Jaiden Duncan grew his hair for nearly 4 years to make a donation to the Society's wig-making program.
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Πέμπτη 13 Δεκεμβρίου 2018
VIDEO: Chilliwack boy donates more than a foot of hair to Canadian Cancer Society - Maple Ridge News
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Uganda: Temperature Dip Triggers Health Alert
[Monitor] Kampala -Ugandans with respiratory diseases or conditions such as asthma or allergies are at increased risk of severe attacks due to the sudden change in weather, currently marked by significant drop in temperatures, experts said yesterday. (Source: AllAfrica News: Health and Medicine)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
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Salvage surgery for recurrence after radiotherapy for HNSCC | Otolaryngology-Head & Neck Surgery - MD Linx
Salvage surgery for recurrence after radiotherapy for HNSCC | Otolaryngology-Head & Neck Surgery MD Linx
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Otolaryngology Article: Salvage surgery for recurrence after radiotherapy for squamous cell carcinoma of the head and neck.
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Survival analysis of distant metastasis of laryngeal carcinoma | European Archives of Oto-Rhino-Laryngology - MD Linx
Survival analysis of distant metastasis of laryngeal carcinoma | European Archives of Oto-Rhino-Laryngology MD Linx
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Otolaryngology Article: Survival analysis of distant metastasis of laryngeal carcinoma: Analysis based on SEER database.
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Study suggets ADHD is genetic, may help lead to new treatments - UPI News
Millions of American kids with attention-deficit/hyperactivity disorder may have a genetic vulnerability to the disease, a new study suggests.
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Survival analysis of distant metastasis of laryngeal carcinoma | European Archives of Oto-Rhino-Laryngology - MD Linx
Survival analysis of distant metastasis of laryngeal carcinoma | European Archives of Oto-Rhino-Laryngology MD Linx
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Otolaryngology Article: Survival analysis of distant metastasis of laryngeal carcinoma: Analysis based on SEER database.
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Salvage surgery for recurrence after radiotherapy for HNSCC | Otolaryngology-Head & Neck Surgery - MD Linx
Salvage surgery for recurrence after radiotherapy for HNSCC | Otolaryngology-Head & Neck Surgery MD Linx
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Otolaryngology Article: Salvage surgery for recurrence after radiotherapy for squamous cell carcinoma of the head and neck.
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Uganda: Temperature Dip Triggers Health Alert
[Monitor] Kampala -Ugandans with respiratory diseases or conditions such as asthma or allergies are at increased risk of severe attacks due to the sudden change in weather, currently marked by significant drop in temperatures, experts said yesterday. (Source: AllAfrica News: Health and Medicine)
MedWorm Message: Have you tried our new medical search engine? More powerful than before. Log on with your social media account. 100% free.
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Study suggets ADHD is genetic, may help lead to new treatments - UPI News
Millions of American kids with attention-deficit/hyperactivity disorder may have a genetic vulnerability to the disease, a new study suggests.
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VIDEO: Chilliwack boy donates more than a foot of hair to Canadian Cancer Society - Maple Ridge News
Jaiden Duncan grew his hair for nearly 4 years to make a donation to the Society's wig-making program.
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An approach to identifying the relative importance of different radionuclides in ecological radiological risk assessment: Application to nuclear power plant releases
Publication date: February 2019
Source: Journal of Environmental Radioactivity, Volume 197
Author(s): Karine Beaugelin-Seiller, Brenda J. Howard, Jacqueline Garnier-Laplace
Abstract
There is a need to prioritise the requirements for data to assess the radiological risk for fauna and flora, as inevitable large data gaps occur due to the large number of combinations of radionuclides and organisms for which doses need to be assessed. The potentially most important dose-forming radionuclide-pathways combinations need to be identified to optimize filling these gaps. Few attempts have been made to classify the importance of isotopes with regard to radiation protection of the environment. A hierarchical approach is described here for radionuclides that are potentially present in generic ecosystems (freshwater, marine or terrestrial) and is applied for scenarios considering ecologically relevant chronic exposure. In each ecosystem, the top ten radionuclides that may contribute to doses were identified using a qualitative Chronic Hazard Index. Including quantitative aspects by incorporating discharge quantities changed the priority list, and increased the relative importance of radionuclides contributing most to the authorized releases of nuclear facilities (14C and 3H followed by 60C). The potentially most important dose-contributing radionuclides in the framework of environmental radiation protection under a chronic exposure situation included isotopes of about 20 elements. The five most important in order of decreasing importance were: carbon, hydrogen, caesium, cobalt and americium. Consideration of acute exposure situations was hampered by data gaps that were even greater than that for chronic exposure situations, so it was only possible to consider the feasibility of developing a consistent approach.
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Preliminary investigation of 222Rn in the Yakumo Wind-hole, an algific talus deposits, from Izumo, southwest Honshu, Japan
Publication date: February 2019
Source: Journal of Environmental Radioactivity, Volume 197
Author(s): Ritsuo Nomura, Mutsuo Inoue, Hisaki Kofuji
Abstract
The Yakumo Wind-hole in southwest Japan formed by landslip, and it is known as a cold air blowhole. This wind-hole consists of two parts, which have complementary relationships in regard to the flow of air, namely, topographically upper and lower holes that can be characterized as a warm wind-hole (WWH) and cold wind-hole (CWH), respectively. We carried out a preliminary investigation of radon behavior in the Yakumo Wind-hole. The data showed remarkable seasonal change from high 222Rn concentrations reaching to 7.6 ± 0.1 kBq/m3 in the warm season (mid-May to October) to low 222Rn concentrations in the cold season (December to early May) at the CWH. The threshold in the regional atmospheric temperature was estimated as 16.2 °C for the beginning and 17.1 °C for the ending periods of air blow with higher 222Rn concentrations. These seasonal changes in 222Rn were not only associated with the dynamic convection caused by temperature differences in and out of the talus, but were also related to the relative humidity of air that is blown out. High 222Rn concentrations were formed in the high humidity environment, and the humidity may possibly be associated with melting ice. According to the known information on 222Rn behavior in relation to humidity, a radon trap in the growing ice in spring and in the melted water in summer are suggested. This study revealed that 222Rn measurements are a useful tool to understand the air dynamics in the talus.
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An approach to identifying the relative importance of different radionuclides in ecological radiological risk assessment: Application to nuclear power plant releases
Publication date: February 2019
Source: Journal of Environmental Radioactivity, Volume 197
Author(s): Karine Beaugelin-Seiller, Brenda J. Howard, Jacqueline Garnier-Laplace
Abstract
There is a need to prioritise the requirements for data to assess the radiological risk for fauna and flora, as inevitable large data gaps occur due to the large number of combinations of radionuclides and organisms for which doses need to be assessed. The potentially most important dose-forming radionuclide-pathways combinations need to be identified to optimize filling these gaps. Few attempts have been made to classify the importance of isotopes with regard to radiation protection of the environment. A hierarchical approach is described here for radionuclides that are potentially present in generic ecosystems (freshwater, marine or terrestrial) and is applied for scenarios considering ecologically relevant chronic exposure. In each ecosystem, the top ten radionuclides that may contribute to doses were identified using a qualitative Chronic Hazard Index. Including quantitative aspects by incorporating discharge quantities changed the priority list, and increased the relative importance of radionuclides contributing most to the authorized releases of nuclear facilities (14C and 3H followed by 60C). The potentially most important dose-contributing radionuclides in the framework of environmental radiation protection under a chronic exposure situation included isotopes of about 20 elements. The five most important in order of decreasing importance were: carbon, hydrogen, caesium, cobalt and americium. Consideration of acute exposure situations was hampered by data gaps that were even greater than that for chronic exposure situations, so it was only possible to consider the feasibility of developing a consistent approach.
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Preliminary investigation of 222Rn in the Yakumo Wind-hole, an algific talus deposits, from Izumo, southwest Honshu, Japan
Publication date: February 2019
Source: Journal of Environmental Radioactivity, Volume 197
Author(s): Ritsuo Nomura, Mutsuo Inoue, Hisaki Kofuji
Abstract
The Yakumo Wind-hole in southwest Japan formed by landslip, and it is known as a cold air blowhole. This wind-hole consists of two parts, which have complementary relationships in regard to the flow of air, namely, topographically upper and lower holes that can be characterized as a warm wind-hole (WWH) and cold wind-hole (CWH), respectively. We carried out a preliminary investigation of radon behavior in the Yakumo Wind-hole. The data showed remarkable seasonal change from high 222Rn concentrations reaching to 7.6 ± 0.1 kBq/m3 in the warm season (mid-May to October) to low 222Rn concentrations in the cold season (December to early May) at the CWH. The threshold in the regional atmospheric temperature was estimated as 16.2 °C for the beginning and 17.1 °C for the ending periods of air blow with higher 222Rn concentrations. These seasonal changes in 222Rn were not only associated with the dynamic convection caused by temperature differences in and out of the talus, but were also related to the relative humidity of air that is blown out. High 222Rn concentrations were formed in the high humidity environment, and the humidity may possibly be associated with melting ice. According to the known information on 222Rn behavior in relation to humidity, a radon trap in the growing ice in spring and in the melted water in summer are suggested. This study revealed that 222Rn measurements are a useful tool to understand the air dynamics in the talus.
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Physical exercise enhances adult cortical plasticity in a neonatal rat model of hypoxic-ischemic injury: Evidence from BOLD-fMRI and electrophysiological recordings
Publication date: Available online 12 December 2018
Source: NeuroImage
Author(s): Sun Young Chae, Jun Ho Jang, Geun Ho Im, Ji-Hyun Jeong, Won-Beom Jung, Sukjin Ko, Hyesoo Jie, Ji Hye Kim, Yun Sil Chang, Seungsoo Chung, Ki-Soo Kim, Jung Hee Lee
Abstract
Neuroplasticity is considered essential for recovery from brain injury in developing brains. Recent studies indicate that it is especially effective during early postnatal development and during the critical period. The current study used functional magnetic resonance imaging (fMRI) and local field potential (LFP) electrophysiological recordings in rats that experienced neonatal hypoxic-ischemic (HI) injury during the critical period to demonstrate that physical exercise (PE) can improve cortical plasticity even when performed during adulthood, after the critical period. We investigated to what extent the blood oxygen level-dependent (BOLD)-fMRI responses were increased in the contralesional spared cortex, and how these increases were related to the LFP electrophysiological measurements and the functional outcome. The balance of excitation and inhibition was assessed by measuring excitatory and inhibitory postsynaptic currents in stellate cells in the primary somatosensory (S1) cortex, which was compared with the BOLD-fMRI responses in the contralesional S1 cortex. The ratio of inhibitory postsynaptic current (IPSC) to excitatory postsynaptic current (EPSC) at the thalamocortical (TC) input to the spared S1 cortex was significantly increased by PE, which is consistent with the increased BOLD-fMRI responses and improved functional outcome. Our data clearly demonstrate in an experimental rat model of HI injury during the critical period that PE in adulthood enhances neuroplasticity and suggest that enhanced feed-forward inhibition at the TC input to the S1 cortex might underlie the PE-induced amelioration of the somatosensory deficits caused by the HI injury. In summary, the results of the current study indicate that PE, even if performed beyond the critical period or during adulthood, can be an effective therapy to treat neonatal brain injuries, providing a potential mechanism for the development of a potent rehabilitation strategy to alleviate HI-induced neurological impairments.
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A framework for offline evaluation and optimization of real-time algorithms for use in neurofeedback, demonstrated on an instantaneous proxy for correlations
Publication date: Available online 13 December 2018
Source: NeuroImage
Author(s): Michal Ramot, Javier Gonzalez-Castillo
Abstract
Interest in real-time fMRI neurofeedback has grown exponentially over the past few years, both for use as a basic science research tool, and as part of the search for novel clinical interventions for neurological and psychiatric illnesses. In order to expand the range of questions which can be addressed with this tool however, new neurofeedback methods must be developed, going beyond feedback of activations in a single region. These new methods, several of which have already been proposed, are by their nature complex, involving many possible parameters. Here we suggest a framework for evaluating and optimizing algorithms for use in a real-time setting, before beginning the neurofeedback experiment, by offline simulations of algorithm output using a previously collected dataset. We demonstrate the application of this framework on the instantaneous proxy for correlations which we developed for training connectivity between different network nodes, identify the optimal parameters for use with this algorithm, and compare it to more traditional correlation methods. We also examine the effects of advanced imaging techniques, such as multi-echo acquisition, and the integration of these into the real-time processing stream.
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Automatic labeling of cortical sulci for the human fetal brain based on spatio-temporal information of gyrification
Publication date: Available online 12 December 2018
Source: NeuroImage
Author(s): Hyuk Jin Yun, Ai Wern Chung, Lana Vasung, Edward Yang, Tomo Tarui, Caitlin K. Rollins, Cynthia M. Ortinau, P. Ellen Grant, Kiho Im
Abstract
Accurate parcellation and labeling of primary cortical sulci in the human fetal brain is useful for regional analysis of brain development. However, human fetal brains show large spatio-temporal changes in brain size, cortical folding patterns, and relative position/size of cortical regions, making accurate automatic sulcal labeling challenging. Here, we introduce a novel sulcal labeling method for the fetal brain using spatio-temporal gyrification information from multiple fetal templates. First, spatial probability maps of primary sulci are generated on the templates from 23 to 33 gestational weeks and registered to an individual brain. Second, temporal weights, which determine the level of contribution to the labeling for each template, are defined by similarity of gyrification between the individual and the template brains. We combine the weighted sulcal probability maps from the multiple templates and adopt sulcal basin-wise approach to assign sulcal labels to each basin. Our labeling method was applied to 25 fetuses (22.9–29.6 gestational weeks), and the labeling accuracy was compared to manually assigned sulcal labels using the Dice coefficient. Moreover, our multi-template basin-wise approach was compared to a single-template approach, which does not consider the temporal dynamics of gyrification, and a fully-vertex-wise approach. The mean accuracy of our approach was 0.958 across subjects, significantly higher than the accuracies of the other approaches. This novel approach shows highly accurate sulcal labeling and provides a reliable means to examine characteristics of cortical regions in the fetal brain.
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Physical exercise enhances adult cortical plasticity in a neonatal rat model of hypoxic-ischemic injury: Evidence from BOLD-fMRI and electrophysiological recordings
Publication date: Available online 12 December 2018
Source: NeuroImage
Author(s): Sun Young Chae, Jun Ho Jang, Geun Ho Im, Ji-Hyun Jeong, Won-Beom Jung, Sukjin Ko, Hyesoo Jie, Ji Hye Kim, Yun Sil Chang, Seungsoo Chung, Ki-Soo Kim, Jung Hee Lee
Abstract
Neuroplasticity is considered essential for recovery from brain injury in developing brains. Recent studies indicate that it is especially effective during early postnatal development and during the critical period. The current study used functional magnetic resonance imaging (fMRI) and local field potential (LFP) electrophysiological recordings in rats that experienced neonatal hypoxic-ischemic (HI) injury during the critical period to demonstrate that physical exercise (PE) can improve cortical plasticity even when performed during adulthood, after the critical period. We investigated to what extent the blood oxygen level-dependent (BOLD)-fMRI responses were increased in the contralesional spared cortex, and how these increases were related to the LFP electrophysiological measurements and the functional outcome. The balance of excitation and inhibition was assessed by measuring excitatory and inhibitory postsynaptic currents in stellate cells in the primary somatosensory (S1) cortex, which was compared with the BOLD-fMRI responses in the contralesional S1 cortex. The ratio of inhibitory postsynaptic current (IPSC) to excitatory postsynaptic current (EPSC) at the thalamocortical (TC) input to the spared S1 cortex was significantly increased by PE, which is consistent with the increased BOLD-fMRI responses and improved functional outcome. Our data clearly demonstrate in an experimental rat model of HI injury during the critical period that PE in adulthood enhances neuroplasticity and suggest that enhanced feed-forward inhibition at the TC input to the S1 cortex might underlie the PE-induced amelioration of the somatosensory deficits caused by the HI injury. In summary, the results of the current study indicate that PE, even if performed beyond the critical period or during adulthood, can be an effective therapy to treat neonatal brain injuries, providing a potential mechanism for the development of a potent rehabilitation strategy to alleviate HI-induced neurological impairments.
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The U.S. Preventive Services Task Force's Opportunity to Pursue a New Strategy for Behavioral Health
Publication date: Available online 13 December 2018
Source: American Journal of Preventive Medicine
Author(s): Nathaniel Z. Counts, J. David Hawkins, Diana H. Fishbein
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Disparities in Preventable Hospitalizations Among Public Housing Developments
Publication date: Available online 13 December 2018
Source: American Journal of Preventive Medicine
Author(s): Brian Yim, Renata E. Howland, Gretchen M. Culp, Anna Zhilkova, Oxiris Barbot, Tsu-Yu Tsao
Introduction
This study assesses preventable hospitalization rates among New York City residents living in public housing developments compared with all New York City residents and residents in low-income areas. Additionally, preventable hospitalization rates by development (one or multiple buildings in close proximity and served by the same management office) were determined.
Methods
The 2010–2014 New York City hospital discharge data were geocoded and linked with New York City Housing Authority records using building-level identifiers. Preventable hospitalizations resulting from ambulatory care–sensitive conditions were identified for public housing residents, citywide, and residents of low-income areas. Age-adjusted overall and ambulatory care–sensitive, condition–specific preventable hospitalization rates (11 outcomes) were determined and compared across groups to assess potential disparities. Additionally, rates were ranked and compared among public housing developments by quartiles. The analysis was conducted in 2016 and 2017.
Results
The age-adjusted rate of preventable hospitalization was significantly higher among public housing residents than citywide (rate ratio [RR]=2.67, 95% CI=2.65, 2.69), with the greatest disparities in hospitalizations related to diabetes (RR=3.12, 95% CI=3.07, 3.18) and asthma (RR=4.14, 95% CI=4.07, 4.21). The preventable hospitalization rate was also higher among residents of public housing than low-income areas (RR=1.33, 95% CI=1.31, 1.35). There were large differences between developments ranked in the top and bottom quartiles of preventable hospitalization (RR=1.81, 95% CI=1.76, 1.85) with the largest difference related to chronic obstructive pulmonary disease (RR=3.38, 95% CI=3.08, 3.70).
Conclusions
Preventable hospitalization rates are high among public housing residents, and vary significantly by development and condition. By providing geographically granular information, geocoded hospital discharge data can serve as a valuable tool for health assessment and engagement of the healthcare sector and other stakeholders in interventions that address health inequities.
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Life's Simple 7 and Peripheral Artery Disease: The Multi-Ethnic Study of Atherosclerosis
Publication date: Available online 13 December 2018
Source: American Journal of Preventive Medicine
Author(s): Jonathan T. Unkart, Matthew A. Allison, Michael H. Criqui, Mary M. McDermott, Alexis C. Wood, Aaron R. Folsom, Donald Lloyd-Jones, Laura J. Rasmussen-Torvik, Norrina Allen, Gregory Burke, Moyses Szklo, Mary Cushman, Robyn L. McClelland, Christina L. Wassel
Introduction
In 2010, the American Heart Association initiated Life's Simple 7 with the goal of significantly improving cardiovascular health by the year 2020. The association of Life's Simple 7 with risk of peripheral artery disease has not been thoroughly explored.
Methods
Racially diverse individuals from the Multi-Ethnic Study of Atherosclerosis (2000–2012) were followed for incident peripheral artery disease (ankle brachial index ≤0.90) and decline in ankle brachial index (≥0.15) over approximately 10 years of follow-up. Cox and logistic regression were used to assess associations of individual Life's Simple 7 components (score 0–2) and overall Life's Simple 7 score (score 0–14) with incident peripheral artery disease and ankle brachial index decline, respectively, adjusted for age, sex, race/ethnicity, education, and income. Analyses were performed in 2016–2018.
Results
Of 5,529 participants, 251 (4.5%) developed incident peripheral artery disease; 419 (9.8%) of 4,267 participants experienced a decline in ankle brachial index. Each point higher for the overall Life's Simple 7 score was associated with a 17% lower rate of incident peripheral artery disease (hazard ratio=0.83, 95% CI=0.78, 0.88, p<0.001). Additionally, each point higher in overall Life's Simple 7 was associated with a 0.94-fold lower odds of decline in ankle brachial index (OR=0.94, 95% CI=0.87, 0.97, p=0.003). Four components (smoking, physical activity, glucose, and blood pressure) were associated with incident peripheral artery disease and two (smoking and glucose) with decline in ankle brachial index.
Conclusions
Better cardiovascular health as measured by Life's Simple 7 is associated with lower incidence of peripheral artery disease and less decline in ankle brachial index. Use of the Life's Simple 7 to target modifiable health behaviors may aid in decreasing the population burden of peripheral artery disease–related morbidity and mortality.
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Healthcare Costs of Secondhand Smoke Exposure at Home for U.S. Children
Publication date: Available online 12 December 2018
Source: American Journal of Preventive Medicine
Author(s): Tingting Yao, Hai-Yen Sung, Yingning Wang, James Lightwood, Wendy Max
Introduction
The purpose of this study is to estimate healthcare utilization and healthcare costs due to secondhand smoke exposure at home for children in the U.S.
Methods
Using data from the 2000, 2005, and 2010 U.S. National Health Interview Surveys, the authors analyzed the association between secondhand smoke exposure at home and utilization of three types of healthcare services (hospital nights, emergency room visits, and doctor visits) for children aged 3–14 years (N=16,860). A zero-inflated Poisson regression model was used to control for sociodemographic characteristics and the number of months without health insurance. The authors determined excess healthcare utilization attributable to secondhand smoke exposure at home for children and then estimated annual secondhand smoke–attributable healthcare costs as the product of annual excess healthcare utilization and unit costs obtained from the 2014 Medical Expenditures Panel Survey. This study was conducted from 2016 to 2018.
Results
The prevalence of secondhand smoke exposure at home for children in 2000, 2005, and 2010 was 25.0%, 12.3%, and 9.1%, respectively. Secondhand smoke exposure at home was positively associated with emergency room visits, but was not significantly associated with nights at the hospital or doctor visits for children. Secondhand smoke exposure at home for children resulted in an excess of 347,156 emergency room visits in 2000, 124,412 visits in 2005, and 101,570 visits in 2010, which amounted to $215.1 million, $77.1 million, and $62.9 million in excess annual healthcare costs (2014 dollars) in 2000, 2005, and 2010, respectively.
Conclusions
Although U.S. healthcare costs attributable to secondhand smoke exposure at home for children are declining, interventions to reduce secondhand smoke exposure at home for children are still needed to reduce the economic burden attributable to secondhand smoke exposure.
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Trauma Exposure, DSM-5 Post-Traumatic Stress Disorder, and Sexual Risk Outcomes
Publication date: Available online 12 December 2018
Source: American Journal of Preventive Medicine
Author(s): Natalie P. Mota, Sarah Turner, Tamara Taillieu, Isabel Garcés, Kirby Magid, Japandeep Sethi, Shannon Struck, Renée El-Gabalawy, Tracie O. Afifi
Introduction
The current study examined associations between DSM-5 post-traumatic stress disorder (PTSD) and three sexual risk outcomes: presence of a sexually transmitted disease/infection, frequency of condom use, and sex with a known user of injection drugs.
Methods
Data were from the National Epidemiologic Survey on Alcohol and Related Conditions–III (2012–2013, analyzed 2017), a nationally representative survey of non-institutionalized U.S. adults aged ≥18 years. Sexual outcomes and trauma exposure were assessed via self-report, and PTSD was assessed using a validated structured interview. Logistic and multinomial regression analyses examined associations between PTSD, PTSD symptom clusters, trauma type, and each sexual outcome.
Results
Lifetime PTSD was associated with increased odds of having a past-year sexually transmitted disease/infection and sex with a known injection drug user (AOR = 1.54 and 1.74, respectively); fewer intrusion symptoms were associated with sometimes/fairly often condom use relative to very often. Reporting of adult sexual assault, assaultive violence, and other trauma as one's worst event was associated with increased odds of a past-year sexually transmitted disease/infection (AOR range, 1.69–4.56), whereas child maltreatment was associated with using condoms never/almost never in the past 12 months (AOR = 1.40). No other significant findings emerged.
Conclusions
The current study demonstrates an association between certain trauma exposures, PTSD symptoms, and an increased likelihood of sexual risk outcomes. Clinicians working with individuals with PTSD symptoms, particularly those who have been exposed to interpersonal trauma, should screen for the presence of these sequelae.
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Trauma Exposure, DSM-5 Post-Traumatic Stress Disorder, and Sexual Risk Outcomes
Publication date: Available online 12 December 2018
Source: American Journal of Preventive Medicine
Author(s): Natalie P. Mota, Sarah Turner, Tamara Taillieu, Isabel Garcés, Kirby Magid, Japandeep Sethi, Shannon Struck, Renée El-Gabalawy, Tracie O. Afifi
Introduction
The current study examined associations between DSM-5 post-traumatic stress disorder (PTSD) and three sexual risk outcomes: presence of a sexually transmitted disease/infection, frequency of condom use, and sex with a known user of injection drugs.
Methods
Data were from the National Epidemiologic Survey on Alcohol and Related Conditions–III (2012–2013, analyzed 2017), a nationally representative survey of non-institutionalized U.S. adults aged ≥18 years. Sexual outcomes and trauma exposure were assessed via self-report, and PTSD was assessed using a validated structured interview. Logistic and multinomial regression analyses examined associations between PTSD, PTSD symptom clusters, trauma type, and each sexual outcome.
Results
Lifetime PTSD was associated with increased odds of having a past-year sexually transmitted disease/infection and sex with a known injection drug user (AOR = 1.54 and 1.74, respectively); fewer intrusion symptoms were associated with sometimes/fairly often condom use relative to very often. Reporting of adult sexual assault, assaultive violence, and other trauma as one's worst event was associated with increased odds of a past-year sexually transmitted disease/infection (AOR range, 1.69–4.56), whereas child maltreatment was associated with using condoms never/almost never in the past 12 months (AOR = 1.40). No other significant findings emerged.
Conclusions
The current study demonstrates an association between certain trauma exposures, PTSD symptoms, and an increased likelihood of sexual risk outcomes. Clinicians working with individuals with PTSD symptoms, particularly those who have been exposed to interpersonal trauma, should screen for the presence of these sequelae.
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A Cluster-Randomized Trial on Small Incentives to Promote Physical Activity
Publication date: Available online 13 December 2018
Source: American Journal of Preventive Medicine
Author(s): Jan-Niklas Kramer, Peter Tinschert, Urte Scholz, Elgar Fleisch, Tobias Kowatsch
Introduction
There has been limited research investigating whether small financial incentives can promote participation, behavior change, and engagement in physical activity promotion programs. This study evaluates the effects of two types of small financial incentives within a physical activity promotion program of a Swiss health insurance company.
Study design
Three-arm cluster-randomized trial comparing small personal financial incentives and charity financial incentives (10 Swiss Francs, equal to US$10.40) for each month with an average step count of >10,000 steps per day to control. Insureds' federal state of residence was the unit of randomization. Data were collected in 2015 and analyses were completed in 2018.
Setting/participants
German-speaking insureds of a large health insurer in Switzerland were invited. Invited insureds were aged ≥18 years, enrolled in complementary insurance plans and registered on the insurer's online platform.
Main outcome measures
Primary outcome was the participation rate. Secondary outcomes were steps per day, the proportion of participant days in which >10,000 steps were achieved and non-usage attrition over the first 3 months of the program.
Results
Participation rate was 5.94% in the personal financial incentive group (OR=1.96, 95% CI=1.55, 2.49) and 4.98% in the charity financial incentive group (OR=1.59, 95% CI=1.25, 2.01) compared with 3.23% in the control group. At the start of the program, the charity financial group had a 12% higher chance of walking 10,000 steps per day than the control group (OR=1.68, 95% CI=1.23, 2.30), but this effect dissipated after 3 months. Steps per day and non-usage attrition did not differ significantly between the groups.
Conclusions
Small personal and charity financial incentives can increase participation in physical activity promotion programs. Incentives may need to be modified in order to prevent attrition and promote behavior change over a longer period of time.
Trial registration
This study is registered at www.isrctn.com ISRCTN24436134.
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The U.S. Preventive Services Task Force's Opportunity to Pursue a New Strategy for Behavioral Health
Publication date: Available online 13 December 2018
Source: American Journal of Preventive Medicine
Author(s): Nathaniel Z. Counts, J. David Hawkins, Diana H. Fishbein
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Disparities in Preventable Hospitalizations Among Public Housing Developments
Publication date: Available online 13 December 2018
Source: American Journal of Preventive Medicine
Author(s): Brian Yim, Renata E. Howland, Gretchen M. Culp, Anna Zhilkova, Oxiris Barbot, Tsu-Yu Tsao
Introduction
This study assesses preventable hospitalization rates among New York City residents living in public housing developments compared with all New York City residents and residents in low-income areas. Additionally, preventable hospitalization rates by development (one or multiple buildings in close proximity and served by the same management office) were determined.
Methods
The 2010–2014 New York City hospital discharge data were geocoded and linked with New York City Housing Authority records using building-level identifiers. Preventable hospitalizations resulting from ambulatory care–sensitive conditions were identified for public housing residents, citywide, and residents of low-income areas. Age-adjusted overall and ambulatory care–sensitive, condition–specific preventable hospitalization rates (11 outcomes) were determined and compared across groups to assess potential disparities. Additionally, rates were ranked and compared among public housing developments by quartiles. The analysis was conducted in 2016 and 2017.
Results
The age-adjusted rate of preventable hospitalization was significantly higher among public housing residents than citywide (rate ratio [RR]=2.67, 95% CI=2.65, 2.69), with the greatest disparities in hospitalizations related to diabetes (RR=3.12, 95% CI=3.07, 3.18) and asthma (RR=4.14, 95% CI=4.07, 4.21). The preventable hospitalization rate was also higher among residents of public housing than low-income areas (RR=1.33, 95% CI=1.31, 1.35). There were large differences between developments ranked in the top and bottom quartiles of preventable hospitalization (RR=1.81, 95% CI=1.76, 1.85) with the largest difference related to chronic obstructive pulmonary disease (RR=3.38, 95% CI=3.08, 3.70).
Conclusions
Preventable hospitalization rates are high among public housing residents, and vary significantly by development and condition. By providing geographically granular information, geocoded hospital discharge data can serve as a valuable tool for health assessment and engagement of the healthcare sector and other stakeholders in interventions that address health inequities.
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Life's Simple 7 and Peripheral Artery Disease: The Multi-Ethnic Study of Atherosclerosis
Publication date: Available online 13 December 2018
Source: American Journal of Preventive Medicine
Author(s): Jonathan T. Unkart, Matthew A. Allison, Michael H. Criqui, Mary M. McDermott, Alexis C. Wood, Aaron R. Folsom, Donald Lloyd-Jones, Laura J. Rasmussen-Torvik, Norrina Allen, Gregory Burke, Moyses Szklo, Mary Cushman, Robyn L. McClelland, Christina L. Wassel
Introduction
In 2010, the American Heart Association initiated Life's Simple 7 with the goal of significantly improving cardiovascular health by the year 2020. The association of Life's Simple 7 with risk of peripheral artery disease has not been thoroughly explored.
Methods
Racially diverse individuals from the Multi-Ethnic Study of Atherosclerosis (2000–2012) were followed for incident peripheral artery disease (ankle brachial index ≤0.90) and decline in ankle brachial index (≥0.15) over approximately 10 years of follow-up. Cox and logistic regression were used to assess associations of individual Life's Simple 7 components (score 0–2) and overall Life's Simple 7 score (score 0–14) with incident peripheral artery disease and ankle brachial index decline, respectively, adjusted for age, sex, race/ethnicity, education, and income. Analyses were performed in 2016–2018.
Results
Of 5,529 participants, 251 (4.5%) developed incident peripheral artery disease; 419 (9.8%) of 4,267 participants experienced a decline in ankle brachial index. Each point higher for the overall Life's Simple 7 score was associated with a 17% lower rate of incident peripheral artery disease (hazard ratio=0.83, 95% CI=0.78, 0.88, p<0.001). Additionally, each point higher in overall Life's Simple 7 was associated with a 0.94-fold lower odds of decline in ankle brachial index (OR=0.94, 95% CI=0.87, 0.97, p=0.003). Four components (smoking, physical activity, glucose, and blood pressure) were associated with incident peripheral artery disease and two (smoking and glucose) with decline in ankle brachial index.
Conclusions
Better cardiovascular health as measured by Life's Simple 7 is associated with lower incidence of peripheral artery disease and less decline in ankle brachial index. Use of the Life's Simple 7 to target modifiable health behaviors may aid in decreasing the population burden of peripheral artery disease–related morbidity and mortality.
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Healthcare Costs of Secondhand Smoke Exposure at Home for U.S. Children
Publication date: Available online 12 December 2018
Source: American Journal of Preventive Medicine
Author(s): Tingting Yao, Hai-Yen Sung, Yingning Wang, James Lightwood, Wendy Max
Introduction
The purpose of this study is to estimate healthcare utilization and healthcare costs due to secondhand smoke exposure at home for children in the U.S.
Methods
Using data from the 2000, 2005, and 2010 U.S. National Health Interview Surveys, the authors analyzed the association between secondhand smoke exposure at home and utilization of three types of healthcare services (hospital nights, emergency room visits, and doctor visits) for children aged 3–14 years (N=16,860). A zero-inflated Poisson regression model was used to control for sociodemographic characteristics and the number of months without health insurance. The authors determined excess healthcare utilization attributable to secondhand smoke exposure at home for children and then estimated annual secondhand smoke–attributable healthcare costs as the product of annual excess healthcare utilization and unit costs obtained from the 2014 Medical Expenditures Panel Survey. This study was conducted from 2016 to 2018.
Results
The prevalence of secondhand smoke exposure at home for children in 2000, 2005, and 2010 was 25.0%, 12.3%, and 9.1%, respectively. Secondhand smoke exposure at home was positively associated with emergency room visits, but was not significantly associated with nights at the hospital or doctor visits for children. Secondhand smoke exposure at home for children resulted in an excess of 347,156 emergency room visits in 2000, 124,412 visits in 2005, and 101,570 visits in 2010, which amounted to $215.1 million, $77.1 million, and $62.9 million in excess annual healthcare costs (2014 dollars) in 2000, 2005, and 2010, respectively.
Conclusions
Although U.S. healthcare costs attributable to secondhand smoke exposure at home for children are declining, interventions to reduce secondhand smoke exposure at home for children are still needed to reduce the economic burden attributable to secondhand smoke exposure.
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Ecological momentary assessment of various tobacco product use among young adults
Publication date: Available online 11 December 2018
Source: Addictive Behaviors
Author(s): Carla J. Berg, Regine Haardörfer, Jackelyn B. Payne, Betelihem Getachew, Milkie Vu, Alexandra Guttentag, Thomas R. Kirchner
Abstract
Introduction
Young adults are at high risk for using traditional and novel tobacco products. However, little is known about daily/weekly use patterns or psychosocial triggers for using various tobacco products.
Methods
This ecological momentary assessment (EMA) study examined timing, tobacco cravings, affect, social context, and other substance use (alcohol, marijuana) in relation to use of cigarettes, electronic nicotine delivery systems (ENDS), and any tobacco product (i.e., cigarettes, ENDS, cigars, hookah), respectively. We also examined interactions between these predictors, sex, and race/ethnicity. From a longitudinal study of 3418 18–25 year-olds from seven Georgia colleges/universities, we recruited 72 reporting current tobacco use to participate in the 21-day EMA study; 43 participated, of which 31 completed ≥66% assessments and were analyzed. Cravings, affect, social context, and substance use were assessed daily across four four-hour windows.
Results
Of the 31 participants, average age was 21.10 years (SD = 1.95), 45.2% were female, and 71.0% non-Hispanic White; 71.0% used cigarettes, 58.1% ENDS, 38.7% cigars, and 25.8% hookah (25.6% used one product, 46.5% two, 27.9% ≥ three). Predictors of cigarette use included higher anxiety, greater odds of marijuana and alcohol use, and higher boredom levels among women. Predictors of ENDS use included being non-White and greater odds of marijuana use, as well as higher tobacco cravings among women and higher boredom among men. Predictors of any tobacco product use included being non-White, higher boredom levels, and greater odds of marijuana and alcohol use.
Conclusions
Distinct interventions may be needed to address use of differing tobacco products among young adults.
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Parent-Implemented Communication Treatment for Infants and Toddlers With Hearing Loss: A Randomized Pilot Trial.
Conclusions: This study provides modest preliminary support for the short-term effects of a parent-implemented communication treatment for children with hearing loss. Parents learned communication support strategies that subsequently impacted child prelinguistic skills. Although these results appear promising, the sample size is very small. Future research should include a larger clinical trial and child-level predictors of response to treatment. PMID: 30535174 [PubMed - as supplied by publisher] (Source: Journal of speech, language, and hearing research : JSLHR)
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Impact of processing load on analogical mapping with visual sequences in children with developmental language disorders (DLD).
CONCLUSIONS & IMPLICATIONS: Children with DLD have impaired analogical mapping competences, especially when the relational similarities are not supported by perceptual cues. This impairment may be the cause of their difficulties in abstracting construction schemas, thus provoking their poor linguistic productivity and creativity. However, more studies are needed to confirm this hypothesis, as the influence of analogical reasoning on language development could also be reversed or could be linked to another external factor. PMID: 30536567 [PubMed - as supplied by publisher] (Source: International Journal of Language and Communication Disorders)
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Prepositions and pronouns in connected discourse of individuals with aphasia.
Authors: Martínez-Ferreiro S, Ishkhanyan B, Rosell-Clarí V, Boye K Abstract The lexical-grammatical divide has been a widely addressed topic in aphasia. Speech parts are generally classified as either belonging to a lexical or a grammatical category based on the frequency of acquisition of new members in their paradigms (open vs. closed classes), thus neglecting heterogeneity within categories. Such an approach has led to contradictory findings. First, prepositions form closed classes, but are classically taken as lexical items. Pronouns, also belonging to a closed class, are analyzed as grammatical elements. Second, both within the group of prepositions and pronouns, forms with different syntactic and semantic properties co-exist. Following the theoretical notions granted by a u...
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Size matters in the case of graphic health warning: Evidence from physiological measures
Publication date: Available online 7 December 2018
Source: Addictive Behaviors
Author(s): Carlos Gantiva, Miguel Sotaquirá, Marisol Marroquín, Camilo Carné, Lisbeth Parada, Miguel A. Muñoz
Abstract
Objectives
>50 countries use graphic health warnings (GHWs) with the minimum size that is recommended by the World Health Organization (WHO). The aim of the present study was to evaluate the effect of the size of GHWs on physiological responses that serve as indices of arousal and aversive motivation in nonsmokers, weekly smokers, and daily smokers.
Methods
The skin conductance response, corrugator muscle activity, and startle reflex were recorded in 35 nonsmokers, 35 weekly smokers, and 35 daily smokers while they observed pictures of cigarette packs without GHWs, cigarette packs with GHWs that covered 30% of the pack, and cigarette packs with GHWs that covered 60% of the pack.
Results
Cigarette packs with 30% GHWs did not generate significantly higher responses on any of the physiological measures compared with cigarette packs without GHWs. Conversely, cigarette packs with GHWs that covered 60% of the pack generated a greater skin conductance response, greater corrugator muscle activity, and an increase in the startle reflex compared with cigarette packs without GHWs. No significant differences were found between groups in any of the physiological measures.
Conclusions
The minimum size of GHW that is recommended by the WHO is insufficient to generate an emotional response that favors avoidance of the cigarette pack. GHW that cover 60% of the cigarette pack significantly reduced the attractiveness of the tobacco packaging and generated greater arousal responses.
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Documenting need for naloxone distribution in the Los Angeles County jail system
Publication date: Available online 12 December 2018
Source: Addictive Behaviors
Author(s): Peter J. Davidson, Karla D. Wagner, Paula L. Tokar, Shoshanna Scholar
Abstract
Background
The Los Angeles County Jail system is the largest jail system in the United States, with an average daily inmate population of 17,024 in 2017. Existing literature shows the weeks following release from incarceration are associated with increased risk of overdose death among individuals who previously used opioids. One response is to train inmates in overdose prevention and response (OPR) and to provide the opioid antagonist naloxone on release. However, in large jail systems training all inmates can be logistically and financially difficult, leading to interest identifying individuals most likely to benefit from such programs.
Method
In 2017, the Los Angeles County Office of Diversion and Reentry collaborated with the Los Angeles County Sheriff Department to conduct an OPR needs assessment evaluation with all inmates entering the jail over a two week period.
Results
3781 inmates provided complete data for this analysis (3315 men, 466 women). 17% reported using opioids within the last 12 months, 7% reported witnessing an overdose within the last 12 months, and 5% report ever having received medication assisted treatment (MAT). 39% reported interest in being trained in overdose prevention and response. The single largest predictor of interest in OPR was being present at an overdose in the past year.
Conclusion
Our results suggest OPR should be provided to all inmates who opt-in to receiving training regardless of other risk factors. Our results also suggest this population has had little prior exposure to MAT and incarceration could represent a significant opportunity to provide such evidence-based treatments.
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Typology of cannabis use among adults: A latent class approach to risk and protective factors
Publication date: Available online 10 December 2018
Source: Addictive Behaviors
Author(s): Kara Manning, Lorra Garey, Daniel J. Paulus, Julia D. Buckner, Julianna B.D. Hogan, Norman B. Schmidt, Michael J. Zvolensky
Abstract
Background
Cannabis is among the most widely used substances worldwide. The United States has seen an increase in the number of adult daily cannabis users and in the number of adults diagnosed with cannabis use disorder. However, little work has examined patterns of use or unique subgroups of adult cannabis users, which may be useful in developing targeted treatment interventions for problematic cannabis users. Therefore, the current study used latent profile analysis to identify whether cannabis users can be categorized across distinct subgroups of adult users.
Method
The sample included 374 current cannabis using adults (64.2% Male; Mage = 32.6). Cannabis use frequency, quantity, and related problems were used to differentiate subgroups. Further, age, race, emotion dysregulation, affect, anxiety sensitivity, other substance use, and motives for cannabis use were examined as class correlates.
Results
Results supported five unique classes of cannabis users, generally ranging from light, infrequent users with few problems to heavy, frequent users with more problems. Additionally, race, negative affectivity, anxiety sensitivity, emotion regulation, cannabis use motives, and alcohol use emerged as unique predictors of class membership. The current findings substantiate past work for heterogeneous latent classes that underlie the larger cannabis using population, however, this study provides novel evidence for subgroups of adult users.
Conclusion
The identification of different classes of cannabis users may inform future treatment interventions, and ultimately, lead to the development of personalized treatments for each class based on correlates of group membership.
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Patterns of sustained e-cigarette use in a sample of young adults
Publication date: Available online 12 December 2018
Source: Addictive Behaviors
Author(s): MeLisa Creamer, Kathleen Case, Alexandra Loukas, Maria Cooper, Cheryl L. Perry
Abstract
Introduction
E-cigarette use and devices are rapidly changing, yet there is not much scientific evidence examining these changes over time. The purpose of this study is to describe patterns of e-cigarette use in a sample of sustained (i.e., reporting past 30-day e-cigarette use at every wave) e-cigarette users over a two-year period.
Methods
Data are drawn from five waves of the Project M-PACT cohort. Analyses are limited to those reporting past 30-day e-cigarette use at each wave (n = 75). Mixed effects regressions were conducted for the following dependent variables: device type, number of days used, combustible tobacco product use, and symptoms of nicotine dependence. Each model used survey wave as the time variable, and controlled for sociodemographic variables.
Results
Among sustained users, the majority reported using a rechargeable device. The average number of days used was about 2 for disposable devices and 14 for rechargeable devices (p < .0001). The odds of combustible tobacco product use decreased over time (AOR = 0.71; 95% CI 0.57–0.89), while symptoms of e-cigarette nicotine dependence increased over time (β = 0.07 SE = 0.03, p-value = .02). For both e-cigarette device types, there were no changes in device type or number of days used over time.
Conclusion
This is one of the first studies to look at changes in e-cigarette use, including symptoms of dependence and number of days used over a two-year period. This brief report extends the current literature by examining more than the prevalence and frequency of e-cigarette use.
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Microbiome and disease in the upper airway
Purpose of review Microbiome refers to the genetic potential of resident microorganisms that inhabit a given niche. The exact role of the microbiome and its relation to chronic disease processes remains largely unknown, although various associations have been observed. We reviewed current literature investigating the microbiome of the upper airway by subsite (nasal cavity, sinus cavities, nasopharynx, and larynx) and its relation to chronic inflammatory disease processes. Recent findings The disruption of indigenous microbiota at a specific subsite may lead to pathogen overgrowth and increased susceptibility to infection. This has previously been demonstrated in the gastrointestinal tract and lower airways. The role of the microbiome and its relation to pathogenesis of disease in the upper airway, however, is less clearly understood. The present review discusses the recent studies that appear to link dysbiosis to upper airway chronic inflammatory diseases. Summary Despite mounting research, the role of microbiota in the upper airway remains poorly understood. Based on review of the current literature comparing healthy versus diseased patients with site-specific inflammatory conditions, a complex consortium of microbial communities inhabits the upper airway. Fluctuations in the baseline microbiome may contribute to disease pathogenesis, and improved understanding of the dynamics between shifting microbiota may be critical to guiding future medical therapy. Correspondence to Jivianne T. Lee, MD, David Geffen School of Medicine at UCLA, Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles 10833 Le Conte Ave., CHS 62-132, Los Angeles, CA 90095-1624, USA. E-mail: JTLee@mednet.ucla.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Prepositions and pronouns in connected discourse of individuals with aphasia.
Authors: Martínez-Ferreiro S, Ishkhanyan B, Rosell-Clarí V, Boye K Abstract The lexical-grammatical divide has been a widely addressed topic in aphasia. Speech parts are generally classified as either belonging to a lexical or a grammatical category based on the frequency of acquisition of new members in their paradigms (open vs. closed classes), thus neglecting heterogeneity within categories. Such an approach has led to contradictory findings. First, prepositions form closed classes, but are classically taken as lexical items. Pronouns, also belonging to a closed class, are analyzed as grammatical elements. Second, both within the group of prepositions and pronouns, forms with different syntactic and semantic properties co-exist. Following the theoretical notions granted by a u...
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Impact of processing load on analogical mapping with visual sequences in children with developmental language disorders (DLD).
CONCLUSIONS & IMPLICATIONS: Children with DLD have impaired analogical mapping competences, especially when the relational similarities are not supported by perceptual cues. This impairment may be the cause of their difficulties in abstracting construction schemas, thus provoking their poor linguistic productivity and creativity. However, more studies are needed to confirm this hypothesis, as the influence of analogical reasoning on language development could also be reversed or could be linked to another external factor. PMID: 30536567 [PubMed - as supplied by publisher] (Source: International Journal of Language and Communication Disorders)
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The Development of a Self-Efficacy Measurement Tool For Counseling in Speech-Language Pathology.
Conclusion: The adapted Counselor Activity Self-Efficacy Scales for speech-language pathologists is psychometrically sound; factor analysis, reliability, and validity were in line with reported values for the original survey tool. Potential uses for the survey tool within the field of speech-language pathology are discussed, along with implications for graduate education and clinical supervision related to counseling skills. PMID: 30535061 [PubMed - as supplied by publisher] (Source: American Journal of Speech-Language Pathology)
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Masthead.
Authors: PMID: 30535048 [PubMed - in process] (Source: Journal of speech, language, and hearing research : JSLHR)
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Age Effects on Concurrent Speech Segregation by Onset Asynchrony.
Conclusion: Both age groups benefit to a similar extent from onset asynchrony as a cue for concurrent speech segregation during active (behavioral measurement) and during passive (electroencephalographic measurement) listening. PMID: 30534994 [PubMed - as supplied by publisher] (Source: Journal of speech, language, and hearing research : JSLHR)
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Locating gambling problems across a continuum of severity: Rasch analysis of the Quinte Longitudinal Study (QLS)
Publication date: Available online 12 December 2018
Source: Addictive Behaviors
Author(s): S. Cowlishaw, S.S. Merkouris, N.A. Dowling, S. Rodda, A. Suomi, S.L. Thomas
Abstract
Addressing gambling problems across a continuum requires understanding of low severity problems, as well as severe levels of problem gambling or disorder. The aims of this study were thus to derive a map of how problematic gambling behaviours and harms are situated across a continuum, and identify the best available indicators of low severity problems to inform assessment and secondary prevention. This involved the Rasch analyses of baseline data from the Quinte Longitudinal Study (QLS); a community-based survey involving random-digit dialling of numbers around Belleville, Canada. Participants were n = 1305 adults with non-zero scores across 26-items from: (American Psychiatric Association, 2013) the Problem Gambling Severity Index (PGSI); (Delfabbro, 2013) the NORC DSM Screen for Gambling Problems (NODS); and (Korn & Shaffer, 1999) the Problem and Pathological Gambling Measure (PPGM). Results indicated that item-level measures except chasing losses provided fit to the Rasch model, and most were clustered within a narrow region of the continuum which resembled addictive disorders. At the most severe end were mainly items about harms, while there were few items representing low severity levels (feeling guilty, betting more than one can afford, attempts to reduce gambling, gambling more than intended). There was Differential Item Functioning (DIF) for several indicators of low severity problems. The findings suggest that measures remain closely aligned with psychiatric models and are suited for discriminating across severe levels of problem gambling or addictive disorder. Although cognitive-affective and behavioural indicators comprise the best available indicators of low severity symptoms, there is an urgent need for improvements in conceptualisation and measurement.
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Opioid and sedative misuse among veterans wounded in combat
Publication date: Available online 10 December 2018
Source: Addictive Behaviors
Author(s): Michelle L. Kelley, Adrian J. Bravo, Victoria R. Votaw, Elena Stein, Jason C. Redman, Katie Witkiewitz
Abstract
Background
Military veterans wounded in combat are a high-risk group for emotional and physical distress, which may be exacerbated by misuse of prescription opioids and sedatives. The goal of the current study was to examine the prevalence and correlates of prescription opioid and sedative misuse among veterans wounded in combat.
Method
We recruited veterans from the Combat Wounded Coalition (n = 212; 84% non-Hispanic White; 97.6% male) to complete an online survey of mental health and substance use disorder symptoms, assessed via the DSM-5 Self-Rated Level 1 Cross-Cutting Symptoms Measure, the Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5, the Pain Enjoyment General Activity Scale, and the Alcohol Use Disorders Identification Test (AUDIT). Prescription opioid and sedative misuse was assessed by frequency of use in the past year that was not currently prescribed or using more than prescribed.
Results
Participants reported high rates of past year prescription opioid misuse (46.2%) and sedative misuse (21.7%). Misuse of both opioids and sedatives was associated with the most distress, including greater depression, anger, sleep disturbance, AUDIT scores, PTSD symptoms, suicidality, and pain interference. In multivariable multinomial logistic regression analyses, greater sleep disturbance (OR = 1.73) was associated with greater odds of sedative misuse versus no misuse. Higher AUDIT scores were associated with greater risk of sedative misuse (OR = 1.16) versus opioid misuse only.
Conclusions
Military veterans wounded in combat have high rates of prescription opioid misuse and sedative misuse. Sleep problems and AUDIT scores might help identify veterans who are at most risk for opioid and sedative misuse.
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Microbiome and disease in the upper airway
Purpose of review Microbiome refers to the genetic potential of resident microorganisms that inhabit a given niche. The exact role of the microbiome and its relation to chronic disease processes remains largely unknown, although various associations have been observed. We reviewed current literature investigating the microbiome of the upper airway by subsite (nasal cavity, sinus cavities, nasopharynx, and larynx) and its relation to chronic inflammatory disease processes. Recent findings The disruption of indigenous microbiota at a specific subsite may lead to pathogen overgrowth and increased susceptibility to infection. This has previously been demonstrated in the gastrointestinal tract and lower airways. The role of the microbiome and its relation to pathogenesis of disease in the upper airway, however, is less clearly understood. The present review discusses the recent studies that appear to link dysbiosis to upper airway chronic inflammatory diseases. Summary Despite mounting research, the role of microbiota in the upper airway remains poorly understood. Based on review of the current literature comparing healthy versus diseased patients with site-specific inflammatory conditions, a complex consortium of microbial communities inhabits the upper airway. Fluctuations in the baseline microbiome may contribute to disease pathogenesis, and improved understanding of the dynamics between shifting microbiota may be critical to guiding future medical therapy. Correspondence to Jivianne T. Lee, MD, David Geffen School of Medicine at UCLA, Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles 10833 Le Conte Ave., CHS 62-132, Los Angeles, CA 90095-1624, USA. E-mail: JTLee@mednet.ucla.edu Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Parent-Implemented Communication Treatment for Infants and Toddlers With Hearing Loss: A Randomized Pilot Trial.
Conclusions: This study provides modest preliminary support for the short-term effects of a parent-implemented communication treatment for children with hearing loss. Parents learned communication support strategies that subsequently impacted child prelinguistic skills. Although these results appear promising, the sample size is very small. Future research should include a larger clinical trial and child-level predictors of response to treatment. PMID: 30535174 [PubMed - as supplied by publisher] (Source: Journal of speech, language, and hearing research : JSLHR)
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Patterns of sustained e-cigarette use in a sample of young adults
Publication date: Available online 12 December 2018
Source: Addictive Behaviors
Author(s): MeLisa Creamer, Kathleen Case, Alexandra Loukas, Maria Cooper, Cheryl L. Perry
Abstract
Introduction
E-cigarette use and devices are rapidly changing, yet there is not much scientific evidence examining these changes over time. The purpose of this study is to describe patterns of e-cigarette use in a sample of sustained (i.e., reporting past 30-day e-cigarette use at every wave) e-cigarette users over a two-year period.
Methods
Data are drawn from five waves of the Project M-PACT cohort. Analyses are limited to those reporting past 30-day e-cigarette use at each wave (n = 75). Mixed effects regressions were conducted for the following dependent variables: device type, number of days used, combustible tobacco product use, and symptoms of nicotine dependence. Each model used survey wave as the time variable, and controlled for sociodemographic variables.
Results
Among sustained users, the majority reported using a rechargeable device. The average number of days used was about 2 for disposable devices and 14 for rechargeable devices (p < .0001). The odds of combustible tobacco product use decreased over time (AOR = 0.71; 95% CI 0.57–0.89), while symptoms of e-cigarette nicotine dependence increased over time (β = 0.07 SE = 0.03, p-value = .02). For both e-cigarette device types, there were no changes in device type or number of days used over time.
Conclusion
This is one of the first studies to look at changes in e-cigarette use, including symptoms of dependence and number of days used over a two-year period. This brief report extends the current literature by examining more than the prevalence and frequency of e-cigarette use.
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Age Effects on Concurrent Speech Segregation by Onset Asynchrony.
Conclusion: Both age groups benefit to a similar extent from onset asynchrony as a cue for concurrent speech segregation during active (behavioral measurement) and during passive (electroencephalographic measurement) listening. PMID: 30534994 [PubMed - as supplied by publisher] (Source: Journal of speech, language, and hearing research : JSLHR)
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The Development of a Self-Efficacy Measurement Tool For Counseling in Speech-Language Pathology.
Conclusion: The adapted Counselor Activity Self-Efficacy Scales for speech-language pathologists is psychometrically sound; factor analysis, reliability, and validity were in line with reported values for the original survey tool. Potential uses for the survey tool within the field of speech-language pathology are discussed, along with implications for graduate education and clinical supervision related to counseling skills. PMID: 30535061 [PubMed - as supplied by publisher] (Source: American Journal of Speech-Language Pathology)
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Ecological momentary assessment of various tobacco product use among young adults
Publication date: Available online 11 December 2018
Source: Addictive Behaviors
Author(s): Carla J. Berg, Regine Haardörfer, Jackelyn B. Payne, Betelihem Getachew, Milkie Vu, Alexandra Guttentag, Thomas R. Kirchner
Abstract
Introduction
Young adults are at high risk for using traditional and novel tobacco products. However, little is known about daily/weekly use patterns or psychosocial triggers for using various tobacco products.
Methods
This ecological momentary assessment (EMA) study examined timing, tobacco cravings, affect, social context, and other substance use (alcohol, marijuana) in relation to use of cigarettes, electronic nicotine delivery systems (ENDS), and any tobacco product (i.e., cigarettes, ENDS, cigars, hookah), respectively. We also examined interactions between these predictors, sex, and race/ethnicity. From a longitudinal study of 3418 18–25 year-olds from seven Georgia colleges/universities, we recruited 72 reporting current tobacco use to participate in the 21-day EMA study; 43 participated, of which 31 completed ≥66% assessments and were analyzed. Cravings, affect, social context, and substance use were assessed daily across four four-hour windows.
Results
Of the 31 participants, average age was 21.10 years (SD = 1.95), 45.2% were female, and 71.0% non-Hispanic White; 71.0% used cigarettes, 58.1% ENDS, 38.7% cigars, and 25.8% hookah (25.6% used one product, 46.5% two, 27.9% ≥ three). Predictors of cigarette use included higher anxiety, greater odds of marijuana and alcohol use, and higher boredom levels among women. Predictors of ENDS use included being non-White and greater odds of marijuana use, as well as higher tobacco cravings among women and higher boredom among men. Predictors of any tobacco product use included being non-White, higher boredom levels, and greater odds of marijuana and alcohol use.
Conclusions
Distinct interventions may be needed to address use of differing tobacco products among young adults.
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Opioid and sedative misuse among veterans wounded in combat
Publication date: Available online 10 December 2018
Source: Addictive Behaviors
Author(s): Michelle L. Kelley, Adrian J. Bravo, Victoria R. Votaw, Elena Stein, Jason C. Redman, Katie Witkiewitz
Abstract
Background
Military veterans wounded in combat are a high-risk group for emotional and physical distress, which may be exacerbated by misuse of prescription opioids and sedatives. The goal of the current study was to examine the prevalence and correlates of prescription opioid and sedative misuse among veterans wounded in combat.
Method
We recruited veterans from the Combat Wounded Coalition (n = 212; 84% non-Hispanic White; 97.6% male) to complete an online survey of mental health and substance use disorder symptoms, assessed via the DSM-5 Self-Rated Level 1 Cross-Cutting Symptoms Measure, the Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5, the Pain Enjoyment General Activity Scale, and the Alcohol Use Disorders Identification Test (AUDIT). Prescription opioid and sedative misuse was assessed by frequency of use in the past year that was not currently prescribed or using more than prescribed.
Results
Participants reported high rates of past year prescription opioid misuse (46.2%) and sedative misuse (21.7%). Misuse of both opioids and sedatives was associated with the most distress, including greater depression, anger, sleep disturbance, AUDIT scores, PTSD symptoms, suicidality, and pain interference. In multivariable multinomial logistic regression analyses, greater sleep disturbance (OR = 1.73) was associated with greater odds of sedative misuse versus no misuse. Higher AUDIT scores were associated with greater risk of sedative misuse (OR = 1.16) versus opioid misuse only.
Conclusions
Military veterans wounded in combat have high rates of prescription opioid misuse and sedative misuse. Sleep problems and AUDIT scores might help identify veterans who are at most risk for opioid and sedative misuse.
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Typology of cannabis use among adults: A latent class approach to risk and protective factors
Publication date: Available online 10 December 2018
Source: Addictive Behaviors
Author(s): Kara Manning, Lorra Garey, Daniel J. Paulus, Julia D. Buckner, Julianna B.D. Hogan, Norman B. Schmidt, Michael J. Zvolensky
Abstract
Background
Cannabis is among the most widely used substances worldwide. The United States has seen an increase in the number of adult daily cannabis users and in the number of adults diagnosed with cannabis use disorder. However, little work has examined patterns of use or unique subgroups of adult cannabis users, which may be useful in developing targeted treatment interventions for problematic cannabis users. Therefore, the current study used latent profile analysis to identify whether cannabis users can be categorized across distinct subgroups of adult users.
Method
The sample included 374 current cannabis using adults (64.2% Male; Mage = 32.6). Cannabis use frequency, quantity, and related problems were used to differentiate subgroups. Further, age, race, emotion dysregulation, affect, anxiety sensitivity, other substance use, and motives for cannabis use were examined as class correlates.
Results
Results supported five unique classes of cannabis users, generally ranging from light, infrequent users with few problems to heavy, frequent users with more problems. Additionally, race, negative affectivity, anxiety sensitivity, emotion regulation, cannabis use motives, and alcohol use emerged as unique predictors of class membership. The current findings substantiate past work for heterogeneous latent classes that underlie the larger cannabis using population, however, this study provides novel evidence for subgroups of adult users.
Conclusion
The identification of different classes of cannabis users may inform future treatment interventions, and ultimately, lead to the development of personalized treatments for each class based on correlates of group membership.
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Locating gambling problems across a continuum of severity: Rasch analysis of the Quinte Longitudinal Study (QLS)
Publication date: Available online 12 December 2018
Source: Addictive Behaviors
Author(s): S. Cowlishaw, S.S. Merkouris, N.A. Dowling, S. Rodda, A. Suomi, S.L. Thomas
Abstract
Addressing gambling problems across a continuum requires understanding of low severity problems, as well as severe levels of problem gambling or disorder. The aims of this study were thus to derive a map of how problematic gambling behaviours and harms are situated across a continuum, and identify the best available indicators of low severity problems to inform assessment and secondary prevention. This involved the Rasch analyses of baseline data from the Quinte Longitudinal Study (QLS); a community-based survey involving random-digit dialling of numbers around Belleville, Canada. Participants were n = 1305 adults with non-zero scores across 26-items from: (American Psychiatric Association, 2013) the Problem Gambling Severity Index (PGSI); (Delfabbro, 2013) the NORC DSM Screen for Gambling Problems (NODS); and (Korn & Shaffer, 1999) the Problem and Pathological Gambling Measure (PPGM). Results indicated that item-level measures except chasing losses provided fit to the Rasch model, and most were clustered within a narrow region of the continuum which resembled addictive disorders. At the most severe end were mainly items about harms, while there were few items representing low severity levels (feeling guilty, betting more than one can afford, attempts to reduce gambling, gambling more than intended). There was Differential Item Functioning (DIF) for several indicators of low severity problems. The findings suggest that measures remain closely aligned with psychiatric models and are suited for discriminating across severe levels of problem gambling or addictive disorder. Although cognitive-affective and behavioural indicators comprise the best available indicators of low severity symptoms, there is an urgent need for improvements in conceptualisation and measurement.
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Masthead.
Authors: PMID: 30535048 [PubMed - in process] (Source: Journal of speech, language, and hearing research : JSLHR)
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Documenting need for naloxone distribution in the Los Angeles County jail system
Publication date: Available online 12 December 2018
Source: Addictive Behaviors
Author(s): Peter J. Davidson, Karla D. Wagner, Paula L. Tokar, Shoshanna Scholar
Abstract
Background
The Los Angeles County Jail system is the largest jail system in the United States, with an average daily inmate population of 17,024 in 2017. Existing literature shows the weeks following release from incarceration are associated with increased risk of overdose death among individuals who previously used opioids. One response is to train inmates in overdose prevention and response (OPR) and to provide the opioid antagonist naloxone on release. However, in large jail systems training all inmates can be logistically and financially difficult, leading to interest identifying individuals most likely to benefit from such programs.
Method
In 2017, the Los Angeles County Office of Diversion and Reentry collaborated with the Los Angeles County Sheriff Department to conduct an OPR needs assessment evaluation with all inmates entering the jail over a two week period.
Results
3781 inmates provided complete data for this analysis (3315 men, 466 women). 17% reported using opioids within the last 12 months, 7% reported witnessing an overdose within the last 12 months, and 5% report ever having received medication assisted treatment (MAT). 39% reported interest in being trained in overdose prevention and response. The single largest predictor of interest in OPR was being present at an overdose in the past year.
Conclusion
Our results suggest OPR should be provided to all inmates who opt-in to receiving training regardless of other risk factors. Our results also suggest this population has had little prior exposure to MAT and incarceration could represent a significant opportunity to provide such evidence-based treatments.
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Size matters in the case of graphic health warning: Evidence from physiological measures
Publication date: Available online 7 December 2018
Source: Addictive Behaviors
Author(s): Carlos Gantiva, Miguel Sotaquirá, Marisol Marroquín, Camilo Carné, Lisbeth Parada, Miguel A. Muñoz
Abstract
Objectives
>50 countries use graphic health warnings (GHWs) with the minimum size that is recommended by the World Health Organization (WHO). The aim of the present study was to evaluate the effect of the size of GHWs on physiological responses that serve as indices of arousal and aversive motivation in nonsmokers, weekly smokers, and daily smokers.
Methods
The skin conductance response, corrugator muscle activity, and startle reflex were recorded in 35 nonsmokers, 35 weekly smokers, and 35 daily smokers while they observed pictures of cigarette packs without GHWs, cigarette packs with GHWs that covered 30% of the pack, and cigarette packs with GHWs that covered 60% of the pack.
Results
Cigarette packs with 30% GHWs did not generate significantly higher responses on any of the physiological measures compared with cigarette packs without GHWs. Conversely, cigarette packs with GHWs that covered 60% of the pack generated a greater skin conductance response, greater corrugator muscle activity, and an increase in the startle reflex compared with cigarette packs without GHWs. No significant differences were found between groups in any of the physiological measures.
Conclusions
The minimum size of GHW that is recommended by the WHO is insufficient to generate an emotional response that favors avoidance of the cigarette pack. GHW that cover 60% of the cigarette pack significantly reduced the attractiveness of the tobacco packaging and generated greater arousal responses.
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General versus spinal anesthesia for the elderly hip fractured patient
Purpose of review There is an urge to improve care for patients with hip fracture. The present review will compare the efficacy of spinal versus general anesthesia for patients requiring hip fracture surgery. Recent findings The present review gives an overview with particular emphasis on literature published during the past 24 months. Summary So far, no clear evidence form randomized trials exists to identify the best anesthesia technique for hip fracture surgery. However, several large-scale pragmatic trials are ongoing and will provide future guidance. Correspondence to Prof. Mark Coburn, Department of Anaesthesiology, Medical Faculty RWTH Aachen, Pauwelsstrasse 30, D-52074 Aachen, Germany. Tel: +49 241 8088179; fax: +49 241 8082593; e-mail: mcoburn@ukaachen.de Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Pulse pressure and perioperative stroke
Purpose of review Central pulse pressure (PP), a marker of vascular stiffness, is a novel indicator of risk for perioperative morbidity including ischemic stroke. Appreciation for the mechanism by which vascular stiffness leads to organ dysfunction along with understanding its clinical detection may lead to improved patient management. Recent findings Vascular stiffness is associated with increased mortality and neurologic, cardiac, and renal injury in nonsurgical and surgical patients. Left ventricular hypertrophy and diastolic dysfunction along with microcirculatory changes in the low vascular resistance, high blood flow, cerebral and renal vasculature are seen in patients with vascular stiffness. Pulse wave velocity and the augmentation index have higher sensitivity for detecting of vascular stiffness than peripheral PP as the hemodynamic consequences of vascular stiffness are secondary to alterations in the central vasculature. Vascular stiffness alters cerebral autoregulation, resulting in a high likelihood of having a lower limit of autoregulation more than 65 mmHg during surgery. Vascular stiffness may predispose to cerebral hypoperfusion, increasing vulnerability to ischemic stroke, postoperative delirium, and acute kidney injury. Summary Vascular stiffness leads to alterations in cerebral, cardiac, and renal hemodynamics increasing the risk of perioperative ischemic stroke and neurologic, cardiac, and renal dysfunction. Correspondence to Charles W. Hogue, MD, Professor and Chair, Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 251 East Huron St, Feinberg Pavilion 5-704, Chicago, IL 60611, USA. Tel: +1 312 926 2949; e-mail: charles.hogue@nm.org Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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High-flow nasal cannula oxygen therapy in patients undergoing thoracic surgery: current evidence and practice
Purpose of review: Patients undergoing thoracic surgery are at high risk for pulmonary and extra pulmonary complications, and may develop impairment of gas exchange during surgery and in the postoperative period. This review focuses on the potential benefits of high-flow nasal cannula (HFNC) oxygen therapy in those patients. Recent findings: HFNC oxygen therapy can be used pre, intra and postoperatively. However, evidence for the use of HFNC oxygen therapy is still limited. Most trials investigated the effects of HFNC oxygen therapy in the postoperative period only, with promising beneficial effects. Preoperative HFNC oxygen therapy might be an alternative to conventional techniques, and allows continuous oxygenation during the apneic time of laryngoscopy. In certain patients, thoracic surgery might be performed in awake and nonintubated patients who are breathing spontaneously. Under these conditions, HFNC oxygen therapy might be considered for respiratory support by experienced anesthesiologists. In the postoperative period, HFNC oxygen therapy can prevent escalation of respiratory management and has the potential to reduce the length of hospital stay. Throughout the perioperative period, close monitoring of patients receiving HFNC oxygen therapy is key, and intubation criteria to avoid delayed intubation should be defined a priori to prevent harm. Summary: HFNC oxygen therapy is a promising tool in the perioperative care of thoracic surgical patients, when properly set, performed by experienced staff and closely monitored. Correspondence to Marcelo Gama de Abreu, MD, MSc, PhD, DESA, Department of Anesthesiology and Intensive Care Medicine, Pulmonary Engineering Group, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscher Strasse 74, 01307 Dresden, Germany. Tel: +49 351 458 4488; e-mail: mgabreu@uniklinikum-dresden.de Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Enhanced recovery in thoracic surgery: can fuzzy logic bring clear results?
Pulse pressure and perioperative stroke
Purpose of review Central pulse pressure (PP), a marker of vascular stiffness, is a novel indicator of risk for perioperative morbidity including ischemic stroke. Appreciation for the mechanism by which vascular stiffness leads to organ dysfunction along with understanding its clinical detection may lead to improved patient management. Recent findings Vascular stiffness is associated with increased mortality and neurologic, cardiac, and renal injury in nonsurgical and surgical patients. Left ventricular hypertrophy and diastolic dysfunction along with microcirculatory changes in the low vascular resistance, high blood flow, cerebral and renal vasculature are seen in patients with vascular stiffness. Pulse wave velocity and the augmentation index have higher sensitivity for detecting of vascular stiffness than peripheral PP as the hemodynamic consequences of vascular stiffness are secondary to alterations in the central vasculature. Vascular stiffness alters cerebral autoregulation, resulting in a high likelihood of having a lower limit of autoregulation more than 65 mmHg during surgery. Vascular stiffness may predispose to cerebral hypoperfusion, increasing vulnerability to ischemic stroke, postoperative delirium, and acute kidney injury. Summary Vascular stiffness leads to alterations in cerebral, cardiac, and renal hemodynamics increasing the risk of perioperative ischemic stroke and neurologic, cardiac, and renal dysfunction. Correspondence to Charles W. Hogue, MD, Professor and Chair, Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 251 East Huron St, Feinberg Pavilion 5-704, Chicago, IL 60611, USA. Tel: +1 312 926 2949; e-mail: charles.hogue@nm.org Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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General versus spinal anesthesia for the elderly hip fractured patient
Purpose of review There is an urge to improve care for patients with hip fracture. The present review will compare the efficacy of spinal versus general anesthesia for patients requiring hip fracture surgery. Recent findings The present review gives an overview with particular emphasis on literature published during the past 24 months. Summary So far, no clear evidence form randomized trials exists to identify the best anesthesia technique for hip fracture surgery. However, several large-scale pragmatic trials are ongoing and will provide future guidance. Correspondence to Prof. Mark Coburn, Department of Anaesthesiology, Medical Faculty RWTH Aachen, Pauwelsstrasse 30, D-52074 Aachen, Germany. Tel: +49 241 8088179; fax: +49 241 8082593; e-mail: mcoburn@ukaachen.de Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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High-flow nasal cannula oxygen therapy in patients undergoing thoracic surgery: current evidence and practice
Purpose of review: Patients undergoing thoracic surgery are at high risk for pulmonary and extra pulmonary complications, and may develop impairment of gas exchange during surgery and in the postoperative period. This review focuses on the potential benefits of high-flow nasal cannula (HFNC) oxygen therapy in those patients. Recent findings: HFNC oxygen therapy can be used pre, intra and postoperatively. However, evidence for the use of HFNC oxygen therapy is still limited. Most trials investigated the effects of HFNC oxygen therapy in the postoperative period only, with promising beneficial effects. Preoperative HFNC oxygen therapy might be an alternative to conventional techniques, and allows continuous oxygenation during the apneic time of laryngoscopy. In certain patients, thoracic surgery might be performed in awake and nonintubated patients who are breathing spontaneously. Under these conditions, HFNC oxygen therapy might be considered for respiratory support by experienced anesthesiologists. In the postoperative period, HFNC oxygen therapy can prevent escalation of respiratory management and has the potential to reduce the length of hospital stay. Throughout the perioperative period, close monitoring of patients receiving HFNC oxygen therapy is key, and intubation criteria to avoid delayed intubation should be defined a priori to prevent harm. Summary: HFNC oxygen therapy is a promising tool in the perioperative care of thoracic surgical patients, when properly set, performed by experienced staff and closely monitored. Correspondence to Marcelo Gama de Abreu, MD, MSc, PhD, DESA, Department of Anesthesiology and Intensive Care Medicine, Pulmonary Engineering Group, University Hospital Carl Gustav Carus, Technische Universität Dresden, Fetscher Strasse 74, 01307 Dresden, Germany. Tel: +49 351 458 4488; e-mail: mgabreu@uniklinikum-dresden.de Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.
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Enhanced recovery in thoracic surgery: can fuzzy logic bring clear results?
The Development of a Self-Efficacy Measurement Tool For Counseling in Speech-Language Pathology.
Conclusion: The adapted Counselor Activity Self-Efficacy Scales for speech-language pathologists is psychometrically sound; factor analysis, reliability, and validity were in line with reported values for the original survey tool. Potential uses for the survey tool within the field of speech-language pathology are discussed, along with implications for graduate education and clinical supervision related to counseling skills. PMID: 30535061 [PubMed - as supplied by publisher] (Source: American Journal of Speech-Language Pathology)
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Application of the Communication Complexity Scale in Peer and Adult Assessment Contexts for Preschoolers With Autism Spectrum Disorders.
Conclusions: Results showed that the CCS was sensitive to change over time but did not discriminate changes in communication complexity associated with maturation versus treatment. It did show some differences based on interactions with peer versus adult partners. Outcomes provide preliminary support for using this scale to measure communication changes in different contexts. Supplemental Material: https://ift.tt/2SzXdNB. PMID: 30521663 [PubMed - as supplied by publisher] (Source: American Journal of Speech-Language Pathology)
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Application of the Communication Complexity Scale in Peer and Adult Assessment Contexts for Preschoolers With Autism Spectrum Disorders.
Conclusions: Results showed that the CCS was sensitive to change over time but did not discriminate changes in communication complexity associated with maturation versus treatment. It did show some differences based on interactions with peer versus adult partners. Outcomes provide preliminary support for using this scale to measure communication changes in different contexts. Supplemental Material: https://ift.tt/2SzXdNB. PMID: 30521663 [PubMed - as supplied by publisher] (Source: American Journal of Speech-Language Pathology)
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