Remote Period Research Articles

Assessment of the prevalence of lower back pain syndromes among students during the remote teaching period

Assessment of the prevalence of lower back pain syndromes among students during the remote teaching period

Volar Locking Plating of Extra-articular Distal Radius Fracture: A Retrospective Clinical Study Comparing Locking Screws versus Smooth Locking Pegs.

Background Open reduction and internal fixation of distal radius fractures is one of the most common procedures performed in wrist surgery. The use of volar locking plate has gained increasing interest in the past decade. Epiphyseal fixation can be done either with locking screws or smooth locking pegs, with no evidence supporting the use of one rather than the other. Purpose The aim of this study is to compare the stability of distal radius fixation by volar locking plate using locking screws or smooth locking pegs. Methods Adult patients with A2-A3 AO fractures treated with a volar plate with locking screws only or smooth locking pegs only were retrospectively included. Radiographic assessment was performed to evaluate extra-articular parameters in the intraoperative postreduction and fixation period and after bony healing. Forty-seven distal radius fractures were included. Results Twenty-four fractures had fixation with locking screws and 23 had fixation with smooth locking pegs. For both groups, all radiographic parameters measured showed a statistically significant difference between the intraoperative postreduction and fixation period and the remote postoperative period after union of the fracture ( p < 0.05) attesting a slight loss of reduction. Nevertheless, there were no significant differences between the groups in radiographic extra-articular parameters. Conclusion This clinical study shows that there is no difference in stability fixation between locking screws or smooth locking pegs in A2-A3 distal radius fractures. Clinical Relevance The use of smooth locking pegs only for epiphyseal fixation appears to be safe in volar plating of A2-A3 distal radius fractures in adult patients and could be an alternative to locking screws. More clinical data are needed to confirm these results. Level of Evidence Level III; retrospective comparative study.

School closures significantly reduced arrests of black and latinx urban youth.

Youth of color are surveilled and arrested by police at higher rates than their White peers, contributing to racial inequities across the life course and in population health. Previous research points to schools as an increasingly relevant site for youth criminalization, but existing studies emphasize within-school mechanisms, with limited analysis of policing in surrounding school areas. To fill this gap, we study changes in police arrests of youth after initial COVID-19 school closures in 2020 across four US cities overall and in relation to public school locations. We analyze geocoded arrest records and use interrupted time series negative binomial regression models with city and month fixed effects to estimate change in weekly arrest rates among White, Black, and Latinx youth. We estimate arrest densities within school areas before and after school closures using spatial buffers of 300 feet. In the immediate weeks and months following COVID-19 pandemic school closures, youth arrest rates fell dramatically and with lasting impacts compared to other age groups. During the period of remote learning, weekly youth arrest rates declined by 54.0% compared to youth arrests rates in 2019, adjusting for city and seasonality (Incident Rate Ratio 0.46, 95% CI: 0.41, 0.52). We estimate Black youth weekly arrests fell from 43.6 to 16.8 per 100,000, vs. 4.6 to 2.2 per 100,000 among White youth. However, Black youth arrest rates during the remote learning period were still nearly 5 times that of White youth pre-pandemic. We also find that youth arrest rates declined during two school closure periods: at the start of the pandemic in 2020 and during Summer 2019. A spatial analysis shows Black and Latinx youth arrest densities in the surrounding 300 feet of K-12 schools were at least 15 and 8.5 times that of White youth, respectively, in both pre- and remote-learning periods. Black and Latinx youth face a higher likelihood of being arrested near a school than do White youth and older age groups, and racial inequities in arrests remains after school closures. Our findings show school closures significantly reduced arrests of urban youth of color, and policies addressing youth criminalization and structural racism should consider the joint spatial context of schools and policing. Although school closures may have resulted in learning loss and harms to youth wellbeing, closures interrupted comparatively high levels of arrest for Black and Latinx youth.

Early and long-term results of endovascular treatment of cerebral aneurysms

Introduction. Postoperative angiographic examinations after endovascular treatment of cerebral aneurysms may demonstrate unstable results, both in the form of recurrence formation, and in the form of increased degree of occlusion with initially incomplete occlusion of the aneurysm sac. Cerebral aneurysm recurrences represent an important medical and social problem comparable in terms of hemorrhage risks with nonoperated aneurysms.Aim. To estimate the early and long‑term results of endovascular treatment of patients with cerebral aneurysms ope rated on using different endovascular techniques. Materials and methods. The present study included 167 patients (48 men and 119 women) with 195 cerebral aneurysms aged from 18 to 75 years who were operated on using endovascular techniques at the neurosurgical department No. 3 of the Russian Research Neurosurgical Institute named after Prof. A. L. Polenov from 2013 to 2016. The average age of the patients was 52 ± 12 years, the minimum age was 18 years, and the maximum age was 75 years. The choice of endovascular treatment method in the patients included in the study was based on anatomico‑topographic and morphometric features of aneurysm, as well as taking into account the period of aneurysmal disease course.Results. The study of data of control angiographic examinations after endovascular treatment of patients with cerebral aneurysms showed that in the remote postoperative period the degree of aneurysm occlusion may differ from that initially achieved. The probability of aneurysm recurrence after its isolated occlusion with coils may reach 13.1 % already in 6 months after surgical treatment, 31.7 % after 12 months and 22.3 % after 36 months, averaging 22.5 % (p &lt; 0.05).Conclusion. The personalized approach in choosing optimal surgical tactics for the treatment of patients with cerebral aneurysms allows to achieve stable radical aneurysm occlusion, to decrease the incidence of postoperative complications and aneurysm recurrences in the long‑term postoperative period.

Clinical signs of the quality level of fixed dentures in the process of use and rationale for feasibility of their replacement

The growing requirements for the quality of dental care necessitates expert evaluation of dental prostheses. Therefore, on the way to improve the structure and process of providing dental care, it is important to analyze the primary data of its results in quantitative and qualitative terms. The purpose of this work is to clarify the content and results of consulting care by analyzing clinically important indicators of the quality of fixed dentures that determine their applicability for further use. Among the 410 patients aged 35-81 examined for damage to abutment teeth and periodontal tissues, unsatisfactory condition of crowns and bridges, the 1st subgroup included 76 (18.5%) persons who sought counseling on their own initiative and the 2nd subgroup – 334 (81.5%) persons with referrals from other medical institutions. Quality indicators of 759 artificial crowns and 803 bridges were determined (K08.5 – unsatisfactory restoration of teeth) in the early (up to 24 months) and remote (more than 24 months of use) periods of observation using a modified index of clinical and technological quality. In patients of both groups in the early observation period 67 crowns and 101 bridges (all signs – 253), and in the remote period – 692 crowns and 702 bridges (3804 signs) of low quality were revealed. Quality index of these structures in the early and remote periods of observation was 0,71 versus 0,36 (p&lt;0.05) and 0.64 versus 0.37 respectively (p&lt;0.05). In 71 (93.4%) patients of the 1st group grounds for replacement of 292 out of 327 (89.3%), and in 238 (71.3%) patients of the 2nd group – 827 (67.0%) out of 1235 fixed partial dentures were found. Thus, expert assessment of the quality of dental care is an integral part of ensuring the predicted results of prosthetic treatment. The proposed method of assessing the clinical and technological quality of fixed dentures makes it possible to determine their suitability or unsuitability for further use.

Barriers to and Facilitators of Using Remote Measurement Technology in the Long-Term Monitoring of Individuals With ADHD: Interview Study.

Remote measurement technology (RMT) has the potential to address current research and clinical challenges of attention-deficit/hyperactivity disorder (ADHD) symptoms and its co-occurring mental health problems. Despite research using RMT already being successfully applied to other populations, adherence and attrition are potential obstacles when applying RMT to a disorder such as ADHD. Hypothetical views and attitudes toward using RMT in a population with ADHD have previously been explored; however, to our knowledge, there is no previous research that has used qualitative methods to understand the barriers to and facilitators of using RMT in individuals with ADHD following participation in a remote monitoring period. We aimed to evaluate the barriers to and facilitators of using RMT in individuals with ADHD compared with a group of people who did not have a diagnosis of ADHD. We also aimed to explore participants' views on using RMT for 1 or 2 years in future studies. In total, 20 individuals with ADHD and 20 individuals without ADHD were followed up for 10 weeks using RMT that involved active (questionnaires and cognitive tasks) and passive (smartphone sensors and wearable devices) monitoring; 10 adolescents and adults with ADHD and 12 individuals in a comparison group completed semistructured qualitative interviews at the end of the study period. The interviews focused on potential barriers to and facilitators of using RMT in adults with ADHD. A framework methodology was used to explore the data qualitatively. Barriers to and facilitators of using RMT were categorized as health-related, user-related, and technology-related factors across both participant groups. When comparing themes that emerged across the participant groups, both individuals with and without ADHD experienced similar barriers and facilitators in using RMT. The participants agreed that RMT can provide useful objective data. However, slight differences between the participant groups were identified as barriers to RMT across all major themes. Individuals with ADHD described the impact that their ADHD symptoms had on participating (health-related theme), commented on the perceived cost of completing the cognitive tasks (user-related theme), and described more technical challenges (technology-related theme) than individuals without ADHD. Hypothetical views on future studies using RMT in individuals with ADHD for 1 or 2 years were positive. Individuals with ADHD agreed that RMT, which uses repeated measurements with ongoing active and passive monitoring, can provide useful objective data. Although themes overlapped with previous research on barriers to and facilitators of engagement with RMT (eg, depression and epilepsy) and with a comparison group, there are unique considerations for people with ADHD, for example, understanding the impact that ADHD symptoms may have on engaging with RMT. Researchers need to continue working with people with ADHD to develop future RMT studies for longer periods.

Impact of the correctional rehabilitation program on the walking locomotion of amateur athletes after brain contusion

The ascertaining experiment involved 38 men involved in amateur sports at the age of 25-42 years with the consequences of brain contusion in the late remote period. The issue of renewal of combatants by means of physical culture and sports rehabilitation for amateur sports becomes topical. A correctional and rehabilitation program was developed: stage 1 (28 days) was held on the basis of the Ukrainian Research Institute of Prosthetics, stage 2 (42 days) independently, but Gr1 was trained under the supervision of a specialist in physical culture and sports rehabilitation using modern telecommunication technologies. The difference of the program in Gr1 was the appointment in the variable component of the Neurac technique on the Redcord suspension system, instead of training on a multifunctional block simulator; Nordic walking instead of training walking; vestibular gymnastics. It was found that after the 2nd stage in amateur athletes Gr1, the assessment of muscle strength according to the Lovett test, indicators of the dynamic characteristics of walking, such as the coefficient of rhythm and load asymmetry, acquired a normative value. Gr2 men showed a slow improvement in all studied parameters. The formative experiment confirmed that a multidisciplinary approach, conducting independent classes under the supervision of a rehabilitation specialist positively affects the walking locomotion of amateur athletes with the consequences of a brain contusion and brings the return to sports closer.

Remote learning and mental health during the societal lockdown: a study of primary school students and parents in times of COVID-19

BackgroundThe COVID-19 pandemic has brought challenges to families around the world. The prolonged school closures in Hong Kong have forced young students to stay at home and adapt to remote learning for over a year, putting their mental health conditions at risk. Focusing on primary school students and their parents, the main objective of our research is to investigate the socioemotional factors and their associations with mental health conditions.MethodsA total of 700 Hong Kong primary schoolers (mean age = 8.2) reported their emotional experiences, loneliness, and academic self-concept via a user-friendly online survey; 537 parents reported depression and anxiety, perceived child depression and anxiety, and social support. Responses from students and parents were paired to account for the family context. Structural Equation Modeling was used for correlations and regressions.ResultsThe results of students’ responses showed that positive emotional experiences were negatively associated with loneliness and positively related to academic self-concept among students. Furthermore, the paired sample results showed that, during the one-year societal lockdown and remote learning period, the socioemotional factors were associated with mental health conditions among primary school students and their parents. Among our family sample in Hong Kong, evidence supports the unique negative association between students-reported positive emotional experiences and parents-reported child depression and anxiety, as well as between social support and parents’ depression and anxiety.ConclusionsThese findings highlighted the associations between socioemotional factors and mental health among young primary schoolers during the societal lockdown. We thus call for more attention to the societal lockdown and remote learning context, especially since the social distancing practice could be “the new normal” for our society to handle the future pandemic crisis.

Parent opinions on distance education practices in the emergency remote education period in Turkey

The aim of this study is to examine the experiences and opinions of parents in Turkey regarding distance education practices during the pandemic period. Quota sampling has been made by considering Turkey Statistical Regional Units Classification. 2371 parents participated in the research. The data collection tool consists of a scaled questionnaire, open-ended questions, preferential questions, demographic and personal information form. The descriptive survey model has been used to reach the aim of the study for data analysis. The findings of the study are as follows: The majority of the parents evaluated distance education as being insufficient, difficult to learn, restrictive in terms of the time allocated to the lessons, and a system that does not replace face-to-face education, but will support the students when they return to normal process. Teacher guidance was emphasized in overcoming technical problems. They drew attention to the guidance of teachers in overcoming technical problems, the difficulty of adapting students and providing working discipline, the inadequacy of educational content, and the inequality of opportunity caused by financial deprivations

Nursing assistance aimed at the health of woman in front of complicable conditions of puerperia: an integrative review

The puerperal period is understood as the immediate puerperium which corresponds to the time that follows the dehiscence of the placenta extending to the 10th day after delivery, the late period corresponds to the 11th to the 45th day and the remote period is from the 45th day after delivery. During this phase the woman goes through several physiological changes, but which have the capacity to reflect on an exposure to risks for the development of pathologies characteristic of the puerperal period. It is then up to the professional nurse to offer individualized assistance depending on the needs of the puerperal woman, promoting integral and qualified care. The research has as a general objective to understand the nursing care to women's health facing the complications in the puerperium and as specific objectives to understand the factors that interfere with the comprehensive care to women in the midst of the puerperal period; discuss the biopsychosocial changes that affect women during pregnancy and postpartum; discuss the main complications of the puerperal phase; identify the roles of nursing professionals in promoting care for women in the puerperium period. This work corresponds to an integrative literature review, which used the following descriptors: "Nursing Care" "Comprehensive Health Care", "Puerperal Disorders", "Postpartum Period". Studies published from 2017 to the present day were used, in databases such as MEDLINE, LILACS, BDENF - Nursing, IBECS, CUMED, Sec. Est. Saúde SP, CVSP - Brazil and Sec. Munic. Saúde SP. In sequence, the gestational period is responsible for provoking several transformations in the woman, which are considered physiological and are directed to the physical and psychological conditions and the modifications continue happening during the puerperium in which there is the return to the pre-pregnancy state, thus the woman is exposed to conditions of vulnerability due to this whole process. When a disorder occurs in the transformations puerperal pathologies show up and are then evidenced as the main complications the infections, hemorrhage, and problems associated with the breasts, as well as the occurrence of psychological changes that can be seen in the midst of the puerperium. Thus, the nurse must act providing guidance about all the changes that the female body undergoes during this phase even though they are considered physiological, highlighting signs that are warning signs of complications and perform nursingconsultation with a focus on humanization keeping a holistic view to evaluate the biopsychosocial aspects and thus be able to identify the needs and possible complications that the puerpera presents, to offer assistance in a systematized way. Therefore, nurses should act to prevent changes that can affect the health of women in the gravidic puerperal period and to promote health, ensuring that pathologies are seen early to avoid further aggravation.

SOFT TISSUE COMPLICATIONS IN THE EARLY POSTOPERATIVE PERIOD AFTER OSTEOSYNTHESIS OF CALCANEU

Introduction. The complex anatomy and biomechanics of the calcaneal bone is an important component in stability of a lower extremity. According to the literature, calcaneus fractures occur in 2% of all skeletal bone fractures. The vast majority of such fractures (almost 75%) are intra-articular injuries resulting from high-energy trauma. The absolute majority of studies show the indisputable advantage of surgical tactics for the treatment of intra-articular fractures of the calcaneal bone in a remote period. Conservative treatment of displaced fractures, in turn, is considered as an alternative in cases where there are absolute contraindications to surgical treatment. An analysis of reliable sources demonstrates better long-term functional results in patients treated by applying minimally invasive techniques. To date, the question of the relationship between the choice of surgical treatment method and early postoperative complications from soft tissues remains not fully resolved. The purpose of this work is to analyze soft tissue complications in the early postoperative period after calcaneus osteosynthesis and to determine the relationship between the frequency of such complications and various methods of surgical treatment. Materials and methods. The treatment outcomes of 42 patients with displaced calcaneal fractures (47 fractures) were analyzed. Patients were divided into 3 groups depending on the surgical techniques used in the treatment: open direct reduction through an extended L-shaped approach followed by fixation with a plate, minimally invasive open reduction through access to the subtalar sinus followed by the fixation with a calcaneal mini-plate, closed reduction with transcutaneous cancellous screw fixation. Results. The main soft-tissue complications in the early postoperative period after calcaneus osteosynthesis among patients of different groups were recorded, and the relationship between the frequency of such complications and various methods of surgical treatment was established. Conclusion. The use of minimally invasive methods of surgical treatment for displaced calcaneus fracture prevents a number of early postoperative complications in soft tissues, promotes wound healing and prevents the development of secondary infectious complications.

Perspectives among College Students with Disabilities on Access and Inclusion

This qualitative, narrative study explores the experiences of college students with disabilities before and during the remote learning period. Three main themes emerged as critical influences on student perceptions of institutional access and inclusion: accommodations and accessibility; building relationships and community and course structure and design. The purpose of this study is to inform policies and practices in order to make campuses more accessible and equitable moving forward.

Delayed fatal intracranial hemorrhage in a pediatric patient following resection and adjuvant cranial radiotherapy for ependymoma: illustrative case.

Cranial radiotherapy (CRT) is an important treatment modality for malignancies of the central nervous system. CRT has deleterious effects that are commonly classified into acute, early delayed, and late delayed. Late-delayed effects include weakening of the cerebral vasculature and the development of structurally abnormal vasculature, potentially leading to ischemic or hemorrhagic events within the brain parenchyma. Such events are not well reported in the pediatric population. The authors present the case of a 14-year-old patient 8.2 years after CRT who experienced intracerebral hemorrhage. Autopsy demonstrated minimal pathological change without evidence of vascular malformation or aneurysm. These findings were unexpected given the degree of hemorrhage in this case. However, in the absence of other etiologies, it was believed that late-delayed radiation effect was the cause of this patient's fatal hemorrhage. Although not all cases of pediatric spontaneous intracerebral hemorrhage will have a determined etiology, the authors' patient's previous CRT may represent a poorly defined risk for late-delayed hemorrhage. This correlation has not been previously reported and should be considered in pediatric patients presenting with spontaneous hemorrhage in a delayed fashion after CRT. Neurosurgeons must not be dismissive of unexpected events in the remote postoperative period.

ЭФФЕКТИВНОСТЬ ОТКРЫТЫХ ХИРУРГИЧЕСКИХ ВМЕШАТЕЛЬСТВ ПРИ ПАХОВЫХ ГРЫЖАХ У ПАЦИЕНТОВ ПОЖИЛОГО ВОЗРАСТА

Purpose. To evaluate the effectiveness of open methods of surgical treatment of inguinal hernia in elderly patients. Material and methods. The study includes 336 elderly patients with inguinal hernias. The Bassini hernioplasty was performed on 106 patients, the Liechtenstein technique was applied to 110 patients and the new tension-free method – to 120 patients. The effectiveness of hernioplasty was evaluated according to the results of the examination of patients in the early and remote postoperative periods, as well as the methodology for calculating the effectiveness of medical technologies in healthcare. Results. With open surgical interventions in patients with inguinal hernias in the early postoperative period there is an increase in the volume of the testicle on the side of surgery. In the remote period only after the Lichtenstein hernioplasty there was a decrease in the volume of the testicle (p&lt;0.05). The relapse of the hernia (1-3 years later) after the Bassini hernioplasty took place in 9.4% cases, after the Liechtenstein hernioplasty - in 3.6% patients, and after applying the new method of hernioplasty there was no relapse of hernia. The new technique of tension-free hernioplastics was characterized by the highest level of medical (Km=1.00) and social efficiency (Ks=0.86). Conclusion. The new technique of open tension-free inguinal hernioplasty is characterized by the highest level of medical and social efficiency.

Long-Term Functional Consequences of Treatment of Fractures of the Distal Metaepiphysis of the Radius

Summary. The frequency of damage to the distal metaepiphysis of the radius reaches from 16% to 33% of all fractures of the bones of the skeleton, and the increase in the incidence of osteoporosis definitely maintains the tendency to increase the frequency of damage to this localization. About 53.3% of the injured need repositioning; half of them (26.6%) have large unstable fractures of type B and C, which are subject to surgical treatment.&#x0D; Materials and Methods. The study was carried out based on the materials of the trauma centers and trauma departments of the “City Clinical Hospital No. 2” of the DCC (Dnipro) and the MNPE “City Clinical Hospital No. 6” of the DCC (Dnipro). To assess the long-term consequences, a retrospective analysis of archive records of 318 patients with damage to the distal metaepiphysis of the radius was performed, including 271 radiographs of females (85.2%) and 47 males (14.8%).&#x0D; Results. The conducted analysis gives grounds to state that remote manifestations depend on the nature and severity of fractures, the quality of reposition or surgical treatment. Fractures of type A and C have a pronounced tendency to develop manifestations of deforming arthrosis of the radiocarpal joint in the remote period after the injury, which may be due to the presence of incongruity of the articular surfaces against the background of residual “permissible” displacements of the fragments.&#x0D; Conclusions. Ensuring accurate repositioning of fractures and expanding the indications for surgical treatment in case of “permissible” displacement of bone fragments in fractures of the distal metaepiphysis of the radial bone will reduce the frequency and severity of arthrosis in the remote period after the injury.

Teachers' Experiences of Emergency Remote Schooling During the Pandemic: Drivers for Student and Teacher Wellbeing.

This article discusses findings from a recent survey (n = 297) of teachers' views of both their own and their students' experiences during the 2021 enforced emergency remote schooling period occurring in New South Wales Australia, due to the COVID-19 pandemic. The quantitative analysis reported here explores teachers' views regarding teaching and learning during this challenging period. It identifies three latent constructs, learning, assessment, and interaction, and then uses structural equation modelling to identify the perceived impact of these constructs on student and teacher wellbeing. The remote schooling period had a significant negative impact for teachers and their students across a range of elements of teaching and learning, as well as wellbeing. Student learning experiences and their peer interactions were found to be strong predictors of students' wellbeing outcomes. Assessment design and teachers' feedback to students were significant in predicting levels of teacher wellbeing. Future research directions are also provided.

Distance learning during the pandemic era: Russian instructors’ experience

The article focuses on studying Russian university instructors’ experience acquired during the emergency remote learning period in 2020–2021. The need to adjust the development route of the distance learning system determines the topicality of the research. The novelty of the article is determined by significant gaps in scientific literature concerning studying, generalizing, and comprehending such experience.The study employed quantitative and qualitative methods of data collection and processing. Russian university instructors (N = 57) filled in an online questionnaire which aimed to identify the advantages and disadvantages of distance learning. Corpus linguistics methods were used to outline the most common key themes, which made it possible to identify the frequent words employed to describe positive and negative experiences. Responses to open-ended questions were examined using contextual and content analysis.The most significant positive aspects of the online format identified by the respondents included travel time saving, extending the repertoire of teaching strategies and access to visual methods of presenting information thanks to the online platform technological capabilities. This enabled instructors to involve usually silent students in active communication. Moreover, the respondents cited safe communication during the spread of a viral disease as well as students’ constant access to information resources. As for disadvantages, respondents mentioned a marked deterioration in interaction with students due to the lack of personal and/or visual contact, technical communication problems, and labor intensity. Other often cited drawbacks were difficulties in developing practical skills and effectively monitoring students’ knowledge and psychological state, learners’ decreased motivation as well as health problems.Based on the results of the study, the article concludes that it is necessary to improve instructors’ professional competencies and improve technical facilities of educational institutions. This would provide access to and usage of multifunctional distance learning management systems and programs that permit videoconferencing, file sharing and demonstrating multimedia presentations and online materials.The research is relevant as it is important to study and summarize instructors’ positive and negative experience to improve professional development programs, make decisions on purchasing and using equipment and software, and change university development agendas.

THE INFLUENCE OF PHYSICAL THERAPY ON INDICATORS OF THE LOCOMOTIVE SYNDROME IN ELDERLY PERSONS WITH THE CONSEQUENCES OF TOTAL KNEE ARTHROPLASTY

Objective: to evaluate the effectiveness of the developed physical therapy program on the parameters of the locomotive syndrome in elderly people with the motor consequences of total knee arthroplasty against the background of the geriatric syndrome of sarcopenia, in the remote period after the operation.&#x0D; Methods. 80 elderly people were examined. The control group consisted of 24 people without joint endoprostheses, with no signs of sarcopenia. The comparison group consisted of individuals with knee arthroplasty and sarcopenia with low rehabilitation compliance with regard to active rehabilitation intervention. Representatives of the main group with knee endoprosthesis and sarcopenia practiced according to a developed program of physical therapy, created taking into account the specifics of each comorbid condition. The program lasted 6 months; contained the following elements: therapeutic exercises, functional training, massage, kinesiotaping; dietary recommendations; patient education. Its purpose was: correction of the phenomena of motor stereotype violation as a consequence of total knee arthroplasty, in particular, phenomena of the locomotive syndrome, leveling of the phenomena of sarcopenia both at the level of its motor manifestations and at the level of etiopathogenesis of this geriatric condition; facilitation of activities of daily life, improvement of psycho-emotional state, and – as a result – improvement of quality of life. In the process of physical therapy, individual short- and long-term goals defined in the SMART format were consistently achieved within the framework of the patient-centered rehabilitation model. The effectiveness of the program was evaluated according to the dynamics of The Short Physical Performance Battery, Functional Gait Assessment, Fall efficacy scale, 25-question Geriatric Locomotive Function Scale.&#x0D; Results. In elderly patients with knee arthroplasty and sarcopenia, signs of locomotor syndrome were found in the form of impaired balance when performing simple movements (according to The Short Physical Performance Battery), violation of the normal gait stereotype and the resulting risk of falling (according to the Functional Gait Assessment), which led to awareness of the fear of falling (according to the Fall efficacy scale). The hall level of movement disorders corresponded to locomotive syndrome of the II degree (according to the 25-question Geriatric Locomotive Function Scale). The developed physical therapy program revealed a statistical improvement in the condition of patients due to the effect on the components of the locomotive syndrome due to the improvement of balance and gait parameters, reduction of the risk of falling and fear of falling compared to the initial indicators for all the studied parameters (р&lt;0.05); however, the indicators of the control group were not reached (p&gt;0.05). Low rehabilitation compliance in patients with knee arthroplasty and sarcopenia, despite awareness of the risks of this comorbidity, was associated with a lack of improvement over a similar follow-up period.&#x0D; Conclusions. Elderly patients with the consequences of total knee arthroplasty and sarcopenia require the development of physical therapy programs taking into account and correcting the specifics of each condition, the presence of physical status disorders and the risk of falling, which will increase the overall effectiveness of rehabilitation measures.

Future Proofing Streaming Video Acquisitions: A Medium Sized Academic Library Adapts

ABSTRACT The pedagogical appeal of using film in higher education, while not new, has undeniably grown since the COVID-19 pandemic necessitated remote teaching for health and safety reasons. This dramatic rise in streaming video requests is challenging for academic libraries of all sizes. Yet, smaller- and medium-sized institutions have personnel who already juggle multiple roles and responsibilities, resulting in chaos and the need for new workflows. This article will reflect on the past 24 months of managing streaming video at the University of San Diego’s Copley Library, comparing the remote instruction period to the hybrid teaching that followed.

Wearable Devices in Pulmonary Arterial Hypertension: What Are We Trying to Learn?

Background Wearable technologies (accelerometers) are currently being evaluated as an alternative to the 6-minute walk test as an objective measure of functional status in pulmonary arterial hypertension (PAH). Multiple observational studies incorporating accelerometers have shown patients with PAH have low physical activity (PA) time. Implications for clinicians Despite widespread use of accelerometers, PA has not been shown to increase after adding vasodilator therapy, which suggests a behavioral component influencing activity. A decrease in PA from baseline may identify clinical worsening and someone at risk for future hospitalization. Cardiac Effort, the number of heart beats used during the 6-minute walk test/6-minute walk distance (beats per meter), has less variability than 6-minute walk distance and provides a comparable clinic measurement in the home setting. Cardiac Effort may provide a better remote measurement than changes in total daily activity when evaluating for clinical improvement. Conclusions The amount and duration of PA achieved in patients with PAH is likely related to a combination of right ventricular (RV) function, deconditioning, and environmental factors. Strategies to target all aspects are needed to improve PA. Further studies are needed to determine the optimal remote measure and monitoring period.