Feasibility of Chest Wall and Diaphragm Proprioceptive Neuromuscular Facilitation (PNF) Techniques in Mechanically Ventilated Patients

Physical therapy is part of the treatment for patients admitted to ICU. Proprioceptive neuromuscular facilitation (PNF) is one of the physiotherapy concepts including manual techniques and verbal stimulation. The purpose of this paper is to examine the feasibility of PNF techniques in mechanically ventilated (MV) ICU patients. Another aim is to verify whether the technique using resistance during the patient’s inhalation will have a different effect than the technique used to teaching the correct breathing patterns. Methods: Patients admitted to tertiary ICU were enrolled in this study, randomly divided into two groups, and received four 90-second manual breathing stimulations each. The following vital signs were assessed: HR, SBP, DBP, and SpO2. Results: 61 MV ICU adult patients (mean age 67.8; 25 female and 36 male) were enrolled in this study. No significant differences in HR, SBP, and DBP were observed both for two techniques measured separately and between them. Statistically significant differences were noticed analysing SpO2 in the rhythmic initiation technique (RIT) group (p-value = 0.013). Conclusions: Short-term PNF interventions did not influence clinically relevant vital parameters among MV patients and seem to be feasible in this group of ICU patients.

Child Development Knowledge and Father Engagement: The Mediating Role of Parenting Self-efficacy

Early father engagement is associated with numerous positive child outcomes including cognitive development, emotional regulation, and fewer problem behaviors. Various fathering programs attempt to encourage father engagement through teaching fathers about young children’s development and needs. This study examined 181 low-income fathers’ child development knowledge (self-perceived and objective) as predictors of father engagement (verbal stimulation, caregiving, and physical play) with infants. Additionally, parenting self-efficacy (PSE) was examined as a mediator. Results revealed that fathers’ self-perceived child development knowledge positively predicted engagement with infants (verbal stimulation and caregiving), but objective knowledge did not. PSE did not mediate the relationship between self-perceived knowledge and father engagement. These findings yield important implications for fathering research and interventions, suggesting that it may be particularly beneficial to increase fathers’ confidence in their ability to understand and meet their child’s needs rather than exclusively focusing on improving fathers’ knowledge of child development.

Pembinaan Teknik Berpidato dalam Meningkatkan Kreatifitas Santri

The mission of Da'wah in Islamic educational institutions such as the Al-Qur'an Education Park demands the supply of learners to have adequate verbal communication skills. Verbal stimulation is necessary to provide an understanding of the importance of reactualization of speech ability in order to ensure the success of Da'wah. In the context of the Qur'an Education Park requires assistance in obtaining an integral stakeholder empowerment vehicle. Through the approach of assets and resources mentoring speech exercises as a verbal stimulation in the education Park Al-Qur'an at-Taqwa Sumberejo Lengkong Nganjuk produces the ability to empower assets and potential managers and key figures. Performance can be fulfilled because it is supported by the effectiveness of social sales, planning with partner devotion, implementation of programs involving assets and potential and role of key figures in the control function.

Effects of Physical Exercises and Verbal Stimulation on the Functional Efficiency and Use of Free Time in an Older Population under Institutional Care: A Randomized Controlled Trial

Older people in institutional care are, for the most part, physically inactive and do not interact with each other or medical staff. Therefore, reducing sedentary behaviour is a new, important, and modifiable lifestyle variable that can improve the health of elderly people. The aim of the project was to assess the degree of improvement in functional performance and the possibility of changing habitual, free time behaviour among elderly people under institutional care by applying physical training with verbal stimulation. The study covered older people, aged 65–85 years, who are living a sedentary lifestyle in care homes in Southeastern Poland. Those who met the eligibility criteria were enrolled in the study and were assigned, at random, to one of four parallel groups: basic exercises (n = 51), basic exercises combined with verbal stimulation (n = 51), functional exercise training (n = 51), and functional exercise training with verbal stimulation (n = 51). No statistically significant differences in baseline characteristics were observed across the groups. Data were collected at baseline and at 12 and 24-weeks following the completion of the intervention. In the group with functional exercise training with verbal stimulation, in comparison to the group with basic exercises, the greatest positive short-term impact of intervention was demonstrated in terms of functional fitness (increased by 1.31 points; 95% confidence interval (CI) = 0.93–1.70), gait speed (improved by 0.17 m/s, 95% CI = 0.13–0.22), hand grip strength (by over 4 kg; 95% CI = 2.51–4.95), and upper-limb flexibility (by 10 cm; 95% CI = 5.82–12.65). There was also a significant increase in the level of free-time physical activity and an improvement in the quality of life, especially as expressed in the domain of overall physical functioning. Our study showed that a functional exercise program, combined with verbal stimulation, is effective at improving physical fitness and raising the level of free-time physical activity.

Verbal Memory in Late-life Depressions and Normal Ageing

In the present article, authors analyze characteristics of verbal memory in late-life depressions and normal ageing. During last decades, the increase of frequency of affective disorders in depression spectrum in late age attracts attention of specialists. Memory is one of the most sensitive functions in late-life depressions. The maingoal of this research is to estimate verbal memory of senior patients with depression and normal persons. Two groups of participants, consisting of 197 patients with depressions of Scientific Center of Mental Health (Moscow) and 100 mentally healthy people participated in this research. Control and clinical groups were comparable by socio-demographical parameters. The results of two methods were interpreted: (1) memorization and delayed reproduction of five words; (2) naming of five sharp objects. In first method, the volume of first reproduction (FR), the number of material presentations required for memorization (N) and the volume of delayed reproduction (DR) were examined. In addition, the frequency of occurrence of various types of errors such as omissions, inert repetitions, impairments of order and of selectivity was estimated. In the second method were examined: presence of pauses, necessity of psychological assistance, such as verbal stimulation or clarification of the semantic field. Statistical analysis was made using SPSS Statistics and Microsoft office Excel 2007. The research results showed that patients with depression deal with offeredmethods worse than mentally healthy people do. In memorization of five words, volumes of FR and DR were lower and patients needed more repetitions to memorize. When analyzing age dynamic, negative changes in verbal memory were more evident in clinical group. When naming of five sharp objects, patients with depression made more pauses and needed more frequently clarification of semantic field or verbal stimulation. Keywords: verbal memory, normal ageing, late-life depressions, neuropsychology

HUBUNGAN TINGKAT PENGETAHUAN ORANGTUA TENTANG STIMULASI VERBAL DENGAN PERKEMBANGAN BAHASA PADA ANAK USIA DINI DI TK YAYASAN BHAKTI SIWI DESA SORAN KABUPATEN KLATEN

Background : children who experience language disorders in preschool 40% to 60% willhave learning difficulties in writing and academic subjects. Information from one of theparents of students in kindergarten Yayasan Bhakti Siwi Soran village during the2016/2017 school year in which students in the kindergarten were 32 students, 9 ofthem have not been able to use words that are obvious in everyday communication,some parents provide stimulation to train their children to talk, some parents motivatefor daring to express their opinions, but there are also parents not know how tostimulate children who have a language disorder.Purpose of the study: to determine the relationship of the level of parental knowledgeabout verbal stimulation with language development in early children at the TK YayasanBhakti Siwi Soran village.Methods : the research design correlation with cross sectional approach. Subject were32 student with mother. Data obtained by questionaire to determine level of parentalknowledge with language development. Data analyzed with Chi Square test p=0.05.Results : based on the test results of the bivariate analysis using Chi-Square with α =5% (0.05) was obtained p <0.001 to p <0.05, which means the hypothesis is accepted.Conclusion : there is the correlation between parental knowledge about verbalstimulation with language development in children.Keywords: Knowledge, Verbal Stimulation, Language Development

Learning by Playing: Echo and Tact in Expanding the Verbal Repertoire of Infants

To refer to an object or event by providing its corresponding name is an important acquisition in the learning of verbal behavior. The relationship between the spoken name and its referent, called tact, is considered essential in the expansion of verbal repertoires in children. This study aimed to teach tact to four institutionalized children, aged between 26 and 29 months, with reduced exposure to verbal stimulation. The procedure introduced playful characteristics into the teaching of tact and the required repertoire, which was the emission of echoic responses, through procedures typically used to teach verbal repertoire for children with language delay. All children learned to tact (and echo). The procedure was effective in increasing the echoic repertoire and promoting the acquisition of the tact repertoire. These results confirm the literature that considers learning echoic repertoire to be a requirement for the acquisition of tact.

The use of dexmedetomidine in intensive care sedation

The goals and recommendations for ICU (Intensive Care Unit) patients’ sedation and analgesia should be to have adequately sedated patients who are calm and arousal, so that they can guarantee a proper evaluation and an adequate control of pain. This way, it is also possible to perform their neurological evaluation, preserving intellectual faculties and helping them in actively participating to their care. Dexmedetomidine is a selective alpha-2 receptor agonist, member of theraputical cathegory: “other hypnotics and sedatives” (ATC: N05CM18). Dexmedetomidine is recommended for the sedation of adult ICU patients who need a sedation level not deeper than arousal in response to verbal stimulation (corresponding to Richmond Agitation-Sedation Scale 0 to -3). After the EMA approval, some European government authorities have elaborated HTA on dexmedetomidine, based on clinical evidence derived from Prodex and Midex trials. Dexmedetomidine resulted to be as effective as propofol and midazolam in maintaining the target depth of sedation in ICU patients. The mean duration of mechanical ventilation with dexmedetomidine was numerically shorter than with propofol and significantly shorter than with midazolam. The resulting favourable economic profile of dexmedetomidine supported the clinical use in ICU. Dexmedetomidine seems to provide clinical benefits due to the reduction of mechanical ventilation and ventilator weaning duration. Within the present review, an economic analysis of costs associated to the use of dexmedetomidine was therefore performed also in the Italian care setting. Thus, four different analyses were carried out based on the quantification of the total number of days in ICU, the time spent on mechanical ventilation, the weighted average number of days with mechanical ventilation or not and TISS points (Therapeutic Intervention Scoring System). Despite the incremental cost for drug therapy associated with dexmedetomidine, a reduction of the management costs for ICU has been estimated, with savings ranging between € 800 and € 1,400 per patient.