Lessons learned from a pilot implementation of physical activity recommendations in axial spondyloarthritis exercise group therapy

Background The Ankylosing Spondylitis Association of Switzerland (SVMB) aimed to implement physical activity recommendations (PAR) within their exercise groups (EGs). The PAR promote exercise in all fitness dimensions at the correct dose. To implement the PAR within EGs, they were translated into a new EG concept with five key activities: (a) training for supervising physiotherapists (PTs), (b) correctly dosed exercises in all fitness dimensions, (c) exercise counselling, (d) bi-annual fitness assessments, and (e) individual exercise training, in addition to EG. All these activities were realized in close coordination with SVMB management. Objectives To analyse the implementation success by evaluating adherence/fidelity, feasibility, and satisfaction at the patient, PTs, and organisational level. Methods The five key activities of the new EG concept were developed, executed, and assessed after 6 months. The primary outcomes for implementation success were adherence of patients to the recommended exercise behaviour, self-reported by electronic diary; fidelity of PTs to the new concept, self-reported by diary; SVMB organisational changes. Secondary outcomes were feasibility and satisfaction with the new EG concept at all three levels. The tertiary outcome, to evaluate the effectiveness of PAR, was patient fitness, assessed through fitness assessments. Results 30 patients with axSpA (ten women, mean age 58 ± 9 years) and four PTs (three women, mean age 46 ± 9 years) participated. The patients' self-reporting of adherence to the PAR was insufficient (43%), possibly due to technical problems with the electronic dairy. The PTs' fidelity to the new EG concept was satisfactory. On all levels, the new concept was generally perceived as feasible and useful for supporting personalised exercise.The frequency of exercise counselling and the fitness assessments was found by patients and PTs to be too high and rigid. Patients' cardiorespiratory fitness [ES 1.21 (95%CI 0.59, 1.89)] and core strength [ES 0.61 (95%CI 0.18, 1.06)] improved over the 6 months. Conclusions The pilot implementation of PAR showed acceptance and satisfaction to be sufficient, thus confirming the need for evidence-based EGs, provided by a patient organisation in order to support active PA behaviour. However, adaptations are necessary to increase its feasibility for nationwide implementation. Trial Registration: SNCTP, SNCTP000002880. Registered 31 May 2018, https://www.kofam.ch/en/snctp-portal/search/0/study/42491.

Usability and effectiveness of inhaled methoxyflurane for prehospital analgesia - a prospective, observational study

Background Pain relief in the prehospital setting is often insufficient, as the administration of potent intravenous analgesic drugs is mostly reserved to physicians. In Australia, inhaled methoxyflurane has been in routine use by paramedics for decades, but experience in Central European countries is lacking. Thus, we aimed to assess whether user friendliness and effectiveness of inhaled methoxyflurane as sole analgesic match the specific capabilities of local ground and air-based EMS systems in Austria. Methods Observational study in adult trauma patients (e.g. dislocations, fracture or low back pain following minor trauma) with moderate to severe pain (numeric rating scale [NRS] ≥4). Included patients received a Penthrop® inhaler containing 3 mL of methoxyflurane (maximum use 30 min). When pain relief was considered insufficient (NRS reduction < 3 after 10 min), intravenous analgesics were administered by an emergency physician. The primary endpoint was effectiveness of methoxyflurane as sole analgesic for transport of patients. Secondary endpoints were user friendliness (EMS personell), time to pain relief, vital parameters, side effects, and satisfaction of patients. Results Median numeric pain rating was 8.0 (7.0–8.0) in 109 patients. Sufficient analgesia (reduction of NRS ≥3) was achieved by inhaled methoxyflurane alone in 67 patients (61%). The analgesic effect was progressively better with increasing age. Side effects were frequent (n = 58, 53%) but mild. User satisfaction was scored as very good when pain relief was sufficient, but fair in patients without benefit. Technical problems were observed in 16 cases (14.7%), mainly related to filling of the inhaler. In every fifth use, the fruity smell of methoxyflurane was experienced as unpleasant. No negative effects on vital signs were observed. Conclusion In prehospital use, inhaled methoxyflurane as sole analgesic is effective for transport of trauma patients (62%) with moderate to severe pain. Older patients benefit especially from inhaled methoxyflurane. Side effects are mild and vital parameters unaffected. Thus, inhaled methoxyflurane could be a valuable device for non-physician EMS personnel rescue services also in the central Europe region.

EHealth and Its Role in Supporting Audiological Rehabilitation: Patient Perspectives on Barriers and Facilitators of Using a Personal Hearing Support System With Mobile Application as Part of the EVOTION Study

BackgroundHearing loss is a major public health challenge. Audiology services need to utilise a range of rehabilitative services and maximise innovative practice afforded by technology to actively promote personalized, participatory, preventative and predictive care if they are to cope with the social and economic burden placed on the population by the rapidly rising prevalence of hearing loss. Digital interventions and teleaudiology could be a key part of providing high quality, cost-effective, patient-centred management. There is currently very limited evidence that assesses the hearing impaired patient perspective on the acceptance and usability of this type of technology.AimThis study aims to identify patient perceptions of the use of a hearing support system including a mobile smartphone app when used with Bluetooth-connected hearing aids across the everyday life of users, as part of the EVOTION project.MethodsWe applied a questionnaire to 564 participants in three countries across Europe and analysed the following topics: connectivity, hearing aid controls, instructional videos, audiological tests and auditory training.Key FindingsOlder users were just as satisfied as younger users when operating this type of technology. Technical problems such as Bluetooth connectivity need to be minimised as this issue is highly critical for user satisfaction, engagement and uptake. A system that promotes user-controllability of hearing aids that is more accessible and easier to use is highly valued. Participants are happy to utilise monitoring tests and auditory training on a mobile phone out of the clinic but in order to have value the test battery needs to be relevant and tailored to each user, easy to understand and use. Such functions can elicit a negative as well as positive experience for each user.ConclusionOlder and younger adults can utilise an eHealth mobile app to complement their rehabilitation and health care. If the technology works well, is tailored to the individual and in-depth personalised guidance and support is provided, it could assist maximisation of hearing aid uptake, promotion of self-management and improving outcomes.

Propuesta metodológica para la caracterización y tipificación de las costas españolas. Aplicación a las costas de Galicia.

There are several coastal classifications. Most of them have been elaborated worldwide using tectonic, climatic, topographic, or oceanographic criteria. Other classifications have been generated on a larger scale and focused on classifying the coastal forms, as cliffs, beaches, estuaries, lagoons, or dune complexes in different places.This project analyzes the types of coastlines, understanding as such each sector that presents certain topographic conditions marked by the elevation and slope, and that was modeled on a concrete type of rock in a specific climatic and marine environment. This paper describes a methodological approach for a detailed scale classification. This approach based on the delimitation of the different coastal systems, exemplified in cliffs and boulder beaches, sandy beaches, and dunes. In this case the shore platforms, marshes and lagoons have not been considered for the technical problems derived from the LiDAR data source, from which the 2 m spatial resolution digital terrain models (DTM) are derived.The first step in the classification was a manual delimitation combining DTMs and orthophotographs. Subsequently, other typification has been carried out through the automatic creation of Coastal Topographic Units (CTU). This index is the combination of two variables: coastal elevation and slope. The possible integration of others, such as orientation or lithology, is possible, but generate a very high number of units and make it difficult to interpret. For this reason, this study did not consider more variables.In this project 30 CTUs was generated, and then selecting only those that appear in the cliffs, boulder beaches, sandy beaches, and coastal dunes sectors. The possibility of viewing one or several CTUs in any sector of the coast allows to know more accurately the conditions of each sector and these categories could be improve the coastal management plans.

Facts and their Discontents: A Research Agenda for Online Disinformation, Race, and Gender

The January 6th attack on the U.S. Capitol demonstrated how online disinformation can have severe offline consequences. For some time, the problems and possible impacts on democracy caused by online mis- and dis-information have dominated public policy discussions and thus research about these topics has developed rapidly in the last few years. However, this research generally lacks a focus on the impact of disinformation and misinformation on people of color, women, LGBTQIA+ communities, and other voices that are less prominent in mainstream political discourse in the U.S.Many disinformation campaigns are specifically designed with racist and/or misogynistic content, suggesting that disinformation is a tool used to promote ideologies like white supremacy and patriarchy.In September 2020, CDT brought together an interdisciplinary and international group of experts to share and discuss research on this issue. This report presents some of those ideas and builds upon them to identify key research opportunities, including important unresolved questions around the intersections of online disinformation, race, and gender. This report also makes recommendations for how to tackle the related methodological and technical problems that researchers and others face in addressing these topics. This is important in generating research that will be directly relevant for developing policy solutions to address disinformation.

Properties and Engineering Applications of a New Goaf Grouting Filling Material

In the treatment of goafs in traffic engineering, technical problems such as those related to large-volume grouting and the precise control of material properties are often encountered. To address these issues, we developed a new composite material comprising cement-fly ash-modified sodium silicate (C-FA-MS). The setting time, fluidity, unconfined compressive strength, and microstructure were varied for different proportions of cement-sodium silicate (C-S) slurry, cement-fly ash-sodium silicate (C-FA-S) slurry, and C-FA-MS slurry, and their performances were compared and analysed. The experimental results showed that the initial setting time of the slurry was the shortest when both the original sodium silicate volume ratio ( V S ) and modified sodium silicate volume ratio ( V MS ) were 0.2. The final setting time of the C-S and C-FA-S slurries tended to decrease but then increased with decrease in V S , while that of the C-FA-MS slurry increased with lower V MS . The fluidity of the C-FA-S and C-FA-MS slurries decreased with decrease in V S or V MS at different fly ash admixture ratios. The consolidation compressive strength of C-S increased with decreasing V S , while that of C-FA-S showed a considerable increase only when V S decreased from 0.4 to 0.2. Meanwhile, the compressive strength of the C-FA-MS concretions first increased and then decreased with decrease in V MS . Microstructural analysis revealed that there were more cracks in the C-S agglomerate, the fly ash in the C-FA-S agglomerate reduced the relative density of the skeletal structure, and the stronger cross-linking in the C-FA-MS agglomerate improved the strength of the agglomerate. Under the condition of unit grouting volume, the cost of the C-FA-MS slurry was approximately 44.7% and 31.3% lower than that of the C-S and C-FA-S slurries, respectively. The new C-FA-MS material was applied for the treatment of the goaf in the Wu Sizhuang coal mine. Core drilling detection and audiofrequency magnetotelluric survey revealed that the goaf was sufficiently filled.

Advantages and Limits of Remote Care and Stress Management Experienced by Mothers of Students with Specific Learning Disabilities During the Covid-19 Period

These instructions give you guidelines for preparing papers. Use this document as a template if you are using Microsoft Word. Otherwise, use this document as an instruction set.. Define all symbols used in the abstract. Do not cite references in the abstract. Do not delete the blank line immediately above the abstract; it sets the footnote at the bottom of this column. Page margins are 1,78 cm top and down; 1,65 cm left and right. Each column width is 8,89 cm and the separation between the columns is 0,51 cm. Abstract-Introduction : The period of confinement due to the COVID-19 pandemic has harmful consequences on the psychological state of parents and their children, especially those with psychological or neurocognitive problems. The care of these children plays a primordial role in their development, particularly during the COVID-19 period. For this reason, our objective is to assess the state of stress among mothers of children with learning disabilities during the COVID-19 period in Morocco, as well as the support of these children. Materials and methods : This is a cross-sectional study that was conducted during the period from April to June 2020. To realise it, we used a investigation form which contains three parts. To evaluate the state of stress in mothers, we used the "PSS10d" scale adapted to the Moroccan context. The target population is composed of mothers of children with learning disabilities who are being monitored by Moroccan Association for Learning Disorders and Difficulties (MALDD) in Casablanca. Results : During the period of confinement, only 13% (n=15) of mothers reported that their children "Dys" had benefited from remote remediation by specialists According to the Odds Ratio calculation, the risk factors influencing the care of "Dys" children during this period of confinement are: lack of cooperation from the child (Odds Ratio= 16.8; IC95%=[3.5-79]). 1]; P-value=0.001), the educational level of mothers (Odds Ratio= 9.4; IC95%=[2.4-35.7]; P-value=0.001), the economic situation (Odds Ratio= 5.1; IC95%=[1.5-17.4]; P-value=0.01) and technical problems (Odds Ratio= 5.1; IC95%=[1.5-17.4]; P-value=0.01). Conclusion : According to our results, we noticed that the psychological state of the mothers is influenced by the remote care of the "Dys" children. For this the responsible authorities in Morocco must support this population.

Features of software development using arrays in an object-oriented environment

The features of software development using static and dynamic arrays in the C ++ Builder object-oriented environment are considered. The syntax of various options for creating static and dynamic arrays in the C ++ Builder language is considered in detail. Examples of working with static and dynamic arrays in C ++ Builder developed by the authors and the corresponding algorithms are presented in the form of block diagrams, program codes and program interfaces. Examples of program development are given using one-dimensional and multidimensional arrays. Examples of memory allocation are given for dynamic arrays. The choice of the required method for solving the problem is substantiated, taking into account the available input data and taking into account the expected results, as well as the peculiarities of their obtaining and processing. The external specification and the main features of the solution of the assigned tasks are considered. The development of algorithms and programs for solving problems using arrays in the C ++ Builder environment is the basis for solving engineering and technical problems using software on a computer. The proposed approaches can be used in practice, since the algorithms outlined in the work will serve as a complex example in solving the set engineering and technical problems.

Digital Platforms in the Emergency Remote Education: the Students’ Preferences

One positive side of the Covid-19 pandemic is the unprecedented opportunity it has offered to the Higher Education Institutions to experience digital learning like never before. During the pandemic, Distant Learning platforms, including Learning Management Systems and Video Conferencing Platforms, have been ubiquitous, and no single institution survived without them during the pandemic. Hence, one of the critical lessons that should be learned is the students’ experiences with these platforms. This study aims to investigate the digital platform preferences of English major students in the College of Language and Translation at King Saud University in Saudi Arabia during the Emergency Remote Education due to the Covid-19 pandemic. Its significance lies in the fact that it underscores and addresses students’ needs and preferences with regard to the digital platforms to be used for language learning, a pragmatic examination of which has been carried out in the following pages. It focuses on reasons for the preferences of the two leading digital platforms used in King Saud University: Blackboard and Zoom. A Survey with open-ended and closed-ended questions was designed to answer the questions of the study: which digital platforms do students prefer to use during Emergency Remote Education, and what were the reasons behind students’ preferences? A total of 300 students from both male and female campuses at different levels of study participated in the study. The results showed that students preferred the Zoom to Blackboard. Reasons of preferences were mainly the ease of use, followed by supporting smartphones, then having an app for smartphones. The thematic analysis of the open-ended question showed that technical problems and connection latency were the main reasons behind students’ preferences of the Zoom. The findings also indicated gender differences in reasons of preferences.

Framework for the Structuring of Distance Education in Higher Education Institutions in the COVID-19 Pandemic Process

The aim of this study is to examine the structure, tasks, and resources of distance education centers of Turkey universities to determine the changes occurring in the centers during the pandemic process by interviews with center employees and to create the framework for the tasks and responsibilities of centers. For this purpose, the organizational structure, tasks, and resources of distance education centers were examined by websites and a variety of documents by content analysis. Then, new tasks, problems, and solutions in the COVID-19 pandemic process were examined with semi-structured interviews with center employees, and changes in the structuring of center were determined. According to results, it is seen that there are more support requests coming to the assessment and evaluation unit than the normal process, communication problems with instructors, slowing and delayed question checks, and technical problems.