Do Filling Defects of the Vestibule Represent a Neuroradiological Marker for Congenital Cytomegalovirus? A Retrospective Case Series.

INTRODUCTION: The aim of this study was to investigate whether radiological marker(s) of the inner ear can be detected in congenital cytomegalovirus (cCMV) patients with severe-profound sensorineural hearing loss. METHODS: A retrospective imaging review of confirmed cCMV paediatric patients that had undergone consecutive cochlear implantation was performed at a tertiary hospital. Available pre- and postoperative imaging was examined, and abnormalities of the labyrinth were catalogued by a consultant neuroradiologist in the study group and control group. RESULTS: Twenty-eight paediatric patients with cCMV having undergone cochlear implantation were identified between the ages of 1-15 years (mean 4.7 years) at the time of implantation. Increased density of the vestibule on computed tomography (CT) or filling defects of the vestibule on magnetic resonance imaging (MRI) were identified in 11 and 4 patients, respectively, of the 24 in the case series. No filling defects were identified in any of the 48 CT and MRI control group. CONCLUSION: This study demonstrates a potential novel radiological finding of the inner ear of patients with cCMV. With more research, greater onus placed on MRI and CT for inner ear assessment may facilitate early detection and treatment for patients at risk of significant hearing loss. Further prospective studies in this area will help to validate radiological markers in order to establish a comprehensive inner ear classification system for neuroradiological features in cCMV.

Using an Implementation Research Framework to Identify Facilitators and Barriers to Physical Activity and Weight Loss in Appalachia.

OBJECTIVES: West Virginia (WV) is the only state entirely located in Appalachia, a large, mostly rural area in the eastern United States. WV has the highest adult obesity rate in the United States, as well as one of the highest physical inactivity rates. Obesity has been found to be significantly higher in rural counties than in urban counties, and many rural communities do not have the resources to address this growing health concern. It is well documented that healthy eating and becoming more physically active can be successful in reducing weight and managing obesity-related illness. Despite this overwhelming evidence, obesity rates in WV continue to climb. The purpose of this study was to understand the factors associated with obesity in WV and identify what influences the behavior of people in regard to weight loss and exercise. METHODS: Four focus groups were conducted across the state of WV, transcribed, and thematically analyzed to examine the facilitators and barriers associated with healthy behaviors. The Consolidated Framework for Implementation Research (CFIR) was used as an approach to classify characteristics and plan implementation strategies integrating five domains. The CFIR has been used to identify potential barriers and facilitators to interventions and can be used before or during an intervention. In addition, the CFIR has been used as a framework to guide analysis and provide a means to organize intervention stakeholders' perceptions of barriers and facilitators to successful interventions. RESULTS: Participants identified barriers and facilitators across all 5 major domains of the CFIR-intervention characteristics, outer setting (eg, cultural norms, infrastructure), inner setting (eg, access to knowledge), characteristics of individuals, and the implementation process-and 16 subdomains. Participants discussed how socioeconomic, cultural, and environmental factors influenced diet and exercise. Cost, family culture, and limited access to resources (eg, healthy foods, community-based fitness programs, health care) were common themes expressed by participants. CONCLUSIONS: The results of this study identify how individuals living in rural Appalachian view lifestyle changes and what influences their ability to pursue physical activity and healthy eating. Future programs to encourage healthy lifestyles in Appalachia need to consider the characteristics of the given community to achieve the goal of a tailored lifestyle intervention program that is feasible and effective. In addition, the findings suggest that the CFIR can be used to implement and refine intervention strategies that can be used in the real world.

A Community Respite Ministry/University Partnership Creates Meaningful Elder-Care Experiences.

As the North American population of older adults increases, so does the need for nursing students to gain skills in geriatric care. Locating appropriate clinical sites for undergraduate students, including community and health promotion opportunities, prompted a public university's school of nursing to partner with a faith-based respite program. The collaboration between a public educational institution and a church-based program benefited the geriatric participants, the program leadership, and the nursing students and faculty.