COPING WITH PAIN AND HEALTH-RELATED QUALITY OF LIFE AMONG ADULTS WITH SICKLE CELL DISEASE

Objectives The objectives of this dissertation are to: 1) to examine the psychometric properties of the CSQSCD among adult sickle cell disease (SCD) patients; 2) to identify psychosocial predictors of health-related quality (HRQOL) among adult SCD patients; and 3) to identify the distinct, multidimensional patterns of strategies for coping with SCD and their association with HRQOL among adult SCD patients in the United States. Methods This cross-sectional study was conducted using a web-based self-administered survey. Adults with SCD were recruited with the help of Rare Patient Voice, a market research company that maintains a panel of SCD patients. Psychometric properties of the CSQ-SCD were assessed in terms of its construct validity and internal consistency reliability using confirmatory factor analysis (CFA) and further exploratory factor analysis was also conducted. Structural equation modeling (SEM) was used to test a theory-driven model to identify psychosocial predictors of HRQOL in the study sample. Finally, unobserved subtypes of coping patterns among adult SCD patients were evaluated using latent class analysis. Results The study sample consisted of 196 adults SCD patients. The CSQ-SCD was found to have less than adequate psychometric properties. The CFA revealed a three-factor model for the CSQSCD but had a mediocre model fit. An exploratory factor analysis (EFA) revealed a three-factor model with different subscale loadings, demonstrating a better fit compared to the CFA model. Results from the SEM analysis suggested that crises severity, frequency, affective coping, and self-efficacy were key predictors of HRQOL among adults with SCD. The latent class analysis revealed three groups of underlying coping strategy patterns: cognitive coping, negative thinking/passive adherence coping, and physiological coping. Conclusions The study results indicated that the CSQ-SCD has somewhat poor psychometric properties to assess coping in adults with SCD. Clinicians and caregivers of patients with SCD should aim to mitigate affective coping strategies and encourage more self-efficacy related behaviors while discussing treatment with patients. This study also shows that SCD patients do not utilize one single method of coping, but instead use multiple coping strategies to improve their HRQOL

Pengaruh Model Pembelajaran Tipe Kooperatif Think Pair Share Dan Problem Based Learning Terhadap Kemampuan Pemecahan Masalah Dan Pemahaman Konsep Matematis Pada Materi SPtLDV Kelas X SMK Swasta Al-Fattah 2 Medan

Kunci: Think Pair Share Dan Problem Based Learning, Kemampuan Pemecahan Masalah danPemahaman Konsep. Penelitian ini bertujuan untuk mengetahui pengaruh model pembelajaran tipe kooperatif think pair share dan problem based learning terhadap kemampuan pemecahan masalah dan pemahaman konsep. Penelitian ini adalah jenis penelitian kuantitatif dengan menggunakan pendekatan quasi eksperimen. Teknik pengumpulan data yang digunakan adalah teknik tes, baik dalam pembelajaran Think Pair Share maupun Problem Based Learning. Tes yang digunakan berbentuk uraian populasinya adalah seluruh siswa kelas X SMK Swasta Al-Fattah 2 Medan, Tahun Ajaran 2020-2021 yang berjumlah 150 siswa. Analisis data dilakukan dengan analisis Regresi. Hasil temuan penelitian ini menunjukkan: 1) Terdapat Pengaruh Think Pair Share dengan Model Problem Based Learning terhadap kemampuan pemecahan masalah matematis, dengan Qhit (5,05) > Qtabel (3,96); 2) Terdapat pengaruh model Think Pair Share dengan model Problem Based Learning terhadap kemampuan pemahaman konsep, dengan Qhit (24,74) > Qtabel (3,96); 3) Terdapat pengaruh model Think Pair Share terhadap kemampuan pemecahan masalah dan pemahaman konsep matematis siswa, dengan Qhit (5,29) < Qtabel (3,96); 4) Terdapat pengaruh model Problem Based Learning terhadap kemampuan pemecahan masalah dan pemahaman konsep matematis, dengan Qhit (8,34) < Qtabel (3,96). Simpulan penelitian ini menjelaskan bahwa Siswa yangmemiliki kemampuan pemecahan masalah dan pemahaman konsep lebih baik diajar menggunakan model Think Pair Share daripada menggunakan model Problem Based Learning

Do Formulation and Dose of Long-Term Opioid Therapy Contribute to Risk of Adverse Events among Older Adults?

Background: Chronic non-cancer pain (CNCP) is highly prevalent in older adults and long-term opioid therapy (LTOT) has been used to manage chronic pain. However, the safety of LTOT among older adults with CNCP is not well-established and there is a need to identify therapy-related risk factors of opioid-related adverse events among older adults. Objective: To evaluate the relationship between opioid dose and formulation and the risk of opioid-related adverse events among Medicare-eligible older adults on LTOT. Design: Nested case-control study. Participants: Older Medicare beneficiaries (N=35,189) who received \u3e 3 opioid prescriptions with a total days-supply of \u3e45 days within a 90-day period for CNCP between 2012 and 2016. Main Measures: This study utilized Medicare 5% medical and prescription claims data. Outcome measures included opioid-induced respiratory depression (OIRD), opioid overdose, all-cause mortality, and a composite outcome, defined as the first occurrence of any of the previous three events. Key independent variables were opioid formulation and opioid dose (measured in morphine milligram equivalents (MME)) prescribed during LTOT. Key Results: Seventy-four OIRD, 133 overdose, 982 all-cause mortality, and 1122 composite outcome events were observed during follow-up. In unadjusted analyses, the use of combination opioids (OR: 4.52 [95%CI: 1.51–13.47]) was significantly associated with OIRD compared to short-acting (SA) opioids. In adjusted analyses, opioid-related adverse events were significantly associated with the use of LA (overdose OR: 13.00 [95%CI: 1.30–130.16] and combination opioids (overdose OR: 6.27 [95%CI: 1.91–20.55]; mortality OR: 2.75 [95%CI: 1.87–4.04]; composite OR: 2.82 [95%CI: 2.01–3.96]) when compared to SA opioids. When compared to an average dose of less than 20 MME, outcomes were significantly associated with doses of 20–50 MME (mortality OR: 1.61 [95%CI: 1.24–2.10]; composite OR: 1.59 [95%CI: 1.26–2.01]) and \u3e50 MME (mortality OR: 1.99 [95%CI: 1.28–3.10]; composite OR: 2.09 [95%CI: 1.43–3.04]). Conclusions: Older adults receiving medically prescribed opioids at higher doses and those using LA and combination of LA and SA opioids are at increased risks for opioid-related adverse events, highlighting the need for close patient supervision

Dental Management towards Sickle Patients: A Literature Review

Sickle cell disease is an autosomal dominant haemoglobinopathy in which an abnormal form of hemoglobin (hemoglobin S) polymerizes under low oxygen saturation and alters normal spherical shaped RBCs into sickle shape. In India, sickle cell disease is prevalent in central and southern states like Chhattisgarh, Madhya Pradesh, Orissa, Maharashtra, Jharkhand, Karnataka, Kerala, and Tamil Nadu. In various districts like Korba, Kanker, Rajnandgaon, Durg, Bilaspur, Raipur, Dantewada, Bastar, Mahasumund, Dhamtari, Kawardha and Jangjir-Champa of Chhattisgarh, frequency of sickle cell disease are approximately 10%. Screening results suggest that the prevalence of homozygous sickle cell disease was 2.1% and that of heterozygous sickle cell disease was 10% among different tribes. Prevalence rate among schedule tribe was 43.0%, schedule caste was 18.26% and 35.3% among OBC group with the majority of cases reported in Agharia, Kurmi, Teli and Panika castes. Common oral findings of dental hypoplasia, delayed eruption, mucosal pallor, and radiographic changes are noticed in this disease. This paper aims to describe etiology, prevelance of sickle cell disease in chhattisgarh region and the role of dental surgeon for the management of such patients

Music Therapy and Its Role in Pain Control

Music has occupied our day-to-day life; as it is readily available, accessible and further technological advancement has made access to music a common norm. Music has been present since the very early part of human evolution and has helped in forming society and civilizations. It has served various purposes like social cohesion, emotional expressions, interpersonal communication as well as recreation. Due to its great bonding power; it is important in terms of social dynamics. Music therapy is convenient, inexpensive and user-controlled and seems to be influencing the physiological system positively if rightly used. Vast research is going on to find the right music that could be having a beneficial therapeutic effect. Music seems to affect the pain perception, modulation and also has the affective component to help positively in controlling the pain. This chapter is an attempt to evaluate the various pain modulating effects of music through a systematic music therapy intervention using the vast research work done in this field. This review is consistent to integrate the best scientific evidence for pain relief into practice, education, and research. Music being a non-pharmacologic, nontoxic intervention and is free from adverse effects and also is an inexpensive, low cost modality

Criticality in confined ionic fluids

A theory of a confined two dimensional electrolyte is presented. The positive and negative ions, interacting by a $1/r$ potential, are constrained to move on an interface separating two solvents with dielectric constants $\epsilon_1$ and $\epsilon_2$. It is shown that the Debye-H\"uckel type of theory predicts that the this 2d Coulomb fluid should undergo a phase separation into a coexisting liquid (high density) and gas (low density) phases. We argue, however, that the formation of polymer-like chains of alternating positive and negative ions can prevent this phase transition from taking place.Comment: RevTex, no figures, in press Phys. Rev.

Steady state rheological behaviour of multi-component magnetic suspensions

In this paper, we study the rheological behaviour (in the absence of a magnetic field and upon its application) of multi-component magnetic suspensions that consist of a mixture of magnetic (iron) and non-magnetic (PMMA) particles dispersed in a liquid carrier. These suspensions exhibit considerably higher viscosity and yield stress in the absence of a magnetic field than single-component suspensions of the same solid fraction, as a consequence of the adsorption of the iron particles on the PMMA ones. The adsorbed layer of iron particles on the PMMA ones is observed through optical microscopy of dilute samples and confirmed by attenuated total reflectance. Microscopic observations also show that the resulting non-magnetic-core–magnetic-shell composites move upon magnetic field application and aggregate into particle structures aligned with the applied field. These structures, which consist of both types of particles, give rise to high values of the static and dynamic yield stresses upon field application. Actually, both quantities are much higher than those of a suspension with the same volume fraction of magnetic particles, and increase when the amount of non-magnetic ones increases. These trends are adequately predicted by a theoretical model that considers that the main contribution to the yield stress is the change of the suspension magnetic permeability when particle chains are deformed by the shear.This work was supported by Projects P08-FQM-3993, P09-FQM-4787 (Junta de Andalucía, Spain) and FIS2009-07321 (MICINN, Spain). In addition, L. Rodríguez-Arco and M.T. López-López acknowledge financial support by Secretaría de Estado de Educación, Formación Profesional y Universidades (MECD, Spain) through its FPU program and the University of Granada (Spain), respectively