A comparison of the pre-intervention and post-intervention MDT scores showed approximately a 44% decrease in acute moral distress in the Burn/Trauma ICU nurses. In addition, the MMD-HP identified 10 consistent triggers of moral distress in all 24 RNs during the initial survey period. Some reoccurring themes included futile care, false hope, and unnecessary care with benefit to the patient. Conclusions Nursing huddles with clinical ethicists considerably reduced the impact of the moral distress identified in Burn/Trauma ICU nurses. These findings support the need for continuous evaluation of moral distress and implementation of interventions to reduce moral distress in this nursing specialty. Applicability of Research to Practice Identifying and mitigating moral distress in the Burn/Trauma ICU nurse population is absolutely necessary. The unique ethical dilemmas that arise on a daily basis requires continuous monitoring and implementation of varying interventions to support the nurses and reduce the level of moral distress they may be experiencing. Moral distress does not dissipate on its own. Moral distress needs to be addressed and recognized as a serious and prevalent issue in this nursing population.

Short and long-term effectiveness of external shock wave therapy for chronic pelvic pain syndrome in men

ABSTRACT Introduction Chronic pelvic pain syndrome (CPPS) is a frequent urological diagnosis that affects men’s quality of life. Extracorporeal shockwave therapy (ESWT) is a recent treatment option for patients with CPPS. We evaluated ESWT’s short and long – term efficacy in managing CPPS. Methods This prospective self-controlled study included 75 patients diagnosed with CPPS at our tertiary pelvic pain clinic between January 2017-June 2019. Patients were referred for ESWT and received four sessions one week apart. The National Institute for Health – Chronic Prostatitis Symptom Index (NIH – CPSI) questionnaire was used to assess patients’ symptom severity before starting therapy and at 0, 12 and 26 weeks after completing ESWT. Demographics, clinical data and complications were also recorded. Results Patients’ mean age was 37.9 ± 8.6 years, and mean duration of symptoms was 5 ± 4.5 years. Compared to pre-treatment scores, all patients exhibited improvements across all NIH – CPSI domains directly after completing ESWT (week 0 post-treatment), with a mean difference improvement of 9.26 ± 5.7, 5.2 ± 3.4, 1.19 ± 2.18 and 2.88 ± 2.46 points in the total, pain, urinary symptoms, and quality-of-life scores respectively. At 12 weeks after completing ESWT, 80.9% of patients reported improvements, with mean difference improvement of 8.07 ± 7.56, 4.55 ± 4.6, 0.76 ± 2.48, 2.85 ± 2.78 in the total, pain, urinary symptoms, and quality-of-life scores respectively. Again, none of the patients developed any treatment-related complications. At 26 weeks after completing ESWT, 82.4% of patients reported improvements, with mean difference improvement of 8.29 ± 7.7%, 4.92 ± 4.69, 0.75 ± 2.96, 2.5 ± 3.0 in total, pain, urinary symptoms, and quality-of-life scores respectively. None of the patients developed treatment-related complications. Conclusions ESWT is a safe and effective treatment modality for patients with CPPS, with short-term improvement in total, pain, urinary symptom, and quality-of-life scores; and long-term improvement in total, pain, and quality-of-life scores.

Evaluation of the Effectiveness of a Structured Educational Program on Improving the Knowledge of COVID-19 Among the Vaccine-Reluctant Population in a Block of Jharkhand, India.

Background Low vaccination uptake is a major public health concern and is more prevalent in rural areas. Educational interventions have been proposed as an effective strategy to increase vaccine acceptance. The objective of this study was to assess the impact of an educational program on acquiring knowledge for promoting vaccination uptake among a sample of participants. Methodology This study was conducted in a rural area in the state of Jharkhand, India. The study period was from July 2022 to September 2022. The area was surveyed for COVID-19 vaccination and a total of 510 people did not take any dose or took only the first dose and then skipped the second dose. An educational program was designed in the local language. The knowledge of the sample was assessed before and after a week of intervention with a surveyor-administered questionnaire. The vaccination status before and after the intervention was also recorded. We used the chi-square test, Fisher's exact test, and binomial test for comparing the categorical variables. Results A total of 178 participants' data were analyzed. The majority of the participants were in the age group of 18-25 years. The pre-intervention score regarding the knowledge of COVID-19 and vaccination was 18.93 ± 5.10 which significantly increased after the intervention to 25.06 ± 4.35 (p <0.0001). The number of individuals receiving vaccination significantly increased. Before the program, 95 participants did not take the vaccine and 83 received the first dose and did not take the second dose. After the program, 17 participants did not take the vaccine, 161 completed the first dose, and 112 completed the second dose (p <0.0001). Conclusions The educational program was successful in improving knowledge and awareness about vaccination, leading to an increase in the number of individuals receiving vaccination. These findings suggest the importance of educational interventions in the local language in promoting vaccination uptake and can be used to design effective public health campaigns to increase vaccine acceptance.

Pediatric-Onset Chronic Inflammatory Demyelinating Polyneuropathy: A Multicenter Study

BackgroundTo evaluate the clinical features, demographic features, and treatment modalities of pediatric-onset chronic inflammatory demyelinating polyneuropathy (CIDP) in Turkey. MethodsThe clinical data of patients between January 2010 and December 2021 were reviewed retrospectively. The patients were evaluated according to the Joint Task Force of the European Federation of Neurological Societies and the Peripheral Nerve Society Guideline on the management of CIDP (2021). In addition, patients with typical CIDP were divided into two groups according to the first-line treatment modalities (group 1: IVIg only, group 2: IVIg + steroid). The patients were further divided into two separate groups based on their magnetic resonance imaging (MRI) characteristics. ResultsA total of 43 patients, 22 (51.2%) males and 21 (48.8%) females, were included in the study. There was a significant difference between pretreatment and post-treatment modified Rankin scale (mRS) scores (P < 0.05) of all patients. First-line treatments include intravenous immunoglobulin (IVIg) (n = 19, 44.2%), IVIg + steroids (n = 20, 46.5%), steroids (n = 1, 2.3%), IVIg + steroids + plasmapheresis (n = 1, 2.3%), and IVIg + plasmapheresis (n = 1, 2.3%). Alternative agent therapy consisted of azathioprine (n = 5), rituximab (n = 1), and azathioprine + mycophenolate mofetil + methotrexate (n = 1). There was no difference between the pretreatment and post-treatment mRS scores of groups 1 and 2 (P > 0.05); however, a significant decrease was found in the mRS scores of both groups with treatment (P < 0.05). The patients with abnormal MRI had significantly higher pretreatment mRS scores compared with the group with normal MRI (P < 0.05). ConclusionsThis multicenter study demonstrated that first-line immunotherapy modalities (IVIg vs IVIg + steroids) had equal efficacy for the treatment of patients with CIDP. We also determined that MRI features might be associated with profound clinical features, but did not affect treatment response.

Transforaminal Epidural Steroid Injection for Patients with Lumbosacral Disc Herniation in the Absence of Spine Magnetic Resonance Imaging - Is Better Really the Enemy of the Best?

This study aimed to evaluate the effect of transforaminal epidural steroid injection (TFESI) in patients with lumbosacral disc herniation by comparing its effect between those diagnosed by clinical evaluation and plain radiography only (X-ray group) and those by additional magnetic resonance imaging (MRI) (MRI group). Additionally, we investigated the accuracy of the preliminary clinical assumption in the X-ray group using confirmative post-injection MRI. We retrospectively recruited 367 patients with back and radicular pain due to lumbosacral disc herniation from a single pain clinic. Among them, 201 and 166 patients were categorized into the X-ray and MRI groups, respectively. In the X-ray group, the pathological level assumed initially by clinical evaluation and plain radiography concurred with that confirmed later on post-injection MRI in 139 patients (corresponding group); the remaining 62 patients lacked this concurrence (non-corresponding group). The NRS scores and Macnab criteria results were compared between the X-ray and MRI groups as well as the corresponding and non-corresponding groups. Both the X-ray and MRI groups showed significant reductions in the NRS scores at 2 and 10 weeks post-injection when compared with the pretreatment scores. However, no significant difference was noted between the groups in terms of the magnitude of clinical improvement assessed by successful reduction in the NRS or Macnab scores. Furthermore, similar results were obtained in the comparison between the corresponding and non-corresponding groups of the X-ray group. TFESI guarantees favorable clinical outcomes even in the absence of confirmative MRI in patients with back and radicular pain. The preemptive application of this procedure could be prioritized and justified in patients suspected of lumbosacral disc herniation based on clinical evaluation and plain radiography only without the preceding MRI verification.

A QUASI EXPERIMENTAL STUDY TO ASSESS THE EFFECTIVENESS OF AWARENESS PROGRAM ON SELFIE OBSESSION AMONG ACADEMIC STUDENTS IN SELECTED COLLEGES, HOSHIARPUR, PUNJAB

Sele obsession disorder or seltis is a strange urge to keep snapping pictures of oneself and sharing it on social media. Studies indicate that persons obsessed with sele-taking may have an underlying mental health disorder and need to seek help. A quasi experimental non – equivalent control group design was used. 70 academic students were selected with non- probability purposive sampling technique i.e. 35 in experimental group and 35 in control group. Seltis behavior scale (SBS) was used to assess the level of sele obsession. Collected data was analysed by calculating frequency, percentage, mean, standard deviation, chi-square, t-test and f-test. The results showed that the difference between pre interventional and post interventional mean scores in experimental group was tested by “t” test and found statistically signicant (3.29) at p &lt;0.01 level of signicance as compared to control group (0.49) found statistically non-signicant at p &lt;0.05 level of signicance. Hence it has been concluded that the awareness program is effective in enhancing the knowledge regarding sele obsession among academic students

“A STUDY TO ASSESS THE EFFECTIVENESS OF YOGA THERAPY AMONG ANTENATAL WOMEN WITH PREGNANCY INDUCED HYPERTENSION ATTENDING AT ANTENATAL CLINIC IN SELECTED HOSPITAL IN DEHRADUN, UTTARAKHAND.”

Background: The rate of maternal morbidity due to hypertensive disorder even with highly improved maternity service is high. In India there is high prevalence of pregnancy induced hypertension but the hospital services for the patient is less. The use of antihypertensive drugs for treatment of the pregnancy induced hypertension has its side effect like intrauterine growth retardation. So, if the pregnancy induced hypertension is treated with the use of non-pharmacological measure like yoga therapy it will be improve the health of the mother and the baby, it will also reduce the complications which occurs due to pregnancy induced hypertension and will help to improve the pregnancy outcome Method and Material: A total of 60 antenatal women attending antenatal clinic in Govt. Doon Medical college and hospital were included in this study by using purposive sampling technique. A self-structured interview was used to check the level of pregnancy induced hypertension in the antenatal women. Results: Finding related to effectiveness of yoga therapy on pregnancy induced hypertension among antenatal Mothers-Study showed that post-test mean for pregnancy induced hypertension among antenatal mothers is signicantly lower than pre-test mean score with the difference of 5.59. The p value of statistical “t” test for pregnancy induced hypertension is found to be p=&lt;0.001 which is less than 0.05. Findings related to Comparison between experimental and control group pre and post intervention mean score of level of pregnancy induced hypertension among antenatal women (N=60)-Study showed reveals that post-test mean for pregnancy induced hypertension among antenatal women in experimental group is signicantly lower than post-test mean score of control group. The p value of statistical unpaired “t” test for pregnancy induced hypertension is found to be p=&lt;0.001 which is less than 0.05. Findings related to Association between pre-interventional pregnancy induced hypertension with their socio demographic variable (N=60)-There was statistically signicant association between level of pregnancy induced hypertension and age, gravida and education. The obtained p value of these variables is less than 0.05. Conclusion: The main conclusion drawn from this study that yoga therapy is effective in reducing the level of pregnancy induced hypertension that denoted by signicant difference between the pre-intervention and post intervention score of PIH among antenatal women in experimental group. Subjects became aware and found themselves comfortable and also expressed their satisfaction. Aim of the study: Aim of this study was to evaluate the effectiveness of yoga therapy among antenatal women with pregnancy induced hypertension attending at antenatal clinic in selected Hospital in Dehradun, Uttarakhand. Objectives: Ÿ To assess the pre-and post-intervention level of blood pressure among the antenatal women experimental and control group. Ÿ To evaluate the effectiveness of Yoga therapy on pregnancy induced hypertension among antenatal women (experimental group) attending antenatal clinic. Ÿ To nd out association between pre-interventional pregnancy induced hypertension among antenatal women in experimental and control group with their selected demographical variable. Ÿ To compare the post-intervention level of pregnancy induced hypertension among antenatal women in experimental and control group

Effect of Warm Water Foot Bath on Post Dialysis Fatigue in patients on Maintenance Hemodialysis

Aim: To evaluate the effectiveness of warm water foot bath therapy on post dialysis fatigue. Method: A Quasi experimental single group (pre and post-test) design was conducted in Nawaz Sharif Kidney Hospital, Swat. Single time intervention was provided to sixty (60) participants recruited through consecutive sampling technique. Demographic data were collected through self-structured interview and fatigue level was measured using Piper’s Fatigue Scale before and after foot bath therapy. The data were interred and analyzed through SPSS. Paired t-test was used to find out differences in mean while chi-square test was applied for association of fatigue score on the basis demography. To evaluate the effectiveness of the intervention paired t-test was calculated. Results: Cumulative pre-intervention fatigue score was 47.33±12.8 and post intervention cumulative fatigue score was 29.9±9.8. Mean of Pre-fatigue score of different groups made on the basis of demographic characteristics were not statistically different. Pre intervention individual mean fatigue sore was 5.25±142 while the post intervention was 3.33±1.09. A significant difference (P valve 0.000) was found between pre and post intervention individual mean fatigue score. Conclusion: Result of the study suggested that warm water foot bath therapy had therapeutic effects in decreasing post dialysis fatigue. It provides relief and promotes comfort level of the patients. Keywords: Nurses, hemodialysis, Fatigue, warm water foot bath

Schlafbezogene Metakognitionen und kognitive Verhaltenstherapie für Insomnie

Abstract Background Cognitive behavioral therapy for insomnia (CBT-I) is the treatment of choice for chronic insomnia. In the metacognitive model of Ong et al., a current model of the pathogenesis of chronic insomnia, sleep-related metacognitions are considered to be an insomnia-promoting factor. Objective The objective of this study is to investigate the role of metacognitions in insomnia and CBT‑I. Are metacognitions reduced by CBT-I? Can the pretreatment scores of sleep-related metacognitions predict the effectiveness of the therapy? Does treatment response improve when sleep-related metacognitions are directly addressed? Materials and methods A total of 92 persons with chronic insomnia participated in CBT‑I with seven 90-min group sessions. Of these patients, 52 received CBT‑I and 40 received CBT‑I with integrated metacognitive elements (CBT-I + MCE). Sleep-related metacognitions and insomniac complaints were quantified using the Metacognitions Questionnaire—Insomnia (MCQ‑I 20) and the Insomnia Severity Index (ISI). Results CBT‑I improved subjective sleep quality (effect sizes d &gt; 2.0) and decreased sleep-related metacognitions (effect sizes d &gt; 0.8). Neither the presence of comorbidities nor the extent of sleep-related metacognitions affected treatment response. Treatment response did not differ between the CBT‑I and CBT-I + MCE groups. Conclusion Sleep-related metacognitions seem to play an important role in insomnia etiology but did not predict treatment response. The introduction of elements from metacognitive therapy (MCT) is as effective as the classical CBT‑I and might therefore be considered as an addition to the standard cognitive strategies of CBT‑I.

Assessing the Efficacy of the 3R (Reframe, Reprioritize, and Reform) Communication Model to Increase HPV Vaccinations Acceptance in Ghana: Community-Based Intervention.

The study examined whether the 3R (reframe, prioritize, and reform) communication model intervention can impact parents' and adolescents' HPV vaccination acceptability. We used face-to-face methods to recruit participants from three local churches in the Ashanti Region of Ghana. Participants completed pre- and post-intervention assessments based on the validated Theory of Planned Behavior survey. We organized two face-to-face presentations for parents and adolescents separately for parents (n = 85) and adolescents (n = 85). Participants' post-intervention vs. pre-intervention scores for attitude (mean = 35.46 ± SD = 5.46 vs. mean = 23.42 ± SD = 8.63), knowledge (M = 28.48 ± SD = 5.14 vs. M = 16.56 ± SD = 7.19), confidence (M = 8.96 ± SD = 3.43 vs. M = 6.17 ± SD = 2.84), and intention for vaccine acceptance (M = 4.73 ± SD = 1.78 vs. M = 3.29 ± SD = 1.87) increased significantly (p < 0.001). The intervention showed that for every one-unit increase in the participants' self-confidence and attitude scores, the odds of the HPV vaccination acceptability increased by 22% (95% CI: 10-36) and 6% (95% CI: 0.1-12), respectively. Intention for vaccine acceptance, F (1167) = 6.89, and attitude toward vaccination, F (1167) = 19.87, were significantly higher among parents than adolescents (p < 0.001), after controlling for the baseline scores. These findings suggest that the intervention targeting parents' and adolescents' attitudes and knowledge has the potential to increase HPV vaccination acceptance in Ghana.

Impact of Pretreatment Systemic Inflammatory Markers on Treatment Persistence with Biologics and Conventional Systemic Therapy: A Retrospective Study of Patients with Psoriasis Vulgaris and Psoriatic Arthritis.

Systemic inflammation plays a central role in the pathophysiology of psoriasis. This study examined accessible systemic inflammatory markers in patients with psoriasis vulgaris and psoriatic arthritis. We aimed to evaluate their association with psoriasis severity, the presence of arthritis, and drug continuation rates. The findings revealed that neutrophil, monocyte, and platelet count, neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio, systemic inflammation response index, systemic immune/inflammation index (SII), and CRP were positively correlated with Psoriasis Area and Severity Index scores. Patients presenting with higher platelet/lymphocyte ratio (PLR) or CRP values were more likely to be diagnosed with psoriatic arthritis than with psoriasis vulgaris in the multivariate regression analysis. Importantly, patients with higher pretreatment neutrophil or platelet count, PLR, and SII were associated with lower treatment continuation rates of conventional systemic agents. Higher pretreatment scores of systemic inflammatory markers did not affect treatment retention rates of biologics. These findings suggest that several accessible systemic inflammatory markers may effectively assess underlying systemic inflammation and may provide an indication for a therapeutic approach in patients with psoriasis vulgaris and psoriatic arthritis.

Patient-Reported Outcome Measures for Use in Women With Pelvic Organ Prolapse: A Systematic Review.

To describe the psychometric properties of existing patient-reported outcome measures for women with prolapse using the COSMIN (Consensus-Based Standards for the Selection of Health Measurement Instruments) framework. Additional objectives were to describe the patient-reported outcome scoring method or interpretation, methods of administration, and to compile a list of the non-English languages in which the patient-reported outcomes are reportedly validated. PubMed and EMBASE was searched through September 2021. Study characteristics, patient-reported outcome details, and psychometric testing data were extracted. Methodologic quality was assessed with COSMIN guidelines. Studies reporting the validation of a patient-reported outcome in women with prolapse (or women with pelvic floor disorders that included a prolapse assessment) and reporting psychometric testing data on English-language patient-reported outcome for at least one measurement property per COSMIN and the U.S. Department of Health and Human Services definitions were included, as well as studies reporting the translation of an existing patient-reported outcome into another language, a new method of patient-reported outcome administration, or a scoring interpretation. Studies reporting only pretreatment and posttreatment scores, only content or face validity, or only findings for nonprolapse domains of the patient-reported outcome were excluded. Fifty-four studies covering 32 patient-reported outcomes were included; 106 studies assessing translation into a non-English language were excluded from the formal review. The number of validation studies per patient-reported outcome (one version of one questionnaire) ranged from 1 to 11. Reliability was the most reported measurement property, and most measurement properties received an average rating of sufficient. The condition-specific patient-reported outcomes had on average more studies and reported data across more measurement properties compared with adapted and generic patient-reported outcomes. Although measurement property data vary on patient-reported outcomes for women with prolapse, most data were of good quality. Overall, condition-specific patient-reported outcomes had more studies and reported data across more measurement properties. PROSPERO, CRD42021278796.

The Effect of Daily Meditative Practices Based on Mindfulness and Self-Compassion on Emotional Distress under Stressful Conditions: A Randomized Controlled Trial

Intervention programs based on self-compassion have demonstrated their efficacy both in reducing psychological distress and increasing well-being. The goal of this study was to test the efficacy of an online intervention to increase mindfulness and self-compassion levels in a non-clinical sample in a highly stressful context: the ten weeks of lockdown imposed in the early stages of the COVID-19 pandemic. The intervention sessions consisted of thirty-minute guided meditations followed by thirty minutes of inquiry. Sixty-one participants completed two thirds of the sessions or more, and 65 individuals participated in a waiting-list (WL) control group. Self-compassion, anxiety, depression and stress levels were assessed. The analysis of pre-post results suggests that the interventions increased self-compassion levels and decreased anxiety, depression and stress levels, whereas the WL group did not show any significant changes. The emotional changes in the intervention group were associated with the increase in self-compassion. However, at follow-up, the scores of emotional distress variables returned to the initial pre-intervention scores. These data can be interpreted in line with previous results that have shown the efficacy of self-compassion-based intervention programs. Given that this efficacy was not maintained at follow-up, data are discussed according to the pervasive role of a highly stressful context and-as described in other studies-the need for regular practice to maintain the benefits obtained.

Examining the Feasibility of Telehealth Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) with Young People in Foster Care.

Purpose: Despite the high rate of trauma exposure among young people with child welfare involvement, various systematic and patient barriers exist that inhibit utilization of evidence-based trauma treatments. One strategy for alleviating barriers to such treatments is using telehealth. A few studies have found that the clinical outcomes of telehealth TF-CBT are comparable to those found from clinic-based, in-person treatment administration. Studies have yet to examine the feasibility of telehealth TF-CBT with young people in care. The current study sought to address this gap by examining outcomes for patients who received telehealth TF-CBT, along with factors that may have impacted successful completion, at an integrated primary care clinic exclusively serving young people in care. Methods: Patient data were collected retrospectively from the electronic health records of 46 patients who received telehealth TF-CBT between March 2020 and April 2021, and feedback was sought via focus group from 7 of the clinic's mental health providers. A paired-sample t-test was conducted to evaluate the impact of the intervention for the 14 patients who completed treatment. Results: Responses from the Child and Adolescent Trauma Screen showed a significant decrease in posttraumatic stress symptoms when comparing pre-treatment scores (M = 25.64, SD = 7.85) to post-treatment scores (13.57, SD = 5.30), t(13) = 7.50, p < .001. The mean decrease in scores was 12.07 with a 95% confidence interval ranging from 8.60 to 15.55. Themes emerging from the focus group centered on home environment, caregiver participation, and systemic topics. Conclusions: Findings suggest that telehealth TF-CBT with young people in care is feasible but relatively low completion rates suggest that barriers to treatment completion remain.

A Real-World Data Study on the Impact of the ReadRx Cognitive Training and Reading Intervention on Cognition, Basic Reading Ability, and Psychosocial Skills for 3527 Children

The state of reading proficiency among children in the United States continues to be a subject of concern among psychologists, teachers, parents, policy makers, and the education community at large. Despite the widespread use of curricular methods that teach basic reading skills, there remains a large percentage of children that struggle to read. Therefore, novel approaches to reading remediation should be explored. The aims of this study were to examine 1) the effect of a multicomponent cognitive and reading intervention on cognitive and reading skills; 2) the role of ADHD, age, sex, IQ score, and individual cognitive skills on the effectiveness of the ReadRx intervention; and 3) parent-reported behavioral outcomes following the ReadRx intervention. The current study analyzed a large real-world dataset to examine cognitive, reading, and behavioral outcomes for struggling readers (n = 3527) who had completed 24 weeks (120 hours) of intense cognitive training integrated with a structured literacy intervention using ReadRx in a one-on-one clinic setting. Analyses of pretest and post-test scores showed statistically significant changes on all cognitive and reading measures including attention, visual processing, processing speed, long-term memory, working memory, reasoning, phonological awareness, Work Attack, phonetic coding, spelling, comprehension, and overall IQ score with medium to very large effect sizes. The results included an average 4.1-year gain in reading skills including a 6-year gain in phonological awareness. No differences were found based on age, sex, or ADHD status, and minimal differences were found based on pre-intervention IQ score and cognitive test scores. The study also included a qualitative thematic analysis of parent-reported behavioral outcomes revealing themes of improved cognition, academic performance, and psychosocial skills including confidence and perseverance. Our findings were consistent with previous controlled studies on this intervention and offer an encouraging alternative instructional approach to reading remediation that aligns with the Science of Reading and includes intensive remediation of underlying cognitive skills.

Effect of Skills Competency-Based Orientation on Clinical Performance Among Nursing Interns at University of Lahore Teaching Hospital

The competencies of nursing interns have direct effects on the wellbeing and health of patients, and lack of it can result in severe problems for the patients. Thus, the clinical performance and competence of nursing interns are the main professional and corporate problems for nurses and patients. Furthermore, it is needed that the nurses show the capability to supply quality care for patients and to collaborate with other nurses and colleagues. Objective: To determine the effect of skills Competency- based orientation on clinical performance among nursing interns at University of Teaching Hospital Lahore. Methods: A quasi experimental study design was used to conduct this study at University of Lahore Teaching Hospital among nursing interns. A simple random sample of n=40 participants was recruited. The educational intervention consisted of 12 sessions of 40 to 50 minutes each, from June, 2022 to August 2022.To collect data, permission was granted from the Research Ethical Committee (REC) and then Medical superintendent of University of Lahore Teaching Hospital. To assess the performance among nursing interns, an observational checklist was used. Data of the study participants were entered in statistical software SPSS 21.0 and was analyzed accordingly. Results: Findings revealed a significant effect of the educational intervention program on performance of nursing interns (Pre interventional performance score 21.00 +5.088and post interventional performance score 38.00+4.481among the nursing interns (p- value &lt;0.001). Conclusion: It is concluded that nursing education program has effect on performance among nursing interns.

Muscle contraction exercise for low back pain.

Low-back pain (LBP) continues to be one of the main problems for which sufferers seek treatment in primary care. It can be treated with different physiotherapy mechanisms. The purpose of the study is to compare the effect of isotonic and isometric exercise on the reported pain of patients with low back pain. Thirty participants, 16 males and 14 females aged between 22 and 50 years suffering from nonspecific low back pain were included. The sample was divided randomly into two groups, group A isometric exercises and group B isotonic exercises, both groups received conservative therapy of TENS and infrared (IR) therapy. The following outcome measures were used: Visual analogue scale, modified Oswestry disability index (MODI) and Endurance Test Measurement were administered pre-treatment and at the end of four weeks of treatment. Both groups were comparable in terms of demographic data, except for weight. Inter group analysis was done using the Mann-Whitney test. When comparing pre- and post-treatments using VAS scores, there were no significant differences between group A and group B (pre-test: ; Post-test: ). Mann-Whitney test was used to calculate the P-value test between pre-treatment and post- treatment for MODI and there was no significant difference between group A and group B, where the pre-test P-value was 0.061, and post-treatment was 0.077. Comparing between groups, pre- and post-abdominal endurance scores were done using the Mann-Whitney test. The pre-treatment scores revealed P value of 0.345, and the post-treatment scores revealed P value of 0.305. Therefore, there is no statistically significant difference between group A and group B in endurance scores. There was no difference between the use isotonic and isometric exercises on LBP patients.

Effect of Interpersonal Communication Training Program on Knowledge, Attitude, and Reinforcing/Support Skills of Anti-retroviral Therapy Providers in Gombe State Hospitals

Evidence from the developed world suggests that healthcare practitioners with greater Interpersonal communication (IPC) skills have better health outcomes after IPC training. There is less evidence from developing nations. This study examined the impact of an IPC training program on the knowledge, attitude, and reinforcing/supporting skills of ART practitioners at public ART hospitals in Gombe state, Nigeria. The study used a quasi-experimental design with two groups and two stages, as well as a multi-stage sampling approach. The knowledge disposition, attitude, and reinforcing and supporting IPC skills of 120 ART practitioners from six randomly selected hospitals were assessed. Then three weeks later, a 2-day IPC training using a self-administered structured questionnaire was carried out. SPSS Software (v. 22) was used to perform descriptive and inferential analyses on the data. At baseline, the Chi-Square test indicated no association between the groups on any of the demographic factors. The pre-intervention mean knowledge score was significantly higher (p = 0.019) in the experimental group than in the control group, although there were no significant differences in attitude (p=0.32) or reinforcing and support skills (p=0.786). After the IPC skills training program, significant differences were noticed between the experimental and control groups in terms of knowledge (p=.000) and attitude (p=0.006), but not in terms of reinforcing and support skills (p=.119). Training in interpersonal communication skills influences the knowledge and attitude of ART health providers in Gombe State. As a result, in-service IPC training is suggested for ART Health Providers in the State. Keywords: Anti-retroviral therapy (ART), Interpersonal communication (IPC), Reinforcing and supporting skills.

Effect of Theraband Exercises on Neck Pain and Forward Head Posture in Various Occupation

Introduction: Various occupation experience daily neck pain largely due to their awkward postures and high work demand. This puts extra strain on the muscles and predispose to development of faulty posture and muscles imbalance. So to avoid all this problems and exercise plan is needed, which can be easily performed even at the workplace. The purpose of the study was to determine the effects of the band exercises on neck pain and forward head posture in various occupation. Methodology: Thirty patients between the age of 25-50 participated in the study. They were randomly assigned to either and experimental (15) or a control group (15). The experiment group participated in Thera Band exercises Programme while control performed conventional exercises for 6 weeks. Evaluation of neck pain done by numeric pain rating scale and forward head posture was measured by digital photography technique. Results: The paired sample t-test results showed statistically significant difference in the pre and post intervention scores of both NPRS (p=&lt;0.01) and CV angle (p=&lt;0.01) in the participants of both the groups. Conclusion: the result of this study suggests that the use of TheraBand exercises may be helpful for reducing neck pain and carting forward head posture in various occupation. Methods: An comparative study was conducted on 30 patients having neck pain and forward head posture in various physiotherapy OPD and rehabilitation Centre Dehradun. The patient neck pain was measured by NPRS (Numeric Pain Rating Scale) and forward head posture measured by the digital photography technique. Results: The majority of patient was showing significant reduction in neck pain and extent of forward head Posture. Conclusion: The result of this study suggests that the use of Thera Band exercises maybe helpful for reducing neck pain and correction forward head posture in various occupation.