Impact of Swallowing Impairment on Quality of Life of Individuals with Dysphagia.

To explore oral intake and quality of life measures among individuals with dysphagia. This cross-sectional study with purposive sampling included 15 individuals with dysphagia. Functional oral intake scale (FOIS) and Dysphagia Quality of Life questionnaire in Marathi (DQOL-QM) were administered on individuals with dysphagia to evaluate oral intake levels and swallow related quality of life respectively. Data was collected using the interview method via tele-mode. Statistical analysis using Spearman's rank correlation revealed significant negative correlation (ρ = - 0.87) between oral intake and overall quality of life of the individuals with dysphagia. This negative impact was observed across all the domains of their quality of life. A considerable negative impact on quality of life was observed with declining oral intake of the individual with dysphagia. As oral intake plays an important role in the quality of life, decisions regarding the mode of feeding must be guided by the preferences of the individual and their family. strategies that enhance oral intake improves quality of life of dysphagic individual.

Association between physical activity and life satisfaction among adults with multimorbidity in Canada.

OBJECTIVE: Maintaining life satisfaction may aid in multimorbidity resilience. As the prevalence of multimorbidity continues to rise in Canada, understanding modifiable factors that can influence life satisfaction among people with multimorbidity is warranted. This study aimed to examine the relationship between physical activity and life satisfaction among adults affected by multimorbidity. METHODS: Cross-sectional data from the 2015-2018 cycles of the Canadian Community Health Survey were used; 22,851 respondents with multimorbidity aged 20 years and older were included. Multiple linear regression models were used to investigate the relationship between physical activity (sedentary, somewhat active, moderately active, active) and life satisfaction for the whole population and for those having specific types of chronic conditions, controlling for self-perceived health status and sociodemographic factors. RESULTS: Respondents affected by multimorbidity who were somewhat active (ß = 0.20, 95% CI: 0.08, 0.32), moderately active (ß = 0.28, 95% CI: 0.13, 0.44), and active (ß = 0.29, 95% CI: 0.17, 0.41) were more satisfied with life than respondents who had a sedentary lifestyle. The relationship between physical activity and life satisfaction was also found to be statistically significant in sub-populations of respondents affected by cancer, diabetes, chronic respiratory diseases, and mental health disorders but not cardiovascular diseases. CONCLUSION: Physical activity may contribute to better life satisfaction among adults with multimorbidity. As multimorbidity increases in Canada, further investigation on the relationship between physical activity and life satisfaction is warranted to help improve interventions to cope with the effects of multimorbidity.

RéSUMé: OBJECTIF: Le maintien de la satisfaction à l'égard de la vie peut aider la résistance à la multimorbidité. Alors que la prévalence de la multimorbidité continue de monter au Canada, il est justifié de comprendre les facteurs modifiables qui peuvent influencer la satisfaction à l'égard de la vie des personnes ayant une multimorbidité. Cette étude visait à examiner la relation entre l'activité physique et la satisfaction à l'égard de la vie chez les adultes ayant la multimorbidité. MéTHODES: Les informations transversales des cycles 2015-2018 de l'Enquête sur la santé dans les collectivités canadiennes (ESCC) ont été utilisées; 22 851 répondants multimorbides âgés de 20 ans et plus ont été inclus. Les modèles de régression linéaire multiple ont été utilisés pour examiner la relation entre le niveau d'activité physique (inactive, quelque peu actif, modérément actif, actif) et la satisfaction à l'égard de la vie pour l'entier de la population et pour ceux qui souffrent d'un type spécifique de maladies chroniques, contrôlant pour état de santé perçu et les facteurs sociodémographiques. RéSULTATS: Les répondants affectés par la multimorbidité qui étaient quelque peu actifs (ß = 0,20, IC à 95% : 0,08 à 0,32), modérément actifs (ß = 0,28, IC à 95% : 0,13 à 0,44), et actifs (ß = 0,29, IC à 95% : 0,17 à 0,41) étaient plus satisfaits à l'égard de la vie que les répondants avec un mode de vie plus sédentaire. La relation entre l'activité physique et la satisfaction à l'égard de la vie est statistiquement significative dans les sous-populations des répondants affectées par le cancer, le diabète, les maladies respiratoires chroniques et les troubles de santé mentale, mais pas les maladies cardiovasculaires. CONCLUSION: L'activité physique peut contribuer à une meilleure satisfaction à l'égard de la vie pour les adultes ayant une multimorbidité. À mesure que la multimorbidité augmente au Canada, une enquête plus approfondie sur la relation entre l'activité physique et la satisfaction à l'égard de la vie est justifiée pour aider à améliorer les interventions visant d'affronter les effets de la multimorbidité dans la population canadienne.

Intravenous colistin for the management of multidrug-resistant bacterial infections in Indian patients.

Multidrug-resistant Gram-negative bacterial infection is a serious global concern and especially in low and middle-income countries (LMIC) such as India. Colistin, an antimicrobial once abandoned following reports of organ toxicity, has re-emerged as an essential therapeutic agent in the management of these infections. A retrospective review of 162 inpatients was done, focusing on culture-proven multidrug-resistant infections requiring colistin. The overall clinical outcome in 58% of patients was found to be good, with nephrotoxicity and neurotoxicity occurring only in 8 (5%) and 4 (2.5%) patients, respectively. Multivariate analysis revealed an elevated lactate and raised urea to be independent factors associated with poor clinical response. In conclusion, there appears to be strong evidence supporting the use of colistin in the management of multidrug-resistant Gram-negative bacterial infections.

Effect of BATHE interview technique on patient satisfaction in an ambulatory family medicine centre in South India.

OBJECTIVE: The objective of the study is to determine the effect of background, affect, trouble, handling and empathy (BATHE) versus usual interview technique on patient satisfaction during regular consultation with family physicians in ambulatory care. DESIGN: The research design was a prospective, randomised control trial. SETTING: The trial took place in a family practice unit in South India, which was one of the clinical service units of the academic Department of Family Medicine of a tertiary hospital. PARTICIPANT: The eligible participants were adults above the age of 18 years, who did not have any acute presenting illness. The participants should have given consent and also not have any cognitive disability. A total of 138 participants took part in the trial, 70 in BATHE group and 68 in the non-BATHE group. All participants entering the trial completed the questionnaire. RESULT: The BATHE group had a significantly higher mean score for questions grouped under professional satisfaction. This included questions on whether the patient felt that the physician treated them as a person and also whether they felt the appropriate clinical examination was communicated to them. The questionnaire used for scoring satisfaction had 18 questions with a maximum possible score of 90. When taking a cut-off of 75% (68) from the total possible score of 90, 72.9% (51) of the participants for whom the BATHE consultation technique was used were satisfied as compared with only 55.9% (30) for whom the routine consultation was carried out. This was statistically significant (χ2=11.15, p value=0.0006) CONCLUSION: The study suggests that using BATHE in this family practice centre is beneficial in improving the perception of person centeredness in the consultation. However, further studies ruling out all possible bias are needed in our setting before the range of probable benefits of the BATHE technique can be fully gauged.

Neurobiological substrates of animal personality and cognition in a nonhuman primate (Microcebus murinus).

INTRODUCTION: The gray mouse lemur (Microcebus murinus) is an important nonhuman primate model in biomedical research. Numerous studies investigated mouse lemur behavior and possible factors underlying interindividual variation in both, animal personality and cognitive performance. Some effects, such as an age-related decline in executive functioning, have robustly been found across laboratory colonies; however, little is known about the brain structural substrates in mouse lemurs. METHODS: Here, we provide first exploratory data linking in vivo magnetic resonance imaging of 34 mouse lemurs to performance in a standardized, touchscreen-based task on object discrimination and reversal learning as well as to animal personality under different scenarios in an open field. RESULTS: High interindividual variability in both brain morphometric and behavioral measurements was found, but only few significant correlations between brain structure and behavior were revealed: Object discrimination learning was linked to the volume of the hippocampus and to temporal lobe thickness, while reversal learning was linked to thalamic volume and the thickness of the anterior cingulate lobe. Emergence latency into the open field correlated with volume of the amygdala. General exploration-avoidance in the empty open-field arena correlated with thicknesses of the anterior cingulate lobe and fronto-parietal substructures. Neophilia, assessed as exploration of a novel object placed in the arena, among others, related to the volume of the caudate nucleus. CONCLUSION: In summary, our data suggest a prominent role of temporal structures (including the hippocampus) for learning capability, as well as thalamic and anterior cingulate structures for cognitive flexibility and response inhibition. The amygdala, the anterior cingulate lobe, and the caudate nucleus are particularly linked to animal personality in the open-field setting. These findings are congruent with the comparative psychological literature and provide a valuable basis for future studies elucidating aspects of behavioral variation in this nonhuman primate model.

Evaluating a Longitudinal Cohort of Clinics Engaging in the Family Planning Elevated Contraceptive Access Program: Study Protocol for a Comparative Interrupted Time Series Analysis.

BACKGROUND: Access to high-quality, comprehensive contraceptive care is an inherent component of reproductive human rights. However, hindrances to specific aspects of contraceptive provision, including availability, accessibility, acceptability, and quality, continue to perpetuate unmet needs. The state of Utah has recently passed a series of contraceptive policies intended to improve contraceptive access. Despite these positive changes to theoretical access, fiscal appropriations to support the implementation of these policies have been minimal, and many individuals still struggle to access contraception. OBJECTIVE: The Family Planning Elevated Contraceptive Access Program (FPE CAP), part of a larger statewide contraceptive initiative, specifically aims to improve contraceptive access within health clinics. This paper describes the study protocol for evaluating the success of FPE CAP. METHODS: Health clinics apply for membership in the FPE CAP. On acceptance in the program, they receive a cash grant for clinical supplies, equipment, and personnel expenses; reimbursement for contraceptive services and methods for eligible clients; technical support, training, and proctoring on counseling and providing all methods of contraception; method stocking of intrauterine devices and implants; and demand generation activities, including local media campaigns, to inform community members about the FPE CAP and possible eligibility. FPE collects monthly service delivery reports from participating clinics for evaluation purposes. The primary outcomes of FPE CAP are level and trend changes in contraceptive service delivery among individuals earning ≤138% federal poverty level (FPL) following membership in FPE CAP and among FPE CAP clients earning between 139% and 250% FPL (including those ineligible for Medicaid) compared with historical data and control clinics. To assess this, we will conduct comparative interrupted time series analyses assessing the level and trend changes in intervention and control clinics 12 months before the intervention, for the 2-year duration of the intervention, and for the subsequent 12 months following the intervention. RESULTS: We found that the study is adequately powered (>80% power) with our planned number of clinics and the number of months of data available in the study. To date, we have successfully completed the recruitment and enrollment of 8 of the expected 9 health organizations and 4 of the control clinics. Completed health organization enrollment for both intervention and control organizations is expected to be completed in December 2020. CONCLUSIONS: The study aims to provide insight into a new approach to contraceptive initiatives by addressing comprehensive aspects of contraceptive care at the health system level. Ongoing state policy changes and implementation components may affect the evaluation outcomes. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/18308.