ગુજરાતી ભાષામાં થતા અધ્યાપન માટે કમ્પ્યૂટર આધારિત મલ્ટિમીડિઆ પેકેજનો વિકાસ અને અજમાયશ

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Effectiveness of adult community-based physical activity interventions with objective physical activity measurements and long-term follow-up: a systematic review and meta-analysis.

OBJECTIVE: To identify randomised controlled trials (RCTs) of physical activity (PA) interventions with objective PA outcomes in adults and to evaluate whether intervention effects were sustained beyond 12 months. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Seven databases (Medline, Embase, PsycINFO, Web of Science, Cochrane library, CINAHL (Cumulative Index of Nursing and Allied Health Literature) and ASSIA (Applied Social Sciences Index and Abstracts)) were searched from January 2000 until December 2019. ELIGIBILITY CRITERIA: RCTs reporting objective PA outcomes beyond 12 months with community-based participants aged ≥18 years were included; those where controls received active interventions, including advice to increase PA levels, were excluded. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers completed extraction of aggregate data and assessed risk of bias. Meta-analyses used random-effects models at different follow-up points. Primary outcomes were daily steps and weekly minutes of moderate-to-vigorous PA (MVPA). RESULTS: Of 33 282 records identified, nine studies (at generally low risk of bias) were included, five in meta-analyses with 12 months to 4 year follow-up. We observed 12 month increases for intervention vs control participants in steps/day (mean difference (MD)=554 (95% CIs: 384 to 724) p<0.0001, I2=0%; 2446 participants; four studies) and weekly MVPA minutes (MD=35 (95% CI: 27 to 43) p<0.0001, I2=0%; 2647 participants; four studies). Effects were sustained up to 4 years for steps/day (MD=494 (95% CI: 251 to 738) p<0.0001, I2=0%; 1944 participants; four studies) and weekly MVPA minutes (MD=25 (95% CI: 13 to 37) p<0.0001, I2=0%; 1458 participants; three studies). CONCLUSIONS: There are few PA interventions with objective follow-up beyond 12 months, more studies are needed. However, this review provided evidence of PA intervention effects beyond 12 months and sustained up to 4 years for both steps/day and MVPA. These findings have important implications for potential long-term health benefits. PROSPERO REGISTRATION NUMBER: CRD42017075753

Mini High Velocity Clouds

Neutral hydrogen mapping of several small, very low column density High Velocity Clouds (HVC), using the Arecibo telescope, is reported. Some were found serendipitously superimposed at distinct velocities on largerHVCs; others were found to comprise the four most isolated low column density sources in the observations of Lockman et al. but proved to be individually much smaller than the Green Bank 140 Foot telescope beam. We call these clouds ``mini-HVC'' to distinguish them from the larger and denser Compact High Velocity Clouds (CHVC). Peak column densities are typically a few X 10^18 cm^-2 averaged over the Arecibo 3.2' beam, and diameters to our detection limit ~ 10^18 cm^-2 range from 9' to 35'. These column densities and angular diameters overlap with those for CHVC, but are typically smaller. We consider three possiblities: (1) that most mini-HVC are related to the Magellanic Stream, (2) that most mini-HVC are part of M31's retinue of CHVC, or (3) that the mini-HVC are simply the low column density tail of the distribution of CHVC. None of these possibilities can be rejected as yet, given the selection biases in our sample. We also discuss controversies about the amount of ionized hydrogen in CHVC and mini-HVC, which may be mainly ionized, and the implications of these small clouds for Lyman Limit Systems.Comment: Astronomical Journal, in pres

Laryngeal manual therapy: a preliminary study to examine its treatment effects in the management of muscle tension dysphonia

The objectives of this study were to determine appropriate acoustic and outcome measures for the evaluation of a method of laryngeal manual therapy (LMT) used in the treatment of patients with muscle tension dysphonia (MTD). The effects of this technique were also investigated. The study was based on the hypotheses that the vertical position of the larynx in the vocal tract would lower, that the quality of the voice would normalize, and that a reduction in any vocal tract discomfort (VTD) would occur after LMT. This was a small, prospective, repeated measures pilot study in which each member of the research team was "blinded" to all other stages of the study and during which all data were anonymized until the final stage of data analysis. Ten subjects presenting with MTD completed outcome measures and provided audiorecordings immediately before, immediately after, and 1 week after LMT. The Kay CSL 4150 was used for signal acquisition and for some acoustic measurements. Spectrographic evaluation was accomplished with Praat. A new perceptual, self-rating scale, the VTD scale, and a new proforma for use by the clinician for palpatory evaluation, were developed for the study. Relative average perturbation during connected speech was significantly reduced after LMT, indicating a reduction in abnormal vocal function. The severity and frequency of VTD was shown to have reduced after LMT. This pilot study showed positive evidence for LMT as a method of therapy in the treatment of hyperfunctional voice disorders. Its effects were shown to be measurable with both acoustical analysis and the VTD scale

In-home dementia caregiving is associated with greater psychological burden and poorer mental health than out-of-home caregiving: a cross-sectional study

Introduction: Caregivers who live with a person with dementia who receives care, compared with those who live elsewhere, are often considered to experience greater levels of psychological and affective burden. The evidence for this is, however, only limited to studies employing small sample sizes and that failed to examine caregivers’ psychological wellbeing. We address these issues in a large cohort of dementia caregivers. // Methods: We conducted a cross-sectional study comparing caregivers living with a dementia care recipient (n = 240) to caregivers living elsewhere (n = 255) on caregivers’ burden, anxiety, and depression. // Results: We found that caregivers living with the care recipient relative to those living elsewhere showed significantly greater burden and depression, but we found no group difference in anxiety. // Conclusions: Our study adds to the evidence by showing that cohabiting with a care recipient with dementia is associated with greater burden and poorer psychological wellbeing. Strategies aiming to improve caregivers’ burden and psychological wellbeing should take account of caregivers’ living arrangements

Cohort Profile: The Health Survey for England

To monitor the health of the public in England, UK, the Central Health Monitoring Unit within the UK Department of Health commissioned an annual health examination survey, which became known as the Health Survey for England (HSE). The first survey was completed in 1991. The HSE covers all of England and is a nationally representative sample of those residing at private residential addresses. Each survey year consists of a new sample of private residential addresses and people. The HSE collects detailed information on mental and physical health, health-related behaviour, and objective physical and biological measures in relation to demographic and socio-economic characteristics of people aged 16 years and over at private residential addresses. There are two parts to the HSE; an interviewer visit, to conduct an interview and measure height and weight, then a nurse visit, to carry out further measurements and take biological samples. Since 1994, survey participants aged 16 years and over have been asked for consent to follow-up through linkage to mortality and cancer registration data, and from 2003, to the Hospital Episode Statistics database, thus converting annual cross-sectional survey data into a longitudinal study. Annual survey data (1994–2009) are available through the UK Data Archive

The Effects of a Web-Based Tool for Parents of Children With Juvenile Idiopathic Arthritis: Randomized Controlled Trial

Background: Juvenile idiopathic arthritis (JIA) is a group of autoinflammatory diseases that cause pain and disability if not controlled by treatment. Parenting a child with JIA is stressful for parents, who express concerns about their child’s treatment and may experience anxiety and powerlessness concerning their child’s illness. Parenting stress is greater in parents of children with chronic illness than in those with healthy children and is related to poorer psychological adjustment in both parents and children. It is therefore important to develop interventions to support parents. This paper reports the evaluation of a web-based tool that provides information and practical skills to help increase parents’ confidence in managing their child’s illness and reduce parenting stress. Objective: The aim of this study is to evaluate the benefits of a web-based tool (WebParC) for parents of children with recently diagnosed JIA. Methods: A multicentered randomized controlled trial was conducted at pediatric rheumatology centers in England. We recruited parents of children aged ≤12 years who had been diagnosed with JIA within the previous 6 months. They were randomized to the intervention (WebParC access plus standard care) or the control (standard care alone) and followed up 4 months and 12 months after randomization. Where both parents participated, they were randomized by household to the same trial arm. The WebParC intervention consists of information about JIA and its treatment plus a toolkit, based on cognitive behavioral therapy, to help parents develop skills to manage JIA-related issues. The primary outcome was the self-report Pediatric Inventory for Parents measure of illness-related parenting stress. The secondary outcomes were parental mood, self-efficacy, coping, effectiveness of participation in their child’s health care, satisfaction with health care, and child’s health-related quality of life. Results: A total of 203 households comprising 220 parents were randomized to the intervention (100/203, 49.3%) or control (103/203, 50.7%) arm. Follow-up assessments were completed by 65.5% (133/203) of the households at 4 months (intervention 60/100, 60%, and control 73/103, 70.9%) and 61.1% (124/203) of the households at 12 months (intervention 58/100, 58%, and control 66/103, 64.1%). A main effect of the trial arm was found on the Pediatric Inventory for Parents: the intervention participants reported less frequency (subscales communication F1,120627=5.37; P=.02, and role function F1,27203=5.40; P=.02) and difficulty (subscales communication F1,2237=7.43; P=.006, medical care F1,2907=4.04; P=.04, and role function F1,821=4.37, P=.04) regarding illness-related stressful events than the control participants. Conclusions: The WebParC website for parents of children with JIA reduced illness-related parenting stress. This web-based intervention offers a feasible preventive approach for parents of children with JIA and potentially could be adapted and evaluated for parents of children with other chronic illnesses. Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN) 13159730; http://www.isrctn.com/ISRCTN1315973