Individual Programs Research Articles

Sustainability and Efficiency in the Implementation of Technical Infrastructure Projects in an Urban Environment

The individual national programs through which part of the common policies of the EU are implemented contain strict requirements regarding the scope of measures financed by means of funds from the Union budget. In general, the programs are structured in such a way as to ensure both demarcation and complementarity between them, in order to achieve a certain degree of synergism accompanied by long-term investment. There are some opportunities to increase sustainability and efficiency in the implementation of technical infrastructure projects in urban environments financed by EU funds. The same are revealed when analyzing the scope of the specific measures implemented by different beneficiaries. They arise mainly from technological features, incl. consistency in the implementation of individual construction operations. The present study focuses on such possibilities, incl. specific actions contributing to increasing the efficiency of investments and saving public funds in the conditions of their limited amount. Two specific programs are covered, the implementation of which is forthcoming within the 2021-2027 programming period.

Advocacy Skill Development in Public Health Education Curriculum: A Pilot Study.

The National Commission for Health Education Credentialing (NCHEC) released updated Responsibilities and Competencies for Health Education Specialists based on the 2020 HESPA II. For the first time, advocacy is a standalone area of responsibility (Area V: Advocacy) for health education specialists. Although this is exciting for the field of health education, there is limited consensus on how to effectively teach advocacy or what content and skills to include. Furthermore, while the HESPA II was updated, the Council on Education for Public Health (CEPH) criteria for advocacy have not been. This pilot study examined how CEPH-accredited programs in the United States are addressing the profession-wide advocacy competency in their health education curricula. A cross-sectional research design with single-point data collection was used to assess how CEPH-accredited university programs (including Standalone Baccalaureate Programs, Public Health Programs, and Schools of Public Health) are preparing health education students to meet the national advocacy responsibility. The survey included items from the Advocacy Area of Responsibility and potential barriers for faculty teaching advocacy. Results indicate that most programs are teaching something about advocacy, but there is no program teaching all listed sub-competencies. Barriers to including all components of the advocacy responsibility were largely related to faculty motivation, knowledge, and time. With a full responsibility area devoted to advocacy, it is reasonable to expect that programs will adjust with the profession. However, program administrators must be catalysts for these changes in their individual programs.

Dynamics of the functional state of the cardiovascular system in individuals after cholecystectomy under the influence of a rehabilitation program in sanatorium-resort conditions.

The article discusses the dynamics of the functional state of the cardiovascular system (CVS) in individuals after laparoscopic cholecystectomy (LCС) under the influence of a rehabilitation program in SANATORIUM-RESORT CONDITIONS. The study involved 79 individuals after LCC aged 45 to 59 years. The individuals were divided into 2 groups: group A (n=39) and group B (n=40). Individuals in group A received rehabilitation services according to the clinical protocol (diet, hydrotherapy, mineral or coniferous baths, and physical therapy, etc.) In group B, individual rehabilitation programs were formed depending on the existing dysfunctions and the tolerance of the CVS to physical activity. In group B, the rehabilitation intervention to increase the function of endurance and physical performance was applied Nordic walking (NW). The initial examination in both groups revealed an increase in resting heart rate (RHR), diastolic (DBP) and systolic (SBP) blood pressure, a decrease in the performance of a 6- minute walk test and the presence of a feeling of shortness of breath during the test. The implementation of a physical rehabilitation (physical therapy) program in group B, which used Nordic walking to increase physical activity, tolerance to physical activity, and improve cardiovascular function, was effective. The use of NW in sanatorium-resort conditions of rehabilitation (lasting at least 18 days) has a positive effect and leads to a statistically significant decrease in RHR, SBP, DBP, an increase in walking distance in 6 minutes and a decrease in the feeling of shortness of breath when walking, compared to the control group. It was established that diet therapy, hydrotherapy, mineral or coniferous baths, and other water procedures, classical abdominal and back massage, group daily therapeutic gymnastics in group A did not have a positive effect on increasing the level of physical activity tolerance, CVS functioning in patients after LCC.

Große Transformation für eine Nachhaltige Raumentwicklung als Herausforderung für die raumbezogene Hochschullehre

Climatic and ecological changes across the globe represent a challenge for humanity that can only be solved through a great transformation, that is, a widespread shift toward sustainable spatial development. This means addressing transformation needs in all systems to recognize that civil society, economies and politics are all predetermined by planetary boundaries. This transformation demands that the fields of applied spatial science and spatial planning identify strategies and solutions. This paper examines the extent to which these topics are already being addressed by the university-level spatial studies programs currently training future planners. It develops and examines criteria for evaluating these programs using guideline-based interviews and literature research to perform detailed analysis of selected programs. The study demonstrates that not only specialist knowledge, but also personal and methodological skills are crucial to the success for far-reaching change processes and, ultimately, a society-wide paradigm shift. In some cases, these skills are already being addressed by individual spatial studies programs, especially planning programs. However, there remains a need to accelerate the cultivation of independent learning skills and collaboration in inter- and transdisciplinary teams. Accordingly, this paper proposes a differentiated view of teaching and learning formats in higher education and encourages deepening the focus of spatial studies programs on sustainability and transformation issues.

Multidisciplinary Home-Based Rehabilitation Program for Individuals With Disabilities: Longitudinal Observational Study.

Disability affects a significant portion of the global population nowadays, necessitating innovative approaches to access rehabilitation processes. Home-based rehabilitation has emerged as a beneficial approach, offering comfort and context-specific therapy. This study aims to evaluate the impact of a multidisciplinary home-based rehabilitation program for individuals with moderate neuromusculoskeletal disabilities in terms of motor function and mood. A total of 270 participants with median age of 66 (IQR 20-98) years were recruited from the National Disability Registry of Chile. The intervention involved a multidisciplinary team composed of 49 health care professionals providing personalized treatment plans over 4 months (32 sessions for physical therapy, 8 sessions for occupational therapy, 4 sessions for nutrition, 8 sessions for psychology, and 4 sessions for nursing and podiatry). This program also included 2 medical evaluations (at the beginning and the end) to monitor clinical progress in terms of motor function and mental health, using the Berg Balance Scale and Beck Depression Inventory, respectively. The home-based rehabilitation program showed significant improvements (P<.001) in motor function and balance with a reduction in fall risk. Specifically, the Berg Balance Scale score decreased close to 15% after the home-based rehabilitation program for all enrolled participants. On the other hand, depression levels showed no significant changes (P=.27), with percentages of variation less than 8% between the 2 assessed conditions. In this sense, participants remained with the same mild depression level (14 of 63) concerning the Beck Depression Inventory score. This study concludes that personalized home-based rehabilitation programs are effective in enhancing motor function and balance, particularly in individuals with neurological conditions. On the other hand, the findings in terms of mood advocate for further exploration of psychological support within such programs to enhance overall patient well-being. ClinicalTrials.gov NCT06537791; https://clinicaltrials.gov/study/NCT06537791.

Conducting Assessments of Community-Based Programs for Individuals with Dementia and their Family Caregivers.

While the gold standard for intervention science is the randomized controlled trial (RCT), there is growing emphasis on the practical implementation and evaluation of evidence-based programs into community agencies. Assessment of program efficacy by community-based organizations can confirm planned delivery of services, implementation fidelity, and demonstrate positive outcomes, which can provide justification for funding. Methods and measures used in an RCT, however, often cannot be implemented in non-research settings and different approaches are needed. This manuscript reviews the emerging literature on program evaluation work and draws upon the authors' experiences conducting evaluations with three community-based organizations funded by Administration for Community Living to implement programs for individuals with dementia and their family care partners. This manuscript argues for an examination of the expectations of evaluation efforts for translation of research-based trials to practice and emphasizes three main strategies for assessment: (1) Development of brief tailored assessments; (2) Measuring fidelity of implementation of the program; and (3) Measuring acceptability of the program to clients.

Examining lexical profile in general-audience English podcasts: A close replication of Nurmukhamedov and Sharakhimov (2021)

Abstract We closely replicated Nurmukhamedov and Sharakhimov (2021), which was the first study to examine the lexical profile of general-audience English podcasts. Nurmukhamedov and Sharakhimov (2021) found that podcast listeners should have a knowledge of the most frequent 3,000 word families and 5,000 word families, respectively, plus proper nouns, marginal words, transparent compounds, and acronyms in order to achieve good and high-level listening comprehension. We followed the methods and procedures of the initial study with a much larger corpus. Specifically, a total of 8,862 podcast transcripts sampled from 12 general-audience podcast programs were used to compile the 14-million-word corpus. Results of the study confirmed Nurmukhamedov and Sharakhimov's (2021) findings in the vocabulary size required to understand general-audience English podcasts. However, some minor differences pertaining to individual podcast programs were revealed, indicating that the sampling of data had an effect on the lexical demand. These findings provide solid evidence to support the validity and generalizability of the initial study's findings. Implications for second language teaching and learning are also discussed.

Opportunities to rehabilitation of multimorbid patients with asthma and obesity

BACKGROUND: The challenges of rehabilitation and achieving asthma control in patients with multimorbid conditions remain relevant despite advances in asthma treatment. Improving therapeutic approaches requires not only the development of new drugs, but also the creation of comprehensive individualized rehabilitation programs. AIM: To develop complex rehabilitation programs for patients with asthma and multimorbid diseases (obesity, osteoarthritis) and assess their impact on asthma and comorbid conditions. MATERIALS AND METHODS: 70 patients with asthma and obesity were divided into two groups: a rehabilitation group and a control group. The study evaluated external respiration functions, quality of life using Asthma Quality of Life Questionnaire (standardized), asthma control with Asthma Control Questionnaire-5 (ACQ-5), multimorbid pathology with Cumulative Illness Rating Scale (CIRS), Lequesne index, exercise capacity via 6-minute walk test, physical activity using questionnaire ODA23+, and levels of interleukin-6, interleukin-4, tumor necrosis factor alpha, leptin. RESULTS: Both groups were comparable across all assessed parameters, with most participants presenting moderate to severe asthma. Physical activity levels were low to moderate. The CIRS index was 10.0 ± 1.1 in group 1 and 9.2 ± 1.1 in group 2 (p 0.05), while the Lequesne index was 9.70 ± 1.47 and 8.80 ± 1 (p = 0.3900), respectively. After rehabilitation program, the Lequesne index in the group 1 decreased by 2.37 ± 0.60 (р 0,05), which correlated with improved exercise tolerance (6-minute walk test) and increased physical activity by 6.57 ± 2.00 (р 0.05), and increased asthma control (with ACQ-5 decreasing by 0.74 ± 0.20 points; р 0.05) and quality of life with Asthma Quality of Life Questionnaire (standardized) 3.8 ± 0.4 to 4.5 ± 0.3 (р 0.05). In group 2, no significant changes were observed in the Lequesne index, physical activity, asthma control, or quality of life (p 0.05). Proinflammatory cytokines, including interleukin-6, tumor necrosis factor alpha, and leptin, decreased significantly in group 1, while the control group showed no significant changes. CONCLUSIONS: Multicomponent rehabilitation programs tailored to the individual characteristics of patients with multimorbid conditions contribute to better management of both asthma and comorbidities. Rehabilitation improves asthma control, quality of life, and exercise tolerance. It also helps to reduce pain syndrome, increase physical activity, and decrease proinflammatory cytokines and leptin levels.

Language Learning Strategies of Maritime Students

Language learning strategies for maritime students might differ depending on their individual requirements and programs. In this premise, this study aimed to determine the extent of Language Learning Strategies by Maritime Students in a private school in a highly urbanized city in the central Philippines during the first semester of the School Year 2023-2024 as the basis for the language mastery program. The data needed for this descriptive research framework, coupled with statistical analysis to investigate the language learning strategies, was collected from 438 first-year maritime students using a standardized questionnaire. The results indicate that most parents hold graduate-level education, influencing academic environments. Most students are enrolled in a Bachelor of Science in Marine Transportation, with a balanced distribution of private and public school backgrounds. The study examines language learning strategies used by maritime students, finding moderate utilization in both direct and indirect dimensions. The study highlights the importance of tailored language learning support in marine education, enhancing language learning practices and promoting practical communication skills for professional endeavors. Moreover, it reveals notable language learning strategy employment variations among BSMT and BSMarE students. BSMT students showed slightly higher engagement in metacognitive aspects, while BSMarE students showed moderate engagement in affective and social strategies. The overall mean suggests areas for improvement in language learning behaviors. The study compares language learning strategies among maritime students and reveals significant differences based on a program of study. Bachelor of Science in Marine Transportation students show higher engagement; in contrast, BSMarE students show no significant difference. The findings suggest tailoring specific language learning strategies to enhance students’ proficiency and academic success. Specialized support programs tailored to academic specializations and collaborative efforts among language teachers and faculty across programs are essential to enhancing language learning in maritime education. Keywords: Education, language learning, maritime, strategies, private school, central Philippines

Does Topiramate Add-On Enhance the Response to the MATRIX Program in Individuals with Methamphetamine Use Disorder? A Double-Blinded Randomized Placebo-Controlled Trial

Background: Methamphetamine dependence significantly impacts individuals and society. Treating methamphetamine use disorder is challenging due to limited evidence on effective pharmacotherapies and their interaction with nonpharmacologic interventions. This study evaluated the efficacy of topiramate compared to placebo in treating methamphetamine use disorder among participants in a Matrix program. Methods: Participants were recruited from the Addiction Center of Iran Psychiatric Hospital between January 2020 and June 2023 and randomly assigned to receive either topiramate or a placebo for 12 weeks, alongside Matrix program sessions. Blinding was maintained for participants, personnel, outcome assessors, and statisticians. Main outcomes included craving, desire to use, positive urine amphetamine toxicology rates, and depression severity. Craving was assessed using the Visual Analog Scale (VAS) and the Substance Craving Questionnaire–brief (SCQ-B). The desire to use was evaluated with the Addiction Severity Index (ASI), while depression severity was measured using the Beck Depression Inventory. Data analysis utilized IBM SPSS Statistics® 20.0, employing various statistical tests for comparison. Results: Both groups exhibited improvement in craving as per VAS scores (p=0.007), with greater reduction in the topiramate group; however, no significant difference was found between groups (p=0.06). The negative urine toxicology rates showed no significant difference (Hazard ratio=1.15, 95% CI: 0.75, 1.78). Depression scores decreased in both groups without significant between-group differences (p=0.78). Conclusion: The findings do not support the efficacy of topiramate in enhancing outcomes within a Matrix program for individuals with methamphetamine use disorder.

Desirability in Real-World Blended Care for Psychosis: Insights from the Development and Pilot Study of Digital NAVIGATE

&lt;p&gt;Blended care, a psychosocial intervention merging face-to-face therapy with digital tools, holds significant potential for enhancing psychosis treatment outcomes by extending access and increasing patient engagement with therapeutic materials. Recent blended care interventions for psychosis were solely developed within controlled research conditions, and an attempt to transition one of these interventions into real-world practice yielded inadequate engagement and effectiveness. This suggests that the development context of blended care may significantly impact its implementation potential. This study represents the first attempt to both develop and research a blended care intervention in a real-world setting, directly addressing the specific challenges and unmet needs within NAVIGATE, a coordinated speciality care program for individuals who have experienced a first-episode psychosis. Both clients and practitioners agreed on the potential benefits of integrating digital tools into NAVIGATE, and clients expressed a willingness to adopt them once available. However, when the digital program became available, clients' actual desire to incorporate it into their usual care was unexpectedly low. We observed a strong correlation between clients' expressed desire to use Digital NAVIGATE before engaging with it and their subsequent engagement with the digital tools. These findings highlight a distinction between clients’ attitudes towards digital tools adaptation before being offered to use them, and their actual intention and desire to utilize such tools during the treatment they receive. These findings underscore the need to reassess current frameworks for developing and implementing digital mental health tools, particularly within existing mental health programs.&lt;/p&gt;

Опыт применения шкал развития MPR в диагностике детей раннего возраста с риском РАС

&lt;p style="text-align: justify;"&gt;&lt;strong&gt;Objectives. &lt;/strong&gt;Early diagnosis of children with Autism Spectrum Disorder (ASD) allows parents to assess the validity of their concerns, develop individual support programs, and begin working with the child as early as possible, which will lead to greater success in educational support. To achieve these goals, a comprehensive assessment is needed, including the use of standardized tools for assessing the level of current development and identifying special characteristics of children&amp;rsquo;s functioning. In order to determine the level of development, the possibilities of using the Merril-Palmer Revised (MPR) Development Scales in assessment of children with ASD were studied.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Methods.&amp;nbsp;&lt;/strong&gt;The pilot study involved eight children (5 toddlers and 3 preschoolers; 6 males, 2 females; Mage=2.8, SD=0.8). Children were divided into &amp;ldquo;risk of ASD&amp;rdquo; and &amp;ldquo;autism&amp;rdquo; diagnostic groups according to their ADOS-2 results. All participants were also tested using the MPR. Statistical analysis was conducted in IBM SPSS Statistics 23, using descriptive statistics, correlation analysis with Pearson and Spearman criteria.&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Results.&amp;nbsp;&lt;/strong&gt;According to the data obtained, the development index of all children is below the age norm (M=52, SD=26), ranging from &amp;ldquo;significant developmental delay&amp;rdquo; to &amp;ldquo;below average developmental level&amp;rdquo; and does not depend on the severity of autistic symptoms. It was found that scores in the cognitive sphere correlate positively with scores obtained in fine motor skills (r=0,93, p=0,01); visual-motor coordination (r=0,95, p=0,01); speech comprehension (r=0,87, p=0,01). The results on the scale assessing protest behavior during the examination cor relate negatively with the level of development of the socio-emotional sphere (r=&amp;ndash;0,75, p=0,05) and self-care skills (r=&amp;ndash;0,79, p=0,05).&lt;/p&gt; &lt;p style="text-align: justify;"&gt;&lt;strong&gt;Conclusions.&amp;nbsp;&lt;/strong&gt;Experience using the MPR Scales in evaluation of toddlers and preschoolers with ASD has shown that the tool is informative and allows a comprehensive assessment of developmental indicators in children with this nosology, which suggests its use in developing effective interventions. The limitation of the study is the small sample size, and the results obtained are planned to be verified with a larger number of participants.&lt;/p&gt;

Evaluating the Impact of a Rebt-Based Suicide Prevention Program for Individuals with Alcohol Use Disorders

The purpose of this study was to evaluate the effectiveness of a suicide prevention program based on Rational Emotive Behavior Therapy (REBT) for individuals with Alcohol Use Disorder. Theoretical Framework: The study is grounded in the Rational Emotive Behavior Therapy (REBT) framework, which aims to reduce irrational beliefs, one of the root causes of emotional disturbances, including depression and suicidal ideation. Methods: A nonequivalent quasi-experimental design was employed, involving participants from two Addiction Management Integrated Support Centers in K Province, South Korea. Forty-eight individuals were divided into two groups: 24 in the experimental group and 24 in the control group, each assigned to a different center. The experimental group underwent 10 REBT sessions over 5 weeks, in addition to standard interventions. The control group received only the usual interventions. Outcome variables measured included irrational beliefs, depression, suicidal ideation, and problem-solving ability. Data were collected at baseline and again five weeks after the program ended. Statistical analyses were conducted using chi-square, Fisher's exact test, and independent t-tests. Results: Prior to the intervention, no significant differences in demographic characteristics or baseline outcome variables were observed between the two groups. After the intervention, the experimental group exhibited a significant reduction in irrational beliefs (t=2.36, p=.023), depression (t=3.80, p&lt;.001), and suicidal ideation (t=4.59, p&lt;.001) compared to the control group. Additionally, the experimental group demonstrated a significant improvement in problem-solving ability (t=4.59, p&lt;.001). Discussion/Implications: The study demonstrates that the REBT-based suicide prevention program was effective in reducing irrational beliefs, depression, and suicidal ideation, while also enhancing problem-solving ability in individuals with Alcohol Use Disorder. These results underscore the potential benefits of integrating cognitive-behavioral approaches like REBT into suicide prevention programs for this population. Originality/Value: This research contributes to the limited literature on suicide prevention programs tailored for individuals with Alcohol Use Disorder and offers valuable insights into the applicability of REBT in community-based mental health interventions. The findings suggest the importance of developing structured therapeutic programs that address both cognitive distortions and emotional well-being to prevent suicide in vulnerable populations.

High prevalence of prediabetes and type 2 diabetes, and identification of associated factors, in high-risk adults in Vietnam: A cross-sectional study

ObjectivesThe prevalences of diabetes and prediabetes have increased rapidly in recent years in emerging nations such as Vietnam, particularly in the population at high risk of diabetes. This study aimed to investigate the prevalence of prediabetes and undiagnosed diabetes in individuals at high risk of type 2 diabetes (T2D), as well as the related risk factors. MethodsThis cross-sectional study at the clinics of the University Medical Center in Ho Chi Minh City included 360 patients who were 18 years of age or older, and were at risk of developing T2D. The diagnosis of prediabetes and diabetes relied on measurements of fasting plasma glucose, HbA1c, and 2-hour plasma glucose after a 75 g oral glucose tolerance test. ResultsThe prevalence of prediabetes was 60.6 % (95 % CI: 55.3–65.6 %), and the prevalence of diabetes was 18.3 % (95 % CI: 14.6–22.8 %). Older age (OR = 1.06), obesity (OR = 3.89), hypertension (OR = 5.71), and dyslipidemia (OR = 2.01) were factors associated with increasing frequencies of undiagnosed T2D and prediabetes. ConclusionThe prevalences of prediabetes and undiagnosed diabetes were significantly higher among people with a high-risk of dysglycemia in Vietnam. There is a need for screening programs for such high-risk individuals.

Effects of inhaled nitric oxide on endothelial function in patients with ischemic stroke

BACKGROUND: A crucial pathogenetic link in the development of stroke is the deterioration of endothelial function, which is a pathological condition characterized by an imbalance between endothelium-dependent relaxing and constricting factors. An example of an endothelium-dependent relaxing factor is nitric oxide, a substance synthesized by the body’s cells that has a vasodilating, antithrombogenic, anti-inflammatory, and antiproliferative effect. Studies have shown the neuroprotective function of inhaled nitric oxide after ischemia; however, determining the minimum effective dose of inhaled nitric oxide in patients who have suffered an acute cerebrovascular accident remains challenging. AIM: To analyze the protective effect of exogenous nitric oxide using the TIANOX device on the vascular endothelium in patients who have had an ischemic stroke in the early and late recovery period during medical rehabilitation. MATERIALS AND METHODS: The study involved 21 patients (10 people in the main group, 56.9±8.9 years old, 11 people in the control group, 57.2±8.8 years old) in the early or late recovery period after an ischemic stroke. Patients in the main group underwent an individual medical rehabilitation program and a course of 8–10 inhalations of a gas mixture with nitric oxide at 20 ppm for 20 minutes. Those in the control group underwent an individual rehabilitation course without nitric oxide therapy. Flow-dependent vasodilation of the brachial artery was evaluated to assess endothelial function. RESULTS: In the main group, a statistically insignificant (p 0.05) increase was found in the diameter of the brachial artery (3.68±0.64 mm), whereas in the control group, this indicator at rest during repeated diagnostics was less than the initial one (3.09±0.87 mm). During repeated diagnostics, the average endothelial shear velocity in patients of the control group increased from 141.53±52.62 to 159.3±82 versus from 143.17±43.53 to 143.48±46.37 in the main group; however, the results were not statistically significant (p=0.753). CONCLUSION: The increase in the diameter of the brachial artery during flow-dependent vasodilation in patients in the main group may indicate a prosthetic effect of the exogenous form of nitric oxide when using the Tianox device on the vascular endothelium, owing to the possibility of depositing nitric oxide in the body. To confirm the obtained data, a larger sample size of patients is critical in order to further divide the groups of patients into early and late recovery periods after ischemic stroke.

The influence of assistance in home-based exercise programmes for individuals with intellectual disabilities.

Regular physical activity (PA) decreases the risk of comorbidities associated with a sedentary lifestyle in individuals with intellectual disabilities (IDs). They also may experience additional barriers that may prevent PA, including access, proper instruction and support. At-home PA programming is a feasible alternative to long-term adherence. This study aimed to determine (1) how an at-home DVD programme affects PA adherence and (2) the extent to which caregiver support influences PA. Thirty-one adolescent or adult-aged participants with mild or moderate ID were randomised into a DVD or control group exercise intervention. Participants were given autonomy to choose what type of PA modality from the intervention they would like to participate in. Caregiver support during the PA was also measured. The two-way repeated-measures MANOVA demonstrated that the intervention DVD group was statistically significant, with a large effect size in PA minutes (P=0.014, ηP2=0.236) and rate of perceived exertion (P=0.002, ηP2=0.342) compared with the control group. The findings demonstrated that using an adapted DVD increased PA minutes and the rate of perceived exertion without high levels of caregiver support.

Discerning personhood through lena‐dena: Disability professionals, ethics, and communication

AbstractThis article looks at practices of discernment in disability spaces in India by analyzing (hierarchical) relational contexts in which disability professionals and disabled people in India interact. We argue that discernment, which we explore through lena‐dena (giving and taking), allows us to analyze the ethical stakes of processes of communication, interpreting, and facilitation. Vaidya analyzes how special educators make broad discernments about intellectually disabled people by interpreting their unconventional and nonlinguistic communicative cues. In contrast, Friedner examines how speech and language therapists that work with deaf children make narrow discernments regarding what counts as language and perform the labor of training deaf children to communicate in the normatively correct way—that is, using speech. While disability professionals produce specific kinds of personhood for disabled people through their practices of discernment, they also end up discerning themselves in the process as professionals with difficult yet rewarding jobs. We conclude by discussing a program for individuals with intellectual disabilities where both authors conducted ethnographic research wherein disability professionals discerned disabled people as having social needs and desires on par with nondisabled people and created enabling environments, scaffolded activities, and facilitated conversations to produce and enable complex personhood for them.

Regular Physical Activity Seems to Eliminate Lower Limb Perfusion Asymmetries in Sedentary Non-Healthy Older Individuals.

Perfusion asymmetries have been associated with vascular pathology. Physical activity is a component of vascular health. Here, we investigate the impact of a thirty-day regular home-based physical activity program in older individuals with multiple age-related comorbidities. Eleven participants of both sexes were included. Skin perfusion was assessed in both feet by laser Doppler flowmetry (LDF, for deeper perfusion) and polarized light spectroscopy (PSp, for superficial perfusion). At baseline, participants had significant perfusion differences between right and left feet (p = 0.005 with LDF; p = 0.028 with PSp), which disappeared with activity and reappeared in recovery. After 30 days, both feet showed significant perfusion increases as assessed with LDF (p = 0.005) compared to D0. At this point, the perfusion asymmetry observed at D0 was no longer present. However, the superficial perfusion asymmetry assessed by PSp persisted at D30 (p = 0.028). Data show that regular physical activity positively altered the lower limb perfusion pattern. Systolic pressure and mean arterial pressure were also significantly reduced at D30. These impacts seem to be directly related to the physical activity program introduced in the day-by-day routines of these participants. These also encourage further research on the role of symmetry-asymmetry in prevention, treatment, and rehabilitation in vascular medicine.

Reducing colorectal cancer mortality in South Africa: experiences and progress from the South African National Cancer Prevention Services

Aim The incidence rates of colorectal cancer are rapidly increasing in South Africa. Previous studies have shown that the prevalence of inherited colorectal cancer in South Africa is 3-5 times higher than in high-income countries. Targeted screening and surveillance programmes for individuals with known colorectal cancer-causing mutations have resulted in increased life expectancy. The South African National Cancer Prevention Services (SANCaPS), was established to implement national systems for identifying individuals with inherited cancers, improving their clinical management, and reducing the overall disease burden. Methods Using colorectal cancer as an example, SANCaPS aimed to extend surveillance and management practices from the Western Cape to a national level. The goals included improving the quality of pathology reporting, establishing counselling systems for at-risk individuals, developing cost-effective mutation detection protocols, identifying and counselling at-risk family members, providing mutation testing, organising endoscopic surveillance programmes for high-risk individuals, setting ethical frameworks for research, and extrapolating learnings from the inherited colorectal cancers surveillance programme to other cancers with known hereditary predispositions. Results SANCaPS initiated the standardisation of national pathology reporting for colorectal cancers. Currently, a minimum core pathology dataset collection is being piloted in the National Health Laboratory Service’s TrakCare system. Subsequently, SANCaPS aims for broader adoption through stakeholder engagements. This will help to identify patients with mismatch repair-deficient colorectal cancers, facilitate research, and improve reporting. Conclusions To improve patient outcomes, this consultative process and framework will be replicated to introduce standardised management workflows for other common cancers, including breast, prostate, uterine, and others.

Agile Backward Design: A Framework for planning higher education curriculum

AbstractIn the last two decades there has been an increase in research and discussion regarding curriculum in Higher Education (HE). The literature in this field tends to focus on curriculum change at either the whole institution or individual program or unit level. Formal writing on HE curriculum also does not offer a framework that openly draws upon context, learner needs, pedagogical approaches, and industry requirements to formulate a collaborative model of curricular development. To fill these gaps in HE curriculum discussion and literature the aim of this study was to develop a cross-disciplinary model applicable to both unit (academic module that makes up a program) and program (degree) levels of curriculum development by enabling academics to generate and structure engaging learning opportunities for students. The research team developed this model by drawing on elements of Agile mindset and Backward Design. We call it Agile Backward Design (ABD). This paper reports on this new approach to curricular design. A critical reflective inquiry approach was used to discuss the development of the model. To report the transformation that was made at the program and unit level a case study was employed. In ABD, the researchers have constructed a dynamic and responsive framework that has been foundational in the design and development of innovative curriculum and pedagogy at the unit and program level of undergraduate degrees in the IT discipline area.