-
JMIR Formative Research Apr 2022Atrial fibrillation is commonly associated with obesity. Observational studies have shown that weight loss is associated with improved prognosis and a decrease in atrial...
BACKGROUND
Atrial fibrillation is commonly associated with obesity. Observational studies have shown that weight loss is associated with improved prognosis and a decrease in atrial fibrillation frequency and severity. However, despite these benefits, nonadherence to lifestyle programs is common.
OBJECTIVE
In this study, we evaluated adherence to and feasibility of a multidisciplinary lifestyle program focusing on behavior change in patients with atrial fibrillation and obesity.
METHODS
Patients with atrial fibrillation and obesity participated in a 1-year goal-oriented cardiac rehabilitation program. After baseline assessment, the first 3 months included a cardiac rehabilitation intervention with 4 fixed modules: lifestyle counseling (with an advanced nurse practitioner), exercise training, dietary consultation, and psychosocial therapy; relaxation sessions were an additional optional treatment module. An advanced nurse practitioner monitored the personal lifestyle of each individual patient, with assessments and consultations at 3 months (ie, immediately after the intervention) and at the end of the year (ie, 9 months after the intervention). At each timepoint, level of physical activity, personal goals and progress, atrial fibrillation symptoms and frequency (Atrial Fibrillation Severity Scale), psychosocial stress (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9) were assessed. The primary endpoints were adherence (defined as the number of visits attended as percentage of the number of planned visits) and completion rates of the cardiac rehabilitation intervention (defined as performing at least of 80% of the prescribed sessions). In addition, we performed an exploratory analysis of effects of the cardiac rehabilitation program on weight and atrial fibrillation symptom frequency and severity.
RESULTS
Patients with atrial fibrillation and obesity (male: n=8; female: n=2; age: mean 57.2 years, SD 9.0; baseline weight: mean 107.2 kg, SD 11.8; baseline BMI: mean 32.4 kg/m2, SD 3.5) were recruited. Of the 10 participants, 8 participants completed the 3-month cardiac rehabilitation intervention, and 2 participants did not complete the cardiac rehabilitation intervention (both because of personal issues). Adherence to the fixed treatment modules was 95% (mean 3.8 sessions attended out of mean 4 planned) for lifestyle counseling, 86% (mean 15.2 sessions attended out of mean 17.6 planned) for physiotherapy sessions, 88% (mean 3.7 sessions attended out of mean 4.1 planned) for dietician consultations, and 60% (mean 0.6 sessions attended out of mean 1.0 planned) for psychosocial therapy; 70% of participants (7/10) were referred to the optional relaxation sessions, for which adherence was 86% (mean 2 sessions attended out of mean 2.4 planned). The frequency of atrial fibrillation symptoms was reduced immediately after the intervention (before: mean 35.6, SD 3.8; after: mean 31.2, SD 3.3), and this was sustained at 12 months (mean 24.8, SD 3.2). The severity of atrial fibrillation complaints immediately after the intervention (mean 20.0, SD 3.7) and at 12 months (mean 9.3, SD 3.6) were comparable to that at baseline (mean 16.6, SD 3.3).
CONCLUSIONS
A 1-year multidisciplinary lifestyle program for obese patients with atrial fibrillation was found to be feasible, with high adherence and completion rates. Exploratory analysis revealed a sustained reduction in atrial fibrillation symptoms; however, these results remain to be confirmed in large-scale studies.
PubMed: 35486435
DOI: 10.2196/32625 -
World Journal of Radiology Nov 2016To find accompanying anomalies of typical and atypical Scheuermann's disease (SD) is reported in the present study.
AIM
To find accompanying anomalies of typical and atypical Scheuermann's disease (SD) is reported in the present study.
METHODS
Study included 20 patients (16 men and 4 women) who had radiological imaging radiography, magnetic resonance imaging (MRI) and computed tomography, if available, due to back pain, curved back and low back pain in November 2011-February 2016 period. Patients were categorized into typical and atypical patterns based on the region involved. Thoracic kyphosis values were measured using real Cobb angle. Accompanying disc degeneration, herniations and spinal cord pathologies were studied using MRI.
RESULTS
Age of the patients ranged from 11.0 to 23.0 (mean 17.2 ± 3.0). Typical pattern of SD were detected in 15 patients while atypical pattern were detected in 5 patients. Cobb angle range was 40.2-67.2 (mean 55.5 ± 8.7) in typical Scheuermann's patients and 24.7-49.9 (mean 36.7 ± 10.8) in atypical ones. Intervertebral level was affected and had the measures of 3-8 (mean 5.3 ± 1.6) and 7-9 (mean 8.2 ± 0.8) in typical and atypical Scheuermann's patients, respectively. Level of degenerative disc disease in MRI was 1-7 discs (mean 4.1 ± 1.7) in typical patients and 5-10 discs (mean 7.6 ± 1.9) in atypical patients.
CONCLUSION
SD can be seen in typical and atypical patterns, typical being more frequent. Because degenerative disc diseases, herniations and cord pathologies such as syringomyelia can accompany SD (albeit more common in atypical pattern), it is necessary to evaluate these patients with plain radiography and MRI together.
PubMed: 27928471
DOI: 10.4329/wjr.v8.i11.895 -
Nursing Open Jan 2021To assess the health promotion practices of Syrian refugees in the north of Jordan and to determine their correlation with some socio-demographic variables.
AIM
To assess the health promotion practices of Syrian refugees in the north of Jordan and to determine their correlation with some socio-demographic variables.
DESIGN
Cross-sectional descriptive correlational.
METHODS
Health-Promotion Lifestyle Profile II (HPLP-II) was used to measure health promotion practices of Syrian refugees. Data were collected from a convenient sample of 250 Syrian refugees who lived in the North of Jordan. Descriptive and inferential statistics were used to analyse data.
RESULTS
The results showed that Syrian refugees in Jordan had low scores of total health promotion scale (mean = 2.28) with a cut score of 2.5, which indicated that they minimally adopted health promotion practices in general. The higher score was found on the interpersonal relation domain (mean = 2.89, 0.52). While the stress management domain (mean = 2.48, 0.43), spiritual growth domain (mean = 2.38, 0.39) and nutrition domain (mean = 2.34, 0.37) were lower than 2.5, the scores on responsibility and physical activity domains (mean = 2.20, 0.62), (mean = 1.35, 0.18) respectively, were the lowest. Women, married and unemployed, have more healthy behaviours than their counterparts.
Topics: Cross-Sectional Studies; Female; Health Promotion; Humans; Jordan; Refugees; Syria
PubMed: 33318835
DOI: 10.1002/nop2.626 -
The Medical Journal of Malaysia Jul 2022The aim of this study was to compare temperature readings measured at the forehead and wrist against the tympanic temperature which is generally accepted as the standard.
BACKGROUND
The aim of this study was to compare temperature readings measured at the forehead and wrist against the tympanic temperature which is generally accepted as the standard.
METHOD
This is a cross-sectional study carried out on 325 people from the general population entering a private hospital for consultation or work. Forehead and wrist temperature was taken using the CEFC RoHS K3 model (China) and tympanic temperature using the Braun Thermoscan 7 Thermometer Irt6520 by the same investigator on consenting individuals.
RESULTS
There was no significant difference between the forehead (mean =36.6, standard deviation, SD=0.30) and tympanic (mean=36.6, SD=0.41), Z= -1.609, p=0.108. However, there was significant difference between the wrist (mean=36.4, SD= 0.28) and tympanic (mean=36.6, SD=0.41) temperature values, Z= -8.749, p<0.001, the former being lower. Temperature measured at forehead (mean=36.6, SD=0.30) was also significantly higher than the wrist (mean=36.4, SD=0.28), Z= -9.381, p<0.001. The wrist temperature values were lower than forehead and tympanic.
CONCLUSION
Forehead temperature values are better representatives of the core temperature (tympanic) and be the preferred site of measurement compared to the wrist.
Topics: Body Temperature; Cross-Sectional Studies; Forehead; Humans; Prospective Studies; Temperature
PubMed: 35902943
DOI: No ID Found -
Work (Reading, Mass.) 2021Occupational burnout, which is more and more commonly encountered among medical professionals and investigated by researchers worldwide, may in particular affect health...
BACKGROUND
Occupational burnout, which is more and more commonly encountered among medical professionals and investigated by researchers worldwide, may in particular affect health care workers during the COVID-19 pandemic.
OBJECTIVES
The aim of the study was to assess the risk of occupational burnout among physiotherapists working actively in clinical hospitals in south-eastern Poland during the COVID-19 pandemic.
METHODS
The level of burnout among the studied physiotherapists was assessed using the Polish version of the Maslach Burnout Inventory by Maslach (MBI). The study was conducted from 20 March to 3 May, 2020 among physiotherapists working professionally during the COVID-19 pandemic in the south east of Poland, during which time health services related to therapeutic rehabilitation were suspended. The study was conducted among 1,540 physiotherapists with a license to practice who worked in clinical departments. Considering the inclusion and exclusion criteria, 106 physiotherapists were qualified for the study.
RESULTS
The current findings show that during the COVID-19 pandemic physiotherapists present high burnout rates in all three dimensions: EE (Mean 32.31; CI 29.47-35.15); DP (Mean 16.25; CI 14.48-18.03); PA (Mean 26.25; CI 24.41-28.10). As for gender-related effects, higher burnout rates were observed in the male workers, compared to the females, in all three domains: EE (Men: Mean 34.70; CI 29.90-39.50 -Women: Mean 31.03; CI 27.45-34.60); DP (Men: Mean 18.78; CI 15.98-21.59 -Women: Mean 14.90; CI 12.64-17.16) and PA (Men: Mean 24.54; CI 21.32-27.76 -Women: Mean 27.17; CI 24.90-29.44). The highest burnout rates, presented by the physiotherapists working in the profession for more than 20 years, were identified in the domain of EE (Mean: 35.30; CI 30.51-40.10) and in those with 10-15 years of experience, in the domains of DP (Mean: 18.31; CI 14.89-21.73) and PA (Mean: 23.97; CI 20.13-27.81). The highest rate of occupational burnout, reflected by the scores in all three domains (EE, DP, PA), was identified in Department I -Intensive Care and Anaesthesiology Department: EE - (Mean: 40.89, CI 35.27-46.52); DP - (Mean: 21.39, CI 17.90-24.88); and PA - (Mean: 23.07, CI 20.04-26.10), compared to the other departments. The subjects who rarely participated in courses or training programs showed the highest burnout rates (EE- Mean: 33.55, CI 29.33-37.77; DP- Mean: 16.71, CI 13.99-19.43; PA- Mean: 25.45, CI 22.47-28.43).
CONCLUSIONS
Occupational burnout during the COVID-19 pandemic is noticeable among physiotherapists working in clinical departments. The current findings show high burnout rates in all three domains: emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA). A comparative analysis of these findings with reference to related studies published before the pandemic shows that the burnout rates among physiotherapists may have significantly increased during the COVID-19 pandemic. However, given the scarcity of scientific evidence related to this specific problem in Poland and worldwide, it is necessary to continue research in occupational burnout affecting physiotherapists, particularly during the second wave of the pandemic, in order to gain a better understanding of the possible effects of social isolation and greater personal work-related health risks on the mental health of these medical professionals.
Topics: Adult; Burnout, Professional; COVID-19; Emotions; Female; Health Workforce; Hospitals; Humans; Male; Middle Aged; Occupational Health; Pandemics; Physical Therapists; Physical Therapy Specialty; Poland; SARS-CoV-2; Stress, Physiological; Surveys and Questionnaires; Workload
PubMed: 33492259
DOI: 10.3233/WOR-203375 -
The American Review of Respiratory... Aug 1985Infants requiring mechanical ventilation are usually intubated with uncuffed endotracheal tubes, which permit gas to leak between the tube and the trachea. This gas leak...
Infants requiring mechanical ventilation are usually intubated with uncuffed endotracheal tubes, which permit gas to leak between the tube and the trachea. This gas leak may alter the mean pressure transmitted to the trachea by changing the pattern of airway flow and modifying the resistive behavior of the endotracheal tube. To test this hypothesis, we measured mean tracheal pressure, gas flow through the endotracheal tube, and resistance of the tube in rabbits ventilated with and without a leak. We also studied the effect of the tube size and the pattern of ventilation on these measurements. We found that a leak reduced the mean tracheal pressure by 15 to 21% with respect to the mean proximal airway pressure. This reduction was caused by an increased difference between inspiratory and expiratory flow through the endotracheal tube, and by the mean expiratory resistance of the tube being lower than its mean inspiratory resistance. The rabbits with smaller tubes had lower mean tracheal pressures. A ventilatory pattern of short inspiratory times and high peak pressures was associated with a proportionally greater decrease in mean tracheal pressure caused by the leak. These findings suggest that the mean proximal airway pressure, measured at the ventilator, may overestimate the mean tracheal pressure in the presence of a gas leak around the tube. Furthermore, the decrease in mean tracheal pressure caused by the leak may decrease oxygenation despite a constant mean proximal airway pressure.
Topics: Airway Resistance; Animals; Intubation, Intratracheal; Mathematics; Pressure; Rabbits; Respiration, Artificial; Trachea
PubMed: 4026056
DOI: 10.1164/arrd.1985.132.2.339 -
Neurogastroenterology and Motility Sep 2013Esophageal high-resolution manometry (HRM) is a novel method to assess esophageal motility. Several software and hardware systems are currently available. A set of...
BACKGROUND
Esophageal high-resolution manometry (HRM) is a novel method to assess esophageal motility. Several software and hardware systems are currently available. A set of normal values for HRM parameters was established in the US, using proprietary tactile-sensing catheter technology (Given Imaging). We wished to determine normal values for HRM performed with another type of catheter (Unisensor).
METHODS
Fifty-two healthy volunteers underwent supine HRM. Each subject swallowed 10 liquid water boluses. Esophageal contraction parameters were evaluated and normal values were calculated (defined as 5th and 95th percentile of values).
KEY RESULTS
The normal range for the following parameters was calculated; distal contractile integral (mean 1319.44, with a 5-95th percentile range [185.65-3407.60]), contractile front velocity (mean 3.98, 5-95th percentile range [2.40-6.50]), Intrabolus pressure (mean 9.68, range [1.00-19.00]), contraction amplitude measured 5 cm above the esophagogastric junction (EGJ; mean 78.76, range [23.00-146.00]), contraction amplitude 15 cm above the EGJ (mean 43.66, range [3.60-96.00]), transition zone (TZ) length (mean 1.34, range [0.00-5.63]), upper esophageal sphincter (UES) pressure (mean 81.63, range [19.50-165.10]), EGJ length (mean 2.97, range [2.17-4.00]), EGJ resting pressure (mean 29.35, range [8.95-51.40]), EGJ relaxation pressure (mean 16.79, range [1.00-39.35]), IRPs4 (mean 13.42, range [2.59-28.28]), and gastric pressure (mean 5.06, range [0.00-9.46]).
CONCLUSIONS & INFERENCES
Overall, the normal values of esophageal HRM parameters obtained with the Unisensor catheter resemble those of the previously published series. Marked differences in upper limits of normal were found for parameters related to the esophageal sphincters and TZ length. Users of HRM should be aware of these differences and define pathology based on comparison to appropriate normal values.
Topics: Adolescent; Adult; Catheters; Esophageal Motility Disorders; Esophagus; Female; Humans; Male; Manometry; Middle Aged; Muscle Contraction; Muscle, Smooth; Reference Values; Young Adult
PubMed: 23803156
DOI: 10.1111/nmo.12167 -
Journal of Voice : Official Journal of... Mar 2022Patients with chronic cough are some of the most challenging to treat. This preliminary study is the first to examine the effects of a single exercise muscle strength...
OBJECTIVES
Patients with chronic cough are some of the most challenging to treat. This preliminary study is the first to examine the effects of a single exercise muscle strength training program to reduce cough severity in patients who failed other treatments.
METHODS
A total of 19 females were included in this study, ranging from age 24 to 80. The maximum phonation time (MPT), laryngeal airway resistance (LAR), maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), Voice Handicap Index-10, (VHI-10) and the Cough Severity Index (CSI) values were obtained pre- and post-treatment. ANOVA two-factor without replication was used to compare values pre- and post-treatment.
RESULTS
MIP (Mean of 62.00 to a mean of 78.53) and MEP (Mean of 90.00 to a mean of 112.16) showed significant increase post-treatment. In addition, LAR (Mean of 73.30 to a mean of 60.67) and CSI (Mean of 19.37 to a mean of 15.00) significantly decreased post-treatment. General changes in pre- and post-treatment values were identified with MPT (Mean of 14.89 to a mean of 16.17) and VHI-10 (Mean of 8.00 to a mean of 6.76). A follow-up questionnaire indicated that the majority of patients felt their cough was better after 4 weeks.
CONCLUSIONS
Muscle strength training provides a tool to aid in the control of cough for patients who are refractory to medical and other behavioral treatments. Improvement in cough may be associated with a reduction in subglottic pressure and increased air flow resulting in lower laryngeal airway resistance.
PubMed: 35260288
DOI: 10.1016/j.jvoice.2022.01.011 -
Journal of Patient Safety Dec 2021The primary aim was to measure patient safety culture in two home care services in Belgium (Flanders). In addition, variability based on respondents' profession was...
OBJECTIVES
The primary aim was to measure patient safety culture in two home care services in Belgium (Flanders). In addition, variability based on respondents' profession was examined.
METHODS
A cross-sectional study was conducted by administering the SCOPE-Primary Care questionnaire in two home care service organizations.
RESULTS
In total, 1875 valid questionnaires were returned from 2930 employees, representing a response rate of 64%. The highest mean patient safety culture score was found for "organizational learning" (mean [SD] = 3.81 [0.53]), followed by "support and fellowship" (mean [SD] = 3.76 [0.61]), "open communication and learning from error" (mean [SD] = 3.73 [0.64]), and "patient safety management" (mean [SD] = 3.71 [0.60]). The lowest mean scores were found for "handover and teamwork" (mean [SD] = 3.28 [0.58]) and "adequate procedures and working conditions" (mean [SD] = 3.30 [0.56]). Moreover, managers/supervisors scored significantly higher on the dimensions "open communication and learning from error," "adequate procedures and working conditions," "patient safety management," "support and fellowship," and "organizational learning" than clinical and nonclinical staff.
CONCLUSIONS
In conclusion, organizational learning is perceived as most positive. However, large gaps remain in the continuity of care as "handover and teamwork" is perceived as the most negative safety culture dimension. With knowledge of the current patient safety culture, organizations can redesign processes or implement improvement strategies to avoid patient safety incidents and patient harm in the future.
Topics: Attitude of Health Personnel; Cross-Sectional Studies; Humans; Organizational Culture; Patient Safety; Primary Health Care; Safety Management; Surveys and Questionnaires
PubMed: 29394195
DOI: 10.1097/PTS.0000000000000458 -
The Journal of the Acoustical Society... Jul 2000An exact solution for one-dimensional acoustic fields in ducts in the presence of an axial mean temperature gradient and mean flow is presented in this paper. The...
An exact solution for one-dimensional acoustic fields in ducts in the presence of an axial mean temperature gradient and mean flow is presented in this paper. The analysis is valid for mean Mach numbers such that the square of the mean Mach number is much less than one. The one-dimensional wave equation for ducts with axial mean temperature gradient and mean flow is derived. By appropriate transformations, the wave equation is reduced to an analytically solvable hypergeometric differential equation for the case of a linear mean temperature profile. The developed solution is applied to investigate the dependence of sound propagation in a duct on factors such as temperature gradient and mean flow. The results obtained using the analytical solution compare very well with the numerical results. The developed solution is also compared with an existing analytical solution.
Topics: Acoustics; Humans; Models, Theoretical; Temperature
PubMed: 10923868
DOI: 10.1121/1.429442