Age Institute

Objective: Assessment of value of fat plug myringoplasty as office-based procedure small tympanic membrane perforations.Material and Methods: Prospective study of consecutive patients undergoing fat pluc myringoplasty under local anesthesia. Minimum follow-up considered was 6 months which included several microscopic examinations. All data were recorded and analyze statistically.Results: 33 patients matched the inclusion criteria; the mean perforation size was mm. No change in PTA was noted after surgery in the whole series. Recurrence of per foration was detected in 7 cases (21%), which was statistically related with the causi of perforation rather than location or size (p-value <0.01).Conclusions: Fat plug myringoplasty is a safe procedure with very low rate of compli cations, and it is an office-based procedure well tolerate by all patients. Results in case of primary surgery are excellent, with a high success rate (90%). In case of recurren perforation after traditional surgery, success rate get decreased.

Tutkimuksen tavoitteena oli selvittää millä tavalla vanhushoivapolitiikkaa ohjaavissa asiakirjoissa kuvataan ikääntyvien henkilöiden perhehoitoa ja kuinka perhehoidon palvelumallia niissä perustellaan. Dokumenttiaineiston muodostivat vanhushoivapolitiikkaa ohjaavat asiakirjat vuosilta 2014–2024. Induktiivisen teema-analyysin avulla analysoitiin ikääntyvien henkilöiden perhehoitoa kuvaavia asiakirjoja (n=31). Teemoittelua ohjasi tulkitseva politiikka-analyysi. Perhehoitoon liittyvät teemat olivat: perhehoidon jatkuvuuden turvaaminen, taloudellistettu perhehoito, perhehoitajien hyvinvointia tukeva toiminta ja ikääntyvien henkilöiden hyvinvointi. Aineistossa kuvattiin perhehoitoa palvelumallina, jota on tarpeen kehittää ja laajentaa. Kehittämis- ja laajenemistarve liittyy huoleen yhteiskunnan palvelurakenteen kestävyydestä tarjota riittävästi hoiva- ja asumispalveluita ikäihmisille. Yksi kehittämisen näkökulma on, että sosiaali- ja terveydenhuollon henkilöstön ja perhehoitajan välisen yhteistyön ajatellaan tukevan paikallaan ikääntymisen politiikkatavoitetta. Perhehoidon tarpeellisuutta perusteltiin erityisesti taloudellisilla syillä: perhehoito tuottaa ikääntyville ihmisille monipuolisia ja edullisempia ratkaisuja kuin muut vaihtoehdot. Analyysi osoitti, että perhehoidon tarvitsijoiden eli ikääntyvien henkilöiden näkökulma jää vähäiselle huomiolle. Tarvitaan lisää tietoa perhehoidon vaikuttavuudesta ja erityisesti siitä, miten ikäihmisten yksilölliset tarpeet tulevat huomioiduksi. Behind the development talk, economic emphasis and silences ‒ Foster care for older people from the perspective of elder care policy The aim of the study was to examine how foster care for older people is described in the elder care policy documents as well as how the service model of foster care is justified in these documents. The documentary material consisted of elder care policy documents for older people published between 2014 and 2024. These 31 documents about foster care for older people were analysed using inductive thematic analysis, which was guided by interpretative policy analysis. The themes that were identified from the data included ensuring the continuity of foster care, financing foster care, activities supporting the well-being of foster carers, and the well-being of older people. Foster care was portrayed as a service model that requires further development and expansion. This need for development was attributed to concerns about how to ensure the sustainability of societal services, such as care and housing services for older people. One aspect of development highlighted was the importance of fostering co-operation between social and health care staff and foster carers. This collaboration is considered to support the objective of the ageing-in-place policy. Foster care was described as a service that offered older people more varied and cost-effective solutions compared to other options. The analysis revealed limited attention to the perspective of older people who require foster care services. However, more information is needed regarding the effectiveness of foster care, particularly in terms of addressing the individual needs of elderly people.

Kansallisessa ikäohjelmassa esitetään, että digitaaliset ratkaisut ja etäpalvelut voivat osaltaan tukea iäkkäiden toimintakykyä ja itsenäistä kotona asumista. Tutkimuksessa seurattiin yhden mahdollisen ratkaisun, etäohjatun liikunnan toteutusta seitsemässä kunnassa. Kuntien työntekijöiden (n=14) elisitaatiohaastatteluilla ja sähköpostikyselyllä selvitettiin, mitkä tekijät edistivät tai vaikeuttivat iäkkäille suunnatun etäohjatun liikunnan implementaatiota kunnissa. Implementaatiotutkimuksen viitekehyksen avulla pyrittiin tunnistamaan rakenteita, toimintaa ja kokemuksia, joilla on yhteys etäohjatun liikunnan toimeenpanon onnistumiseen ja haasteisiin. Aineistosta etsittiin etäohjatun liikunnan implementaatioon vaikuttavia tekijöitä: tietoja osallistuneista, näkemyksiä iäkkäistä liikkujina ja teknologian käyttäjinä, johdon linjauksia, organisaatioiden ja työntekijöiden tekoja sekä ratkaisuja, joilla pyrittiin tukemaan osallistujien toimintakykyä. Implementaation tuloksia ja prosessia tarkasteltiin lopuksi hyväksyttävyyden, käyttöönoton, soveltuvuuden, käytettävyyden, pysyvyyden, kustannusten, leviämisen ja juurtumisen näkökulmista. Paikallinen toimintakulttuuri, resurssit ja näkemykset iäkkäistä heijastuivat etäohjattua liikuntaa koskeviin päätöksiin. Implementaatio onnistui parhaiten kunnissa, joissa etäohjattu liikunta oli juurtunut rakenteisiin, henkilöstövaihdokset olivat hallittuja, ja joissa suhtauduttiin iäkkäiden oppimispotentiaaliin myönteisesti ja ongelmiin ratkaisukeskeisesti. Toimintamallin joustavuus edisti implementaatiota erilaisiin kuntiin ja tilanteisiin. Implementaatiota haastoivat ennakoimattomat muutokset henkilöja tilaresursseissa, organisaatioiden välisen yhteistyön rajaaminen sekä kielteiset näkemykset iäkkäistä teknologian käyttäjinä. Tulosten perusteella esitämme, että etäohjattu liikunta voi osaltaan ratkaista haavoittuvien ryhmien terveyden edistämisen haasteita ja sen järjestämistä kannattaa harkita kunnissa ja hyvinvointialueilla, mutta implementaation haasteet on huomioitava huolellisesti.

Photodynamic therapy (PDT) is a promising cancer treatment that uses photosensitizers (PSs) to generate cytotoxic reactive oxygen species (ROS) under light, but improving its efficacy is crucial for clinical applications. To address this, we propose a smart nanoplatform (P@BAO-DOX) for synergistic chemo-photodynamic therapy, featuring efficient PDT, controllable drug release, and fluorescence imaging guidance. We designed an aggregation-induced emission (AIE)-based PS (BAO) with effective ROS generation and NIR-II fluorescence. Additionally, BAO as a PS and doxorubicin (DOX) as a chemo drug were encapsulated in pH-responsive nanogels (PNA) to obtain P@BAO-DOX nanogels. Upon uptake by tumor cells, the nanogel releases drugs in acidic conditions, leading to cell death. White light irradiation further triggers BAO to produce substantial ROS, enhancing phototoxicity and synergistic chemo-PDT cancer therapy. Thus, P@BAO-DOX nanogels, as a smart nanoplatform, offer precise drug release and efficient ROS generation for imaging-guided chemo-PDT synergistic therapy, showing promise in advancing cancer treatment.

This study aims to compare and evaluate the changes in color caused by four different biomaterials utilized as intracanal coronal barriers in the regenerative endodontic procedure at varying intervals of time. A total of 100 extracted mandibular single-rooted premolars were taken. Samples were standardized, and access cavity preparation was done. All the canals were instrumented and irrigated thoroughly. They were divided into five groups: A, B, C, D, and E (n=20), i.e., the control group, gray mineral trioxide aggregate (MTA), white MTA, Biodentine, and calcium hydroxide. Each group was further subdivided into two subgroups (n=10), where one subgroup was prepared with normal saline and the other was prepared with platelet-rich fibrin (PRF). Digital photographs were taken at baseline, immediately after the placement of biomaterials, after 72 hours, seven days, and sixmonths, using a DSLR camera. The color evaluation was done using the Adobe Photoshop 2021 software using the CIE L*a*b color system. The data obtained were recorded and statistically analyzed using IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York). Continuous variables were analyzed using a one-way ANOVA test and post-hoc analysis. The P-value was set to be significant at <0.05. Statistically significant variation was obtained in all four experimental groups regarding change in color (ΔE) over periods of 72 hours, seven days, and six months. At six months, all the experimental groups presented with a perceptible color variation (ΔE>3.3). The color change was significant after six months in all groups. Biodentine produced the least color alteration, whereas gray MTA produced the highest.

Introduction Hemiplegia is the common term used to describe a multitude of clinical problems associated with a stroke. Hemiplegic stroke accounts for 70-85% of all first strokes. Trunk stability is impaired due to hypertonia and weakness in hemiplegia. Impaired trunk control leads to gait and postural abnormalities which if left untreated causes permanent disability in hemiplegics. Objective To investigate the scope of research on the benefits of explicit training using Neurodevelopmental Therapy (NDT) for enhancing tone and postural control in subjects with hemiplegic stroke. Methods In order to adhere to established protocols of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, the systematic review will be carried out to find pertinent studies published up to the search date, and a thorough search strategy will be applied across popular electronic databases including PubMed/Medline, Scopus, and Cochrane Library. This systematic review methodology has been registered in PROSPERO for rigorous and transparent dissemination of study search, synthesis, and analysis. Discussion As the motor impairments due to abnormal tone and postural impairment in hemiplegic stroke substantially impact a stroke survivor’s quality of life, this study will provide a thorough and methodical approach to synthesize and report the merits and demerits on the effectiveness of NDT in enhancing tone and postural control, considering the potential variability in interventions and outcomes, and the methodological rigor of particular studies. The review also intends to provide significant insights for clinicians, researchers, and policymakers by critically analysing and summarizing the present state of research in this domain. This will facilitate evidence-based decision-making in rehabilitation techniques for patients with hemiplegic stroke. Systematic Review Registration number CRD42023476137

The most common cause of visual impairment globally is refractive error. The prevalence of refractive error has been on the rise since the coronavirus disease 2019 (COVID-19) pandemic, possibly due to increased indoor activities and excessive use of electronic devices. Impaired vision during childhood can affect the overall development of a child adversely, and it often remains unreported due to the inability of children to complain about impaired vision. The main aim of this study was to assess the prevalence of refractive errors among school-going children in urban and rural areas. This was a cross-sectional study that included 2024 children going to schools situated in urban and rural areas. All study subjects were tested for visual acuity for distance using Snellen's chart with and without glasses after taking a brief history regarding visual complaints. All children who had visual acuity less than 6/6 on Snellen's chart underwent refraction check-ups. Retinoscopy was performed in all study subjects. Analysis of the collected data was done using SPSS for Windows, Version 16.0 (Released 2007; SPSS Inc., Chicago, United States). The analysis of numerical data was done by an unpaired t-test, and the analysis of categorical data was done by a chi-square test. A P-value of less than 0.05 was considered statistically significant. The mean age of the children was 10.92 ± 2.73 years, with 10.93 ± 2.73 years in urban and 10.91 ± 2.73 years in rural groups. Females (n=1031; 50.93%) were more in number than males (n=993; 49.06%). The overall prevalence of refractive error was 17.43%. The prevalence was higher in urban areas (22.14%) than in rural areas (12.71%). The age group below 10 years comprised 886 (43.77%) study subjects, and 218 (62.1%) children with refractive error had no ocular complaints. The most common refractive error found in this study was simple myopia in both groups, and the least common was astigmatism. The prevalence of uncorrected refractive error was higher in urban school-going children as compared to rural children. Theprevalence of refractive error was 17.43% in our study. The prevalence was highin urban areas (22.67%) as compared to rural areas (13.12%). Regular screening of school-going children for refractive errors should be done. Also, awareness regarding the use of electronic gadgets must be raised, especially among urban children.

Studies that have methodically compiled the body of research on the competency-based medical education (CBME) assessment procedure and pinpointed knowledge gaps about the structure of the assessment process are few. Thus, the goals of the study were to create a model assessment framework for competency-based medical education that would be applicable in the Indian setting as well as to thoroughly examine the competency-based medical education assessment framework. PubMed, MEDLINE (Ovid), EMBASE (Ovid), Scopus, Web of Science, and Google Scholar were the databases that were searched. The search parameters were restricted to English language publications about competency-based education and assessment methods, which were published between January 2006 and December 2020. A descriptive overview of the included research (in tabular form) served as the foundation for the data synthesis. Databases provided 732 records; out of which 36 fulfilled the inclusion and exclusion criteria. Thirty-six studies comprised a mix of randomized controlled trials, focus group interviews, and questionnaire studies, including cross-sectional studies, qualitative studies (03), mixed-method studies, etc. The papers were published in 10 different journals. The greatest number was published in BMC Medical Education (18). The average quality score for included studies was 62.53% (range: 35.71-83.33%). Most authors are from the UK (07), followed by the USA (05). The included studies were grouped into seven categories based on their dominant focus: moving away from a behavioristic approach to a constructive approach of assessment (01 studies), formative assessment (FA) and feedback (10 studies), the hurdles in the implementation of feedback (04 studies), utilization of computer or online based formative test with automated feedback (05 studies), video feedback (02 studies), e-learning platforms for formative assessment (04 studies), studies related to workplace-based assessment (WBA)/mini-clinical evaluation exercise (mini-CEX)/direct observation of procedural skills (DOPS) (10 studies). Various constructivist techniques, such as concept maps, portfolios, and rubrics, can be used for assessments. Self-regulated learning, peer feedback, online formative assessment, an online computer-based formative test with automated feedback, the use of a computerized web-based objective structured clinical examination (OSCE) evaluation system, and the use of narrative feedback instead of numerical scores in mini-CEX are all ways to increase student involvement in the design and implementation of the formative assessment.

A comparative study to assess the knowledge regarding the prevention of swine flu among the urban and rural high school children at selected schools,Bangalore,with a view to develop a self-instructional module.Objectives:To assess the existing knowledge regarding prevention of swine flu among urban and rural high school children.To compare the level of knowledge on prevention of swine flu among rural and urban high school children and To find out to the association between level of knowledge regarding prevention of swine flu with their selected demographic variables. Material And Method: The descriptive comparative design was selected to assess the knowledge on prevention of swine flu among 100 high school students (50 urban and 50 rural). The tool used for data collection was structured questionnaire. Collected data was analysed by using descriptive and inferential statistics in terms of frequencies, percentage, mean, standard deviation, t-test and chi-square. Results: The majority of the students 87(87%) had inadequate knowledge and very few students 13(13%) had moderate knowledge, none had adequate knowledge regarding prevention of swine flu.The calculated "t" value is found to be significantly difference in the knowledge score of urban and rural high school children.The demographic variables educational status, area of residence,education of father and previous knowledge are significantly associated with knowledge scores of urban high schools' children. Conclusion: The knowledge of the swine flu should be imparted through information guidelines, as their level of understanding is quite good, so the investigator felt that school children should have awareness regarding cause, symptoms and preventive strategies through health education.

The word language appears in just one place in the American Council on Education (ACE) Comprehensive Framework for Internationalization—the study of foreign languages is included as a core component of the undergraduate curriculum, along with areas such as regional and global studies. Although not stated explicitly, the term foreign languages in this framework (and in popular U.S. discourse more broadly) refers to languages other than English. This framing of languages other than English as “foreign” and the absence of any mention of languages in areas other than curriculum in the ACE framework reveals an implicit monolingual English bias that is based on two faulty assumptions. The first assumption is that domestic undergraduate student body of U.S. institutions of higher education (IHEs) is comprised solely of monolingual English speakers. The second assumption is that languages other than English are not relevant for other aspects of institutional internationalization. For U.S. IHEs to meet the goal of the ACE framework to promote “internationalization that is anti-colonial, anti-racist, and globally and locally inclusive,” they must move from a “monolingual mindset” (Clyne, 2008) to both provide opportunities for additional language learning for all students and recognize and further promote the existing linguistic diversity within IHEs and in all aspects of institutional internationalization. This chapter offers two case studies from the UW Language Institute. The first focuses on the Wisconsin Language Roadmap, a federally funded, crosssector initiative that developed a set of policy recommendations for the educational sector to meet the state’s future multilingual workforce and community needs. The second describes a campus-wide project to increase awareness of existing linguistic diversity in the university. Through these efforts, the Language Institute aims to contribute to anti-colonial, anti-racist, and inclusive approaches to comprehensive institutional internationalization at UW-Madison.