Comparisons of the Effects of Watching Virtual Reality Videos and Chewing Gum on the Length of Delivery Stages and Maternal Childbirth Satisfaction: A Randomized Controlled Trial.

Background: Maternal childbirth satisfaction is one of the important indicators of the quality of the care provided. The use of non-pharmacological therapies can make the childbirth process a pleasurable event for the mother. This study aimed to compare the effects of watching virtual reality videos and chewing gum on the length of delivery stages and maternal satisfaction. Methods: This clinical trial study was performed on 93 women with first and second pregnancies, who were referred to Allameh Bohlool Hospital in Gonabad and Sajjadieh Hospital in Torbat-e-Jam, Iran, for childbirth between 2018 and 2019. Pregnant women were randomly assigned to three groups of chewing gum, virtual reality, and control. Interventions were performed twice: in the active (dilation of 4-5 cm) and second (dilation of 7-8 cm) phases of parturition for 20 minutes each. Data were collected using data-gathering forms, including a demographic characteristics form, a midwifery characteristics form, and the Mackey Childbirth Satisfaction Rating Scale. The data were analyzed using SPSS, version 22, via the Chi square tests, ANOVA, Kruskal-Wallis, and Tukey's post hoc tests. Results: The difference in the mean maternal childbirth satisfaction score between the two intervention groups of virtual reality and chewing gum was not statistically significant (P=0.339), but the mean score in the intervention groups was higher than that of the control group (P<0.001(. There was no significant difference in the mean length of the active and second phases of parturition between the two intervention groups, but this value in the intervention groups was significantly lower than that of the control group. Conclusion: The thought divergence interventions of chewing gum and watching virtual reality videos enhanced childbirth satisfaction, and curtailed parturition stages in our sample of pregnant women. Trial Registration Number: IRCT20181214041963N1.

Medicated Chewing Gums (MCGs): Composition, Production, and Mechanical Testing.

Medicated chewing gums (MCGs) represent a unique platform for drug delivery. They have been defined as solid single-dose preparations, which may contain more than one active pharmaceutical ingredient (API) with base consisting primarily of gum that has to be chewed for a certain period of time. They mainly contain a tasteless masticatory gum base as the core with other minor nonmasticatory ingredients, such as flavors and sweeteners. Despite their advantages in drug delivery, MCGs remain a niche product due to the complexity of their formulation, lack of acceptable testing methods, and intricacy of their manufacturing. Few studies have been reported on their use, and most of the information on their composition and production could be found in patent search. The aim of this review is to provide an overview of gum composition, manufacturing process, and characterization. Due to the scarcity of studies concerning the evaluation of the mechanical properties of MCGs, greater emphasis was placed on the available performance tests and procedures for the estimation of their mechanical and textural properties. While very few tests have been recommended by the official pharmacopeias, several tests have been suggested for assessing the mechanical properties of MCGs in vitro. Properties, such as chewiness, elasticity, and firmness, of chewing gums during mastication are imperative quality attributes that have been found to strongly correlate with gum composition and mouth feel.

Tolerability and Product Properties of a Gum-Containing Thickener in Patients With Dysphagia.

PURPOSE: The aim of the study was to determine the gastrointestinal (GI) tolerability of drinks and foods thickened with a gum-containing thickener compared to a starch-based thickener in patients with dysphagia. DESIGN: A randomized, double-blind, controlled, parallel group study. METHODS: Subjects started with a 3-day run-in period on a starch-based thickener and continued with a 14-day intervention on either the starch-based or gum-containing thickener. GI tolerance parameters were recorded at baseline and for three consecutive days in both weeks. Product properties were studied using a feedback questionnaire from carers. FINDINGS: Incidence and intensity of GI symptoms was low and not significantly different between groups. Carers indicated that starch-thickened drinks became significantly thinner with time compared to gum-containing thickened drinks (p = .029). CONCLUSIONS AND CLINICAL RELEVANCE: No differences in GI tolerance parameters between groups were observed. We hypothesize that use of the gum-containing thickener is preferred to a starch-based thickener due to the stability of its viscosity during consumption.

Two-colour chewing gum mixing ability: digitalisation and spatial heterogeneity analysis.

Many techniques are available to assess masticatory performance, but not all are appropriate for every population. A proxy suitable for elderly persons suffering from dementia was lacking, and a two-colour chewing gum mixing ability test was investigated for this purpose. A fully automated digital analysis algorithm was applied to a mixing ability test using two-coloured gum samples in a stepwise increased number of chewing cycles protocol (Experiment 1: n = 14; seven men, 19-63 years), a test-retest assessment (Experiment 2: n = 10; four men, 20-49 years) and compared to an established wax cubes mixing ability test (Experiment 3: n = 13; 0 men, 21-31 years). Data were analysed with repeated measures anova (Experiment 1), the calculation of the intraclass correlation coefficient (ICC; Experiment 2) and Spearman's rho correlation coefficient (Experiment 3). The method was sensitive to increasing numbers of chewing cycles (F5,65 = 57·270, P = 0·000) and reliable in the test-retest (ICC value of 0·714, P = 0·004). There was no significant correlation between the two-coloured gum test and the wax cubes test. The two-coloured gum mixing ability test was able to adequately assess masticatory function and is recommended for use in a population of elderly persons with dementia.

Transdermal nicotine replacement and smoking cessation.

Transdermal nicotine systems are a useful adjunct to smoking cessation. The larger-sized nicotine patches provide steady-state replacement of approximately 50 percent of the average serum nicotine level obtained by smoking one to one and one-half packs of cigarettes a day. This level is sufficient to prevent many symptoms of nicotine withdrawal, including physical craving, irritability, anxiety, restlessness, hostility, hunger and difficulty concentrating. In double-blind, placebo-controlled trials, transdermal nicotine systems have been about twice as successful as placebo in helping patients stop smoking.