The Effect of Early versus Traditional Hospital Discharge on Activities of Daily Living for Women Undergoing Elective Cesarean Section. An Observational Cohort Study

Background: Cesarean section is one of the most common surgeries performed worldwide and its consequences and complications represent a major public health concern. The policy of enhanced recovery after surgery has been implemented after cesarean section to optimize perioperative care. Enhanced recovery also aims to reduce the length of hospital stay, which might imply substantial healthcare savings. Rising hospital costs are one of the factors in early discharge. Patients & Methods: This was a prospective cohort study. 158 patients met the inclusion criteria of the study, 81 patients were discharged after 48 hours and 77 patients were discharged after 24 hours. All patients received the same postoperative care and instructions. All the study participants received a phone call 1, 3, and 5 days after discharge to objectively assess the activities of daily living through Katz index of independence in activities of daily living. All patients were offered a postpartum visit 1 week after discharge during which the wound was assessed by the Southampton wound assessment scale. Moreover, other maternal complications such as mastitis, puerperal sepsis, or pyelonephritis were assessed and cases who were readmitted were documented. Initiation of successful breastfeeding and neonatal readmission were reported as well. Results: 158 patients met the inclusion/exclusion criteria of the study. There was no significant difference between the two arms of the study regarding baseline characteristics. Katz index of independence showed that the resumption of activities of daily living after CS was similar in both arms of the study on days 1, 3 and 5 after discharge. Time till the passage of flatus and stool after the cesarean section was significantly shorter among the early discharge arm (9.31 VS 14.68, p value < 0.001 & 13.25 VS 24.82, p value < 0.001 respectively). Maternal readmission was not significantly higher among the early discharge arm and at the 1-week postpartum visit, objective wound assessment by Southampton wound scoring assessment was made and there was no significant difference between the two arms of the study. Initiation of successful breastfeeding, and neonatal readmission were similar in both groups. Conclusion: The policy of early discharge can be adopted in low-risk cases scheduled for elective uncomplicated CS provided that the mother and the neonate are in good general condition and proper instructions regarding red flag manifestations are given.

Enhancing Proficiency in Quadratic Equations and Functions Through the MILAPlus Strategy

This study investigates the efficacy of the Mathematics Independent Learning Activity Practice and Play Unite Scheme(MILAPlus)as an instructional strategy to improve the proficiency levels of Grade 9 students in quadratic equations and functions through a study carried out at Quezon National High School.The research involved 116 Grade 9 students and utilized a quantitative approach,incorporating both pre-assessment and post-assessment measures.The research utilizes a quasi-experimental design,examining the academic performance of students before and after the introduction of MILAPlus.The pre-assessment establishes a baseline,and the subsequent post-assessment measures the impact of the instructional strategy.Statistical analyses,including t-tests,assess the significance of differences in mean scores and mean percentage scores,providing quantitative insights into the effectiveness of MILAPlus.Findings from the study revealed a statistically significant improvement in both mean scores and mean percentage scores after the utilization of MILAPlus,indicating enhanced proficiency in quadratic equations and functions.The Mean Proficiency Scores(MPS)also showed a substantial increase,demonstrating a marked improvement in overall proficiency levels among Grade 9 students.In light of the results,recommendations were given including the continued utilization of MILAPlus as an instructional strategy and aligning its development with prescribed learning competencies.Emphasizing the consistent adherence to policies and guidelines for MILAPlus implementation is suggested for sustaining positive effects on students’long-term performance in mathematics.This research contributes valuable insights into the practical application and effectiveness of MILAPlus within the context of Grade 9 mathematics education at Quezon National High School.

Independent modal variable structure fuzzy active vibration control of thin plates laminated with photostrictive actuators

Photostrictive actuators can produce photodeformation strains under illumination of ultraviolet lights. They can realize non-contact micro-actuation and vibration control for elastic plate structures. Considering the switching actuation and nonlinear dynamic characteristics of photostrictive actuators, a variable structure fuzzy active control scheme is presented to control the light intensity applied to the actuators. Firstly, independent modal vibration control equations of photoelectric laminated plates are established based on modal analysis techniques. Then, the optimal light switching function is derived to increase the range of sliding modal area, and the light intensity self-adjusting fuzzy active controller is designed. Meanwhile, a continuous function is applied to replace a sign function to reduce the variable structure control （VSC） chattering. Finally, numerical simulation is carried out, and simulation results indicate that the proposed control strategy provides better performance and control effect to plate actuation and control than velocity feedback control, and suppresses vibration effectively.