Treatment Persistence and Real- World Effectiveness of Aripiprazole Once Monthly: A Four-Year Follow-Up

ObjectivesTreatment persistence refers to the act of continuing a treatment as prescribed and reflects the patient's or doctor's judgment about efficacy, tolerability, and acceptability. In patients with schizophrenia, antipsychotic persistence is often poor, because of issues such as lack or loss of efficacy, side effects, and poor adherence, which is often related to the degree to which patients find the medication and overall intervention to be helpful, tolerable, fair, reasonable, appropriate, and consistent with expectations of treatment. Despite the poor antipsychotic persistence that has been reported to date in patients with schizophrenia, we previously observed a relatively high (86%) 6-month persistence with aripiprazole once-monthly (AOM) in a group of patients with schizophrenia, treated in the real world Italian clinical practice. The present study explores the longer-term persistence with AOM, over a mean follow-up period of 48 months MethodsThis was an observational, multicenter, retrospective, non-interventional follow-up study, aimed at evaluating the longer-term persistence with AOM in a group of patients with schizophrenia who had already shown persistence over a period of at least 6 months. The study included 161 individuals who had participated in our previous study, where 86% of participating individuals had shown persistence with AOM for at least 6 months. Non-persistence was defined as discontinuing the medication for any reason. Baseline demographic and clinical characteristics of patients who continued AOM were then compared to those of patients who discontinued the medication ResultsStudy subjects were predominantly male (64.4%) and their mean age was 39.7 (SD: 12.24). Treatment persistence with AOM was 69.6% and 112 out of 161 patients were still receiving AOM treatment at the last follow-up visit. The mean duration of AOM treatment until the last recorded observation was 55.87 months (median 56.17, SD6.23) for the 112 persistent patients and 32.23 (median 28.68.SD 15.09) months for the 49 non-persistent individuals. The mean observation period for all patients (persistent and non-persistent) was 48.78 months (median 52.54, SD 14.64). For non-persistent subjects, the observation period ended with the discontinuation of AOM. Subjects treated with AOM at 400 mg presented a 69.6% lower risk of all-cause treatment discontinuation when compared with patients treated with 300 mg (HR: 0.314; 95% confidence interval [CI]: 0.162-0.608; P=0.001). The main reasons for discontinuation were lack of efficacy (30.6%), patient/caregiver choice (18.4%), physician’s choice (16.3%), non-adherence (12.2%) and inconvenience (6.1%). Only 3 patients (6.1%) discontinued AOM for tolerability issues. ConclusionsIn subjects with schizophrenia, who had already shown a 6-month persistence with AOM, a high number of patients (69.6%) continued to be persistent over a four-year follow-up period. This may reflect a favourable profile of efficacy, tolerability, and acceptability. Larger and prospective studies are warranted to confirm our observations.

The Manners Of Cognitive Processin Translating English Phrasal Verbs Into Indonesian

This study dealt with the cognitive process of students in translating English Phrasal Verbs into Indonesian by using the think-aloud protocol (TAP) technique and introspective interview. The objectives of the study was1) to elaboratethe manner of cognitive processes occurring in translating English Phrasal Verbs into Indonesian . This research was conducted by descriptive qualitative design. The source of data was the bilingual students, they were sixth semester students of English Education Program at State University of Medan. The source of data were taken by using Snowballing Technique. The data consisted of the transcription of audio recorded observation of think-aloud protocols (TAP), and the transcription of interview. The findings showed that there are six behaviors available during the process of translation done by the students, namely 1) reading the text, 2) alternating between the SL and the TL 3) monitoring the proposed translation, 4) consulting the dictionary 5) paraphrasing, and 6) translation. The cognitive processes occur when the subjects 1) read the text, either they read the whole SL or segment by segment, 2) kept repeating the term (the lexical) which indicates hesitation, questioning, and remembering the real meaning 3) were not able to make decision for an equivalent, 4) did not understand the meaning of verbs and consult the dictionary, 6) tried to clarify a concept and reformulate a proposed translation by paraphrase, and 7) wrote down a translation and express it orally.

First record of predation of a hatchling turtle by the Western tiger snake (Notechis scutatus occidentalis).

ABSTRACT Snake-Turtle interactions have been rarely documented. We recorded a hatchling Chelodina oblonga within the stomach contents of a Western tiger snake (Notechis scutatus occidentalis). This is the first recorded observation of an interaction between snakes and hatchling freshwater turtles in Western Australia. Field based palpation failed to detect the hatchling, suggesting that without dissection, turtle hatchling predation by snakes more generally could be higher than commonly reported. Snake predation of hatchlings could be placing additional pressure on threatened populations of freshwater turtles in Australia, warranting further investigation.

A REVIEW OF PANCHAKARMA THERAPIES WITH RESPECT TO BALA (IMMUNITY) FOR PREVENTION AND MANAGEMENT OF COVID-19

Introduction: Worldwide prevalence rate of COVID-19 is increasing day wise, and estimated at 6.6% in the Indian population in August 2020, the curable medicine and immunization for COVID-19 is not availa-ble yet. The disease COVID-19 can be compared with Janapadodhansa Vyadhi (Epidemic) mentioned in Ayurveda. Panchakarma therapies are advised in Janapadodhansa Vyadhi. Virus is very prominent, and it is the common cause mentioned in both. The Ayurved fraternity and people have fear about Panchakarma therapies in the COVID-19 era. Aim: need of current situation is to find applicability effectiveness of Pan-chakarma therapies. Methodology: By critical literary search of Classical Ayurvedic texts, electronic me-dia, PubMed, indexed Journal, Google scholar is carried out and observations were recorded. Observation and Results: Panchakarma helps to increase Bala (Immunity) and improves immunomodulation effect of Rasayana (Rejuvenation) medicine. Fever, Headache, Common cold, Cough, Dyspnea, these are common symptoms found in COVID-19 and Panchakarma therapies are indicated in the same. Conclusion: Pan-chakarma Therapies, are independently advocated for improvement of Bala (Immunity) and as a preopera-tive measure for improving immunomodulation property of Rasayana (Rejuvenation) medicines. These principles of Panchakarma Therapies can be applied in prevention and treatment of COVID- 19 disease.

THE ANALYSIS OF JOKO WIDODO, PRABOWO SUBIANTO, AND NADIEM MAKARIM SPEECH’S IN SPEECH ACT AND THE FUNCTION OF THE EXPRESSION OF THE CORONA VIRUS

This aimed to describe the use of speech acts in the form of locutionary acts, illocutionary acts, perlocutionary acts, and expressive speech acts used by corona virus topic as the hot news. This research used descriptive qualitative method. The subject of this research are Ir. H. Joko Widodo, Nadiem Anwar Makarim, B.A., M.B.A. who had been joining KompasTV Program at Channel Youtube and H. Prabowo Subianto Djojohadikusumo who had been joining Garuda Siaga RI Facebook Page channel. The technique of collecting data was using free listening comprehension, video, and writing. The researcher took three of them as the subject. There are two kinds of instruments used in this research are observation and recorded. Observation with the passive observer where the writer used video recorder to record of the speech and also transcribing. The instrument was an indirect observation. The results showed that there were types of locutionary acts, illocutionary acts, perlocutionary acts, and functions of expressive speech acts consisting of expressing thanksgiving, complaining, praising, apologized and motivate.

Predicting the Outbreak of Tikka and Rust in Grountnut (Arachis Hypogaea)

Groundnut (Arachis hypogaea) is one among the most important oil seed crop cultivated in India. Tikka leaf spot and Rust are the major disease of groundnut that effects on production and productivity. The prediction was made based on factors such as minimum and maximum temperature, morning and evening humidity, wind speed, sunshine hours that quantifies the disease infestation in groundnut. The relationship between the weather, pest and disease infestation are identified which supports the model to predict the occurrence of the disease. The observations were recorded at an interval of one week from the occurrence of tikka and rust. The percent disease intensity is calculated based on the scale explained by Mayee and Data. The favourable climatic conditions for tikka and rust disease development ranges between 26OC – 31OC and 25OC – 30OC respectively, relative humidity greater than 85%, prolonged heavy rainfall, wind speed and rain. The rules are generated based on the recorded observation and the weather parameters. The main objective is to diagnose the existence of tikka and rust disease coupled with weather parameters.

A Comparison of User Behaviors for a Fertility-Tracking App: Does Training in an NFP Method Improve Persistence and Use?

This study explores differences in the use of CyclePro Go™ (CPG), a fertility-tracking app developed by Couple to Couple League (CCL), between those exposed to it as a part of natural family planning (NFP) instruction versus those who find it on their own. An anonymous data set of 17,543 CPG accounts opened between April 2013 and June 2016 was used for analysis. Nonmember users opened the most accounts (58 percent, n = 10,134), CCL members represented 38 percent ( n = 6,758) of new accounts, and 207 CCL teachers (4 percent) were using CPG for personal charting. Significantly more nonmember accounts had zero days of use after the initial opening compared to CCL member accounts (61 percent vs. 23 percent, respectively, χ2 = 2,405.9, p < .001). Conversely, significantly more CCL member accounts were used for ninety days or longer than nonmember accounts (47 percent vs. 13 percent, respectively, χ2 = 2,404.2, p < .001). CCL students—those who began using the app as part of a formal NFP teaching curriculum—were more likely to use the app for > six cycles compared to nonmembers. In accounts with at least one complete cycle, CCL students were the most diligent at daily recording (95 percent of cycle days with observation recorded) followed by CCL members (88 percent) and nonmembers (76 percent). CCL teachers had the lowest frequency of cycle days with a recorded observation (73 percent). Within each cohort, accounts with > six recorded cycles had a lower proportion of cycle days with an observation recorded, likely reflecting increasing knowledge of their personal fertility patterns. Long-term users who had no known formal training in NFP still had the lowest proportion cycle days with a fertility observation. We conclude formal NFP instruction increases the probability of long-term app use, and regardless of training, long-term users will likely record observations on about 70 percent of cycle days. Summary: “CyclePro Go™ users with NFP training were more persistent and diligent about daily data input than those without training.”

Robson ten groups classification system for caesarean section audit: are our operation theatre registers RTGC enabled?

Background: Rising caesarean section rate is a global problem. Robson ten groups classification (RTGC) system of audit has been recommended as the first step towards planning strategies to reduce caesarean section rate. Getting data for this audit is often difficult. If operation theatre (OT) registers are maintained properly this would become easy. The study proposes to know if enough information is available in the operation theatre registers to get caesarean section data for ten groups of Robson classification system. To suggest changes in OT register format for future convenience.Methods: We studied data from 100 consecutive caesarean section entries in OT registers from two medical college institutions to know if the information recorded is adequate to classify these 100 caesarean sections into ten groups given by Robson. Last 100 caesarean section entries into the OT register during the period 1st April 2018 till 31st March 2019 were studied.Results: Presentation of the foetus was the only factor which could be clearly known for all 100 cases. Labour onset whether spontaneous or induced was the least recorded observation in traditional operation theatre registers. The next information which was commonly not recorded was the labour status (woman in labour or not in labour) at the time of caesarean section.Conclusions: For Robson’s classification of caesarean sections to become useful tool to guide strategies in reducing caesarean sections we need to modify format of our OT registers. Traditional OT registers do not provide enough information to categorize caesarean section cases into Robson ten groups. Missing information makes caesarean section audit imperfect or impossible. We suggest a format for it to be incorporated into the operation theatre registers of centres providing maternity services.

Enhancing Interaction through Visual Interfaces in the design of Hypermedia Games for English learning at Preschool

As the presence of technologies becomes more apparent in every corner of our lives, interaction and user-centered design can be a vital tool in addressing target groups with special needs. Within the realm of education, this research proposes enhanced, user-friendly hypermedia applications for young children so they can be proficient enough to handle web-based interfaces and easily interact with content. The issue of how graphic content and visual design can be tailored for both the user and the content will be dealt with by examining the implementation of enhanced computer games interfaces for children. Research will be centered on the interaction design applied in creating instructions (referred to as intros) in gaming, the navigation icons needed by early learners while moving through hypermedia tasks and the understanding of the different backgrounds to recognize the type of game they are working on (e.g. matching, click and color, drag and drop, and the like). Evaluation through recorded observation of young learners´ interactions during class sessions detects trouble spots which consequently lead us to rethink navigation and interaction elements for the purpose of improving communication on the final product.