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Kuria, Susan Wangeci, Sarah Kanana Kiburi, Jackline Ochieng, John Maina Mburu, and Fredrick Owiti. "Substance use patterns and negative urine opioid screen among patients on methadone treatment at a referral hospital in Nairobi, Kenya." PLOS Mental Health 1, no. 5 (2024): e0000027. http://dx.doi.org/10.1371/journal.pmen.0000027.
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Background Substance use is a global health concern, with opioids contributing significantly to the disease burden. In Kenya, Medically Assisted Therapy (MAT) programs using methadone have been implemented to address opioid use disorder. Despite the effectiveness of methadone, the concurrent use of other substances remains a critical challenge. This study aimed to assess substance use patterns at enrolment and evaluate the prevalence of negative urine opioid screens among patients attending a MAT clinic at a tertiary hospital in Kenya. Methods This retrospective cohort study analyzed data from the medical records of 713 patients enrolled in the MAT clinic between December 2014 and February 2018. Data on sociodemographic characteristics, concurrent substance use at enrolment, and urine opioid screen results at 6, 12, 18, and 24 months were collected. Multivariate analyses were performed to identify factors associated with concurrent substance use, and the likelihood of achieving negative urine opioid screens. Results At enrolment into the MAT program, nearly all participants (712 out of 713) reported concurrent use of additional substances, with tobacco (91%) and cannabis (82.9%) being the most common. Concurrent substance use was significantly influenced by participants age, gender, education level, and route of administration of the substance. The program achieved an 81.3% retention rate at 24 months. However, the prevalence of negative urine opioid screens was lower compared to other populations, with a gradual increase from 61.3% at 6 months to 81.4% at 24 months. Notably, male patients (HR = 1.411, 95% C.I. 1.063–1.873, p = 0.01700) and those receiving higher methadone doses (HR 7.052, 95% CI 3.408–14.593, p<0.0001) were more likely to achieve negative urine opioid screens. Conclusions This study reveals a high prevalence of concurrent substance use among patients enrolling in the MAT program in Kenya, which may affect their likelihood of achieving negative urine opioid screens. These findings underscore the need for methadone treatment programs to adopt comprehensive approaches that address all substance use disorders to improve treatment outcomes.
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Vézina-Im, Lydi-Anne, Dominique Beaulieu, Stéphane Turcotte, Joanie Roussel-Ouellet, Valérie Labbé, and Danielle Bouchard. "Association between Recreational Screen Time and Sleep Quality among Adolescents during the Third Wave of the COVID-19 Pandemic in Canada." International Journal of Environmental Research and Public Health 19, no. 15 (2022): 9019. http://dx.doi.org/10.3390/ijerph19159019.
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The study objective was to verify whether recreational screen time was associated with sleep quality among adolescents during the third wave of the COVID-19 pandemic in Canada. Data collection took place in four high schools in the region of Chaudière-Appalaches (Quebec, Canada) from the end of April to mid-May 2021. Recreational screen time and sleep quality were measured using the French versions of validated questionnaires specifically designed for adolescents. A total of 258 adolescents (14–18 years; 66.3% girls) answered the online survey. Adolescent boys had a higher total mean recreational screen time (454.3 ± 197.5 vs. 300.5 ± 129.3 min/day, p < 0.0001) and a higher total mean sleep quality score (4.2 ± 0.9 vs. 3.9 ± 0.8, p = 0.0364) compared to girls. Recreational screen time (β = −0.0012, p = 0.0005) and frequency of concurrent screen use (sometimes: β = −0.3141, p = 0.0269; often: β = −0.4147, p = 0.0048; almost always or always: β = −0.6155, p = 0.0002) were negatively associated with sleep quality while being a boy (β = 0.4276, p = 0.0004) was positively associated with sleep quality and age (p = 0.6321) was not. This model explained 16% of the variance in adolescents’ sleep quality. Public health interventions during and after the COVID-19 pandemic should target recreational screen time, concurrent screen use and especially girls to possibly improve sleep quality and promote adolescents’ physical and mental health.
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Neeraj, Singh. "Association between Screen time and Psychosocial Hidness: A Closer Look." International Journal of Pharmaceutical and Clinical Research 16, no. 1 (2024): 1584–90. https://doi.org/10.5281/zenodo.11128817.
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<strong>Aim:</strong> The aim and objective were to obtain an association between screen time and the psychosocial morbidities of adolescent students. It is indicated in studies that there is a strong correlation between the amount of time spent on screens and mental health development issues such as attention deficit disorder, anxiety, and depression. <strong>Method:</strong> The data collection took place in secondary classes students public or private schools in Deolali, who have enrolled in classes 7th to 12th (12-17 years only) and can communicate in English. A group of 1300 adolescents was assessed, with a M: F ratio of 1.23. The total number of male-to-female participants was 718 and 582, respectively. <strong>Results:</strong> The PSC-Y scores were plotted against the gender of the participants, p-value 0.39. 154 female adolescents had positive scores as against 175 male participants. In the blood group, ‘B’ blood group 35.4% whereas ‘O’ 30.3% (p-value 0.77) statistically insignificant. The study found that most of these adolescents had psychosocial morbidity. The average weight was 48.5 kg with an SD of 12.4 kg. The increasing weight of participants had a highly significant relationship with positive PSC-Y scores (p-value 0.0000046). The family structure of the participating cohort was 16.7% living in joint families, 44 respondents had joint family structures, and 285 had nuclear families. The comparison on the Χ2 test was insignificant (p-value 0.58). 73.7% of participants reported with sleeping time of 6-8 hours. The distribution of sleep time was similar among both genders (p-value 0.0019). <strong>Conclusion:</strong> The study found a significant association between increased screen time and adolescent psychosocial morbidity and potential approach could involve devising public health initiatives that specifically focus on reducing the amount of leisure time individuals spend in front of screens, particularly among this demographic.
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Sampasa-Kanyinga, Hugues, and Jean-Philippe Chaput. "Use of Social Networking Sites and Adherence to Physical Activity and Screen Time Recommendations in Adolescents." Journal of Physical Activity and Health 13, no. 5 (2016): 474–80. http://dx.doi.org/10.1123/jpah.2015-0343.
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Background:Adolescents are recommended to achieve ≥ 60 min/day of moderate-to-vigorous physical activity (PA) and ≤2 h/day of screen time (ST). This study examined the relationships between the use of social networking sites (SNSs) and adherence to PA and ST recommendations in a large sample of Canadian adolescents.Methods:This cross-sectional school-based survey included a representative sample of 9388 students in grades 7 to 12 across Ontario, Canada.Results:After adjustment for several confounding variables, results showed that male adolescents who use SNSs for fewer hours (≤ 1 h/day) had greater odds of adherence to PA and to both PA and ST recommendations concurrently, while those who use it for more hours (≥ 3 h/day) had lower odds of adherence to the ST recommendation. Female adolescents who use SNSs for more hours had lower odds of adherence to the ST recommendation (use of SNSs ≥ 2 h/day) and to both PA and ST recommendations concurrently (use of SNSs ≥ 5 h/day).Conclusions:Heavy use of SNSs has a negative influence on the adherence to the ST recommendation in both males and females; however, infrequent use of SNSs was related to the adherence to the PA recommendation and concurrent adherence to both recommendations in males only.
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Van Oeckel, Veerle, Benedicte Deforche, Nicola D. Ridgers, Elling Bere, and Maïté Verloigne. "Validity of Items Assessing Self-Reported Number of Breaks in Sitting Time among Children and Adolescents." International Journal of Environmental Research and Public Health 17, no. 18 (2020): 6708. http://dx.doi.org/10.3390/ijerph17186708.
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Background: Sedentary behaviour guidelines recommend that individuals should regularly break up sitting time. Accurately monitoring such breaks is needed to inform guidelines concerning how regularly to break up sitting time and to evaluate intervention effects. We investigated the concurrent validity of three “UP4FUN child questionnaire” items assessing the number of breaks in sitting time among children and adolescents. Methods: Fifty-seven children and adolescents self-reported number of breaks from sitting taken at school, while watching TV, and during other screen time activities. Participants also wore an activPAL monitor (PAL Technologies, Glasgow, UK) to objectively assess the number of sitting time breaks (frequency/hour) during the school period and the school-free period (which was divided in the periods “after school” and “during the evening”). Concurrent validity was assessed using Spearman rank correlations. Results: Self-reported number of breaks/hour at school showed good concurrent validity (ρ = 0.676). Results were moderate to good for self-reported number of breaks/hour while watching TV (ρ range for different periods: 0.482 to 0.536) and moderate for self-reported number of breaks/hour in total screen time (ρ range for different periods: 0.377 to 0.468). Poor concurrent validity was found for self-reported number of breaks/hour during other screen time activities (ρ range for different periods: 0.157 to 0.274). Conclusions: Only the questionnaire items about number of breaks at school and while watching TV appear to be acceptable for further use in research focussing on breaks in prolonged sitting among children and adolescents.
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Guo, Miao. "Social Television Viewing with Second Screen Platforms: Antecedents and Consequences." Media and Communication 7, no. 1 (2019): 139–52. http://dx.doi.org/10.17645/mac.v7i1.1745.
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This study investigates the causal relationship between antecedents and consequences of social television viewing combining the television screen and concurrent use of a mobile, “second screen” media platform. The results indicate that social television viewing is a complex process driven by the viewers’ program affinity, motives, interpersonal interaction, and the perceived media characteristics of alternative platforms. The social television viewing behavior also has a positive influence on loyalty to television programs, time-shifted viewing, and product purchase intention. The implications of these findings and recommendations for future research are discussed.
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Yeh, Michelle, Joseph Jaworski, and Stephanie Chase. "Pilot Perceptions on the Integration of Electronic Flight Bag Information in New Flight Deck Designs." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 63, no. 1 (2019): 91–95. http://dx.doi.org/10.1177/1071181319631335.
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The purpose of this study was to gather usability data on a new flight deck concept in which pilots are shown certified and uncertified information concurrently on installed avionics. Specifically, we wanted to examine perceptions on the concepts of concurrent use and differentiation for electronic flight bag (EFB) applications that show ownship position. We presented an uncertified electronic chart on either a portable electronic device (PED) alone (off to the pilot’s side) or on both a PED and an installed flight deck display. The uncertified electronic chart was always shown concurrently with an approved navigation source. We differentiated the electronic chart from the navigation information via display medium (portable vs. installed) and a header labeled “EFB,” drawn at the top of the uncertified electronic chart on the installed display. Thirteen flightcrews flew eight scenarios using the flight deck concept. Pilots liked the concurrent display of the electronic chart, and the repeated display functionality, in particular, because they could control the presentation of information on the forward display using the touch screen on the side display. Our method of differentiation—a header—was less successful and suggests a need to consider the potential for stimulus habituation when evaluating these techniques.
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Harrington, Deirdre M., Ekaterini Ioannidou, Melanie J. Davies, et al. "Concurrent screen use and cross‐sectional association with lifestyle behaviours and psychosocial health in adolescent females." Acta Paediatrica 110, no. 7 (2021): 2164–70. http://dx.doi.org/10.1111/apa.15806.
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Harandian, Kianoush, Beatrice Necsa, Tracie A. Barnett, and Linda S. Pagani. "Family Meal Environment Differentially Conditions the Prospective Association between Early Childhood Screen Time and Key Social Relationships in Adolescent Girls." Children 11, no. 2 (2024): 145. http://dx.doi.org/10.3390/children11020145.
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Background: Despite screen time recommendations, children are increasingly spending time on electronic devices, rendering it an important risk factor for subsequent social and developmental outcomes. Sharing meals could offer a way to promote psychosocial development. This study examines the interaction between family meal environment and early childhood screen time on key adolescent social relationships. Methods: Participants are 1455 millennial children (49% boys) from the Quebec Longitudinal Study of Child Development birth cohort. Parents reported on child screen use at ages 2 and 6 years and family meal environment quality at age 6 years. Parents and children reported on parent–child relationships and peer victimization experiences, respectively, at age 13 years. Sex-stratified multiple regression estimated the direct association between screen time trends, family meal environment quality, and their interaction on later social relationship outcomes. Results: For girls, when preschool screen time increased, sharing family meals in high-quality environments was associated with more positive and less conflictual relationships with their mothers, whereas meals shared in low- and moderate-quality environments were associated with fewer instances of victimization by their peers. Non-linear associations were not significant for boys. Conclusion: Capitalizing on family meal environment represents a simple/cost-efficient activity that can compensate for some long-term risks associated with increased screen use, above and beyond pre-existing and concurrent individual and family characteristics. Public health initiatives may benefit from considering family meals as a complementary intervention strategy to screen use guidelines.
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Champion, Katrina E., Cath Chapman, Matthew Sunderland, et al. "Associations Between Personality Traits and Energy Balance Behaviors in Emerging Adulthood: Cross-Sectional Study." JMIR Public Health and Surveillance 9 (June 15, 2023): e42244. http://dx.doi.org/10.2196/42244.
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Background Internalizing and externalizing personality traits are robust risk factors for substance use and mental health, and personality-targeted interventions are effective in preventing substance use and mental health problems in youth. However, there is limited evidence for how personality relates to other lifestyle risk factors, such as energy balance–related behaviors, and how this might inform prevention efforts. Objective This study aimed to examine concurrent cross-sectional associations between personality traits (ie, hopelessness, anxiety sensitivity, impulsivity, and sensation seeking) and sleep, diet, physical activity (PA), and sedentary behaviors (SB), 4 of the leading risk factors for chronic disease, among emerging adults. Methods Data were drawn from a cohort of young Australians who completed a web-based, self-report survey in 2019 during early adulthood. A series of Poisson and logistic regressions were conducted to examine the concurrent associations between the risk behaviors (sleep, diet, PA, and sitting and screen time) and personality traits (hopelessness, anxiety sensitivity, impulsivity, and sensation seeking) among emerging adults in Australia. Results A total of 978 participants (mean age 20.4, SD 0.5 years) completed the web-based survey. The results indicated that higher scores on hopelessness were associated with a greater daily screen (risk ratio [RR] 1.12, 95% CI 1.10-1.15) and sitting time (RR 1.05, 95% CI 1.0-1.08). Similarly, higher scores on anxiety sensitivity were associated with a greater screen (RR 1.04, 95% CI 1.02-1.07) and sitting time (RR 1.04, 95% CI 1.02-1.07). Higher impulsivity was associated with greater PA (RR 1.14, 95% CI 1.08-1.21) and screen time (RR 1.06, 95% CI 1.03-1.08). Finally, higher scores on sensation seeking were associated with greater PA (RR 1.08, 95% CI 1.02-1.14) and lower screen time (RR 0.96, 95% CI 0.94-0.99). Conclusions The results suggest that personality should be considered when designing preventive interventions for lifestyle risk behaviors, particularly in relation to SB, such as sitting and screen time. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12612000026820; https://tinyurl.com/ykwcxspr
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Szlyk, Hannah S., Anna Constantino-Pettit, Xiao Li, et al. "Self-Identified Stage in Recovery and Substance-Use Behaviors among Pregnant and Postpartum Women and People with Opioid Use Disorder." Healthcare 11, no. 17 (2023): 2392. http://dx.doi.org/10.3390/healthcare11172392.
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Opioid use among pregnant and postpartum women and people (PPWP) has significant health repercussions. This study explores how substance-use behaviors may vary by stage in recovery among PPWP with opioid use disorder (OUD). We recruited 29 PPWP with OUD. “High-risk” participants self-identified as “not being engaged in treatment” or “new or early in their recovery” (n = 11); “low-risk” participants self-identified as being “well-established” or “in long-term recovery” (n = 18). Participants were queried regarding sociodemographic, mental health, and drug-misuse factors; urine drug screens were collected at baseline. Univariate group comparisons between high-risk and low-risk PPWP were conducted. High-risk PPWP were more likely to self-identify as non-Hispanic African American and more likely to report current opioid use, other illicit drugs, and tobacco. High-risk PPWP had higher opioid cravings versus low-risk PPWP. High-risk PPWP were more likely to screen positive on urine tests for non-opioid drugs and on concurrent use of both non-opioid drugs and opioids versus low-risk participants. PPWP earlier in recovery are at higher-risk for opioid and other illicit drug misuse but are willing to disclose aspects of their recent use. PPWP early in recovery are an ideal population for interventions that can help facilitate recovery during the perinatal period and beyond.
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Larson, Lincoln R., Rachel Szczytko, Edmond P. Bowers, Lauren E. Stephens, Kathryn T. Stevenson, and Myron F. Floyd. "Outdoor Time, Screen Time, and Connection to Nature: Troubling Trends Among Rural Youth?" Environment and Behavior 51, no. 8 (2018): 966–91. http://dx.doi.org/10.1177/0013916518806686.
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Evidence suggests that contemporary children are spending less time outdoors than their predecessors. Concurrent reports also highlight the rise of electronic media use in the lives of youth. We explored relationships between self-reported outdoor time, screen time, and connection to nature in a sample of sixth- to eighth-grade students across rural South Carolina ( N = 543). We found that most youth spent time outdoors, but they spent more time with electronic media. The outdoor versus screen time discrepancy was particularly pronounced for girls, African Americans, and eighth graders. Connection to nature, linked to outdoor time, was highest among boys, White students, and sixth graders. Our study contributes to growing evidence highlighting the negative influence of escalating screen time on outdoor time and connection to nature during adolescence. Programs designed to address these troubling trends could focus on two groups at particularly high risk: girls and youth of color.
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Shaffer, Sarah E., Kristin J. Shaffer, Kenzie D. Perryman, Jasey K. Patterson, and Jessica L. Hartos. "Does Mental Health Differ by Alcohol Use in Elderly Male Veterans?" Gerontology and Geriatric Medicine 5 (January 2019): 233372141983780. http://dx.doi.org/10.1177/2333721419837803.
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Introduction: With limited research for mental health and alcohol use among veterans in the general population and none for elderly male veterans only, the purpose is to assess whether mental health differs by alcohol use in elderly male veterans in the general population. Method: This cross-sectional analysis uses 2017 Behavioral Risk Factor Surveillance System data for male veterans aged 65 and older in general population samples from Florida ( n = 1,700), Maryland ( n = 1,060), New York ( n = 552), and Washington ( n = 1,031). Multiple logistic regression by state assessed the relationship between mental health and alcohol use, after controlling for health-related, demographic, and socioeconomic factors. Results: Across states, most participants reported good mental health (80%-84%) and more than half reported drinking (53%-63%). Adjusted results indicated that mental health did not differ by alcohol use in any state; however, it was related to physical health and activity limitations across states. Conclusion: Overall, alcohol use was not related to mental health in elderly male veterans in the general population; however, physical health status and activity limitations were. Practitioners should always screen for alcohol use and should automatically screen for mental health, physical health, and activity limitations when symptoms present for any and assess concurrent treatment and management strategies.
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Hides, Leanne, Dan I. Lubman, Harriet Devlin, et al. "Reliability and Validity of the Kessler 10 and Patient Health Questionnaire among Injecting Drug Users." Australian & New Zealand Journal of Psychiatry 41, no. 2 (2007): 166–68. http://dx.doi.org/10.1080/00048670601109949.
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Objective: To examine the reliability and validity of the Kessler 10 (K10) and the Patient Health Questionnaire (PHQ) in a sample of injecting drug users (IDUs). Method: Participants were 103 IDUs with a current substance use disorder accessing a needle and syringe programme. Presence of mental health disorders was assessed using the Mini International Neuropsychiatric Interview (MINI). Results: Both the K10 and PHQ had high levels of internal consistency and concurrent validity. Individuals with a positive screen on the K10 were ten lines more likely to have a current affective disorder, while those with a positive PHQ screen had nearly 14 times the risk. Conclusions: The K10 and PHQ are recommended as brief screening and diagnostic tools for current affective disorders among IDUs.
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Nanthakumaran, H., A. K. Sullivan, and F. C. Boag. "An audit of emergency contraception: a look at patient characteristics and the effects of a consultation proforma." International Journal of STD & AIDS 9, no. 1 (1998): 48–50. http://dx.doi.org/10.1258/0956462981920865.
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Summary: The aim of this study was to examine the characteristics of patients requesting emergency postcoital contraception at a genitourinary medicine (GUM) clinic. We also compared the quality of information obtained during the consultation, before and after a proforma was introduced. A retrospective review of all clinical notes of patients who attended for postcoital contraception between January and December 1994 and April to June 1995 was performed. Eighty-three per cent of patients were aged 17-29 years, 68.8% were in relationship, 41.3% were not using regular contraception, 33.8% accepted a sexual health screen and of these, 14.8% had a concurrent sexually transmitted disease (STD). The introduction of a consultation proforma significantly improved certain areas of the consultation. The results suggest that sexual health screens should be encouraged in women attending GUM clinics for postcoital contraception and that the use of a proforma improves the quality of information obtained.
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Pedrini, Laura, Serena Meloni, Julia Dawson, et al. "The Associations between Lifestyle Habits and Anxiety: A Prospective Study on Adolescents One Year after the Outbreak of the COVID-19 Pandemic." Children 11, no. 3 (2024): 282. http://dx.doi.org/10.3390/children11030282.
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Changes in lifestyle during the pandemic may have predisposed adolescents to vulnerability to poor mental health. This study aims to evaluate these changes and their association with the course of anxiety. A prospective study was conducted with 153 participants (16 years old, 72% female) who were assessed before the pandemic (T0, November 2019–January 2020) and one year later (T1, April–May 2021). Lifestyle habits (free-time activities, maladaptive behaviors, sleep, screen use) and anxiety were measured. Data concerning experiences related to COVID-19 and family relations during lockdown were collected. A worsening in lifestyle habits and anxiety was found. Of note, the pattern of associations between lifestyle habits and anxiety was quite different in the two time-points, suggesting that the purpose and the impact of some habits may be changed after the pandemic. Regression analyses showed that increases in anxiety were associated with increases in sleep problems, heightened efforts to reduce screen time, and loneliness. Pathway analysis revealed the absence of cross-lagged effects among anxiety, screen use, and sleep, while concurrent associations between variables were found in both the assessments. These results suggest possible long-term effects of the pandemic. Risk-factors associated with the course of anxiety were identified among lifestyle habits, thus contributing to identifying targets for interventions.
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Portnoy, Galina A., Mark R. Relyea, Candice Presseau, et al. "Screening for Intimate Partner Violence Experience and Use in the Veterans Health Administration." JAMA Network Open 6, no. 10 (2023): e2337685. http://dx.doi.org/10.1001/jamanetworkopen.2023.37685.
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ImportanceThe practice of screening women for intimate partner violence (IPV) in health care settings has been a critical part of responding to this major public health problem. Yet, IPV prevention would be enhanced with detection efforts that extend beyond screening for IPV experiences to identifying those who use violence in relationships as well.ObjectiveTo determine rates of IPV experiences and use (ie, among perpetrators of IPV) and factors associated with disclosures among adult patients seeking mental health services at the Veterans Health Administration.Design, Setting, and ParticipantsThis cross-sectional study used electronic medical record data drawn from a quality improvement initiative at 5 Veterans Health Administration medical centers conducted between November 2021 and February 2022 to examine IPV disclosures following concurrent screening for IPV experience and use. Participants included patients engaged in mental health services. Data were analyzed in April and May 2023.ExposureMental health clinicians were trained to screen for IPV experience and use concurrently and instructed to screen all patients encountered through routine mental health care visits during a 3-month period.Main Outcomes and MeasuresOutcomes of interest were past-year prevalence of IPV use and experience, sociodemographic characteristics, and clinical diagnoses among screened patients.ResultsA total of 200 patients were offered IPV screening. Of 155 participants (mean [SD] age, 52.45 [15.65] years; 124 [80.0%] men) with completed screenings, 74 (47.7%) denied past-year IPV experience and use, 76 (49.0%) endorsed past-year IPV experience, and 72 (46.4%) endorsed past-year IPV use, including 67 participants (43.2%) who reported IPV experience and use concurrently; only 9 participants (5.8%) endorsed unidirectional IPV experiences and 5 participants (3.2%) endorsed unidirectional IPV use. Patients who reported past-year IPV experience and use were younger than those who denied IPV (experience: mean difference, −7.34 [95% CI, 2.51-12.17] years; use: mean difference, −7.20 [95% CI, 2.40-12.00] years). Patients with a posttraumatic stress disorder diagnosis were more likely to report IPV use (43 patients [59.7%]) than those without a posttraumatic stress disorder diagnosis (29 patients [40.3%]; odds ratio, 2.14; [95% CI, 1.12-4.06]). No other demographic characteristics or clinical diagnoses were associated with IPV use or experience.Conclusions and RelevanceIn this cross-sectional study of IPV rates and associated factors, screening for IPV found high rates of both IPV experience and use among patients receiving mental health care. These findings highlight the benefit of screening for IPV experience and use concurrently across gender and age. Additionally, the associations found between PTSD and IPV use underscore the importance of strengthening and developing additional targeted treatment for IPV.
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Bertoni, Alessandro, and Marco Bertoni. "Supporting Early Stage Set-Based Concurrent Engineering with Value Driven Design." Proceedings of the Design Society: International Conference on Engineering Design 1, no. 1 (2019): 2367–76. http://dx.doi.org/10.1017/dsi.2019.243.
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AbstractSet-Based Concurrent Engineering is commonly adopted to drive the development of complex products and systems. However, its application requires design information about a future product that is often not mature enough in the early design stages, and that it is not encompassing a service and lifecycle- oriented perspective. There is a need for manufacturers to understand, since the early design stages, how customer value is created along the lifecycle of a product from a hardware and service perspective, and how to use such information to screen radically new technologies, trade-off promising design configurations and commit to a design concept. The paper presents an approach for the multidisciplinary value assessment of design concepts in sub-systems design, encompassing the high-level concept screening and the trade-off of different design concepts, and enabling the integration of value models results into a Set-based Concurrent Engineering process. The approach is described through its application in the case study of the development of a subsystem component for a commercial aircraft engine.
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Lee, David, Tao Jiang, Jennifer Crocker, and Baldwin Way. "Social Media Use and Its Concurrent and Subsequent Relation to a Biological Marker of Inflammation: Short-Term Longitudinal Study." Journal of Medical Internet Research 25 (December 8, 2023): e46309. http://dx.doi.org/10.2196/46309.
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Background Although many studies have examined the impact of social media use (SMU) on mental health, very few studies have examined the association of SMU with health-relevant biomarkers. Objective Addressing this gap, we conducted a short-term longitudinal study examining the link between SMU and C-reactive protein (CRP), a biological marker of systemic inflammation predictive of major depression, chronic diseases, and mortality. Methods We measured college students’ weekly amount of SMU for 5 consecutive weeks objectively via the Screen Time app and collected blood samples at baseline and 5 weeks later. Results In separate cross-sectional analyses conducted at phase 1 (baseline) and at phase 2 (5 weeks after baseline), objective SMU had a positive, concurrent association with CRP at both time points. Critically, in a longitudinal analysis, more SMU between phase 1 and phase 2 predicted increased CRP between these time points, suggesting that increased SMU led to heightened inflammation during that period. Conclusions Although more research is needed to understand why SMU led to higher inflammation, the association between objective SMU and a marker of a biological process critical to physical health presents an intriguing opportunity for future research on social media effects.
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Da Rocha, Fabiola. "DOCÊNCIA NO ENSINO SUPERIOR: O IMPACTO DA INSTRUMENTALIZAÇÃO DAS TECNOLOGIAS DIGITAIS NO ENSINO REMOTO SOBRE AS PRÁTICAS DOS DOCENTES." Revista Tecnológica da Fatec de Americana 10, no. 01 (2022): 21–40. https://doi.org/10.47283/244670492022100121.
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emote education sometimes goes beyond distance education, since as it is practical classes, in addition to educating the concerns with the participation of the times, there is also a concern with technical issues, such as screen sharing, use of videos, and several other techniques that the teacher uses in his classes. In the current scenario, there is an urgent need to learn how to deal with online tools, and even so, they already have some technological background, which seeks to improve their knowledge, especially regarding their knowledge. Thus, the present work has the concurrent objective, which, in addition to the problems related to infrastructure, to new technological tools quickly, made an emergency to the pandemic, emerging the need to prepare teachers and school managers, for the use of these tools. In fact, due to a teaching urgency, few teachers and students had to use this tool, and precisely because of this, they sought a pandemic to implement this methodology in several educational institutions.
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Leonardson, Gary R., Frederick K. Ness, Mark C. Daniels, Erica Kemper, Brett A. Koplin, and Greg A. Leonardson. "Validity and Reliability of the Audit and Cage-Aid in Northern Plains American Indians." Psychological Reports 97, no. 1 (2005): 161–66. http://dx.doi.org/10.2466/pr0.97.1.161-166.
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According to the Indian Health Service, substance abuse and Type 2 diabetes are serious problems among Native Americans. To assess substance use in a medical setting, valid screening tests are needed so the Alcohol Use Disorders Identification Test (AUDIT), a simple brief screen for excessive drinking, and the CAGE-adapted to Include Drugs (CAGE-AID) for identifying primary care patients with alcohol and drug disorders were given 50 Northern Plains American Indians with diabetes. Both are short, easy to administer, have good sensitivity and specificity, and can be easily incorporated into a medical history protocol or intake procedure. Reliability coefficients were above .90 and appeared to have sufficient concurrent and divergent validity indicated by moderate correlations with the General Well-being Schedule ( rs = –.39 and –.36), the Family-Adaptation, Partnership, Growth, Affection, & Resolve ( r = –.47 and –.36), and the Beck Depression Inventory-II ( r = .36 and .29).
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Adhikari, Chiranjivi. "Application and Validation of the Beck Anxiety Inventory among Nepalese School Adolescents." Journal of Health and Allied Sciences 9, no. 1 (2019): 51–58. http://dx.doi.org/10.37107/jhas.10.
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Anxiety is a common mental disorder (CMD) and it affects all the age groups including children and adolescents. Various scales and tools are available to screen and diagnose anxieties. Beck Anxiety Inventory (BAI) is a reliable tool recommended for 12- 80 years to screen panic to geriatric anxiety. It is also applied and validated among Nepalese adults for Generalised Anxiety Disorder (GAD). This study was aimed to apply and validate the Beck Anxiety Inventory (BAI) against school adolescents in Nepal. BAI is a 21-item self-reported scale having four-point Likert scale from “0” (Not at all) through “3” (Severely-I could barely stand it). The tool was translated into Nepali and back-translated into English and several iterations were done till the original meaning was obtained. The tool was concurrently validated against seven-item Generalized Anxiety Disorder scale (GAD-7) as a gold standard, which possesses only seven items and similar Likert scale. Descriptive, inferential including sensitivity, specificity and principal component analysis were performed for 2007 sample adolescents from 13 public and ten private schools of five development regions of the country. The prevalence of generalized anxiety was 34.78% and descriptive data revealed that the BAI and GAD-7 scores were positively skewed. The concurrent validity was moderate (ρ=0.58, p<0.001) and the BAI showed a good internal consistency (a=0.86). The cut-off of 13/14 showed acceptable sensitivity (70.9% ), specificity (73.1% ), and AUC (80.0% (95%CI; 77.4-82.5)) (p<0.001). The principal component analysis showed six-factor explaining 52.04 percent variance, instead of four-factor in most of the literatures. The Nepalese BAI-Adolescent is a valid tool for age group 13-19 years; if applied cautiously regarding the items three, six and thirteen. It can screen 80.0% of the generalized anxiety cases with 70.9 percent sensitivity and 73.1 percent specificity among students and hence recommended to use in schools.
 Key words: Adolescent, application, anxiety, Beck, Nepalese, school, validation.
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Nishad, Raj, Siddhant Mali, Harshit Pandey, and Asmita Marathe. "DECENTRALIZED REAL-TIME COMMUNICATION APPLICATION." International Journal of Engineering Applied Sciences and Technology 09, no. 12 (2025): 121–28. https://doi.org/10.33564/ijeast.2025.v09i12.017.
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Peermesh is a cutting-edge, web-based, decentralized, peer-to-peer (P2P) communication application designed to deliver secure, real-time messaging with high performance and minimal bandwidth usage. Developed with Rust, Peermesh leverages the language’s memory safety and concurrency features to optimize speed and efficiency, making it well-suited for modern mobile and web-based communication needs. It supports various communication methods, including rich text chat that can be cached for offline access, providing a seamless user experience even in low-bandwidth scenarios. The application utilizes WebRTC, an open-source protocol that enables audio and video calling and concurrent screen sharing capabilities directly in the browser, and WebSocket for full-duplex, low-latency data transmission, enhancing real-time communication. Peermesh also emphasizes privacy and security, incorporating optional end-to-end encryption to ensure that messages, photos, and other shared content remain private and accessible only to intended recipients. Moreover, users have the choice to persist encrypted messages on a centralized network or retain them strictly on their devices, adding an additional layer of control over personal data. With its robust content-sharing features, Peermesh aims to redefine secure communication by combining highperformance technology with rigorous privacy protections, making it a versatile and secure solution for both personal and professional use.
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Nikolaeva, Sofiya, and Tetiana Korol. "PROSPECTIVE PHILOLOGISTS’ TRANSLATION ASSESSMENT TRIANGULATION: SCREEN VIDEO RECORDING AND THINK ALOUD PROTOCOL COMBINATION." Advanced Education 8, no. 18 (2021): 30–41. http://dx.doi.org/10.20535/2410-8286.228550.
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Purpose. The article strives for the enhancement of the efficiency of translation competence assessment in philologists’ university training with the help of the triangulation method. It is deemed in the concurrent involvement of different assessment agents (teacher, peer and self) into integrated and collaborative translation performance evaluation from two perspectives, i.e. translation product quality and process workflow, with the use of diversified methods based on different theoretical approaches. This research aims at the study of students’ video screen recording contribution combined with think-aloud protocols (TAPs) to increase the assessment objectivity and reliability of the received translation product. Method. A mixed research design was developed and implemented. It involved 40 third-year university students majoring in Philology, who were asked to perform a written translation of the excerpt of English popular science article in Marketing (c. 250 words) into Ukrainian in MS Word using any reference sources at hand, video record the process of their translation and accompany it with their comments. The research was completed with the questionnaire on students’ attitude to the screen recording and TAP involvement into translation task performance and assessment. Findings. The findings of this study reported on the positive impact of screen recording on the assessment accuracy, informative value of the collected data and formative effect of triangulated assessment method on students’ translation competence acquisition. Implications for research and practice. The received results can serve for the optimisation of the procedures of translation task difficulty measurement and competence assessment in the translation classroom.
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Papageorgiou, Eleni, Eftychia Kapsalaki, Efthymios Dardiotis, Asimina Mataftsi, and Evangelia E. Tsironi. "Spasm of the near reflex: a common diagnostic dilemma?" International Journal of Ophthalmology 14, no. 4 (2021): 541–46. http://dx.doi.org/10.18240/ijo.2021.04.10.
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AIM: To report the clinical characteristics and diagnostic procedures used in patients with spasm of the near reflex (SNR), in order to present common investigation strategies and diagnostic pitfalls. METHODS: Retrospective case series of twenty-two patients, mainly children, with SNR or accommodation spasm (AS). AS was diagnosed on the basis of blurred vision and a difference of &#x0026;#x003E;2 dioptres between manifest and cycloplegic retinoscopy. If esotropia and miosis were present, the patients were diagnosed with SNR. All patients underwent visual acuity testing, orthoptic evaluation, assessment of refraction before and after cycloplegia, and dilated fundoscopy. Additional diagnostic investigations, such as neuroimaging, lumbar puncture (LP), electrophysiology and blood tests, were also recorded. Screen use among children was assessed in hours per day. RESULTS: There were 19 female and 3 male patients (age range 7-33y, median=10y). Seventeen patients had AS and 5 patients had SNR, with episodic blurry vision and headaches being the most common symptoms. Brain neuroimaging was performed in six patients (27%), although only one had a history of brain trauma. Two of those patients underwent visual evoked potentials and three also underwent LP and received intravenous steroid therapy. The majority of patients (90%) reported prolonged daily screen time (&#x0026;#x003E;2h/d), and in 55% of cases there were concurrent social problems or psychological triggers. Treatment consisted of careful explanation of the condition, atropine 1% eye drops and full cycloplegic correction by means of bifocal glasses. CONCLUSION: The diagnosis of SNR and AS may be challenging, because symptoms are usually intermittent and nonspecific, and a large number of patients are often subjected to redundant and potentially time-consuming examinations and treatment, that may exaggerate the underlying psychological disorder. Hence, detailed clinical testing and assessment of psychosocial profile is necessary, in order to avoid unnecessary investigations. Neuroimaging should be performed only in selected cases. Finally, due to prolonged screen use SNR and AS may become more frequent in the future.
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Ghani, Sadia B., Eric Taylor, and Siddesh Gopalakrishnan. "Is this Withdrawal or Intoxication? Case Report Regarding Complications of Unregulated Use of Tianeptine, Etizolam, and Phenibut in the USA." CNS Spectrums 26, no. 2 (2021): 169. http://dx.doi.org/10.1017/s1092852920002734.
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AbstractBackgroundThe internet allows easy access for the sales of psychoactive agents that are not regulated by the FDA. Some of those agents are used to help manage anxiety, depression and sleep, such as tianeptine, etizolam, and phenibut. These medications have the potential for abuse and potentially leading to altered mental status when intoxicated or withdrawing. This presents a challenge to clinicians who may not be aware of availability of such substances. Available literature has discussed the use of above substances individually, but how do you treat if there is use of more than one substance with different mechanisms of actions? Here we present a case of an adult male who has used all three agents simultaneously, leading to a hospital admission.Case HistoryA 32-year-old male presented to the emergency department (ED) for altered mental status (AMS). He has a documented history of anxiety but was never treated with prescription medications. No history of substance use was documented. He was self-medicating with concurrent use of tianeptine (atypical antidepressant with mu agonist properties,) phenibut (GABA mimetic) and etizolam (a benzodiazepine-like agent). During his stay, he was agitated and delirious with reports of visual hallucinations. Neuroimaging and lab studies were within normal limits, EEG showed no seizure activity. Over the course of his hospital stay, he was started on Depakote for agitation, a Valium taper for suspected benzodiazepine withdrawal and prevention of seizures, Seroquel for delirium, and baclofen for suspected GABAergic withdrawal symptoms. The patient’s AMS improved and he was discharged on hospital day 10.ConclusionsThis case illustrates the difficulty managing poly-substance use/abuse and stresses the importance for physicians to screen for psychoactive agents purchased over the internet or over the counter to improve treatment outcomes. Continued discussions with patients regarding risks/benefits of use of such substances would be beneficial and help increase awareness.
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Chichetto, Natalie. "3129 Association of concurrent unhealthy alcohol use, tobacco use, and depressive symptoms on incident cardiovascular disease among HIV-infected and uninfected adults: Veterans Aging Cohort Study." Journal of Clinical and Translational Science 3, s1 (2019): 34–35. http://dx.doi.org/10.1017/cts.2019.84.
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OBJECTIVES/SPECIFIC AIMS: This study applied a syndemic framework to 1) assess whether the concurrence of unhealthy alcohol use, smoking, and depressive symptoms is associated with increased risk for incident CVD among people living with and without HIV and 2) determine whether the association between this syndemic and incident CVD is differential by HIV status. METHODS/STUDY POPULATION: We evaluated 5731 participants (50.3% HIV+) without baseline CVD from the Veterans Aging Cohort Study, a prospective, observational cohort of PLWH and matched uninfected veterans enrolled in 2002 and followed through 2015. We assessed baseline number of conditions (syndemic score: 0-3; unhealthy alcohol use (>14 drinks per week for men [women] or 5 or more drinks in one occasion for men [women]), cigarette smoking (former/current), and depressive symptoms (Patient Health Questionnaire-9 score ≥ 10) and incident CVD through 14 years. Clinical ICD-9 codes identified incident cases of CVD (acute myocardial infarction, heart failure, revascularization, and stroke). We constructed age-adjusted survival curves and CVD rates. Multivariable Cox proportional hazards regressions estimated the hazard ratio (HR) and 95% confidence intervals (CI) of the syndemic score on incident CVD by HIV status, adjusting for baseline demographic, health status, and HIV-related factors. RESULTS/ANTICIPATED RESULTS: Under 10% of all veterans had zero conditions; 25.8% had one; 49.6% had two, and 14.3% had all three. Based on the prevalence of each individual condition in the cohort (unhealthy drinking: 41.5%, cigarette smoking: 75.0%, and depressive symptoms: 21.3%), the observed prevalence of all three conditions was more than double that expected by chance (6.6%). There were 835 cases of incident CVD (50.4% HIV+) during the median follow-up (10.6 years). Overall, age-adjusted incidence rates/1000 person-years increased with greater number of conditions (zero 10.1, one 12.5, two 15.8, three 19.6). Compared to uninfected people with zero conditions, the adjusted hazard ratios of incident CVD were similar by HIV status for each number of conditions. DISCUSSION/SIGNIFICANCE OF IMPACT: The syndemic of unhealthy drinking, cigarette smoking, and depressive symptoms is common and associated with high CVD risk. However, this risk was similar by HIV status. Our results underscore the need to screen for and treat these co-occurring conditions.
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González-Roz, Alba, Víctor Martínez-Loredo, Roberto Secades-Villa, Michael Amlung, and James MacKillop. "Concurrent validity of the alcohol purchase task in relation to alcohol involvement: protocol for a systematic review and meta-analysis." BMJ Open 10, no. 6 (2020): e035400. http://dx.doi.org/10.1136/bmjopen-2019-035400.
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IntroductionAlcohol demand, as measured by an alcohol purchase task (APT), provides a multidimensional assessment of the relative reinforcing efficacy of alcohol. The objective of this meta-analysis is to critically appraise the existing literature on the concurrent validity of the APT by meta-analysing the cross-sectional relationships between indices of the APT (ie, breakpoint, Omax, Pmax, elasticity and intensity) and alcohol-related measures. It also aims to examine methodological procedures used to obtain APT indices and individual variables as potential moderators on the assessed estimations.Methods and analysisA comprehensive literature search conducted from inception to April 2020 will be conducted in the PubMed, PsycINFO, Web of Science and Scopus databases. Two authors will independently screen and extract data from articles using a predefined protocol search and extraction forms. Disagreements will be resolved through discussion with two additional reviewers. All results will be tabulated, and a random-effect meta-analysis will be conducted. Participants’ sex, number of prices and APT methodological procedures will be examined as potential moderators on the observed effect sizes.Ethics and disseminationResults of this meta-analysis will characterise the concurrent validity of the APT in the existing literature. Further, the results are anticipated to provide evidence on which index (or indices) is most robustly associated with alcohol use and severity. Ethics approval was not required for this study and the results will be published in a peer-reviewed journal.PROSPERO registration numberCRD42019137512
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McMurray, Josephine, AnneMarie Levy, and Paul Holyoke. "Psychometric Evaluation and Workflow Integration Study of a Tablet-Based Tool to Detect Mild Cognitive Impairment in Older Adults: Protocol for a Mixed Methods Study." JMIR Research Protocols 10, no. 5 (2021): e25520. http://dx.doi.org/10.2196/25520.
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Background With the rapid aging of the global population, experts anticipate a surge in the prevalence of mild cognitive impairment (MCI) and dementia worldwide. It is argued that developing more sensitive, easy to administer, and valid MCI screening tools for use in primary care settings may initiate timely clinical and personal care planning and treatment, enabling early access to programs and services. Including functional competence measures in screening tests makes them more ecologically valid and may help to identify cognitive deficits at an earlier stage. Objective We aim to conduct a preliminary evaluative study comparing the sensitivity, specificity, and reliability of the BrainFx Screen (referred to as SCREEN hereafter), a novel digital tool designed to assess functional competence and detect early signs of cognitive impairment, with the Quick Mild Cognitive Impairment, a validated and highly sensitive tool that detects MCI in the older adult population. We will also investigate the perceived usefulness and integration of the SCREEN into primary care practice to identify demonstrable impacts on clinical workflow and health care providers’ (HCP) perceptions of its success as a screening tool. Patients’ perceptions of completing the SCREEN and its impact on their quality of life will also be explored. Methods This study has a concurrent, mixed methods, prospective, and quasi-experimental design. Participants will be recruited from 5 primary care family health teams (FHTs; defined by multidisciplinary practice and capitated funding) across southwestern Ontario, Canada. Participants will include HCPs, patients, care partners, and FHT administrative executives. Patients 55 years and older with no history of diagnoses for MCI, dementia, or Alzheimer disease rostered in one of the FHTs participating in the study will be eligible to participate. Their care partners will help triangulate the qualitative data collected from patients. Participating FHTs will identify an occupational therapist from their site to participate in the study; this HCP will both administer the research protocol and participate in semistructured in-depth interviews and questionnaires. Principal component analysis will be conducted on the SCREEN data to understand the test components better. Tests comparing sensitivity, specificity, and test-retest reliability will assess the validity of SCREEN as a screening tool for MCI. Results This paper describes the study protocol and its activities to date. Data collection was halted early because of COVID-19 restrictions on research activity, and data analysis is currently in progress. Conclusions At the end of the project, we anticipate having an initial comparative evaluation of the SCREEN as a tool for early detection of MCI in primary care older adult patient populations. Resource constraints on this research study limit our ability to conduct a randomized controlled trial; however, the results will assist developers of the SCREEN in determining whether rigorous controlled testing is warranted. International Registered Report Identifier (IRRID) DERR1-10.2196/25520
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Lubick, Kirk James, Miranda Radke, Suzanne Wilson, and Mark Jutila. "Application of adjuvant therapy for increased innate resistance against Phase II Coxiella burnetii (47.14)." Journal of Immunology 178, no. 1_Supplement (2007): S68—S69. http://dx.doi.org/10.4049/jimmunol.178.supp.47.14.
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Abstract Coxiella burnetii, the causative agent of Q fever, is an obligate intracellular bacterial parasite of macrophages, is classified as a select agent and can be readily weaponized. To date, there is no approved vaccine for C. burnetti in the U.S. and antibiotic therapy is only effective if given very early following initial infection. Infected macrophages can be induced to kill the bacterium, suggesting that “adjuvant therapy” may be an alternative approach to countering infection. As a first test of this approach, the capacity of TLR2 and TLR4 agonists to activate and induce increased killing of Phase II C. burnetii was tested in vitro and in vivo. TLR agonists induced activation and increased killing in vitro, yet showed minimal activity in vivo. In a concurrent drug discovery effort we screened 2,000 natural compounds on macrophage cells as well as on other innate cells for their potential use in “adjuvant therapy”. These novel activating agents identified in the drug screens induced IL-8 release and upregulation of cathepsin D and reproducibly increased clearance of C. burnetii both in vitro and in vivo. These results show that Phase II C. burnetii is susceptible to adjuvant therapy, but TLR agonists are not consistent in inducing protection. Novel agonists from a screen of a natural product library hold promise as potential therapeutic adjuvants for Q-fever. Funded by: NIH AI-04018 and DoD W91 13M-04-1-0001.
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Goemans, Anouk, Michael Tarren-Sweeney, Mitch van Geel, and Paul Vedder. "Psychosocial screening and monitoring for children in foster care: Psychometric properties of the Brief Assessment Checklist in a Dutch population study." Clinical Child Psychology and Psychiatry 23, no. 1 (2017): 9–24. http://dx.doi.org/10.1177/1359104517706527.
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Children in foster care experience higher levels and rates of psychosocial difficulties than children from the general population. Governments and child welfare services have a responsibility to identify those children in care who have need for therapeutic services. This can be achieved through systematic screening and monitoring of psychosocial difficulties among all children in foster care. However, general screening and assessment measures such as the Strengths and Difficulties Questionnaire (SDQ) and Child Behavior Checklist (CBCL) might not adequately screen for the range of difficulties experienced by foster children. The Brief Assessment Checklists for Children (BAC-C) and Brief Assessment Checklists for Adolescents (BAC-A) are measures designed to screen for and monitor attachment- and trauma-related difficulties among child welfare populations. This article reports psychometric properties of the BAC-C and BAC-A, estimated in a population study of 219 Dutch foster children. The results suggest the BAC-C and BAC-A perform both screening and monitoring functions well. Their screening accuracy, internal reliability and concurrent validity are comparable to those estimated for the SDQ within the same child and adolescent sample. Future research is needed to assess the value of the Brief Assessment Checklists (BAC) compared to other measures and to validate cut-points for the BAC. This study further establishes the BAC-A and BAC-C as valid and useful mental health screening and monitoring measures for use with children and adolescents in foster care.
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Hamed, Ruba Ahmed, Greg Korpanty, and Dervla Kelly. "Toxicities and outcomes of neoadjuvant treatment in elderly patients with locally advanced rectal cancer: a scoping review protocol." BMJ Open 12, no. 5 (2022): e061397. http://dx.doi.org/10.1136/bmjopen-2022-061397.
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IntroductionColorectal cancer remains the second leading cause of cancer-related death in 60–79 years old and the third leading cause of death in patients aged 80 and above. Rectal cancer accounts for approximately a third of colorectal cancer diagnoses. The current standard of care for managing locally advanced rectal cancer involves a multimodal combined approach with neoadjuvant treatment, surgery with total mesorectal excision and adjuvant chemotherapy. Neoadjuvant treatment can be in the form of short-course radiotherapy, long-course concurrent radiotherapy with chemotherapy or total neoadjuvant chemotherapy with concurrent chemoradiotherapy followed by chemotherapy. This scoping aims to assess the toxicity and outcome of the different neoadjuvant treatment modalities in elderly patients.Methods and analysisWe will use Arksey and O'Malley’s five scoping review methodology framework stages. Searches will be conducted in Ovid Medline, Embase, Cochrane database and CINAHL. In addition, the researcher will hand search for all registered trials, using a combination of terms such as “locally advanced rectal cancer”, “neoadjuvant treatment”, and “elderly patients.” Two independent reviewers will screen titles and abstracts and then full text based on predefined inclusion and exclusion criteria. Publications will be extracted using a customised data extraction tool to include study characteristics, research topics, exposures and outcomes.Ethics and disseminationEthics approval is not required as the data will be collected from the existing literature. The findings of this study will help with future clinical research on the topic. We will publish the findings of this review in a peer-reviewed journal and present them at academic conferences targeting geriatric oncology service providers.
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Ummul Muttaqinah, Asyiah, Laila Qodariah, and Fredrick Dermawan Purba. "Validasi Aplikasi Komputer untuk Peningkatan Fokus Atensi pada Anak dengan Gangguan Pemusatan Perhatian (GPP)." Psikologika: Jurnal Pemikiran dan Penelitian Psikologi 26, no. 1 (2021): 101–20. http://dx.doi.org/10.20885/psikologika.vol26.iss1.art6.
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This research is a study on the adaptation of a training program aimed to increase focused attention into a computer. It aims to develop a tool for such training by applying some adaptations into a computer program (software). This study uses concurrent mixed methods (using quantitative and qualitative research methods at the same time). In the first process, the software was assessed by a Game Developer expert and three child and adolescence clinical psychologists. The expert of Game Developer suggests a change of the intensity of the color of the stimulus and the screen background. Using the Content Validity index (CVI) technique, the psychologists found that the “Attention Focus Training” software has a value of S-CVI/Average (S-CVI/AVE) = .91 (> .80), indicating its conformity to the existing theories. The next stage is user experience by three child and adolescence clinical psychologists, conducted by comparing the use of the software and manual tools. It shows that the software is more practical and tends to have less negative bias.
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Cawood, Abbie L., Emily R. Walters, Sarah K. E. Sharp, Marinos Elia, and Rebecca J. Stratton. "‘Self-screening’ for malnutrition with an electronic version of the Malnutrition Universal Screening Tool (‘MUST’) in hospital outpatients: concurrent validity, preference and ease of use." British Journal of Nutrition 120, no. 5 (2018): 528–36. http://dx.doi.org/10.1017/s000711451800185x.
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AbstractSelf-screening using an electronic version of the Malnutrition Universal Screening Tool (‘MUST’) has been developed but its implementation requires investigation. A total of 100 outpatients (mean age 50 (sd 16) years; 57 % male) self-screened with an electronic version of ‘MUST’ and were then screened by a healthcare professional (HCP) to assess concurrent validity. Ease of use, time to self-screen and prevalence of malnutrition were also assessed. A further twenty outpatients (mean age 54 (sd 15) years; 55 % male) examined preference between self- screening with paper and electronic versions of ‘MUST’. For the three-category classification of ‘MUST’ (low, medium and high risk), agreement between electronic self-screening and HCP screening was 94 % (κ=0·74, se 0·092; P<0·001). For the two-category classification (low risk; medium+high risk) agreement was 96 % (κ=0·82, se 0·085; P<0·001), comparable with the previously reported paper-based self-screening. In all, 15 % of patients categorised themselves ‘at risk’ of malnutrition (5 % medium, 10 % high). Electronic self-screening took 3 min (sd 1·2 min), 40 % faster than previously reported for the paper-based version. Patients found the tool easy or very easy to understand (99 %) and complete (98 %). Patients that assessed both tools found the electronic tool easier to complete (65 %) and preferred it (55 %) to the paper version. Electronic self-screening using ‘MUST’ in a heterogeneous group of hospital outpatients is acceptable, user-friendly and has ‘substantial to almost-perfect’ agreement with HCP screening. The electronic format appears to be as agreeable and often the preferred format when compared with the validated paper-based ‘MUST’ self-screening tool.
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Lockwood Estrin, Georgia, Supriya Bhavnani, Amy Goodwin, et al. "From the lab to the field: acceptability of using electroencephalography with Indian preschool children." Wellcome Open Research 7 (October 12, 2023): 99. http://dx.doi.org/10.12688/wellcomeopenres.17334.2.
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Background: Measurement of social and cognitive brain development using electroencephalography (EEG) offers the potential for early identification of children with elevated risk of developmental delay. However, there have been no published reports of how acceptable EEG technology is to parents and children within communities, especially in low-resource contexts such as in low and middle income countries (LMICs), which is an important question for the potential scalability of these assessments. We use a mixed-methods approach to examine whether EEG assessments are acceptable to children and their caregivers in a low resource community setting in India. Methods: We assessed the acceptability of neurophysiology research and Braintools (a novel neurodevelopmental assessment toolkit using concurrent EEG and eye-tracking technology) using: 1) a child engagement measure, 2) interviews with caregivers (n=8); 3) survey about caregiver’s experience (n=36). Framework analysis was used to analyse interview data. Results: A high level of child engagement in EEG tasks was demonstrated, with children’s gaze at the screen during the task averaging at 85.4% (±12.06%) of the task time. External distractions and noise during the tasks were measured, but not found to significantly effect child’s attention to the screen during EEG tasks. Key topics were examined using the framework analysis: 1) parental experience of the assessment; and 2) the acceptability of research. From topic 1, four sub-themes were identified: i) caregivers’ experience of the assessment, ii) caregivers’ perception of child's experience of assessment, iii) logistical barriers and facilitators to participation, and iv) recommendations for improvement. Results from interviews and the survey indicated acceptability for gaze-controlled EEG research for parents and children. From topic 2, three themes were identified: i) caregivers' understanding of the research, ii) barriers to participation, and iii) facilitators to participation. Barriers to participation mainly included logistical challenges, such as geographic location and time, whereas involvement of the wider family in decision making was highlighted as an important facilitator to partake in the research. Conclusions: We demonstrate for the first time the acceptability of conducting neurodevelopmental assessments using concurrent EEG and eye-tracking in preschool children in uncontrolled community LMIC settings. This kind of research appears to be acceptable to the community and we identify potential barriers and facilitators of this research, thus allowing for future large scale research projects to be conducted investigating neurodevelopment and risk factors for suboptimal development in LMICs.
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Sim, Nicholas Keyi, Eng Chuan Foo, Khine Lwin, Shwe Zin Tun, and Badr Dafalla. "Case presentation competition|5 Back to basics." Journal of Neurology, Neurosurgery & Psychiatry 93, no. 9 (2022): e2.190. http://dx.doi.org/10.1136/jnnp-2022-abn2.43.
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Serotonin syndrome associated with clozapine withdrawal and concurrent selective serotonin reuptake inhibitor (SSRI) use has previously been reported.A 56-year-old female with schizophrenia was admitted for pyrexia, rigidity, and altered mental state after her second dose of clozapine restart. She had discontinued her long-term clozapine 2 weeks prior. She developed ventilatory failure, reduced consciousness, eye deviation, and worsening rigidity, requiring ICU support. Examination showed a right upper motor neurone syndrome with absent ankle reflexes.She had raised inflammatory markers and creatine kinase. Serum neuropathy, encephalitis screen, and COVID PCR were negative. Respiratory investigations were unfruitful. MRI head and spine did not show brain or cord signal change to correlate to signs. Lumbar puncture showed a quiet CSF, negative culture, viral PCR, and encephalitis antibodies. EEG showed bihemispheric background slowing.Despite clinical improvement, repeat examination showed persistent signs. She was diagnosed with serotonin syndrome after developing a bilateral tremor. Treatment with cyproheptadine correlated with an improvement in her signs, cognitive state, and EEG.Serotonin syndrome can present with reversible neuromuscular signs. With clozapine withdrawal, it can require a prolonged time course of recovery in contrast with classical serotonin syndrome. Cyprohepta- dine can cause agranulocytosis and this delays clozapine restart.
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Uddin, Muhammad Erfan, Eric D. Eisenmann, Yang Li, et al. "MATE1 Deficiency Exacerbates Dofetilide-Induced Proarrhythmia." International Journal of Molecular Sciences 23, no. 15 (2022): 8607. http://dx.doi.org/10.3390/ijms23158607.
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Dofetilide is a rapid delayed rectifier potassium current inhibitor widely used to prevent the recurrence of atrial fibrillation and flutter. The clinical use of this drug is associated with increases in QTc interval, which predispose patients to ventricular cardiac arrhythmias. The mechanisms involved in the disposition of dofetilide, including its movement in and out of cardiomyocytes, remain unknown. Using a xenobiotic transporter screen, we identified MATE1 (SLC47A1) as a transporter of dofetilide and found that genetic knockout or pharmacological inhibition of MATE1 in mice was associated with enhanced retention of dofetilide in cardiomyocytes and increased QTc prolongation. The urinary excretion of dofetilide was also dependent on the MATE1 genotype, and we found that this transport mechanism provides a mechanistic basis for previously recorded drug-drug interactions of dofetilide with various contraindicated drugs, including bictegravir, cimetidine, ketoconazole, and verapamil. The translational significance of these observations was examined with a physiologically-based pharmacokinetic model that adequately predicted the drug-drug interaction liabilities in humans. These findings support the thesis that MATE1 serves a conserved cardioprotective role by restricting excessive cellular accumulation and warrant caution against the concurrent administration of potent MATE1 inhibitors and cardiotoxic substrates with a narrow therapeutic window.
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Rubio-Valdés, Guillermo, Diego Cabello, Hava F. Rapoport, and Luis Rallo. "Olive Bud Dormancy Release Dynamics and Validation of Using Cuttings to Determine Chilling Requirement." Plants 11, no. 24 (2022): 3461. http://dx.doi.org/10.3390/plants11243461.
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Dormancy release dynamics in olive tree (Olea europaea L.) reproductive buds as affected by cold accumulation, tree bearing status, and budburst temperature was studied under natural and controlled conditions, using both cuttings and container- and field-grown plants. The chilling necessary for dormancy release was acquired at different times within the bud population, presenting a progressive pattern of reproductive budburst. Once sufficient chilling is accumulated, 20 °C is a suitable temperature for reproductive budburst, although higher temperature, e.g., 30 °C, during dormancy release can inhibit budburst. While the bearing status of trees determined the amount of return bloom, dormancy release followed a similar pattern for previously bearing and non-bearing trees. Concurrent with investigating budburst factors, the use of shoot cuttings was tested as a method for olive dormancy release studies by contrasting with results from whole trees. It was found it to be valid for studying reproductive budburst, thus providing a useful method to screen chilling requirements in cultivar evaluation and the breeding programs currently ongoing in this species. However, the method was not valid for vegetative budburst, with varying results between cuttings and the whole plant.
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Witt, Rochelle, Benjamin Wisniewski, Melissa Cole, et al. "0410 Utility of the Urine Drug Screen in Maintenance of Wakefulness Testing Interpretation - A Single-Center, Retrospective Analysis in Pediatric Patients." Sleep 45, Supplement_1 (2022): A183—A184. http://dx.doi.org/10.1093/sleep/zsac079.407.
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Abstract Introduction Accurate assessment of hypersomnia depends upon consideration of several factors, including use of medications that affect alertness and sleep organization. Urine drug screens (UDS) are recommended when assessing hypersomnia, but there is little standardization with respect to screening methods, types of substances detected, and use in maintenance of wakefulness test (MWT) interpretation, in part because there is scant literature relating UDS results to patients’ characteristics, MWT findings and implications. Methods A retrospective analysis was performed in adolescents evaluated at Cincinnati Children's Sleep Center between 2008 and 2021 who underwent MWT with concurrent UDS to determine the adequacy of hypersomnia treatment. UDS in our laboratory were performed by Qualitative Immunoassay/Gas Chromatography-Mass Spectrometry/Liquid Chromatography-Tandem Mass Spectrometry. Results A total of 109 MWTs were accompanied by UDS in 79 patients. Patients were 17.7 [16.6, 18.6] years old (median, [IQ range]), 41.3% female, 68.8% White, 25.7% Black, 5.5% Other, with a BMI of 25.8 [22.1, 31.8] kg/m2. 85.3% had narcolepsy. In addition to prescribed medications, caffeine was positive in 54.1% of UDS, and diphenhydramine was positive in 58.7%. No patients reported use of caffeine or diphenhydramine on the day of MWT. There were no significant demographic differences between those who tested positive and negative for caffeine. The median sleep latency in those with caffeine-positive UDS was longer than those with caffeine-negative UDS, although it did not reach statistical significance (27.3 [14.7, 38.3] vs 19.1 [9.8, 36.1] minutes; P=0.15). Patients with a positive UDS for diphenhydramine all took modafinil/armodafinil. In addition, 80% of patients taking modafinil/armodafinil had diphenhydramine-positive results. Nicotine and cannabinoids were detected in 2 UDS. Conclusion Two unexpected substances (caffeine and diphenhydramine) were found on UDS during MWTs in a significant proportion of our cohort. Caffeine may influence the results of MWTs, although further investigations are warranted. The unexpected presence of diphenhydramine is a false positive for those patients on modafinil/armodafinil (supported by literature and confirmed by our laboratory director). Sleep clinicians should be aware of these findings and the implications of unexpected substances when interpreting MWTs. Support (If Any) Cincinnati Children's Hospital Research Fund
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Schmidt, Richard, Manja Marcinkowski, Claudia Feller, and Uwe Partsch. "Investigation towards the optimum of power capability, ageing stability and costs effectiveness on thick film resistor pastes for AlN ceramics." International Symposium on Microelectronics 2018, no. 1 (2018): 000606–12. http://dx.doi.org/10.4071/2380-4505-2018.1.000606.
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Abstract The focus of this work was the optimization of a 10 Ω/□ thick film resistor (TFR) paste composition to obtain increased power capability, aging stability and minimum use of ruthenium oxide for cost savings without changing the defined narrow sheet resistance (R□) and temperature coefficient of resistance (TCR) specifications. In times of highly fluctuating precious metal costs, the use of a minimum of the precious metal ruthenium respectively ruthenium dioxide is one essential part for cost-effectiveness. The thick film paste formulation consists of the electrically conducting phase ruthenium dioxide, a lead-free glass phase and two inorganic additives for tuning thermo-mechanical and electrical properties of the formed films. A phthalate free organic vehicle with ethyl cellulose polymer was used to formulate a screen printable ceramic thick film paste. For this paper, RuO2 powders with various specific surface area values (BET) were prepared by thermal annealing of a precipitated fine ruthenium dioxide powder. All other solid and liquid components of the paste were the same as used for IKTS 10 Ω/□ TFR paste FK9611 for AlN substrates. Furthermore, the content of ruthenium dioxide in the paste compositions was changed systematically around an assumed target content to achieve the desired sheet resistivity. Concurrent to the variation of the ruthenium dioxide content the inorganic additives had to be adapted too. The influence of the variations of raw material and paste composition on the film properties were investigated by screen printing 24 resistors of 2 mm × 1 mm dimension on an 1” × 1” AlN substrate, firing at 850 °C for 10 minutes in air atmosphere and subsequently measuring R□, TCR, the stability of resistance ΔR/R0 effected by artificial aging of the resistors (stored 100 up to 1000 hours @ 200°C) and the maximum rated power dissipation (MRPD) as well as short term overload voltage (STOL). The results are discussed in regard to find an optimum between all demands of the most important electrical film properties.
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WANG, Hanxiao, Siman Chen, Huangliang WEN, Jialan Wu, and Xiaoyan Liao. "304 - Prevalence of and factors related to eating problems in people with dementia." International Psychogeriatrics 32, S1 (2020): 61–62. http://dx.doi.org/10.1017/s1041610220002045.
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Background & aims:Eating-related problems are common in people with dementia, and may have many adverse consequences. To provide a comprehensive assessment and understanding of these issues, we validated the Chinese version of the Abnormal Eating Behavior Questionnaire (AEBQ), and investigated the prevalence of and factors related to eating-related problems in people with dementia.Methods:A total of 129 people with dementia were recruited from a nursing home and a psychiatric hospital for a cross -sectional study. Internal consistency and test–retest reliability were tested using Cronbach’s α and intra-class correlation coefficient. Dimensionality was evaluated by principal component analysis. Concurrent validity was assessed using Spearman’s correlation coefficient to compare scores for AEBQ and the eating-related items in the Neuropsychiatric Inventory. Factors affecting the prevalence of eating-related problems were identified using logistic regression analysis.Results:The Chinese version of the AEBQ showed acceptable internal consistency, time stability, dimensionality, and concurrent validity. Overall, 86.8% of the participants showed eating-related problems. “Needs supervision” was the most common one, followed by “swallowing problems”. History of stroke (OR: 12.62, 95% CI: 1.58–101.06) and Clinical Dementia Rating (OR: 1.82, 95% CI: 1.02–3.24) were risk factors for “swallowing problems”. Use of antipsychotics protected against “decline in table manners” (OR: 0.21, 95% CI: 0.06–0.74), but was a risk factor for “decrease in appetite” (OR: 3.15, 95% CI: 1.35–7.38). Clinical Dementia Rating (OR: 9.27, 95% CI: 4.13–20.79) independently predicted “needs supervision”.Conclusion:The Chinese version of the AEBQ is a reliable and valid tool. People with dementia had a high prevalence of eating-related problems. Clinical assessment of eating-related problems in this group needs to screen for secondary causes or risk factors, such as psychotropic medications and comorbidities. Targeted interventions should be used to manage reversible eating-related problems among people with dementia.
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Cao, Yi, Weijing Wang, Xuxia Song, Qian Wen, Jing Xie, and Dongfeng Zhang. "Identification of Key Genes and Imbalanced SNAREs Assembly in the Comorbidity of Polycystic Ovary Syndrome and Depression." Genes 15, no. 4 (2024): 494. http://dx.doi.org/10.3390/genes15040494.
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Background: Women with polycystic ovary syndrome (PCOS) have increased odds of concurrent depression, indicating that the relationship between PCOS and depression is more likely to be comorbid. However, the underlying mechanism remains unclear. Here, we aimed to use bioinformatic analysis to screen for the genetic elements shared between PCOS and depression. Methods: Differentially expressed genes (DEGs) were screened out through GEO2R using the PCOS and depression datasets in NCBI. Protein–protein interaction (PPI) network analysis and enrichment analysis were performed to identify the potential hub genes. After verification using other PCOS and depression datasets, the associations between key gene polymorphism and comorbidity were further studied using data from the UK biobank (UKB) database. Results: In this study, three key genes, namely, SNAP23, VTI1A, and PRKAR1A, and their related SNARE interactions in the vesicular transport pathway were identified in the comorbidity of PCOS and depression. The rs112568544 at SNAP23, rs11077579 and rs4458066 at PRKAR1A, and rs10885349 at VTI1A might be the genetic basis of this comorbidity. Conclusions: Our study suggests that the SNAP23, PRKAR1A, and VTI1A genes can directly or indirectly participate in the imbalanced assembly of SNAREs in the pathogenesis of the comorbidity of PCOS and depression. These findings may provide new strategies in diagnosis and therapy for this comorbidity.
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Yan, Mingli, Huiru Yin, Qiuyan Meng, et al. "A Virtual Supermarket Program for the Screening of Mild Cognitive Impairment in Older Adults: Diagnostic Accuracy Study." JMIR Serious Games 9, no. 4 (2021): e30919. http://dx.doi.org/10.2196/30919.
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Background Mild cognitive impairment (MCI) is often a precursor of dementia, and patients with MCI develop dementia at a higher rate than healthy older adults. Early detection of cognitive decline at the MCI stage supports better planning of care and interventions. At present, the use of virtual reality (VR) in screening for MCI in older adults is promising, but there is little evidence regarding the use of virtual supermarkets to screen for MCI. Objective The objectives of this study are to validate a VR game–based test, namely, the Virtual Supermarket Program (VSP), for differentiating patients with MCI and healthy controls and to identify cutoff scores for different age levels. Methods Subjects were recruited from several nursing homes and communities in Changchun, China. They were divided into a healthy control group (n=64) and an MCI group (n=62). All subjects were administered the VSP and a series of neuropsychological examinations. The study determined the optimal cutoff, discriminating validity, concurrent validity, and retest reliability of the VSP. We used the area under the receiver operating characteristic curve (AUC) to evaluate the discriminating validity and obtain the optimal cutoff values. Pearson correlation analysis and the intraclass correlation coefficient were used to evaluate the concurrent validity and retest reliability, respectively. Results A cutoff score of 46.4 was optimal for the entire sample, yielding a sensitivity of 85.9% and specificity of 79.0% for differentiating individuals with MCI and healthy controls, and the AUC was 0.870 (95% CI 0.799-0.924). The median index of VSP score was 51.1 (range 42.6-60.0). There was a moderate positive correlation between the VSP total score and Mini-Mental State Examination score (r=0.429, P<.001). There was a strong positive correlation between VSP total score and Montreal Cognitive Assessment score (r=0.645, P<.001). The retest reliability of the VSP was feasible (r=0.588, P=.048). Conclusions The VSP is interesting and feasible for subjects. It shows high sensitivity and specificity for the identification of MCI in older adults, which makes it a promising screening method. The VSP may be generalized to older adults in other countries, although some cultural adaptation may be necessary. Trial Registration Chinese Clinical Trial Registry ChiCTR2000040074; https://www.chictr.org.cn/showprojen.aspx?proj=64639
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Gobao, Valerie, Mostafa Alfishawy, Neel Shah, Karin Byers, Mohamed Yassin, and Kenneth Urish. "393. Changing Trends, Risk Factors, and Treatment Challenges in Staphylococcus aureus Septic Arthritis." Open Forum Infectious Diseases 6, Supplement_2 (2019): S202. http://dx.doi.org/10.1093/ofid/ofz360.466.
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Abstract Background Staphylococcus aureus is a common organism in native septic arthritis. It is traditionally believed to be self-limited with rapid and aggressive debridement and appropriate antibiotic selection. The incidence of S. aureus septic arthritis is increasing, and further characterization is needed to improve diagnosis and treatment. For patients presenting with native S. aureus septic arthritis, we evaluated the reliability of methicillin-resistant S. aureus (MRSA) screening as a predictor to rule out MRSA septic arthritis, the risk factors associated with this disease, and the treatment and surgical outcomes. Methods A retrospective case–control study of patients diagnosed with septic arthritis in the UPMC health system (Pittsburgh, PA) between 2012 and 2016 was completed. The primary outcomes of interest were surgical intervention and the need to alter antibiotic treatment. Patient demographics, characteristics, and outcomes were recorded. Results A total of 215 cases of septic arthritis were identified, and 64% (n = 138) had S. aureus cultured. In this set, 36% (50/138) of these patients were identified with MRSA. Of the patients diagnosed with MRSA septic arthritis, 50% screened prior to admission had a positive result (8/16) and 48% screened during admission had a positive result (14/29). Compared with septic arthritis with other organisms, risk factors associated with S. aureus included history of intravenous drug use (OR: 4.3, CI: 1.7 to 10.8, P = 0.002) and being immunocompetent (OR: 0.3, CI: 0.1 to 0.6, P = 0.002). These infections were associated with concurrent infections of the spine (OR: 5.7, CI: 2.1 to 15.1, P = 0.0005). As compared with other organisms, there was a high probability of switching antibiotics during treatment (OR: 3.7, CI: 1.1 to 13.0, P = 0.04) and relapse of infection (OR: 4.2, CI: 1.2 to 14.6, P = 0.02). Conclusion S. aureus septic arthritis is associated with intravenous drug use, and not with immunosuppression. A negative MRSA screen does not rule out this organism. Concurrent spine infections are common. There is a high likelihood of infection relapse and that antibiotics will need to be altered during treatment. With the opioid epidemic, the incidence is likely to increase further. More work is needed to improve diagnosis and overcome treatment challenges. Disclosures All authors: No reported disclosures.
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Kenney, MD, Connor, Julie Rizzo, Elsa Coates, et al. "701 Impact of Alcohol and Methamphetamine Use on Burn Resuscitation." Journal of Burn Care & Research 44, Supplement_2 (2023): S126—S127. http://dx.doi.org/10.1093/jbcr/irad045.176.
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Abstract Introduction Mortality associated with burn injuries is declining with improved critical care, including resuscitation. However, patients admitted with concurrent substance use have increased risk of complications and poor outcomes. The impact of alcohol and methamphetamine use on acute burn resuscitation has been described in single center studies, however, has not been studied since implementation of computerized decision support for resuscitation. The purpose of this study was to evaluate resuscitation volumes for patients with alcohol and methamphetamine use within a large prospective observational trial at 5 major US burn centers. Methods We performed an observational trial across five institutions with &gt; 20% total body surface area (TBSA) burn, weighing &gt;40kg that were resuscitated utilizing computerized decision support. Patients were evaluated based presence of alcohol, with a minimum blood alcohol level of 0.10, or positive methamphetamines on urine drug screen. Fluid volumes and urine output were examined over 48 hours and Wilcoxon Method was utilized to compare patient groups. Results A total of 296 patients were analyzed. 37 (12.5%) were positive for methamphetamine use, 50 (16.9%) were positive for alcohol use, and 209 (70.1%) with negative for both. Patients positive for methamphetamine received a mean of 5.30 ±2.63 cc/kg/TBSA, patients positive for alcohol received a mean of 5.41 ± 2.49 cc/kg/TBSA, and patients with neither received a mean 4.33 ± 1.79 cc/kg/TBSA. Patients with methamphetamine or alcohol use had significantly higher fluid requirements than those who were negative for both substances. In the first 6 hours patients with alcohol use had significantly higher urinary output in comparison to patients with methamphetamine use which had similar output to patients negative for both substances. Conclusions This study demonstrated that patients with alcohol and methamphetamine use had statistically significantly larger fluid resuscitation requirements compared to patients without. The effects of alcohol as a diuretic align with previous literature. However, patients with methamphetamine lack the increased urinary output as a cause for their increased fluid requirements. Methamphetamine’s neurologic and cardiovascular effects due to increased release of dopamine, serotonin, and norepinephrine are known. Further investigation is required to better understand the mechanism underlying the need for increased resuscitation after burn injury in patients positive for methamphetamines. Applicability of Research to Practice The impact of alcohol and illicit substances on burn care, especially during the initial resuscitation, aids providers in guiding early critical care.
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Roper, Jennifer E., Brian A. Gottwalt, Julienne K. Kirk, et al. "Adherence to opioid prescribing guidelines at an academic family medicine practice." Journal of Opioid Management 21, no. 2 (2025): 111–19. https://doi.org/10.5055/jom.0931.
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Introduction: Opioid prescribing practices and guidelines are outlined by the United States Centers for Disease Control and Prevention (CDC), but limited data are currently available regarding their use in clinical practice. A primary care residency clinical site at an academic medical center attempted to improve compliance with the CDC best practices in 2022. As a quality improvement initiative, a policy was created, and education was provided to clinicians and patients. The clinical impact of these interventions was analyzed. Methods: A retrospective chart review was performed for patients on chronic opiates during 2023. Extracted electronic health record data were analyzed to collect information on the prescriber (resident/faculty/advanced practice provider), opioid type and duration, concurrent benzodiazepine use, and mental health diagnoses. The main outcomes were whether these patients had an opioid agreement and/or urine drug screen (UDS) in the past 12 months. Results: A total of 245 patients met the criteria, with 29 percent also being prescribed benzodiazepines, and 69 percent having at least one mental health diagnosis. Forty-one percent of the patients had a UDS in the electronic medical record in 2023, with the statistically significant predictors being nontramadol opioid use and a completed opioid agreement. Thirty-two percent had a completed opioid agreement, with the statistically significant predictors being a concomitant mental health diagnosis, provider type, and UDS obtained. Discussion/conclusion: Despite policy and education, compliance with our primary outcomes remained low. Residents were the most compliant. Tramadol was also uniquely identified as having lower compliance with having a UDS on file. Next steps include continued education efforts on the risk and best practices for reducing opioid-related harms and structured chart reviews.
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Roper, Jennifer E., Brian A. Gottwalt, Julienne K. Kirk, et al. "Video: Adherence to opioid prescribing guidelines at an academic family medicine practice." Journal of Opioid Management 21, no. 2 (2025): S1—S20. https://doi.org/10.5055/jom.0939.
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Introduction: Opioid prescribing practices and guidelines are outlined by the United States Centers for Disease Control and Prevention (CDC), but limited data are currently available regarding their use in clinical practice. A primary care residency clinical site at an academic medical center attempted to improve compliance with the CDC best practices in 2022. As a quality improvement initiative, a policy was created, and education was provided to clinicians and patients. The clinical impact of these interventions was analyzed. Methods: A retrospective chart review was performed for patients on chronic opiates during 2023. Extracted electronic health record data were analyzed to collect information on the prescriber (resident/faculty/advanced practice provider), opioid type and duration, concurrent benzodiazepine use, and mental health diagnoses. The main outcomes were whether these patients had an opioid agreement and/or urine drug screen (UDS) in the past 12 months. Results: A total of 245 patients met the criteria, with 29 percent also being prescribed benzodiazepines, and 69 percent having at least one mental health diagnosis. Forty-one percent of the patients had a UDS in the electronic medical record in 2023, with the statistically significant predictors being nontramadol opioid use and a completed opioid agreement. Thirty-two percent had a completed opioid agreement, with the statistically significant predictors being a concomitant mental health diagnosis, provider type, and UDS obtained. Discussion/conclusion: Despite policy and education, compliance with our primary outcomes remained low. Residents were the most compliant. Tramadol was also uniquely identified as having lower compliance with having a UDS on file. Next steps include continued education efforts on the risk and best practices for reducing opioid-related harms and structured chart reviews.
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Singh, Devinder Kaur Ajit, Jing Wen Goh, Muhammad Iqbal Shaharudin, and Suzana Shahar. "A Mobile App (FallSA) to Identify Fall Risk Among Malaysian Community-Dwelling Older Persons: Development and Validation Study." JMIR mHealth and uHealth 9, no. 10 (2021): e23663. http://dx.doi.org/10.2196/23663.
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Background Recent falls prevention guidelines recommend early routine fall risk assessment among older persons. Objective The purpose of this study was to develop a Falls Screening Mobile App (FallSA), determine its acceptance, concurrent validity, test-retest reliability, discriminative ability, and predictive validity as a self-screening tool to identify fall risk among Malaysian older persons. Methods FallSA acceptance was tested among 15 participants (mean age 65.93 [SD 7.42] years); its validity and reliability among 91 participants (mean age 67.34 [SD 5.97] years); discriminative ability and predictive validity among 610 participants (mean age 71.78 [SD 4.70] years). Acceptance of FallSA was assessed using a questionnaire, and it was validated against a comprehensive fall risk assessment tool, the Physiological Profile Assessment (PPA). Participants used FallSA to test their fall risk repeatedly twice within an hour. Its discriminative ability and predictive validity were determined by comparing participant fall risk scores between fallers and nonfallers and prospectively through a 6-month follow-up, respectively. Results The findings of our study showed that FallSA had a high acceptance level with 80% (12/15) of older persons agreeing on its suitability as a falls self-screening tool. Concurrent validity test demonstrated a significant moderate correlation (r=.518, P<.001) and agreement (k=.516, P<.001) with acceptable sensitivity (80.4%) and specificity (71.1%). FallSA also had good reliability (intraclass correlation .948; 95% CI .921-.966) and an internal consistency (α=.948, P<.001). FallSA score demonstrated a moderate to strong discriminative ability in classifying fallers and nonfallers. FallSA had a predictive validity of falls with positive likelihood ratio of 2.27, pooled sensitivity of 82% and specificity of 64%, and area under the curve of 0.802. Conclusions These results suggest that FallSA is a valid and reliable fall risk self-screening tool. Further studies are required to empower and engage older persons or care givers in the use of FallSA to self-screen for falls and thereafter to seek early prevention intervention.
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Medvedkov, Yevgeniy, Aigerim Nazymbekova, Dinara Tlevlessova, Mikhail Shaprov, and Ainura Kairbayeva. "Development of the juice extraction equipment: physico-mathematical model of the processes." Eastern-European Journal of Enterprise Technologies 1, no. 11 (109) (2021): 14–24. http://dx.doi.org/10.15587/1729-4061.2021.224986.
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Multifruit juicers are designed, constructed and improved to be able to process pineapples, oranges and watermelons efficiently. Little juice manufacturers need both a small and efficient device for juice extraction for being economically concurrent compared to big corporations. The authors of the represented paper aim to present the experimental device for juice extraction, its effectiveness, and functional. This device was created using the compressive and compressive shear forces conveyed by an auger conveyor system as a working power. The juicer consists of a hopper, a screw conveyor shaft, a filter screen, a juice outlet, gearbox housing, and a motor. The analysis of the component design enabled the authors to use the data in order to identify the sizes, manufacture and assemble the machine. The authors have made a lot of tests to detect the efficiency and functionality of the presented device. Tests of the device productivity were carried out using watermelons loaded into the device both peeled and unpeeled. Percentage of juice yield, juice extraction efficiency and extraction losses were used as performance indicators. Productivity analysis results revealed that a fruit type and peel condition reliably influenced productivity indicators at the value of 1 %. The percentage of juice yield from peeled and unpeeled watermelons constituted 89.5 % and 89.7 %, respectively. Extraction efficiency constituted 96.6 % for peeled watermelons and 97.1 % for unpeeled ones. Extraction losses amounted to 2.9 % and 2.6 % correspondingly. The proposed device is easy to use and maintain, therefore, it will perfectly suit the needs of small fruit juice manufacturers and can help to get economic efficiency to the small manufacture
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Chagas, Danillo Magnum Farias, Isla Thamera Medeiros da Cunha, Giedra Marinho Hollanda Cavalcanti, Ana Paula Noriko Cimino, and Maria Junia Lira e Silva. "O USO DE MÍDIAS DIGITAIS E O DESENVOLVIMENTO DE SINTOMAS DE AUTISMO NA INFÂNCIA: Uma revisão integrativa." Psicologia e Saúde em Debate 11, no. 1 (2025): 1117–35. https://doi.org/10.22289/2446-922x.v11a1a65.
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The increase in screen use by children has raised concerns among experts due to its potential impacts on cognitive and social development. Concurrently, there has been a significant rise in the diagnosis of Autism Spectrum Disorder (ASD). In this context, this review aimed to explore the relationship between excessive screen use in childhood and the emergence of autism-like symptoms, which could lead to misdiagnosis. Through an integrative review, 5 databases were accessed, and 36 studies were selected for initial analysis. Eleven studies met the inclusion criteria and their results were described. Excessive screen use in childhood appears to be associated with deficits in social communication, impaired eye contact, sensory-motor delays, behavioral and learning problems, lack of self-control and emotional intelligence, as well as sleep disturbances. These symptoms may be exacerbated in children with ASD. Parents often use screens to calm, distract, or educate their children. Interventions that reduce screen time have shown improvements in autism symptoms in both children with and without ASD. Excessive screen use in childhood may cause or exacerbate symptoms similar to those of ASD. These findings highlight the need for careful evaluations in ASD diagnoses to prevent excessive screen use from being a confounding factor. It is crucial to acknowledge the current limitations of research due to methodological variations, which necessitates more comprehensive and long-term studies for a clearer understanding of these relationships.