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1.
Trends Hear ; 28: 23312165231224643, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38361477

RESUMO

Cochlear implantation successfully improves hearing in most adult recipients. However, in rare cases, post-implant rehabilitation is required to maximize benefit. The primary aim of this investigation was to test if self-reports by cochlear implant users indicate the need for post-implant rehabilitation. Listening performance was assessed with the Speech, Spatial and Qualities short-form SSQ12, which was self-administered via a web-based survey. Subjects included over 2000 adult bilateral or unilateral cochlear implant users with at least one year of experience. A novel application of regression tree analysis identified core SSQ12 items that serve as first steps in establishing a plan for further rehabilitation: items 1, 8, and 11 dealing with single-talker situations, loudness perception, and clarity, respectively. Further regression and classification tree analyses revealed that SSQ12 item scores were weakly related to age, degree of tinnitus, and use of bilateral versus unilateral implants. Conversely, SSQ12 scores were strongly associated with self-rated satisfaction and confidence in using their cochlear implant. The SSQ12 total scores did not vary significantly over 1-9 or more years' experience. These findings suggest that the SSQ12 may be a useful tool to guide rehabilitation at any time after cochlear implantation. Identification of poor performance may have implications for timely management to improve the outcomes, through various techniques such as device fitting adjustments, counseling, active sound exposure, and training spatial hearing.


Assuntos
Implante Coclear , Implantes Cocleares , Percepção da Fala , Adulto , Humanos , Fala , Audição
2.
Pain ; 2024 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-38323645

RESUMO

ABSTRACT: Productivity loss because of chronic pain in the working age population is a widespread concern internationally. Interventions for chronic pain in working age adults might be expected to achieve enhanced productivity in terms of reduced costs of workers' compensation insurance, reduced disability support, and improved rates of return to work for injured workers. This would require the use of measures of productivity in the evaluation of chronic pain management interventions. The aim of this review was to identify and interpret the productivity outcomes of randomised controlled trials reported by studies that conducted economic evaluations (eg, cost-effectiveness and cost-utility) of chronic pain management interventions in the working age population published from database inception to March 2023. Econlit, Embase, and Pubmed electronic databases were searched, yielding 12 studies that met the selection criteria. All 12 studies used absenteeism to measure productivity, translating return to work measures into indirect costs. Only one study included return to work as a primary outcome. Ten studies found no statistically significant improvements in productivity-related costs. Despite evidence for reduced pain-related disability after pain management interventions, this review suggests that the use of measures for assessing productivity gains is lacking. Including such measures would greatly assist administrators and payers when considering the broader societal benefits of such interventions.

3.
Int J Biometeorol ; 68(4): 661-673, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38189988

RESUMO

There are more incidents of violence in summer and on hot days, a trend likely to be exacerbated by climate change. Urban areas experience additional temperature modulation due to the urban form, however, to date, no studies have considered the effect of the urban heat island (UHI) or green space with respect to the temperature-violence relationship. This study modelled the relationship between the number of daily violent crime incidents that occurred inside or outside between July 2013 and June 2018, and the average surface UHI or percentage greencover (including grasses, shrubs and trees) within each local government area in Greater Sydney, Australia. Panelised negative binomial time series regression models indicated that the violent crime rate was associated with higher surface UHI for crimes committed outside (p = 0.006) but not inside (p = 0.072). Greater percentage of all vegetation was associated with significantly lower rates of violent crime committed outside (p = 0.011) but was not associated with violent crimes committed inside (p = 0.430). More socio-economic disadvantage was associated with higher rates of violent crime committed inside (p = 0.002) but not outside (p = 0.145). Greater temperature was non-linearly associated with higher rates of violent crime committed both inside and outside (p < 0.001). The findings of this study are important because both violence and heat exposure are critical health issues and will be stressed by urbanisation and climate change. The expansion of green space and/or reduction in UHI may mitigate these effects.


Assuntos
Temperatura Alta , Parques Recreativos , Temperatura , Cidades , Violência
4.
Dev Psychopathol ; : 1-16, 2024 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-38174409

RESUMO

There is limited evidence on heterogenous co-developmental trajectories of internalizing (INT) and externalizing (EXT) problems from childhood to adolescence and predictors of these joint trajectories. We utilized longitudinal data from Raine Study participants (n = 2393) to identify these joint trajectories from 5 to 17 years using parallel-process latent class growth analysis and analyze childhood individual and family risk factors predicting these joint trajectories using multinomial logistic regression. Five trajectory classes were identified: Low-problems (Low-INT/Low-EXT, 29%), Moderate Externalizing (Moderate-EXT/Low-INT, 26.5%), Primary Internalizing (Moderate High-INT/Low-EXT, 17.5%), Co-occurring (High-INT/High-EXT, 17%), High Co-occurring (Very High-EXT/High-INT, 10%). Children classified in Co-occurring and High Co-occurring trajectories (27% of the sample) exhibited clinically meaningful co-occurring problem behaviors and experienced more adverse childhood risk-factors than other three trajectories. Compared with Low-problems: parental marital problems, low family income, and absent father predicted Co-occurring and High Co-occurring trajectories; maternal mental health problems commonly predicted Primary Internalizing, Co-occurring, and High Co-occurring trajectories; male sex and parental tobacco-smoking uniquely predicted High Co-occurring membership; other substance smoking uniquely predicted Co-occurring membership; speech difficulty uniquely predicted Primary Internalizing membership; child's temper-tantrums predicted all four trajectories, with increased odds ratios for High Co-occurring (OR = 8.95) and Co-occurring (OR = 6.07). Finding two co-occurring trajectories emphasizes the importance of early childhood interventions addressing comorbidity.

5.
One Health ; 17: 100652, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38024267

RESUMO

Growing reports of diverse antibiotic resistance genes in wildlife species around the world symbolises the extent of this global One Health issue. The health of wildlife is threatened by antimicrobial resistance in situations where wildlife species develop disease and require antibiotics. Chlamydial disease is a key threat for koalas in Australia, with infected koalas frequently entering wildlife hospitals and requiring antibiotic therapy, typically with chloramphenicol or doxycycline. This study investigated the occurrence and diversity of target chloramphenicol and doxycycline resistance genes (cat and tet respectively) in koala urogenital and faecal microbiomes. DNA was extracted from 394 urogenital swabs and 91 faecal swabs collected from koalas in mainland Australia and on Kangaroo Island (KI) located 14 km off the mainland, before (n = 145) and during (n = 340) the 2019-2020 wildfires. PCR screening and DNA sequencing determined 9.9% of samples (95%CI: 7.5% to 12.9%) carried cat and/or tet genes, with the highest frequency in fire-affected KI koalas (16.8%) and the lowest in wild KI koalas sampled prior to fires (6.5%). The diversity of cat and tet was greater in fire-affected koalas (seven variants detected), compared to pre-fire koalas (two variants detected). Fire-affected koalas in care that received antibiotics had a significantly higher proportion (p < 0.05) of cat and/or tet genes (37.5%) compared to koalas that did not receive antibiotics (9.8%). Of the cat and/or tet positive mainland koalas, 50.0% were Chlamydia-positive by qPCR test. Chloramphenicol and doxycycline resistance genes in koala microbiomes may contribute to negative treatment outcomes for koalas receiving anti-chlamydial antibiotics. Thus a secondary outcome of wildfires is increased risk of acquisition of cat and tet genes in fire-affected koalas that enter care, potentially exacerbating the already significant threat of chlamydial disease on Australia's koalas. This study highlights the importance of considering impacts to wildlife health within the One Health approach to AMR and identifies a need for greater understanding of AMR ecology in wildlife.

6.
Stat Med ; 42(30): 5577-5595, 2023 12 30.
Artigo em Inglês | MEDLINE | ID: mdl-37845791

RESUMO

The accelerated failure time (AFT) model offers an important and useful alternative to the conventional Cox proportional hazards model, particularly when the proportional hazards assumption for a Cox model is violated. Since an AFT model is basically a log-linear model, meaningful interpretations of covariate effects on failure times can be made directly. However, estimation of a semiparametric AFT model imposes computational challenges even when it only has time-fixed covariates, and the situation becomes much more complicated when time-varying covariates are included. In this paper, we propose a penalised likelihood approach to estimate the semiparametric AFT model with right-censored failure time, where both time-fixed and time-varying covariates are permitted. We adopt the Gaussian basis functions to construct a smooth approximation to the nonparametric baseline hazard. This model fitting method requires a constrained optimisation approach. A comprehensive simulation study is conducted to demonstrate the performance of the proposed method. An application of our method to a motor neuron disease data set is provided.


Assuntos
Modelos Estatísticos , Humanos , Funções Verossimilhança , Modelos de Riscos Proporcionais , Simulação por Computador , Modelos Lineares
8.
Sci Total Environ ; 902: 166336, 2023 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-37591385

RESUMO

Enteropathogenic Escherichia coli (EPEC) is an important cause of diarrhoeal disease in human infants. EPEC strains are defined by the presence of specific virulence factors including intimin (encoded by the eae gene) and bundle forming pili (Bfp). Bfp is encoded by the bfp operon and includes the bfpA gene for the major pilus subunit. By definition, Bfp are only present in typical EPEC (tEPEC), for which, humans are considered to be the only known natural host. This study detected tEPEC in faecal samples from a wild Australian fruit bat species, the grey-headed flying-fox (Pteropus poliocephalus). Whole genome sequencing of 61 E. coli isolates from flying-foxes revealed that 21.3 % (95%CI: 13 %-33 %) were tEPEC. Phylogenetic analyses showed flying-fox tEPEC shared evolutionary lineages with human EPEC, but were predominantly novel sequence types (9 of 13) and typically harboured novel bfpA variants (11 of 13). HEp-2 cell adhesion assays showed adherence to human-derived epithelial cells by all 13 flying-fox tEPEC, indicating that they all carried functional Bfp. Using an EPEC-specific duplex PCR, it was determined that tEPEC comprised 17.4 % (95%CI: 13 %-22 %) of 270 flying-fox E. coli isolates. Furthermore, a tEPEC-specific multiplex PCR detected the eae and bfpA virulence genes in 18.0 % (95%CI: 8.0 %-33.7 %) of 506 flying-fox faecal DNA samples, with occurrences ranging from 1.3 % to 87.0 % across five geographic areas sampled over a four-year period. The identification of six novel tEPEC sequence types and five novel bfpA variants suggests flying-foxes carry bat-specific tEPEC lineages. However, their close relationship with human EPEC and functional Bfp, indicates that flying-fox tEPEC have zoonotic potential and that dissemination of flying-fox tEPEC into urban environments may pose a public health risk. The consistent detection of tEPEC in flying-foxes over extensive geographical and temporal scales indicates that both wild grey-headed flying-foxes and humans should be regarded as natural tEPEC hosts.


Assuntos
Quirópteros , Escherichia coli Enteropatogênica , Proteínas de Escherichia coli , Lactente , Animais , Humanos , Escherichia coli Enteropatogênica/genética , Adesinas Bacterianas/genética , Filogenia , Proteínas de Escherichia coli/genética , Austrália
9.
Int J Pediatr Otorhinolaryngol ; 170: 111583, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37245391

RESUMO

OBJECTIVES: The aim of this study was to report on the educational placement, quality of life and speech reception changes in a prospectively recruited group of children after they received a cochlear implant (CI). METHOD: Data was collected on 1085 CI recipients of as part of a prospective, longitudinal, observational, international, multi-centre, paediatric registry, initiated by Cochlear Ltd (Sydney, NSW, Australia). Outcome data from children (≤10 years old) implanted in routine practice was voluntarily entered into a central, externally hosted, e-platform. Collection occurred prior to initial device activation (baseline) and at six monthly follow-up intervals up to 24 months and then at 3 years post activation. Clinician reported baseline and follow up questionnaires and Categories of Auditory Performance version II (CAP-II) outcomes were collated. Self-reported evaluation forms and patient information were provided by the parent/caregiver/patient via the implant recipient baseline and follow up, Children Using Hearing Implants Quality of Life (CuHIQoL) and Speech Spatial Qualities (SSQ-P) Parents Version questionnaires. RESULTS: Children were mainly bilaterally profoundly deaf, unilaterally implanted and used a contralateral hearing aid. Prior to implant 60% used signing or total communication as their main mode of communication. Mean age at implant was 3.2 ± 2.2 years (range 0-10 years). At baseline 8.6% were in mainstream education with no additional support and 82% had not yet entered school. After three years of implant use, 52% had entered mainstream education with no additional support and 38% had not yet entered school. In the sub-group of 141 children who were implanted at or after three years of age and were thus old enough to be in mainstream school at the three-year follow up, an even higher proportion (73%) were in mainstream education with no support. Quality of life scores for the child improved statistically significantly post implant compared to baseline and continued to improve significantly at each interval up to 3 years (p < 0.001). Parental expectation scores reduced statistically significantly from baseline compared to all intervals (p < 0.028) and then increased significantly at 3 years compared to all post baseline follow-up intervals (p < 0.006). The impact on family life was reduced post implant compared to baseline and continued to reduce between annual intervals (p < 0.001). At three years post follow up median CAP II scores were 7 (IQR 6-7) and mean SSQ-P scores were 6.8 (SD1.9) 6.0 (SD1.9) and 7.4 (SD 2.3) for speech spatial and qualities scales respectively. SSQ-P and CAP II scores improved statistically and clinically significantly compared to baseline by one year post implantation. CAP II scores continued to improve at each test interval up to three years post implant. Speech and Qualities scores improved significantly between years 1 and 2 (p < 0.001), but only the Speech scores improved significantly between years 2 and 3 (p = 0.004). CONCLUSIONS: Mainstream educational placement was achievable for most of the children, including those implanted at an older age. Quality of life for the child and the wider family improved. Future research could focus on the impact of mainstream school placement on children's academic progress, including measures of academic attainment and social functioning.


Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Percepção da Fala , Criança , Humanos , Recém-Nascido , Lactente , Pré-Escolar , Surdez/cirurgia , Surdez/reabilitação , Qualidade de Vida , Estudos Prospectivos , Percepção da Fala/fisiologia , Resultado do Tratamento
10.
Trials ; 24(1): 197, 2023 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-36927497

RESUMO

BACKGROUND: Exercise for the prevention of low back pain recurrences is recommended, but under-researched. The effectiveness and cost-effectiveness of a walking program for preventing low back pain recurrence remains unknown. This a priori statistical analysis plan describes the methods of analysis for the WalkBack trial. METHODS: WalkBack is a prospectively registered, pragmatic, randomised controlled trial. The aim is to investigate the effectiveness and cost-effectiveness of a 6-month progressive and individualised walking and education program (intervention) for the prevention of low back pain recurrences, compared to a no-treatment control group. The primary outcome is days to the first recurrence of an episode of activity-limiting low back pain. Key secondary outcomes include days to any recurrence of low back pain, days to a care-seeking recurrence of low back pain, disability level, health-related quality of life, costs associated with low back pain and adverse events. All participants will be followed for a minimum of 12 months. Analysis will follow the intention-to-treat principle. Cox regression is planned to assess the effects for the outcomes of time to activity-limiting, minimal and care-seeking recurrence. Hazard ratios and median survival times with 95% confidence intervals will be calculated. The effect of the intervention on continuous outcomes will be estimated with repeated-measure linear mixed models. An economic evaluation will be performed from the societal perspective for recurrence prevented (yes/no) and quality-adjusted life years. The proportion of adverse events between groups will be compared using Fisher's exact test. DISCUSSION: The WalkBack trial will provide evidence on the effectiveness and cost-effectiveness of a walking intervention to prevent low back pain recurrences. This statistical analysis plan provides transparency on the analysis of the trial. TRIAL REGISTRATION: WalkBack - Effectiveness and cost-effectiveness of a progressive individualised walking and education program for the prevention of a recurrence of low back pain. ACTRN12619001134112 . Date Registered: 14/08/2019.


Assuntos
Dor Lombar , Humanos , Adulto , Dor Lombar/diagnóstico , Dor Lombar/prevenção & controle , Análise Custo-Benefício , Qualidade de Vida , Caminhada , Exercício Físico
11.
Sci Rep ; 13(1): 716, 2023 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-36639676

RESUMO

Episodic memory deficits are a common consequence of aging and are associated with a number of neurodegenerative disorders (e.g., Alzheimer's disease). Given the importance of episodic memory, a great deal of research has investigated how we can improve memory performance. Transcranial electrical stimulation (TES) represents a promising tool for memory enhancement but the optimal stimulation parameters that reliably boost memory are yet to be determined. In our double-blind, randomised, sham-controlled study, 42 healthy adults (36 females; 23.3 ± 7.7 years of age) received anodal transcranial direct current stimulation (tDCS), theta transcranial alternating current stimulation (tACS) and sham stimulation during a list-learning task, over three separate sessions. Stimulation was applied over the left temporal lobe, as encoding and recall of information is typically associated with mesial temporal lobe structures (e.g., the hippocampus and entorhinal cortex). We measured word recall within each stimulation session, as well as the average number of intrusion and repetition errors. In terms of word recall, participants recalled fewer words during tDCS and tACS, compared to sham stimulation, and significantly fewer words recalled during tACS compared with tDCS. Significantly more memory errors were also made during tACS compared with sham stimulation. Overall, our findings suggest that TES has a deleterious effect on memory processes when applied to the left temporal lobe.


Assuntos
Memória Episódica , Estimulação Transcraniana por Corrente Contínua , Adulto , Feminino , Humanos , Córtex Pré-Frontal/fisiologia , Aprendizagem/fisiologia , Rememoração Mental/fisiologia
12.
Knee Surg Sports Traumatol Arthrosc ; 31(1): 199-205, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35809103

RESUMO

PURPOSE: The majority of methods for measuring glenoid bone loss in shoulder instability use the best-fit circle following the inferior glenoid rim. However, there is no precise method on how to draw this circle, particularly in case of a missing rim segment. Defining the radius is a source of substantial error. It was hypothesized that there is a relationship between the best-fit inferior circle (inner circle), defined by Sugaya, and the circle tangent to the supra- and infra-glenoid tubercles (outer circle), defined by Itoi, thus allowing a more consistent appreciation of the paleo-glenoid. METHODS: Ninety-five normal dry scapulae were examined. The specimens were digitally photographed obtaining perpendicular images of the glenoid cavity. Using HOROS® imaging software, a best-fit inferior circle (inner circle) and a second circle fitting the most inferior and superior points of the glenoid (outer circle) were drawn by two investigators. The diameters and areas of the circles were recorded. Two-way random-effects intra-class correlation coefficients (ICC) were used to measure intra- and inter-observer agreement. A Bayesian measurement-error regression model was used to determine the relationship between outer and inner circle measurements. RESULTS: The mean glenoid height was 35.1 mm and the glenoid width 25.6 mm. The mean diameter of the outer circle was 35.7 ± 4.2 mm and the mean diameter of the inner circle was 26.8 ± 3.2 mm. ICC showed excellent inter- and intra-observer agreement for both the outer circle diameter (ICC ≥ 0.95) and inner circle diameter (ICC ≥ 0.93). The two diameters demonstrated a very strong significant Pearson correlation (0.92, p < 0.001) and the regression showed excellent model fit R2 = 0.87. The areas of the two circles were also highly and significantly correlated (r = 0.94; p < 0.001). The ratio of inner circle to outer diameters was 0.74. CONCLUSION: There is a strong correlation between the inner and outer glenoid circle diameters. This study sets the base for the use the combined outer and inner circle and its ratio to better appreciate the paleo-glenoid morphology and thus obtain a more reliable bone loss estimation. Application of this method aids in a more reliable estimation bone loss with potential benefit in surgical decision-making.


Assuntos
Doenças Ósseas Metabólicas , Cavidade Glenoide , Instabilidade Articular , Articulação do Ombro , Humanos , Articulação do Ombro/diagnóstico por imagem , Relevância Clínica , Teorema de Bayes , Tomografia Computadorizada por Raios X/métodos , Imageamento Tridimensional , Escápula , Cavidade Glenoide/diagnóstico por imagem
13.
J Physiother ; 69(1): 15-22, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36529640

RESUMO

QUESTION: What is the effect of Bobath therapy on arm activity and arm strength compared with a dose-matched comparison intervention or no intervention after stroke? DESIGN: Systematic review of randomised trials with meta-analysis. PARTICIPANTS: Adults after stroke. INTERVENTION: Bobath therapy compared with no intervention or other interventions delivered at the same dose as the Bobath therapy. OUTCOME MEASURES: Arm activity outcomes and arm strength outcomes. Trial quality was assessed with the PEDro scale. RESULTS: Thirteen trials were included; all compared Bobath with another intervention, which were categorised as: task-specific training (five trials), arm movements (five trials), robotics (two trials) and mental practice (one trial). The PEDro scale scores ranged from 5 to 8. Pooled data from five trials indicated that Bobath therapy was less effective than task-specific training for improving arm activities (SMD -1.07, 95% CI -1.59 to -0.55). Pooled data from five trials indicated that Bobath therapy was similar to or less effective than arm movements for improving arm activities (SMD -0.18, 95% CI -0.44 to 0.09). One trial indicated that Bobath therapy was less effective than robotics for improving arm activities and one trial indicated similar effects of Bobath therapy and mental practice on arm activities. For strength outcomes, pooled data from two trials indicated a large benefit of task-specific training over Bobath therapy (SMD -1.08); however, this estimate had substantial uncertainty (95% CI -3.17 to 1.01). The pooled data of three trials indicated that Bobath therapy was less effective than task-specific training for improving Fugl-Meyer scores (MD -7.84, 95% CI -12.99 to -2.69). The effects of Bobath therapy relative to other interventions on strength outcomes remained uncertain. CONCLUSIONS: After stroke, Bobath therapy is less effective than task-specific training and robotics in improving arm activity and less effective than task-specific training on the Fugl-Meyer score. REGISTRATION: PROSPERO CRD42021251630.


Assuntos
Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Adulto , Humanos , Braço , Atividades Cotidianas , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/terapia
14.
J Manipulative Physiol Ther ; 45(5): 358-364, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-36184322

RESUMO

OBJECTIVE: The aim of this study was to assess the agreement between a web-based scoliosis screening tool and a standard screening procedure. METHODS: Sixty participants were selected (median age, 12 years; 75% were women) and separated into 2 groups: those with unknown spinal curvature status and those with confirmed scoliosis. Each participant was assessed by 2 blinded assessors, with one measuring the angle of trunk rotation using a scoliometer and the second using a web-based screening application. The app provided a relative risk score for having scoliosis based on a weighted algorithm. Those with an angle of trunk rotation ≥7° or risk score >2 were deemed as being at risk for having scoliosis. RESULTS: There was fair agreement (kappa = 0.34; 95% confidence interval [CI], 0.14-0.55; P < .001) between the app and the scoliometer among the unconfirmed cases. The McNemar test indicated a difference in the proportion of positive tests (P = .001), whereby the screening app produced a significantly higher number of positive tests (15/53 = 28.3%) compared to the standard screening procedure (4/53 = 7.5%) for unconfirmed cases. Among the confirmed cases, the app correctly identified 5 out of 7 (sensitivity: 71%; 95% CI, 29%-96%) participants, whereas the scoliometer correctly identified 6 out of 7 (sensitivity: 86%; 95% CI, 42%-100%) participants. CONCLUSION: These findings indicate fair agreement between the app and the scoliometer, though it was not possible to precisely estimate the sensitivity of the app in this study.


Assuntos
Cifose , Escoliose , Humanos , Adolescente , Feminino , Criança , Masculino , Escoliose/diagnóstico , Reprodutibilidade dos Testes , Fatores de Risco , Software , Programas de Rastreamento
15.
Sci Rep ; 12(1): 14423, 2022 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-36002556

RESUMO

Tinnitus is a common symptom in cochlear implant (CI) recipients. There is no clear evidence of the influence of tinnitus on hearing-related quality of life (QoL) in this population. The aim of this study was to assess the relationship between hearing-related QoL measured by the Speech, Spatial and Qualities of Hearing scale (SSQ12) and tinnitus annoyance or perceived change in tinnitus annoyance after cochlear implantation. The study sample consisted of 2322 implanted adults across France, Germany, Ireland, Italy, the Netherlands, Sweden and the United Kingdom. Information relating to QoL measured using the SSQ12 and tinnitus annoyance and change in tinnitus annoyance, assessed using single-item questions, were collected one or more years post-implantation. The relationship between SSQ12 score and tinnitus annoyance or change in tinnitus annoyance was analysed using linear models adjusted for age and unilateral versus bilateral implants. Tukey pairwise tests were used to compare mean SSQ12 scores across levels of tinnitus annoyance and changes. Tinnitus prevalence was 33.9% post-implantation. Recipients with tinnitus had a significantly lower SSQ12 score than recipients without tinnitus. SSQ scores varied significantly with tinnitus annoyance, age and unilateral versus bilateral implants. Overall, CI recipients who experienced less bothersome tinnitus reported better hearing-related QoL. Healthcare professionals should be aware of the influence of tinnitus on CI recipients' hearing to manage patient expectations.


Assuntos
Implante Coclear , Implantes Cocleares , Percepção da Fala , Zumbido , Adulto , Audição , Humanos , Qualidade de Vida , Inquéritos e Questionários , Zumbido/etiologia , Zumbido/cirurgia , Resultado do Tratamento
16.
J Shoulder Elbow Surg ; 31(12): e575-e585, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35872168

RESUMO

BACKGROUND: A transverse force couple (TFC) functional imbalance has been demonstrated in osteoarthritic shoulders by recent 3-dimensional (3D) muscle volumetric studies. Altered rotator cuff vectors may be an additional factor contributing to a muscle imbalance and the propagation of glenoid deformity. METHODS: Computed tomography images of 33 Walch type A and 60 Walch type B shoulders were evaluated. The 3D volumes of the entire subscapularis, supraspinatus, and infraspinatus-teres minor (ISP-Tm) and scapula were manually segmented. The volume masks and scapular landmarks were imported into MATLAB to create a coordinate system, enabling calculation of muscle force vectors. The direction of each muscle force vector was described in the transverse and vertical plane, calculated with respect to the glenoid. Each muscle vector was then resolved into compression and shear force across the glenoid face. The relationship between muscle force vectors, glenoid retroversion or inclination, compression/shear forces on the glenoid, and Walch type was determined using linear regression. RESULTS: In the transverse plane with all rotator cuff muscles combined, increasing retroversion was significantly associated with increasing posterior drag (P < .001). Type B glenoids had significantly more posterior drag than type A (P < .001). In the vertical plane for each individual muscle group and in combination, superior drag increases as superior inclination increases (P < .001). Analysis of individual muscle groups showed that the anterior thrust of ISP-Tm and supraspinatus switched to a posterior drag at 8° and 10° of retroversion respectively. The compression force on the glenoid face by ISP-Tm and supraspinatus did not change with increasing retroversion for type A shoulders (P = .592 and P = .715, respectively), but they did for type B shoulders (P < .001 for both). The glenoid shear force ratio in the transverse plane for the ISP-Tm and supraspinatus moved from anterior to posterior shear with increasing glenoid retroversion, crossing zero at 8° and 10° of retroversion, whereas the subscapularis exerted a posterior shear force for every retroversion angle. CONCLUSION: Increased glenoid retroversion is associated with increased posterior shear and decreased compression forces on the glenoid face, explaining some of the pathognomonic bone morphometrics that characterize the osteoarthritic shoulder. Although the subscapularis always maintains a posterior thrust, the ISP-Tm and supraspinatus together showed an inflection at 8° and 10° of retroversion, changing from an anterior thrust to a posterior drag. This finding highlights the importance that in anatomic TSA the rotator cuff functional balance might be better restored by correcting glenoid retroversion to less than 8°.


Assuntos
Cavidade Glenoide , Articulação do Ombro , Humanos , Manguito Rotador/diagnóstico por imagem , Manguito Rotador/fisiologia , Ombro/fisiologia , Articulação do Ombro/diagnóstico por imagem , Articulação do Ombro/fisiologia , Escápula/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Cavidade Glenoide/diagnóstico por imagem
17.
Longit Life Course Stud ; 13(4): 647-666, 2022 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-35900894

RESUMO

Background: Risk-taking behaviours are a major contributor to youth morbidity and mortality. Vulnerability to these negative outcomes is constructed from individual behaviour including risk-taking, and from social context, ecological determinants, early life experience, developmental capacity and mental health, contributing to a state of higher risk. However, although risk-taking is part of normal adolescent development, there is no systematic way to distinguish young people with a high probability of serious adverse outcomes, hindering the capacity to screen and intervene. This study aims to explore the association between risk behaviours/states in adolescence and negative health, social and economic outcomes through young adulthood. Methods: The Raine Study is a prospective cohort study which recruited pregnant women in 1989-91, in Perth, Western Australia. The offspring cohort (N = 2,868) was followed up at regular intervals from 1 to 27 years of age. These data will be linked to State government health and welfare administrative data. We will empirically examine relationships across multiple domains of risk (for example, substance use, sexual behaviour, driving) with health and social outcomes (for instance, road-crash injury, educational underachievement). Microsimulation models will measure the impact of risk-taking on educational attainment and labour force outcomes. Discussion: Comprehensive preventive child health programmes and policy prioritise a healthy start to life. This is the first linkage study focusing on adolescence to adopt a multi-domain approach, and to integrate health economic modelling. This approach captures a more complete picture of health and social impacts of risk behaviour/​states in adolescence and young adulthood.


Assuntos
Assunção de Riscos , Transtornos Relacionados ao Uso de Substâncias , Criança , Humanos , Adolescente , Feminino , Gravidez , Adulto Jovem , Adulto , Estudos Prospectivos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Estudos de Coortes , Armazenamento e Recuperação da Informação
18.
Sci Total Environ ; 843: 156980, 2022 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-35764154

RESUMO

Salmonellosis is a climate-sensitive gastroenteritis with over 92 million cases and over 50,000 deaths a year globally. Australia has high rates of salmonellosis compared with other industrialised nations. This study used a negative binomial time-series regression model to investigate the association between Australian salmonellosis notifications and monthly climate variables including El Niño Southern Oscillation (ENSO) and mean temperature anomaly from 1991 to 2019. Between 1991 and 2019 in Australia there were 275,753 salmonellosis notifications and the median annual rate for salmonellosis was 40.1 per 100,000 population. Salmonellosis notifications exhibited strong seasonality, reaching a peak in summer and a minimum in winter. There was an estimated increase of 3.4 % in salmonellosis cases nationally per 1 °C increase in monthly mean temperature anomaly (incidence rate ratio [IRR] of 1.034, 95 % confidence interval [CI]: 1.009, 1.059). Similar associations between salmonellosis and mean temperature anomaly were found for some states. Mean temperature anomaly exhibited an upward trend of 0.9 °C over the period 1991 to 2019. Additionally, a positive association was found between salmonellosis in Australia and ENSO whereby El Niño periods were associated with 7.9 % more salmonellosis cases compared to neutral periods (IRR 1.079, 95 % CI: 1.019, 1.143). A similar ENSO association was detected in the two eastern states of New South Wales and Queensland. This study suggests public health preventative measures to reduce salmonellosis could be enhanced in some regions during El Niño as well as during times of increased temperatures.


Assuntos
El Niño Oscilação Sul , Infecções por Salmonella , Austrália/epidemiologia , Mudança Climática , Humanos , Infecções por Salmonella/epidemiologia , Estações do Ano , Temperatura
19.
ERJ Open Res ; 8(2)2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35586447

RESUMO

COPD is responsible for an increasing number of deaths worldwide. Smoking is the most reliable predictor for developing COPD later in life. However, women make up the majority of patients with COPD who have never smoked. There is therefore a need to identify other factors that can predict COPD in women. The aim of this study is to identify factors associated with increasing the risk of developing COPD later in life in women who have never smoked. Data from the Australian Longitudinal Study on Women's Health (ALSWH) cohort born between 1946 and 1951 were used to investigate potential predictors of COPD. Retrospective analyses were performed on data from two of the ALSWH surveys: wave 1 (1996) and wave 9 (2019). There were 3584 women who self-reported as being never-smokers (at waves 1 and 9) and did not have COPD at baseline, of which 109 had developed COPD at wave 9. Logistic regression showed a significant relationship between COPD at wave 9 and baseline breathing difficulties (p<0.001), asthma (p<0.001) and allergies (p=0.026), though significance of asthma and allergies disappeared when included together in a single model, implying that women with these symptoms earlier in life were more likely to be diagnosed with COPD later in life compared to women without these symptoms. Our study supports the inclusion of lung function testing in primary care settings for women over the age of 45 years who have never smoked and have a history of breathing difficulties, asthma or allergies.

20.
J Epidemiol Community Health ; 76(6): 556-562, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34965969

RESUMO

BACKGROUND: Road traffic crashes (RTC) are a leading cause of mortality and morbidity in young people. Severe mental health and behavioural conditions increase the likelihood of RTC, as do a range of driving-risk activities. METHOD: We used data from the Raine Study, a prebirth cohort from Perth, Australia, to assess the relationship between measures of common mental health or behavioural conditions (Child Behavior Checklist Internalising and Externalising scores) at age 17 and subsequent RTC by 27 years, controlling for substance use and driving-risk activities. RESULTS: By 27 years of age, of 937 participants, 386 (41.2%) reported zero crashes and 551 (58.8%) reported ≥1 crashes. In the baseline Poisson model, increased Externalising scores (eg, aggression and delinquency) were associated with increased RTC (incidence rate ratio (IRR)=1.02, 95% CI 1.01 to 1.02): increased Internalising scores (eg, anxiety and depression) were associated with fewer RTC (IRR=0.99, 95% CI 0.98 to 1.00). In the fully adjusted model, the mental health measures were not significant (Externalising IRR=1.01, 95% CI 0.99 to 1.02: Internalising IRR=0.99, 95% CI 0.99 to 1.00). Risky driver activities, such as falling asleep while driving (IRR=1.34), more frequent use of a hands-free telephone (IRR=1.35) and more frequent hostility towards other drivers (IRR=1.30) increased the rate of RTC. CONCLUSION: Measures of mental health scores at age 17 were not predictive of subsequent RTC, after adjusting for measures of driving-risk activities. We need to better understand the determinants of externalising and risky driving behaviours if we are to address the increased risk of RTC.


Assuntos
Acidentes de Trânsito , Condução de Veículo , Adolescente , Agressão , Criança , Estudos de Coortes , Humanos , Saúde Mental , Adulto Jovem
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