PENGETAHUAN PERAWAT GIGI TENTANG METODE STERILISASI DENGAN PENCEGAHAN INFEKSI SILANG DI POLI GIGI PUSKESMAS RANOTANA WERU DI KOTA MANADO

2018 ◽  
Vol 1 (1) ◽  
pp. 44-51
Author(s):  
Jean Henry Raule
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Spearman's Rho ◽  
Spearman’S Rho

Dalam Praktek pelayanan Kesehatan prinsip Sterilisasi merupakan hal yang mutlak di lakukan, Sterilisasi merupakan rangkaian suatu proses yang bertujuan untuk menghilangkan semua bentuk kehidupan mikro Organisme (bakteri, jamur, parasit, dan virus termasuk spora). Perawat gigi berkewajiban menghindari atau mencegah infeksi silang dalam prakteknya dengan cara melakukan sterilisasi pada alat kesehatan gigi dengan tepat dengan benar. Penelitian ini bertujuan untuk mengetahui apakah ada hubungan pengetahuan perawat gigi tentang metode sterilisasi dengan pencegahan infeksi silang di poli gigi puskesmas di kota Manado. Metode penelitian ini adalah Survei analitik dengan pendekatan cross sectional study dimana data dikumpulkan dalam waktu bersamaan. Populasi penelitian pada perawat gigi yang bekerja di 7 puskesmas yang berjumlah 16 orang, sampel yang diambil yaitu total populasi. Alat ukur menggunakan kuesioner pengetahuan dan lembar checklist  tindakan.  Hasil uji correlation spearman’s rho  pada taraf  signifikansi pemaknaan 99% (α = 0.01), diperoleh nilai (p) = 0.001 (0.001 < α 0.01) yang artinya terdapat hubungan bermakna antara pengetahuan tentang metode sterilisasi dengan pencegahan infeksi silang, dengan koefisien korelasi 0.741 yang mempunyai kekuatan hubungan yang kuat.  Kolerasi antara variable ini berada pada arah korelasi positif, dimana semakin tinggi pengetahuan tentang sterilisasi semakin baik juga tindakan pencegahan infeksi silang.

scholarly journals Refractive Outcomes of  Table-Mounted and HandheldAuto-Refractometers in Children: An Observational Cross-Sectional Study

2021 ◽  
Author(s):  
müjdat karab ◽  
sinem karabulut ◽  
Aylin karalezli
Keyword(s):  
Cross Sectional Study ◽  
Spherical Equivalent ◽  
Sectional Study ◽  
Cross Sectional ◽  
Refractive Outcomes ◽  
Spearman's Rho ◽  
Spearman’S Rho ◽  
The Mean ◽  
Mean Differences ◽  
Cylinder Power

Abstract Background: To compare the refractive results of two autorefractors.Methods: We designed this study as an observational, cross-sectional study. We compared the mean spheric and cylinder power, spherical equivalent, Jackson cross-cylinder values, determined the limits of agreement (LoA), and evaluated reliability.Results: Nidek HandyRef-K autorefractor measured more astigmatism and myopia in terms of the mean cylindrical power (P<.001) and spherical equivalent (P=.024). Nidek HandyRef-K showed significantly more myopic results in subgroups with spherical power more than +1.50 Diopters (D) hyperopia and -3.00 D myopia (P=.031; P=.045; P=.026; respectively) and higher astigmatism in the subgroup with the cylindric power less than -1.00 D (P<.001). The mean differences and 95% LoA were 0.06 D ± 0.47 D (-0.82 D to 0.98 D) in spherical power, 0.08 D ± 0.28 D (-0.47 D to 0.64 D) in cylindrical power, 0.11 D ± 0.47 D (-0.81 D to 1.01 D) in spherical equivalent, 0.02 D ± 0.36 D (-0.73 D to 0.69 D) in Jackson cross-cylinder power at 0°, 0.005 D ± 0.54 D (-1.07 D to 1.06 D) in Jackson cross-cylinder power at 45°. There was a strong correlation for spherical power (Spearman’s rho=0.99, P<.001), cylindrical power (Spearman’s rho=0.88, P<.001), spherical equivalent (Spearman’s rho=0.98, P<.001).Conclusion: Nidek HandyRef-K showed more myopic results regarding spherical equivalent and cylindrical power. Nidek HandyRef-K showed significantly more myopia in spherical power more than +1.50 D hyperopia, -3.00 D myopia, and more prominent astigmatism in cylindrical power less than -1.00 D subgroups.

scholarly journals Refractive outcomes of table-mounted and hand-held auto-refractometers in children: an observational cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Müjdat Karabulut ◽  
Sinem Karabulut ◽  
Aylin Karalezli
Keyword(s):  
Cross Sectional Study ◽  
Spherical Equivalent ◽  
Sectional Study ◽  
Good Reliability ◽  
Cross Sectional ◽  
Refractive Outcomes ◽  
Spearman's Rho ◽  
Spearman’S Rho ◽  
The Mean ◽  
Cylinder Power

Abstract Background To compare the refractive results of hand-held and table-mounted autorefractors. Methods We designed this study as an observational, cross-sectional study. We compared the mean spheric and cylinder power, spherical equivalent, Jackson cross-cylinder values, determined the limits of agreement (LoA), and evaluated the reliability of two autorefractors. Results We evaluated 256 eyes of 256 pediatric patients (mean age, 9.12 ± 2.26 years; range, 5–16 years). 49% of the patients were female, and 51% were male. The Nidek HandyRef-K autorefractor measured relatively more astigmatism (P < 0.001) and less hyperopia (P = 0.024). The mean differences and 95% LoA were 0.06 D ± 0.47 D (− 0.82 D to 0.98 D) in spherical power, 0.08 D ± 0.28 D (− 0.47 D to 0.64 D) in cylindrical power, 0.11 D ± 0.47 D (− 0.81 D to 1.01 D) in spherical equivalent, 0.02 D ± 0.36 D (− 0.73 D to 0.69 D) in Jackson cross-cylinder power at 0°, 0.005 D ± 0.54 D (− 1.07 D to 1.06 D) in Jackson cross-cylinder power at 45°. We found the difference within 0.50 D in 244 (95%) eyes for spherical power, in 245 (96%) eyes for cylindrical power, 228 (89%) eyes for spherical equivalent, 224 (87%) eyes for Jackson cross-cylinder power at 0°, 213 (83%) eyes for Jackson cross-cylinder power at 45°. When comparing devices, there were strong correlations for spherical power (Spearman’s rho = 0.99, P < 0.001), cylindrical power (Spearman’s rho = 0.88, P < 0.001), and spherical equivalent (Spearman’s rho = 0.98, P < 0.001). Conclusion Two autorefractors showed clinically applicable agreement limits; excellent reliability for spherical power and spherical equivalent and good reliability for cylindrical power; high positive percent agreement for spherical and cylindrical power, spherical equivalent, Jackson cross-cylinder power at 0°and 45°. These results showed that both devices might be used interchangeably for screening of refractive error in children.

scholarly journals HUBUNGAN BURNOUT DAN KELUHAN NYERI MUSKULOSKELETAL PADA MAHASISWA PROFESI NERS DI UNIVERSITAS KLABAT

2019 ◽  
Vol 5 (2) ◽  
pp. 155-164
Author(s):  
James Richard Maramis ◽  
Claudia Priscilla Kandowangko
Keyword(s):  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Purposive Sampling ◽  
Spearman's Rho ◽  
Spearman’S Rho ◽  
Body Map

Mahasiswa perawat rentan mengalami keadaan lelah baik emosional, psikologi dan fisik yang dirasakan akibat melakukan aktivitas ataupun tuntutan praktik yang dilakukan secara berulang-ulang dan dalam waktu yang lama. Keluhan nyeri muskuloskeletal merupakan salah satu gejala yang terjadi pada gangguan musculoskeletal (MSDs). Tujuan penelitian adalah mengetahui hubungan antara burnout dan keluhan nyeri musculoskeletal pada mahasiswa profesi ners di Universitas Klabat. Metode penelitian yang digunakan ialah deskriptif correlation dengan menggunakan pendekatan cross sectional study dan menggunakan rumus Spearman's rho, proses pengambilan sampel dalam penelitan ini adalah menggunakan teknik purposive sampling. Pengumpulan data menggunakan kuesioner burnout dengan kuesioner Nordic Body Map yang diberikan kepada 127 mahasiswa profesi ners di Universitas Klabat, Didapati pada umumnya sebanyak 109 mahasiswa (85,8%) memiliki tingkat burnout sedang, dan 100 mahasiswa (78,7%) merasakan keluhan musculoskeletal ringan. Daerah tubuh yang paling banyak dikeluhkan ialah di punggung dengan jumlah nilai sebanyak 273 Sedangkan hasil uji statistic antara burnout dengan keluhan nyeri musculoskeletal menunjukkan  nilai p=0,000<0,05, dengan demikian ada hubungan antara burnout dengan keluhan nyeri musculoskeletal. Nilai r=0,337 yang menunjukkan arah korelasi positif antara dua variabel atau searah. Peneliti selanjutnya dapat meneliti pengaruh rutinitas kegiatan tertentu dan postur tubuh yang dilakukan oleh perawat ketika bekerja terhadap keluhan MSD-nya, dan juga agar mencari tahu hubungannya dengan keluhan-keluhan MSD yang dirasakan responden lebih dari tujuh hari.  Kata kunci : Burnout, keluhan nyeri musculoskeletal, Nordic Body Map

scholarly journals Epidemiology and associated factors of polypharmacy in older patients in primary care: a northern Italian cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Giuliano Piccoliori ◽  
Angelika Mahlknecht ◽  
Marco Sandri ◽  
Martina Valentini ◽  
Anna Vögele ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sectional Study ◽  
Cluster Rct ◽  
Cross Sectional ◽  
Spearman's Rho ◽  
Spearman’S Rho

Abstract Background A precondition for developing strategies to reduce polypharmacy and its well-known harmful consequences is to study its epidemiology and associated factors. The objective of this study was to analyse the prevalence of polypharmacy (defined as ≥8 prescribed drugs), of potentially inappropriate medications (PIMs) and major drug-drug interactions (DDIs) among community-dwelling general practice patients aged ≥75 years and to identify characteristics being associated with polypharmacy. Methods This cross-sectional study is derived from baseline data (patients’ demographic/biometric characteristics, diagnoses, medication-related data, cognitive/affective status, quality of life) of a northern-Italian cluster-RCT. PIMs and DDIs were assessed using the 2012 Beers criteria and the Lexi-Interact® database. Data were analysed using descriptive methods, Wilcoxon rank-sum tests, Fisher’s exact tests and Spearman correlations. Results Of the eligible patients aged 75+, 13.4% were on therapy with ≥8 drugs. Forty-three general practitioners and 579 patients participated in the study. Forty five point nine percent of patients were treated with ≥1 Beers-listed drugs. The most frequent PIMs were benzodiazepines/hypnotics (19.7% of patients) and NSAIDs (6.6%). Sixty seven point five percent of patients were exposed to ≥1 major DDI, 35.2% to ≥2 major DDIs. Antithrombotic/anticoagulant medications (30.4%) and antidepressants/antipsychotics (23.1%) were the most frequently interacting drugs. Polypharmacy was significantly associated with a higher number of major DDIs (Spearman’s rho 0.33, p < 0.001) and chronic conditions (Spearman’s rho 0.20, p < 0.001), higher 5-GDS scores (thus, lower affective status) (Spearman’s rho 0.12, p = 0.003) and lower EQ-5D-5L scores (thus, lower quality of life) (Spearman’s rho − 0.14, p = 0.001). Patients’ age/sex, 6-CIT scores (cognitive status), BMI or PIM use were not correlated with the number of drugs. Conclusions The prevalence of polypharmacy, PIMs and major DDIs was considerable. Results indicate that physicians should particularly observe their patients with multiple conditions, reduced health and affective status, independently from other patients’ characteristics. Careful attention about indication, benefit and potential risk should be paid especially to patients on therapy with specific drug classes identified as potentially inappropriate or prone to major DDIs in older persons (e.g., benzodiazepines, NSAIDs, protonic pump inhibitors, antithrombotics/anticoagulants, antidepressants/antipsychotics). Trial registration The cluster-RCT on which this cross-sectional analysis is based was registered with Current Controlled Trials Ltd. (ID ISRCTN: 38449870) on 2013-09-11.

scholarly journals Hubungan onset to door time respons dengan clinical outcomes pada pasien CVA Iskemik

2021 ◽  
Vol 17 (2) ◽  
pp. 32-40
Author(s):  
Leo Yosdimyati Romli ◽  
Ucik Indrawati
Keyword(s):  
Clinical Outcomes ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Consecutive Sampling ◽  
Spearman's Rho ◽  
Spearman’S Rho

Banyak upaya telah dilakukan untuk mengurangi keterlambatan masuk rumah sakit pada pasien dengan stroke, kedatangan di rumah sakit lebih awal dapat meningkatkan hasil fungsional dan mengurangi kematian. Tujuan penelitian ini untuk menganalisis hubungan onset to door time respons dengan clinical outcomes pada pasien CVA iskemik. Desain penelitian ini yaitu cross sectional study dengan populasi semua penderita CVA Iskemik di Ruang Flamboyan RSUD Jombang dan jumlah sampel sebanyak 45 responden yang diambil dengan consecutive sampling. Variabel penelitian ini adalah onset to door time respons dan clinical outcomes. Pengumpulan data dilakukan dengan peneliti melakukan observasi dan pengukuran pada variabel onset to door time respons dan clinical outcomes. Analisis data hasil penelitian dilakukan dengan uji Korelasi Spearman’s rho. Hasil penelitian menunjukkan bahwa sebagian kecil (20%) responden memiliki onset to door time respons dengan clinical outcomes membaik dan sebagian kecil (17,8%) responden memiliki onset to door time respons dengan clinical outcomes memburuk. Hasil analisis statistik menunjukkan bahwa sig. (2-tailed) = 0,001 < 0,05 maka artinya ada hubungan onset to door time respons dengan clinical outcomes. Kesimpulan dalam penelitian ini adalah onset to door time respons berhubungan dengan clinical outcomes pada pasien CVA Iskemik. Penanganan onset to door time respons merupakan faktor yang sangat penting yang berpegaruh pada clinical outcomes pada pasien CVA Iskemik.

scholarly journals Lama Merokok dan Jumlah Konsumsi Rokok terhadap Trombosit pada Laki-laki Perokok Aktif

2015 ◽  
Vol 9 (3) ◽  
pp. 257
Author(s):  
Rini Sundari ◽  
Dinyar Supiadi Widjaya ◽  
Aditya Nugraha
Keyword(s):  
Large Cell ◽  
Cardiovascular Disorder ◽  
Cross Sectional Study ◽  
Cigarette Consumption ◽  
Cross Sectional ◽  
Distribution Width ◽  
Garment Factory ◽  
Normality Test ◽  
Spearman's Rho ◽  
Spearman’S Rho

Jumlah perokok dan jumlah rokok yang dikonsumsi mengalami peningkatan dari waktu ke waktu. Rokok dapat memengaruhi trombosit yang dapat menyebabkan gangguan kardiovaskular. Penelitian ini merupakan penelitian potong lintang yang bertujuan untuk menganalisis lama merokok dan jumlah rokok yang dikonsumsi terhadap jumlah trombosit, mean platelet volume (MPV), platelet distribution width (PDW), platelet crit (PCT), dan platelet large cell ratio (PLCR). Penelitian dilakukan di Pabrik Garmen Cimahi pada tahun 2014 yang diikuti oleh 31 laki-laki perokok aktif berusia 19 - 50 (32,97 + 10,28) tahun, 70,9% di antaranya sebagai perokok sedang. Analisis data dilakukan secara deskriptif, uji normalitas Shapiro-Wilk, dan uji korelasi Spearman’s rho. Peserta telah merokok selama minimal dan maksimal dengan rata-rata (+ SB), yaitu 3 - 25 tahun (10,48 + 6,33) dan konsumsi rokok sebanyak 5 - 25 batang per hari (13,10 + 4,99). Jumlah trombosit 171 - 422 (280,9 + 56,2) x 10^3 sel/mm3, MPV 8,8 - 13,6 (10,14 + 0,93) fL, PDW 8,7 - 13,8 (10,27 + 1,22) fL, PLCR 14,4 - 38,8% (24,91 + 5,46), dan PCT 0,1 - 0,4%(0,28 + 0,06). Sebaran ukuran trombosit ditemukan normal, namun dengan ukuran besar sesuai nilai MPV dan PLCR yang tinggi. PCT normal berkorelasi sangat kuat dengan jumlah trombosit. Jumlah batang rokok yang dikonsumsi berkorelasi lemah dengan lamanya merokok. Lama merokok dan jumlah rokok yang dikonsumsi berkorelasi negatif dengan jumlah trombosit, MPV, PDW maupun PLCR.Smoking Period and Number of Cigarette Consumption with Thrombocyte among Active Male SmokersNumber of smokers and cigarette consumption are increasing from time to time. Cigarettes influence thrombocytes which may cause cardiovascular disorder. This study was a cross sectional study aiming to analyze smoking period and cigarette consumption number toward the number of thrombocytes, MPV, PDW, PCT and PLCR. This study was conducted at Cimahi Garment Factory in 2014 participated by 31 active male smokers in age of 19 - 50 (32,97+10,28) years old in which 70,9% of them were medium smokers. Data analysis was conducted descriptively, using Shapiro-Wilk normality test and Spearman’s rho correlation test. Participants had been smoking for the minimum and maximum 3 - 25 (10.48 + 6.33) years and 5 - 25 (13.10 + 4.99) cigarettes in average per day. The number of thrombocytes was worth 171 - 422 (280,9 + 56,2)x10^3 cells/mm3, MPV 8.8 - 13.6 (10.14 + 0.93) fL, PDW 8.7 - 13.8 (10.27+ 1.22) fL, PLCR 14.4 - 38.8% (24.91 + 5.46) and PCT 0.1 - 0.4% (0.28 + 0.06). PDW was found normal with the giant shape in accordance with the high MPV and PLCR value. PCT was normal correlated strongly with thrombocyte number. The cigarette consumption number had a weak correlation with the smoking period. The smoking period and the cigarette consumption number had a negative correlation with the number of thrombocytes, MPV, PDW and PLCR.

scholarly journals Serum periostin in obstructive airways disease

2016 ◽  
Vol 47 (5) ◽  
pp. 1383-1391 ◽  
Author(s):  
James Fingleton ◽  
Irene Braithwaite ◽  
Justin Travers ◽  
Darren Bowles ◽  
Rianne Strik ◽  
...  
Keyword(s):  
Inhaled Corticosteroids ◽  
Airflow Obstruction ◽  
Cross Sectional Study ◽  
Blood Eosinophil ◽  
Cross Sectional ◽  
Spearman's Rho ◽  
Potential Biomarker ◽  
Spearman’S Rho ◽  
Serum Periostin

Serum periostin is a potential biomarker of response to therapies that target type 2 inflammation in asthma. The objectives of this study were to describe: 1) the distribution of serum periostin levels in adults with symptomatic airflow obstruction; 2) its relationship with other variables, including type 2 biomarkers; and 3) the effect of inhaled corticosteroids on periostin levels.Serum periostin levels were measured in a cross-sectional study exploring phenotypes and biomarkers in 386 patients aged 18–75 years who reported wheeze and breathlessness in the past 12 months. In 49 ICS-naïve patients, periostin levels were measured again after 12 weeks of budesonide (800 μg·day−1).The distribution of serum periostin levels was right skewed (mean±sd 57.3±18.6 ng·mL−1, median (interquartile range) 54.0 (45.1–65.6) ng·mL−1, range 15.0–164.7 ng·mL−1). Periostin was positively associated with exhaled nitric oxide (Spearman's rho=0.22, p<0.001), blood eosinophil count (Spearman's rho=0.21, p<0.001), and total IgE (Spearman's rho=0.14, p=0.007). The Hodges–Lehmann estimator (95% CI) of change in periostin level after ICS therapy was −4.8 (−6.7– −3.2) ng·mL−1 (p<0.001).These findings provide data on the distribution of serum periostin in adults with symptomatic airflow obstruction, the weak associations between periostin and other type 2 markers, and the reduction in periostin with inhaled corticosteroid therapy.

Correlation of Clinical Score and Serum Acetylcholinesterase Level as a Predictor of Outcome among Patients with Acute Organophosphate Poisoning Admitted in Emergency Ward of a Tertiary Hospital

2019 ◽  
Vol 2 (2) ◽  
pp. 19-27
Author(s):  
R Chaudhary ◽  
R Bhandari ◽  
G Malla ◽  
M. Poudel ◽  
M Lamsal
Keyword(s):  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Clinical Score ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Organophosphate Poisoning ◽  
Emergency Ward ◽  
Cross Sectional ◽  
Spearman's Rho ◽  
Spearman’S Rho

Background: Monitoring a patient's serum acetylcholinesterase (AChE) status after clinical score of organophosphate poisoning enables the verification of exposure to anticholinesterase agents. Methods: A cross-sectional study was conducted among the patients fulfilling the inclusion criteria and was categorized according to POP (Peradeniya Organophosphorus Poisoning) score. The study was conducted at a tertiary hospital for one year in the period of Jan 2016 to Dec 2016. POP score was applied and serum acetylcholinesterase level was determined in the lab. Spearman’s rho coefficient method was applied for correlation. Results: Seventy four patients survived in emergency ward who presented within (4.1 ± 2.9; 95% confidence interval [CI], 3.43- 4.80; P= 0.021) hours of ingestion of OP compounds, POP score 3 (Q1, Q3, 2, 4), serum AChE 2221 (Q1, Q3, 768.5, 4703.5) IU/L with 9 ( Q1,Q3, 8.75, 34.75) mg of atropine used, 94% received PAM for 5 (Q1, Q3, 3, 7) days of hospital stay. Four patients died within (7.5 ± 5.4; 95% CI, -1.16- 16.16; P= 0.021) hours of presentation, POP score of 4 (Q1, Q3, 4, 7.75), serum AChE 588 (Q1, Q3, 173, 1912) IU/L, atropine used 170 (Q1, Q3, 152.5, 297) mg, 5.1% received PAM for 3.5 (Q1, Q3, 1, 11.25) days of hospital stay. Spearman’s rho coefficient showed well correlation between POP score and serum AChE level (coefficient -0.356; P= 0.001), POP score for the need of atropine (coefficient= 0.536; P= 0.001). Serum AChE also correlated with the length of hospital stay (coefficient= 0.414; P= 0.001) compared to POP score (coefficient= 0.420; P= 0.001). Conclusions: The higher degree of POP score correlated to higher degree of serum acetylcholinesterase derangement, need for atropine, PAM and length of hospital stay. Thus, it enhances in the prediction of outcome among patients with acute organophosphate poisoning at index visit.

scholarly journals The Smiles of Older People through Recreational Activities: Relationship between Smiles and Joy

2021 ◽  
Vol 18 (4) ◽  
pp. 1600
Author(s):  
Ryuichi Ohta ◽  
Megumi Nishida ◽  
Nobuyasu Okuda ◽  
Chiaki Sano
Keyword(s):  
Rural Communities ◽  
Older People ◽  
Video Camera ◽  
Cross Sectional Study ◽  
Validity And Reliability ◽  
Cross Sectional ◽  
Recreational Activities ◽  
Spearman's Rho ◽  
Spearman’S Rho ◽  
Analysis Application

Recreational activities are found to increase people’s smiles, arising joy in older people, but there is limited research on this topic within the Japanese context. This cross-sectional study aimed to measure the quality and frequency of smiles in older people living in rural settings using a smile analysis application. The participants comprised 13 females aged over 65 years who lived in Unnan City, Japan, and regularly attended recreational meetings. In this study, the recreational activity that the participants joined was a game called Mattoss. A video camera captured the participants’ faces, while a smile assessment application assessed their facial expressions for smiles and joy. A total of 2767 smiles were recorded. For validity, we calculated the Spearman’s rho score between smile and joy, which was 0.9697 (p < 0.001), while for reliability, we determined the Spearman’s rho score for each participant, which exceeded 0.7 (p < 0.001). Surges of smiles were induced by one’s own mistakes, successes, and big mistakes in the game and by severe or mild judgments by the referee. High validity and reliability of smile evaluation were demonstrated. The study found that smiling increased during recreational activities. Therefore, recreational activities can be encouraged for older people living in rural communities.

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