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1.
Front Psychol ; 15: 1280366, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38544515

RESUMO

Introduction: The discourse on immigration and immigrants is central to contemporary political and public discussions. Analyzing online conversations about immigrants provides valuable insights into public opinion, complemented by data from questionnaires on how attitudes are formed. Methods: The research includes two studies examining the expressive and informational use of social media. Study 1 conducted a computational text analysis of comments on Singaporean Facebook pages and forums, focusing on how social media is used to discuss immigrants. Study 2 utilized survey data to examine the use of social media at the individual level, testing the relationships between cognitive ability, perceptions of threat, negative emotions towards immigrants, and social media usage within the Integrated Threat Theory framework. Results: Study 1 found that discussions about immigrants on social media often involved negative emotions and concerns about economic impact, such as competition for jobs and crime. Complementing these findings about perceived economic threats, Study 2 showed that individuals with higher social media usage and greater perceptions of threat were more likely to have negative emotions towards immigrants. These relationships were mediated by perceptions of threat and were stronger in individuals with lower cognitive abilities. Discussion: The findings from both studies demonstrate the role of social media in shaping public attitudes towards immigrants, highlighting how perceived threats influence these attitudes. This research suggests the importance of considering how digital platforms contribute to public opinion on immigration, with implications for understanding the dynamics of attitude formation in the digital age.

2.
J Robot Surg ; 16(3): 715-721, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34431025

RESUMO

The purpose of the study is to evaluate the impact of a multimodal Enhanced Recovery After Surgery (ERAS) protocol on perioperative opioid consumption and hospital length of stay (LOS) after robotic-assisted radical prostatectomy (RARP). We compared the first 176 patients enrolled in the protocol (ERAS group) with the previous 176 patients (non-ERAS group) at a single quaternary institution from December 2017 to June 2019. The ERAS protocol included a multimodal opioid-sparing regimen utilizing acetaminophen, gabapentin, celecoxib, and liposomal bupivacaine. Demographic data, co-morbidities, post-operative pain scores, post-operative opiate consumption measured by morphine milligram equivalents (MME), operating time, and LOS were collected. The two groups were compared using chi-squared, Fisher exact, or Student t tests as appropriate. Multivariable logistic regression analysis was performed to identify predictors of prolonged LOS (> 1 day). The ERAS and non-ERAS groups were equivalent in terms of baseline characteristics and pathological data. The ERAS group had lower post-operative pain scores, post-operative opiate consumption (MME 15 vs. 46, p < 0.01), and LOS (1.2 vs. 1.7 days, p < 0.01) compared to the non-ERAS group. Only 22% in the ERAS cohort had a prolonged LOS compared to 39% of the non-ERAS group (p < 0.01). The ERAS protocol was a negative predictor of prolonged LOS on multivariable logistic regression analysis (odds ratio 0.39, 95% confidence interval 0.22-0.70, p < 0.01). A limitation of this study is its single-center retrospective design. The implementation of a multimodal opioid-sparing ERAS protocol was associated with improved pain control, reduced perioperative opioid usage, and shorter LOS after RARP.


Assuntos
Alcaloides Opiáceos , Procedimentos Cirúrgicos Robóticos , Analgésicos Opioides/uso terapêutico , Humanos , Tempo de Internação , Masculino , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/prevenção & controle , Prostatectomia , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/métodos
3.
Laryngoscope ; 131(3): E792-E799, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-32516508

RESUMO

OBJECTIVES: We implement a novel enhanced recovery after surgery (ERAS) protocol with pre-operative non-opioid loading, total intravenous anesthesia, multimodal peri-operative analgesia, and restricted red blood cell (pRBC) transfusions. 1) Compare differences in mean postoperative peak pain scores, opioid usage, and pRBC transfusions. 2) Examine changes in overall length of stay (LOS), intensive care unit LOS, complications, and 30-day readmissions. METHODS: Retrospective cohort study comparing 132 ERAS vs. 66 non-ERAS patients after HNC tissue transfer reconstruction. Data was collected in a double-blind fashion by two teams. RESULTS: Mean postoperative peak pain scores were lower in the ERAS group up to postoperative day (POD) 2. POD0: 4.6 ± 3.6 vs. 6.5 ± 3.5; P = .004) (POD1: 5.2 ± 3.5 vs. 7.3 ± 2.3; P = .002) (POD2: 4.1 ± 3.5 vs. 6.6 ± 2.8; P = .000). Opioid utilization, converted into morphine milligram equivalents, was decreased in the ERAS group (POD0: 6.0 ± 9.8 vs. 10.3 ± 10.8; P = .010) (POD1: 14.1 ± 22.1 vs. 34.2 ± 23.2; P = .000) (POD2: 11.4 ± 19.7 vs. 37.6 ± 31.7; P = .000) (POD3: 13.7 ± 20.5 vs. 37.9 ± 42.3; P = .000) (POD4: 11.7 ± 17.9 vs. 36.2 ± 39.2; P = .000) (POD5: 10.3 ± 17.9 vs. 35.4 ± 45.6; P = .000). Mean pRBC transfusion rate was lower in ERAS patients (2.1 vs. 3.1 units, P = .017). There were no differences between ERAS and non-ERAS patients in hospital LOS, ICU LOS, complication rates, and 30-day readmissions. CONCLUSION: Our ERAS pathway reduced postoperative pain, opioid usage, and pRBC transfusions after HNC reconstruction. These benefits were obtained without an increase in hospital or ICU LOS, complications, or readmission rates. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:E792-E799, 2021.


Assuntos
Recuperação Pós-Cirúrgica Melhorada , Procedimentos Cirúrgicos Otorrinolaringológicos/reabilitação , Assistência Perioperatória/métodos , Procedimentos de Cirurgia Plástica/reabilitação , Transplante de Tecidos/reabilitação , Idoso , Analgesia/métodos , Analgésicos Opioides/uso terapêutico , Transfusão de Sangue/estatística & dados numéricos , Método Duplo-Cego , Feminino , Cabeça/cirurgia , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pescoço/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Manejo da Dor/estatística & dados numéricos , Medição da Dor/estatística & dados numéricos , Dor Pós-Operatória/epidemiologia , Dor Pós-Operatória/terapia , Readmissão do Paciente/estatística & dados numéricos , Estudos Retrospectivos , Retalhos Cirúrgicos , Resultado do Tratamento
5.
Ocul Surf ; 16(4): 478-486, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30077709

RESUMO

PURPOSE: To investigate the relationship between tear concentration of the homeostatic protein clusterin (CLU) and dry eye signs and symptoms, and to characterize tear CLU protein. METHODS: Two independent studies were conducted, one in Tucson (44 subjects), the other in Los Angeles (52 subjects). A cohort study design was employed to enroll patients without regard to dry eye diagnosis. Dry eye signs and symptoms were assessed using clinical tests. Tear samples were collected by Schirmer strip, and also by micropipette at slit lamp when possible. CLU from both sample types was quantified by immunoassay. The relationship between CLU concentration and clinical test scores was determined by Pearson's correlation coefficient (for individual eyes) and multiple linear regression analysis (including both eyes). CLU was also evaluated biochemically by western blotting. RESULTS: In the Tucson cohort, a positive correlation was observed between tear CLU concentration and results of the Schirmer strip test, a measure of tear flow (p = 0.021 includes both eyes). This result was corroborated in the Los Angeles cohort (p = 0.013). The mean tear CLU concentration was 31 ±â€¯14 µg/mL (n = 18 subjects, 33 eyes; range = 7-48 µg/mL). CLU from clinical tear samples appeared biochemically similar to CLU from a non-clinical tear sample and from blood plasma. CONCLUSIONS: Results support the hypothesis that an optimal concentration of tear CLU is important for ocular surface health, and that this drops below the effective threshold in dry eye. Tear CLU measurement might identify patients that could benefit from supplementation. Information about concentration will aid development of therapeutic dosage parameters.


Assuntos
Clusterina/metabolismo , Síndromes do Olho Seco/diagnóstico , Lágrimas/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Síndromes do Olho Seco/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão
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