Significant Difference In Total Score Research Articles

Quality of life, mood and cognitive performance in older adults with cognitive impairment during the first wave of COVID 19 in Argentina

BackgroundIn Argentina, government has established lock down on 19 March in order to decrease SARS‐COV 2 infection. These restrictions have remained effective for long time, with increase of anxiety depression and insomnia as shown in several studies. Older population was particularly at risk due to greater limitations to go out. Our objective was to evaluate the impact of confinement in quality of life, mood and cognitive performance of older adults with cognitive impairment.MethodLongitudinal descriptive‐observational study. Patients with cognitive impairment (CDR 0.5‐1) attending to virtual cognitive stimulation sessions have participated. Participants have completed by themselves Quality of Life in Alzheimer's Disease scale (QOL AD), Beck Depression Inventory (BDI‐II), Test your Memory (TYM) and an attention and executive battery created by our institution. Same assessments were done at the beginning of the lock down and 7 months later. SPSS program was used and means, standard deviations and paired‐samples t test were calculated.Result51 adults (43 women, mean age: 68.53 SD: 8.06, mean education: 14.33 SD: 2.63) were included. An increase in BDI ‐II score (p = 0.049) and worse performance in one of the executive attention tests (p = 0.012) were found. No significant differences in total score of QOL‐AD (p = 0.090), TYM (p = 0.067), verbal fluency (p = 0.323) or memory tests (p = 0.098) were found. Reviewing sub items, differences in changes in sleep habits (p = 0.021), decrease in the energy level (p = 0.004), worse subjective record of memory capacity (p = 0.028) and decrease in ability to do housework (p = 0.007) were found. In those who lived alone a higher score in BDI ‐ II (p = 0.030) and TYM (p = 0.22) were found.ConclusionThis is the first longitudinal study that measures the impact of lockdown on quality of life and cognitive performance in older adults with cognitive impairment in Argentina. Lockdown and isolation have shown worsening of mood and some quality of life variables and decrease in attention. Finally, our results show an increase in depressive symptoms in those patients who lived alone.

Impact of rapid correction of vitamin D deficiency in asthmatic patients.

Asthma is one of the most common chronic diseases, which is agrowing public health concern worldwide. In recent years, there has been an increasing number of interests in the relationship between vitaminDlevel and asthma control. Hence, the objective of this study was to assess the effect of high doses of vitamin D3 injection on asthmatic patient's respiratory condition and quality of life. This was asingle arm, before and after interventional study involving 18patients with moderate to severe asthma. Spirometry test, St George's respiratory questionnaire (SGRQ) and serum vitaminD assay were performed. Subjects with 25-hydroxyvitamin D3 (25-(OH) D3) < 20 ng/ml were deemed deficient (n = 18) and received 2 intramuscular injections of vitamin D3 300,000 IU at monthly intervals consecutively. The mean changes of forced expiratory volume in the first second (FEV1) were significantly different in subjects who received vitamin D3 injections (p = 0.008). Also, the mean changes in FEV1/forced vital capacity ratio (FEV1/FVC) were significant (p < 0.001) as well as maximum expiratory flow between 25% and 75% of FVC (MEF25-75) (p = 0.001). Interestingly, improvement in clinical parameters of SGRQ was also observed with significant differences in total score (p = 0.001). Naturally, serum vitaminD levels were increased in our patients following the injections (p < 0.001). Our findings suggest that screening for serum 25-(OH) D3 deficiency is important in asthmatic patients and correction of this deficiency with high doses of vitamin D3 injection may lead to improvement in pulmonary function, symptoms and quality of life (QOL).

Mobile Health, Disease Knowledge, and Self-Care Behavior in Chronic Kidney Disease: A Prospective Cohort Study

Mobile health (mHealth) management is an emerging strategy of care for patients with chronic diseases. However, the effect of mHealth management on clinical outcomes of patients with chronic kidney disease (CKD) has not been well-studied. The aim of this study was to investigate the additional influence of mHealth on disease knowledge and self-care behavior in CKD patients who had received traditional education. We designed and developed a new healthcare mobile application, called iCKD, which has several major features, including home-based physiological signal monitoring, disease health education, nutrition analysis, medication reminder, and alarms and a warning system. Trained nurses interviewed patients with CKD using structured questionnaires of disease knowledge and self-care behavior. After propensity score matching, we analyzed 107 patients who used iCKD and traditional education, and 107 who received traditional education. The patients who used iCKD had higher disease knowledge scores than those who received traditional education. In multivariate analysis, iCKD was significantly and positively associated with disease knowledge scores. Patients with high education levels could have greater disease knowledge through using mHealth. There was no significant difference in total scores of self-care behavior between the two groups. In conclusion, mHealth can significantly increase disease knowledge in patients with CKD.

Effects of Spider Cage Therapy in Combination with Conventional Speech Therapy on Speech and Language Function in Children with Cerebral Palsy of Age between 05 and 15 Years

Objective: The objective of study was to determine the effects of spider cage therapy in combination with conventional speech therapy on speech and language function in children with cerebral palsy of age between 05 And 15 Years.&#x0D; Materials and Methods: A total of 20 children from a special institute with cerebral palsy who were provided with spider cage therapy in combination with conventional speech therapy were evaluated from January 2017 to June 2017. Effect of spider cage therapy in combination with conventional speech therapy was determined by applying dysarthric profile revised before and after the treatment.&#x0D; Results: Baseline score on dysarthric profile was 34.76±2.67 and post intervention score was 69.93±8.14. Result indicated that out of 20 children with cerebral palsy, there was a statistically significant difference in total score.&#x0D; Conclusion: The findings suggested that the Mean score of spider cage therapy in combination with conventional speech therapy post treatment in children with cerebral palsy was improved. On the basis of this study it is concluded that speech therapy in combination with conventional speech therapy is more effective in children with cerebral palsy.

P57. A double blind, randomized controlled, prospective trial assessing the effectiveness of oral corticoids in the treatment of symptomatic lumbar stenosis

P57. A double blind, randomized controlled, prospective trial assessing the effectiveness of oral corticoids in the treatment of symptomatic lumbar stenosis

Feasibility and Evaluation of Surgical Simulation with Developed Crisis Scenarios: A Comparison of Performance by Vascular Surgery Training Paradigms

Surgical simulation is an integral component of training and has become increasingly vital in the evaluation and assessment of surgical trainees. Simulation proficiency determination has been traditionally based on accuracy and time to completion of various simulated tasks, but we were interested in assessing clinical judgment during a simulated crisis scenario. This study assessed the feasibility of creating a crisis simulator station for vascular surgery and evaluated the performance of vascular surgery integrated residents (0+5) and vascular surgery fellows (5+2) during a technical testing with an integrated crisis scenario. A Modified Delphi method was used to create vascular surgery crisis simulation stations containing a clinical scenario in conjunction with either an open or endovascular simulator. Senior level vascular surgery trainees from both integrated residencies (0+5) and traditional vascular surgery fellowships (5+2) were then evaluated on two simulation stations: 1) Elective carotid endarterectomy (CEA) where the crisis is a postoperative stroke and 2) Endovascular aneurysm repair (EVAR) for a ruptured abdominal aortic aneurysm (rAAA). Each simulation had a crisis scenario incorporated into the procedure. Assessment was completed using a performance assessment tool containing a Likert scale. Total score was calculated as a percentage. Scores were also sub-divided in the following four categories: Situation Recognition and Decision-making, Procedural Flow, Technical Skills, and Interpretation and Use of Imaging Skills. Student's t-test was used for analysis. 40 senior-level trainees were evaluated (27 fellows and 13 integrated residents) completing 80 simulations. The CEA crisis simulation yielded similar results between both groups (0+5 vs. 5+2, p = 1.00). The 0+5 residents in vascular surgery were graded to be more proficient in the EVAR for rAAA crisis simulation and demonstrated significant differences in Total Score (p = 0.04), Procedural Flow (p=0.03), and Interpretation and Use of Imaging Skills (p = 0.02). The creation of crisis-based simulation for trainees in vascular surgery is feasible and actionable. Integrated 0+5 residents performed similarly to 5+2 fellows on an open carotid endarterectomy (CEA) crisis simulation, but 0+5 residents scored significantly higher compared to traditional 5+2 fellows in an endovascular rAAA crisis simulation. Crisis simulation may offer better educational experiences and improved value compared to routine simulation. Further studies using different procedural models and clinical scenarios are needed to assess the validity of crisis simulation in vascular surgery and to better understand the performance disparities found between these training paradigms.

The Antenatal Risk Questionnaire-Revised: Development, use and test-retest reliability in a community sample of pregnant women in Australia

BackgroundRoutine psychosocial assessment during pregnancy and the first postnatal year is a public health strategy that prioritises early identification of known risk factors for poor perinatal mental health. We aimed to report on the development and use of the Antenatal Risk Questionnaire-Revised (ANRQ-R), contribute normative data for a community sample of pregnant women and examine its test-retest reliability. MethodsThe ANRQ-R was developed in consultation with an expert advisory group. Women completed the ANRQ-R with their midwife at their first antenatal appointment. Test-retest analysis was restricted to women who consented to follow-up and completed a repeat ANRQ-R within four weeks. Results7183 women completed the ANRQ-R (total score M = 12.05, Mdn=10; range =5–49). There were some statistically significant differences in total score across maternal age group (χ2=69.75, p<.001), country of birth (χ2=144.01, p<.001) and socioeconomic quintiles (χ2=20.13, p<.001), however the effect sizes of all differences were either small or not clinically significant. Test-retest reliability for the ANRQ-R total score was good (N = 1670; ICC=0.77). Item-level test-retest reliabilities were moderate to good (ICC range=0.65–0.80; kappa coefficient range=0.31–0.74). LimitationsThe study was conducted at a single site. Although there was significant diversity in terms of maternal age and country of birth, the majority of participants were partnered and resided in socio-economically advantaged areas, limiting the generalisability of results. ConclusionsThis study contributes significant normative data for the ANRQ-R and offers valuable insights for clinicians and researchers working with particular sub-groups of the perinatal population. Additional psychometric examination of the ANRQ-R, including its concurrent and predictive validity, is required.

Examining the association between meal context and diet quality: an observational study of meal context in older adults

BackgroundThough a healthy diet is widely associated with reduced risks for chronic disease and mortality, older adults in the U.S. on average do not meet dietary recommendations. Given that few studies have examined the association between meal context on older adult diet quality, the aims of this study were (1) to compare the dietary quality of foods consumed in different meal contexts, as measured by the Healthy Eating Index 2015 (HEI-2015): meal location, the presence of others, and the use of electronic screens; and (2) to examine which components of the HEI-2015 drove differences in HEI-2015 total scores by meal context.MethodsInteractive Diet and Activity Tracking in AARP study participants (50–74 years) completed the Automated Self-Administered 24-h Dietary Assessment tool (ASA24, version 2011) that included foods and beverages consumed and three meal contexts: “at home” versus “away from home,” “alone” versus “with company,” and “with screen time” versus “without screen time.” A population ratio approach was used to estimate HEI-2015 total and component scores for all food items consumed by meal context. Mean HEI-2015 scores (range: 0–100) for the three meal context variables were compared using t-tests. Where there were significant differences in total scores, additional t-tests were used to explore which HEI-2015 components were the primary drivers. All tests were stratified by sex and adjusted for multiple comparisons.ResultsHEI-2015 scores were lower for meals consumed away vs. at home (mean difference (SE), males: − 8.23 (1.02); females: − 7.29 (0.93); both p < 0.0001) and for meals eaten with vs. without company (mean difference (SE), males: − 6.61 (1.06); females: − 7.34 (1.18); both p < 0.0001). There was no difference comparing with vs. without screen time. When HEI-2015 component scores were examined, fewer total fruits, whole grains, and dairy were consumed away from home or with company; more total vegetables and greens and beans, and less added sugars were consumed with company.ConclusionsOur findings suggest an association between the behavior cues of meal location and companions and dietary choices among older adults. Future studies can explore the individual and interactive effects of meal context on diet quality and subsequent health outcomes.

Validation of the French-Canadian Version of a Short Questionnaire to Assess Knowledge in Cardiac Patients (CADE-Q SV).

The long-term success of cardiac rehabilitation programs rests in part on the patient's ability to maintain health behaviors, which is influence by the patient education received. Therefore, a short and reliable tool to assess patients' knowledge is warranted. The aim of this study was to translate, culturally-adapt and psychometrically validate the French-Canadian version of the Coronary Artery Disease Education Questionnaire Short Version (CADE-Q SV). The French CADE-Q SV - translated and culturally-adapted - was reviewed by 3 bilingual experts in cardiovascular disease. This version was then psychometrically tested in 115 CR patients in two Canadian provinces (Québec and New Brunswick). The questionnaire was completed at patients' first CR session and in the end of their 6-month program to assess interpretability. The internal consistency was assessed using Kuder-Richardson-20 (KR-20) and Cronbach's alpha, factor structure using confirmatory factor analysis, and criterion validity regarding level of education and family income. KR-20 was 0.72. Factor analysis revealed 5 factors, all internally consistent. Criterion validity was supported by significant differences in total scores by educational level and family income (p < 0.05). Results showed that increases in knowledge can moderately increase mean steps per day and peakVO2, with an MCID of 3.00. The overall mean was 15.7 ± 2.0. The area with the highest knowledge was risk factors and the lowest was psychosocial risk. The French-Canadian CADE-SV was demonstrated to have good validity and reliability.

Characteristics and subtypes of depressive symptoms in Chinese female breast cancer patients of different ages: a cross-sectional study

PurposeTo identify the characteristics and subtypes of depressive symptoms and explore the relationship between depressive subtypes and age among Chinese female breast cancer patients.MethodIn this cross-sectional study, 566 breast cancer patients were recruited from three tertiary comprehensive hospital in Shandong Province, China through convenient sampling from April 2013 to June 2019. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9). Data analyses included descriptive analyses, latent class analysis.ResultsThere were significant differences in specific depressive symptoms by age group, but no significant difference in total scores on PHQ-9. The depressive subtypes were severe (Class 4), relatively severe (Class 3; with lower psychomotor agitation/retardation and suicidal ideation), moderate (Class 2; with higher psychomotor agitation/retardation and suicidal ideation), and mild depressive symptoms (Class 1). The distribution of depression subtypes is different in various age groups. In the 45–59 age groups, severe symptoms subtype showed the highest ratios (i.e. 50.3%).ConclusionThis is the first study that analyses depressive symptom characteristics and identifies depressive subtypes in Chinese women with breast cancer across ages to explore symptom heterogeneity. Our findings can contribute to identifying the mechanisms behind these relationships and developing targeted interventions for patients with specific depressive subtypes.

규칙적인 여가활동이 노인의 건강관련 삶의 질에 미치는 영향: 신체적 여가활동을 중심으로

This study examined the effects of regular physical leisure activities on the health-related quality of life (SF-36) of the elderly. For this purpose, pre-post data on health physical fitness factors, body composition factors, and health-related quality of life were compared and analyzed. The subjects of this study were 60 elderly persons who participated in the customized exercise class at the health center in Gyeonggi-do, and 23 elderly people who did not participate in the program. The regular group physical activity program was conducted three times a week for 15 weeks. The data analysis was conducted by analyzing the difference of pre-post test between the experimental group and the control group, and analyzing the difference between the experimental group and the control group. First, the results of the analysis showed that there was a significant decrease in the experimental group in both the body composition and physical fitness among the elderly, but there was no significant decrease in the control group. The experimental group showed significant differences in total score and sub-factors (PF), general health (GH), vitality (VT), mental health (MH), pain (BP), and health change (HC). On the other hand. And the control group showed a decrease in both the total score and sub-factors of health-related quality of life. The results of this study suggest that the elderly who do not have physical activity, the lower their musculoskeletal and cardiovascular functions, and it may have influenced negative on the quality of life related to health. Therefore, regular physical activity is expected to have a positive effect on the quality of life by improving the physical strength and body composition among the elderly. The results of this study suggest the development and activation of programs and service related to leisure activities for the elderly persons.

Addressing knowledge gaps in Parkinson\u2019s disease: a report on the Movement Disorder Society\u2019s Centre-to-Centre initiative to improve Parkinson\u2019s disease services in Lao People\u2019s Democratic Republic

BackgroundLao People’s Democratic Republic (Lao PDR) has only nine neurologists for seven million people; none have formal training in Parkinson’s disease (PD). Medical specialists require sufficient PD knowledge to provide high-quality care.MethodsThis study outlines a Centre-to-Centre programme for developing PD expertise in underserved regions through a tailored two-year educational enterprise between an established movement disorder mentor centre at Chulalongkorn University in Thailand and mentee centres in Lao PDR. Background knowledge of 80 Laotian physicians was assessed using a validated PD knowledge questionnaire containing 26 questions divided into 3 sections (diagnosis, therapeutic options, disease course) before and immediately after one-day kick-start training. Responses were compared across physicians’ demographic groups.ResultsOf 80 respondents, 50 (62.5%) were board-certified physicians, of which 27 (54%) specialised in internal medicine. Apparent knowledge gaps were shown by a 51.2% correct response rate for total score, 52.8% for diagnosis, 50.6% for therapeutic options, and 48.2% for disease course. No significant differences in total score or any domain sub-scores between neurologists and other specialties were found. Many did not know which non-motor symptoms could occur as prodromal symptoms or late in course of PD. Incorrect responses mainly reflected a lack of knowledge of the impact of medication on disease. Total and domain sub-scores significantly improved after the course (p < 0.05, each). The size of difference of the means was significant for the total score (d = 0.82), therapeutic option (d = 0.56), and disease course (d = 0.68) sub-scores.ConclusionsSignificant improvement of PD knowledge amongst Laotian physicians is demonstrated after a training course, focusing on practical management of PD. Our findings highlight the importance of continued medical education, especially PD-specific training.

Impact of a Preschool Obesity Prevention (I-POP) Program on Nutrition Knowledge Scores of Head Start Parents and Teachers

Abstract Objectives To determine the effectiveness of an evidence-based preschool obesity prevention intervention on rural, low-income parents’ and Head Start teachers’ nutrition knowledge relative to advice from experts, nutrient content of foods, and health benefits of foods. Methods Parent-child dyads were recruited from 9 randomized Head Start centers with 5 centers in the experimental group and 4 centers in the control. The intervention consisted of 8 weekly evidence-based nutrition education sessions for children delivered by the Head Start teachers; a teacher workshop on the use of Positive Behavior Interventions and Supports (PBIS) in the classroom; and 8 parent workshops using an evidence-based behavioral intervention, Parent Child Interaction Therapy (PCIT). The PBIS and PCIT reinforced nutrition education sessions by including instruction for positive meal-time behaviors. A repeated measures design consisted of data collected at pre- (T1), post-intervention (T2), and a 6-month follow-up (T3). T1 and T2 results of a validated and reliable nutrition knowledge survey to address the sub-objective of the main study are reported here. Results 175 parents and 75 teachers participated in T1 data collection, of which 95 parents and 64 teachers completed T2. There were no significant differences in total scores within or between parent or teacher groups, scoring an average of 34% and 38% out of 100% for parents and teachers, respectively. However, there was a significant change in the knowledge of health benefits of foods survey section (31.6% to 39.5% correct) for parents in the experimental group from T1 to T2 (P &amp;lt; .05). Conclusions Overall, parents and teachers had poor knowledge of advice from experts, nutrient content of foods, and health benefits of foods at T1. Parents and teachers did have minimal, indirect nutrition education during PCIT and PBIS, which may have contributed to parents’ increase in awareness of health benefits of food at T2. However, there may be a lack of knowledge of how to apply nutrition principles. Nutrition education and intervention should target parents and teachers of children with a specific aim in application of nutrition principals. Funding Sources US Department of Health and Human Services, Office of Minority Health.

Evaluation of the effectiveness of immersive virtual reality-based exercise system for vestibular rehabilitation

Objective:To evaluate the efficacy of virtual reality technology assisted vestibular rehabilitation training（VRT） in treating chronic vestibular dysfunction patients. Method:Ninety-eight vestibular dysfunction patients were assigned into the experimental group（n=73） and the control group（n=25） using mechanical sampling. The experimental group received immersive virtual reality assisted VRT treatment, while the control group received conventional VRT treatment. Chinese vertigo symptom scale（VSS-C） was used to measure vertigo symptoms before treatment and 12 weeks post-treatment. Balance feedback instrument was used to measure the center of pressure（COP）, maximum oscillation length（MOL） and COP envelope area（EA） which smaller numbers indicating better balance functions. Analysis of variance and Fisher's exact test were performed using SPSS 20.0 software to compare mean values and frequencies, respectively. Result:①Before treatment as baseline, there were no statistically significant differences in the total score of VSS-C scale, balance correlation and anxiety correlation score between the two groups. Total score and balance related score of experimental group were significantly different between before and after treatment（P<0.01）, while no statistically significant difference in anxiety related scores. After treatment, there were statistically significant differences in total VSS-C score（P<0.01） and balance correlation score（P<0.05） between the two groups, while no statistically significant difference in anxiety correlation score. ②After 12 weeks of treatment, there were statistically significant differences between MOL and EA in open-eye state（P<0.01）, but no statistically significant difference in close-eye state between two groups. Conclusion:The introduction of VR technology by VRT can provide interesting interactions for patients in training and encourage patients to actively participate in various repetitive rehabilitation exercises that are boring, achieving good effect. The effect of VR on subjective balance rehabilitation without visual impairment is better than that of conventional.

Defecatory Dysfunction After Colon Cancer Resection: The Role of Inferior Mesenteric Artery Tie.

Although oncological results for resection of colon cancer with inferior mesenteric artery (IMA) ligation at its origin (high tie) or immediately below the left colic artery (low tie) are similar, injury of the superior hypogastric plexus may be caused when the IMA is tied at its origin, thus impairing defecatory functions. The importance of IMA tie location on defecatory dysfunction in patients undergoing laparoscopic sigmoidal resection without preoperative radiation therapy was studied. From February 2013 to December 2018, 56 consecutive patients submitted to curative laparoscopic resection for stage II and III, M0, sigmoidal cancer were randomized to a high or low tie of the IMA. All demographic data and information on symptoms and comorbidity, intra- and post-operative outcomes and defecatory function before and after surgery [according to the following scales: Fecal Incontinence Quality of Life (FIQL) scale, Jorge-Wexner incontinence and Agachan-Wexner constipation scores] were collected into a computerized database. All patients completed the questionnaires. The educational and social status, and lifestyle habits (defined as active or sedentary) of our groups were similar. A significant difference in total score of FIQL scale was observed between the high and low tie groups at 1 month [88±6 and 93±7, p=0.005, confidence interval for the difference between mean values (CIΔ)=1.706-9.065] and 6 months (93±7 and 97±6, p=0.030, CIΔ=0.390-7.547). The Jorge-Wexner incontinence scores showed a significant decrease in patients of the high group (1 month: 0.59±0.76 and 6 months: 0.62±0.79, respectively) when compared to those of the low tie group (1 month 0.17±0.38 and 6 months 0.17±0.38, respectively) (p=0.008 and p=0.006 at 1 and 6 months, respectively). At 1, 6 and 12 months, the overall Agachan-Wexner constipation scores were significantly higher in patients of the high tie group when compared to those of the low tie group (1 month: 5.1±1.1 and 4.3±0.86, p=0.002, CIΔ=-1.350--0.316; 6 months: 7.4±1.4 and 6.2±1.4, p=0.003, CIΔ=-1.959--0.436; and 12 months: 7.2±1.3 and 6±1.1, p=0.001, CIΔ=-1.840--0.576, respectively). Patients affected with stage II and III sigmoidal cancer had a better fecal continence at the short- to medium-term and less abdominal pain in the medium- to long-term when a low tie technique was utilized.

Inadequate Knowledge and Practice of Pharmacovigilance affecting Adverse Drug Reaction Reporting by Health Professionals in Private Healthcare Facilities in Lusaka, Zambia

Background:&#x0D; There is currently insufficient information regarding the levels of knowledge and practice of Adverse Drug Reactions (ADRs) reporting among healthcare professionals in Zambia.&#x0D; Aim:&#x0D; The study examined knowledge, attitude and reporting practices among medical doctors, pharmacists and nurses in private healthcare facilities in Lusaka, Zambia.&#x0D; Methods:&#x0D; A descriptive cross-sectional study was undertaken. Data was collected using a selfadministered questionnaire assessing general knowledge, attitudes and practice of ADR reporting. A rated score was used to categorize knowledge as poor, average, or good. A Kruskal-Wallis H test followed by Bonferroni test was used to compare knowledge levels among medical doctors, pharmacists and nurses, respectively. To assess practice and attitude towards the ADR reporting,proportions were used to analyze responses to items in each of the respective domain.&#x0D; Results:&#x0D; General knowledge of ADR reporting among the medical doctors, pharmacists and nurses in the private sector was relatively low. A Kruskal-Wallis H test showed that there was a statistically significant difference in total score between thedifferent occupations, ÷ 2 (2) = 10.839, p = 0.004, with a mean rank score of 34.08 for pharmacists (n =18), 22.17 for doctors (n = 24) and 16.19 for nurses (n = 8). Low knowledge levels of ADR reporting were attributed to lack of pharmacovigilancetraining, with thirty nine (78%) of the participants indicating that they had never received any training on ADR reporting and thirty seven participants (74%) indicated that they had never reported an ADR. Factors that discouraged ADR reporting included: practitioner concern that the information reported may be wrong (46.8%); the level of clinicalknowledge to decide whether an ADR had occurred (46.8%); lack of time to complete the ADR report forms (36.2%); reporting generating extra work load (25.5%); and the perceived unimportance of reporting a recognized ADR believing it would make little difference to knowledge and practice (19.1%). The major factors that encouraged ADR reporting included: seriousness of the ADR (98%); unusual reactions (77.6%); adverse reaction to a new product (83.7%); confidence in diagnosis of an ADR (73.5%), and if the reaction was well recognized for a particular drug (67.3%). The training of personnel in private practice was major indicator for improvement of ADR reporting.&#x0D; Conclusion:&#x0D; Despite the relative positive attitudes indicated, low levels of knowledge due to lack of training was the main driver of ADR underreporting practice among private health practitioners that participated in this study.Addressing the knowledge and practice gaps identified will go a long way to further improveADR reporting rates and medication safety in private healthcare practice settings.

الوحدة النفسیة وفقًا لمستوى النرجسیة لدى المتفوقین دراسیًا والعادیین من طلاب کلیة التربیة بجامعة الأزهر Psychological Loneliness According to Level of Narcissism among High achieving and Average Students at Faculty of Education Al-Azhar University

حاول البحث الکشف عن الفروق في الوحدة النفسية وفقا لمتغيري النرجسية (مرتفع / متوسط / منخفض) والأداء (متفوق دراسيا / عادي)، والتعرف على التفاعل بين هذين المتغيرين في الوحدة النفسية، وذلک لدى عينة قوامها 319 من طلاب کلية التربية بجامعة الأزهر. واستخدم مقياس الوحدة النفسية ومقياس النرجسية، وکلاهما من إعداد الباحث. وأسفرت النتائج عن وجود فروق دالة في الدرجة الکلية للوحدة النفسية وبعديها (اضطراب العلاقات الاجتماعية، وافتقاد إشباع الحاجات النفسية) وفقا لمتغير النرجسية في اتجاه مرتفعي النرجسية، ووفقا لمتغير الأداء في اتجاه المتفوقين دراسيا. کما وجد تفاعل دال إحصائيا بين متغيري مستوى النرجسية والأداء الدراسي في الدرجة الکلية للوحدة النفسية وبعديها (اضطراب العلاقات الاجتماعية، وافتقاد إشباع الحاجات النفسية). This research attempted to identify differences in psychological loneliness according to level of narcissism (high / moderate / low) and academic performance (high achieving / average) as well as pointing out the interaction between both variables on psychological loneliness. The sample consisted of (319) students at the faculty of education Al-Azhar University. Both variables of psychological loneliness and narcissism (prepared by the researcher) were utilized. Results yielded statistically significant differences in total score and both dimensions (social relations disruption – lack of psychological needs satisfaction) of psychological loneliness according to level of narcissism (in favor of those with high levels of narcissism) and academic performance (in favor of the high achievers). Additionally, there was a statistically significant effect of interaction between both variables of level of narcissism and academic performance on total score and both dimensions (social relations disruption – lack of psychological needs satisfaction) of psychological loneliness.

Association of quality of life with physical activity, depression, and demographic characteristics and its predictors among medical students.

BACKGROUND:Medical students face a variety of challenges during their years of medical education that can affect their quality of life (QOL). This study aimed to investigate the association of QOL with physical activity (PA), depression, and demographic characteristics, as well as to determine its predictors among medical students in different stages of education.METHODS:A cross-sectional descriptive-correlational study was conducted on 186 medical students of Tabriz University of Medical Sciences in different educational stages including basic sciences, physiopathology, externship, and internship using stratified random sampling method. Data were collected using demographic questionnaire, International PA Questionnaire, World Health Organization QOL Questionnaire, and Beck depression inventory-2. Data analysis was performed using SPSS/Ver 23 through descriptive and analytic statistics including one-way analysis of variance, independent t-test, Pearson and Spearman correlation coefficient, and multivariate linear regression model.RESULTS:There were significant differences in total score of QOL among students in different stages (P < 0.05). There were indirect significant correlations between total score of QOL (β [confidence interval 95%]:−0.85 [−1.11–−0.59]) and its all subdomains with Beck depression score but direct significant correlations with total PA (P < 0.05) except for social relationship. Educational stage, employment status, family income, inhabitant, moderate PA, and depression were the predictors of QOL and altogether explained 63% of its variance.CONCLUSIONS:To pay attention to the predictors of QOL, life among medical students seems necessary for increasing their QOL to provide high-quality care for people with disabilities as well as for the whole community.

Inadequate Knowledge and Practice of Pharmacovigilance affecting Adverse Drug Reaction Reporting by Health Professionals in Private Healthcare Facilities in Lusaka, Zambia

Background:&#x0D; There is currently insufficient information regarding the levels of knowledge and practice of Adverse Drug Reactions (ADRs) reporting among healthcare professionals in Zambia.&#x0D; Aim:&#x0D; The study examined knowledge, attitude and reporting practices among medical doctors, pharmacists and nurses in private healthcare facilities in Lusaka, Zambia.&#x0D; Methods:&#x0D; A descriptive cross-sectional study was undertaken. Data was collected using a selfadministered questionnaire assessing general knowledge, attitudes and practice of ADR reporting. A rated score was used to categorize knowledge as poor, average, or good. A Kruskal-Wallis H test followed by Bonferroni test was used to compare knowledge levels among medical doctors, pharmacists and nurses, respectively. To assess practice and attitude towards the ADR reporting,proportions were used to analyze responses to items in each of the respective domain.&#x0D; Results:&#x0D; General knowledge of ADR reporting among the medical doctors, pharmacists and nurses in the private sector was relatively low. A Kruskal-Wallis H test showed that there was a statistically significant difference in total score between thedifferent occupations, ÷ 2 (2) = 10.839, p = 0.004, with a mean rank score of 34.08 for pharmacists (n =18), 22.17 for doctors (n = 24) and 16.19 for nurses (n = 8). Low knowledge levels of ADR reporting were attributed to lack of pharmacovigilancetraining, with thirty nine (78%) of the participants indicating that they had never received any training on ADR reporting and thirty seven participants (74%) indicated that they had never reported an ADR. Factors that discouraged ADR reporting included: practitioner concern that the information reported may be wrong (46.8%); the level of clinicalknowledge to decide whether an ADR had occurred (46.8%); lack of time to complete the ADR report forms (36.2%); reporting generating extra work load (25.5%); and the perceived unimportance of reporting a recognized ADR believing it would make little difference to knowledge and practice (19.1%). The major factors that encouraged ADR reporting included: seriousness of the ADR (98%); unusual reactions (77.6%); adverse reaction to a new product (83.7%); confidence in diagnosis of an ADR (73.5%), and if the reaction was well recognized for a particular drug (67.3%). The training of personnel in private practice was major indicator for improvement of ADR reporting.&#x0D; Conclusion:&#x0D; Despite the relative positive attitudes indicated, low levels of knowledge due to lack of training was the main driver of ADR underreporting practice among private health practitioners that participated in this study.Addressing the knowledge and practice gaps identified will go a long way to further improveADR reporting rates and medication safety in private healthcare practice settings.&#x0D;

Impact of web-based learning for health program planning competency, knowledge and skills among mid-level public health nurses: A randomized controlled trial.

To evaluate the impact of web-based learning modules for health program planning competency, recognition, knowledge and skills among mid-level public health nurses (PHNs). Parallel-group randomized controlled trial. During 2018, 244 Japanese PHNs were eligible as participants with 5-20years experiences as a PHN were randomly allocated to the intervention (n=121) or control group (n=123). The outcome was assessed using the Competency Measurement of Creativity for PHNs (CMC) and 26 questions about recognition, knowledge, and skills for health program planning. Eight web-based modules. No significant differences in CMC scores between the control and intervention groups at base line and post-intervention. By contrast, significant differences in total score of the 26 items of knowledge and skills. In an exploratory analysis, there was a significant difference identified in CMC scores in the demographic of post graduate training in program planning at base line and post-intervention. (p=.034). The findings suggested that web-based learning with flexibility in terms of time and location would improve competency, skills and knowledge of health program planning among mid-level PHNs.