The effects of virtual reality telemedicine a single pediatric use case patient with PTSD, post COVID-19: Exploratory research method. (Preprint)

UNSTRUCTURED This paper is an exploratory research comparison between using standard tele psych over 2D devices with HMD ( Head Mounted Device) using the Thera VRTM software. The single case example is with the pediatric mental health subject, and was specifically used to treat PTSD and co morbid symptoms related to the impact of COVID-19. The case usage was all delivered as telemedicine, and was conducted in private practice. Interventions used on all devices were Trauma Focused CBT. Results suggested a positive improvement on both patient engagement and outcome in treatment after continuous use of Virtual Reality as telehealth with avatar technology. Written informed consent was obtained from the minor’s legal guardian under the THERA VR™ agreement, for the publication of any potentially identifiable images or data included in this article.

Isoniazid preventive therapy in child household contacts of adults with active TB in Bamako, Mali

BACKGROUND and OBJECTIVE: Isoniazid preventive therapy (IPT) is known to reduce the risk of developing active TB in about 59% in children aged 15 years. We assessed adherence, completion and adverse events among children who were household contacts of a newly diagnosed adult with smear-positive TB in Bamako, Mali.METHODS: Children aged <15 years living in the same house with an adult smear-positive index case were enrolled in the study in the Bamako Region after consent was obtained from the parent or legal guardian. Adherence was assessed based on the number of tablets consumed during 6 months.RESULTS: A total of 260 children aged <15 years were identified as household contacts of 207 adult patients with smear-positive TB during the study period. Among all child contacts, 130/260 (50.0%) were aged 0–4 years and were eligible for IPT; 128/130 (98.5%) were started on IPT and 83/128 (64.8%) completed with good adherence at the end of the 6 months, and without any significant adverse events.CONCLUSION: We successfully implemented IPT with good acceptance, but low completion rate. The Mali National TB Program and partners should expand this strategy to reach more children in Bamako and the whole country and create greater awareness in the population.

Beethovens Auseinandersetzung um die Vormundschaft über seinen Neffen Karl aus historischer und soziologischer Perspektive

This article investigates from a historical and sociological perspective, Beethoven's struggle for the guardianship of his nephew, Karl, from November 1815 until September 1820. Its purpose is to illuminate Beethoven's knowledge and actions in the case of guardianship against the backdrop of contemporary historical and sociological conditions. In the early nineteenth century guardianship meant most certainly more than just the acceptance of legal custody of a minor; rather it was understood as an expression of the public recognition of talent, assets and social standing, as well as of character and honor. It furthermore functioned as an indicator of social status and position. Of great significance were also aspects of the position of legal guardian, the types of disputes with relatives, matters of family politics, the societal roles of fathers, issues of child-rearing, perceptions of status and rank, the traditional construction of gender difference and, lastly, norms of sexual behavior. The article reads Beethoven's letters and statements against the guardianship provisions of the Allgemeines Bürgerliches Gesetzbuch and contemporary legal practice, and argues that his struggle for Karl's guardianship was motivated by his ideas about social advancement through education as well as gendered norms of good parenthood.

Attitudes of legal guardians and legally supervised persons with and without previous research experience towards participation in research projects: A quantitative cross-sectional study

Background Vulnerable groups, e.g. persons with mental illness, neurological deficits or dementia, are often excluded as participants from research projects because obtaining informed consent can be difficult and tedious. This may have the consequence that vulnerable groups benefit less from medical progress. Vulnerable persons are often supported by a legal guardian in one or more demands of their daily life. We examined the attitudes of legal guardians and legally supervised persons towards medical research and the conditions and motivations to participate in studies. Methods We conducted a cross-sectional study with standardized surveys of legal guardians and legally supervised persons. Two separate questionnaires were developed for the legal guardians and the supervised persons to asses previous experiences with research projects and the reasons for participation or non-participation. The legal guardians were recruited through various guardianship organizations. The supervised persons were recruited through their legal guardian and from a previous study among psychiatric patients. The data were analysed descriptively. Results Alltogether, 82 legal guardians and 20 legally supervised persons could be recruited. Thereof 13 legal guardians (15.6%) and 13 legally supervised persons (65.0%) had previous experience with research projects. The majority of the guardians with experience in research projects had consented the participation of their supervised persons (n = 12 guardians, 60.0%; in total n = 16 approvals). The possible burden on the participating person was given as the most frequent reason not to participate both by the guardians (n = 44, 54.4%) and by the supervised persons (n = 3, 30.0%). The most frequent motivation to provide consent to participate in a research study was the desire to help other patients by gaining new scientific knowledge (guardians: n = 125, 78.1%; supervised persons: n = 10, 66.6%). Conclusions Overall, an open attitude towards medical research can be observed both among legal guardians and supervised persons. Perceived risks and no sense recognized in the study are reasons for not participating in medical research projects.

Applying a gendered lens to understanding self-reported changes in alcohol and cannabis consumption during the second wave of the COVID-19 pandemic in Canada, September to December 2020

Introduction Increased alcohol and cannabis consumption and related harms have been reported since the beginning of the COVID-19 pandemic. Existing evidence shows that substance use and related harms differ by gender. Yet, no Canadian study has applied a gendered lens to alcohol and cannabis consumption use during this time. Our objectives were to (1) provide gender-specific prevalence estimates of self-reported increased alcohol and cannabis use; and (2) examine gender-specific associations between sociodemographic and mental health variables and alcohol and cannabis use. Methods Using data from the Survey on COVID-19 and Mental Health, we calculated nationally representative, gender-specific prevalence estimates and disaggregated them by sociodemographic and mental health variables. Four logistic regression models were used to assess the likelihood of self-reported increased alcohol and cannabis use. Results The prevalence of self-reported increase in alcohol use (16.2% women; 15.2% men) and cannabis use (4.9% women; 5.8% men) did not differ by gender. For both genders, income, racialized group membership, working in the past week, being a parent/legal guardian of a child aged under 18 and screening positive for depression and anxiety were associated with increased alcohol use. Men and women who were between the ages of 18 to 44, screened positive for depression, or both, were more likely to report increased cannabis use. For women, education was significantly associated with increased alcohol use. For men, being a parent/legal guardian was significantly associated with lower odds of increased cannabis use. Conclusion Sociodemographic factors, as well as depression and anxiety, were similarly associated with increased alcohol and cannabis use for both men and women in the second wave of the pandemic.

THE VIEWS OF THE WOMEN ACTIVISTS IN SRI LANKA ON THE VALIDITY OF WALĪ IN A MARRIAGE: A JURISTIC ANALYSIS

The women activists in Sri Lanka, namely the Muslim Women Research and Action Forum (MWRAF) advocate for reform in the Muslim Marriage and Divorce Act of Sri Lanka (MMDA). Nonetheless, since the Shāfiʿī Madhhab is predominant in Sri Lanka, the All-Ceylon Jam-e-athul Ulama (ACJU) - the mainstream organization of the jurists in Sri Lanka refutes the demands of the MWRAF. Consequently, there has been a deadlock over the years between the MWRAF and the ACJU. Hence, this research aims to analyse the critiques of the MWRAF regarding the validity of Walī (legal guardian) in a marriage and the responses of the ACJU. Accordingly, it explores the arguments of the women activists and their justifications such as the prioritisation of the opinions of the Ḥanafī jurists, refusal of the Ḥadīths regarding the Walī and the claim that the Ḥadīths regarding the Walī are contradictory to the Qur’an. Moreover, it analyses the coercion of matured and unmatured bride. Since this is a juristic analysis, it draws on the Quran, the Ḥadīths and the opinions of the classical and the modern jurists. Finally, this research finds that the critiques of the women activists are against the majority opinion of the jurists and proves that validating the marriage without Walī cause detrimental effects in the Muslim Community of Sri Lanka. Hence, this research enlightens the women activists regarding validity of Walī in a marriage providing the persuasive evidence from the divine texts and the prominent jurists.

Rideshare use among parents and their children

Motor vehicle crashes are the leading cause of death for young children. Millions of ridesharing trips are taken each day, and use of these services is predicted to increase. Therefore, it is important to examine the safety of children in these vehicles. We conducted a survey of a nationally representative sample of U.S. adults aged 18 years or older (N = 2017). Of the total sample, 450 respondents reported being a parent or legal guardian of children below the age of 10. Of these, 307 or 68% had ever used ridesharing. Among those who had used ridesharing, a total of 253 or 82% reported using ridesharing with their children below the age of 10 years. Among this group, rideshare use was significantly higher among individuals with college education, and in higher income households. Given that the majority of U.S. states have legislation exempting rideshare vehicles from child restraint system law coverage, our finding of high rates of rideshare use among parents suggests that a large number of children could be at risk of injury due to a lack of appropriate restraint use.

The Correlation Between Participation in Extracurricular Activities and Student Engagement During Distance Learning

The research described in this chapter aimed to find the correlation between participation in virtual extracurricular activities (ECAs) and student engagement during distance learning at a secondary school located in Northern California. Data was gathered on current student engagement through grades, attendance, teacher perception, and student and legal guardian opinion during the first two quarters of the 2020-2021 school year. Furthermore, data was gathered on student, teacher, and legal guardian opinions on the correlation between participation in virtual ECAs and student engagement during distance learning. The data revealed that there is a significant loss of student engagement during distance learning and that students are not participating in virtual ECA's due to a lack of interest. This data can be corroborated by the number of Ds and Fs students are obtaining which indicates a significant loss in student academic success. Looking forward to increase student engagement, the school must focus on creating virtual ECAs that pertain to student interest.

Effects of nasal aspiration by the Proetz® method in pediatric patients with sinusitis

SUMMARY OBJECTIVE: To characterize the effects of nasal aspiration with Proetz® in peak nasal inspiratory flow (PNIF) in pediatric sinusitis (PS) patients with nasal obstruction. METHODS: This is a non-randomized descriptive-analytical clinical trial with a quantitative approach. The sample comprised 30 children. Initially, the PNIF was measured and the Visual Analogical Scale (VAS) was used for nasal obstruction, followed by the nasal aspiration procedure. The SNOT-22 questionnaire was applied to the legal guardian of each child, and one week later, it was reapplied for the sake of follow-up. RESULTS: 16 (53.3%) patients were females and 14 (46.7%) were males, with an average age of 6.4±1.8 years (between 4 and 10 years of age). Analyses of the VAS for obstruction before the intervention revealed that 10 of the participants (33.3%) presented moderate levels, and 20 of them (66.7%) severe levels. However, after the Proetz® method was applied, all the samples (n=30) had mild levels. The PNIF significantly increased after the technique was used, with an improvement of 23.4% in mean values. There was no significant correlation between the VAS and the PNIF. CONCLUSION: Nasal aspiration with the Proetz® method significantly improved the clinical condition of sinusitis patients with nasal obstruction according to the visual analogical scale, the PNIF, and the SNOT-22 questionnaire. No correlation between the VAS and the PNIF could be found. The study confirms the importance of non-pharmacological interventions in the treatment of sinusitis in children, thus resulting in an improvement in their quality of life.