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Authority and Governance when in Problems: Any Balancing Act with regard to Nonprofit Boards.
The effects of electrotherapy with task-oriented training on upper limb function in subacute stroke patients are unclear. This study investigated the influence of transcutaneous electrical nerve stimulation (TENS) with task-oriented training on spasticity, hand function, upper limb function, and activities of daily living in patients with subacute stroke. Forty-eight patients with subacute stroke were randomly assigned to either the TENS group (n = 22) or the placebo-TENS group (n = 21). High-frequency (100 Hz) TENS with below-motor threshold intensity or placebo-TENS was applied for 30 min/day, five times a week, for 4 weeks. The two groups also received task-oriented training after TENS. The Modified Ashworth Scale (MAS), Jebsen-Taylor Hand Function Test (JTHFT), Manual Function Test (MFT), and Modified Barthel Index (MBI) were used to assess spasticity, hand function, upper limb function, and activities of daily living, respectively. There was a significant time-group interaction with the MFT (p = 0.003). The TENS group showed significantly improved MAS (p = 0.003), JTHFT (p less then 0.001), MFT (p less then 0.001), and MBI (p less then 0.001) scores after the intervention. The placebo-TENS group showed significantly improved JTHFT (p less then 0.001), MFT (p = 0.001), and MBI scores (p less then 0.001). There was a significant correlation between the MFT and MBI scores (p = 0.025). These results suggest that electrotherapy with task-oriented training can be used to improve upper limb function in patients with subacute stroke.Discharge against medical advice (DAMA) and readmissions are important issues worldwide and can lead to adverse clinical outcomes, financial burden, and exposure of healthcare workers to unintended medical disputes. This study aimed to identify factors that affect readmissions within 48 h after DAMA. This retrospective study utilized the medical records of patients who visited an emergency medical center in Korea for treatment and were readmitted during a 10-year period. Factors predicting readmission after being DAMA were identified using logistic regression analysis. The total number of patients who were DAMA during the study period was 5445, of which 351 were readmitted to the emergency department within 48 h (6.4%). Factors influencing readmission included medical aid (odds ratio (OR) = 2.02, 95% confidence interval (CI) 1.46-2.83) and foreign worker insurance (OR = 2.07, 95% CI 1.04-4.09) as their health insurance, as well as presenting for readmission by car (OR = 1.41, 95% CI 1.08-1.82). Healthcare workers should treat patients who are DAMA and those who are likely to return with a more careful and preventative management strategy so that potential clinical, legal, and economic impacts of DAMA can be mitigated.We aimed to investigate the effect of a 12-week Taekwondo self-defense training course on oxidative stress and inflammation in postmenopausal women. Sixteen middle-aged women participated and were randomized into two groups a control group (CG, n = 8) and a Taekwondo self-defense training group (TSDG, n = 8). The TSDG was trained for 60 min, four times per week, for 12 weeks. Following the Taekwondo training intervention, side-step was significantly higher in the TSDG than in the CG (p less then 0.001). Malondialdehyde levels were significantly lower after the intervention than before in the TSDG (p less then 0.01). Superoxide dismutase (SOD) levels were also significantly higher after the intervention than before in the TSDG (p less then 0.001). After the Taekwondo training intervention, SOD levels were significantly higher in the TSDG than in the CG (p less then 0.01). Tumor necrosis factor α (TNF-α) levels were significantly lower after the intervention than before in the TSDG (p less then 0.05). After the Taekwondo training intervention, TNF-α levels were significantly lower in the TSDG than in the CG (p less then 0.05). The results of this study suggest that Taekwondo self-defense training is an effective exercise that improves agility, oxidative stress, and inflammatory responses in postmenopausal women.This review raises a number of compelling issues related to the condition of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). Some historical perspective is necessary in order to highlight the nature of the controversy concerning its causation. Throughout history, a pattern tends to repeat itself when natural phenomena require explanation. Dogma usually arrives first, then it is eventually replaced by scientific understanding. The same pattern is unfolding in relation to ME/CFS, but supporters of the psychological dogma surrounding its causation remain stubbornly resistant, even in the face of compelling scientific evidence to the contrary. Acceptance of the latter is not just an academic issue; the route to proper understanding and treatment of ME/CFS is through further scientific research rather than psychological theorisation. Only then will a long-suffering patient group benefit.This study aimed to evaluate the intaglio surface trueness of interim dental crowns fabricated with three 3-dimensional (3D) printing and milling technologies. Dental crown was designated and assigned as a computer-aided design (CAD) reference model (CRM). Interim dental crowns were fabricated based on CRM using two types of 3D printer technologies (stereolithography apparatus and digital light processing) and one type of milling machine (n = 15 per technology). The fabricated interim dental crowns were obtained via 3D modeling of the intaglio surface using a laboratory scanner and designated as CAD test models (CTMs). The alignment and 3D comparison of CRM and CTM were performed based on the intaglio surface using a 3D inspection software program (Geomagic Control X). Statistical analysis was validated using one-way analysis of variance and Tukey HSD test (α = 0.05). There were significant differences in intaglio surface trueness between the three different fabrication technologies, and high trueness values were observed in the milling group (p less then 0.05). In the milling group, there was a significant difference in trueness according to the location of the intaglio surface (p less then 0.001). In the manufacturing process of interim dental crowns, 3D printing technologies showed superior and uniform manufacturing accuracy than milling technology.Medicines management is known to be an integral part of the role of family caregivers; it also contributes to the burden and stress of caregivers' experience. As dementia progresses, new challenges arise as a consequence, which negatively affects the ability of people living with dementia (PLWD) regarding practical decision making and may lead to a change of setting. The aim of this study is to identify and explore changes in medicines management and associated caregiver burden as dementia progresses. To examine medicines management and related issues across severities, a qualitative approach utilising face-to-face and telephone interviews with PLWD and their family caregivers in both the community and care-home setting in London was used. Follow-up interviews with family caregivers were also conducted to gain additional insight into change over time. Eleven family caregivers, ten PLWD, and eight care-home staff were interviewed in 2016. Findings identified how key changes along dementia progression affect medication use. These include changes to caregiver burden, respecting the PLWD's autonomy and decline in capacity, scheduling and administration, choice of formulation, interactions with and between providers, and information needs. The findings assist in informing recommendations to optimise medication use and alleviate caregiver burden.Respiratory monitoring is a significant issue to reduce patient risks and medical staff labor in postoperative care and epidemic infection, particularly after the COVID-19 pandemic. Oximetry is widely used for respiration monitoring in the clinic, but it sometimes fails to capture a low-functional respiratory condition even though a patient has breathing difficulty. Another approach is breathing-sound monitoring, but this is unstable due to the indirect measurement of lung volume. Kobayashi in our team is developing a sensor measuring temporal changes in lung volume with a displacement sensor attached across the sixth and eighth ribs. For processing these respiratory signals, we propose the combination of complex-valued wavelet transform and the correlation among spectrum sequences. We present the processing results and discuss its feasibility to detect a low-functional condition in respiration. The result for detecting low-functional respiration showed good performance with a sensitivity of 0.88 and specificity of 0.88 to 1 in its receiver operating characteristic (ROC) curve.Adolescence (10-19 years) is marked by many physiological changes and is vulnerable to health and nutritional problems. Adolescence, particularly, early adolescence is inadequately addressed in our national surveys. The present study aimed to assess the reproductive health awareness, nutrition, and hygiene of marginalized adolescent girls and boys and compare them among early and late adolescents. Our cross-sectional study was a part of a community-based project across India's five zones, namely North, East, West, Central, and South. Unadjusted and adjusted logistic regression was performed to compare awareness about HIV/AIDS, or Sexually Transmitted Infections (STI), consumption of Iron Folic Acid (IFA) tablets and three meals in a day, safe menstrual hygiene practices, history of anemia, and open defecation practice among early and late adolescents. Data were reported as unadjusted and adjusted odds ratio (aOR) with a 95% confidence interval (95% CI). Among early adolescents, around 58% of girls and boys did not consume IFA tablets, and 28% of girls and 24% of boys defecated in the open. Compared to late adolescents, early adolescent girls had lower odds of awareness about HIV/AIDS (aOR (95% CI) 0.50 (0.47-0.54)) and open defecation (aOR (95% CI) 0.90 (0.83-0.98)) and higher odds of hand hygiene after defecation (aOR (95% CI) 1.52 (1.37-1.68)) and safe menstrual practices (aOR (95% CI) 1.42 (1.23-1.64)). There is a dire need to start public health interventions from early adolescence for long-term benefits throughout adolescence.Vascular calcification (VC) involves the deposition of calcium apatite in vascular intima or media. Individuals of advanced age, having diabetes mellitus or chronic kidney disease (CKD) are particularly at risk. The pathogenesis of CKD-associated VC evolves considerably. The core driver is the phenotypic change involving vascular wall constituent cells toward manifestations similar to that undergone by osteoblasts. Gender-related differences are observed regarding the expressions of osteogenesis-regulating effectors, and presumably the prevalence/risk of CKD-associated VC exhibits gender-related differences as well. Despite the wealth of data focusing on gender-related differences in the risk of atherosclerosis, few report whether gender modifies the risk of VC, especially CKD-associated cases. We systematically identified studies of CKD-associated VC or its regulators/modifiers reporting data about gender distributions, and extracted results from 167 articles. A significantly higher risk of CKD-associated VC was observed in males among the majority of original investigations.
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