OBJECTIVE: To determine medications available and used in the management of six symptoms at the end of life among pediatric palliative care practitioners in Asia Pacific. To identify alternative pharmacological strategies for these six symptoms if the oral route was no longer possible and injections are refused.
DESIGN AND SETTING: An online survey of all Asia Pacific Hospice Palliative Care Network (APHN) members was carried out to identify medications used for six symptoms (pain, dyspnea, excessive respiratory secretions, nausea/vomiting, restlessness, seizures) in dying children. Two scenarios were of interest: (1) hours to days before death and (2) when injectables were declined or refused.
RESULTS: There were 54 responses from 18 countries. Majority (63.0%) of respondents were hospital based. About half of all respondents were from specialist palliative care services and 55.6% were from high-income countries. All respondents had access to essential analgesics. Several perceived that there were no available drugs locally to treat the five other commonly encountered symptoms. There was a wide variation in preferred drugs for treating each symptom that went beyond differences in drug availability or formulations.
CONCLUSION: Future studies are needed to explore barriers to medication access and possible knowledge gaps among service providers in the region, so that advocacy and education endeavors by the APHN may be optimized.
OBJECTIVES:: The aim was to investigate their dynamic characteristics and create a relationship between these dynamic data and the prescription of foot.
STUDY DESIGN:: Experimental Assessment.
METHODS:: This article presents the modal analysis results of the full range of Össur Flex-Run™ running feet that are commercially available (1LO-9LO) using experimental modal analysis technique under a constant mass at 53 kg and boundary condition.
RESULTS:: It was shown that both the undamped natural frequency and stiffness increase linearly from the lowest to the highest stiffness category of foot which allows for a more informed prescription of foot when tuning to a matched natural frequency. The low damping characteristics determined experimentally that ranged between 1.5% and 2.0% indicates that the feet require less input energy to maintain the steady-state cyclic motion before take-off from the ground. An analysis of the mode shapes also showed a unique design feature of these feet that is hypothesised to enhance their performance.
CONCLUSION:: A better understanding of dynamic characteristics of the feet can help tune the feet to the user's requirements in promoting a better gait performance.
CLINICAL RELEVANCE: The dynamic data determined from this study are needed to better inform the amputees in predicting the natural frequency of the foot prescribed. The amputees can intuitively tune the cyclic body rhythm during walking or running to match with the natural frequency. This could eventually promote a better gait performance.
METHOD: The participants ranged from 3 years 3 months to 4 years 9 months at the start of the study. Beyond-clinic speech samples were obtained at 1 month and 1 week pretreatment and immediately post-Stage 1, and at 1 month, 3 months, 6 months and 12 months post-Stage 1.
RESULTS: Two participants, who were bilingual, achieved near-zero levels of stuttering at 12 months posttreatment. Near zero levels of stuttering were also present in their untreated languages. One participant withdrew due to reasons not connected with the research or treatment. The remaining participant, who presented with severe stuttering, completed Stage 1 but had some relapse in Stage 2 and demonstrated mild stuttering 12 months post-Stage 1.
CONCLUSIONS: The outcomes were achieved without the need to significantly adapt Lidcombe Program procedures to Malaysian culture. Further research to continue evaluation of the Lidcombe Program with Malaysian families and to estimate proportion of those who will respond is warranted.
METHODS: Patients diagnosed with a single lumbar herniated intervertebral disc (HIVD) refractory to conservative management but not willing for immediate surgery were selected for a prospective nonrandomized comparative study. An SNRB was administered as a therapeutic alternative using the AP subpedicular approach in one group (n = 25; mean age, 45 ± 5.4 years) and the oblique Scotty dog subpedicular approach in the other group (n = 22; mean age, 43.8 ± 4.7 years). Results were compared in terms of the duration of the procedure, the number of C-arm exposures, accuracy, pain relief, functional outcome and the duration of relief.
RESULTS: Our results suggest that the oblique Scotty dog subpedicular approach took a significantly longer duration (p = 0.02) and a greater number of C-arm exposures (p = 0.001). But, its accuracy of needle placement was 95.5% compared to only 72% using the AP subpedicular approach (p = 0.03). There was no significant difference in terms of clinical outcomes between these approaches.
CONCLUSIONS: The AP subpedicular approach was simple and facile, but the oblique Scotty dog subpedicular approach was more accurate. However, a brief window period of pain relief was achieved irrespective of the approaching technique used.
EDUCATIONAL ACTIVITY AND SETTING: Community pharmacists attended a one-day workshop, supplemented with comprehensive training materials which enabled participants to conduct similar sessions with their peers at their own time. The workshop, consisting of case study discussion and role plays, was designed to be an engaging and interactive program that combined traditional didactic sessions and experiential, discussion-based learning. A pre- and post-workshop questionnaire were administered immediately before and after the event to all attending participants.
FINDINGS: Core concepts covered in the workshop included: (1) overview of an ageing population, (2) issues with ageing population, (3) medication review, and (4) dietary requirements and dosage forms in older adults. Participants' (n = 39) noted significant improvements in knowledge (mean score change 0.7, p
DISCUSSION: It is a set of various methodologies which are used to capture internal or external images of the human body and organs for clinical and diagnosis needs to examine human form for various kind of ailments. Computationally intelligent machine learning techniques and their application in medical imaging can play a significant role in expediting the diagnosis process and making it more precise.
CONCLUSION: This review presents an up-to-date coverage about research topics which include recent literature in the areas of MRI imaging, comparison with other modalities, noise in MRI and machine learning techniques to remove the noise.