Attitudes of people diagnosed with cancer and cancer care providers towards use of nicotine vaping products in high-income countries: a scoping review.

PURPOSE: To investigate the attitudes, beliefs and perceptions of people diagnosed with cancer and health practitioners on use of nicotine vaping products. METHODS: Scopus and OVID Medline were searched for papers published between 2013 and 2023. Two authors independently selected the studies and extracted data, with conflicts resolved through discussion. Nine studies were selected for further synthesis. Reporting follows the PRISMA Scoping Reviews checklist. RESULTS: E-cigarettes were commonly perceived as less harmful compared to conventional cigarettes and less detrimental to cancer treatment effectiveness among people with a current or previous cancer diagnosis. This population also cited smoking cessation, smoking in non-smoking areas and less risky alternative as the most common reasons for e-cigarette use. Nevertheless, low levels of clinician support on the effectiveness of e-cigarettes as a smoking cessation tool/alternative were identified. CONCLUSION: Findings show differences in beliefs and attitudes of e-cigarettes between clinicians and people diagnosed with cancer. Additional research into the health impacts of e-cigarettes in people with a current or previous cancer diagnosis will allow for greater congruence between patients and clinicians and assist providers in recommending effective tools for smoking cessation within this population. IMPLICATIONS FOR CANCER SURVIVORS: This study provides an overview of the attitudes, beliefs and perceptions of e-cigarette use among people with a current or previous diagnosis of cancer and health practitioners. Given the increased prevalence of e-cigarette use within this population, these findings highlight a greater need for dialogue between patients and clinicians regarding the safety and efficacy of these devices.

Submaximal isometric fatiguing exercise of the elbow flexors has no age-related effect on GABAB-mediated inhibition.

Age-related changes in the neuromuscular system can result in differences in fatigability between young and older adults. Previous research has shown that single-joint isometric fatiguing exercise of small muscle results in an age-related compensatory decrease in γ-aminobutyric acid (GABAB)-mediated inhibition. However, this has yet to be established in a larger muscle group. In 15 young (22 ± 4 yr) and 15 older (65 ± 5 yr) adults, long interval cortical inhibition [LICI; 100 ms Interstimulus interval (ISI)] and corticospinal silent period (SP) were measured in the biceps brachii during a 5% electromyography (EMG) contraction using transcranial magnetic stimulation (TMS) before, during, and after a submaximal contraction [30% of maximum voluntary contraction (MVC) force] held intermittently to task failure. Both age groups developed similar magnitude of fatigue (∼24% decline in MVC; P = 0.001) and ∼28% decline in LICI (P = 0.001) post fatiguing exercise. No change in SP duration was observed during and immediately following fatigue (P = 0.909), but ∼6% decrease was seen at recovery in both age groups (P < 0.001). Contrary to previous work in a small muscle, these findings suggest no age-related differences in GABAB-mediated inhibition following single-joint isometric fatiguing exercise of the elbow flexors, indicating that GABAB modulation with aging may be muscle group dependent. Furthermore, variations in SP duration and LICI modulation during and post fatigue in both groups suggest that these measures are likely mediated by divergent mechanisms.NEW & NOTEWORTHY Transcranial magnetic stimulation was used to examine GABAB-mediated inhibition during fatiguing exercise of large muscle group in older adults and young adults. We provide novel evidence to show that when older and young adults are faced with a similar magnitude of elbow flexor muscle fatigue, they have a similar decline in GABAB-mediated inhibition. This suggests that when measured in a large muscle group, older adults maintain the ability to modulate GABAB inhibition during fatiguing exercise.

Single joint fatiguing exercise decreases long but not short-interval intracortical inhibition in older adults.

Ageing is accompanied by neuromuscular changes which may alter fatigue in older adults. These changes may include changes in corticospinal excitatory and inhibitory processes. Previous research has suggested that single joint fatiguing exercise decreases short-(SICI) and long-(LICI) interval intracortical inhibition in young adults. However, this is yet to be established in older adults. In 19 young (23 ± 4 years) and 18 older (69 ± 5 years) adults, SICI (2 ms interstimulus interval; ISI) and LICI (100 ms ISI) were measured in a resting first dorsal interosseous (FDI) muscle using transcranial magnetic stimulation (TMS) before and after a 15 min sustained submaximal contraction at 25% of their maximum EMG. Subsequent ten 2-min contractions held at 25% EMG were also performed to sustain fatigue for a total of 30 min, while SICI and LICI were taken immediately after each contraction. There was no change in SICI post-fatiguing exercise compared to baseline in both young and older adults (P = 0.4). Although there was no change in LICI post-fatiguing exercise in younger adults (P = 1.0), LICI was attenuated in older adults immediately post-fatiguing exercise and remained attenuated post-fatigue (PF)1 and PF2 (P < 0.05). Contrary to previous studies, the lack of change in SICI and LICI in young adults following a sustained submaximal EMG contraction suggests that GABA modulation may be dependent on the type of fatiguing task performed. The reduction in LICI in older adults post-fatiguing exercise suggests an age-related decrease in GABAB-mediated activity with sustained submaximal fatiguing exercise.

Older Adults Differentially Modulate Transcranial Magnetic Stimulation-Electroencephalography Measures of Cortical Inhibition during Maximal Single-joint Exercise.

The effects of muscle fatigue are known to be altered in older adults, and age-related changes in the brain are likely to be a contributing factor. However, the neural mechanisms underlying these changes are not known. The aim of the current study was to use transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) to investigate age-related changes in cortical excitability with muscle fatigue. In 23 young (mean age ±â€¯SD: 22 ±â€¯2 years) and 17 older (mean age ±â€¯SD: 68.3 ±â€¯5.6 years) adults, single-pulse TMS-EEG was applied before, during and after the performance of fatiguing, intermittent isometric abduction of the index finger. Motor-evoked potential (MEP) measures of cortical excitability were increased during (estimated mean difference, 123.3%; P < 0.0001) and after (estimated mean difference, 117.5%; P = 0.001) fatigue and this was not different between groups (P > 0.5). For TMS-EEG, the amplitude of the P30 and P180 potentials were unaffected by fatigue in older participants (P > 0.05). In contrast, the amplitude of the N45 potential in older adults was significantly reduced both during (positive cluster: mean voltage difference = 0.7 µV, P < 0.005; negative cluster: mean voltage difference = 0.9 µV, P < 0.0005) and after (mean voltage difference = 0.5 µV, P < 0.005) fatiguing exercise, whereas this response was absent in young participants. These results suggest that performance of maximal intermittent isometric exercise in old but not young adults is associated with modulation of cortical inhibition likely mediated by activation of gamma-aminobutyric acid type A receptors.

Intermittent single-joint fatiguing exercise reduces TMS-EEG measures of cortical inhibition.

Fatiguing intermittent single-joint exercise causes an increase in corticospinal excitability and a decrease in intracortical inhibition when measured with peripherally recorded motor evoked potentials (MEPs) after transcranial magnetic stimulation (TMS). Combined TMS and electroencephalography (TMS-EEG) allows for more direct recording of cortical responses through the TMS-evoked potential (TEP). The aim of this study was to investigate the changes in the excitatory and inhibitory components of the TEP during fatiguing single-joint exercise. Twenty-three young (22 ± 2 yr) healthy subjects performed intermittent 30-s maximum voluntary contractions of the right first dorsal interosseous muscle, followed by a 30-s relaxation period repeated for a total of 15 min. Six single-pulse TMSs and one peripheral nerve stimulation (PNS) to evoke maximal M wave (Mmax) were applied during each relaxation period. A total of 90 TMS pulses and 5 PNSs were applied before and after fatiguing exercise to record MEP and TEP. The amplitude of the MEP (normalized to Mmax) increased during fatiguing exercise ( P < 0.001). There were no changes in local and global P30, N45, and P180 of TEPs during the development of intermittent single-joint exercise-induced fatigue. Global analysis, however, revealed a decrease in N100 peak of the TEP during fatiguing exercise compared with before fatiguing exercise ( P = 0.02). The decrease in N100 suggests a fatigue-related decrease in global intracortical GABAB-mediated inhibition. The increase in corticospinal excitability typically observed during single-joint fatiguing exercise may be mediated by a global decrease in intracortical inhibition. NEW & NOTEWORTHY Fatiguing intermittent single-joint exercise causes an increase in corticospinal excitability and a decrease in intracortical inhibition when measured with transcranial magnetic stimulation (TMS)-evoked potentials from the muscle. The present study provides new and direct cortical evidence, using TMS-EEG to demonstrate that during single-joint fatiguing exercise there is a global decrease in intracortical GABAB-mediated inhibition.

Occupational heat-related illness emergency department visits and inpatient hospitalizations in the southeast region, 2007-2011.

BACKGROUND: Heat-related illness (HRI) is an occupational health risk for many outdoor, and some indoor, workers. METHODS: Emergency department (ED) and inpatient hospitalization (IH) data for 2007-2011 from nine southeast states were analyzed to identify occupational HRI numbers and rates, demographic characteristics, and co-morbid conditions. RESULTS: There were 8,315 occupational HRI ED visits (6.5/100,000 workers) and 1,051 IHs (0.61/100,000) in the southeast over the study period. Out-of-state residents comprised 8% of ED visits and 12% of IHs. Rates for both, ED visits and IHs were significantly elevated in males and blacks. Younger workers had elevated rates for ED visits, while older workers had higher IH rates. CONCLUSIONS: This is the first study to evaluate occupational HRI ED visits and IHs in the southeast region and indicates the need for enhanced heat-stress prevention policies in the southeast. Findings from this study can be used to direct state health department tracking and evaluation of occupational HRI.

Social cognition in bulimia nervosa: a systematic review.

OBJECTIVE: Clinical accounts and previous evidence suggest that socio-emotional impairments may be present in people with bulimia nervosa (BN). The aim of this paper was to systematically review studies of social cognition, and to evaluate whether social cognitive deficits exist in BN. METHOD: Keywords were identified using an existing model of social cognition (Green et al., 2007) [16], and used to search for relevant papers in three online databases. Records were then screened according to a priori inclusion/exclusion criteria. RESULTS: Five papers reporting seven social cognition tasks were identified as pertinent to the review. All involved either theory of mind ability or emotional processing skills. Participants with BN had impaired performance on the Levels of Emotional Awareness Scale and showed greater attentional bias than controls on an emotional Stroop task. There were no overall group differences for any other tasks, although there were small differences for some specific test items. CONCLUSIONS: Basic social cognition does not appear to be impaired in people with BN. Future research should make use of more complex, ecologically valid measures, and consider the relationship between task performance and everyday social functioning.

Arthroscopic anterior cruciate ligament surgery: results of autogenous patellar tendon graft versus the Leeds-Keio synthetic graft five year follow-up of a prospective randomised controlled trial.

We conducted a prospective, randomised controlled trial comparing anterior cruciate ligament reconstruction using middle third patellar tendon graft (PT) to synthetic Leeds-Keio (LK) ligament. The patients were randomised (26 PT, 24 LK). Subjective knee function was classified (Lysholm, Tegner activity, IKDC scores), laxity was measured (Lachman test, Stryker laxometer), and functional ability was assessed (one-hop test). There were no significant differences between Lysholm or IKDC scores at any stage by 5 years. Significant differences were found between the groups at 2 years for Tegner activity scores, laxity and one-hop testing. By 5 years there were no significant differences. Clinical equivalence was demonstrated between the two groups for the Lysholm score and one-hop test but not for the Tegner activity score at 5 years. The use of the LK ligament has been largely abandoned due to reports of its insufficiency. Our results demonstrate that it is not as inferior as one might expect. We conclude that the results of LK ligament ACL reconstruction are as acceptable as those using PT. It may provide an additional means of reconstruction where no suitable alternative is present.

Attenuation of muscle damage by preconditioning with muscle hyperthermia 1-day prior to eccentric exercise.

This study investigated the hypothesis that muscle damage would be attenuated in muscles subjected to passive hyperthermia 1 day prior to exercise. Fifteen male students performed 24 maximal eccentric actions of the elbow flexors with one arm; the opposite arm performed the same exercise 2-4 weeks later. The elbow flexors of one arm received a microwave diathermy treatment that increased muscle temperature to over 40 degrees C, 16-20 h prior to the exercise. The contralateral arm acted as an untreated control. Maximal voluntary isometric contraction strength (MVC), range of motion (ROM), upper arm circumference, muscle soreness, plasma creatine kinase activity and myoglobin concentration were measured 1 day prior to exercise, immediately before and after exercise, and daily for 4 days following exercise. Changes in the criterion measures were compared between conditions (treatment vs. control) using a two-way repeated measures ANOVA with a significance level of P < 0.05. All measures changed significantly following exercise, but the treatment arm showed a significantly faster recovery of MVC, a smaller change in ROM, and less muscle soreness compared with the control arm. However, the protective effect conferred by the diathermy treatment was significantly less effective compared with that seen in the second bout performed 4-6 weeks after the initial bout by a subgroup of the subjects (n = 11) using the control arm. These results suggest that passive hyperthermia treatment 1 day prior to eccentric exercise-induced muscle damage has a prophylactic effect, but the effect is not as strong as the repeated bout effect.

Responses of old men to repeated bouts of eccentric exercise of the elbow flexors in comparison with young men.

A bout of eccentric exercise confers protection against subsequent bouts of the same exercise. This study investigated whether the protective effect would be produced similarly between old and young adults. Eight old men (70.5 +/- 4.1 years) and ten young men (20.4 +/- 2.0 years) performed two bouts of eccentric exercise of the elbow flexors (six sets of five eccentric actions) separated by 4 weeks. Changes in maximal isometric strength, range of motion (ROM), upper arm circumference (CIR), plasma creatine kinase (CK) activity, myoglobin (Mb) concentration, and muscle soreness (SOR) before, immediately after, and 1, 24, 48, 72 and 96 h following exercise were compared between bouts, and between groups by a two-way repeated measures ANOVA. Changes in the measures following the first bout were significantly (P < 0.05) smaller for the old than the young group. The young group showed significantly (P < 0.05) smaller changes in all measures following the second bout than the first bout; however, the old group had the protective effect only for ROM, Mb, and SOR. The magnitude of the effect observed for ROM and Mb concentration in the old group was significantly (P < 0.05) smaller compared with that of the young group. These results suggest that the protective effect conferred by the first bout was less for the old than the young group. This may be due to the less muscle damage after the first bout in the old subjects, but it is also possible that the protective effect of old adults does not last as long as that of young adults.

A conservative approach for proximal interphalangeal joint arthroplasty.

Access to the proximal interphalangeal joint of the finger for arthroplasty is difficult without detaching its stabilizers or dividing the tendons that cross it, which then require repair and slow rehabilitation. We describe a method that conserves both, so facilitating post-operative rehabilitation.A C-shaped incision is made on the dorsum of the finger. The lateral bands of the extensor expansion are separated from the central slip proximally to the extensor hood. They are then retracted to expose the condyles of the proximal phalanx, which are excised. The PIP joint is then dislocated between the central slip and a lateral band allowing the remainder of the head to be excised. The middle and proximal phalanges are then prepared to accept the prosthesis. The prosthesis is then inserted and the joint is reduced. The lateral bands of the extensor mechanism are sutured back to the central slip before the skin is closed.

Cortical evoked potentials in the ruptured anterior cruciate ligament.

The sensory role of the intact and ruptured anterior cruciate ligament was studied by the use of cortical evoked potentials during arthroscopy. This showed a response from the intact ligament in four patients that was reproducible. This response was consistent with those obtained from stimulation of the ipsilateral posterior tibial nerve. No response was elicited from either the femoral or tibial stump of ruptured ligaments using the same technique in six patients who had ruptured their anterior cruciate ligament (two femoral and four mid-substance ruptures). We believe that this demonstrates that there is no functional nervous tissue within the anterior cruciate ligament after rupture.

Orthopaedic clinical note. Patella metastases: a case report.

Here we report the first noted case of a small cell carcinoma of the lung (oat cell carcinoma) presenting as metastases in the patella. Malignancies of the patella, primary or secondary, are rare. First presentation of a malignancy with metastases in the patella has only been recorded once previously.

Quality assurance in mental health: the QUARTZ system.

This paper is concerned with how quality might be assured in mental health services. It includes an account of why a concern with quality and quality assurance procedures are now high on the agenda of the Health Service. A quality assurance programme requires a decision about what elements of a service to monitor, what information is relevant, how it can be collected, and a system for acting on the results. This paper provides a brief review of the kind of information that has been considered relevant and the methods that have been used to collect it. In addition, the principles underlying good and comprehensive quality assurance programmes will be outlined and the development of a particular system, known as QUARTZ, which has attempted to incorporate these principles, described briefly.

Preferential inspection of views of 3-D model heads.

The importance of different perspective views for the recognition of model heads was studied. In experiment 1 subjects were instructed to learn the appearance of six heads placed individually on a turntable free to rotate through 360 degrees. Subjects did not distribute their time evenly but focussed their inspection on particular views (the full face view and a view close to the profile). Despite differential inspection of these two views during the learning phase, the face, half profile, and profile views were recognized with equal efficiency in a subsequent recognition task with static views. Experiment 2 used the inspection paradigm to investigate view preference during the recognition of heads from memory. In this experiment subjects were asked to learn the appearance of three heads each seen rotating at an even speed. In a subsequent retrieval task the subjects actively inspected six model heads on the turntable and were asked to differentiate the three heads previously seen rotating from three novel heads. The pattern of inspection in this retrieval task was equivalent to that in experiment 1. Results suggest that during the encoding into memory subjects construct descriptions of specific prototypical views of the head and that descriptions of these same views are preferentially utilised during recognition.

The effects of nurses changing from uniforms to everyday clothes on a psychiatric rehabilitation ward.

There are few controlled studies investigating the effects of nurses changing from uniforms to everyday clothes. A quasi-experimental design was used where patient behaviour was measured before and after such a change and in which some degree of control was achieved by assessing the major sources of bias (i.e. medication, ward practices, etc.). The results suggest that the change in dress led to a decrease in deviant behaviour (particularly violent incidents) and patient estrangement and an increase in the number of nurses in whom patients could confide. These changes in behaviour appeared to be the result of changes in the nature of the relationships/interactions between patients and staff brought about by the change in nurse dress.

Improving the quality of care on psychiatric hospital rehabilitation wards. A controlled evaluation.

This study attempted to use feedback from the Model Standards Questionnaires (a series designed to measure the quality of care) to improve care on a psychiatric hospital's rehabilitation wards. Both a controlled and quasi-experimental design were used. The controlled design provided evidence that feedback from the Questionnaire concerned with the Individual Programmes of Treatment and Care led to improvements in these practices but not for the remaining three questionnaires. The quasi-experimental design indicated that the significant generalised improvement in care, over all questionnaires, was most likely due to the feedback.

Sexual fulfillment of heterosexual, bisexual, and homosexual women.

Seventy females were interviewed in depth regarding their sexual responses and sexual fulfillment. They were categorized as heterosexual, bisexual, or homosexual according to self-definition. The quantity and quality of female sexual response, the source of the response, and the interactional patterns of sexuality were analyzed, and shown to differ, for different sexual orientations. The fallacy of emphasizing heterosexuality, and the fallacy of utilizing a heterosexual-homosexual dichotomy, in studies of female sexuality are indicated. It is suggested that knowledge about all sexual orientations can lead to more fulfilling sexuality in general, regardless of the individual's particular orientation.

Gaze patterns of mentally retarded adults in two contrasting environments.

Two matched samples of mentally retarded adults were video recorded on two occasions, before and after one group was transferred to a different type of hospital, and their gaze patterns analyzed. Overall, only slight changes after transfer were found, but analysis according to amount of looking at the interviewer on the first occasion showed that those transferred subjects who initially looked little of the time significantly increased their amount of looking after transfer. Some correlations with the Adaptive Behavior Scale were also reported.