Effect of Swiss Ball Training on Balance and Postural Stability in Stroke Patient

Stroke is sudden loss of neurological function. It is caused by interruption in cerebral blood flow. Objectives: To analyze the difference in the balance and postural stability score pre &post swiss ball training in stroke patients. Study Design: Randomized control trial. Methodology: This study was performed on stroke patients which are selected according to inclusion and exclusion criteria. The patients were allocated randomly into two groups, experimental group with exercises being performed on swiss ball and control group with exercises performed as per conventional methods with no additional intervention. Statistical analysis: SPSS software, v 20 analyzed data. Independent samples t test and paired sample test were applied. Results: The results showed mean difference of Berg Balance Scale at pre-intervention level and post-interventional level was 0.15 and 14.15 with p values 0.653 and 0.000, respectively. The TIS also showed non-significant difference at pre-interventional level as shown by p value 0.170 , which was significant at post interventional level with a p value to be 0.000 . Paired sample statistics showed a significant improvement for both groups at pre-post level of measurement with a p value of 0.000. Conclusion: We concluded that in stroke patients performing exercises on swiss ball showed significant better outcomes as compared to control group in improving balance and postural stability. However, both groups improved significantly when tested at pre-post levels of measurement. Keywords: Swiss Ball, Stroke, Physical Therapy, Exercise Therapy and Balance.

HETEROTOPIC OSSIFICATION IN ACETABULAR FRACTURES: SYSTEMATIC REVIEW AND META-ANALYSIS OF PROPHYLAXIS

ABSTRACT Objective: Heterotopic ossification is defined as the formation of trabecular bone in soft tissues. It is a common complication after surgical treatment of acetabular fractures. However, its prophylaxis and treatment are still controversial. The objective of this research is to evaluate the effectiveness of actions to prevent the development of heterotopic ossification after surgical correction of acetabular fractures. Methods: A systematic review was carried out with research in the databases PubMed/MEDLINE, Embase, LILACS and Cochrane until August 4, 2020, without restrictions on language and year of publication. Only randomized clinical studies carried out in humans without restrictions based on the dosage of treatments, use and duration of prophylaxis were included in this review. Results: Two studies compared the use of radiotherapy and indomethacin and three compared the use of indomethacin with a placebo or non-indomethacin group. The meta-analysis calculations did not indicate statistical differences between radiotherapy versus indomethacin (RR 1.45, IC 95% 0.97 to 2.17, p = 0,55) and indomethacin versus placebo or not indomethacin (RR 0.85, IC 95% 0.68 to 1.06, p = 0,59). Conclusion: There is insufficient evidence to affirm that the use of radiotherapy or indomethacin are effective to prevent the formation of heterotopic ossification after surgery for fractures of the acetabulum. In addition, the number of complications was higher in the indomethacin group when compared to placebo or no intervention. Level of Evidence I, Systematic Review.

Application of an Implementation Framework Using Mixed Methods in Preschool Settings

Research Findings. Application of mixed methods in a dissemination and implementation framework can give researchers a better understanding of the reach and delivery of early childhood obesity prevention programs in preschool settings, as well as potential facilitators and barriers related to implementation and sustainability. This study utilized a simultaneous, exploratory, mixed-methods design to investigate individual-, organizational-, and intervention-level factors that were related to the implementation and sustainability of policy, system, and environment (PSE) changes as part of a larger obesity prevention program in a randomly selected sample of preschool centers ( n = 20). Individual-level factors, and specifically the attitudes and skills of preschool providers, were identified in both the qualitative and quantitative data as important factors related to the sustainability of PSE changes ( r = .56, p < .01). Staff and leadership engagement and adaptability of the program were also identified as important factors related to the implementation and sustainability of PSE changes. Practice or Policy. These findings highlight the complexity of implementation success and suggest PSE obesity prevention interventions in preschool centers require the consideration of numerous, multilevel factors to ensure programming is impactful and sustained over time.

Assessment The Knowledge of Covid-19 Among Sudanese Societies

Introduction: COVID-19 is the most dangerous epidemic that has afflicted the world and claimed lives, and everyone should be made aware of it in order to avoid the wider spread of it, especially in third world countries that do not have the full powers to cope with it. Material & Method: Descriptive Study design. Participants were randomly assigned to the intervention. Level of knowledge were measured at baseline and at 1 month, involved a systematic collection, analysis and interpretation of data to evaluate the current knowledge. The sample consist of 100 person and that who were available during study period. Result: The results showed 90 % of population have good knowledge about the cause of COVID-19 and 50% have good knowledge about the symptoms and signs of COVID-19 but the 20% of participants have poor knowledge about the modes of transmission, 44% knowing about hand washing is the protect from COVID-19. Conclusion: Based on the results of current study, we concluded help enhance knowledge among Sudanese societies. Recommendation: Educational workshops on COVID-19, methods of transmission and prevention. Keywords: COVID-19 - educational program- Sudanese societies - Wuhan - wash hands.

The Short Form of the Glasgow Composite Measure Pain Scale in Post-operative Analgesia Studies in Dogs: A Scoping Review

The measurement and treatment of acute pain in animals is essential from a welfare perspective. Valid pain-related outcome measures are also crucial for ensuring reliable and translatable findings in veterinary clinical trials. The short form of the Glasgow Composite Measure Pain Scale (CMPS-SF) is a multi-item behavioral pain assessment tool, developed and validated using a psychometric approach, to measure acute pain in the dog. Here we conduct a scoping review to identify prospective research studies that have used the CMPS-SF. We aim to describe the contexts in which it has been used, verify the correct use of the scale, and examine whether these studies are well-designed and adequately powered. We identify 114 eligible studies, indicating widespread use of the scale. We also document a limited number of modifications to the scale and intervention level, which would alter its validity. A variety of methods, with no consensus, were used to analyse data derived from the scale. However, we also find many deficiencies in reporting of experimental design in terms of the observers used, the underlying hypothesis of the research, the statement of primary outcome, and the use of a priori sample size calculations. These deficiencies may predispose to both type I and type II statistical errors in the small animal pain literature. We recommend more robust use of the scale and derived data to ensure success of future studies using the tool ensuring reliable and translatable outcomes.

Creating the Scratch Cooked School Food Framework: Qualitative Data Analysis of a Scratch Cooking Pilot

The purpose of this study is to develop a novel framework that outlines the system required to implement scratch cooking in school kitchens. The data used in this study were 57 interviews with key stakeholders during the Return to Scratch Cooking Pilot that occurred in two New York City school kitchens in 2018–2019 and made significant modifications to many aspects of the existing school food system. The guiding framework for the data analysis was Meadows’s Intervention Level Framework. Intervention Level Framework describes analyzing systems by examining five layers: (1) paradigm shift, (2) goals, (3) system structure (4) feedback and delays, and (5) structural elements. It also provides a framework for describing a system by defining its elements, interconnections, and purpose. Data analysis revealed four elements of the school food system: ingredients and recipes, kitchen, cooking, and the community. The interconnections that played a role in each of these elements were policies, practice, people, and promotion. Together, these four elements and four interconnections comprise the Scratch Cooked School Food framework, which has the purpose of being a tool for researchers and practitioners to utilize when planning, implementing, and evaluating scratch cooking in the school food environment.

IMPACT OF STRENGTH AND PLYOMETRIC TRAINING ON AGILITY, ANAEROBIC POWER AND CORE STRENGTH IN BADMINTON PLAYERS

The study aimed to evaluate the effectiveness of strengthening and plyometric resistance training on anaerobic power and muscular strength in badminton players. The design used for the research is an experimental study with pre-test and pos-test measurement. The sample size used for the study was 40 both male and female with age ranging from 18 to 24 years and with the inclusion criteria of athletes who are under training for at least 1-2 years (.elite). Study procedure was started by measuring the agility of each badminton player by t-test, vertical jump and plank test before the strengthening and plyometric training. The subjects recruited for the study were equally distributed in two groups which included group A training group and group B control group. The mean and standard deviation bar graphs were used for the comparison. Comparison between the three outcomes measures done for the training group for the pre and post-test, concluding that there was a significant improvement in the values of the post-intervention level.

319Congenital cytomegalovirus education, translation and prevention

Focus of Presentation Congenital cytomegalovirus (CMV) is a known cause of sensorineural hearing loss, cerebral palsy and other disabilities. International consensus guidelines (2017) and the Australasian Society of Infectious Diseases (2014) recommend all pregnant women be provided with information on CMV and strategies to reduce their risk of infection. Here we describe the multifaceted strategies implemented to date to promote uptake of these guidelines. Findings At policy level, we influenced national clinical practice standards through input into new CMV prevention recommendations by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and Department of Health, which sparked state public health campaigns. At the intervention level, we presented hospital in-services, podcasts and webinars and developed an e-learning course for midwives. In collaboration with the Department of Health &gt;11,000 pamphlets were disseminated to NSW GPs. At the community level, we developed patient information and media resources. During a recent month-long campaign, our cCMV video had &gt;62,000 views, CMV content on social media had &gt;1.4M total impressions, &gt;77,000 total engagements and &gt;200,000 viewed CMV awareness pieces via television/radio/print. Conclusions/Implications Implementation of congenital CMV practice guidelines provide an important opportunity to prevent neurodevelopmental disability. Collaborations between families, clinicians, researchers, professional bodies and health departments are essential to drive translation. Key messages A multifaceted approach in implementing congenital CMV practice guidelines gives the opportunity to reach numerous stakeholders including policymakers, health professionals and expectant mothers.

Implementing at-birth, point-of-care HIV testing in Kenya: a qualitative study using the Consolidated Framework for Implementation Research

Background At-birth and point-of-care (POC) testing can expedite early infant diagnosis of HIV and improve infant outcomes. Guided by the Consolidated Framework for Implementation Research (CFIR), this study describes the implementation of an at-birth POC testing pilot from the perspective of implementing providers and identifies the factors that might support and hinder the scale up of these promising interventions. Methods We conducted 28 focus group discussions (FGDs) with 48 providers across 4 study sites throughout the course of a pilot study assessing the feasibility and impact of at-birth POC testing. FGDs were audio-recorded, transcribed, and analyzed for a priori themes related to CFIR constructs. This qualitative study was nested within a larger study to pilot and evaluate at-birth and POC HIV testing. Results Out of the 39 CFIR constructs, 30 were addressed in the FGDs. While all five domains were represented, major themes revolved around constructs related to intervention characteristics, inner setting, and outer setting. Regarding intervention characteristics, the advantages of at-birth POC (rapid turnaround time resulting in improved patient management and enhanced patient motivation) were significant enough to encourage provider uptake and enthusiasm. Challenges at the intervention level (machine breakdown, processing errors), inner settings (workload, limited leadership engagement, challenges with access to information), and outer setting (patient-level challenges, limited engagement with outer setting stakeholders) hindered implementation, frustrated providers, and resulted in missed opportunities for testing. Providers discussed how throughout the course of the study adaptations to implementation (improved channels of communication, modified implementation logistics) were made to overcome some of these challenges. To improve implementation, providers cited the need for enhanced training and for greater involvement among stakeholders outside of the implementing team (i.e., other clinicians, hospital administrators and implementing partners, county and national health officials). Despite provider enthusiasm for the intervention, providers felt that the lack of engagement from leadership within the hospital and in the outer setting would preclude sustained implementation outside of a research setting. Conclusion Despite demonstrated feasibility and enthusiasm among implementing providers, the lack of outer setting support makes sustained implementation of at-birth POC testing unlikely at this time. The findings highlight the multi-dimensional aspect of implementation and the need to consider facilitators and barriers within each of the five CFIR domains. Trial registration ClinicalTrials.gov, NCT03435887. Retrospectively registered on 19 February 2020

Community Mental Health Delivery

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) is a modular, flexible intervention that has been applied in various community mental health settings by community clinicians to diverse adolescents across the United States and Australia. This chapter summarizes key adaptations that were commonly used by community clinicians across two effectiveness trials. For example, clinicians flexibly abbreviated the UP-A when they only had limited time with an adolescent. Many clinicians also referred to “module summary” outlines during their sessions to ensure they covered key take-home points. Lastly, the chapter summarizes intervention-level, clinician-level, and patient-level barriers for UP-A implementation in community settings and provides recommendations for clinicians, supervisors, and consultants about how to troubleshoot these barriers. Furthermore, the chapter describes the case of a community clinician who initially worried about deviating too far from UP-A content but was later able to flexibly apply the UP-A to her cases.