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2021 ◽  
Vol 118 (31) ◽  
pp. e2105573118
Amie M. Gordon ◽  
Wendy Berry Mendes

Stress is often associated with pathophysiologic responses, like blood pressure (BP) reactivity, which when experienced repeatedly may be one pathway through which stress leads to poor physical health. Previous laboratory and field studies linking stress to physiological measures are limited by small samples, narrow demographics, and artificial stress manipulations, whereas large-scale studies often do not capture measures like BP reactivity in daily life. We examined perceived stress, emotions, heart rate, and BP during daily life using a 3-wk app-based study. We confirmed the validity of a smartphone-based optic sensor to measure BP and then analyzed data from more than 330,000 daily responses from over 20,000 people. Stress was conceptualized as the ratio of situational demands relative to individual resources to cope. We found that greater demands were associated with higher BP reactivity, but critically, the ratio of demands relative to resources improved prediction of BP changes. When demands were higher and resources were lower, there was higher BP reactivity. Additionally, older adults showed greater concordance between self-reported stress and physiologic responses than younger adults. We also observed that physiologic reactivity was associated with current emotional state, and both valence and arousal mattered. For example, BP increased with high-arousal negative emotions (e.g., anger) and decreased with low-arousal positive emotions (e.g., contentment). Taken together, this work underscores the potential for expanding stress science and public health data using handheld phones to reliably and validly measure physiologic responses linked to stress, emotion, and physical health.

Ahmad Neetoo ◽  
Nabil Zary ◽  
Youness Zidoun

Background: Serious games are conceptualized as a broad topic and overlap segments of more modern forms of education: e-learning, edutainment, game-based learning, and digital game-based learning. Serious Games aligns with digitalization and the modern era and creates novel opportunities for learning and assessment in medical education. Escape rooms, a type of serious games, merge mental and physical aspects to reinforce critical skills useful in daily life. It challenges logic and reasoning and demands careful analysis of situations to correlate and solve different stages of the escape room under pressurized, timed conditions. Furthermore, it serves as an adequate environment to build problem-solving skills, communication skills, and leadership skills through the collaboration of people to achieve a common goal. The aim of this study was to investigate the applications of escape rooms in Medical Education. Method: This study investigated the applications of escape rooms in medical education. Serious games are expanding in education and have attained great relevance due to their intriguing and intrinsically motivating attributes. Within serious games, we focused on escape rooms in which participants are locked in a room, faced with puzzles that must be solved to ‘escape the room’. Compiling the data from the first 100 hits of medical application of escape rooms, we found 72 cases and categorized them by year, specialty, participants structure, simulation experience, and design. Results: We reported on escape rooms in medical education by the year in which they were reported, the medical specialty, the participant structure, grouped or individual, the experience design; real, hybrid, or digital, and the modality of the delivery. 72% of the escape rooms focused on four main areas: nursing education (25.0%), emergency medicine (22.2%), pharmacy (12.5%), and interprofessional education (12.5%). Most of the escape rooms had a group-based physical design and little attention was given to provide a detailed description of the design considerations, such as the pathway type (linear, semi-linear, open). Conclusion: Escape rooms are applied in a wide range of medical education areas. In Medical Education, group-based on-site escape rooms with a focus on nursing, emergency medicine, pharmacy and interprofessional education dominates the implementation landscape. To further advance the field, stronger emphasis on making explicit the design considerations will advance the research and inform implementations.

2021 ◽  
Vol 9 (1) ◽  
pp. 73
Adang Kuswaya ◽  
Muhammad Ali

<p>This research aims not only to understand the concept of peace in the Qur’an but also analyze Muslims’ contestation in Salatiga to lead to a peaceful life among religious believers. It requires an in-depth examination on dialectical perspectives between the ideal concept of peace in the Quran and the reality of a peaceful culture in the public sphere. Methodologically, this research combines literature review and semi-structured interviews to gather theoretical data based on social responses and literature of contemporary Qur’anic interpretation. The research subjects consist of (1) Muslims living with non-Muslim family members in the same house, (2) Muslims in a non-Muslim neighborhood, (3) religious figures, and (4) non-Muslims with Muslim family members. In order to interpret a special meaning of Qur’anic terms related to peaceful life, this research employs a hermeneutical approach of socio-thematic interpretation of the Qur’an. In conclusion, this research points out that Muslims in Salatiga play a significant role in building a peaceful life where some concepts, such as unity, freedom, honesty, and respect, are principles thriving vividly throughout society. Additionally, tolerance is a foundation of social interaction leading them to cooperate. Besides, several values, namely harmonization, tolerance, and coexistence, can be seen as dominant ideas within the communities, and practices such as cooperation and friendship can also be seen in their daily life. Thus, this research affirms that the Muslim majority can lead to tolerance and accommodate diversity as a way of life.</p>

2021 ◽  
Sarah A Moore ◽  
Guy Faulkner ◽  
Ryan E Rhodes ◽  
Leigh M Vanderloo ◽  
Leah J Ferguson ◽  

Abstract Daily life has changed for families due to the COVID-19 pandemic. The aim of this repeated cross-sectional study was to describe movement behaviours in Canadian children and youth six months into the pandemic (T2; October 2020) compared with the start of the pandemic (T1, April 2020). An online survey was distributed to parents (N = 1568) of children and/or youth (5–17 years; 58% girls) in October 2020. The survey assessed changes in movement behaviours [physical activity (PA) and play, sedentary behaviours (SB), and sleep] from before the pandemic to October 2020 (T2). We compared these data to spring data (T1; April 2020; Moore et al., 2020) collected using identical methodology (N = 1472; 54% girls). We report correlations between movement behaviours and relevant parental factors and provide word frequency distributions for open-ended responses. During the second wave, 4.5% of children (4.6% girls; 4.3% boys) and 1.9% of youth (1.3% girls, 2.4% boys) met the movement guidelines (3.1% overall). Whereas, during the first wave, 4.8% (2.8% girls, 6.5% boys) of children and 0.6% (0.8% girls, 0.5% boys) of youth were meeting combined guidelines (2.6% overall). Parental support was correlated with their child’s movement behaviours (T1 and T2). Our study demonstrates the ongoing challenges for children and youth to engage in healthy movement during the pandemic.

2021 ◽  
Vol 15 ◽  
Nayo M. Hill ◽  
Theresa Sukal-Moulton ◽  
Julius P. A. Dewald

Tasks of daily life require the independent use of the arms and hands. Individuals with hemiparetic cerebral palsy (HCP) often experience difficulty with fine motor tasks demonstrating mirrored movements between the arms. In this study, bilateral muscle activations were quantified during single arm isometric maximum efforts and submaximal reaching tasks. The magnitude and direction of mirrored activation was examined in 14 individuals with HCP and 9 age-matched controls. Participants generated maximum voluntary torques (MVTs) in five different directions and completed ballistic reaches while producing up to 80% of shoulder abduction MVT. Electromyography (EMG) signals were recorded from six upper extremity muscles bilaterally. Participants with HCP demonstrated more mirrored activation when volitionally contracting the non-paretic (NP) arm than the paretic arm (F = 83.543, p &lt; 0.001) in isometric efforts. Increased EMG activation during reach acceleration resulted in a larger increase in rest arm co-activation when reaching with the NP arm compared to the paretic arm in the HCP group (t = 8.425, p &lt; 0.001). Mirrored activation is more pronounced when driving the NP arm and scales with effort level. This directionality of mirroring is indicative of the use of ipsilaterally terminating projections of the corticospinal tract (CST) originating in the non-lesioned hemisphere. Peripheral measures of muscle activation provide insight into the descending pathways available for control of the upper extremity after early unilateral brain injury.

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 657
Donna S. Zhukovsky ◽  
Cathy L. Rozmus ◽  
Rhonda Robert ◽  
Eduardo Bruera ◽  
Robert J. Wells ◽  

Understanding the symptom and illness experience of children with advanced cancer facilitates quality care; yet, obtaining this understanding is complicated by the child’s developmental level and physical and psychological health factors that affect communication. The purpose of this study was to describe the symptom and illness experience of English- and Spanish-speaking children with advanced cancer as described by the child and parent. We conducted hermeneutic phenomenological, descriptive, and interpretive interviews with eligible children and parents. The interdisciplinary research team analyzed transcripts hermeneutically until consensus on theme labels was reached. Four themes and associated subthemes were identified from the interviews of the 10 child–parent dyads: 1. symptoms disrupt life (path to diagnosis, life is disrupted), 2. isolation (lack of understanding, family separations/relationships), 3. protection, and 4. death is not for children. Children and parents readily described the impact symptoms and cancer treatment had on their lives and relationships. These findings underscore the salient aspects of daily life disrupted by cancer. With a deeper understanding of symptom burden and its interference, relationship and communication implications, and anticipatory grief, the treating team may better optimize care for children and their families living with advanced cancer.

Bianca Senf ◽  
Bernd Bender ◽  
Jens Fettel

Abstract Purpose Suicidality and suicidal ideation (SI) in oncology has long been an underestimated danger. Although there are cancer-specific distress screening tools available, none of these specifically incorporates items for SI. We examined the prevalence of SI in cancer patients, investigated the relation between SI and distress, and tried to identify additional associated factors. Methods A cross-sectional study with patients treated for cancer in a primary care hospital was conducted. Psychosocial distress and SI in 226 patients was assessed. An expert rating scale (PO-Bado-SF) and a self-assessment instrument (QSC-R23) were used to measure distress. SI was assessed with item 9 of the PHQ-9. Data was descriptively analyzed, and correlations and group comparisons between clinically distressed and non-distressed patients were calculated. Results SI was reported by 15% of patients. Classified as clinically distressed were 24.8% (QSC-R23) to 36.7% (PO-Bado-SF). SI was correlated with externally (rτ = 0.19, p < 0.001) and self-rated distress (rτ = 0.31, p < 0.001). Symptoms sufficiently severe for at least a medium major depressive episode were recorded in 23.5% of patients (PHQ-9). Factors associated with SI were feeling bad about oneself, feeling down, depressed, and hopeless, deficits in activities of daily life, psycho-somatic afflictions, social restrictions, and restrictions in daily life. Being in a steady relationship seemed to have a protective effect. Conclusions SI is common in cancer patients. Distress and associated factors are increased in patients with SI. A distress screening with the ability to assess SI could be an important step in prevention, but more research is necessary.

2021 ◽  
Vol 11 (8) ◽  
pp. 1002
Vincenza Tarantino ◽  
Francesca Burgio ◽  
Roberta Toffano ◽  
Elena Rigon ◽  
Francesca Meneghello ◽  

Cognitive impairment after a stroke has a direct impact on patients’ disability. In particular, impairment of Executive Functions (EFs) interferes with re-adaptation to daily life. The aim of this study was to explore whether adding a computer-based training on EFs to an ordinary rehabilitation program, regardless of the specific brain damage and clinical impairment (motor, language, or cognitive), could improve rehabilitation outcomes in patients with stroke. An EF training was designed to have minimal motor and expressive language demands and to be applied to a wide range of clinical conditions. A total of 37 stroke patients were randomly assigned to two groups: a training group, which performed the EF training in addition to the ordinary rehabilitation program (treatment as usual), and a control group, which performed the ordinary rehabilitation exclusively. Both groups were assessed before and after the rehabilitation program on neuropsychological tests covering multiple cognitive domains, and on functional scales (Barthel index, Functional Independence Measure). The results showed that only patients who received the training improved their scores on the Attentional Matrices and Phonemic Fluency tests after the rehabilitation program. Moreover, they showed a greater functional improvement in the Barthel scale as well. These results suggest that combining an EF training with an ordinary rehabilitation program potentiates beneficial effects of the latter, especially in promoting independence in activities of daily living.

Education ◽  
2021 ◽  

Considering the vicious cycle of exclusion that students with special needs are often trapped in— lacking the means for equal participation in education, society, and mainstream development programs—assistive technology has proven to have great potential in providing to all learners the ability to access the general education curriculum. Approaches in the use of assistive technology basically focus on facilitating individuals in their interaction with their environment. Assistive technology is a generic term that includes assistive, adaptive, and rehabilitative devices that might be used to compensate for lack of certain abilities, in order to participate in the activities of daily life. With assistive technology individuals have the option of approaching and completing their tasks with greater ease and independence, since it helps in removing functional barriers that inhibit their individual performance. With the emergence of the social model of disability, it is increasingly being argued that inaccessible environments have been the greatest barrier to the inclusion of students with special needs. Research on the successful implementation of inclusive education in developing countries identifies the ineffective and inefficient use of assistive technologies, citing this as the major obstacle hindering inclusion. Since it has been widely acknowledged, that the success and applicability of an assistive device is governed by its acceptance and actual usage by its users considering their perception, expectations, satisfaction, and their level of access and success with the technology when interacting with their environment; approaches in the use of technology therefore have to be needs-based; inexpensive to produce, purchase, and maintain; and be easy to use and effective in addressing an identified need. This can be ensured by the direct involvement of potential users at each stage of the planning and implementation process to help overcome barriers that inhibit the efficient use and applicability of assistive technology devices in different contexts. Moreover, although assistive technology is seen to have a major role in remediating and compensating the performance deficits experienced by students with special needs, it should not be viewed merely within a rehabilitative or remediative context, but as a tool for accessing curriculum and exploring and drawing out means to help learners achieve positive outcomes. Researches on the use of assistive technology point toward the distinct need to identify ways to encourage the development of tools and strategies for effective technology integration, and to work together on issues surrounding the use of technology, ensuring that the same high standards of instruction and need-based assistance is available to all despite the difference in their functional abilities.

2021 ◽  
Chrystyna D Kouros ◽  
Lauren Papp ◽  
Brian C. Kelly ◽  
Shari M. Blumenstock

Background: This study examined social and situational context predictors of prescription drug misuse among college-students at a large public university in the Midwest. Social and situational context predictors considered were hour of the day, weekend vs weekday, whether participants were at home or another place, and who they were with during instances of misuse. Salient social events, including home football games, city-regulated parties, and the 2019 Midwest polar vortex were also recorded.Method: Using ecological momentary assessment methodology, 297 students completed momentary reports for 28 days. Participants indicated whether they had misused prescription medication (sedatives or sleeping pills, tranquilizers or anxiety medications, stimulants, and pain relievers) and reported on their social and situational context in the moment of misuse.Results: Multilevel modeling indicated that participants were more likely to misuse prescription medication earlier in the day vs. the evening, on weekdays vs. weekends, when at home vs. not at home, and while alone vs. with others.Conclusions: This study provides descriptive information on the social context in which prescription drug misuse is most likely to occur among college students. Our findings suggest that social and situational contexts of prescription drug misuse likely differ as compared to other substances (e.g., alcohol) among college students. Further research aimed at identifying momentary predictors of prescription drug misuse in this population is warranted.

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