Does practice of multi-directional stepping with auditory stimulation improve movement performance in patients with Parkinson\u27s disease

Parkinson’s disease (PD) is a debilitating neurodegenerative disorder causing many physical limitations. Rhythmic auditory stimulation (RAS) influences motor complications not alleviated by medicine and has been used to modify straight line walking in this population. However, motor complications are exacerbated during more complex movements including those involving direction changes. Thus immediate RAS effects on direction switch duration (DSD) and other kinematic measures during a multi-directional step task were investigated in PD patients. Long term RAS application was also explored by evaluating functional gait and balance and kinematic step measures before and after 6 weeks of multi-directional stepping either with (Cue, C group) or without (No cue, NC group) RAS use. Evaluations were also administered 1, 4 and 8 weeks after training termination. Kinematic measures were collected during stepping without, then with RAS for the C group and without RAS for the NC group. Step testing/training was performed at slow, normal and fast speeds in forward, back and side directions. Participants with PD switched step direction during the stepping task faster with RAS use before training. Like straight line walking RAS application influenced the more complex task of direction switching and counteracted the well-known bradykinesia in PD. After training both groups improved their functional gait and balance measures and maintained balance improvements for at least 8 weeks. Only the C group retained gait improvements for at least 8 weeks after training termination. Adding RAS resulted in functional benefits not observed in training without it. Kinematic measures compared before and after step training clarified the underlying contributors to functional performances. Both groups reduced the variability of DSD. The C group participants maintained this alteration longer. DSD reduction also occurred after training and was retained for at least 8 weeks for this group. These outcomes further support the advantages of adding RAS to training regiments for those with PD. The current results indicate that RAS effects are not limited to simple activities like straight line walking. Moreover, RAS can be used for improving and maintaining improvements longer in activities involving various forms of transition which present most difficulties for those with PD

On the Efficacy of Isolating Shoulder and Elbow Movements with a Soft, Portable, and Wearable Robotic Device

Treatment intensity has a profound effect on motor recovery following neurological injury. The use of robotics has potential to automate these labor-intensive therapy procedures that are typically performed by physical therapists. Further, the use of wearable robotics offers an aspect of portability that may allow for rehabilitation outside the clinic. The authors have developed a soft, portable, lightweight upper extremity wearable robotic device to provide motor rehabilitation of patients with affected upper limbs due to traumatic brain injury (TBI). A key feature of the device demonstrated in this paper is the isolation of shoulder and elbow movements necessary for effective rehabilitation interventions. Herein is presented a feasibility study with one subject and demonstration of the device's ability to provide safe, comfortable, and controlled upper extremity movements. Moreover, it is shown that by decoupling shoulder and elbow motions, desired isolated joint actuation can be achieved

Designing and Evaluating a Child Maltreatment Surveillance System: Towards Improving the Management of Child Abuse Incidents

Background: Child abuse is a significant global concern, with short-term and long-term consequences for the lives of children who are victims of violence. For effective action by decision-makers, the information and analysis obtained from surveillance systems must be used to determine the problem, the magnitude of maltreatment, its relationship with other issues, and the likelihood of preventing maltreatment.Objectives: Due to the importance of child abuse and the management and control of this event, this study was conducted to design and evaluate a child abuse surveillance system.Methods: The system was designed in Visual Studio version 2017 using the C# programming language and ASP.NET framework. SQL Server was used to store the data. The design of the child abuse surveillance system was evaluated according to the usability evaluation.Results: The minimum data set was indexed to collect and store data on abused children by the standard format. Web-based child abuse surveillance system (CASS) has 3 types of users. The system evaluation results showed that the highest number of problems were related to the principle of "help and documentation".Conclusion: Designing a CASS is a practical step in managing and controlling the data of abused children. This system and registration of information will help professionals, managers, and decision-makers make the right decisions to take care of injured children with up-to-date informatio

Physicians’ and nurses’ decision making to encounter neonates with poor prognosis in the neonatal intensive care unit

This is an Accepted Manuscript of an article published by Sage in Clinical Ethics on 03/06/2020. Available online: https://journals.sagepub.com/doi/abs/10.1177/1477750920927173This is an Accepted Manuscript of an article published by Sage in Clinical Ethics on 03/06/2020.Available online: https://journals.sagepub.com/doi/abs/10.1177/1477750920927173acceptedVersio

The Effectiveness of Interventions based on Positive Psychotherapy on Improving Coping Styles, Relapse Prevention in Individuals with Substance Use Disorder

The aim of the study was to evaluate the effectiveness of interventions based on positive psychotherapy on improving coping styles, relapse prevention in individuals diagnosed with substance use disorder. The research design was quasi-experimental with pretest-posttest, a month Follow-up and control group. Thirty-one individuals with substance use disorder, who were admitted to addiction treatment centers in Zahedan city, were selected through purposeful sampling method and were randomly assigned to an experimental (14 persons) and control (17 persons) groups. Both groups were asked to respond to Coping Styles Questionnaire by Billings and Mouse, at the pretest stage. In later stages of research, the experimental group received an intervention based on positive psychotherapy for ten sessions each session60 minutes. Data was analyzed using covariance and chi-square test. The results showed that intervention based on positive psychotherapy improved the coping styles and relapse prevention in the experimental group and the effect of the intervention was significant in post-test and follow-up stages. The result also showed that interventions based on positive psychotherapy could be used as an efficient technique to improve coping skills and relapse prevention in patients with substance use disorder

The Role of Academic Optimism, Academic Emotions and School Well-Being in Mathematical Performance of Students

The objective of the study was to explain the role of academic optimism, academic emotions and school well-being on the mathematical performance of girl and boy students. The research method was descriptive and correlation. A sample of 440 (109 boys and 331 girls) students was selected by cluster random sampling. The research instruments were Student Academic Optimism Scale (Tschannen-Moran, Bankole, Mitchell & Moore), Academic Emotions Questionnaire (Pekrun, Goetz & Frenzel), and School Well-being Questionnaire (Konu, Alanen, Lintonen, & Rimpela). A teacher- made questionnaire was also used to evaluate math scores. The data were analyzed by using descriptive statistics, Pearson correlation, stepwise multiple regression analysis and independent t- test. Findings showed that academic optimism, academic emotions and school well-being had significant positive correlation with math performance (0.20, 0.23, 0.16). The results showed academic well-being had significant positive relationship whit mathematic performance of girls and boys and predicts mathematic performance, too. Also, the results showed academic emotions had significant positive relationship with students mathematic performance in the girls and in combination with academic well-being explained %16 mathematic performance; but it was not the case in the boys. Academic optimism with academic well-being could explain %17 of boys mathematic performance, while in the girls there were not such explanation power

Bilateral Primary Breast Angiosarcoma: A Case Report

Background: Angiosarcoma can develop in all parts of the body containing blood vessels, including breast. Statistically, less than 10% of all angiosarcomas originate in the breast. Angiosarcoma accounts for less than 0.05% of breast primary cancers. Primary angiosarcoma develops without a history of treatment for breast cancer, whereas secondary angiosarcoma develops in patients who have already had treatments for other primary breast cancer. Case presentation: In review of the literature, primary angiosarcoma, particularly bilateral, is rare. In this study, we present a patient, a young woman, with primary bilateral angiosarcoma. Conclusion: Although breast angiosarcoma is rare, we should be aware of it, particularly in young women with breast mass that is hyperflow in color Doppler ultrasound