bluuebunny/crossref_metadata_2025 huggingface dataset:
The development and validation of a digital leadership competency scale
Authors: Munsamy Mervin , Dhanpat Nelesh , Barkhuizen Emmerentia N.
Published: May 2023

Orientation: The advent of the fourth industrial revolution (4IR) and its digital disruptions require new competencies from leaders to ensure the sustainability and competitiveness of business enterprises.Purpose of the study: The purpose of the study was to develop and validate a scale to measure the digital leadership competencies that will enable employees to remain relevant.Motivation for the study: Despite a proliferation of empirical studies on 4IR and its impact on leadership, validated assessments of leadership competencies for the digital age are scarce.Research approach, design and method: A quantitative research approach was followed with data collected from employees (N = 241) from a multinational company in the technology and engineering industry. A newly developed digital leadership competency questionnaire was distributed electronically to the respondents. The data was analysed using the SPSS and AMOS programmes. The data analyses included descriptive statistics, confirmatory factor analyses and reliability analyses.Main findings: The results confirmed and supported a valid and reliable six-dimensional leadership competence assessment supported by sub-competencies. The six competences include embracing digital, leadership facilitating the digital drive, digital adaptiveness and resilience, cultivating a digital culture and digital skills and digital competitiveness intelligence.Practical/managerial implications: The digital leadership competency scale can be used to assess and develop employee competencies, which will positively affect business performance.Contribution/value-add: The study provides a holistic digital leadership competency framework that encompasses generational theory as well as levels of work theory.
Identity construction among deaf adolescents and young adults: A literature review
Authors: Sekoto Lieketseng V. , Hlayisi Vera-Genevey
Published: May 2023

Background: Identity construction is an integral developmental task for adolescents and young adults (AYA). The intersection of deaf identity and disabling hearing loss (DHL) adds a layer to the complex process of identity construction.Aim: This literature review highlights the self-ascribed deaf identities of AYA and seeks to understand how AYA with DHL forge these identities. Knowledge areas for prospective research and practice are uncovered.Method: A traditional literature review of qualitative empirical evidence on AYA’s accounts of their deaf identity construction was conducted on seminal literature and peer-reviewed journals in psychology, disability studies and deaf studies.Results: The emerging self-ascribed deaf identities of AYA are diverse. The identities include Deaf, hearing, hard-of-hearing (HOH), bicultural HOH, identities that detach from disability, bicultural DeaF, unresolved and fluid identities. Complex trade-offs exist where the construction of certain identities forgoes certain reasonable accommodations, interventions or relations that are critical for personal development and wellbeing.Conclusion: Current literature orients deaf identity formation around hearing status and Deaf-hearing communal dynamics. In-depth research comprising facets of AYA’s personal, enacted and relational identities is required to conscientise rehabilitation professionals about the nuances of deaf identity issues and how to develop interventions that are supportive and responsive to the clinical and psychosocial challenges of AYA with DHL.Contribution: This paper deviates from the d/Deaf identity dichotomy, revealing a spectrum of deaf identities that AYA forge. The rationales of AYA’s deaf identities, underlying processes and possible vulnerable identities are unpacked. Recommendations for prospective research pertaining to identity construction among deaf AYA are made.
Do fiscal deficits influence private savings in South Africa? An empirical note
Authors: Marire Juniours
Published: May 2023

Orientation: The neoclassical loanable funds theory predicts that fiscal deficits reduce the pool of available savings in the economy, but heterodox scholarship disputes the claim.Research purpose: The paper sets out to test the relationship between fiscal deficits and private savings.Motivation for the study: Scholars are divided on whether corporate South Africa is building up excess savings, with some arguing that it is not and others arguing that it is because of mistrust of government and uncertainty largely. The trends of net private savings and fiscal deficits suggest that something contrary to the postulation of the neoclassical loanable funds theory could be happening in the South African context.Research approach/design and method: The paper used data for the period 1960–2021 within the Toda-Yamamoto vector autoregressive modelling framework.Main findings: The results show that fiscal deficits increase savings but reduce interest rates in line with the heterodox view that the financial asset creation effect of debt-financed deficits improves savings and reduces interests through the liquidity channel.Managerial/practical implications: The lesson for policy is that fiscal deficits are healthy for the economy. However, the government must manage them at some reasonable level to maintain a constant flow of net financial assets to the private sector, thus bolstering savings. An unhealthy pursuit of fiscal surpluses can shift deficits to households and firms, and breed systemic financial instability.Contribution/value-added: The paper contributed to a nuanced understanding of the role of fiscal deficits in expanding savings, which runs counter to the theoretical underpinnings of fiscal conduct that pursues budget surpluses.
Risk factors for mild cognitive impairment among older adults in a hospital in southern Nigeria
Authors: Anieto Amaefuna C. , Owolabi Akinwumi O. , Owolabi Mojisola O. , Nwajei Anthony I. , Onwuka Mabel O.
Published: May 2023

Background: About 63% of people living with mild cognitive impairment (MCI) and dementia live in low- and middle-income countries (LMICs). Emerging evidence suggests that early risk factors for the development of MCI and dementia can be modified by public health and preventive intervention approaches.Aim: This study aimed to assess the prevalence of MCI in older adult patients and its relationship with some risk factors.Setting: The study was conducted among older adults at the Geriatric Clinic of the Family Medicine Department of a hospital in southern Nigeria.Methods: A cross-sectional study was carried out involving 160 subjects aged 65 years and above over a period of 3 months. Socio-demographic and clinical data were obtained using an interviewer-administered questionnaire. Subjects were accessed for impaired cognition using the 10-word delay recall test scale. Data were analysed using SPSS version 23.Results: There were 64 males and 96 females; male to female ratio was 1:1.5. Majority of the study population were in age range of 65–74 years. The overall prevalence of MCI was 59.4%. Respondents with tertiary education were 82% less likely to have MCI on logistic regression analysis (OR = 0.18, 95% CI = 0.465–0.719).Conclusion: Mild cognitive impairment was prevalent among older adults in this study and was found to be significantly associated with low level of education.Contribution: It is therefore recommended that screening for MCI and known risk factors should be prioritized at geriatric clinics.
Paediatric palliative care for the generalist
Authors: Ambler Julia F. , Bell Christoffel H.
Published: May 2023

Palliative care has been defined as ‘the active holistic care of individuals across all ages with serious health-related suffering due to severe illness, and especially of those near the end of life’. Unfortunately, palliative care and especially paediatric palliative care remain a neglected area of medicine and are widely misunderstood, with few healthcare providers having any formal training in South Africa. To relieve health-related suffering, healthcare providers must understand that the field is not limited to end-of-life care for the terminally ill, and holistic care (physical, emotional, social and spiritual) should commence at the time of diagnosis of a serious illness. It is imperative that all healthcare providers develop the knowledge and skills to provide this essential care across all levels of care and disciplines. The article aims to raise awareness and show how to practically implement palliative care through case studies.
Does board gender diversity improve environmental, social and governance disclosure? Evidence from South Africa
Authors: Toerien Francois , Breedt Chanel , De Jager Phillip G.
Published: May 2023

Purpose: This study examines the relationship between board gender diversity and environmental, social and governance (ESG) disclosure of companies listed on the Johannesburg Stock Exchange (JSE).Design/methodology/approach: Panel regressions were used to analyse an unbalanced sample of 92 companies (725 company years) listed on the JSE All Share Index during 2011 to 2021. Board gender diversity, measured as the percentage of women on a board, was regressed against aggregate and individual component Bloomberg ESG disclosure scores. ‘Critical mass theory’ was tested using a 30%+ female board representation dummy variable.Findings/results: Positive correlation is found between female board representation and both aggregate ESG and S-disclosure. This likely results from unexplained differences between company and overall economy level time effects, as no time series correlation remains between board gender diversity and ESG disclosure scores once these effects are controlled for. Little evidence is found in support of critical mass theory.Practical implications: The results, although not conclusive, provide support for the argument that greater female representation on South African corporate boards is desirable to attain higher ESG disclosure. However, both female board representation and ESG disclosure scores may be driven by the same non-modelled underlying process, likely controlled for by the fixed effects.Originality/value: This study adds to the growing ESG and board gender diversity research – specifically in South Africa, an interesting case of an emerging economy with well-developed governance and disclosure frameworks, where more equitable gender board representation and increasing ESG disclosure are topics of great practical and academic importance.
Social media role in addressing employability challenges of graduates: An expert opinion analysis
Authors: Murire Obrain , Cilliers Liezel , Chinyamurindi Willie T.
Published: May 2023

Orientation: South Africa is currently going through a graduate unemployment challenge. Calls exist for research that addresses this challenge.Research purpose: This research study aimed to establish social media tools’ role in addressing employability challenges faced by graduates after completing their tertiary education.Motivation for the study: Calls exist in the literature for nuanced ways of addressing challenges youths face after completing their studies. The role of social media in this remains an area of inquiry with noted importance.Research approach/design and method: The study utilised an interpretivist philosophy relying on a qualitative research approach using interview data with a sample of 15 experts within the human resources field. Thematic analysis was used as a means of data analysis.Main findings: Two primary outcomes emerged from the research study. Firstly, a need exists for unemployed graduates to use social media as a marketing utility for their skills and abilities. Secondly, social media can also be used as an information utility to enhance awareness about labour market issues.Practical/managerial implications: The findings offer insights into addressing the employability challenges faced by graduates when seeking employment opportunities. The role of social media in mitigating graduate challenges is proposed. Through the findings, graduates have the potential to enhance their portfolios to improve their integration into the labour market.Contribution/value add: The study proffers insights into how social media helps increase the employability prospects of graduates entering the job market.
A contextualised model of the use of agile technique in South African software development team
Authors: Teffo Mmaphuti C. , Sigama Khuliso , Kanobe Fred
Published: May 2023

Background: Software development teams are challenged with the adoption of the most appropriate software development methodology. Despite their acceptance of agile methodologies, still many countries use traditional software development methods.Objectives: The major objective of this study was to develop a contextualised model for the adoption of agile methodologies in software development teams in South Africa.Method: Our study identified the factors that contributed to the adoption of agile software development teams in South Africa by conducting a factor analysis. We used descriptive statistics to determine the frequencies of the participant’s demographics and situational variables. A composite research model based on technology, organisation and environment, individual characters and culture constructs was constructed and analysis was performed by applying the statistical techniques of correlation analysis, regression analysis and structural equation modelling.Results: The result of the analysis revealed that many teams do not have a specific model that they use in agile development methodology. Technology, organisation, environment and culture constructs were found to have an impact on teams in adopting agile methodologies.Conclusion: The study demonstrated that organisations lack appropriate models of agile methodologies adoption to inform their decision making. Therefore, adopt the developed model in taking informed decisions for their software development methodologies. The study makes a practical contribution to management and practice.Contribution: This study improves on software development approaches in developing countries. The developed model can be adopted as a theory in future research. It contributed literature to the body of knowledge.
Lifestyle interventions in comorbid mental and physical illness: A systematic review protocol
Authors: Lord Sandy , Naidoo Vaneshveri , Mostert Karien
Published: May 2023

Background: Patients with mental health disorders (MHDs) often present with chronic illness and complain of pain and poor physical health. They present with a high burden of disease and poor quality of life. Significant associations between MHDs and chronic illness have been found. Lifestyle interventions are cost-effective strategies, which seem to be effective in managing comorbid mental and physical health disorders. Therefore, a summary of the evidence and clinical practice guidelines is needed in South Africa.Objectives: Our study will aim to determine the effectiveness of lifestyle interventions on health-related quality of life, in patients with comorbid mental and physical health disorders.Method: The systematic review will be conducted using the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness. MEDLINE (Ovid), CINAHL (EBSCO), LiLACS, Scopus, Physiotherapy Evidence Data Base (PEDro) and Cochrane Central Register of Controlled Trials will be searched. A three-step search strategy will identify published literature in all languages from 2011 to 2022. Critical appraisal of all included studies will be performed, and the relevant data will then be extracted. Where possible, data will be pooled in a statistical meta-analysis.Results: The results will provide the best available evidence regarding lifestyle interventions in the management of patients with comorbid mental and physical health disorders.Conclusion: Our review will provide evidence on the effectiveness of lifestyle interventions in the management of patients with comorbid mental and physical health disorders.Clinical implications: The results may assist in determining the best use of lifestyle interventions in the management of patients with MHDs and comorbidities.
A cross-sectional study to explore the association of peer pressure with Internet gaming
Authors: Donthu Raj Kiran , Mohammed Abdul Salaam , Pasam Ravi Sankar , Manchirevula Shivani
Published: May 2023

Background:

Gaming is a new phenomenon and there are increasing concerns over its negative impact. After the official recognition by diagnostic and statistical manual-5 and International Classification of Disorder-11, much of the research is directed toward understanding the different constructs of the gambling disorder. Peer influence is an established factor in substance use but less researched in gaming.

Aims of the Study:

The aim of this study is to explore and understand the influence of peer pressure on Internet gaming.

Materials and Methods:

Individuals between 15 and 35 years were asked to participate after explaining the study objectives and assessed on the Peer Pressure Scale and Internet Gaming Disorder (IGD) Scale. Responses were analyzed using the R language with R studio as the integrated development environment. Generalized additive model was used to identify the best-fit model. The Akaike information criterion was used to select the best model.

Results:

Battle Ground Mobile India is the most played game. Peer pressure alone accounts for 46.2% of the variability in Internet gaming and along with factors such as student; real friends; strategy games; online mode of playing, night time playing; and hours spent playing, increasing it to 56%. Peer pressure is positively correlated with IGD (P < 0.001, R = 0.65).

Conclusions:

Peer pressure is directly associated and plays a role in developing Internet gaming along with factors such as being a student; playing with real friends; strategy game genre; online mode of playing games; and nightly playing. Substance use such as tobacco may influence peer pressure and Internet gaming, acting as a co-factor for both.
Primary Carnitine Deficiency in a Neonate
Authors: Rasania Manish , Ahmed Naveed Majid , Prafulchandra Bhatt Vivek , Jain Shashank
Published: May 2023

Carnitine deficiency in paediatrics can present in infants with episodes of irritability, lethargy and hepatomegaly. The main treatment for primary carnitine deficiency is to take L-carnitine supplements. Here we report a case of a female neonate with carnitine deficiency. A female child of 1.5 kg of 34 weeks of gestation was admitted for low birth weight. Baby was discharged on 18th day of life. On 25thday of life, parents brought the patient back with complains of lethargy, where hypoglycemia was detected. After recovery, baby was shifted to full feed. Metabolic disorder was suspected. Extended neonatal screening test was sent and was suggestive of decreased levels of free carnitine in blood. For treatment, syrup L-carnitine was started. Signs and symptoms of primary carnitine deficiency typically appear during infancy or early childhood. Infants mostly present with hypoglycaemia. For treatment, carnitine supplements are provided
Basal Cell Nevus Syndrome
Authors: Ravi Anjali , Mohiddin Hannah Maryam , Majumder Bhargabi Paul , Nair Vishal S. , Girish Y. R. , Rao Prasanna Kumar , Pai Deepak , Kini Raghavendra , Gonsalves Nitin
Published: May 2023

Gorlin-Goltz syndrome (GGS) is a hereditary condition; it is transmitted as an autosomal dominant trait and characterized by a wide range of developmental abnormalities and a tendency to neoplasm. This article includes a case report and an extensive review of the GGS with regard to its history, incidence, etiology, features, investigations, diagnostic criteria, and treatment modalities.
Intercostal Chest Tube Drain-Related Bleeding in a Severe COVID-19 Pneumonia Patient with Pneumothorax and its Management
Authors: Jahan Nikahat , Kaur Kaminder Bir , Chapperwal Prabhav , Tiwari Prashant
Published: May 2023

Pneumothorax and pneumomediastinum have both been noted to complicate cases of coronavirus disease-19 (COVID-19) requiring hospital admission; however, the incidence is very low with only few cases reported in the literature. Spontaneous pneumothorax was also reported as a complication of the severe acute respiratory syndrome (SARS) with an incidence of 1.7% in hospitalized patients during the SARS pandemic of 2004. COVID-19 is also associated with a hypercoagulable state leading to pulmonary microvasculature thrombosis and systemic thromboembolic manifestations. Therefore, it is standard practice to start low molecular weight heparin (LMWH) for all moderate and severe COVID-19 pneumonia patients. We report a case of spontaneous pneumothorax in a severe COVID-19 pneumonia patient after three weeks of admission, where placing an intercostal drain (ICD) led to persistent bleeding into the ICD. He was managed with an innovative technique of instillation of Adrenaline saline solution three times into the pleural cavity through the ICD tube. Following the instillation of Adrenaline saline solution, the bleeding from the ICD stopped, however, the patient succumbed to his illness.
COVID-19 Associated Pulmonary Aspergillosis- A Case Report
Authors: Kumar Ankit , Kumar Satish , Mangal Vishal , Menon Anil Shankar
Published: May 2023

Coronavirus disease-19 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2. Viral illnesses such as influenza and COVID-19 are known to coexist with fungal infections, including Aspergillosis. The cases of COVID-19-associated pulmonary Aspergillosis (CAPA) have been reported in the recent past; however, there is a paucity of literature from India. Hence, we report a case of CAPA in a 55-year-old diabetic male from India who was successfully managed with anti-fungals and had a favorable outcome. This case highlights the importance of the high index of suspicion for CAPA in patients with severe COVID-19 pneumonia and acute respiratory distress syndrome who fail to improve or deteriorate clinically and radiologically despite standard therapy. The diagnosis must be confirmed with galactomannan assay from serum or bronchoalveolar lavage samples – early diagnosis and prompt management with anti-fungal results in a favorable outcome.
Abdominal Ultrasound Depicting Vaginal Evisceration of Bowel
Authors: Jain Vinayak , Vasudeva Akhila
Published: May 2023

Vaginal evisceration represents the extreme outcome of intestinal prolapse following iatrogenic uterine perforation. It is a rare occurrence and considered a surgical emergency with a mortality rate of 6%. The whole track is rarely seen in abdominal ultrasound. Ultrasound is the least expensive, easily available imaging tool, which may clearly show the track of perforation. Timely detection prevents deadly sequelae.
Addressing Violence against Doctors
Authors: Chaudhuri Aditi , Chacko Thomas V.
Published: May 2023

Background and Aim:

Lack of formal training and assessment in communication skills in India combined with suboptimal doctor-patient ratio leave them with little time, and therefore, patients dissatisfied with doctor's therapeutic communication and often lead to violence against doctors. There is thus an urgent need for health-care providers and their trainers to be formally and systematically trained and assessed.

Materials and Methods:

Descriptive study (describing the process of training module development using ADDIE Framework) and an educational intervention study (using the Kirkpatrick model for measuring effectiveness of the training). Module's contents were identified through the literature search followed by content, context, and construct validation by communication and subject experts. Modular 8 hour training was implemented for 50 participants in two batches on two different days.

Results:

In the immediate postintervention feedback, all participants agreed that the training will be beneficial to them in real life and they expressed confidence in teaching communication skills to their students, particularly in breaking bad news and resolving doctor-patient conflicts in the real life. Effectiveness of intervention is reflected by gain in knowledge scores from 6.84 (at pretraining) to 10.76 (immediate posttraining) and sustained at 10.8 (at 3 months posttraining). The impact of the training on their communication skills is also demonstrated by the skill scores showing incremental increase from 12.4 (at pretraining) to 19.16 (immediate posttraining) and then 21.8 (at 3 months posttraining) which is statistically significant (P < 0.05).

Conclusion:

The training was effective, accepted well by trainees and has been institutionalised.
Problem-Based Learning Curriculum and Process Assessment System for the Undergraduate Competency-Based Medical Education
Authors: Bhandary Shital
Published: May 2023

This article aims to provide an overview of problem-based learning (PBL) curriculum for integrating basic sciences subjects and clinical sciences with early clinical exposure. This approach provides the opportunity to teach the basic science subjects in context to medical students. PBL promotes self-directed learning skills among the medical students and facilitation skills among the faculty. PBL can also be used to observe, assess, and foster the noncognitive competencies among the medical students for which process assessment system must be established. The use of process assessment to observe, assess, and improve the preparation, participation, self-directed learning, critical thinking, leadership, communication, group skills and reflective competencies among medical students in Nepal for the last 10 years reveals that it can be implemented with the proper planning and training of faculty for this new system. PBL and process assessment system can serve to complement the competency-based medical education in the basic sciences phase of the undergraduate medical education curriculum.
Crossing the Final Hurdle
Authors: Wooster Elizabeth M. , Wooster Douglas L. , Maniate Jerry M.
Published: May 2023

Clinicians juggle many roles in addition to their clinical responsibilities. These roles include teaching and academic responsibilities. When academic responsibilities and productivity is discussed, the question of what is recognized and valued often surfaces. While large “R” research areas may have high barriers preventing entry by many clinicians, scholarly activity and scholarship may be enacted and realized through engagement with daily activities. In this paper, Wooster, Wooster and Maniate explore the role of scholarly activities, discuss practical tips, and reflect on a culture that may be enacted to support scholarly activities and scholarship in the future.
Primary Malignant Melanoma of the Stomach
Authors: Asotra Sarita , Mehta Akshita , Sharma Brij
Published: May 2023

Primary gastrointestinal malignant melanoma is an unusual clinical entity. With primary gastric melanoma being very rare, Primary gastric melanoma is underdiagnosed as clinical manifestations are not specific and usually similar with other common malignancies at this site such as gastric cancer and lymphoma. Most melanomas found in the stomach are metastases from cutaneous source. Cutaneous source with nonspecific signs and symptoms. We report a case of a 65-year-old women with pain abdomen and vomiting. We submit this report as primary gastric melanoma is a rare entity with aggressive behavior and poor prognosis
Study of diagnostic role of GeneXpert test in patients with pulmonary tuberculosis at El-Mahalla Chest Hospital
Authors: Abd El Aaty Hisham E.S. , El-Hefnawy Maha Y. , Khalaf Fatma S.
Published: May 2023

Background

Tuberculosis (TB) is a serious health problem in middle-income and low-income countries and needs rapid diagnosis and treatment. Xpert MTB/RIF assay provides early results by simultaneous detection of Mycobacterium tuberculosis (MTB) and rifampicin (RIF) resistance.

Aim

To evaluate the performance of GeneXpert MTB/RIF technique in diagnosing patients with pulmonary TB at El-Mahalla Chest Hospital, Egypt.

Patients and methods

Data of pulmonary TB were retrospectively analyzed between February 2017 and February 2018 from patient files and included laboratory results regarding Ziehl–Neelsen (ZN) smear microscopy, GeneXpert assay, and culture. Patients were divided into group I, having confirmed TB, where MTB was detected, and group II, having unconfirmed and unlikely TB, where MTB was not detected.

Results

A total of 150 patients were recruited. Overall, 80% were males, and the median age was 45.2±15.1 years. Positivity of ZN smear for TB bacilli was 61.1%, positivity of GeneXpert MTB was 65.9%, and culture positivity was 67.3%. GeneXpert sensitivity and negative predictive value were 96 and 96%, respectively, and were found to be higher when compared with ZN smear with 89 and 90%, respectively. Specificity of both techniques was 100%. Previous history of TB was an independent predictor for GeneXpert positivity, whereas both previous history of TB and positive sputum smear were independent predictors of RIF resistance.

Conclusion

GeneXpert has a higher diagnostic value compared with ZN smear, providing a faster diagnosis for pulmonary TB than culture, and it can detect RIF resistance.
Eosinophilic cationic protein as a marker for detection of acute exacerbations of patients with chronic obstructive pulmonary disease
Authors: Osman Osama , El Zohne Randa A. , Magdy Doaa M. , Elminshawy Alaa A.
Published: May 2023

Background

Eosinophilic inflammatory processes have been implicated in the pathophysiology of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The purpose of this study was to investigate whether eosinophilic cationic protein (ECP) could be a diagnostic marker for diagnosis of AECOPD.

Patients and methods

A total of 84 individuals were enrolled in this study: 32 patients with AECOPD, 32 patients with stable chronic obstructive pulmonary disease (COPD), and 20 healthy controls. Serum levels of ECP were collected and measured using commercial enzyme-linked immunosorbent assay.

Results

The mean concentrations of serum ECP in patients with AECOPD were significantly higher compared with stable COPD and the control group (P<0.05). At cutoff of more than 13.41 ng/ml, ECP exhibited the best performance: 82.2% sensitivity, 93% specificity, 92.5% positive predictive value, and 72.4% negative predictive value, with a diagnostic accuracy of 86%.

Conclusion

Serum ECP is a useful diagnostic marker to evaluate the inflammatory reaction in COPD exacerbations.
Role of chest ultrasound in diaphragmatic assessment among stable chronic obstructive pulmonary disease patients before and after pulmonary rehabilitation
Authors: Abbas Ahmad , Semary Esraa , Fawzy Amany , Awad Mohammed
Published: May 2023

Background

The cornerstone of nonpharmacological treatment of chronic obstructive pulmonary disease (COPD) is pulmonary rehabilitation, not only for enhancement of exercise performance but also for improvement of quality of life. However, the responses to rehabilitation varied among individuals.

Aim

To evaluate the role of chest ultrasound in the assessment of the diaphragm among patients with stable COPD before and after pulmonary rehabilitation.

Patients and methods

Spirometric pulmonary functions, sonographic assessment of diaphragmatic thickness and excursion, and 6-min walking test were done before and after rehabilitation. Based on a decrease in Saint George’s Respiratory Questionnaire (SGRQ), the patients were classified into failed and successful groups.

Results

The prevalence of successful rehabilitation was 71.1%, which was significantly higher in mild and moderate COPD cases. Pulmonary rehabilitation reported a significant improvement of dyspnea scale by 35%, SGRQ by 10%, 6 min walk distance by 9%, and pulmonary functions by up to 2%. There was a significant improvement in diaphragmatic excursion and thickness after rehabilitation by 5 and 13%, respectively. Percentage change of both diaphragmatic excursion (DE) and diaphragmatic thickness (DT) showed significant capability in predicting successful rehabilitation; the area under the curve was 87 and 92%, respectively. The cutoff points of percentage change in DE and DT were 24 and 10%, respectively, with sensitivity, specificity, positive predicative value, and negative predicative value of 95, 85, 58, and 99%, respectively, for DE and 94, 81, 52, and 98%, respectively, for DT.

Conclusions

The effect of pulmonary rehabilitation was significant regarding pulmonary functions, exercise, and diaphragmatic performance. The use of ultrasound in detecting changes of DT and DE after rehabilitation was excellent, which correlated significantly either positively with pulmonary function and 6 min walk distance changes or negatively with changes in SGRQ.
Ethanolamine oleate as a sclerosant in bronchoscopic treatment of pulmonary emphysema
Authors: Rezk Nasef Abd El-Salam , El-hadidy Tamer , Radi Ahmed A. , Abdelwahab Heba W.
Published: May 2023

Introduction

Loss of elastic recoil in pulmonary emphysema can be corrected by lung volume reduction through decreasing the volume of the most destroyed lung segments (dead space), which allow the remaining (less destroyed lung tissues) to regain its size. This article was planned to study the effectiveness and safety of ethanolamine oleate as a sclerosant in bronchoscopic lung volume reduction in patients with pulmonary emphysema.

Patients and methods

A total of 19 patients with pulmonary emphysema (age >40 years old) were included. Clinical evaluation, routine laboratory investigations, and bronchoscopic ethanolamine oleate instillation using fiberoptic video bronchoscopy were done. Outcome assessment measures were reviewed before bronchoscopic instillation of ethanolamine oleate and 4 weeks later using Modified Medical Research Council, 6-min walk distance, and pulmonary function tests such as a high-resolution computed tomography.

Results

Although there was a statistically significant improvement of Modified Medical Research Council scale after 1 month of bronchoscopic ethanolamine instillation, this value failed to meet the minimal clinically important difference (MCID) criteria. Moreover, forced expiratory volume in the 1 s improvement failed to meet the MCID criteria. Regarding 6-min walk distance, there was a statistically significant improvement that met the MCID criteria. There was a statistically significant and clinical improvement of high-resolution computed tomography volumetric quantification of emphysema. Approximately 31.5% of patients had no complications.

Conclusion

This study showed statistical improvement in exercise tolerance and pulmonary function tests in patients with pulmonary emphysema after bronchoscopic instillation of ethanolamine oleate. However, clinical improvement was detected only in exercise tolerance.
Prevalence and Predictors of Internet Addiction among Eastern Indian Undergraduate General College Students
Authors: Dey Surya Prakash , Saha Rajib , Saha Indrajit
Published: May 2023

Background:

Internet addiction (IA) has emerged as a potential problem in young people, which refers to excessive Internet use that interferes with their daily life as well as having significant health impacts.

Objectives:

The objective of this study was to ascertain the prevalence and the predictors of IA among general degree college students of Bankura municipal area.

Materials and Methods:

This analytical cross-sectional study was conducted from July 2019 to December 2019 at Bankura town among 216 undergraduate general degree college students who were regular Internet users (at least once in a week for the last 3 months). The study population was selected through simple random sampling method, and data were collected by a self-administered semi-structured questionnaire comprising Young's IA Test Scale, Patient Health Questionnaire-9 Depression Scale, Insomnia Severity Index, and Rosenberg's Self-Esteem Scale. To ascertain the predictor (s), variables which were found statistically significant in bivariate analysis, were considered for multivariate logistic regression.

Results:

The overall prevalence of IA among college students was 65%. Screen-related health impacts such as eyestrain, musculoskeletal problem, and insomnia were found significantly higher among Internet-addicted students. Multivariate logistic regression revealed that moderately and severely depressed college students are 6 times more prone to develop the IA, whereas it is 4 times higher in those who are in relationship.

Conclusions:

Although Internet technology is considered the most effective tool and one is compelled to use it for various purposes, every individual should be able to recognize the point where the Internet starts to overrule one's life and further hinders other activities of daily living.
Community-based Psychosocial Intervention for Persons with Severe Mental Illness in Rural Kerala
Authors: Pallikkuth Rekha , Kumar T. Manoj , Manickam L. S. Sam , Cherian Anish V. , Bunders-Aelen Joske F. G. , Regeer Barbara J
Published: May 2023

Background:

High-quality mental health care is scarce in rural India. The Mental Health Action Trust a Nongovernmental Organization based in Kozhikode, South India, has been providing free mental health services to the economically disadvantaged people in the surrounding districts. Comprehensive multidisciplinary care is provided through existing health-care clinics through training of lay mental health workers (LMHW). The current paper evaluates the classroom training methods employed to educate the LMHW.

Materials and Methods:

The training module designed after coordination and need assessment was delivered through classroom training sessions by trained trainers over 2 months weekly 6 h and completed by 13 volunteer LMHW (5 males and 8 females and who were in the age range of 22–56 years) could complete all the modules of training. The evaluation of training was done quantitatively and qualitatively.

Results:

The LMHW's knowledge, attitudes, perceived interpersonal skills, and confidence levels demonstrated a noticeable change following the classroom training program.

Conclusion:

It is feasible to train LMHWs to deliver psychosocial interventions for people with severe mental disorders and their families in rural India. In addition to classroom training, case-based training and proper ongoing supervision are required to improve their skills, attitudes, and knowledge.
Stress, Sources of Stress and Coping During the COVID-19 Lockdown
Authors: Fenn Jessy , Chacko Noble , Thomas Tony , Varghese Varghese K. , George Sanju
Published: May 2023

Background:

Pandemics such as COVID-19 (with or without lockdown) can cause considerable stress to individuals, testing their coping resources. To contain the pandemic, there was a nationwide lockdown in India from March 25, 2020, severely limiting movement of the 1.3 billion population till the first relaxation came on April 21. This study was done in the 3rd week of April, just before relaxations were announced, to study the perceived stress, sources of stress, and coping strategies of adults during this core lockdown period in Kerala, India.

Materials and Methods:

We gathered data from 1073 adults using sociodemographic information, perceived stress scale, sources of stress checklist, and COVID-19 coping strategies scale. Correlation analyses, t-test, and one-way analysis of variance were employed for data analyses.

Results:

65.7% of respondents scored high on the stress scale with 8.3% experiencing severe stress and 57.4% reporting moderate stress. Stress was negatively correlated with age, education level and income. Anxiety about the impact of the pandemic on the world and their own personal future were the main sources of stress. This was followed by financial worries, stress due to frustration of limited movement, and fear about contracting COVID. The five most common coping strategies used were increased hygiene, social distancing, increasing awareness about the disease, increased communication with family, and distraction through movies and books. Conclusion: During the core lock down period in April 2020 in India, there was high levels of stress among the people primarily due to the worry about the future impact of the pandemic as well due to the restrictions imposed.
Mental Hospitals and Historical Trauma
Authors: Pinto Sarah Ann
Published: May 2023

Background:

India is facing a mental health crisis but to change community stigma, we need to address historical trauma. This article discusses the issue of community stigma toward mental health care in India. Objective: The research aimed to trace the roots of community stigma toward mental health care facilities.

Method:

This study primarily used the archival method of data collection in constructing its narrative. Primary sources including colonial records, some vernacular newspapers, and a few Indian sources were analysed. The Maharashtra State Archives and the National Archives of India, New Delhi, served as the main repository of primary sources. Additionally, India Office Records at the British Library, London, provided further evidence for this research. Digitized copies of Annual Asylum Reports made available by the National Library of Scotland added to the evidence. The study also involved fieldwork at the Thana, Yerawada, and Ratnagiri mental hospitals in 2014.

Results:

Community stigma to the use of mental health care facilities is a historical problem. The establishment of lunatic asylums in India (as they were referred to in the 19th century, the nomenclature changed in 1921 to the term mental hospitals) caused disruption to local communities and families and left a legacy of trauma and fear.

Conclusions:

Acknowledging the trauma will disrupt patterns of coercion and cultures of abuse within mental health institutions and it will enable new narratives in mental health care.
Role of Schools in Management of “Tech Addiction” in Children and Adolescents During the Pandemic
Authors: Raj Satya
Published: May 2023

Technology and tech devices have revolutionized the world, made things very simple, fast, and quick, especially teaching and learning has been made accessible to all. It has been a blessing during the pandemic definitely as it has helped millions of children learn in the safety of their homes. However, it has also brought with it, numerous problems we are struggling to grapple with now. Tech-addiction is a major problem, in many children and adolescents, and it has been affecting their physical, emotional, and social well-being. This has been a major concern globally. The current article will focus on the role of schools in addressing Tech addiction and the way forward. Addressing tech addiction in schools from a primary and secondary prevention model will be very effective. The article also highlights the simple ways in which this can be done.
Depression, Anxiety, Stress, and Resilience among the Primary Survivors of Natural Disaster
Authors: Rahana S. R. , Sam Juby Merin , Udhayakumar P.
Published: May 2023

Background:

Kerala, the southernmost state in India experienced the worst flood in its history, in August 2018. The disaster led its survivors to psychological trauma, along with several other impacts.

Aims:

The present study assessed the mental health status and level of resilience among the primary survivors in the postdisaster phase of Kerala flood, and the possible interlinkage of demographic factors with the study variables.

Materials and Methods:

The study has done on a sample of 50 primary survivors of flood selected using a purposive sampling method. Two rating scales-Depression Anxiety Stress Scale-21 and brief resilience scale-were used for collecting data, along with a sociodemographic information sheet prepared by the researcher, which was administered in a face to face interview with the participants. IBM SPSS software (version 21) was used for data analysis and statistical tests such as t-test, analysis of variance, and Pearson's correlation tests were used to interpret the data.

Results:

Results revealed the prevalence of depression, anxiety, and stress among the survivors in the postdisaster phase. Statistically significant difference was found in depression and stress scores in terms of education, where survivors with higher education showed lower stress and depression. Results also showed a comorbidity of depression, anxiety, and stress and a negative correlation between resilience and stress scores.

Conclusions:

The disaster had a significant impact on the survivors' mental health and need medical interventions to address it. The educational status and resilience level of the survivors are important determinants of postdisaster mental health.
Prevalence of Various Domains of Sexual Dysfunction in Young Alcohol Dependent Males
Authors: Yadav Bhupendra , Dhillon Harpreet Singh , Kumar Ravish , Dhillon Gurpreet Kaur , Sasidharan Shibu
Published: May 2023

Background

: The available research on alcohol-induced sexual dysfunction has mainly deliberated on erectile dysfunction and premature ejaculation. Other major domains of sexual dysfunctions (viz., sexual pleasure, sexual desire, arousal, orgasmic function, and intercourse satisfaction) were rarely taken into consideration. This study was undertaken with the aim to boost an interest and understanding in this area and to reduce the morbidity associated with alcohol-induced sexual dysfunction.

Materials and Methodology:

The study utilized a cross-sectional descriptive design and recruited 78 male patients admitted for de-addiction. The assessment was conducted using a specially designed intake pro forma and psychometrically strong and validated tools such as Changes in Sexual Functioning Questionnaire-Male Clinical version (CSFQ-MC), International Index of Erectile Function scale, Diagnostic and Statistical Manual of Mental Disorders -5, and International Classification of Disease, 10th revision, diagnostic criteria for research.

Results

: The various domains of sexual dysfunction as per CSFQ revealed decreased sexual pleasure (71.8%) as the most common sexual dysfunction followed by low sexual desire (in terms of frequency) in 61.5%. Sexual desire (in terms of interest) was low in 55.1%. Sexual arousal/excitement was low in 59%. Sexual orgasm/completion scores were low in 48.7% alcohol-dependent male patients. Erectile dysfunction was found in 43.6% of alcohol-dependent male patients.

Conclusion:

The most common sexual dysfunction reported in the current study was decreased sexual pleasure (71.8%) followed by low sexual desire 61.5% (in terms of frequency). These findings emphasize the fact, that alcohol significantly compromises almost all domains of sexual functioning in addition to erectile dysfunction. Further, this information can be used in motivational counseling of heavy drinkers (especially adolescents and young adults) to provide motivation for change.