Tag: pubmed

Sci Total Environ. 2022 Oct 26:159709. doi: 10.1016/j.scitotenv.2022.159709. Online ahead of print.

ABSTRACT

In recent years, there is increasing attention on the contaminants of emerging concern (CECs), which include plasticizers, flame retardants, industrial chemicals, pharmaceuticals, and personal care products, since they have been detected even far away from pollution sources. The polar regions are not exempt from the presence of anthropogenic contaminants, and they are employed as a model for understanding the pollutant fate and impact. During the 2021 spring campaign, sixteen surface snow samples were collected close to the research station of Ny-Ålesund located on the Spitsbergen Island of the Norwegian Svalbard Archipelago. The samples were extracted by solid-phase extraction and analyzed by liquid chromatography-high-resolution tandem mass spectrometry (LC-HRMS/MS) following an untargeted approach. Compound tentative identification was obtained with the aid of the software Compound Discoverer, using both mass spectral database search and manual validation. Among the 114 compounds identified with a high confidence level in the snow samples, >80 have some commercial or industrial use (drugs, plasticizers, fragrances, etc.), therefore they could be of anthropogenic origin. Nonetheless, a clear contamination trend did not appear in the snow samples collected on eight different days during one month. The comparison with aerosol samples collected in the same area did not help identifying the source, either, since only a few compounds were in common, and they were mainly of natural origin. As such, the analysis of aerosol sample did not support possible long-range transport, also considering that compounds were detected mostly in the coarse fraction.

PMID:36309265 | DOI:10.1016/j.scitotenv.2022.159709

J Pediatr Psychol. 2022 Oct 29:jsac076. doi: 10.1093/jpepsy/jsac076. Online ahead of print.

ABSTRACT

OBJECTIVES: To measure the association between psychosocial problems and persistent post-concussive symptoms (PCS) in youth who were seen in the emergency department with mild traumatic brain injury (mTBI) or orthopedic injury (OI).

METHODS: From a larger prospective cohort study, Advancing Concussion Assessment in Pediatrics (A-CAP), 122 child-guardian pairs who presented to the emergency department with mTBI (N = 70) or OI (N = 52) were recruited for this cross-sectional sub-study. Each pair completed 2 measures assessing PCS burden at 2 weeks, 3 months, and 6 months post-injury. At one visit, pairs concurrently completed MyHEARTSMAP, a comprehensive, psychosocial self-assessment tool to evaluate 4 domains of mental wellness.

RESULTS: When measured at the same visit, children who self-reported moderate or severe Psychiatry domain concerns concurrently experienced a greater burden of cognitive symptoms (β = 5.49; 0.93-10.05) and higher overall PCS count (β = 2.59; 0.70-4.48) after adjusting for covariables, including retrospective pre-injury symptoms and injury group. Additionally, reports indicating mild Function domain severity were associated with increased cognitive (β = 3.34; 95% CI: 0.69-5.99) and somatic symptoms (β = 6.79; 2.15-11.42) and total symptom count (β = 1.29; 0.18-2.39).

CONCLUSION: Increasing severity in multiple domains of mental health is associated with more PCS in youth. While the differences in PCS between the mTBI and OI groups appeared somewhat larger for children with more mental health concerns, the interaction was not statistically significant; larger sample sizes are needed to evaluate the moderating effect of psychosocial difficulties on post-concussion symptoms.

PMID:36308773 | DOI:10.1093/jpepsy/jsac076

J Pediatr Psychol. 2022 Oct 29:jsac081. doi: 10.1093/jpepsy/jsac081. Online ahead of print.

ABSTRACT

OBJECTIVE: Research suggests families whose infants are admitted to the Neonatal Intensive Care Unit (NICU) experience elevated distress and may have pre-existing risk factors for maladjustment. This study sought to validate the newly developed Psychosocial Assessment Tool (PAT-NICU/Cardiac Intensive Care Unit [CICU]), a comprehensive screening measure for family psychosocial risk in the NICU.

METHODS: The sample included 171 mothers, who completed the PAT-NICU/CICU and other related measures within 2 weeks of their infant’s NICU admission at a level 4 unit within a large pediatric hospital. PAT-NICU/CICU scores were compared to a companion risk survey completed by NICU social workers. Test-retest reliability was assessed through repeated measures at 2-month follow-up.

RESULTS: Analyses suggest the PAT-NICU/CICU is effective in classifying psychosocial risk. This is supported by statistically significant correlations between the PAT-NICU/CICU and validated measures, in addition to elevated scores on concurrent measures by risk classification. Internal consistency, test-retest reliability, and acceptability for the PAT-NICU/CICU were satisfactory.

CONCLUSIONS: This preliminary study demonstrates the validity, reliability, and acceptability of the PAT-NICU/CICU as a psychosocial screening tool to aid identification of families who may benefit from supportive services during NICU admission. This new measure is a more comprehensive tool that assesses a wide variety of risk factors and stress responses. However, future studies of this measure are needed with more diverse samples. Prompt screening of NICU parents may facilitate earlier linkage with appropriate levels of resources or intervention. This research is crucial in improving risk assessment and psychosocial care for families in the NICU.

PMID:36308772 | DOI:10.1093/jpepsy/jsac081

J Am Med Inform Assoc. 2022 Oct 29:ocac186. doi: 10.1093/jamia/ocac186. Online ahead of print.

ABSTRACT

OBJECTIVE: A hallmark of personalized medicine and nutrition is to identify effective treatment plans at the individual level. Lifestyle interventions (LIs), from diet to exercise, can have a significant effect over time, especially in the case of food intolerances and allergies. The large set of candidate interventions, make it difficult to evaluate which intervention plan would be more favorable for any given individual. In this study, we aimed to develop a method for rapid identification of favorable LIs for a given individual.

MATERIALS AND METHODS: We have developed a method, algorithmic lifestyle optimization (ALO), for rapid identification of effective LIs. At its core, a group testing algorithm identifies the effectiveness of each intervention efficiently, within the context of its pertinent group.

RESULTS: Evaluations on synthetic and real data show that ALO is robust to noise, data size, and data heterogeneity. Compared to the standard of practice techniques, such as the standard elimination diet (SED), it identifies the effective LIs 58.9%-68.4% faster when used to discover an individual’s food intolerances and allergies to 19-56 foods.

DISCUSSION: ALO achieves its superior performance by: (1) grouping multiple LIs together optimally from prior statistics, and (2) adapting the groupings of LIs from the individual’s subsequent responses. Future extensions to ALO should enable incorporating nutritional constraints.

CONCLUSION: ALO provides a new approach for the discovery of effective interventions in nutrition and medicine, leading to better intervention plans faster and with less inconvenience to the patient compared to SED.

PMID:36308771 | DOI:10.1093/jamia/ocac186

Behav Sleep Med. 2022 Oct 29:1-14. doi: 10.1080/15402002.2022.2137511. Online ahead of print.

ABSTRACT

OBJECTIVE: This study examined the longitudinal association between child sleep disturbances from ages 3 to 16 and smoking in adulthood among subjects from a French cohort study.

METHODS: Data from 2,134 subjects who participated in the French TEMPO cohort from 1991 to 2018 were used. Sleep disturbances observed from ages 3 to 16 years defined our exposure. Tobacco consumption trajectories constitute our outcomes and were ascertained by using Group-Based Trajectory Modeling, a semiparametric probabilistic method that hypothesizes the existence of distinct developmental trajectories over time within one population. The impact of SDs in childhood on adulthood’s Tobacco consumption were studied using multinomial logistic regression.

RESULTS: Sleep disturbances at 16 years or under were observed in 26.5% of participants. Five smoking trajectories were defined: “non-smokers”, “decrease in consumption at age 20 years”, “low-level tobacco use”, “smoking followed by cessation at age 30 years” and “high-level tobacco use”. No statistically significant association between sleep disturbances and smoking trajectories was found. Compared with nonsmokers, adjusted odds-ratios and 95% Confidence Intervals for each trajectory were respectively: 0.81 [0.52-1.26], 1.28 [0.74-2.22], 1.37 [0.88-2.15] and 1.01 [0.60-1.69].

CONCLUSION: These results suggest that smoking in adulthood may not be related to sleep disturbances in childhood.

PMID:36308769 | DOI:10.1080/15402002.2022.2137511

Pediatr Blood Cancer. 2022 Oct 29:e30069. doi: 10.1002/pbc.30069. Online ahead of print.

ABSTRACT

OBJECTIVE: Recent increased awareness and research studies reflect possible associations between opioid exposure and cancer outcomes. Children with neuroblastoma (NB) often require opioid treatment for pain. However, associations between tumor response to chemotherapy and opioid exposure have not been investigated in clinical settings.

METHODS: This is a single-institution retrospective review of patients with NB treated between 2013 and 2016. We evaluated opioid consumption quantified in morphine equivalent doses (mg/kg) based on nurse- or patient-controlled analgesia during antibody infusions. We also analyzed their associations with change in primary tumor volume and total tumor burden.

RESULTS: Of 42 patients given opioids for pain related to anti-disialoganglioside monoclonal antibodies (anti-GD2 mAb), data completion was achieved for 36, and details of statistical analyses were entered. Median total weight-based morphine equivalent (over 8 days) was 4.71 mg/kg (interquartile range 3.49-7.96). We found a statistically insignificant weak negative relationship between total weight-based morphine equivalents and tumor volume ratio (correlation coefficient -.0103, p-value .9525) and a statistically insignificant weak positive relationship between total weight-based morphine equivalent and Curie score ratio (correlation coefficient .1096, p-value .5247).

CONCLUSION: Our study found no statistically significant correlation between opioid consumption and natural killer (NK) cell-mediated killing of NB cells as measured by effects on tumor volume/tumor load.

PMID:36308746 | DOI:10.1002/pbc.30069

Med Teach. 2022 Oct 29:1-7. doi: 10.1080/0142159X.2022.2136518. Online ahead of print.

ABSTRACT

BACKGROUND: International data demonstrate that medical students with disabilities experience differential awarding. One cross-sectional study finds lower graduation rates and scores in written exams, with no impact on clinical exams. Disabled students graduated with lower decile scores. This quantitative, retrospective, longitudinal study explored the impact of disability on exam performance, course performance and course discontinuation.

METHOD: Anonymised data were obtained for 1743 students on a UK graduate medical programme from 2011 to present. Statistical tests, including t-tests and one-way ANOVA were conducted for main effects of demographic variables on exam results and categorical outcomes. Regression models established the effects of variables and sub-categories of variables on results and categorical outcomes.

RESULTS: Significant main effects of disability on exam scores were identified, as well as failure probability. Regressions showed significant differences in outcomes between different types of disability, with mental health conditions predicting course discontinuation. A significant amplifying effect was found for BAME students with disability.

CONCLUSION: Disability had a significant negative impact on all course outcomes, illustrating inequity in medical training and an area of focus for curriculum development. Intersectional data identified a key disadvantaged subgroup of medical students.

PMID:36308742 | DOI:10.1080/0142159X.2022.2136518

ANS Adv Nurs Sci. 2022 Oct-Dec 01;45(4):E145-E160. doi: 10.1097/ANS.0000000000000441.

ABSTRACT

An increasing number of individuals are reporting increased stress and anxiety associated with the COVID-19 pandemic. A feasibility, mixed-method design was conducted to investigate distant Reiki as a virtual healing modality within Rogers’ framework of the Science of Unitary Human Beings. Data were collected using pre- and post-distant Reiki session interviews and 2 surveys. Study findings demonstrated changes in participant pattern manifestation and statistically significant reductions in perceived stress and anxiety (P < .001). The preliminary findings support the feasibility of distant Reiki and suggest that nurses, who are Reiki practitioners, may influence the human-environmental field to foster healing.

PMID:36308730 | DOI:10.1097/ANS.0000000000000441

Med Teach. 2022 Oct 29:1-5. doi: 10.1080/0142159X.2022.2133999. Online ahead of print.

ABSTRACT

AIMS: To establish an on-call escape room as a novel educational tool for Foundation Year 1 (FY1) doctors’ induction at Epsom and St Helier University Hospitals Trust. The escape room simulates common on-call scenarios for newly qualified doctors, with a view to facilitating communication and teamwork with unfamiliar peers and establishing a safe environment to develop practical skills. Ultimately aiming to reduce anxiety and improve confidence amongst our FY1 cohort.

METHODS: A pilot escape room, as a simulated on-call shift with nine clinical scenarios, was designed for groups of 4-5 doctors. Following feedback, a 70-minute escape room with 17 clinical scenarios was established. Sequential completion of tasks would ‘unlock’ the door to handover with a senior colleague, thereby finishing the ‘shift’. Questionnaires utilised a 10-point Likert scale to assess confidence and anxiety levels with regards to on-call shifts. Statistical analysis was performed using the Student’s t-test.

RESULTS: Pilot: Nineteen participants trialled the pilot escape room. Perceived levels of confidence increased from a mean of 5.0 to 7.1 (p < 0.05).Final: Forty-one participants underwent the final version of the escape room with perceived levels of on-call confidence increasing from a mean of 4.2 to 6.5 (p < 0.05), prescribing confidence from 5.3 to 6.6 (p < 0.05), using apps from 6.3 to 7.5 (p < 0.05), consulting trust guidelines from 5.0 to 7.0 (p < 0.05) and handing over from 5.8 to 6.8 (p < 0.05). Anxiety levels also decreased from 7.2 to 6.3 (p < 0.05) with an overall mean score of 9/10 for ‘enjoyability’ of the session.

CONCLUSION: Incorporating an on-call escape room scenario into induction has demonstrably increased confidence levels and reduced anxiety levels amongst new FY1 doctors. This novel teaching method maximises participant engagement with the view to an enhanced learning experience.

PMID:36308726 | DOI:10.1080/0142159X.2022.2133999

ANZ J Surg. 2022 Oct 29. doi: 10.1111/ans.18131. Online ahead of print.

ABSTRACT

BACKGROUND: Faecal incontinence (FI) is a debilitating condition which reduces quality of life (QOL). Conservative management with education, pelvic floor exercise and pharmacological agents are first-line treatment. Following which, biofeedback therapy (BFT) is recommended. Although well described in the West, existing literature on its efficacy in Asian populations remains sparse. The primary aim of our study is to evaluate the efficacy of BFT in improvement of symptoms, QOL and overall satisfaction in our Asian population.

METHODS: Patients with moderate FI in Singapore General Hospital between 2012 and 2016 were enrolled. Rockwood FI quality of life scale (FIQL) and Wexner scale were used to evaluate QOL across four domains, and symptom severity respectively. They were scored at baseline and again after four sessions of BFT, with an additional overall satisfaction score (OSS).

RESULTS: A total of 137 patients were included. Mean age was 62 years and 72.3% were female. Majority demonstrated improvement in Wexner score (68.6%) and FIQL (65%). Sixty-five patients (47.4%) reported improvement in both. Positive correlation was found between Wexner score and OSS (r = 0.206), and Wexner score and FIQL across all four domains. Only one FIQL domain-coping/behaviour, showed statistically significant correlation with OSS (r = 0.263).

CONCLUSION: BFT is effective in our Asian population in both symptom reduction and improving QOL. Wexner score demonstrated low correlation with FIQL and OSS-suggesting that FI requires a multi-dimensional approach beyond symptom treatment, of which ability to cope appears crucial. BFT, consistent with the biopsychosocial model, shows benefit in this regard.

PMID:36308700 | DOI:10.1111/ans.18131