A systematic review of community pharmacy interventions to improve peri- and post-menopausal health.

Menopause is defined as the permanent cessation of menstruation due to loss of ovarian follicular function. Symptoms include mood disorders, vaginal atrophy, hot flashes and night sweats and can emerge during a gradual transition period called perimenopause. Community pharmacies are well placed to deliver a wide range of healthcare services, including supporting and educating menopausal women; however, to date, no systematic review has assessed the effectiveness of community pharmacy-led interventions in improving peri- and post-menopausal health. In accordance with PRISMA guidelines we evaluated community pharmacy-led interventions that targeted women in peri- or post-menopause. Electronic searches in EMBASE, MEDLINE, CINAHL and Cochrane Library were conducted on 13th February 2023. Additionally, we examined the included studies references and citation lists using Google Scholar. A total of 915 articles were identified and screened against the inclusion criteria. Two studies were included; one identified post-menopausal women at risk of developing osteoporosis (OP), and one evaluated the outcomes of a community pharmacy-based menopause education programme. Study one found 11 (11%) post-menopausal women were at risk of developing OP based on quantitative ultrasound screening offered by community pharmacists and referred to their physician. Study two reported that women had access to adequate personalised menopause counselling and increased knowledge of menopause topics because of the educational programme within community pharmacies. Both studies were of low quality. The lack of included studies reflects the need for high-quality research to determine whether community pharmacy-led interventions are feasible, effective and acceptable, to improve health outcomes of peri- or post-menopausal women.

Impact of Fat-Free Adipose Tissue on the Prevalence of Low Muscle Mass Estimated Using Calf Circumference in Middle-Aged and Older Adults.

Previous studies proposed calf circumference cutoff values for predicting dual-energy X-ray absorptiometry (DXA)-derived low muscle mass. However, DXA-derived appendicular lean mass (aLM) includes non-skeletal muscle components such as the appendicular fat-free component of adipose tissue fat cells (aFFAT). The purpose of this study was to compare the calf circumference method of classification before (Model #1) and after (Model #2) eliminating the influence of FFAT in healthy Japanese adults (50 to 79 years; mean age 70 (SD 7) years). Model 1, and Model 2 for classifying low muscle mass had a sensitivity of 78% and 64%, specificity of 76% and 75%, positive predictive value of 31% and 28%, and negative predictive value of 96% and 93%, respectively. Appendicular fat-free component of adipose tissue has the potential to influence the ability of calf circumference to accurately classify individuals with low muscle mass. Consideration should be made when using this as a screening tool for low muscle mass.

Blood flow restriction augments the skeletal muscle response during very low-load resistance exercise to volitional failure.

The purpose of this study was to compare the acute muscular response with resistance exercise between the following conditions [labeled (% one-repetition maximum/% arterial occlusion pressure)]: high-load (70/0), very low-load (15/0), very low-load with moderate (15/40), and high (15/80) blood flow restriction pressures. Twenty-three participants completed four sets of unilateral knee extension to failure (up to 90 repetitions) with each condition, one condition per leg, each day. Muscle thickness and maximal voluntary contraction (MVC) were measured before (Pre), immediately after (Post-0), and 15 min after (Post-15) exercise and electromyography (EMG) amplitude during exercise. Pre to Post-0 muscle thickness changes in cm [95% CI] were greater with 15/40 [0.57 (0.41, 0.73)] and 15/80 [0.49 (0.35, 0.62)] compared to 70/0 [0.33 (0.25, 0.40)]. Pre to Post-0 MVC changes in Nm [95% CI] were higher with 15/40 [-127.0 (-162.1, -91.9)] and 15/80 [-133.6 (-162.8, -104.4)] compared to 70/0 [-48.4 (-70.1, -26.6)] and 15/0 [-98.4 (-121.9, -74.9)], which were also different. Over the first three repetitions, EMG increased across sets, whereas in the last three repetitions it did not. EMG was also different between conditions and was generally greater during 70/0. Repetitions decreased across sets reaching the lowest for 70/0, and for very low loads decreased with increased pressure. In trained participants exercising to failure, lower load and the application of restriction pressure augment changes in muscle thickness and torque. The EMG amplitude was augmented by load. Training studies should compare these conditions, as the results herein suggest some muscular adaptations may differ.

Environmental scaling influences the use of local but not global geometric cues during spatial reorientation.

During spatial reorientation, the use of local geometric cues (e.g., corner angles) and global geometric cues (e.g., principal axis) is differentially influenced by enclosure size. Local geometric cues exert more influence in large enclosures compared to small enclosures, whereas the use of global geometric cues is not influenced by changes in enclosure size. Such effects are suggested to occur because of differences in training enclosures sizes or differences in testing enclosure sizes, but investigations of enclosure-size effects on spatial cue use have been confounded by environmental scaling between training and testing. We trained participants in a trapezoid-shaped enclosure to respond to a corner uniquely specified by both local and global geometric cues and tested participants in a rectangle (isolating the use of global geometric cues) and in a parallelogram (placing local and global geometric cues in conflict). Between groups, participants experienced different training environment sizes but identical testing environment sizes or identical training environment sizes but different testing environment sizes, and this allowed categorization with respect to the direction of environmental scaling. We found that environmental scaling between training and testing size (but not training size differences or testing size differences) influenced the relative use of local geometric cues. The use of global geometric cues was not influenced by enclosure size. Results challenge prior explanations of the influence of enclosure size on relative spatial cue use during spatial reorientation. (PsycINFO Database Record

Isolated processing of geometric shapes and their corresponding shape words: Evidence from a delayed match-to-sample task.

Some theorists propose a domain-specific cognitive system dedicated to processing geometric information, but existence of this system remains debatable because of challenges in isolating geometric from linguistic and semantic processing. Recently, Sturz, Edwards, and Boyer (2014) developed a delayed match-to-sample task that presented a sample of a shape, shape word, or bidimensional stimulus composed of a shape and shape word. After a delay, participants identified the sample shape or the sample word by selecting between 2 shapes or 2 shape words. An asymmetrical pattern of interference emerged such that increased response times (RTs) and errors occurred in matching shape targets but not word targets. This was interpreted as shape words activating a semantic and spatial representation of shapes, but shapes only activating a spatial representation. The present experiments attempted to replicate and extend these results by manipulating figure-ground relations to contrast the original condition with an alternative to address an explanation based upon sample shape saliency (Experiment 1), by confirming the effectiveness of the saliency manipulation (Experiment 2), and by explicitly testing the assumption that shapes did not activate a semantic representation by reversing the sample-to-target matching criteria (Experiment 3). Experiment 1 replicated the asymmetrical pattern of results for both conditions, and Experiment 2 confirmed the saliency manipulation, which together undermine a pure saliency explanation. Experiment 3 produced a symmetrical pattern of results and suggests that the reversed matching criteria forced shapes to be processed in both a spatial and semantic fashion. These results provide support for a cognitive system dedicated to processing geometric information isolated from linguistic and semantic processing. (PsycINFO Database Record

Note: A novel technique for analysis of aqueous solutions by laser-induced breakdown spectroscopy.

Surface-enhanced Raman spectroscopy (SERS) substrates typically consist of gold or silver nanoparticles deposited on a non-conductive substrate. In Raman spectroscopy, the nanoparticles produce an enhancement of the electromagnetic field which, in turn, leads to greater electronic excitation of molecules in the local environment. Here, we show that these same surfaces can be used to enhance the signal-to-noise ratio obtained in laser-induced breakdown spectroscopy of aqueous solutions. In this case, the SERS substrates not only lower breakdown thresholds and lead to more efficient plasma initiation but also provide an appropriately wettable surface for the deposition of the liquid. We refer to this technique as surface-enhanced laser-induced breakdown spectroscopy.

Mediastinitis: a life-threatening complication of acute tonsillitis.

Acute tonsillitis is a common condition and usually runs a benign course. However life-threatening complications do still occur, even in this postantibiotic era. Infection can spread downwards into the mediastinum through the anatomic cervical spaces, causing widespread cellulitis, necrosis, abscess formation and sepsis. We present a case of descending mediastinitis in an 18-year-old woman, arising from her first episode of tonsillitis and treated successfully by surgical drainage. We believe that an awareness of this complication, early diagnosis using computed tomography scanning, and prompt, adequate surgical drainage will reduce morbidity and mortality.

The computerization of industrial hygiene records.

A program for computerizing the results of industrial hygiene monitoring data has been developed and implemented. The methodology and approaches taken in data collection, retrieval, and utilization are presented.

Effects of chronic amorphous silica exposure on sequential pulmonary function.

To assess clincial effects of precipitated amorphous silica (PAS), the authors reviewed serial spirograms, respiratory questionnaires, and chest radiographs of 165 workers exposed for a mean of 8.6 years. Monthly exposure was graded on a 1 to 4 scale and a "cumulative exposure index" (CEI) calculated for each worker from the sum of measured exposure. A "mean exposure index" (MEI) was calculated by dividing the CEI by total months exposed. Sputum production and dyspnea were inversely correlated with CEI, while cough and dyspnea correlated with mean pack-years of smoking but not PAS exposure. Linear regression analysis of yearly change of all pulmonary function variables (FVC, FEV1, FEV1/FVC, FEF25-75) showed no correlation with either the dose of PAS (CEI) or total years of exposure. Among 44 workers with a mean exposure time of 18 years (range 10-35 years), yearly decline of FVC and FEV1 were similar to the overall group. Of 143 workers with serial radiographs and exposure to only PAS, none had radiographic pneumoconiosis. Respiratory symptoms in PAS workers correlate with smoking but not with PAS exposure, while serial pulmonary function values and chest radiographs are not adversely affected by long-term exposure.