Tag: pubmed

Women Birth. 2023 Jul 7:S1871-5192(23)00100-2. doi: 10.1016/j.wombi.2023.06.007. Online ahead of print.

ABSTRACT

PROBLEM: There is limited data regarding dose and duration of nitrous oxide use by women in peripartum care. Experiences of using nitrous in Australian settings have not previously been explored BACKGROUND: More than 1:2 women use nitrous oxide analgesia during labour and birth, despite this, there are limited published data on nitrous oxide use for labour or procedural analgesia in Australia.

AIM: To explore the use of nitrous oxide during labour and birth or procedural care.

METHODS: A two-phased sequential design was used; clinical audit (n = 183) and cross-sectional survey (n = 137) approaches supported data collection. Quantitative data were analysed using descriptive and inferential statistics, qualitative data underwent content analysis.

FINDINGS: Nitrous oxide was used by primiparous and multiparous women evenly. Duration of labour-use ranged from < 15 min (10.9%) to > 5 h (10.8%), with equal representation between > 50% concentration (43%) and < 50% (43%). At audit, 75% found nitrous useful; postpartum maternal satisfaction scores remained high, mean indicators were 75%. More multiparous women found nitrous oxide useful than primiparous (95%vs80%,p = 0.009). There was no association between perceived usefulness and whether women were in spontaneous, augmented or induced labour; regardless of concentrations reached. Three key themes described women’s perspectives of physical and psycho-emotional effects and challenges.

DISCUSSION: Nitrous oxide plays an important role in the provision of analgesia during procedural or labour and birth care. Service provision, parent and professional education, and future service design will benefit from these novel findings confirming the utility and acceptability of nitrous oxide use in contemporary maternity care.

PMID:37423802 | DOI:10.1016/j.wombi.2023.06.007

Vaccine. 2023 Jul 7:S0264-410X(23)00809-5. doi: 10.1016/j.vaccine.2023.07.006. Online ahead of print.

ABSTRACT

INTRODUCTION: The purpose of this study is to examine relationships between COVID-19 vaccination, social processes, and the practical issues of healthcare coverage and workplace requirements. We examine these relationships among individuals who expressed some degree of hesitancy towards receiving the vaccine. Assessing relationships between COVID-19 vaccination, social processes, and practical issues among vaccine-hesitant individuals has implications for public health policy and intervention.

METHODS: We analyzed weighted data from a random sample phone survey of Arkansas adults (N = 2,201) between March 1st and March 28th, 2022 and constrained our analytical sample to those who had reported some degree of vaccine hesitancy (N = 1,251). Statistical analyses included weighted and unweighted descriptive statistics, weighted bivariate logistic regressions, and a weighted multivariate logistic regression to obtain adjusted odds ratios for COVID-19 vaccination.

RESULTS: More than two-thirds (62.5 %) of respondents were vaccinated, despite their hesitancy. Adjusted odds of COVID-19 vaccination were greater among Black (OR = 2.55; 95 % CI[1.63, 3.97]) and Hispanic respondents (OR = 2.46; 95 % CI[1.53, 3.95]), respondents whose healthcare provider recommended vaccination (OR = 2.50; 95 % CI[1.66, 3.77]), and as perceptions of vaccination coverage (OR = 2.04; 95 % CI[1.71, 2.43]) and subjective social status increased (OR = 1.10; 95 % CI[1.01, 1.19]). Adjusted odds of COVID-19 vaccination were greater among respondents with a workplace that recommended (OR = 1.96; 95 % CI[1.03, 3.72]) or required vaccination (OR = 12.62; 95 % CI[4.76, 33.45]) and among respondents who were not employed (OR = 1.82; 95 % CI[1.10, 3.01]) compared to those whose workplace did not recommend or require COVID-19 vaccination.

CONCLUSIONS: Some hesitant individuals become vaccinated despite their hesitancy-a group we refer to as “hesitant adopters.” Social processes and practical issues are important correlates of vaccination among those who are hesitant. Workplace requirements appear to be of particular importance for vaccination among hesitant individuals. Provider recommendations, norms, social status, and workplace policies may be effective points of intervention among those who express vaccine hesitancy.

PMID:37423799 | DOI:10.1016/j.vaccine.2023.07.006

J Voice. 2023 Jul 7:S0892-1997(23)00162-5. doi: 10.1016/j.jvoice.2023.05.010. Online ahead of print.

ABSTRACT

OBJECTIVE: The primary objective of this study was to assess objective voice measures in an elderly population representative of those seen in a tertiary laryngology practice, stratified by sex and presbylarynx status, and compare their measures to each other and to a cohort of young adult patients aged 40 years or less. The secondary objectives of this study were to evaluate and compare the strobovideolaryngoscopy findings across all groups and compare the voice complaints and subjective questionnaire results between the presbylarynx and non-presbylarynx groups.

METHODS: Two hundred and eighty-six adult voice patients (147 females/139 males) were included in this study and stratified into one of three groups: (1) young adults aged 40 years or less (n = 122), (2) patients over the age of 60 without presbylarynx (n = 78), and (3) patients over the age of 60 with a diagnosis of presbylarynx (n = 86). The acoustic analysis included fundamental frequency (F₀), voice intensity, standard deviation of the fundamental frequency (SDFF), jitter (Jitt), relative average perturbation (RAP), shimmer (Shim), noise-to-harmonic ratio (NHR), and others. The aerodynamic and pulmonary assessment included maximum phonation time (MPT), S/Z ratio, mean flow rate (MFR), forced expiratory volume in 1 second (FEV₁), and maximal mid-expiratory flow (FEF_25-75). Coexisting vocal fold conditions and pathologies were also characterized and compared. Statistical analysis was performed using SPSS 28.0.0.0 (IBM, Armonk, NY). All tests were performed in two-tailed, and a P value of less than 0.05 was considered statistically significant.

RESULTS: Assessment of vocal fold features revealed a significantly higher prevalence of benign vocal fold lesions in the young adult group for males and females compared to both elderly groups but significantly lower prevalence of vocal fold edema only in young adult females compared to the elderly female groups. Among males, young adults differed significantly from both elderly groups with regard to SDFF, Shim, FEV₁, and FEF_25-75. However, Jitt and RAP only differed significantly between the young adult and presbylarynx groups. Among females, young adults differed significantly from both elderly groups for F₀, SDFF, Jitt, RAP, NHR, CPP, MFR, FEV₁, and FEF_25-75. However, the non-presbylarynx group had a significantly lower S/Z ratio than the young adult and presbylarynx groups. A comparison of voice complaints between elderly groups revealed breathiness to be significantly more common in the presbylarynx group compared to the non-presbylarynx group, but no other significant differences were found in voice complaints or questionnaire scores.

CONCLUSION: When interpreting objective voice measures, it is critical to consider differences in vocal fold features alongside age-related changes. In addition, sex-related differences in anatomy and the aging process may explain discrepancies in significant findings between young adults and elderly patients stratified by presbylarynx status. However, presbylarynx status alone appears insufficient to generate significant differences in most objective voice measures among the elderly. Yet, presbylarynx status may be sufficient to generate differences in perceptual voice symptoms.

PMID:37423795 | DOI:10.1016/j.jvoice.2023.05.010

J Voice. 2023 Jul 7:S0892-1997(23)00156-X. doi: 10.1016/j.jvoice.2023.05.004. Online ahead of print.

ABSTRACT

OBJECTIVES/HYPOTHESIS: Recent investigations into the behavior of aerosolized emissions from the oral cavity have shown that particulate emissions do indeed occur during speech. To date, there is little information about the relative contribution of different speech sounds in producing particle emissions in a free field. This study compares airborne aerosol generation in participants producing isolated speech sounds: fricative consonants, plosive consonants, and vowel sounds.

STUDY DESIGN: Prospective, reversal experimental design, where each participant served as their own control and all participants were exposed to all stimuli.

METHODS: While participants produced isolated speech tasks, a planar beam of laser light, a high-speed camera, and image software calculated the number of particulates detected over time. This study compared airborne aerosols emitted by human participants at a distance of 2.54 cm between the laser sheet and the mouth.

RESULTS: Statistically significant increases in particulate count over ambient dust distribution for all speech sounds. When collapsed across loudness levels, emitted particles in vowel sounds were statistically greater than consonants, suggesting that mouth opening, as opposed to the place of vocal tract constriction or manner of sound production, might also be influential in the degree to which particulates become aerosolized during speech.

CONCLUSIONS: The results of this research will inform boundary conditions for computational models of aerosolized particulates during speech.

PMID:37423794 | DOI:10.1016/j.jvoice.2023.05.004

Prim Care Diabetes. 2023 Jul 7:S1751-9918(23)00112-2. doi: 10.1016/j.pcd.2023.06.009. Online ahead of print.

ABSTRACT

OBJECTIVE: In the study, it was aimed to evaluate the relationship between health literacy and successful aging in elderly individuals with type 2 diabetes.

METHODS: This descriptive study was conducted with the participation of 415 elderly patients with type 2 diabetes who presented to the diabetics outpatient clinic between April-September 2021. The study data were collected through Identifying Information Form, Health Literacy Scale, and Successful Aging Scale. In the analysis of the data, descriptive statistics, Pearson correlation analysis, One-Way ANOVA, and student’s t test were used.

RESULTS: Health Literacy Scale total mean score of the elderly individuals was found as 55.50 ± 6.08, and their Successful Aging Scale total mean score was determined to be 38.91 ± 2.05. A positive correlation was found between Health Literacy Scale total mean score and Successful Aging Scale total mean score, while a negative relationship was determined between Successful Aging Scale mean score and HbA1c values (p < 0.001).

CONCLUSION: As a result of the study, it was concluded that elderly patients with type 2 diabetes who had high levels of health literacy had high levels of successful aging as well.

PMID:37423783 | DOI:10.1016/j.pcd.2023.06.009

Musculoskelet Sci Pract. 2023 Jul 5;66:102819. doi: 10.1016/j.msksp.2023.102819. Online ahead of print.

ABSTRACT

BACKGROUND: Smartphone use may lead to alterations in spinal kinematics and musculoskeletal discomfort.

OBJECTIVES: The aim of this study was to evaluate the effect of smartphone use on spinal kinematics, and to examine the relationship between smartphone addiction, spinal discomfort, and gait parameters.

DESIGN: Cross-Sectional Study.

METHODS: The study included 42 healthy adults aged 18-30 years. A photographic method was used for spinal kinematic evaluation in sitting, standing and at the end of a 3-min walk. GAITRite electronic walkway was used for spatiotemporal gait parameters. Smartphone addiction was evaluated with the Smartphone Addiction Scale – Short Version (SAS-SV). The Cornell Musculoskeletal System Discomfort Questionnaire (CMDQ) was used to evaluate feelings of discomfort and pain.

RESULTS: There was an increase in head, cervical, and thoracic flexion angles while sitting, standing, and at the end of a 3-min walk. Similarly, an increase in thoracolumbar and lumbar flexion angles was observed only in the sitting position (p < 0.05). While using a smartphone during walking, cadence, walking speed, step length decreased, while step duration and double support duration increased (p < 0.05). A statistically significant correlation was determined between the SAS-SV and CMDQ scores (p < 0.05).

CONCLUSION: The study showed that smartphone use has an impact on spinal kinematics during sitting, standing and at the end of a 3 min-walk, as well as on the spatiotemporal parameters of gait. This study suggest that smartphone addiction should be taken into consideration due to its potential to cause musculoskeletal discomfort and there may be a need to raise public awareness on this matter.

PMID:37422953 | DOI:10.1016/j.msksp.2023.102819

Patient Educ Couns. 2023 Jun 25;115:107862. doi: 10.1016/j.pec.2023.107862. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore patients’ usage rate and perceived usefulness and benefits of a question prompt list (QPL) when collecting prescribed medication in community pharmacies.

METHODS: Data were collected in Swedish pharmacies using questionnaires and semi-structured interviews with patients. The Technology Acceptance Model (TAM) was used, and the outcomes were usage rate, factors impacting on use, and perceived ease of use, usefulness, and benefits of self-reported question-asking and self-perceived medication knowledge. Descriptive statistics and group comparisons were performed, and qualitative data were analyzed thematically with the TAM.

RESULTS: Out of 145 patients filling out the questionnaire, 72 (50.0%) reported they had used the QPL. Patients with new prescriptions and non-native Swedish speakers used the QPL more often (p = 0.03; p = 0.009, respectively). The QPL was quick to read (86.3%) and easy to understand (91.4%). Forty percent stated that they asked more questions, and self-reported users scored higher on self-perceived medication knowledge. In the interviews (n = 14), the QPL was described as an eye-opener as to what one could ask the pharmacist.

CONCLUSIONS: Patients were willing to use a QPL in community pharmacies.

PRACTICE IMPLICATIONS: A QPL in pharmacies might improve patients’ engagement medication knowledge, as well as showcase the expertise of pharmacists.

PMID:37422951 | DOI:10.1016/j.pec.2023.107862

J Electrocardiol. 2023 Jun 22;80:155-161. doi: 10.1016/j.jelectrocard.2023.06.006. Online ahead of print.

ABSTRACT

INTRODUCTION: Past research based on observations has suggested that the gut microbiome (GM) could play a role in developing arrhythmias and conduction blocks. Nonetheless, the nature of this association remains uncertain due to the potential for reverse causation and confounding factors in observational research. The aim of this investigation is to elucidate the causal relationship between GM and the development of arrhythmias as well as conduction blocks.

METHODS: This study collected summary statistics regarding GM, arrhythmias, and conduction blocks. Two-sample Mendelian randomization (MR) analysis was carried out employing various methods, with inverse variance weighted being the primary approach, followed by weighted median, simple mode, MR-Egger, and MR-PRESSO. Moreover, the MR findings were corroborated through multiple sensitivity analyses.

RESULTS: Among them, for atrial fibrillation and flutter (AF), phylum_Actinobacteria and genus_RuminococcaceaeUCG004 demonstrated a negative correlation, while order_Pasteurellales, family_Pasteurellaceae, and genus_Turicibacter were associated with an increased risk. In the case of paroxysmal tachycardia (PT), genus_Holdemania and genus_Roseburia were found to reduce risk. For atrioventricular block (AVB), order_Bifidobacteriales, family_Bifidobacteriaceae, and genus_Alistipes exhibited a negative correlation, whereas genus_CandidatusSoleaferrea showed a positive correlation. Concerning the left bundle-branch block (LBBB), family_Peptococcaceae appeared to decrease the risk, while genus_Flavonifractor was linked to an increased risk. Lastly, no causative GM was identified in the right bundle-branch block (RBBB) context.

CONCLUSION: We have uncovered potential causal links between some GM, arrhythmias, and conduction blocks. This insight may aid in designing microbiome-based interventions for these conditions and their risk factors in future trials. Additionally, it could facilitate the discovery of novel biomarkers for targeted prevention strategies.

PMID:37422943 | DOI:10.1016/j.jelectrocard.2023.06.006

Epilepsy Behav. 2023 Jul 7;145:109332. doi: 10.1016/j.yebeh.2023.109332. Online ahead of print.

ABSTRACT

PURPOSE: Stereotactic laser amygdalohippocampotomy (SLAH) is a minimally invasive surgical treatment for drug-resistant temporal lobe epilepsy (TLE) that has comparable rates of seizure freedom to traditional open resective TLE surgery. The objective of this study was to determine psychiatric outcome (i.e., depression and anxiety changes, psychosis) after SLAH, to explore possible contributory factors to these changes, and to determine the prevalence of de novo psychopathology.

METHODS: We explored mood and anxiety in 37 adult patients with TLE undergoing SLAH using the Beck psychiatric symptoms scales (i.e., Beck Depression Inventory-II [BDI-II] and Beck Anxiety Inventory [BAI]) preoperatively and 6 months following surgery. Multivariable regression analysis was conducted to identify predictors of worse depression or anxiety symptoms following SLAH. The prevalence of de novo psychopathology following SLAH was also determined.

RESULTS: We found a significant decrease in BDI-II (mean decline from 16.3 to 10.9, p = 0.004) and BAI (mean decline from 13.3 to 9.0, p = 0.045) scores following SLAH at the group level. While the rate of resolution of depression (from 62% to 49%) did not achieve statistical significance (p = 0.13, McNemar’s), the rate of resolution of anxiety (from 57% to 35%) was statistically significant (p = 0.03, McNemar’s). The de novo rate of psychopathology (i.e., new onset depression or anxiety) following SLAH was 1 of 7 (14%). Using a metric of meaningful change rather than complete symptom resolution, 16 of 37 (43%) patients experienced improvement in depression and 6 of 37 (16%) experienced worsening. For anxiety, 14 of 37 (38%) experienced meaningful improvement and 8 of 37 (22%) experienced worsening. Baseline performance on the Beck Scales was the only factor contributing to outcome status.

DISCUSSION: In one of the first studies to evaluate psychiatric outcomes after SLAH, we found promising overall trends toward stability or significant improvement in symptom burden at the group level for both depression and anxiety. There was also a significant improvement in clinical anxiety, though the decrease in clinical depression was not significant, likely owing to the limitations of sample size. SLAH may improve overall psychiatric symptoms, similarly to traditional resective TLE surgery, but de novo psychopathology and postoperative psychiatric morbidity remain significant issues, and larger samples are necessary to determine causal contributory factors.

PMID:37422933 | DOI:10.1016/j.yebeh.2023.109332

ALTEX. 2023 Jun 27. doi: 10.14573/altex.2210171. Online ahead of print.

ABSTRACT

In chemical safety assessment, benchmark concentrations (BMC) and their associated uncertainty are needed for the toxicological evaluation of in vitro data sets. A BMC estimation is derived from concentration-response modelling and results from various statistical decisions, which depend on factors such as experimental design and assay endpoint features. In current data practice, the experimenter is often responsible for the data analysis and therefore relies on statistical software often without being aware of the software default settings and how they can impact the outputs of data analysis. To provide more insight into how statistical decision-making can influence the outcomes of data analysis and interpretation, we have developed an automatic platform that includes statistical methods for BMC estimation, a novel endpoint-specific hazard classification system, and routines that flag data sets that are outside the applicability domain for an automatic data evaluation. We used case studies on a large dataset produced by a developmental neurotoxicity (DNT) in vitro battery (DNT IVB). Here we focused on the BMC and its confidence interval (CI) estimation as well as on final hazard classification. We identified five crucial statistical decisions the experimenter must make during data analysis: choice of replicate averaging, response data normalization, regression modelling, BMC and CI estimation, and choice of benchmark response levels. The insights gained in are intended to raise more awareness among experimenters on the importance of statistical decisions and methods but also to demonstrate how important fit-for-purpose, internationally harmonized and accepted data evaluation and analysis procedures are for objective hazard classification.

PMID:37422925 | DOI:10.14573/altex.2210171