Statistical Difference In Levels Research Articles

A Mixed-Methods Cohort Study Evaluating the Impact of a One-Day Well-Being Course for Anesthesia Providers Working in Low-Resource Settings.

Burnout, depression, and anxiety are increasingly recognized as common among health care providers. Risks for these conditions are exacerbated in low-resource settings by excessive workload, high disease burden, resource shortage, and stigma against mental health issues. Based on discussions and requests to learn more about burnout during the Vital Anaesthesia Simulation Training (VAST), our team developed VAST Wellbeing, a 1-day course for health care providers in low-resource settings to recognize and mitigate burnout and to promote personal and professional well-being. This mixed-methods study used quantitative pre- and postcourse surveys using validated mental health measures and qualitative semistructured interviews to explore participants' experience of VAST Wellbeing during and after the course. Quantitative outcomes included burnout and professional fulfillment as measured by the Professional Fulfillment Index and general well-being as measured by the Warwick-Edinburgh Mental Wellbeing Scale. Twenty-six participants from 9 countries completed the study. In the immediate postcourse survey, study participants rated the course overall as "very good" (60.7%) and "excellent" (28.6%). Quantitative analysis showed no statistical differences in levels of work exhaustion, interpersonal disengagement, burnout, professional fulfillment, or general mental well-being 2 months after the course. Five themes on the impact of VAST Wellbeing were identified during qualitative analysis: (1) raising awareness, breaking taboos; (2) not feeling alone; (3) permission and capacity for personal well-being; (4) workplace empowerment; and (5) VAST Wellbeing was relevant, authentic, and needed. Causes of burnout are complex and multidimensional. VAST Wellbeing did not change measures of burnout and fulfillment 2 months postcourse but did have a meaningful impact by raising awareness, reducing stigma, fostering connection, providing skills to prioritize personal well-being, and empowering people to seek workplace change.

THE EFFECT OF BROCCOLI SPROUTS ON OXIDATIVE STRESS MARKERS IN MICE FED WITH CAFETERIA DIET

The aim of our study was to determine the ability of broccoli sprouts to influence the intensity of lipid peroxidation in mice fed a high-calorie cafeteria diet. Materials and methods. In this study, C57BL/6J mice were used. For determinatiom of lipid peroxides (LOOH), we used a method based on the ability of lipid peroxides to convert Fe2+to Fe3+. Then Fe3+ forms a complex with xylenol orange that absorbs light at 580 nm at low pH. The reaction mixture contained coumene hydroperoxide (1 mM), FeSO4*7H2O(1 M), xylenol (4 mM), water and supernatant. Differences between groups were analyzed by Duncan’s test for multiple comparision. Results. During the experiment, we monitored the changes in body mass of mice fed with different diets. There were no differences in LOOH levels in cortexes of mice from all experimental groups, but there was a tendency to the lower content of LOOH in the brain of mice fed with cafeteria diet and broccoli. No statistical differences in levels of LOOH were found between groups, but LOOH levels tended to the highest in the groups fed with broccoli sprouts alone and cafeteria diet. A significant difference was observed in the muscles (C) between the broccoli sprout group and the cafeteria diet + broccoli group. We also found a significant difference between the group fed with the cafeteria diet and the cafeteria diet + broccoli, which may indicate protective effects of broccoli on lipid peroxidation on cafeteria diet. Conclusions. Mice fed with cafeteria diet and broccoli spouts had higher body mass than control mice fed with standard group. Hypothalamus of mice fed with standard diet with broccoli spouts or with cafeteria diet showed a tendency to higher LOOH levels, whereas no effects of the diets were found on cortexes LOOH levels. The cafeteria diet + broccoli group had the lowest muscle LOOH content compared to all other groups. Also, LOOH levels tended to be lower in the cortexes in the hypothalamus of mice fed with cafeteria diet + broccoli as compared with the cafeteria diet group. This suggests the potential protective effects of broccoli spouts.

Subjective well-being level as a predictor of university students' psychological engagement in blended learning

The purpose of this research is to identify the level of subjective well-being of university students in blended learning, investigate the relationship between subjective well-being and psychological engagement, determine the differences in their subjective well-being level in terms of gender and academic discipline variables, and explore the predictability of psychological engagement level through subjective well-being. For this purpose, the descriptive comparative correlative approach was utilised. Three hundred and sixteen male and female students participated in this research. For data collection, the College Subjective Well-being Questionnaire and the psychological engagement scale were applied to the participants. Results demonstrated that students had a high level of subjective well-being in all its dimensions, there was a statistically significant correlation at (0.01) level between psychological engagement and subjective well-being, the level of psychological engagement can be predicted through the level of subjective well-being, there were statistical differences in the subjective well-being level and all its dimensions due to gender in favour of female students, there were no statistical differences in the level of subjective well-being as a whole due to the academic discipline variable, while there were statistical differences in all its dimensions due to the academic discipline in favour of the literary disciplines. Keywords: Blended learning, psychological engagement, subjective well-being

Subjective well-being level as a predictor of university students' psychological engagement in blended learning

The purpose of this research is to identify the level of subjective well-being of university students in blended learning, investigate the relationship between subjective well-being and psychological engagement, determine the differences in their subjective well-being level in terms of gender and academic discipline variables, and explore the predictability of psychological engagement level through subjective well-being. For this purpose, the descriptive comparative correlative approach was utilised. Three hundred and sixteen male and female students participated in this research. For data collection, the College Subjective Well-being Questionnaire and the psychological engagement scale were applied to the participants. Results demonstrated that students had a high level of subjective well-being in all its dimensions, there was a statistically significant correlation at (0.01) level between psychological engagement and subjective well-being, the level of psychological engagement can be predicted through the level of subjective well-being, there were statistical differences in the subjective well-being level and all its dimensions due to gender in favour of female students, there were no statistical differences in the level of subjective well-being as a whole due to the academic discipline variable, while there were statistical differences in all its dimensions due to the academic discipline in favour of the literary disciplines. Keywords: Blended learning, psychological engagement, subjective well-being

Assessing Serum Brain Derived Neurotrophic Factor and Matrix MetalloProteinase-9 Levels and Their Correlation With Neurocognitive and Psychosocial Functioning in Bipolar Disorder-I in Remission: A Case-Control Study

Aims1.To determine the association between serum BDNF, serum MMP-9 and cognitive function test in BD-1 patients in remission and to compare with controls.2.To assess the current psychosocial functioning of BD-I patients in remission and their correlates.MethodsSingle center case control study.Cases were BD-I patients in Remission (n = 60) and controls (n = 60) were age and gender matched healthy persons. The diagnosis of BD-1 was confirmed using Structured Clinical Interview For DSM-IV-Tr Axis I Disorders –Research Version along with clinical record. Age group between18–60 years, in remission for at least 2 months [scoring ≤ 8 on the Hamilton Depression Rating Scale, and ≤ 6 on Young Mania Rating Scale] were included. Those with significant head injury, neurological disorder, substance use disorder, Diabetes/Hypertension and premorbid IQ < 70 were excluded.Control group were excluded if their first degree relative had any psychiatric illness as elicited using Family Interview for Genetic Studies scale (FIGS).Cognitive functioning was assessed using Addenbrooke's Cognitive Examination version III (ACE-III) and Trail making test A and B (TMT A and TMT B). Current psychosocial functioning was assessed with Functioning assessment short test (FAST).Five ml blood sample was taken for estimation of serum BDNF and MMP-9 levels by ELISA.Chi-square test used to compare categorical variables. Mann-Whitney U test for continuous variables. Spearman's correlation - evaluate the relationship between scores on the cognitive function tests and serum levels of BDNF and MMP-9, within the group of patients with BD-I.ResultsWith regards to cognitive functioning, compared to controls, cases performed significantly poor in domains of Memory (Z = −3.435, p = 0.001), Processing speed (z=−2.667, p = 0.008), and Executive functioning (Z= −4.084, p = 0.000).No statistical difference in levels of serum BDNF and MMP-9 between patients and controls were found.While BDNF serum levels were not associated with cognitive or psychosocial functioning, there were significant relation between serum MMP-9 and the various domains of FAST scale and total FAST score (rho = 0.447, p < 0.001).BD-I patients exhibited poor psychosocial functioning compared to controls even in euthymic state (U = 702.00, p < 0.000).ConclusionPatients with BD-I display poor performance in memory, executive function and psychosocial functioning even during euthymic state compared to controls.Serum BDNF and MMP-9 levels comparable to the healthy controls during remission- pointing towards them as state markers rather than trait.Need for routine evaluation of cognitive function during follow-up visits and focus on target deficits for rehabilitation for better recovery and improving the quality of life of BD patients.

FETAL GROWTH RESTRICTION WITH EARLY AND LATE MANIFESTATION, PROGNOSTIC MARKERS

Objective of the study: Comprehensive assessment of risk factors, the implementation of which leads to FGR with early and late manifestation. To evaluate the results of the first prenatal screening: PAPP-A, B-hCG, made at 11-13 weeks. Materials and Methods: A retrospective study included 110 pregnant women. There were 48 pregnant women with early manifestation of fetal growth restriction, 62 pregnant women with late manifestation among them. Results of the study: The risk factors for the formation of the FGR are established. Statistically significant differences in the indicators between groups were not established in the analyses of structures of extragenital pathology. According to I prenatal screening, there were no statistical differences in levels (PAPP-A, b-hCG) in the early and late form of FGR.

Cytokine profile in plasma of severe COVID-19 does not differ from ARDS and sepsis.

BACKGROUNDElevated levels of inflammatory cytokines have been associated with poor outcomes among COVID-19 patients. It is unknown, however, how these levels compare with those observed in critically ill patients with acute respiratory distress syndrome (ARDS) or sepsis due to other causes.METHODSWe used a Luminex assay to determine expression of 76 cytokines from plasma of hospitalized COVID-19 patients and banked plasma samples from ARDS and sepsis patients. Our analysis focused on detecting statistical differences in levels of 6 cytokines associated with cytokine storm (IL-1β, IL-1RA, IL-6, IL-8, IL-18, and TNF-α) between patients with moderate COVID-19, severe COVID-19, and ARDS or sepsis.RESULTSFifteen hospitalized COVID-19 patients, 9 of whom were critically ill, were compared with critically ill patients with ARDS (n = 12) or sepsis (n = 16). There were no statistically significant differences in baseline levels of IL-1β, IL-1RA, IL-6, IL-8, IL-18, and TNF-α between patients with COVID-19 and critically ill controls with ARDS or sepsis.CONCLUSIONLevels of inflammatory cytokines were not higher in severe COVID-19 patients than in moderate COVID-19 or critically ill patients with ARDS or sepsis in this small cohort. Broad use of immunosuppressive therapies in ARDS has failed in numerous Phase 3 studies; use of these therapies in unselected patients with COVID-19 may be unwarranted.FUNDINGFunding was received from NHLBI K23 HL125663 (AJR); The Bill and Melinda Gates Foundation OPP1113682 (AJR and CAB); Burroughs Wellcome Fund Investigators in the Pathogenesis of Infectious Diseases #1016687 NIH/NIAID U19AI057229-16; Stanford Maternal Child Health Research Institute; and Chan Zuckerberg Biohub (CAB).

The Perceptions of Teachers at the Secondary Schools in Bani Obaid District at Irbid City for their Schools by Considering the Schools as Learning Organizations: تصورات معلمي المرحلة الثانوية في لواء بني عبيد بمدينة إربد لمدارسهم كمنظمات متعلمة

This study investigates the perceptions of teachers at the secondary schools in Bani Obaid district at Irbid city for their schools by considering the schools as learning organizations. This study discovers the differences in participant responses that are related to their perceptions by considering the schools as educated organizations based on the following factors: gender, qualifications, and years of experience. To achieve the objectives of the study, the researcher follows the descriptive methodology by preparing a questionnaire which includes (35) parts. The sample of the study consists of (250) male and female teachers in the secondary schools at Bani Obaid district. They were collected randomly from the total number of teachers in that district which is (413). They represent (60%) of the teachers in the district. The perceptions of the teachers of the secondary schools at Bani Obaid district at Irbid city for their schools as educated organizations got (5,64) for the highest average based on the general performance using the tool. The results based on the scopes of the study are as the following: working as a team got the highest average (3.91). The followed scope is the mental models (3.66). The third one is related to the personal ability with average (3.91) then the collective vision with average (3.50) and lastly, the critical thinking with average (3.49). There were not much significant statistical differences in level (α≤0.05) in the sample responses which are related to the study scopes and tool based on the sex and years of experience in addition to (collective vision and personal ability) dimensions based on the qualification. There were significant statistical differences in level (α≤0.05) in the sample responses which are related to the scopes of (collective vision, mental models and teamwork) based on the qualification dimension specially the bachelor degree. Based on the results of the research, the researcher recommends providing financial and moral incentives for the distinguished secondary schools to apply the principles of the educated schools.

Increased serum levels of galectin-9 in patients with chikungunya fever

Chikungunya fever (CHIKF) is an arboviral disease that has caused an epidemic burst of chronic inflammatory joint disease in Latin America in the last few years. Efforts are being spent in understanding the mechanisms by which it may cause such articular damage and in determining possible biomarkers of the disease. Galectins (GAL) are a family of animal lectins with an affinity for beta-galactosides. They have multiple functions including working as receptors in innate immunity and as a control for inflammatory responses in both innate and adaptive immunity. They regulate functions of immune cells, such as lymphocytes and macrophages, which have a main role in the chikungunya inflammatory process. Galectins are also involved in chronification of viral diseases, participate in the immunopathogenesis of chronic joint diseases such as rheumatoid arthritis, and have a role in inflammation in other arboviral diseases, such as dengue. Thus, we intended to determine the serum levels of galectin-1, -3, -4, -7, and -9 in patients with subacute and chronic articular manifestations of CHIKF and to evaluate their associations with clinical manifestations. We evaluated 44 patients with clinical manifestations of CHIKF and serological confirmation with IgM and/or IgG chikungunya virus (CHIKV) antibodies. Forty-nine age- and gender-matched healthy individuals served as controls. Anti−CHIKV IgM and IgG antibodies and galectins serum levels were measured by ELISA. We found higher levels of GAL-9 (patients median 2192 [1500–2631] pg/mL, controls median 46.88 [46.88−46.88] pg/mL, p < 0.0001) and lower levels of GAL-3 (patients median 235.5 [175.5–351.8] pg/mL, controls median 2236.0 [1256.0–2236.0] pg/mL, p < 0.0001) in patients than in controls. There was no statistical difference in levels of GAL-1, -4 and -7 between patients and control groups. There was no difference in GAL-9 serum levels between patients with subacute or chronic symptoms (median 2148 [1500–2722] pg/mL x 2212 [1844–2500] pg/mL, p = 0.3626). A significant association of GAL-9 with joint stiffness, both in its duration and intensity, was found. These results may reflect the participation of GAL-9 in the immunopathogenesis of the inflammatory process in chikungunya fever, as morning stiffness may reflect the systemic inflammatory process.

Clinical and Microbiological Evaluation of Surgical and Nonsurgical Treatment of Aggressive Periodontitis.

The present study aimed to evaluate clinical and microbiological effects of surgical and nonsurgical periodontal therapy in generalized aggressive periodontitis (GAgP) treatment. Sixteen GAgP patients were included in this randomized split-mouth design clinical trial. Maxillary quadrants were allocated into two groups: Nonsurgical Therapy (NST) and Surgical Therapy (ST). The following clinical parameters were assessed: plaque index (PI), bleeding on probing index (BoP), probing depth (PD), clinical attachment level (CAL) and gingival margin position (GMP). Concentrations of Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa) in the subgingival biofilm were also determined. Clinical and microbiological parameters were assessed at baseline (n=16), 3 (n=15), 6 (n=15) and 12 months (n=8) after treatment. ST was able to promote higher PD reduction compared to NST in deep pockets at 12 months (p<0.05) and in posterior teeth at 6 months (p<0.05). In addition, higher gingival recession was observed in posterior teeth of the ST group at the 6th month (p<0.05). However, ST failed to promoted additional CAL gain in any timepoint (p>0.05). Moreover, microbiological evaluation showed no statistical difference in levels of Aa and Pg for both groups at all follow-up periods. Surgical therapy promoted similar clinical benefits to GAgP therapy. Moreover, both therapies failed to reduce Aa and Pg levels at different follow-up times.

Early Recovery of Exercise-Related Muscular Injury by HBOT.

Early recovery from muscular injury is crucial for elite athletes. Hyperbaric oxygen therapy (HBOT) has been reported to be beneficial in terms of accelerating cell recovery and tissue repair, which are considered to be helpful for eliminating fatigue and recovering stamina. This study was performed to evaluate the efficacy of HBOT for exercise-related muscular injury. Forty-one athletes with exercise-related muscular injuries were recruited and randomized into an HBOT group and a control group. All participants received 10 sessions of either HBOT or placebo treatment. The brief pain inventory (BPI) was completed, and serum samples were analyzed. Data were collected before treatment (T1), at the end of the fifth treatment session (T2), at the end of the tenth treatment session (T3), and two weeks after T3 (T4). At T3, the HBOT group showed prominent reductions in the levels of creatine phosphokinase (CK), glutamic oxaloacetate transaminase (GOT), and myoglobin (MB), which lasted until T4. However, the control group did not present any statistical differences in levels from T1 to T4. In terms of pain intensity and interference, the HBOT group showed significant improvements at T3, while no improvements were observed in the control group. In conclusion, HBOT facilitates the early recovery of exercise-related muscular injury. This trial is registered with ISRCTN17817041.

Association of klotho gene polymorphism and the regulation of calcium-phosphate metabolism disorders in patients with end-stage renal disease.

Klotho G-395-A gene polymorphism is associated with several diseases; however, its association with calcium-phosphate metabolism disorders in end-stage renal disease (ESRD) is unknown. A total of 137 patients with ESRD and 80 healthy adults (control) were enrolled in the study. Patients with ESRD were divided into three subgroups: haemodialysis (A1, n = 52), peritoneal dialysis (A2, n = 30), and non-dialysis (A3, n = 55). The klotho G-395-A genotype was detected by TaqMan PCR assay, and ELISA was used to detect the soluble klotho protein (sKL) and fibroblast growth factor (FGF23). Intact parathyroid hormone (iPTH) and other related clinical biochemical parameters were also analyzed for all subjects. (i) Three genotypes (GG, GA and AA) of KL G-395A were detected, and a significant difference between the ESRD and control groups was observed, (ii) sKL was inversely associated with FGF23 in each subgroup and phosphate and positively associated with calcium in A1 and A3. FGF23 was positively associated with phosphate and inversely associated with calcium in each subgroup, (iii) a statistical difference in levels of sKL and FGF23 was observed between GG and AA, as well as between GA and AA. The expression of sKL was lowest and the level of FGF23 was highest in AA and (iv). GA + AA genotypes and FGF23 were risk factors and sKL might be protective factor of calcium-phosphate metabolism disorders. Soluble klotho protein and FGF23 were associated with the regulation of calcium and phosphate metabolism, and the A allele of the G-395A klotho gene polymorphism could be a risk factor on calcium-phosphate metabolism disorders in patients with ESRD.

The effect of electroacupuncture preconditioning on cognitive impairments following knee replacement among elderly: A randomized controlled trial

ObjectiveTo investigate if electroacupuncture (EA) preconditioning can mitigate cognitive impairments and reduce the incidence of postoperative cognitive dysfunction (POCD) following knee replacement and its safety among elderly. MethodsTotally 60 participants met the inclusion criteria were enrolled in a randomized controlled trial a ratio of 1:1, with 30 cases allocated to the treatment group and 30 cases allocated to the control group, respectively. The participants in the treatment group were provided with real-EA therapy whereas participants in control group were provided with placebo-EA therapy (Streitberger Placebo-needle). In both groups, Tou sanshen (头三神) acupoints, including Sìshéncōng (四神聪EX-HN1), Shéntíng (神庭 GV24), and bilateral Běnshén (本神GB13) were adopted as the main acupoints, while Bǎihuì (百会GV20), bilateral Hégǔ (合谷LI4), and bilateral Tàichōng (太冲LR3) were adopted as matching acupoints. Interventions were offered 5 days prior to the surgery, once daily, and continued for total 5 days. The global scores of Mini-Mental State Examination (MMSE), and levels of serum inflammatory cytokines including interleukin 1β (IL-1β) and tumor necrosis factor-α (TNF-α), and S100-β protein were observed at 24 h prior to the surgery, and postoperative 24 and 72 h respectively for assessing the incidence of POCD and the severity of cognitive impairments among patients. Meanwhile, adverse effects were monitored and recorded. Results(1) Compared with baseline, MMSE global scores in both treatment and control groups markedly decreased at postoperative 24 h. MMSE global scores in treatment group decreased from 29.43 ± 0.97 to 27.10 ± 1.95 while that in control group decreased from 29.27 ± 1.01 to 26.83 ± 2.25 (all ?P < 0.05), and this trend continued until postoperative 72 h (at postoperative 72 h, MMSE global scores in treatment group was 26.53 ± 2.26 versus 24.79 ± 3.03 in control group). Moreover, decline in control group was more significant than that in treatment group at postoperative 72 h (P < 0.05). (2) Compared with baseline, levels of serum IL-1β, TNF-α and S100-β in both groups increased markedly at postoperative 24 and 72 h. IL-1β in treatment group increased from 43.13 ± 5.51 to 73.13 ± 2.32 at postoperative 24 h and reached 83.17 ± 5.95 at postoperative 72 h, while IL-1β in control group increased from 44.87 ± 5.83 to 91.10 ± 3.55 at postoperative 24 h and reached 111.93 ± 9.18 at postoperative 72 h; TNF-α in treatment group increased from 51.27 ± 6.48 to 88.80 ± 3.55 at postoperative 24 h and reached 94.37 ± 5.22 at postoperative 72 h, while TNF-α in control group increased from 52.07 ± 7.48 to 116.37 ± 3.14 at postoperative 24 h and reached 121.40 ± 3.68 at postoperative 72 h (both ?P < 0.05), furthermore, increases of IL-1β and TNF-α levels in control group were more significant (P < 0.05). Statistical difference in level of S100-β was not observed (P > 0.05). (3) There was no statistical difference in POCD incidence at postoperative 24 h and postoperative 72 h between two groups (P > 0.05), though the incidence of POCD in patients receiving real-EA therapy was indeed much lower than that in patients receiving placebo-EA therapy, particularly at postoperative 72 h (POCD incidence rate at postoperative 24 h in treatment group was 26.67%, 30.00% in control group; POCD incidence rate at postoperative 72 h in treatment group was 30.00%, 46.67% in control group). (4) No serious adverse events were reported in this trial. No one dropped out from this trial. ConclusionEA preconditioning can mitigate cognitive impairments at post-knee replacement surgery 24 and 72 h in elderly through inhibiting expression of inflammation. However, there is insufficient evidence to support that EA pretreatment can reduce the incidence of POCD.

Effects of biofeedback postural training on pre-existing low back pain in static-posture workers.

Many studies report a relationship between poor static posture (SP) and low back pain (LBP). This study examined the effects of a biofeedback postural training program on pre-existing LBP, changes to level of physical activity and workability in participants. To determine if static posture training with biofeedback alleviates LBP. The control group wore a pedometer to track level of physical activity and the experimental group wore the postural training device, Lumo Lift, for three weeks. Participants completed the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) and completed pre- and post-intervention side-view pictures to evaluate changes in posture. Participants were predominately-sedentary work environment (N= 31; 13men, 18women; age = 33.1 ± 13.3years; height = 170.2 ± 9.7cm; mass = 71.6 ± 17.5kg). LBP discomfort was statistically significant when comparing pretest and posttest CMDQ mean score in all subjects [F(1, 18) = 6.25, p= 0.02]. There was no significant evidence of reducing LBP experience and LBP interference at work when comparing all subjects. There was no statistical difference in level of physical activity by analyzing average steps between the experimental and control groups (95% CI =-1040.4-1845.4, p= 0.57). Postural training with biofeedback application helps with LBP management by decreasing level of LBP discomfort. People with LBP should be aware of their static posture and develop good muscle strength and endurance in order to maintain performance at work, school, or sports.

Validation of the entrustable professional activities for new pharmacy graduates.

The face validity of the core entrustable professional activities (EPAs) for new pharmacy graduates published by the American Association of Colleges of Pharmacy (AACP) in 2017 was evaluated. A 28-item questionnaire was sent to experienced pharmacy practitioners affiliated with 4 schools of pharmacy. In addition to demographic information about education, training, credentials, and practice setting, participants were asked whether each EPA statement was pertinent to pharmacy practice and an expected activity that all pharmacists should be able to perform. Questions regarding the secondary attributes of the EPA statements examined whether each activity is observable, is measurable, is transferable to multiple practice settings, and integrates multiple competencies. The questionnaire was distributed to 137 eligible participants, and 71 usable survey responses were received. Participants consistently agreed (≥75% agreement) that the 15 EPA statements for new pharmacy graduates describe activities that are pertinent to pharmacy practice and that pharmacists are expected to perform. A consistent level of agreement was observed regardless of the preceptor's employment with a college or school, board certification status, or completion of postgraduate training, and no statistical differences in level of agreement were found based on these attributes. There was consistent agreement (≥60%) across geographic regions. No statistical differences in agreement were found between acute care practitioners and ambulatory care practitioners. A survey suggested that the core EPAs developed and vetted by AACP have face validity and are believed by experienced pharmacy preceptor-practitioners to be pertinent to pharmacy practice and to describe activities that all pharmacists should be able to competently perform.

PATIENT PERCEPTION RELATED TO URODYNAMIC TESTING: A QUESTIONNAIRE BASED STUDY

Objective: Urodynamic test is a series of test to evaluate the bladder function including voiding and storage physiology. Several previous studies have found that urodynamic testing had association with physical and emotional discomfort. The primary goal of this study was to determine the parameters of anxiety, pain, and shame related to urodynamic testing. Material &amp; Method: From June 2014 to June 2015, a total of 57 consecutive patients who underwent urodynamic study were included in the present study, consisting of 20 men and 37 women. They have completed the questionnaire before and after urodynamic study. Patients were requested to answer four questions related to pain, embarrassment, anxiety, and knowledge related to urodynamic test. Results: Overall, most of the patients felt not at all and nearly not anxious before urodynamic study. Thirty percent of patient thought that there would be moderate pain when the urodynamic test is performed. Majority of patients (68% of patients) felt no embarrassment prior to the test. Overall, patients felt better after urodynamic study in terms of anxiety and pain. Parameter of embarrassment significantly increased after the test. Patient perception of anxiety and pain before urodynamic test are not significantly different with perception after urodynamic test. Conclusion: Urodynamic tests are very well tolerated by men and women. Majority of patients felt better after urodynamic test according to pain and anxiety score. No statistical difference in level of pain and anxiety between before and after the procedure, while parameter of embarrassment was significantly higher after the test was done.

Risk assessment and risk factors of cardiovascular events among elderly patients in Hangzhou

Objective To investigate the risk factors of cardiovascular disease among elderly patients in Hangzhou and to assess the level of risk of cardiovascular events in 10 years, so as to provide a reliable basis for preventing, reducing and delaying the incidence of cardiovascular events among elderly patients. Methods From June 2015 to June 2016, we selected 8 336 elderly patients with health check-up of medical examination center in two ClassⅢ Grade A hospitals by baseline survey. The Self-Designed Living Behavior Pattern Questionnaire was used to investigate the behavior pattern of living such as smoking. The Guidelines for Prevention of Cardiovascular Disease by WHO/ISH was used to assess the risk of cardiovascular events in 10 years combined with physical examination data. Results Among 8 336 elderly patients with health check-up, there were more than 46.34% of the elderly patients with incidence of cardiovascular events in 10 years for higher than 40%. There were statistical differences in levels of risk of cardiovascular events among patients with different sexes and ages (P<0.01) , and male and the aged were the susceptible population. Among the risk factors of cardiovascular events, the abnormal rate of blood pressure, cholesterol and blood glucose was 72.75%, 67.11% and 39.71% respectively. Conclusions The level of risk of cardiovascular events in 10 years among elderly patients in Hangzhou is high. Prevention and intervention should be carried out aiming at susceptible population and risk factors. Key words: Aged; Cardiovascular events; Risk assessment; Risk factors

Effects of oral paricalcitol therapy on arterial stiffness and osteopontin in hypertensive patients with chronic kidney disease and secondary hyperparathyroidism

BackgroundArterial stiffness is linked to the progression of atherosclerosis, while activation of vitamin D receptor exerts favorable cardiovascular effects in patients with renal insufficiency. In this study, we investigated the effects of oral treatment with paricalcitol, a potent vitamin D receptor activator, on arterial stiffness and osteopontin, a marker of atherosclerosis, in hypertensive patients with chronic kidney disease (CKD) and secondary hyperparathyroidism. MethodsWe followed up 29 treated hypertensive patients (mean age: 74.1 years, 19 men, office blood pressure = 132/85 mmHg) with CKD stages 3–5 (mean glomerular filtration rate [GFR] = 19.4 ml/min/1.73 m2) who were on therapy with oral paricalcitol for 1 year. The control group consisted of 10 age-, sex-, and GFR-matched hypertensive patients with secondary hyperparathyroidism. ResultsAfter 1 year of treatment with paricalcitol compared to baseline, there was no statistical difference in levels of GFR, office blood pressure, and osteopontin (p = NS for all), while carotid-femoral PWV was reduced from 11.8 ± 2.6 m/s to 11.2 ± 2.4 m/s (p < 0.05). The control group exhibited no significant changes in carotid-femoral PWV (p = NS). ConclusionsTreatment with oral paricalcitol in hypertensive subjects suffering from CKD stages 3–5 and secondary hyperparathyroidism is accompanied by amelioration of arterial stiffness as reflected by the reduction of carotid-femoral PWV.

PP.07.05] ORAL PARICALCITOL THERAPY REDUCES ARTERIAL STIFFNESS IN HYPERTENSIVE PATIENTS WITH CHRONIC KIDNEY DISEASE AND SECONDARY HYPERPARATHYROIDISM

Objective: Arterial stiffness is linked to the progression of atherosclerosis, while activation of vitamin D receptor exerts favorable cardiovascular effects in patients with renal insufficiency. In this study we investigated the effects of oral treatment with paricalcitol, a potent vitamin D receptor activator on arterial stiffness and osteopontin, a marker of atheroscleroris, in hypertensive patients with chronic kidney disease (CKD) and secondary hyperparathyroidism. Design and method: We followed up 29 treated hypertensive patients (mean age 74.1 years, 19 men, office blood pressure = 132/85 mmHg) with CKD stages 3–5 [mean glomerular filtration rate (GFR) = 19.4 ml/min/1.73m2], who were on therapy with oral paricalcitol for 1 year. All patients at baseline underwent a complete physical examination, while venous blood samples were drawn for estimation of metabolic profile, levels of intact parathormone, phosphorus and calcium and osteopontin. Arterial stiffness was estimated based on carotid-femoral pulse wave velocity (PWV) measured with an automated device. Results: After 1 year of treatment with paracalcitol compared to baseline there was no statistical difference in levels of GFR (19.5 ± 4.8 ml/min/1.73m2 vs 18.0 ± 2.3 ml/min/1.73m2, p = 0.318) and calcium (9.11 ± 2.3 vs 8.98 ± 2.2 mg/dl, p = 0.344). Regarding the metabolic profile of patients, levels of glucose, lipids or uric acid did not differ, while the product of calcium x phosphorus exhibited no pathological values. Additionally, carotid-femoral PWV was reduced after 1 year treatment with oral paricalcitol from 11.8 ± 2.6 m/sec to 11.2 ± 2.4 m/sec (p < 0.05), while blood pressure values and osteopontin levels 1 year after therapy compared to baseline values had no statistical difference (p = NS). Conclusions: Treatment with oral paricalcitol in hypertensive subjects suffering from CKD stages 3–5 and secondary hyperparathyroidism is accompanied by amelioration of arterial stiffness as reflected by the reduction of carotid-femoral PWV. These findings suggest that paricalcitol exerts pleiotropic favorable effects on the vascular system, thus improving cardiovascular prognosis in high risk hypertensive patients.

Emergency preparedness of veterans and nonveterans.

This study examined statistical differences in levels of disaster preparedness between former members of the US Armed Forces (veterans) and civilians (nonveterans). It was hypothesized that veterans would exhibit a higher degree of disaster preparedness as compared to their nonveteran counterparts as a consequence of their training and life experience. Furthermore, if this were proven to be valid, the finding would identify this cohort as an ideal target audience for emergency and disaster preparedness education efforts. A four-page survey consisting principally of closed-ended questions about emergency preparedness was written to measure these differences. Most of the questions required respondents to rank their answers according to a five-step Likert Scale. The survey could be completed either in hard copy or online from September 2014 to January 2015. Ultimately, 113 surveys were returned for evaluation. Of those respondents, 62 were veterans and 51 were nonveterans. The responses were analyzed using one-way analysis of variance tests for statistical significance using the 95 percent confidence standard for each tested value. The results support that veterans are more prepared for domestic emergencies than nonveterans. In addition, veterans were more willing to provide leadership and direction to others in an effort to assist emergency managers in responding to domestic disasters. It is for these reasons that emergency managers should consider targeting veterans for disaster preparedness training to help ensure effective and efficient responses to emergencies.