Effectiveness of Reflexology upon Joint Pain in Arthralgia Patients at Selected Old Age Homes

An Experimental Study to Assess the Effectiveness of Reflexology upon Joint Pain in Arthralgia Patients at Selected Old Age Homes, Chennai. OBJECTIVES: 1. To assess the level of joint pain before and after reflexology in control and experimental groups of arthralgia patients. 2. To assesses the effectiveness of reflexology by comparing the level of joint pain before and after reflexology in control and experimental group of arthralgia patients. 3. To determine the level of satisfaction regarding reflexology in experimental group of arthralgia patients. 4. To find out the association between selected demographic variables and the level of joint pain before and after reflexology in control and experimental group of arthralgia patients. 5. To find out the association between selected clinical variables and the level of joint pain before and after reflexology in control and experimental group of arthralgia patients. The conceptual framework of the present study is based on king’s goal attainment theory. The study variables, reflexology and level of joint pain among arthralgia clients were formulated. The level of significance selected was p < 0.05. An extensive review of literature guided by experts formed the foundation to the development of tool. An experimental approach was used to achieve the objectives of the study. The present study was conducted in SV old age home (control & experimental). The samples (60) were randomly (systematic random sampling) selected and assigned to control (30) and experimental (30) groups. The investigator used a demographic variable proforma, a clinical variable proforma, pain scale (0 -1 0 numerical pain rating scale) and a rating scale on the level of satisfaction on reflexology. The data collection tools were validated and reliability was established. After checking the researchability and feasibility by conducting pilot study, the data for the main study was collected. The collected data was tabulated and analyzed using descriptive and inferential statistics like mean, standard deviation, paired ‘t’ test and chi – square. MAJOR FINDINGS OF THE STUDY: Demographic variables of arthralgia patients: The study findings reveal that significant number of the arthralgia patients were in the age group of 70 – 80 years (43%, 47%), most of them were female (73%, 45%), majority were belonging to nuclear family (87%, 60%), were Hindus (100%, 87%), and residing in urban area (53%, 50%), majority of them were widows (63%, 56%), and were educated (63%, 40%), were un employed (83.33%, 66.7%) and among employed most of them were heavy workers (50%, 43%) in control and experimental group respectively. Clinical variables of arthralgia patients: The majority of the arthralgia patients had injury (47%, 60%), had under gone surgeries (57%, 50%), most of the patients had joint stiffness (55%,45%), half of them with period of illness for more than 10 years (50% ,33.33%),and for all the patients clinical diagnosis is made through radiological investigation (100%, 63.3%), few were on analgesic treatment (37%, 53%), and few were taking non pharmacological treatment like exercise (37%, 36.66%), most of the patients have the co–morbid illness (57% ,33%), for the duration more than 5-10 years (60%,50%) in control and experimental groups respectively. Level of joint pain among arthralgia clients: In the control group there was no significant difference in the joint pain levels before (M = 6.46, SD =2.10) & after therapy (M = 8, SD = 0.91).In contrast, in experimental group the joint pain levels after therapy (M =7.4, SD = 0.55) was lower than the level of pain before therapy (M =3, SD = 0.5). The difference was found to be statistically significant (t=27.7) at p < 0.001, which attributes to effectiveness of reflexology. Association between selected demographic variables with the level of joint pain of arthralgia patients: There was a significant association between the age of the patient (x2 = 7.62, df = 3), (p< 0.05) in experimental, x2 = 22.49, df = 3), (p< 0.001) in control, religion (x2= 19.37, df = 3), (p < 0.1) in control, (x2= 18, df = 3), (p < 0.1) in experimental, marital status (x2= 10.42, df =3), (p < 0.1) in experimental, (x2= 12.44, df =4), (p<0.1) in control and educational qualification (x2= 10.61, df =3), (p<0.05) in control with the level of joint pain in control and experimental groups of patients. And there was no significant association between the other selected demographic variables with the level of joint pain among arthralgia clients in control and experimental group before and after reflexology. Hence the null hypothesis H02 is partially rejected. Association between selected clinical variables with the level of joint pain of arthralgia patients. There was a significant association between the selected clinical variables such as duration of treatment (x2=3.95,df = 1), (p < 0.05) route of administration, (x2=14.68, df=2), (p < 0.001), presence of co morbid illness (x2=10.84 , df =1), (p < 0.1), treatment of co morbid illness x2 = 21.15 , df = 1), (p < 0.001) with the level of joint pain in control and experimental groups of patients, but there was no association between the other clinical variables and the level of joint pain among arthralgia patients in control and experimental group. Hence the null hypothesis H03 is partially rejected. Level of satisfaction on reflexology. All the participants in experimental group (100%) expressed high level of satisfaction regarding reflexology. RECOMMENDATIONS: 1. A similar study can be undertaken on a large scale for a more valid generalization. 2. A comparative study can be conducted to assess the effectiveness of the alternative and complementary therapies. 3. The study can be conducted in different settings. 4. A similar study can be conducted by using cross – over design. 5. A Meta Analysis Study can be conducted to have a more valid information

Quality Assessment of Ambulatory Electrocardiogram Signals by Noise Detection using Optimal Binary Classification

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Customer segmentation using machine learning

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Two sounds with the same pitch may vary from each other based on saliency of their pitch sensation. This perceptual attribute is called “pitch strength.” The study of voice pitch strength may be important in quantifying of normal and pathological qualities. The present study investigated how pitch strength varies across normal and dysphonic voices. A set of voices (vowel /a/) selected from the Kay Elemetrics Disordered Voice Database served as the stimuli. These stimuli demonstrated a wide range of voice quality. Ten listeners judged the pitch strength of these stimuli in an anchored magnitude estimation task. On a given trial, listeners heard three different stimuli. The first stimulus represented very low pitch strength (wide-band noise), the second stimulus consisted of the target voice and the third stimulus represented very high pitch strength (pure tone). Listeners estimated pitch strength of the target voice by positioning a continuous slider labeled with values between 0 and 1, reflecting the two anchor stimuli. Results revealed that listeners can judge pitch strength reliably in dysphonic voices. Moderate to high correlations with perceptual judgments of voice quality suggest that pitch strength may contribute to voice quality judgments

Expert consensus on neurodevelopmental outcomes in pregnancy pharmacovigilance studies

Background: Exposure in utero to certain medications can disrupt processes of fetal development, including brain development, leading to a continuum of neurodevelopmental difficulties. Recognizing the deficiency of neurodevelopmental investigations within pregnancy pharmacovigilance, an international Neurodevelopmental Expert Working Group was convened to achieve consensus regarding the core neurodevelopmental outcomes, optimization of methodological approaches and barriers to conducting pregnancy pharmacovigilance studies with neurodevelopmental outcomes. Methods: A modified Delphi study was undertaken based on stakeholder and expert input. Stakeholders (patient, pharmaceutical, academic and regulatory) were invited to define topics, pertaining to neurodevelopmental investigations in medication-exposed pregnancies. Experts were identified for their experience regarding neurodevelopmental outcomes following medicinal, substances of misuse or environmental exposures in utero. Two questionnaire rounds and a virtual discussion meeting were used to explore expert opinion on the topics identified by the stakeholders. Results: Twenty-five experts, from 13 countries and professionally diverse backgrounds took part in the development of 11 recommendations. The recommendations focus on the importance of neurodevelopment as a core feature of pregnancy pharmacovigilance, the timing of study initiation and a core set of distinct but interrelated neurodevelopmental skills or diagnoses which require investigation. Studies should start in infancy with an extended period of investigation into adolescence, with more frequent sampling during rapid periods of development. Additionally, recommendations are made regarding optimal approach to neurodevelopmental outcome measurement, comparator groups, exposure factors, a core set of confounding and mediating variables, attrition, reporting of results and the required improvements in funding for potential later emerging effects. Different study designs will be required depending on the specific neurodevelopmental outcome type under investigation and whether the medicine in question is newly approved or already in widespread use. Conclusion: An improved focus on neurodevelopmental outcomes is required within pregnancy pharmacovigilance. These expert recommendations should be met across a complementary set of studies which converge to form a comprehensive set of evidence regarding neurodevelopmental outcomes in pregnancy pharmacovigilance

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Three-Dimensional Adaptive Microscopy Using Embedded Liquid Lens

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