Frequency Of Sessions Research Articles

EFFECTS OF A PRESCRIBED, SUPERVISED EXERCISE PROGRAMME ON HEALTH-RELATED QUALITY OF LIFE IN ONCOLOGY PATIENTS: A RETROSPECTIVE OBSERVATIONAL COHORT STUDY

INTRODUCTION & AIMS Individuals diagnosed with cancer experience significant physical and psychosocial consequences from oncological treatment. Based on current research, exercise therapy may be a valuable non-pharmacological approach to improve health-related quality of life (HRQoL). However, the effectiveness of individually tailored exercise programs to improve quality of life in real-world settings is understudied. The current study aims to analyse preliminary clinical data regarding the impact of tailored exercise supervised within an Australian private day hospital (LIFT) on HRQoL in individuals diagnosed with cancer. METHODS A retrospective longitudinal cohort study was conducted on adults diagnosed with cancer who attended the LIFT clinical service for at least 12 months between 2020 and 2023. QoL and symptoms were assessed using the Functional Assessment of Cancer Treatment – General Questionnaire (FACT-G). Data collected included diagnosis (type and stage), medical treatment, session frequency, and demographic data. RESULTS Overall, 40 patients (age=67.0±16.8 years) met the inclusion criteria. A within-group analysis demonstrated significant findings in the subscales of emotional wellbeing (p = 0.008) and functional wellbeing (p = 0.003), and significance was also found in the total FACT-G score (p = 0.0019). Interestingly, while not statistically significant, a clinically significant difference in HRQoL was found between individuals completing ≤1 or ≥ 2 supervised exercise sessions per week at LIFT cancer care centre, favouring those completing ≥ 2 sessions. CONCLUSION Preliminary analysis indicated that a “real-world” individualised supervised moderate-vigorous exercise within a day hospital has the potential to significantly improve HRQoL outcomes in individuals diagnosed with cancer.

Combination of granulocyte–monocyte apheresis and ustekinumab: Multicentre and retrospective study

ObjectiveGranulocyte–monocyte apheresis (GMA) has shown to be safe and effective in ulcerative colitis (UC), also in combination with biologics, mainly with anti-TNF. The aim of this study was to evaluate the efficacy and safety of combining GMA after primary non-response (PNR) or loss of response (LOR) to ustekinumab (UST) in patients with UC. Patients and methodsA retrospective study was performed in 12 IBD Units, including all patients with refractory UC or unclassified IBD (IBD-U) who received combined GMA plus UST. The number and frequency of GMA sessions, filtered blood volume and time of each session were registered. Efficacy was assessed 1 and 6 months after finishing GMA by partial Mayo score, C-reactive protein (CRP) and fecal calprotectin (FC). Descriptive statistics and non-parametric tests were used in the statistical analysis. ResultsSeventeen patients were included (15 UC, 2 IBD-U; median age 47 years [IQR, 35–61]; 59% male; 53% E3). Most patients (89%) had prior exposure to anti-TNF agents and 53% to vedolizumab; 65% were also receiving steroids at baseline. Median partial Mayo score at baseline was 6 (IQR, 5–7) and it significantly decreased after 1 and 6 months (p=0.042 and 0.007, respectively). Baseline FC significantly decreased after 6 months (p=0.028) while no differences were found in CRP. During follow-up, 18% patients started a new biologic therapy and 12% required surgery; 64% of patients under steroids were able to discontinue them. Adverse events were reported in one patient. ConclusionGMA can recapture the response to UST in selected cases of UC after PNR or LOR to this drug.

Examining biomedical waste management knowledge and training level among health care professionals in Saudi Arabia

The rapid development of medical care innovations and the use of newer technologies have resulted in a significant rise in the quantity of waste produced per patient within health care facilities. Biomedical waste in particular has emerged as a pressing concern due to its inherent propensity to pose health hazards and cause environmental harm. The World Health Organization has identified a lack of knowledge and training as primary factors contributing to the failure of Biomedical waste management (BMWM). Thus, our study sought to examine the relationship between BMWM level of knowledge and prior training among health care professionals (HCPs) in 4 different regions in Saudi Arabia. Our study used a cross-sectional design to investigate the BMWM level of knowledge and prior training among HCPs in 4 different regions in Saudi Arabia. Multiple linear and logistic regression was used to assess if Biomedical waste management (MBWM) knowledge and prior tanning are significantly associated with the demographics and professional characteristics of HCPs. 501 HCPs participated in the study. More than half were male, the majority fell within the age range of 24 to 36 years and held a bachelor's degree. The level of BMWM knowledge among HCPs was moderate (M=31.14, SD=4.89) and positively associated with HCPs' prior training in BMWM, workplace environment, and overall experience in the field. Only 26% of the HCPs had received prior BMWM training, and it varied considerably by sex, geographic location, and professional experience. Our study demonstrates a moderate knowledge and lack of training in BMWM among HCPs in Saudi Arabia. Thus, we recommend a national strategy for incorporating infection prevention and control methods associated with BMWM into all health care programs. Furthermore, it is imperative for health officials to enact prompt and efficient surveillance measures, as well as conduct frequent training sessions for HCPs and support personnel.

Use of an Augmented Exposure and Response Prevention Procedure in the Treatment of Obsessive-Compulsive Disorder: A Case Report

This case report describes the assessment and treatment of a 21-year-old male with obsessive-compulsive disorder (OCD) using an intensive exposure and response prevention (ERP) treatment program. The patient and his father received daily 2-hour ERP sessions delivered across 10 consecutive weekdays, and monthly follow-up appointments. In addition to the condensed treatment schedule, ERP procedures were augmented to address ongoing family conflict and depressive symptoms. To the best of the our knowledge, this is the first study to include such treatment adaptations within the context of intensive ERP for an adult with OCD. Results indicated target behaviors decreased over the 2-week intensive treatment phase and were maintained during 4 months of follow-up. Ancillary outcomes reported by the patient and his father included more frequent engagement in activities of daily living and improved family communication. Outcomes of this study provide an important step toward establishing recommendations regarding ERP session frequency, especially among patients with comorbid disorders.

Breastfeeding patterns in one-year-old children was not affected by a breastfeeding support intervention

BackgroundBreastfeeding patterns in 12-month-old children play a central role in the mother-infant dyad, but studies describing the patterns are scarce. AimTo investigate breastfeeding patterns in 12-month-old infants before and after a breastfeeding support programme. Study designA baseline/intervention design as part of a larger implementation project aiming to revive the Ten Steps to Successful Breastfeeding programme. SubjectsDuring a 24-h period, 28 mothers from a baseline group and 24 mothers from an intervention group recorded all breastfeeding sessions on a pen and paper form. ResultsThe median (range) frequency of breastfeeding sessions was 6 (1−22) in the baseline group and 7 (1−20) times per 24 h in the intervention group. No significant difference was observed in frequencies between the two groups. The majority of children (57 % in the baseline group and 62 % in the intervention group) exhibited a pattern classified as partial breastfeeding, engaging in breastfeeding 6 or more times per 24 h throughout a substantial part of the day. A second pattern was classified as token breastfeeding, with few breastfeeding sessions, suggesting that breastfeeding occurred primarily for comfort. ConclusionThis study illuminates the breastfeeding behaviours of 12-month-old children and can serve to normalise frequent breastfeeding patterns, potentially aiding mothers who wish to continue breastfeeding beyond infancy. The findings indicate no difference between the groups, suggesting that the implemented intervention did not influence maternal breastfeeding practices at one year of age. This underscores the potential necessity for prolonged support for parents throughout the breastfeeding period.ISRCTN registry: doi.org/10.1186/ISRCTN91972905.

A Two-Phased Pilot Study Evaluating the Feasibility and Acceptability of the Cognitively Enriched Walking Program "Take a Walk with Your Brain" for Older Adults.

Given the aging population, finding solutions to retain optimal cognitive capacity is a research priority. The potential of physical activity to reduce the risk of cognitive decline and to enhance cognitive functioning is established. Combining physical with cognitive activity has been put forward as a potentially even more effective way to promote healthy cognitive aging. Most studies on combined interventions have however been conducted in laboratory settings. This paper reports on a two-phased pilot study evaluating the acceptability and feasibility of a newly developed real-life cognitively enriched walking program for adults aged 65+ years. In Phase I, the feasibility and enjoyability of the cognitive tasks was evaluated by conducting walk-along interviews with older adults (n = 163). In Phase II, the cognitively enriched walking program was piloted in two groups of older adults (n = 19), and the feasibility and acceptability of the program and cognitive tasks was evaluated by means of questionnaires and focus groups. The cognitive tasks (i.e., median scores of ≥3 on a total of 4 (Phase I) and ≥6 on a total of 10 (Phase II) for most of the tasks) and the cognitively enriched walking program (i.e., median scores of ≥7 on a total of 10) were considered feasible and acceptable. Based on the input of the participants, key considerations for a feasible and acceptable program were defined: participants should be sufficiently challenged cognitively and physically, social interaction is an important motivator, cognitive tasks should make use of stimuli reflecting daily life and be conducted in group, the rationale for the tasks should be explained to participants, the frequency of the group sessions should be maximum 2 times a week, and the program should be supervised by a trained coach. These results warrant future research to establish the effectiveness of this program.

Survival Rate of Hemodialysis Patients and Its Predictors: A Multicentric Retrospective Cohort Study

Background: Despite advancements in medical and nursing care, the mortality rate among hemodialysis patients remains unexpectedly high. Objectives: This study aimed to evaluate the survival rates and identify mortality predictors among hemodialysis patients in Qazvin Province, Iran, over a five-year period from March 2015 to March 2020. Methods: This historical cohort study involved 378 hemodialysis patients from seven hospitals in Qazvin province, including Bu Ali Sina, Velayat, Razi, Alvand, Valiasr, Bueen Zahra, and Avaj, covering the period from March 21, 2015, to March 20, 2020. The study was based on data extracted from the patient's medical records, offering a detailed overview of their medical history and treatments during this timeframe. Results: The study revealed a median survival time of 38.5 months, with survival rates at 1, 2, 3, 4, and 5 years being 84.3%, 68.1%, 53.2%, 39.8%, and 18.0%, respectively. Cox regression analysis identified several key predictors of mortality. Mortality rates increased with age, higher levels of blood urea nitrogen, and when hemoglobin levels fell below 10 g/dL or calcium levels exceeded 9.5 mg/dL. Conversely, patients who underwent hemodialysis three times a week had higher levels of education, used fistula access, and experienced significantly lower mortality rates. Conclusions: The study highlighted the need for targeted interventions to improve both the survival rates and quality of life for hemodialysis patients in Qazvin Province. It emphasized the importance of careful monitoring and effective management of factors such as age, blood urea nitrogen, hemoglobin, and calcium levels, as well as the patients' educational background, frequency of dialysis sessions, and type of vascular access. By focusing on these aspects, healthcare professionals in the region could significantly enhance patient outcomes and prognoses in hemodialysis care.

Effects of a Serious Smartphone Game on Nursing Students' Theoretical Knowledge and Practical Skills in Adult Basic Life Support: Randomized Wait List-Controlled Trial.

Retention of adult basic life support (BLS) knowledge and skills after professional training declines over time. To combat this, the European Resuscitation Council and the American Heart Association recommend shorter, more frequent BLS sessions. Emphasizing technology-enhanced learning, such as mobile learning, aims to increase out-of-hospital cardiac arrest (OHCA) survival and is becoming more integral in nursing education. The aim of this study was to investigate whether playing a serious smartphone game called MOBICPR at home can improve and retain nursing students' theoretical knowledge of and practical skills in adult BLS. This study used a randomized wait list-controlled design. Nursing students were randomly assigned in a 1:1 ratio to either a MOBICPR intervention group (MOBICPR-IG) or a wait-list control group (WL-CG), where the latter received the MOBICPR game 2 weeks after the MOBICPR-IG. The aim of the MOBICPR game is to engage participants in using smartphone gestures (eg, tapping) and actions (eg, talking) to perform evidence-based adult BLS on a virtual patient with OHCA. The participants' theoretical knowledge of adult BLS was assessed using a questionnaire, while their practical skills were evaluated on cardiopulmonary resuscitation quality parameters using a manikin and a checklist. In total, 43 nursing students participated in the study, 22 (51%) in MOBICPR-IG and 21 (49%) in WL-CG. There were differences between the MOBICPR-IG and the WL-CG in theoretical knowledge (P=.04) but not in practical skills (P=.45) after MOBICPR game playing at home. No difference was noted in the retention of participants' theoretical knowledge and practical skills of adult BLS after a 2-week break from playing the MOBICPR game (P=.13). Key observations included challenges in response checks with a face-down manikin and a general neglect of safety protocols when using an automated external defibrillator. Playing the MOBICPR game at home has the greatest impact on improving the theoretical knowledge of adult BLS in nursing students but not their practical skills. Our findings underscore the importance of integrating diverse scenarios into adult BLS training. ClinicalTrials.gov (NCT05784675); https://clinicaltrials.gov/study/NCT05784675.

Preferences of Young Adults With Psychosis for Cannabis-Focused Harm Reduction Interventions: A Cross-Sectional Study: Préférences des jeunes adultes souffrant de psychose pour les interventions de réduction des méfaits axées sur le cannabis : une étude transversale.

Cannabis use is common in people with early-phase psychosis (EP) and is associated with worse treatment outcomes. Few targeted interventions for cannabis use behaviour in this population exist, most focusing on abstinence, none focusing on harm reduction. Many people with EP will not seek treatment for their cannabis use with current therapeutic options. Understanding preferences for cannabis-focused harm reduction interventions may be key to improving outcomes. This study aimed to determine preferences of young adults with EP who use cannabis for cannabis-focused harm reduction interventions. Eighty-nine young adults across Canada with EP interested in reducing cannabis-related harms were recruited. An online questionnaire combining conventional survey methodology and two unique discrete choice experiments (DCEs) was administered. One DCE focused on attributes of core harm reduction interventions (DCE 1) and the second on attributes of boosters (DCE 2). We analysed these using mixed ranked-ordered logistic regression models. Preference questions using conventional survey methodology were analysed using summary statistics. Preferred characteristics for cannabis-focused harm reduction interventions (DCE 1) were: shorter sessions (60 min vs. 10 min, odds ratio (OR): 0.72; P < 0.001); less frequent sessions (daily vs. monthly, OR: 0.68; P < 0.001); shorter interventions (3 months vs. 1 month, OR: 0.80; P < 0.01); technology-based interventions (vs. in-person, OR: 1.17; P < 0.05). Preferences for post-intervention boosters (DCE 2) included opting into boosters (vs. opting out, OR: 3.53; P < 0.001) and having shorter boosters (3 months vs. 1 month, OR: 0.79; P < 0.01). Nearly half of the participants preferred to reduce cannabis use as a principal intervention goal (vs. using in less harmful ways or avoiding risky situations). Further research is required to see if technology-based harm reduction interventions for cannabis featuring these preferences translate into greater engagement and improved outcomes in EP patients.

Stock market and the psychological health of investors

AbstractUtilizing a national individual‐level medical dataset and the home bias phenomenon in investment, our study shows a strong and robust link between declines in local stock returns and increased antidepressant consumption among investors. This effect intensifies in areas with higher per capita dividend income, suggesting a direct relationship between higher stock ownership and stronger responses. We confirm that portfolio losses, not local economic conditions, are responsible for increased antidepressant usage during market downturns. Using the frequency of psychotherapy sessions yields similar findings. Moreover, our study supports the loss aversion hypothesis as we find positive stock returns do not influence antidepressant usage.

Transitioning from injectable resin composite restorations to resin composite CAD/CAM veneers: A clinical report.

To describe a shift from injectable resin composite technique to composite resin computer-aided design and computer-aided manufacturing (CAD/CAM) veneers in addressing esthetic concerns associated with diastemas between anterior lower teeth in a clinical case. Among several techniques proposed for direct resin composite restoration, the "Injectable resin composite technique" has gained popularity for its time-efficiency, reduced technique sensitivity, and diminished reliance on clinician skills. However, challenges such as staining and the need for frequent polishing follow-ups may prompt the consideration of more stable alternatives such as indirect veneer restorations. While ceramic veneers offer superior mechanical and optical properties, resin ceramic veneers, especially those milled from CAD/CAM resin ceramic blocks, offer advantages such as rapid, cost-effective production, simplified intra-oral repairs, less susceptibility to fracture, superior stress absorption, and requires minimal tooth preparation, making them an appealing option for many patients. Moreover, a fully-digital approach not only streamlines the process but also saves time and labor while ensuring the delivery of high-quality restorations to patients. In addressing a patient's dissatisfaction with constant polishing of direct resin composite restorations, a shift to resin composite CAD/CAM veneers was implemented. Utilizing a fully-digital approach with CAD/CAM resin ceramic restorations successfully restored both esthetics and function. While the injectable resin composite technique achieves immediate esthetic results, its low color stability necessitates frequent polishing sessions. The replacement of direct resin composite restorations with CAD/CAM resin composite veneers becomes a viable option for patients seeking more stable restorations that require fewer follow-ups. This transition addresses both esthetic concerns and the need for enduring solutions in restorative dentistry.

Current Applications and Future Perspectives of Photobiomodulation in Ocular Diseases: A Narrative Review

The present article provides an overview of photobiomodulation (PBM), also known as low-level laser light therapy (LLLT), which has garnered attention in ophthalmology for its potential therapeutic benefits in various ocular diseases. Photobiomodulation involves the use of low-intensity lasers or light-emitting diodes to stimulate biological processes in target tissues without causing thermal damage. This article discusses how PBM has been explored across various ocular conditions, including ocular surface diseases, age-related macular degeneration, diabetic retinopathy, myopia, amblyopia, and glaucoma. It summarizes findings from human studies and clinical trials demonstrating positive outcomes of PBM treatment in these areas. Moreover, the article emphasizes the importance of establishing standardized treatment protocols in terms of session duration and frequency, light type, and patients’ inclusion criteria to further validate the role of PBM in managing ocular diseases.

Enablers and barriers to rotavirus vaccine coverage in Assam, India- A qualitative study

BackgroundEstimates suggest that 78,000 children died due to rotavirus gastroenteritis annually between 2011 and 2013 in India. The north eastern state of Assam reported 38.4% pediatric diarrheal admissions testing positive for rotavirus. Rotavirus vaccine (RVV) was introduced in Assam in 2017 following which the National Family Health Survey-5 (NFHS-5) (2019) revealed low RVV coverage in Assam with wide variation between the districts. the current study was conceptualized and undertaken to capture the enablers and barriers to RVV coverage in Assam. MethodsQualitative study conducted in 5 randomly selected districts in Assam. Participants (key informants) were recruited by purposive sampling at each level of the health system including healthcare officials, service providers and caregivers based on availability. Thirty-five in-depth interviews (IDIs) and five focus group discussions (FGDs) were conducted. Interviews were tape recorded and transcribed. Data was coded and analyzed using the thematic framework approach. ResultsFindings from the qualitative data collection were collated and analyzed under 7 identified themes. Difficult terrain, limited service provider availability and no catch-up training for new recruits were some of the barriers to RVV coverage. In contrast, Information, Education & Communication (IEC) in vernacular language, RVV safety profile, development partner support and adequate RVV supply were identified as some of the enablers of RVV coverage. ConclusionFew broad recommendations to overcome identified barriers include comprehensive inter-sectoral coordination, regular monitoring and frequent refresher training sessions. There is a need for a future study utilizing existing coverage data and larger sample size to triangulate the findings of this study.

Virtual pulmonary rehabilitation approaches in patients with post COVID syndrome: a pilot study

BackgroundThe characteristics of optimal virtual pulmonary rehabilitation (PR) for individuals with post-COVID syndrome (PCS) have not been identified. This study aimed to assess the feasibility, safety, and satisfaction associated with a virtual PR program with the exercise component delivered through group or self-directed sessions.MethodsAdults with PCS-respiratory symptoms were randomly assigned to the video conference (PRVC) or self-directed (PRSD) group and completed an exercise program (aerobic, strengthening, and breathing exercises) three times/week for eight weeks. PRVC sessions were led by a physiotherapist via Zoom, whereas the PRSD group exercised individually following a pre-recorded video. Both groups received personalized exercise recommendations, education related to the condition, and a weekly follow up call. Satisfaction was assessed through a patient survey. Lung function, dyspnea, fatigue, sit-to-stand capacity, health-related quality of life, and participation were assessed pre- and post-PR.ResultsFourteen PCS individuals (49 ± 9 years, 86% females) completed 83% of the sessions. All participants were satisfied with information provided by the therapist and frequency of data submission, whereas most were satisfied with the frequency and duration of exercise sessions (88% in PRVC and 83% in PRSD). A higher proportion of participants in the PRVC (88%) were satisfied with the level of difficulty of exercises compared with the PRSD (67%), and 84% of the sample reported a positive impact of the program on their health. No adverse events were reported. Significant changes in sit-to-stand capacity (p = 0.012, Cohen’s r = 0.67) and questions related to fatigue (p = 0.027, Cohen’s r = 0.58), neurocognitive (p = 0.045, Cohen’s r = 0.53), and autonomic (p = 0.024, Cohen’s r = 0.60) domains of the DePaul Symptom Questionnaire short-form were also found between groups.ConclusionVirtual PR with exercises delivered via video conference or pre-recorded video were feasible, safe, and well-received by individuals with PCS.Trial registrationNCT05003271 (first posted: 12/08/2021).

Effect of Lavender Aromatherapy on Anxiety and Fatigue in Hemodialysis Patients: A Systematic Review and Meta-Analysis.

Several studies have evaluated the effects of lavender essential oil on the anxiety of hemodialysis (HD) patients, but most of them did not estimate the pooled effect size. The current systematic review and meta-analysis was conducted to evaluate the effects of lavender on anxiety and fatigue among HD patients. Eligible studies were selected based on the PRISMA steps and protocol. Literature was retrieved from PubMed, Web of Science, Scopus databases, Cochrane, ClinicalTrials.gov, and Google Scholar Search Engines until Sep 2022. The risk of bias and analysis were evaluated using version 2 of the Cochrane risk-of-bias tool and STATA v.14 software, respectively. Effect sizes were pooled using random effect models. Nine studies were included. Lavender oil significantly reduced the average anxiety of HD patients compared to the control group (SMD: -2.51, 95% CI: [-3.56, -1.45], Z=4.67, P<0.001, I2 :89.9%). Also, it significantly reduced the average fatigue compared to the control group (SMD: -1.56, 95% CI: [-2.49, -0.63], Z=3.29, P=0.001, I2:92.2%). Subgroup analysis indicated controversial results regarding session frequency and drop number of lavender oil. Using Lavender oil significantly reduced fatigue and anxiety in HD patients.

Is the cost of the new home dialysis techniques still advantageous compared to in-center hemodialysis? An Italian single center analysis and comparison with experiences from western countries.

Potential advantages of home dialysis remained a questionable issue. Three main factors have to be considered: the progressive reduction in the cost of consumables for in-Center hemodialysis (IC-HD), the widespread use of incremental Peritoneal Dialysis (PD), and the renewed interest in home hemodialysis (H-HD) in the pandemic era. Registries data on prevalence of dialysis modalities generally report widespread underemployment of home dialysis despite PD and H-HD could potentially provide clinical benefits, improve quality of life, and contrast the diffusion of new infection among immunocompromised patients. We examined the economic impact of home dialysis by comparing the direct and indirect costs of PD (53 patients), H-HD (21 patients) and IC-HD (180 patients) in a single hospital of North-west Italy. In order to achieve comparable weekly costs, the average weekly frequency of dialysis sessions based on the dialysis modality was calculated, the cost of individual sessions per patient per week normalized, and the monthly and yearly costs were derived. As expected, PD resulted the least expensive procedure (€ 23,314.79 per patient per year), but, notably, H-HD has a lower average cost than IC-HD (€ 35,535.00 vs. € 40,798.98). A cost analysis of the different dialysis procedures confirms the lower cost of PD, especially continuous ambulatory PD, compared to any extracorporeal technique. Among the hemodialysis techniques, home bicarbonate HD showed the lowest costs, while the weekly cost of Frequent Home Hemodialysis was found to be comparable to In-Center Bicarbonate Hemodialysis.

Factors contributing towards effective maritime simulator training: a systematic literature review

ABSTRACT Training is essential in every industry, and the maritime industry is no exception. Effective training plays a crucial role in ensuring the safety and efficiency of maritime operations. The current study is a systematic literature review examining the factors contributing to effective maritime simulator training. The study identifies key factors that influence the success of simulator training programs, including the quality of training materials, the competency of trainers, the use of realistic scenarios, and the frequency of training sessions. Other important factors include the use of feedback mechanisms, the integration of new technologies, and the inclusion of human factors in the training curriculum. Considering all these factors, the study highlights the need for a comprehensive and integrated approach to maritime simulator training. It also suggests that using advanced simulation technologies, such as virtual reality and artificial intelligence, can enhance the effectiveness of simulator training programs. Overall, this systematic literature review provides valuable insights into the factors contributing to effective maritime simulator training and offers recommendations for improving the design and implementation of such programs.

Impact of Early Mobilization on Patients With Acute Ischemic Stroke Treated With Thrombolysis or Thrombectomy: A Randomized Controlled Trial

Background Early mobilization (EM) within 24 to 72 hours post-stroke may improve patients’ performance and ability. However, after intravenous thrombolysis (IVT) or mechanical thrombectomy (MT), the increased risk of hemorrhagic complications impacts the implementation of early out-of-bed mobilization. Few studies have investigated EM after IVT or MT for acute ischemic stroke (AIS), and its impact in these patients is unknown. Objective To investigate the effect of EM on AIS treated with IVT or MT.| Methods We recruited 122 patients with first AIS; 60 patients were treated with IVT, and 62 patients were treated with MT. For each IVT and MT cohort, the control groups received standard early rehabilitation, and the intervention groups received an EM protocol. The training lasted 30 minutes/day, 5 days/week until discharge. Main Outcomes Measures The effectiveness of the interventions was evaluated using the motor domain of the Functional Independence Measure (FIM-motor) and the Postural Assessment Scale for Stroke Patients (PASS) at baseline, 2-week, 4-week, and 3-month post-stroke, the Functional Ambulation Category 2-week post-stroke, and the total length of stay at the stroke center. Results Both IVT and MT treatment groups showed improved FIM-motor and PASS scores over time; however, only the IVT EM group had significantly improved FIM-motor performance within 1 month after stroke than the control group. Conclusion. An EM protocol with the same intervention time and session frequency per day as in the standard care protocol was effective in improving the functional ability of stroke patients after IVT.

Indicators of learning disabilities among kindergarten students from the perspective of their teachers

Introduction. The study of children's learning disabilities is highly relevant to the global scientific community for several compelling reasons. First and foremost, early identification and intervention in learning disabilities among kindergarten students can significantly impact their long-term academic and social development. By shedding light on indicators of learning disabilities from the perspective of teachers, this research contributes vital insights that can inform evidence-based practices and policies aimed at improving the educational outcomes of young children worldwide. In the vibrant city of Amman, where educational paradigms are progressively evolving, it is crucial to scrutinize the indicators of learning disabilities at this fundamental stage. This research paper aims to fill a critical knowledge gap by delving into the manifestations and indicators of learning disabilities among kindergarten student, as observed and reported by their dedicated teachers in Amman. Study participants and methods. Engaging a sample of 183 teachers (Jordan, Amman), the study examines the relationship between demographic characteristics (age, years of experience, and level of education) and teachers’ observations of learning disabilities, intervention strategies employed, and the sufficiency of professional development and administrative support received. Results. Demographically, the majority of participants were in the age groups of 20-29 (39.9%) and 30-39 (44.3%), with 75.4% holding Bachelor's Degrees. In terms of learning disabilities observation, a substantial number of teachers agreed (38.3%) or strongly agreed (31.7%) that students exhibited difficulty following instructions, and a similar pattern was observed for poor academic performance, with 35.5% agreeing and 35.5% strongly agreeing. Behavioral issues were acknowledged by 39.3%, and 29% strongly agreed. For social interaction problems, 31.7% agreed, and 27.9% strongly agreed. In terms of intervention strategies, peer tutoring was perceived as effective by 36.6% who agreed and 39.9% who strongly agreed. Visual and auditory learning aids were viewed positively, with 41% agreeing and 42.6% strongly agreeing on their effectiveness. Individualized learning plans also garnered support, with 35% agreeing and 36.6% strongly agreeing. In terms of professional development and support, the majority found the frequency of training sessions (53.6%) and the quality of training materials (56.3%) to be adequate, while a significant proportion indicated administrative support (53.6%) as adequate. Practical significance. These findings hold practical significance for educators, policymakers, and scholars, serving as a vital resource for informing policy decisions and pedagogical practices in early childhood education. Additionally, they offer a solid groundwork for future research and the formulation of effective strategies to address learning disabilities in this critical educational domain.

Adherence to Voice Therapy Among Patients with Dysphonia: The Impact of Cultural Background

Voice therapy (VT), a cornerstone in dysphonia treatment, relies on patient adherence for efficacy. Despite its positive outcomes, adherence rates remain consistently low. This study investigates the impact of cultural background on adherence to VT. This is a retrospective cohort study that included all adult patients referred to our institution's Speech and Hearing unit, in 2018 for VT related to dysphonia. The study group included a distinct adult minority group (Bedouin Arabs) which was compared to a control group. Adherence rates, demographic factors, and therapy outcomes were analyzed. A total of 137 adult patients with dysphonia (20 in the study group and 117 in the control group) were included. There were no significant differences in adherence rates between the study and control groups (75% vs 74.3%, P=1), with an overall nonadherence rate of 74.4%. The median leg of time for VT was 239days, and the median number of visits was 3.0. Logistic regression analysis, adjusting for age and visits, indicated lower odds of dysphonia improvement in the study group (odds ratios [OR]: 0.12, P=0.05). However, visits showed a significant positive impact on improvement (OR: 2.58, P<0.001). While cultural background does not impact adherence rate, it is associated with different attendance patterns and lower voice outcomes following VT. Future efforts should concentrate on investigating aspects of adherence such as home exercises, accessibility of treatment, and the frequency of follow-up sessions to facilitate customized interventions for specific populations.