Wilcoxon Test Research Articles

Students Satisfaction with Online Learning during the COVID-19 pandemic: A first-round analysis of Diploma Program in Library and Information Science

The Sri Lanka Library Association (SLLA) has transitioned from conventional teaching-learning to online education. However, no further research has been conducted to assess the successfulness of this online learning from the students’ perspective. Addressing this issue, the objectives of the study were to measure the satisfaction, successfulness and challenges faced by diploma students with online learning at SLLA during the pandemic. The survey was conducted using Google Forms and WhatsApp, with approximately 225 students approached and 194 (88.5%) responding. Data analysis was performed using SPSS software, and statistical tests were applied using the Wilcoxon signed-rank test and Rosenthal r value. Results regarding students’ successfulness indicated that more than 70% agreed with online education during the lockdown. Additionally, students expressed that the online mode was more secure for their health 152(73%) and for transportation 129(66.49%) compared to face-to-face classes and distance mode classes. Concerning satisfaction, 97(50%) students were either highly satisfied or satisfied with online teaching, Regarding the devices used, majority of students (78.9%) used smartphones; whereas the use of laptops, desktops, and tablets was less commonly used (17.5%).Challenges identified were recorded as, clearly hearing the lectures 88(45.4%), expensive equipment requirements 85(43.8%), poor internet connection and difficulty in logging on in a timely manner 84(43.3%) each, and a feeling of isolation while attending class 82(42.3%). Overall, the majority of students were satisfied with online learning and they are moving towards the health security, transportation convenience, and ability to attend classes from home, despite the challenges faced. It is recommended to enhance student interaction and improve the practical effectiveness of the online course. Additionally, action should be taken to address the challenges faced by the students, redesign the online course to improve practical effectiveness, and implement best practices in online education.

GARGLING WITH RED BELT LEAF BOILING (PIPER CROCATUM) ON SALIVA pH IN STUDENTS SMP NEGERI 4 PINELENG MINAHASA DISTRICT

Abnormalities in the mouth or dental and oral diseases that occur in a person are usually caused by several factors. The intra-oral and extra-oral environment greatly influences a person's dental and oral health. To maintain healthy teeth and mouth, it is necessary to control saliva, because saliva or saliva in the mouth plays an active role in supporting healthy teeth and mouth. If there is a decrease in saliva pH, it can cause rapid demineralization of tooth elements, while an increase in pH can result in bacterial colonization which deposits and increases the formation of tartar. One way to control the pH of saliva is to gargle with boiled red betel leaves, because they contain compounds that are antibacterial. This study aims to determine the effectiveness of gargling with boiled red betel leaves (piper crocatum) on saliva pH in students at SMP Negeri 4 Pineleng, Minahasa Regency. This research uses a quasi-experimental method with a one group pre and post-test design. This research was carried out by giving treatment to respondents and measuring the pH of saliva before and after gargling with boiled red betel leaves. The sample in this study was 72 students, using random sampling techniques. Data collection was obtained from the results of salivary pH measurements using universal pH test paper with criteria 0-14, the concentration of red betel leaves used in this study was 15%. The data obtained were analyzed using the Wilcoxon test. Based on the results of the Wilcoxon test, it was found that ? value=0.027 (0.027<0.05), so it can be concluded that gargling with boiled red betel leaves is effective in changing saliva pH.

IMPLEMENTATION OF ART THERAPY TECHNIQUES ON TOOTHBRUSHING SKILLS FOR SCHOOL-AGE CHILDREN IN KUTA TRADITIONAL VILLAGE

Background: The 2023 Indonesian health survey shows that the prevalence of dental caries in Indonesia is 43.6% and the prevalence of cavities in Jawabarat Province is 48%. Based on the characteristics of the age group of 5-9 years is 49.9% and the age group of 10-14 years is 37.2%. Method: This research method is the Quasi Experimental method with One Group Pre-test and Post-test Design. Data analysis used the Wilcoxon Test, with a sample of 32 children aged 6-12 years from Kuta Traditional Village, which is a traditional village located in the area of Karangpaningal Village, Tambaksari District, Ciamis Regency, West Java. The measuring instrument uses an observation sheet of brushing skills. Results: The skills before being given counseling were 3.7 with an average of less skilled criteria, after being given counseling to 8.3 with an average of moderately skilled criteria. Conclusion: The value of p = 0.000 shows that there is an effect of counseling using art therapy techniques on toothbrushing skills in school-age children in Kuta Traditional Village.

Comparison of discussion-based and simulation-based learning methods using the Gas Man® on knowledge of the uptake and distribution of inhalation anesthetics of anesthesia resident: A randomized controlled trial

Abstract Background and Aims: Inhalation anesthetics is basic knowledge that must be mastered by an anesthesiologist. Lack of competencies can result in higher morbidity and mortality in anesthesiology practice. Various learning methods were developed to improve understanding and retention. With the advancement of technology, the utilization of screen-based simulation (SBS) using applications is common, such as the Gas Man® application, to help students understand physiology, pathophysiology, and kinetic inhalation anesthetic agents. The primary objective of this study was to compare the knowledge improvement of anesthesia residents between the simulation-based and discussion-based learning methods on the uptake and distribution of anesthetic inhalation. The secondary objective was to compare the satisfaction levels of participants in both learning methods. Material and Methods: This study is a randomized controlled trial involving anesthesiology and intensive care residents from the Faculty of Medicine, Universitas Indonesia (FKUI) 2022–2023. The participants were randomized into two groups (simulation and discussion groups). A senior attending anesthesiologist led the discussion. The participants answered a pretest, followed by a 1-hour lecture about inhalation gas. Lastly, participants answered a posttest and filled in the satisfaction survey. Statistical analyses used the Mann–Whitney test to compare the two groups. The Wilcoxon test was used to compare the knowledge improvement between the two groups. Results: Thirty-eight residents underwent simulation-based (n = 19) and discussion-based (n = 19) learning methods. The simulation group demonstrated a median (interquartile range) posttest score of 80 (76.67–83.33) compared with the discussion group with a score of 50 (40–66.67) (P value <0.05). More than half of the participants in both groups answered “satisfied.” Conclusion: The simulation-based learning method using the Gas Man® application performed better than the discussion-based learning method on increasing knowledge of the uptake and distribution of inhalation anesthetics in anesthesia residents. Key Message: Simulation-based learning method may improve understanding and retention. This study supported the conclusion that the simulation-based learning method with Gas Man is better than the discussion-based learning method for improving knowledge of the uptake and distribution of inhalation anesthetics.

Nasopharyngeal carriage and antibiotic susceptibility of Streptococcus pneumoniae among diabetes patients in western Kenya

AimsTo compare nasopharyngeal carriage and antibiotic susceptibility of Streptococcus pneumoniae among patients with and without diabetes at Moi Teaching and Referral Hospital (MTRH) in western Kenya. MethodsA cross-sectional study was conducted at MTRH diabetes and eye clinics. Participants were selected using systematic random sampling. Sociodemographic data and risk factors were collected through interviewer-administered questionnaires. Blood samples were taken to measure random blood sugar and HbA1c levels. Nasopharyngeal swabs were cultured and tested for antibiotic susceptibility within 24 h. Data analysis was performed using STATA version 13. Associations were assessed using Pearson’s chi-square, Fisher’s exact test, unpaired t-test, and Wilcoxon test. ResultsA total of 124 participants with diabetes and 121 without diabetes were enrolled. Overall, 7.4 % (95 % CI: 4.4, 11.4) of participants carried S. pneumoniae. Carriage was higher in diabetes (12.1 % [95 % CI: 7.0, 19.0]) than non-diabetes participants (2.48 % [95 % CI: 1.0, 7.0]), with a statistically significant difference (p = 0.004). Diabetes was associated with higher odds of carriage (adjusted OR 6.2, p = 0.012). No association was found with age, sex, cooking fuel, presence of children under 5, or prior antibiotic use. Among participants with diabetes, carriage of Streptococcus Pneumoniae was only associated with insulin use. Antibiotic resistance was highest for cotrimoxazole (94.44 %), followed by amoxicillin (16.7 %) and cefuroxime (11.1 %). No resistance to macrolides was observed. ConclusionNasopharyngeal carriage of S. pneumoniae is higher in patients with diabetes, with significant resistance to common antibiotics, though macrolides remain effective.

Bioelectric brain activity in workers with hand-arm vibration in dynamics

Introduction. A few neurophysiologic studies have shown that changes of the bioelectrical brain activity are observed in hand-arm vibration syndrome (HAVS) patients. There is practically no information about the state of bioelectrical brain activity in the hand-arm vibration. The purpose is to study the dynamics of the formation of neurophysiologic changes in workers exposed to hand-arm vibration. Materials and methods. Electroencephalography (EEG) and registration of evoked potentials (EP) was carried out in workers exposed to hand-arm vibration (practically healthy workers, HAVS individuals who continue to work in their occupation), twice in a connected sample. The results are presented as median, upper and lower quartiles, and extensive indicators. The significance of differences was assessed using Pearson’s χ2 test, Fisher’s angular transformation, and Wilcoxon T-test. Results. In dynamics, there is a change in the EEG pattern from disorganized with a predominance of alpha activity to disorganized with a predominance of delta, and theta activity; a decrease in the spectral power of the main EEG rhythms in all main functional leads in both examined groups. Diffuse changes in the EEG indicate a multisystem nature of bioelectrical brain activity disorders with involvement of the cerebral cortex, stem, and diencephalic structures of the brain. Changes in the amplitude-temporal parameters of EP manifested by an excess of the latency of the main peaks and a decrease in amplitude, indicate an imbalance in the central nervous system, general modulating influences on the cerebral cortex of the thalamocortical systems of the brain. Limitations. One occupational group with different levels of health status – practically healthy workers, HAVS individuals who continue to work in their occupation – was enrolled in the study. Conclusion. The one-direction and progressive development of changes in the bioelectrical brain activity has been established, manifested by a restructuring of the electrical activity of the brain, desynchronization of neuronal activity, an increase in the level of functional activity of the brain, and an imbalance of general modulating influences on the cerebral cortex. The identified changes are a manifestation of the nonspecific part of the pathogenesis of HAVS.

MEDIA EDUCATION E-BOOKLETS GINGIBOOKS ON GINGIVITIS KNOWLEDGE IN TEENAGERS

Background: The prevalence rate of gingivitis in Indonesia is quite high. One of the educational services is e-booklet media. The results of a preliminary study at SMA Negeri 1 Demak showed that 100% of students had never received dental health promotion and did not know about gingivitis. Objective: To find out the influence of gingibooks e-booklet media education on knowledge about gingivitis in adolescents. Methods: The type of quasi experimental research with a Non-equevalent control group design, sampling was conducted using simple random sampling with a total of 82 respondents. This sample was divided into 2 groups, namely the experimental and control groups. The location of the research was at SMA Negeri 1 Demak. The data collection technique used questionnaires and data analysis using wilcoxon and mann-whiteney tests. Results: The initial knowledge level of the experimental group was low (4.9%), medium (70.7%) and high (24.4%). Final knowledge with low (0%), medium (2.4%) and high (97.6%) criteria. The level of initial knowledge of the control group with low criteria (9.8%), medium (75.6%) and high 6 (14.6%). Final knowledge with low (0%), medium (36.6%) and high (63.4%) criteria. From the results of the study, there was an increase in knowledge from (70.7%), to (97.6%). The average knowledge in the experimental group was 4.29 and the control group was 2.56. The results of the Mann-Whitney Test obtained a value of p = 0.000 < 0.05. Conclusion: There is a significant influence in the use of e-booklet media on the improvement of gingivitis knowledge in adolescents.

DENTAL'S AREA LEARNING MODEL AS AN EFFORT TO IMPROVE KNOWLEDGE AND TEETH BRUSHING SKILLS PRESCHOOL CHILDREN

Background: Preschool children have different characteristics from children of other ages, so that maximizing their cognitive, affective and psychomotor potential requires appropriate learning methods. Dental's Learning Area Model is a dental health education model that gives preschool children, especially the 3-4 year age group, the choice to choose the areas they want to learn about dental and oral health so that with this choice children are able to optimize learning according to their criteria and abilities. Objective: Develop a Dental's Area Learning Model as an effort to increase knowledge and skills in brushing teeth and reduce the Plaque Control Record (PCR) of preschool children. Method: Quasy Experiment Pretest And Posttest With Control Group Design, Research subjects were preschool children aged 3-4 years who were divided into 2 groups: 1. Dental's Area Learning Model intervention for 14 days through 4 stages of activities, namely training, simulation, brushing practice teeth and evaluation in children. 2. 14 day tooth brushing model as control. Dependent variable: knowledge and teeth brushing skills. Data were tested using Wilcoxon and Independent t-test. Results: Dental's Area Learning Model is effective in increasing students' knowledge of brushing teeth with a p-value of =0.000 and brushing skills with a p-value of 0.000 (<0.05). Conclusion: Dental's Area Learning Model is effective in increasing knowledge and teeth brushing skills in preschool children

Associations between prenatal distress, mitochondrial health, and gestational age: findings from two pregnancy studies in the USA and Turkey.

Pregnancy outcomes are influenced by maternal distress but the pathways underlying these effects are still unknown. Mitochondria, crucial for stress adaptation and energy production, may link psychosocial stress to its biological effects, especially during pregnancy when energy demands significantly increase. This study explores two mitochondrial markers-circulating cell-free mitochondrial DNA (cf-mtDNA) and Growth Differentiation Factor-15 (GDF15)-as potential mitochondrial health indicators linking maternal distress to pregnancy outcomes in two longitudinal studies from the USA and Turkey. We analyzed biological, demographic, and psychological data from women in two pregnancy studies: EPI (N=187, USA, Mean age=29.6(SD=6.2) and BABIP (N=198, Turkey, Mean age=32.4(SD=4.0)). Data were collected at multiple time points during the perinatal period, including late 2nd and 3rd trimester, with EPI also including additional data at early 2nd trimester and 4-14 months postpartum. Prenatal maternal psychological distress was measured as perceived stress, anxiety, and depressive symptoms. Plasma cf-mtDNA and GDF15 levels were assessed using qPCR and ELISA, respectively. Statistical analyses included Wilcoxon signed-rank tests, Spearman correlations, and Mann-Whitney tests. Plasma cf-mtDNA levels did not change significantly during pregnancy in either study. Plasma GDF15 levels increased from early to late pregnancy in both studies and significantly decreased postpartum in EPI. Perinatal maternal distress in the late 2 nd and 3 rd trimesters was not associated with cf-mtDNA or GDF15 in either study. Metabolic distress, measured as higher pre-pregnancy BMI, was negatively correlated with GDF15 in the late 2 nd trimester in EPI and showed a similar trend in BABIP. Similarly, higher maternal psychological distress in the early 2 nd trimester were associated with lower cf-mtDNA and a trend for lower GDF15 in EPI. Finally, higher pre-pregnancy BMI and maternal distress in late pregnancy were linked to a smaller decline in GDF15 from late pregnancy to postpartum in EPI, suggesting an interaction between metabolic stress, prenatal distress and post-pregnancy physiological recovery. This study identified distinct patterns of plasma cf-mtDNA and GDF15 levels during the perinatal period across studies from two countries, revealing unique associations between maternal characteristics, prenatal distress, and pregnancy outcomes, suggesting that maternal distress can interact with energy mobilization during pregnancy.

Efektivitas Modul dan Film Pendek Check Up Diabetic Foot: Ipswch Touch Test dalam Meningkatkan Pengetahuan dan Ketrampilan Mendeteksi Neuropati Sensori Diabetes Mellitus Tenaga Kesehatan di Kabupaten Bima

Early detection of diabetic neuropathy is very important for patients with type 2 diabetes mellitus because early prevention can reduce morbidity and mortality. One of the examinations to detect diabetic neuropathy is the Ipswich Touch Test (IpTT). The purpose of this study was to determine the Effectiveness of the Diabetic Foot Check Up Module and Short Film: Ipswich Touch Test in Improving Knowledge and Skills in Detecting Sensory Neuropathy of Diabetes Mellitus Health Workers. The research method used was Quasi-experimental with a pre-test and post-test with control group design with a non-parametric Wilcoxon test to analyze knowledge and skills before and after treatment, a total of 60 respondents. A significant test result of 0.0001 was obtained for the intervention group, namely there was a difference in skills before and after treatment in the form of counseling with media in the form of short films, while in the control group a significant test result of 0.0001 was obtained, namely there was a difference in skills before and after treatment in the form of counseling with media in the form of modules with a significance level of 0.05 because p value <0.05. The results of the significant test were obtained at 0.0001 for the intervention group, namely there was a difference in knowledge before and after being given treatment in the form of counseling with media in the form of short films, while in the control group the results of the significant test were obtained at 0.0001, namely there was a difference in knowledge before and after being given treatment in the form of counseling with media in the form of modules with a significance level of 0.05 because the p value <0.05. The conclusion on the results of knowledge in the intervention group before being given intervention in the form of education, modules and short films was that they had good knowledge as much as 50% and after being given education they had good knowledge as much as 90% meaning that there was an increase in knowledge before and after being given intervention, meaning that there was an increase of 40%, while in the intervention group they had good skills 0%, enough 90%, less 10% after being given intervention there was a change to good as much as 83.3% meaning that there was a significant change before being given treatment and after being given treatment.

Long-term spatiotemporal changes in nitrate contamination of municipal groundwater resources after sewerage network construction in the Hungarian Great Plain.

Over the last decades, as a consequence of wastewater discharges and other anthropogenic sources, severe nitrate (NO3-) pollution has developed in municipal environment causing global concern. Thus, eliminating the potential sources of pollution is one of the major challenges of the twenty-first century, whereby sanitation services are essential for ensuring public health and environmental protection. In the present study, long-term monitoring (2011-2022) of shallow groundwater NO3- contamination in municipal environment was carried following the construction of the sewerage network (2014) in the light of the pre-sewerage situation. Our primary aim was to assess the long-term effects of sewerage on nitrate NO3- levels in the shallow groundwater and evaluate the efficiency of these sanitation measures over time. Based on the results, significant pollution of the shallow groundwater in the municipality was identified. During the pre-sewer period, NO3- concentrations exceeded the 50mg/L limit in the majority of monitoring wells significantly, upper quartile values ranged between 341 and 623mg/L respectively. Using Nitrate Pollution Index (NPI) and interpolated NO3- pollution maps, marked spatial north-south differences were detected. In order to verify the presence of wastewater discharges in the monitoring wells, the isotopic ratio shifts (δ) for 18O and D(2H) were determined, confirming municipal wastewater effluent. Variations in NO3-/Cl- molar ratios suggest also contamination from anthropogenic sources, including septic tank effluent from households and the extensive use of manure. Data series of 7years (2015-2022) after the investment indicate marked positive changes by the appearance of decreasing trends in NO3- values confirmed by Wilcoxon signed rank test and ANOVA. By comparing the pre- and post-sewerage conditions, the mean NO3- value decreased from 289.7 to 175.6mg/L, with an increasing number of monitoring wells with concentrations below the limit. Our results emphasise the critical role of sanitation investments, while also indicating that the decontamination processes occur at a notably slow pace. Detailed, long-term monitoring is therefore essential to ensure accurate follow-up of the ongoing changes. The results can provide information for local citizens and authorities to improve groundwater management tools in the region.

Systemic Immunological Changes After Yttrium-90 Radioembolization: A Pilot Prospective Observational Study-Clinical Insights.

To prospectively investigate levels of circulating cytokines, changes in frequencies of various immune cell subsets and expression of proliferation and checkpoint molecules on T cells in the peripheral blood after yttrium-90 radioembolization (TARE) of colorectal cancer liver metastases (CLM). We prospectively collected, isolated, and froze peripheral blood mononuclear cells (PBMC) and plasma samples from 15 patients immediately before, immediately after, 3 and 6 weeks post-TARE of CLM. Plasma samples were assessed for various cytokines using a multiplex immunoassay platform. PBMC samples were analyzed in a monocyte/dendritic cell (DC)/B cell flow panel and a T cell activation/exhaustion flow phenotyping panel. We compared the levels at the respective time points using Wilcoxon signed rank test. IFN-g significantly decreased immediately after (mean 1.62 vs. 3.02 at baseline, p = 0.04) and increased at 6weeks compared to the immediately post-TARE nadir (mean 9.42 vs. 1.62, p = 0.04). IL-10 decreased at 3weeks (mean 0.36 vs. 1.75, p = 0.025) post-TARE compared to baseline. Increased CD3+T cells (mean 78.24 vs. 60.8, p = 0.002) and decreased CTLA-4+CD4+T cells (mean 2.58 vs. 4.41, p = 0.033) were observed at 3weeks compared to baseline. Increased Ki-67+ proliferating CD8+T cells at 3 and 6weeks (mean 7.28 and 9.06, respectively, vs. 3.93 at baseline, p = 0.02 and 0.03) were recorded. A shift toward a favorable antitumoral cytokinic and immune cells response was observed after TARE. Significant changes were in specialized immune cells subsets playing important roles in the activation of the immune system. These results support trials combining TARE with immunotherapy for patients with CLM.

Passive fit and time efficiency for prefabricated versus conventionally constructed cobalt chromium CAD\\CAM 3-unit implant supported frameworks in free end saddle models: a pilot invitro study

BackgroundThe passive fit of 3-unit implant supported prefabricated metal screw-retained prosthesis before implant placement might be difficult. Hence, we aim to evaluate the passive fit and time efficiency of CAD/CAM 3-unit implant supported fixed prostheses that were constructed based on virtual versus those based on actual implant positions in Kennedy Class I models.MethodsA sample of 5 Kennedy class I models with thin wiry ridges were restored by 20 frameworks bilaterally, 10 based on actual (group A) and 10 based on virtual (group V) implant positions. The models were imaged using cone beam computed tomography and scanned using an intraoral scanner. The STL (Standard Tessellation Language files) and the DICOM (Digital Imaging and Communications in Medicine) files were registered on a 3D planning software. A CAD/CAM surgical guide was planned, resin printed and used for installing 6 implants bilaterally. In group V, the framework was designed based on the virtual scan bodies and virtual multi-unit abutments, while in group A intra-oral scanning of the model after attaching the scan bodies was necessary. Frameworks of both groups were milled and tested for passive fit using 8 clinical tests. McNemar and Wilcoxon signed rank tests were used to study the effect of the group on passive fit and time efficiency, respectively. The significance level was set at P ≤ 0.05.ResultsNo statistically significant difference was found between group V and group A frameworks regarding passive fit (p-value = 1, OR = 0.5) and time efficiency (P = 0.179, Effect size = 0.948).ConclusionWithin the limitations of this study, it can be concluded that in free end saddle cases, prefabricated CAD\\CAM 3-unit implant-supported cobalt chromium screw retained prostheses can achieve an adequate passive fit. However, their fit might be negatively affected in thin ridges and they might require some adjustments.

Overloaded Vertebral Body Following Consecutive Three-Level Hybrid Surgery Comparing with Anterior Cervical Discectomy and Fusion.

Based on the varying number and relative positions of cervical disc replacement (CDR) and anterior cervical discectomy and fusion (ACDF) procedures, three-segment hybrid surgery (HS) presents a diverse structural approach. Currently, the potential differential effects of HS with different segment combinations and surgical procedures on overloaded vertebral body (OVB) occurrence remain unexplored. The purpose of this retrospective study is to compare the clinical and radiological outcomes of HS and ACDF in treating cervical degenerative disc disease (CDDD), aiming to provide further insights into OVB. This study included patients with three-level CDDD who underwent ACDF or HS at our institution. Eligible patients were divided into three groups: Type I (one-level CDR and two-level ACDF), Type II (two-level CDR and one-level ACDF), and ACDF (three-level ACDF). For radiographic analysis, patients were further divided into the Replacement Segment Group and the Nonreplacement Segment Group based on the presence of replacement segments above and below the OVB. Clinical outcomes were evaluated using visual analog scale (VAS) scores for neck and arm pain, Japanese Orthopedic Association (JOA) scores, and neck disability index (NDI) scores. The cervical radiological parameters assessed included (1) vertebral cross-sectional area (CSA), (2) wedge angle (WA), (3) anterior vertebral height (AH), (4) posterior vertebral height (PH), and (5) Hounsfield unit (HU) values. Statistical methods included paired t-test, ANOVA test, and chi-square test. Independent samples t-test, Mann-Whitney U test, and Wilcoxon signed-rank test were used to compare the differences between two groups according to the results of normal distribution test. A total of 123 patients, evenly distributed among three groups, were included and were well matched in terms of demographic characteristics. The likelihood of vertebral body collapse (VBC) was notably higher in the ACDF group (41.5%) compared with the Type I (17.9%) and Type II (8.9%) groups (p < 0.01). Following surgery, both at 3 and 6 months, the ACDF group demonstrated higher VAS neck scores and NDI scores compared with the Type I and Type II groups (p < 0.01). Additionally, the WA and AH values of the upper and lower adjacent OVB were consistently lower in the ACDF group than in the Type I and Type II groups at 6 and 12 months and at the final follow-up (p < 0.01). Notably, in the Nonreplacement Segment Group, WA significantly decreased at 12 months postoperatively and at the final follow-up compared with the Replacement Segment Group (p < 0.01). Three levels of HS appear to reduce stress concentrations and alleviate morphological changes in OVB. The occurrence of more VBC patients with OVB was associated with the use of Zero-P or Zero-P VA implants.

Speech Pathology and Occupational Therapy Students’ Perceptions and Experiences of an Interprofessional Simulation

Clinical placements and interprofessional practice for healthcare students are often met with anxiety, unpreparedness and a lack of confidence. Whilst interprofessional simulations may address these concerns, there are gaps in the literature. This study aimed to: (i) investigate the impact of interprofessional simulations on students’ perceived confidence, anxiety and preparedness for placements and their attitudes toward interprofessional practice and education, and, (ii) understand students’ experiences and satisfaction with the simulation. Pre-simulation and post-simulation survey results were collected from 25 speech pathology and 25 occupational therapy graduate-entry Masters degree students from one Australian university. Quantitative data was analysed using descriptive statistics and the Wilcoxon signed-rank test while qualitative data was reviewed through content analysis. Statistically significant (p&lt;0.05) improvements across students’ confidence, anxiety and preparedness ratings were observed. Students’ attitudes towards interprofessional practice and education revealed statistically significant positive changes on 8/10 questions and they described the simulation to be a meaningful learning experience. Results indicate that following participation in an interprofessional simulation, students’ perceptions of their confidence, anxiety and preparedness for an adult inpatient hospital placement improved. Moreover, students’ attitudes towards interprofessional practice and education were more positive and the experience was reported to be beneficial. Future studies could explore timing-related considerations and simulation anxiety itself.

It doesn't hurt as long as I don't move: Aligning pain assessment in patients with rib fractures with mobilization needed for recovery.

Rib fracture pain is a major issue but likely underappreciated, given that patients avoid activity due to the pain. Pain is one criterion used to determine if someone is a candidate for surgical stabilization of rib fractures (SSRF). The purpose of this study was to assess pain for rib fracture patients, hypothesizing pain from rib fractures is underappreciated in current practice. A prospective study analyzing patients with one or more rib fractures admitted to our Level I trauma center from March 2023 through February 2024. Exclusion criteria included refusal to participate, ventilator dependent, younger than 18 years, moderate/severe traumatic brain injury, spinal cord injury, pregnancy, or incarceration. Basic demographics were obtained. Participants rated their pain on an 11-point Numerical Rating Scale while resting in bed and performing a series of movements (0, no pain; 10, worst pain imaginable). Movements included incentive spirometer, flexion, extension, bilateral side bending, bilateral rotation, and holding a 5-pound dumbbell. Patients undergoing SSRF were surveyed pre- and postoperatively. Outcomes included the difference between pain scores at rest versus performing all movements, difference between pain scores pre- and post-SSRF, and incentive spirometry pre- and postoperatively. Nonparametric analysis was completed with the Wilcoxon signed-rank test with statistical significance set at p < 0.05. One-hundred two patients were enrolled. The mean age was 60 ± 15 years; 57.8% were male. The median pain score at rest was 3 (interquartile range [IQR], 2-5.5). Pain scores significantly increased to >5 for all movements. Thirty-one patients underwent SSRF. Resting pain prior to SSRF was 3 (IQR, 1-6) and postoperatively was 2 (IQR, 1.5-3) (p = 0.446). For all movements, median Numerical Rating Scale score was significantly less after SSRF (p < 0.001). The median incentive spirometry was 1,100 mL (IQR, 625-1,600 mL) preoperatively and 2,000 mL (IQR, 1,475-2,250 mL) postoperatively. Traditional assessment of pain in patients with rib fractures significantly underappreciates true pain severity caused by movements involving the chest wall and should be considered when evaluating for SSRF. Therapeutic/Care Management; Level III.

Examining the Effects of Cognitive Behavioral Therapy With a Virtual Agent on User Motivation and Improvement in Psychological Distress and Anxiety: Two-Session Experimental Study.

Cognitive behavioral therapy (CBT) is a valuable treatment for mood disorders and anxiety. CBT methods, such as cognitive restructuring, are employed to change automatic negative thoughts to more realistic ones. This study extends on previous research conducted by the authors, focused on the process of correcting automatic negative thoughts to realistic ones and reducing distress and anxiety via CBT with a virtual agent. It was aimed to investigate whether the previously applied virtual agent would achieve changes in automatic negative thoughts when modifications to the previous experimental paradigm are applied and when user motivation is taken into consideration. Furthermore, thepotential effects of existing participant knowledge concerning CBT or automatic thoughts were explored. A single-group, 2-session experiment was conducted using a within-group design. The study recruited 35 participants from May 15, 2023, to June 2, 2023, via Inter Group Corporation, with data collection following from June 5 to June 20, 2023, at Nara Institute of Science and Technology, Japan. There were 19 male and 16 female participants (age range: 18-50 years; mean 33.66, SD 10.77 years). Participants answered multiple questionnaires covering depressive symptomatology and other cognitive variables before and after a CBT session. CBT was carried out using a virtual agent, who participants conversed with using a CBT dialogue scenario on the topic of automatic negative thoughts. Session 2 of the experiment took place 1 week after session 1. Changes in distress and state anxiety were analyzed using a Wilcoxon signed-rank test and t-test for paired samples. The relationships of motivation with cognitive changes and distress or anxiety changes were investigated via correlation analysis. Multiple linear regression was used to analyze the potential predictive qualities of previous knowledge of CBT and automatic negative thoughts regarding outcome measures. Significant reductions in distress (all P<.001) and state anxiety (all P<.003) emerged throughout the first and second experimental sessions. The CBT intervention increased participants' recognition of their negative thinking and their intention to change it, namely their motivation to change it. However, no clear correlations of motivation with changes in distress or anxiety were found (all P>.04). Participants reported moderate subjective changes in their cognition, which were in part positively correlated with their motivation (all P<.007). Lastly, existing knowledge of CBT did not predict reductions in distress during the first session of the experiment (P=.02). CBT using a virtual agent and a CBT dialogue scenario was successful in reducing distress and anxiety when talking about automatic negative thoughts. The promotion of client motivation needs to be critically considered when designing interventions using CBT with a virtual agent, and further experimental investigations on the causal influences between motivation and outcome measures need to be conducted.

EFFECTIVENESS OF AL-QURAN THERAPY IN REDUCING THE LEVEL OF AUDITORY HALLUCINATIONS

Introduction: Auditory hallucinations, which involve hearing voices that are not present, can severely impact an individual’s mental health and quality of life if left untreated. Qur'anic therapy, which involves reciting verses from the Qur’an, is believed to help calm the mind and reduce hallucination symptoms. The purpose of this community service initiative is to teach staff and patients to incorporate Qur'anic therapy into their daily routines, supporting both spiritual and psychological healing. Methods: This community service was conducted at the Pasuruan Social Rehabilitation Home with 35 clients experiencing auditory hallucinations who were coherent, cooperative, and Muslim. The aim was to provide Al-Quran therapy for 2 weeks, with each session lasting 5 minutes. The effectiveness of the therapy was measured using self-reported frequency of hallucinations and staff observations, with data analyzed through a paired sample t-test or Wilcoxon signed-rank test, depending on the distribution, to assess any significant reduction in the auditory hallucinations. Results: Some of the results experienced by patients after receiving Al-Quran therapy are that patients are more peaceful when experiencing auditory hallucinations. The patient also said that reading the Al Quran could be a distraction when the patient had auditory hallucinations. On average, 60% of patients' hallucinations were mild, 37.1% were moderate, and 2.9% had severe hallucinations. Conclusion: These findings indicate that Al-Quran therapy can be used as an effective method to reduce the frequency of auditory hallucinations in schizophrenia patients at the Pasuruan Social Rehabilitation Home. These findings have important implications for the management and care of patients with auditory hallucinations, as well as providing a therapeutic alternative that can improve patients' quality of life.

The Effect of TENS and Ultrasound Diathermy on Osteoarthritis Patients in Physical Medicine and Rehabilitation Unit of Patut Patuh Patju Hospital, West Nusa Tenggara

Osteoarthritis is generally recognized as a common musculoskeletal condition in Indonesia, characterized by the degeneration of joint cartilage and narrowing of the joint space. The form of therapy that can be given to knee OA patients is a combination of TENS therapy and ultrasound diathermy (USD). WOMAC is an index used to measure osteoarthritis patiens based on pain, stiffness, and physical function. Patut Patuh Patju General Hospital is the only hospital in West Lombok district where physical medicine and medical rehabilitation have recently been introduced. This research aims to determine the effects of administering TENS and ultra sound diathermy on OA patients in the physical medicine and rehabilitation unit of Patut Patuh Patju Hospital, a newly established district hospital in NTB, which has been operational for the past year. This type of research uses a pre-experimental design with a one group pretest-posttest method. Sampling was taken using a purposive sampling technique with a total sample of 30. The research population was knee osteoartritis patients undergoing physiotherapy treatment at the Medical Rehabilitation Unit of Patut Patuh Patju General Hospital. Data was collected using the WOMAC questionnaire before and after 6 until 8 times therapy. The distribution of research data was analyzed using the Shapiro-Wilk test. If the data distribution is normal, it is analyzed using the paired t-test, whereas if it is not normal, it is analyzed using the Wilcoxon test. The combination of TENS therapy and ultra sound diathermy results in improvement of WOMAC scores in knee osteoarthritis patients with p-value = 0.000 (p &lt; 0.05).

Hardware Removal After Lisfranc ORIF Results in Improved Physical Function.

The purpose of this study was to investigate whether HWR after Lisfranc ORIF resulted in significant impact via PROMIS physical function (PF) and pain intensity (PI) scores. Design: Retrospective cohort. Level-1 trauma center. Adult patients with isolated Lisfranc injuries who were treated via ORIF between 2002-2023 that had PROMIS PF and PI scores through 6 months follow-up were included. Patients were excluded if they received index treatment other than ORIF or underwent secondary surgical intervention prior to HWR. A sub analysis was performed at 1 year follow- up. Primary outcomes were PROMIS PF and PI scores. The Wilcoxon signed-rank test compared differences between PROMIS scores within the HWR group. The Wilcoxon ranked-sum test compared differences between HWR vs no HWR. Distributive MCID was calculated using the 0.5 SD method. There were 482 patients (489 feet) identified with isolated Lisfranc injuries. Seventy-seven feet underwent ORIF followed by HWR. Thirty feet underwent ORIF without HWR. The average age of the no HWR group was 45.8 (18.0-81.3) versus the HWR group which was 38.7 (18.3-74.1) (p=0.053). Nineteen (63.3%) were female in the no HWR group compared to 33 (42.9%) in the HWR group (p=0.084). HWR occurred an average of 4.43 months after ORIF. Patients who underwent HWR had a statistically significant increase in average PF scores (39.7 to 45.9, p<0.001) at their standard 6 week (1.5 month) postoperative visit. HWR patients had a non-significant decrease in average PI scores (56.5 to 53.9, p=0.24). Compared to those with retained hardware, the HWR group demonstrated a statistically significant net improvement in PF and PI scores from surgery, with an average improvement of 5.6 and 1.7, respectively (P=0.002, 0.008). Patients experienced significant improvement in PROMIS PF scores for Lisfranc ORIF at 6 weeks after HWR. Compared to patients with retained hardware, they also experienced significant improvement in PROMIS PF and PI scores. III.