Differences in maternal and paternal pressure to eat and perception of household responsibilities.

Controlling feeding practices, such as pressure to eat, are associated with a child's disinhibited eating and extremes in bodyweight. We aimed to explore which factors are associated with parent dyads' pressuring feeding practices, including how mothers and fathers perceive the sharing of household tasks such as mealtime and child feeding responsibilities. In this cross-sectional study, parent dyads (mother and father) of healthy preschool-aged children completed an identical questionnaire consisting of measures of picky eating (food fussiness subscale of Child Eating Behavior Questionnaire), parental concern for undereating, and pressure to eat (Child Feeding Questionnaire). We used separate multivariable linear regression models for mothers and fathers to assess correlates associated with pressure to eat subscale score, including slowness of eating and enjoyment of food, child BMI z-score and race/ethnicity, and household income. Separate unadjusted linear regression models for mothers and fathers were used to report the association of pressure to eat with household responsibilities. Parents (N = 88) had similar mean picky eating, concern for undereating, and pressure to eat scores; more fathers had high pressure to eat scores (36% vs 27%). Higher pressure to eat was significantly associated with lower income, non-Hispanic Black or Black race/ethnicity, slow eating, and lower enjoyment of food. Pressure was not associated with household responsibilities. While there were similar maternal and paternal perceptions of child eating behaviors, more fathers reported pressuring their child to eat. Identifying differences in parental feeding practices may assist in intervention development to improve feeding practices.

Interventions and Outcomes in Glottic Versus Multi-level Airway Stenosis: A Multi-institutional Review.

OBJECTIVE: Airway stenosis-particularly multi-level-presents complex management challenges. This study assessed rates of tracheostomy, decannulation, and the number of surgeries required in patients with posterior glottic stenosis (PGS), multi-level airway stenosis (MLAS), and bilateral vocal fold paralysis (BVFP). METHODS: Airway stenosis patients treated between 2016 and 2021 at three tertiary medical centers were identified. Demographics, etiology of stenosis, medical comorbidities, and patient-reported outcome measures (PROMs) were collected. RESULTS: 158 patients (84 women, mean age 56.98 ± 15.5 years) were identified (54 PGS, 38 MLAS, and 66 BVFP). 72.3% required tracheostomy, including 72.2%, 86.8%, and 63.6% in these groups, respectively. Decannulation rates were 43.6%, 21.2%, and 32.5% in these groups, respectively. Patients with MLAS had higher rates of tracheostomy than BVFP (p < 0.05). However, decannulation rates were not different between groups (p > 0.05). MLAS required more surgeries (mean 4.0 ± 3.9) than PGS (2.4 ± 2.2, p = 0.02) or BVFP (1.0 ± 1.8, p < 0.0001). Mean PROMs scores at the latest follow-up were abnormal: 15.4 ± 12.2 (Dyspnea Index), 19.9 ± 12.2 (Voice Handicap Index-10), and 9.67 ± 11.1 (Eating Assessment Tool-10). Co-morbidities present included body mass index >30 (41.4%), diabetes (31.8%), pulmonary disease (50.7%), gastroesophageal reflux disease (39.4%), autoimmune disease (22.9%), and tobacco use history (55.2%). CONCLUSIONS: Airway stenosis is a challenging clinical problem that negatively impacts patients' quality of life and often requires numerous surgeries. PGS more frequently requires tracheostomy compared to BVFP, but patients can often decannulate successfully. Patients with multi-level stenosis have lower decannulation rates and require more surgeries than glottic stenosis alone; these patients may benefit from earlier and/or more aggressive intervention. LEVEL OF EVIDENCE: 4 Laryngoscope, 133:528-534, 2023.

#Who: Investigation of Who Creates Laryngology Content Posted on Instagram.

OBJECTIVES: The objective of this study was to examine the types of accounts that create posts related to laryngology on Instagram, using hashtags derived from common diagnoses and procedures within the field, in order to assess the source and ownership of laryngology social media discussions. METHODS: Fellowship-trained laryngologists were surveyed to determine the most common diagnoses treated and procedures performed in laryngology. These terms were then queried as hashtags on Instagram. The top 15 posts found per hashtag were classified by the category of individual who shared the content. The categories included laryngologists/otolaryngologists, speech-language pathologists (SLP), vocalists, other physicians, and "other individuals." RESULTS: After surveying 20 fellowship-trained laryngologists, 25 different hashtags related to common diagnoses and procedures in laryngology were created and queried for the top 15 posts on Instagram. 260 posts on Instagram were identified, out of which 30.8% were posted by laryngologists/otolaryngologists, 19.2% by SLPs, 3.1% by vocalists, 6.1% by other physicians, and 40.8% by "other individuals." CONCLUSIONS: A significant portion of top resulted posts on Instagram sharing laryngology-related content is not posted by laryngologists. This raises an issue of the reliability of health information available on social media to patients regarding laryngological conditions.