A Farewell to Ears: Hearing the Call and Answering

A semi-humorous autobiographical account of one first-year MSOT student trying to do their part to support the local healthcare community and its clients during the time of COVID-19 and self-quarantine

Improvisation, truth, and archetyping: Establishing the tools and precepts of comedic acting

This research set out to prove that truth and archetyping are the primary precepts of comedic acting, and that improvisation is justifiably the most prevalent pedagogical tool for instilling these precepts in the comedic actor. To prove this theory, a comprehensive study of the history of the genre was conducted

Vitamin A Status of Women and Children in Yaoundé and Douala, Cameroon, is Unchanged One Year after Initiation of a National Vitamin A Oil Fortification Program.

Vitamin A (VA) fortification of cooking oil is considered a cost-effective strategy for increasing VA status, but few large-scale programs have been evaluated. We conducted representative surveys in Yaoundé and Douala, Cameroon, 2 years before and 1 year after the introduction of a mandatory national program to fortify cooking oil with VA. In each survey, 10 different households were selected within each of the same 30 clusters (n = ~300). Malaria infection and plasma indicators of inflammation and VA (retinol-binding protein, pRBP) status were assessed among women aged 15-49 years and children aged 12-59 months, and casual breast milk samples were collected for VA and fat measurements. Refined oil intake was measured by a food frequency questionnaire, and VA was measured in household oil samples post-fortification. Pre-fortification, low inflammation-adjusted pRBP was common among children (33% <0.83 µmol/L), but not women (2% <0.78 µmol/L). Refined cooking oil was consumed by >80% of participants in the past week. Post-fortification, only 44% of oil samples were fortified, but fortified samples contained VA concentrations close to the target values. Controlling for age, inflammation, and other covariates, there was no difference in the mean pRBP, mean breast milk VA, prevalence of low pRBP, or prevalence of low milk VA between the pre- and post-fortification surveys. The frequency of refined oil intake was not associated with VA status indicators post-fortification. In sum, after a year of cooking oil fortification with VA, we did not detect evidence of increased plasma RBP or milk VA among urban women and preschool children, possibly because less than half of the refined oil was fortified. The enforcement of norms should be strengthened, and the program should be evaluated in other regions where the prevalence of VA deficiency was greater pre-fortification

The Effectiveness of Occupation-based Virtual Reality Intervention on Upper Extremity Functional Improvement in Post-stroke Individuals: A Systematic Review

Purpose: Virtual reality (VR)-based therapy is an emerging practice in the clinical setting and still requires research documenting its efficacy. This review analyzed the effectiveness of VR-based therapy on upper extremity (UE) motor recovery in individuals with chronic stroke by analyzing multiple randomized controlled trials. Methods: Search limits for this review consisted of articles published between January 2010 and January 2020 and available in English. Search keywords were based on language in individual databases (e.g. stroke or cerebrovascular accident, upper extremity, occupational therapy). Articles were limited to include only randomized control trials consisting of adult patients (18+) with UE impairment due to chronic stroke (onset at least 3 months prior) and occupation-based virtual reality intervention. Results: 242 articles were screened; eight met the inclusion criteria. Forms of VR within the reviewed articles included traditional gaming systems, mobile-based game devices, and VR combined with real instrument training. These studies showed improved outcomes following VR training such as improvement of UE function, activity participation, and health-related quality of life. Conclusion: The results of this review suggest that VR-based therapy has efficacy equal to or greater than conventional therapy for improving function in the upper extremity of adult patients with chronic stroke. As supported by research, practitioners may incorporate virtual reality-based therapy into conventional clinical sessions to assist in improving UE function and interactions within different environments and to help enhance overall participation in daily tasks and occupational performance in their clients

Prevalence of Inherited Hemoglobin Disorders and Relationships with Anemia and Micronutrient Status among Children in Yaoundé and Douala, Cameroon.

Information on the etiology of anemia is necessary to design effective anemia control programs. Our objective was to measure the prevalence of inherited hemoglobin disorders (IHD) in a representative sample of children in urban Cameroon, and examine the relationships between IHD and anemia. In a cluster survey of children 12-59 months of age (n = 291) in Yaoundé and Douala, we assessed hemoglobin (Hb), malaria infection, and plasma indicators of inflammation and micronutrient status. Hb S was detected by HPLC, and α⁺thalassemia (3.7 kb deletions) by PCR. Anemia (Hb < 110 g/L), inflammation, and malaria were present in 45%, 46%, and 8% of children. A total of 13.7% of children had HbAS, 1.6% had HbSS, and 30.6% and 3.1% had heterozygous and homozygous α⁺thalassemia. The prevalence of anemia was greater among HbAS compared to HbAA children (60.3 vs. 42.0%, p = 0.038), although mean Hb concentrations did not differ, p = 0.38). Hb and anemia prevalence did not differ among children with or without single gene deletion α⁺thalassemia. In multi-variable models, anemia was independently predicted by HbAS, HbSS, malaria, iron deficiency (ID; inflammation-adjusted ferritin <12 µg/L), higher C-reactive protein, lower plasma folate, and younger age. Elevated soluble transferrin receptor concentration (>8.3 mg/L) was associated with younger age, malaria, greater mean reticulocyte counts, inflammation, HbSS genotype, and ID. IHD are prevalent but contribute modestly to anemia among children in urban Cameroon

Gastrointestinal Dysfunction Criteria in Critically Ill Children: The PODIUM Consensus Conference

CONTEXT Prior criteria to define pediatric multiple organ dysfunction syndrome (MODS) did not include gastrointestinal dysfunction. OBJECTIVES Our objective was to evaluate current evidence and to develop consensus criteria for gastrointestinal dysfunction in critically ill children. DATA SOURCES Electronic searches of PubMed and EMBASE were conducted from January 1992 to January 2020, using medical subject heading terms and text words to define gastrointestinal dysfunction, pediatric critical illness, and outcomes. STUDY SELECTION Studies were included if they evaluated critically ill children with gastrointestinal dysfunction, performance characteristics of assessment/scoring tools to screen for gastrointestinal dysfunction, and assessed outcomes related to mortality, functional status, organ-specific outcomes, or other patient-centered outcomes. Studies of adults or premature infants, animal studies, reviews/commentaries, case series with sample size ≤10, and non-English language studies with inability to determine eligibility criteria were excluded. DATA EXTRACTION Data were abstracted from each eligible study into a standard data extraction form along with risk of bias assessment by a task force member. RESULTS The systematic review supports the following criteria for severe gastrointestinal dysfunction: 1a) bowel perforation, 1b) pneumatosis intestinalis, or 1c) bowel ischemia, present on plain abdominal radiograph, computed tomography (CT) scan, magnetic resonance imaging (MRI), or gross surgical inspection, or 2) rectal sloughing of gut mucosa. LIMITATIONS The validity of the consensus criteria for gastrointestinal dysfunction are limited by the quantity and quality of current evidence. CONCLUSIONS Understanding the role of gastrointestinal dysfunction in the pathophysiology and outcomes of MODS is important in pediatric critical illness

Star kids - reaching out : improving the life chances of vulnerable children

This was the first project the Faculty embarked on once I was elected Dean. The challenges that children, who not out of their own choice had to face, because life dealt them a bad hand, has always been at the centre of our work at the Faculty. Most of our scholarship, professional training and social engagement, at the end of the day lead to ensuring that this segment of our population live a much-deserved quality of life. This project is another loop in addressing this matter and how using technology could fill in the gaps that children experience in their life as they ended up in vulnerable situations. This study emphasises the potential that technology has in levelling out the disadvantages. We hope that as a Faculty this project can move on to the next level and provide a much needed training programme to make sure that the changes that have been localised in our study can have practical application. The team who have worked in this project, academics, administrators and researchers have provide us with an immensely important tool that will serve to help these children.peer-reviewe

Factors affecting ICT education among vulnerable minors in Malta : findings of the star kids research project

This paper identifies and discusses needs and gaps among minors aged 5-17 years who, at the time of the study, resided in out-of-home care and/or made use of community-based welfare services. The discussion is informed by mixed-methods study research carried out in 2018 as part of the project ‘Star Kids – Reaching Out: Improving the Life Chances of Vulnerable Children’. Star Kids’ objectives included developing and delivering a nationally accredited ICT training course for vulnerable minors; in a context where digitization is often described as ubiquitous, yet its experience is complex and not universal. In this paper, data analysed include responses to a questionnaire administered to minors; and data from focus groups with minors, their parents/guardians, and professionals working with the cohort under study. The study found high ICT usage, albeit with gender-based and age-based differences. Gaming, streaming and downloading prevailed among boys and 5–11-year-olds; use of social media prevailed among girls. Most minors considered themselves as self-learnt ICT users; yet the study flagged the need for more support for minors with low socio-economic backgrounds. The study identified shortcomings in the infrastructure available. Recommendations include investment in state-of-the-art ICT infrastructure in residential homes and community centres; further research to assess impacts of COVID-19 on this study’s findings; policy development that steers ICT education towards participatory and empowered involvement of parents /guardians; and that dwells on participants’ existing ICT knowledge and skills.peer-reviewe

The impact of badminton on health markers in untrained females

The purpose of the study was to examine the health effects of eight weeks of recreational badminton in untrained women. Participants were matched for maximal oxygen uptake (V̇ O2max) and body fat percentage and assigned to either a badminton (n = 14), running (n = 14) or control group (n = 8). Assessments were conducted pre and post intervention with physiological, anthropometric, motivation to exercise and physical self-esteem data collected. Post-intervention, V̇ O2max increased (P < 0.05) by 16% and 14% in the badminton and running groups respectively and time to exhaustion increased (P < 0.05) by 19% for both interventions. Maximal power output was increased (P < 0.05) by 13% in the badminton group only. Blood pressure, resting heart rate and heart rate during submaximal running was lower (P < 0.05) in both interventions. Perceptions of physical conditioning increased (P < 0.05) in both interventions. There were increases (P < 0.05) in enjoyment and ill health motives in the running group only, whilst affiliation motives were higher (P < 0.05) for the badminton group only. Findings suggest that badminton should be considered a strategy to improving the health and wellbeing of untrained females who are currently not meeting physical activity guidelines