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71.
This article has a twofold purpose. First, it discusses theoretical and practice developments in both family therapy that include community, and in social work that emphasize acceleration toward social and community developmental welfare, but which should include microsystemic interventions. The authors contend that ethical family therapy and social work practice should use multimodal strategies, and suggest that the community family therapy (CFT) model is useful in addressing gaps in theoretical developments. Second, because the CFT model has not yet been adopted in South Africa, this article discusses evaluations of the CFT model by 3 groups of students for the model to be adopted with full understanding. These student groups are the 2010 cohort of final-year social work undergraduate students and the 2010 and 2011 cohort of postgraduate social work students at the University of KwaZulu Natal, Durban, South Africa. The article presents readers with some understanding of the CFT model, how its teaching has evolved through a learner-centered pedagogy, the merits and demerits of the model, and preconditions that may facilitate adoption of the model. 相似文献
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Ganesh Thiagamoorthy Martino Zacchè Linda Cardozo Madhu Naidu Ilias Giarenis Richard Flint Sushma Srikrishna Dudley Robinson 《International urogynecology journal》2016,27(3):433-437
Introduction
Pelvic Organ Prolapse Quantification (POP-Q) system, measured in centimetres using a ruler (e.g. POPstix®), is recommended to quantify prolapse severity. POPstix® are costly (US $1/ruler). Home-made devices are used instead, but these have not been shown to be reproducible.Hypothesis
Digitally assessed POP-Q (DPOP-Q) is as reliable, reproducible and acceptable as POP-Q assessed using POPstix®.Methods
In this randomised crossover diagnostic agreement trial, each assessor measured the index finger of their dominant hand using a ruler. At visit one, patients were randomised to either POPstix® POP-Q assessment in a modified lithotomy position or DPOP-Q in both modified a lithotomy and a standing position. After the first clinician conducted this assessment, a second blinded clinician then carried out the remaining assessment on the same patient. For each examination, duration was recorded, along with a patient-completed discomfort score. Twenty-five women were invited for visit two, at which DPOP-Q was recorded by the same clinician who undertook DPOP-Q at the first visit. This allowed evaluation of inter- and intraobserver agreement together with examination acceptability.Results
One hundred and nine women were recruited [median age 55 years, parity 2, body mass index (BMI) 27.1]. Of the 25 patients invited, 23 returned for visit two. DPOP-Q had high interobserver reliability [κ?=?0.94, 95 % confidence interval (CI) 0.878–0.996] and intraobserver reliability (α?=?0.96) with POPstix®. DPOP-Q was significantly quicker (p?=?0.02) and less uncomfortable (p?<?0.01) than POPstix® POP-Q.Conclusion
DPOP-Q is reliable, acceptable and cost effective.75.
Piyush Gupta Pooja Dewan Dheeraj Shah Nisha Sharma Nidhi Bedi Iqbal R. Kaur Ajay Kumar Bansal S.V. Madhu 《Indian pediatrics》2016,53(11):967-976
Objective
To evaluate the efficacy of single oral mega-dose of Vitamin D3 for treatment and prevention of pneumonia in underfive children.Design
Randomized, double blind, placebo-controlled trial.Setting
Tertiary-care hospital.Participants
324 children (of 980 assessed) between 6 mo-5 y age (median (IQR): 12 (7,19.8) mo) with WHO-defined severe pneumonia. Of these, 126 (39%) were vitamin D deficient (serum 25(OH)D <12 ng/mL).Intervention
100,000 IU of oral cholecalciferol (n= 162) or placebo (n= 162) in single dose, administered at enrolment.Outcome variables
Primary: Time to resolution of severe pneumonia and proportion of children having recurrence of pneumonia in next 6 months; Secondary: Change in serum levels of 25(OH)D; immunoglobulins IgA, IgG, IgM, and cathelicidin 2 weeks following supplementation; and time taken for overall resolution of illness.Results
Median (95% CI) time for resolution of severe pneumonia was 30 (29, 31) h in the vitamin D group as compared to 31 (29,33) h in the placebo group [adjusted hazard ratio (95% CI): 1·39 (1·11, 1·76); P=0·005]. The risk of recurrence of pneumonia in next 6 months was comparable in the two groups [placebo: 36/158 (22·8%); vitamin D: 39/156 (25%); RR (95% CI): 1·13 (0·67,1·90); P=0·69]. Proportion of vitamin D deficient children declined from 38% to 4% in the supplementation group, and from 41% to 33% in the placebo group, two weeks after supplementation. There was no significant effect of vitamin D supplementation on serum levels of cathelicidin, IgA and IgG. The time taken for complete recovery from pneumonia, duration of hospitalization, and fever clearance time were comparable for the two groups. No adverse event was noted related to the intervention.Conclusion
There is no robust evidence of a definite biological benefit, either for therapy or prevention, to suggest a routine megadose supplement of vitamin D3 for under-five children with severe pneumonia.76.
Shabir Ahmed Dhar Mohammed Farooq Butt Tahir Ahmed Dar Reyaz Ahmed Dar Zameer Ali 《中华创伤杂志(英文版)》2016,19(5):298-301
Nonunion of the humerus in a severely osteoporotic bone is a likely event especially if the fracture is transverse. The management of such a combination is a challenge. Most of the conventional fixation
methods are unlikely to succeed as the bone failure precedes implant failure in osteoporosis. The
challenge is further compounded in severe osteoporosis when the cortical thickness is affected more
severely. We used a combination of an intramedullary fibula with a locking plate in 5 cases. The results show that it may be a good combination in such situations as the bone strength is augmented and the plate pullout is less likely. 相似文献
77.
Abdelkrim Khadir Sina Kavalakatt Dhanya Madhu Maha Hammad Sriraman Devarajan Jaakko Tuomilehto Ali Tiss 《Lipids in health and disease》2018,17(1):291
Background
The hepatokine fetuin-A is linked to obesity and type 2 diabetes, but its presence and expression in adipose tissue remain unclear. In this study, we aimed to assess the circulating levels of fetuin-A and its expression in subcutaneous adipose tissue (SAT) from diabetic and non-diabetic obese subjects and their modulation by exercise.Methods
SAT and blood were obtained from adults obese (diabetic, n=118 and non-diabetic, n=166) before and after a 3-month exercise program (diabetic, n=40 and non-diabetic, n=36, respectively). Plasma fetuin-A was assayed using ELISA. The presence and expression of fetuin-A in SAT, peripheral blood mononuclear cells (PBMCs) and cell lines (3T3-L1, THP-1, HepG2, RAW 264.7) were analysed using confocal microscopy, immunoblotting and qRT-PCR.Results
Plasma fetuin-A level did not significantly differ between diabetic and non-diabetic obese subjects. However, when the non-diabetic group was divided into metabolically healthy and unhealthy phenotypes, significantly higher fetuin-A level was observed in the unhealthy sub-group. Circulating fetuin-A was mainly associated with glycaemic markers. In SAT, fetuin-A protein level was significantly higher in the diabetic obese subjects but its mRNA was not detected. Similarly, fetuin-A protein was detected in PBMCs, but its mRNA was not. In line with this, the use of various cell lines and culture media indicated that the presence of fetuin-A in SAT and PBMCs was due to its uptake from circulation rather than its endogenous expression. Finally, physical exercise decreased fetuin-A levels in both plasma and SAT in both groups.Conclusions
Fetuin-A levels increased in association with diabetes in SAT but not in circulation in the obese subjects. Moreover, physical exercise decreased fetuin-A level. Fetuin-A potentially acts as a hepatokine taken up by other tissues, such as adipose tissue.78.
Kumar Naresh Liu Zhong Jun Poon Wai Sang Park Chun-Kun Lin Ruey-Mo Cho Kyoung-Suok Niu Chi Chien Chen Hung Yi Madhu Sirisha Shen Liang Sun Yu Mak Wai Kit Lin Cheng Li Lee Sang-Bok Park Choon Keun Lee Dong Chan Tung Fu-I Wong Hee-Kit 《European spine journal》2022,31(5):1260-1272
European Spine Journal - Our study aimed to evaluate non-inferiority of ProDisc-C to anterior cervical discectomy and fusion (ACDF) in terms of clinical outcomes and incidence of adjacent segment... 相似文献
79.
Suneeta Dubey Deepti Mittal Saptarshi Mukherjee Madhu Bhoot Yadunandan P Gupta 《Indian journal of ophthalmology》2020,68(11):2427
Purpose:The aim of this study is to study the association between Nocturnal Intraocular Pressure (IOP) related Peak recorded by a Contact Lens Sensor (CLS) and glaucoma progression in treated glaucomatous eyes.Methods:Institutional study in which forty glaucoma patients were recruited from glaucoma clinic. A total of 19 patients were labeled as progressors on current anti-glaucoma treatment despite controlled day time IOP whereas twenty one patients were clinically stable showing no progression. Worse eye of each patient was selected for placement of CLS. The timing of the highest signal (IOP related peak) was noted in 24 hour CLS graph and if it fell within the time frame of 11 pm to 5 am, it was labeled as ''nocturnal IOP related peak''.Results:Progressors were found to be significantly more prone to night spike than Non Progressors (χ2 = 6.812; n = 40; P = 0.009), thus, showing a definite association between the two. Association between Nocturnal IOP related peak and various other variables like age, gender, mean daytime IOP and systemic illness was studied. A positive correlation was established between female gender and Nocturnal IOP related spike with a significantly higher proportion of females showing night spike than their male counterparts (χ2 = 5.763; n = 40; P = 0.016). Other parameters did not show any significant relationship with Nocturnal IOP related spike.Conclusion:Dynamic 24 hour recording by CLS is beneficial in detecting nocturnal IOP-related peak, and thus, can potentially improve the clinical care of glaucoma patients, especially those showing progression. 相似文献
80.
The purpose of this study was to see if subvastus approach would decrease incidence of postoperative contracture and pain following TKA compared to standard parapatellar approach. Retrospective review of 546 patients in Group A undergoing TKA using parapatellar approach were compared to 255 patients in Group B undergoing subvastus approach. No statistically significant differences regarding OR time, blood loss, BMI, or LOS. Total of 23 (4%) manipulations under anesthesia for contracture in Group A compared to 6 (2%) in Group B (p > 0.05). Postoperative pain scores at 6 weeks was greater in Group A, p < 0.05. We feel that a subvastus approach minimizes trauma to the extensor mechanism, and therefore decreases the incidence of postoperative pain following TKA. 相似文献