Military status and alcohol problems: Former soldiers may be at greater risk

Publication date: September 2018
Source:Addictive Behaviors, Volume 84
Author(s): Bonnie M. Vest, D.Lynn Homish, Jennifer Fillo, Gregory G. Homish
ObjectivesThe goal of this study was to explore differences in alcohol problems as a function of military status (current soldier, previous soldier and civilian spouses), and the possible interaction between sex and military status. We hypothesized that 1) soldiers would be at greater risk for alcohol problems than civilian spouses, and 2) former soldiers would be at greater risk compared to current soldiers.MethodsData were drawn from Operation: SAFETY, a longitudinal study examining physical and mental health among U.S. Army Reserve and National Guard soldiers and their partners. The analytic sample included male and female participants who completed both the baseline and first follow-up assessments (N = 772). Negative binomial regression models were used to examine differences between military status group on alcohol problems at follow-up, controlling for sex and alcohol consumption at baseline. Interactions between military status and sex were also examined.ResultsAmong current soldiers, males experienced significantly more alcohol problems compared to women (4.47, 3.46; p = 0.005). Likewise, among previous soldiers, males experienced significantly more alcohol problems compared to women (6.69, 2.92; p = 0.002). Male previous soldiers had significantly more alcohol problems compared to both male current soldiers and male civilian spouses (6.69, 4.47, p = 0.04; 6.69, 3.96; p = 0.02). Among women, there were no significant differences by military status.ConclusionsOur results indicate that male previous soldiers are at greater risk of alcohol problems than both current soldiers and civilian spouses. Health care and service providers should consider screening and monitoring soldiers who separate from the military, as alcohol use may increase.



https://ift.tt/2KqmhUg

Parent-adolescent relationship and adolescent internet addiction: A moderated mediation model

Publication date: September 2018
Source:Addictive Behaviors, Volume 84
Author(s): Wei Wang, Dongping Li, Xian Li, Yanhui Wang, Wenqiang Sun, Liyan Zhao, Lilan Qiu
Substantial research has found that positive parent-adolescent relationship is associated with low levels of adolescent Internet addiction (IA). However, little is known about the mediating and moderating mechanisms underlying this relation. The present study examined a moderated mediation model that included the parent-adolescent relationship (predictor variable), emotion regulation ability (mediator), stressful life events (moderator), and IA (outcome variable) simultaneously. A total of 998 (Mage = 15.15 years, SD = 1.57) Chinese adolescents completed the Parent-Adolescent Relationship Scale, Emotion Regulation Ability Scale, Adolescent Stressful Life Events Scale, and Internet Addiction Diagnostic Questionnaire. After controlling for adolescent gender, age, and family socioeconomic status, results revealed that good parent-adolescent relationship was positively associated with adolescent emotion regulation ability, which in turn was negatively associated with their IA. Moreover, stressful life events moderated the second part of the mediation process. In accordance with the reverse stress-buffering model, the relation between emotion regulation ability and adolescent IA was stronger for adolescents who experienced lower levels of stressful life events. The findings and their implications are discussed and a resilient contextual perspective proposed.



https://ift.tt/2FsKc1s

Poor mental health, peer drinking norms, and alcohol risk in a social network of first-year college students

Publication date: September 2018
Source:Addictive Behaviors, Volume 84
Author(s): Shannon R. Kenney, Graham T. DiGuiseppi, Matthew K. Meisel, Sara G. Balestrieri, Nancy P. Barnett
ObjectiveCollege students with anxiety and depressive symptomatology face escalated risk for alcohol-related negative consequences. While it is well-established that normative perceptions of proximal peers' drinking behaviors influence students' own drinking behaviors, it is not clear how mental health status impacts this association. In the current study, we examined cross-sectional relationships between anxiety and depressed mood, perceived drinking behaviors and attitudes of important peers, and past month alcohol consumption and related problems in a first-semester college student social network.MethodParticipants (N = 1254, 55% female, 47% non-Hispanic White) were first-year students residing on campus at a single university who completed a web-based survey assessing alcohol use, mental health, and social connections among first-year student peers. Network autocorrelation models were used to examine the independent and interactive associations between mental health and perceptions of close peers' drinking on drinking outcomes, controlling for important variables.ResultsMental health interacted with perceptions to predict past-month drinking outcomes, such that higher anxiety and higher perceptions that peers drink heavily was associated with more drinks consumed and consequences, and higher depression and perceptions was associated with more drinks consumed, heavy drinking frequency, and consequences. Attitudes that peers approve of heavy drinking were associated with more drinks consumed and heavy drinking frequency among students with lower (vs. higher) depressed mood.ConclusionsThis study provides strong evidence that perceiving that close peers drink heavily is particularly risk-enhancing for anxious and depressed college students, and offers implications about alcohol intervention targeted at these subgroups.



https://ift.tt/2Krhkum

Prevalence and characteristics of young adult smokers in the U.S. in the precontemplation stage of smoking cessation

Publication date: September 2018
Source:Addictive Behaviors, Volume 84
Author(s): Mary E. Andrews, Melanie Sabado, Kelvin Choi
IntroductionThe precontemplation stage of smoking cessation refers to having no intention to quit smoking in the next six months. We aimed to estimate the prevalence of and characteristics associated with the precontemplation stage of smoking cessation among U.S. young adult smokers to inform the development of targeted interventions.MethodsWe analyzed data in 2017 from the 2013–2014 National Adult Tobacco Survey. Young adult (18–29 years old) daily and non-daily smokers were included (n = 1809). We applied weighted multiple logistic regression models to examine the associations between demographics, tobacco use behaviors, exposure to pro- and anti-tobacco messages, and the precontemplation stage of smoking cessation.Results59.0% of U.S. young adult smokers are in the precontemplation stage of smoking cessation. Unemployment was positively associated with being in the precontemplation stage of smoking cessation (AOR = 1.42 95% CI = 1.05, 1.91). Smoking every day (vs. some days), more cigarettes smoked per day, using roll-your-own cigarettes (vs. manufactured cigarettes only), currently smoking cigars, and signing up for promotional offers were positively associated with being in the precontemplation stage of smoking cessation (p < 0.05). Non-Hispanic Black was negatively associated with precontemplation stage (AOR = 0.40, 95% CI = 0.27, 0.59). Not smoking after viewing a health warning on a cigarette pack was negatively associated with the precontemplation stage of smoking cessation (AOR = 0.36, 95% CI = 0.25, 0.51).ConclusionsMany U.S. young adult smokers classify as being in the precontemplation stage of smoking cessation. Interventions to motivate these smokers to quit smoking with considerations of their specific characteristics (e.g., being unemployed) are warranted.



https://ift.tt/2Fqlwqh

Peer victimization and substance use: Understanding the indirect effect of depressive symptomatology across gender

Publication date: September 2018
Source:Addictive Behaviors, Volume 84
Author(s): Tamika C.B. Zapolski, Alia T. Rowe, Sycarah Fisher, Devon J. Hensel, Jessica Barnes-Najor
ObjectivePeer victimization in school is common, with emerging literature suggesting that it may also increase risk for substance abuse. Yet, little is known about the underlying mechanisms within this risk pathway. The objective of this study is to use a prospective 3-wave design to examine the mediating role of depressive symptomatology on the relationship between peer victimization and substance use, as well as examine if the pathway varies based on gender.Method801 youth between 6th and 12th grade completed surveys across three years, which included measures on school peer victimization, depression symptomatology and substance use. Models tested the mediational pathway between victimization, depressive symptoms, and substance use. Models were stratified by gender.ResultsControlling for grade and the effect of each variable across waves, a significant indirect effect of peer victimization on substance use through depressive symptoms was found for females, with a non-significant indirect effect for males.ConclusionResults suggest that female youth who are victimized by peers engage in substance use behaviors, at least in part, due to increases in depressive symptoms. Given its effect on depression, female victims may therefore benefit from coping skills training that targets emotion regulation and distress tolerance skills in order to combat increased risk for substance use behaviors as a coping response to their victimization. Further research is warranted to better understand the risk pathway for male youth who also experience peer victimization.



https://ift.tt/2Kqmdnu

Never, non-daily, and daily smoking status and progression to daily cigarette smoking as correlates of major depressive episode in a national sample of youth: Results from the National Survey of Drug Use and Health 2013 to 2015

Publication date: September 2018
Source:Addictive Behaviors, Volume 84
Author(s): Amy M. Cohn
BackgroundCigarette smoking is associated with depression, and new initiates who progress more quickly to daily smoking may be at enhanced risk. In a nationally representative sample of youth, this study examined the association between daily, non-daily, and never smoking with past-year and lifetime major depressive episode (MDE) and, among daily smokers, whether faster progression to daily smoking was associated with increased MDE risk.MethodsData were from n = 44,921 youth aged 12–17 in the 2013–2015 National Survey on Drug Use and Health. Weighted adjusted multivariable logistic regression models were used to examine the association of smoking status (daily, non-daily, never) with lifetime and past-year MDE, and the association between progression from cigarette trial to daily smoking with MDE outcomes among daily smokers.ResultsDaily and non-daily smokers had similar rates of lifetime and past-year MDE; rates of MDE were approximately 50% lower among never smokers. Compared to never smokers, adjusted models showed that non-daily smokers had a higher risk of past-year and lifetime MDE, while daily smokers had a higher risk of past-year but not lifetime MDE. Daily smoking youth who progressed more quickly from cigarette trial to daily use had an increased risk of both lifetime and past-year MDE.ConclusionsPrevention programs should target factors associated with the shift from cigarette experimentation to regular use to curb deleterious consequences of use.



https://ift.tt/2FqluyF

Methodological factors as a potential source of discordance between self-report and behavioral measures of impulsivity and related constructs

Publication date: September 2018
Source:Addictive Behaviors, Volume 84
Author(s): Jarrod M. Ellingson, Marc N. Potenza, Godfrey D. Pearlson
There is a consistent but poorly understood finding that self-report and behavioral measures of impulsivity are weakly correlated or uncorrelated. There are many possible explanations for this observation, including differences in how these instruments are administered and scored. The present study examined the utility of alternative scoring algorithms for self-report measures that aim to identify participants' peak impulsivity (or self-control), informed by estimates of item difficulty from Item Response Theory (IRT) analyses. College students were administered self-report questionnaires (Zuckerman Sensation Seeking Scale [ZSS], Barratt Impulsiveness Scale [BIS-11], behavioral measures related to risk-taking and impulsivity (Balloon Analog Risk Task [BART], Experiential Discounting Task [EDT]), and the substance use module of a clinical interview (past-six-month alcohol and marijuana use). IRT analyses were conducted on self-report measures to estimate item difficulty. Scoring algorithms ranked items by difficulty and scored items based on consecutive items endorsed or denied. A maximal scoring algorithm increased the concordance between the BIS-11 and BART (r = 0.08 vs. −0.07), but there was no evidence of increased incremental validity for substance-use. Findings suggest that methodological factors may help explain the poor concordance of self-report and behavioral measures of impulsivity, but the magnitude of these correlations remained quite small. Further, alternative scoring algorithms were correlated with substance use but did not explain any variance that was distinct from typical algorithms. Future directions are discussed for elucidating the discrepancy between self-report and behavioral measures of impulsivity-related constructs, such as using large self-report item pools to develop computer adaptive tests.



https://ift.tt/2Kqmcjq

Testing a motivational model of delivery modality and incentives on participation in a brief alcohol intervention

Publication date: September 2018
Source:Addictive Behaviors, Volume 84
Author(s): Clayton Neighbors, Lindsey M. Rodriguez, Lorra Garey, Mary M. Tomkins
ObjectivesThe current research evaluated delivery modality and incentive as factors affecting recruitment into a personalized normative feedback (PNF) alcohol intervention for heavy drinking college students. We also evaluated whether these factors were differentially associated with participation based on relevance of the intervention (via participants' drinking levels).MethodCollege students aged 18–26 who endorsed at least one heavy drinking episode and one alcohol-related consequence in the past month (N = 2059; 59.1% female) were invited to participate in a PNF intervention study. In this 2 × 2 design, participants were randomized to: (1) complete the computer-based baseline survey and intervention procedure remotely (i.e., at a time and location of their convenience) or in-person in the laboratory, and (2) receive an incentive ($30) for their participation in the baseline/intervention procedure or no incentive.ResultsConsistent with hypotheses, students were more likely to participate when participation occurred remotely (OR = 1.87, p < .001) and when an incentive (OR = 1.64, p = .007) was provided. Moderation analyses suggested that incentives were only associated with higher recruitment rates among remote participants (OR = 2.10, p < .001), consistent with cognitive evaluation theory. Moreover, heavier drinkers were more likely to participate if doing so remotely, whereas drinking was not associated with likelihood of participation among in-person participants.DiscussionThe present results showed a strong selection bias for participation in a web-based intervention study relative to one in which participants were required to participate in-person. Results have implications for researchers recruiting college students for alcohol interventions.



https://ift.tt/2Fql8rP

Regular past year cannabis use in women veterans and associations with sexual trauma

Publication date: September 2018
Source:Addictive Behaviors, Volume 84
Author(s): Kendall C. Browne, Marketa Dolan, Tracy L. Simpson, John C. Fortney, Keren Lehavot
IntroductionThis study sought to describe the prevalence of regular past year cannabis use (i.e., at least monthly use) in women veterans, to characterize women veterans reporting this level of use, and to examine the independent contributions of sexual trauma across the lifespan on regular past year cannabis use.MethodsA national online survey on women veterans' health, with targeted oversampling of lesbian and bisexual women, collected data from US armed forces women veterans, 18 or older, living in the US (N = 636).ResultsEleven percent of women reported regular cannabis use (5% heterosexual women; 21% lesbian/bisexual women). In bivariate analysis, identifying as a sexual and/or racial ethnic minority, younger age, being unmarried, reporting lower income, receiving VA services, smoking tobacco, and screening positive for alcohol misuse were positively associated with regular cannabis use. Additionally, a greater percentage of cannabis users reported experiencing childhood and adult sexual trauma and screened positive for posttraumatic stress disorder (PTSD) when compared to peers who did not use any drugs. In a multivariate model, the number of life eras women endorsed experiencing sexual trauma was significantly associated with regular cannabis use even when adjusting for demographic variables and PTSD symptoms.ConclusionsAmong women veterans, regular cannabis use is fairly common among those who are sexual and racial/ethnic minorities, younger, unmarried, receiving VA services, and reporting alcohol or tobacco use, PTSD symptoms, and/or multiple sexual traumas across the lifespan. Screening and assessment may be important to consider in healthcare settings serving this veteran population.



https://ift.tt/2KrhcuS

Trends of metals enrichment in deposited particulate matter at semi-arid area of Iran

Abstract

The presence and enrichment of heavy metals in dust depositions have been recognized as an emerging environmental health issues in the urban and industrial areas. In this study, the deposition of some metals was found in Qom, a city located in a semi-desert area in Iran that is surrounded by industrial areas. Dust deposition samples were collected using five sampling stations during a year. Dust samples were digested applying acidic condition and then, the metal content was analyzed using inductively coupled plasma technology (ICP-OES). Comparative results showed the following order, from the maximum to the minimum concentration (mg/kg dust) of elements: Ca > Al > Fe > Mg > Ti > Si > K > B > Sr > Mn > P > Ba > Cr > Zn > Ni > Sn > Pb > V > Na > Cu > Co > U > Li > Ce > Ag. The differences among the average concentrations of metals in the five stations were not significant (p value > 0.05). The average concentration of some metals increased significantly during cold seasons. In this study, the cluster analysis (CA) and princicipal component analysis (PCA) were applied, and relationships among some elements in different clusters were found. In addition, the geo-accumulation and enrichment analysis revealed that the following metals had been enriched more than the average values: boron, silver, tin, uranium, lead, zinc, cobalt, chromium, lithium, nickel, strontium, and coper. The presence of thermal power plant, pesticide manufacturing plants, publishing centers, traffic jam, and some industrial areas around the city has resulted in the enrichment of some metals (particularly in cold seasons with atmospheric stable conditions) in dust deposition.

https://ift.tt/2FqZlk3

Acute invasive fungal rhinosinusitis in twenty‐one diabetic patients

Clinical Otolaryngology, EarlyView.


https://ift.tt/2reJlN1

Assessment of auditory discrimination in hearing-impaired patients

Publication date: Available online 30 April 2018
Source:European Annals of Otorhinolaryngology, Head and Neck Diseases
Author(s): E. Legris, M. Gomot, J. Charpentier, J.M. Aoustin, C. Aussedat, D. Bakhos
Hearing loss can impair auditory discrimination, especially in noisy environments, requiring greater listening effort, which can impact socio-occupational life. To assess the impact of hearing loss in noisy environments, clinicians may use subjective or objective methods. Subjective methods, such as speech audiometry in noise, are used in clinical practice to assess reported discomfort. Objective methods, such as cortical auditory evoked potentials (CAEPs), are mainly used in research. Subjective methods mainly comprise speech audiometry in noise, in which the signal-to-noise ratio can be varied so as to determine the individual speech recognition threshold, with and without hearing rehabilitation, the aim being to highlight any improvement in auditory performance. Frequency discrimination analysis is also possible. Objective methods assess auditory discrimination without the patient's active participation. One technique used for patients with auditory rehabilitation is the study of auditory responses by CAEPs. This electrophysiological examination studies cortical auditory rehabilitation oddball paradigms, enabling wave recordings such as mismatch negativity, P300 or N400, and analysis of neurophysiological markers according to auditory performance. The present article reviews all these methods, in order to better understand and evaluate the impact of hearing loss in everyday life.



https://ift.tt/2HHj4h4

The emergency paediatric surgical airway: A systematic review

BACKGROUND Although an emergency surgical airway is recommended in the guidelines for a paediatric cannot intubate, cannot oxygenate (CICO), there is currently no evidence regarding the best technique for this procedure. OBJECTIVE To review the available literature on the paediatric emergency surgical airway to give recommendations for establishing a best practice for this procedure. DESIGN Systematic review: Considering the nature of the original studies, a meta-analysis was not possible. DATA SOURCES MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Google Scholar and LILACS databases. ELIGIBILITY CRITERIA Studies addressing the paediatric emergency surgical airway and reporting the following outcomes: time to tracheal access, success rate, complications and perceived ease of use of the technique were included. Data were reported using a Strengths, Weaknesses, Opportunities and Threats analysis. Strengths and Weaknesses describe the intrinsic (dis)advantages of the techniques. The opportunities and threats describe the (dis)advantage of the techniques in the setting of a paediatric CICO scenario. RESULTS Five studies described four techniques: catheter over needle, wire-guided, cannula or scalpel technique. Mean time for placement of a definitive airway was 44 s for catheter over needle, 67.3 s for the cannula and 108.7 s for the scalpel technique. No time was reported for the wire-guided technique. Success rates were 43 (10/23), 100 (16/16), 56 (87/154) and 88% (51/58), respectively. Complication rates were 34 (3/10), 69 (11/16), 36 (55/151) and 38% (18/48), respectively. Analysis shows: catheter over needle, quick but with a high failure rate; wire-guided, high success rate but high complication rate; cannula, less complications but high failure rate; scalpel, high success rate but longer procedural time. The available data are limited and heterogeneous in terms of reported studies; thus, these results need to be interpreted with caution. CONCLUSION The absence of best practice evidence necessitates further studies to provide a clear advice on best practice management for the paediatric emergency surgical airway in the CICO scenario. Correspondence to Dr. Markus F. Stevens, Department of Anaesthesiology, Academic Medical Centre, Meibergdreef 15, Amsterdam 1105 AZ, The Netherlands E-mail: m.f.stevens@amc.uva.nl Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (https://ift.tt/2ylyqmW). © 2018 European Society of Anaesthesiology

https://ift.tt/2Kk9Wkd

The emergency paediatric surgical airway: A systematic review

BACKGROUND Although an emergency surgical airway is recommended in the guidelines for a paediatric cannot intubate, cannot oxygenate (CICO), there is currently no evidence regarding the best technique for this procedure. OBJECTIVE To review the available literature on the paediatric emergency surgical airway to give recommendations for establishing a best practice for this procedure. DESIGN Systematic review: Considering the nature of the original studies, a meta-analysis was not possible. DATA SOURCES MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Google Scholar and LILACS databases. ELIGIBILITY CRITERIA Studies addressing the paediatric emergency surgical airway and reporting the following outcomes: time to tracheal access, success rate, complications and perceived ease of use of the technique were included. Data were reported using a Strengths, Weaknesses, Opportunities and Threats analysis. Strengths and Weaknesses describe the intrinsic (dis)advantages of the techniques. The opportunities and threats describe the (dis)advantage of the techniques in the setting of a paediatric CICO scenario. RESULTS Five studies described four techniques: catheter over needle, wire-guided, cannula or scalpel technique. Mean time for placement of a definitive airway was 44 s for catheter over needle, 67.3 s for the cannula and 108.7 s for the scalpel technique. No time was reported for the wire-guided technique. Success rates were 43 (10/23), 100 (16/16), 56 (87/154) and 88% (51/58), respectively. Complication rates were 34 (3/10), 69 (11/16), 36 (55/151) and 38% (18/48), respectively. Analysis shows: catheter over needle, quick but with a high failure rate; wire-guided, high success rate but high complication rate; cannula, less complications but high failure rate; scalpel, high success rate but longer procedural time. The available data are limited and heterogeneous in terms of reported studies; thus, these results need to be interpreted with caution. CONCLUSION The absence of best practice evidence necessitates further studies to provide a clear advice on best practice management for the paediatric emergency surgical airway in the CICO scenario. Correspondence to Dr. Markus F. Stevens, Department of Anaesthesiology, Academic Medical Centre, Meibergdreef 15, Amsterdam 1105 AZ, The Netherlands E-mail: m.f.stevens@amc.uva.nl Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (https://ift.tt/2ylyqmW). © 2018 European Society of Anaesthesiology

https://ift.tt/2Kk9Wkd

Intra-operative cutaneous temperature monitoring with zero-heat-flux technique (3M SpotOn) in comparison with oesophageal and arterial temperature: A prospective observational study

BACKGROUND Continuous monitoring of core temperature is essential during major surgery as a way of improving patient safety. Oesophageal probes or specific arterial catheters are invasive methods used in this setting. A new noninvasive device based on zero-heat-flux (ZHF) technique (SpotOn) seems promising but has been poorly investigated during rapid core temperature changes (RCTC). OBJECTIVE To assess the accuracy of a SpotOn sensor vs. an oesophageal probe or specific arterial catheter during a slow change in core temperature of less than 1 °C within 30 min and RCTC ≥ 1 °C within 30 min. DESIGN Prospective observational study. SETTING Operating rooms at the University Hospital of Poitiers, France. PATIENTS Fifty patients scheduled for major abdominal surgery under general anaesthesia were enrolled from June 2015 to March 2016. Data from 49 patients were finally analysed. Among these, 15 patients were treated with hyperthermic intraperitoneal chemotherapy. INTERVENTION Each patient had a ZHF sensor placed on the skin surface of the forehead (TempZHF) and an oesophageal probe (TempEso) used as a reference method. Twenty-two patients also had a thermodilution arterial catheter (TempArt) placed in the axillary artery. MAIN OUTCOME MEASURES Core temperature was continuously recorded from the three devices after induction of anaesthesia. Comparison of temperature measurements between methods was made using the Bland and Altman method during two separate periods according to the speed of core temperature changes. RESULTS Compared with TempEso, bias and limits of agreement for TempZHF were 0.1 ± 0.5 °C during slow core temperature changes periods and 0.6 ± 1.8 °C during RCTC periods (P = 0.0002). Compared with TempArt, these values were −0.1 ± 0.4 and 0.5 ± 1.7 °C, respectively (P = 0.0039). The ZHF sensor was well tolerated. CONCLUSION A SpotOn sensor using the ZHF method seems reliable for core temperature monitoring during abdominal surgery when variations in core temperature are slow rather than rapid. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02869828. Correspondence to Matthieu Boisson, Centre Hospitalier Universitaire de Poitiers, Poitiers, France E-mail: matthieu.boisson@chu-poitiers.fr © 2018 European Society of Anaesthesiology

https://ift.tt/2Kq3TL8

Intra-operative cutaneous temperature monitoring with zero-heat-flux technique (3M SpotOn) in comparison with oesophageal and arterial temperature: A prospective observational study

BACKGROUND Continuous monitoring of core temperature is essential during major surgery as a way of improving patient safety. Oesophageal probes or specific arterial catheters are invasive methods used in this setting. A new noninvasive device based on zero-heat-flux (ZHF) technique (SpotOn) seems promising but has been poorly investigated during rapid core temperature changes (RCTC). OBJECTIVE To assess the accuracy of a SpotOn sensor vs. an oesophageal probe or specific arterial catheter during a slow change in core temperature of less than 1 °C within 30 min and RCTC ≥ 1 °C within 30 min. DESIGN Prospective observational study. SETTING Operating rooms at the University Hospital of Poitiers, France. PATIENTS Fifty patients scheduled for major abdominal surgery under general anaesthesia were enrolled from June 2015 to March 2016. Data from 49 patients were finally analysed. Among these, 15 patients were treated with hyperthermic intraperitoneal chemotherapy. INTERVENTION Each patient had a ZHF sensor placed on the skin surface of the forehead (TempZHF) and an oesophageal probe (TempEso) used as a reference method. Twenty-two patients also had a thermodilution arterial catheter (TempArt) placed in the axillary artery. MAIN OUTCOME MEASURES Core temperature was continuously recorded from the three devices after induction of anaesthesia. Comparison of temperature measurements between methods was made using the Bland and Altman method during two separate periods according to the speed of core temperature changes. RESULTS Compared with TempEso, bias and limits of agreement for TempZHF were 0.1 ± 0.5 °C during slow core temperature changes periods and 0.6 ± 1.8 °C during RCTC periods (P = 0.0002). Compared with TempArt, these values were −0.1 ± 0.4 and 0.5 ± 1.7 °C, respectively (P = 0.0039). The ZHF sensor was well tolerated. CONCLUSION A SpotOn sensor using the ZHF method seems reliable for core temperature monitoring during abdominal surgery when variations in core temperature are slow rather than rapid. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02869828. Correspondence to Matthieu Boisson, Centre Hospitalier Universitaire de Poitiers, Poitiers, France E-mail: matthieu.boisson@chu-poitiers.fr © 2018 European Society of Anaesthesiology

https://ift.tt/2Kq3TL8

Issue Information

Journal of Neuroendocrinology, Volume 30, Issue 5, May 2018.


https://ift.tt/2JA83ij

Managing the late effects of chemoradiation on swallowing: bolstering the beginning, minding the middle, and cocreating the end

Purpose of review Late dysphagia has a profound impact on quality of life in patients treated with chemoradiation therapy for advanced head and neck cancer and the number of survivors is growing. Traditional treatment methods are not uniformly successful in reducing the swallow impairment in these patients. Recent findings Manifestations of late dysphagia are complex and do not follow a uniform trajectory. Patient's experience of eating and engagement in treatment is critical given the complex, variable nature of late dysphagia. Novel swallow treatment methods target respiratory function including coordination and strength as well as patient adherence. Summary Head and neck cancer survivors deserve routine and fastidious surveillance beyond the 5-year survival point with respect to swallow function if the enormous biopsychosocial burden of late dysphagia is to be addressed. Correspondence to Tessa Goldsmith, MA, Massachusetts General Hospital, Boston, MA 02114, USA. E-mail: tgoldsmith@mgh.harvard.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2jeRI7v

Managing the late effects of chemoradiation on swallowing: bolstering the beginning, minding the middle, and cocreating the end

Purpose of review Late dysphagia has a profound impact on quality of life in patients treated with chemoradiation therapy for advanced head and neck cancer and the number of survivors is growing. Traditional treatment methods are not uniformly successful in reducing the swallow impairment in these patients. Recent findings Manifestations of late dysphagia are complex and do not follow a uniform trajectory. Patient's experience of eating and engagement in treatment is critical given the complex, variable nature of late dysphagia. Novel swallow treatment methods target respiratory function including coordination and strength as well as patient adherence. Summary Head and neck cancer survivors deserve routine and fastidious surveillance beyond the 5-year survival point with respect to swallow function if the enormous biopsychosocial burden of late dysphagia is to be addressed. Correspondence to Tessa Goldsmith, MA, Massachusetts General Hospital, Boston, MA 02114, USA. E-mail: tgoldsmith@mgh.harvard.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

https://ift.tt/2jeRI7v

Reconstructive Microsurgery: From a Set of Skills to a Stand-Alone Specialty of Elite Surgeons

J reconstr Microsurg
DOI: 10.1055/s-0038-1639480

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
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https://ift.tt/2jdRY6G

Detection of neurodevelopmental diversity in memory clinics—Validation of a self-report measure

Publication date: June 2018
Source:Research in Developmental Disabilities, Volume 77
Author(s): Alon Seifan, Chiashin Shih, Katherine Hackett, Max J. Pensack, Matthew W. Schelke, Michael Lin, Hemali Patel, Christine A. Ganzer, Mahreen Ahmed, Robert Krikorian, Peter Tamboer, Adolfo M. Henriquez, Richard S. Isaacson, Sheila Steinhof
BackgroundNeurodevelopmental learning and attentional disorders (NLAD) such as dyslexia, dyscalculia and attention deficit hyperactivity disorder (ADHD) affect at least 6% of the adult population or more. They are associated with atypical cognitive patterns in early and adult life. The cognitive patterns of affected individuals in late life have never been described. One main challenge is detecting individuals in clinical settings during which mild cognitive changes could be confounding the clinical presentation. This is a critical research gap because these conditions interact, across the life course, with an individual's risk for dementia. Also, learning disabilities which present in childhood pose persistent cognitive differences in areas involving executive function, reading and math.Clinicians lack tools to detect undiagnosed neurodevelopmental in adults with memory disorders. The majority of patients presenting at memory clinics today come from a generation during which NLAD were not yet clinically recognized. In this study, we hypothesized that a self-report scale can detect NLAD in a memory clinic population.MethodsWe developed a self-report, retrospective childhood cognitive questionnaire including key attributes adapted from prior validated measures. 233 participants were included in the primary analysis.ResultsConfirmatory Factor Analysis resulted in a best-fit model with six labelled factors (Math, Language, Attention, Working Memory, Sequential Processing, and Executive Function) and 15 total question items. The model demonstrated unidimensionality, reliability, convergent validity, discriminant validity, and predictive validity. Using 1.5 standard deviations as the cut-off, subjects were categorized into: Normal (n = 169), Language (n = 10), Math (n = 12), Attention (n = 10) or Other/Mixed (n = 32).ConclusionA self-report measure can be a useful tool to elicit childhood cognitive susceptibilities in various domains that could represent NLAD among patients in a memory clinic setting, even in the presence of mild cognitive impairment.



https://ift.tt/2vUgRh5

In-school service predictors of employment for individuals with intellectual disability

Publication date: June 2018
Source:Research in Developmental Disabilities, Volume 77
Author(s): Jiyoon Park, Emily Bouck
Backgrounds/aims/methodsAlthough there are many secondary data analyses of the National Longitudinal Transition Study-2 (NLTS-2) to investigate post-school outcome for students with disabilities, there has been a lack of research with in-school service predictors and post-school outcome for students with specific disability categories.Methods/proceduresThis study was a secondary data analysis of NLTS-2 to investigate the relationship between current employment status and in-school services for individuals with intellectual disability. Statistical methods such as descriptive statistics and logistic regression were used to analyze NLTS-2 data set.ResultsThe main findings included that in-school services were correlated with current employment status, and that primary disability (i.e., mild intellectual disability and moderate/severe intellectual disability) was associated with current employment status.Conclusion/implicationsIn-school services are critical in predicting current employment for individuals with intellectual disability. Also, data suggest additional research is needed to investigate various in-school services and variables that could predict employment differences between individuals with mild and moderate/severe intellectual disability.



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Association between enterovirus infection and speech and language impairments: A nationwide population-based study

Publication date: June 2018
Source:Research in Developmental Disabilities, Volume 77
Author(s): Tai-Hsin Hung, Vincent Chin-Hung Chen, Yao-Hsu Yang, Ching-Shu Tsai, Mong-Liang Lu, Roger S. McIntyre, Yena Lee, Kuo-You Huang
Background and aimsDelay and impairment in Speech and language are common developmental problems in younger populations. Hitherto, there has been minimal study of the association between common childhood infections (e.g. enterovirus [EV]) and speech and language. The impetus for evaluating this association is provided by evidence linking inflammation to neurodevelopmental disorders. Herein we sought to determine whether an association exists between EV infection and subsequent diagnoses of speech and language impairments in a nationwide population-based sample in Taiwan.MethodsOur study acquired data from the Taiwan National Health Insurance Research Database. The sample was comprised of individuals under 18 years of age with newly diagnosed EV infection during the period from January 1998 to December 2011. 39669 eligible cases were compared to matched controls and assessed during the study period for incident cases of speech and language impairments. Cox regression analyses were applied, adjusting for sex, age and other physical and mental problems.ResultsIn the fully adjusted Cox regression model for hazard ratios, EV infection as positively associated with speech and language impairments (HR = 1.14, 95% CI: 1.06–1.22) after adjusting for age, sex and other confounds. Compared to the control group, the hazard ratio for speech and language impairments was 1.12 (95% CI: 1.03–1.21) amongst the group of EV infection without hospitalization, and 1.26 (95% CI: 1.10–1.45) amongst the group of EV infection with hospitalization.ConclusionsEV infection is temporally associated with incident speech and language impairments. Our findings herein provide rationale for educating families that EV infection may be associated with subsequent speech and language problems in susceptible individuals and that monitoring for such a presentation would be warranted.What this paper adds?Speech and language impairments associated with central nervous system infections have been reported in the literature. EV are medically important human pathogens and associated with select neuropsychiatric diseases. Notwithstanding, relatively few reports have mentioned the effects of EV infection on speech and language problems. Our study used a nationwide longitudinal dataset and identified that children with EV infection have a greater risk for speech and language impairments as compared with control group. Infected children combined other comorbidities or risk factors might have greater possibility to develop speech problems. Clinicians should be vigilant for the onset of language developmental abnormalities of preschool children with EV infection.



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Violence prevention in special education schools – an integrated practice?

Publication date: June 2018
Source:Research in Developmental Disabilities, Volume 77
Author(s): Patricia Pihl, Regine Grytnes, Lars Peter S. Andersen
Research has shown that employees in special education settings are at high risk for work-related threats and violence. Previous research has not yet been able to identify the essential components of training programs that offer protection from work-related threats and violence. Therefore, the aim of this study was to explore how employees in special education schools deal with prevention of work-related threats and violence. Group interviews were conducted with 14 employees working at 5 special education schools. Results show that employees use a wide range of prevention strategies drawing on specific violence prevention techniques as well as professional pedagogical approaches. We propose that the prevention of threats and violence in special education schools can be understood as an integrated pedagogical practice operating on three interrelated levels.



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Parental overcontrol x OPRM1 genotype interaction predicts school-aged children’s sympathetic nervous system activation in response to performance challenge

Publication date: Available online 26 April 2018
Source:Research in Developmental Disabilities
Author(s): Lindsey C. Partington, Jessica L. Borelli, Patricia Smiley, Ella Jarvik, Hannah F. Rasmussen, Lauren C. Seaman, Erika L. Nurmi
Parental overcontrol (OC), the excessive regulation of a child's behavior, cognition, and emotion, is associated with the development of child anxiety. While studies have shown that genetic factors may increase sensitivity to stress, genetic vulnerability to parental OC has not been examined in anxiety etiology. A functional polymorphism in the mu opioid receptor OPRM1 (A118G, rs1799971) has been shown to impact stress reactivity. Using a community sample of children (N = 85, 9–12 years old), we examined the main and interactive effects of maternal OC and child OPRM1 genotype in predicting children's sympathetic nervous system reactivity during a performance stressor. Neither OC nor genotype predicted children's electrodermal activity (EDA); however, the interaction between OC and child genotype significantly predicted stress reactivity, as indexed by EDA, during the challenging task. Among children with the minor G-allele, higher maternal OC was associated with higher reactivity. In A homozygotes, maternal OC was not associated with EDA, suggesting a diathesis-stress pattern of gene x environment interaction. We discuss implications for anxiety etiology and intervention.



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Trajectories of cognitive development in toddlers with language delays

Publication date: Available online 24 April 2018
Source:Research in Developmental Disabilities
Author(s): Laura Henry, Cristan Farmer, Stacy S. Manwaring, Lauren Swineford, Audrey Thurm
BackgroundToddlers with early language delays (LD) are at risk for developmental difficulties, including autism spectrum disorder (ASD). However, little is known about early cognitive skill acquisition in this population.AimsTo explore heterogeneity in cognitive development in toddlers with significant LD (n = 30) or typical development (n = 61), and how this relates to 36-month outcomes (ASD, non-ASD delays, or no delays).MethodsGrowth mixture modeling of nonverbal and verbal mental age (NVMA, VMA) scores from the Mullen Scales of Early Learning was conducted with data from 18, 24 and 36 months.ResultsA two-class NVMA solution was selected (Age Appropriate, 82%, Delayed, 18%); class membership was related to the no delay outcome, and although the proportion of toddlers with ASD in the Age-Expected class was 17% compared to 50% of toddlers with non-ASD delays, this difference was not statistically significant. The best-fitting model for VMA included three classes: Age Appropriate (66%), Delay Catch-Up (23%), Delayed (11%); class assignment differed by outcome. Children in the Delay Catch-Up class were more likely to have non-ASD delays compared to ASD, while the reverse was true in the Delayed class.ConclusionsCognitive development in toddlers with LD is heterogeneous, and delayed verbal trajectories relate to later ASD diagnosis.



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Is the amount of exposure to aggressive challenging behaviour related to staff work-related well-being in intellectual disability services? Evidence from a clustered research design

Publication date: Available online 17 April 2018
Source:Research in Developmental Disabilities
Author(s): Samantha Flynn, Richard P. Hastings, David Gillespie, Rachel McNamara, Elizabeth Randell
BackgroundPrevious research has demonstrated an association between aggressive challenging behaviour (CB) and reductions in work-related well-being for intellectual disability (ID) support staff. Much of this research has used subjective measures of CB.AimsTo examine whether exposure to aggressive CB is associated with reduced work-related well-being in staff working in ID residential settings across the UK.Methods and procedureA cross-sectional analysis was undertaken as part of a randomised trial; 186 staff from 100 settings completed questionnaires on their CB self-efficacy, empathy, positive work motivation, and burnout. Objective measures of aggressive CB in the preceding 16 weeks were collected from each setting.Outcomes and resultsThere was little association between staff exposure to aggressive CB and work-related well-being. Clustering effects were found for emotional exhaustion and positive work motivation, suggesting these variables are more likely to be influenced by the environment in which staff work.Conclusions and implicationsThe level of clustering may be key to understanding how to support staff working in ID residential settings, and should be explored further. Longitudinal data, and studies including a comparison of staff working in ID services without aggressive CB exposure are needed to fully understand any association between aggressive CB and staff well-being.



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Occurrence of anembryonic pregnancy with use of levonorgestrel subdermal implant (JADELLE®): a case report

Progestin-only subdermal implants are one of the most effective contraceptive methods. Anembryonic pregnancy is not reported as a possible outcome in cases of contraceptive failure of these products. We presen...

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Ear Prosthesis for Postburn Deformity

Prosthodontics is not just confined to replacement of missing teeth but beyond one's scope. The fabrication of any extraoral maxillofacial prosthesis presents the prosthodontist with several phenomenal challenges. Psychologically, these patients are severely affected either by congenital absence or loss of ear due to trauma or burns. Replacement or reconstruction can be done by surgical or prosthetic approach. However, not all situations are favourable to surgical reconstruction. This article emphasises on the steps in fabrication of ear prosthesis for burn deformity.

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A comparison of morpho-syntactic abilities in deaf children with cochlear implant and 5-year-old normal-hearing children

Publication date: July 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 110
Author(s): Samane Dehghani Golestani, Nahid Jalilevand, Mohammad Kamali
IntroductionChildren with cochlear implants (CIs) have problems in morpho-syntactic abilities more than other language skills. The current study was aimed to evaluate the language samples of children with CIs by using a numerical measurement tool, Persian developmental sentence scoring (PDSS).MethodIn this cross-sectional, descriptive, analytical study, 33 children (22 children with CIs and 11 with normal hearing) were recruited. Language samples of the children were recorded during the description of pictures. The PDSS was used as a reliable numerical measurement tool for analyzing the first 100 consecutive intelligible utterances.ResultsWe found a significant difference in the mean PDSS total scores (p = 0.0001) between the normal-hearing children and deaf children using CIs for 5 years. Similarly, the results revealed a significant difference in the mean PDSS total scores (p = 0.0001) between the normal-hearing children and 5-year-old deaf children with CIs. There was no significant difference in the mean PDSS total scores between the two groups of children with CIs.ConclusionChildren with CIs can form simple sentences but probably exhibit poor abilities for using complex sentences and essential morphology items.



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