The relation between sleep quality during pregnancy and health-related quality of life-a systematic review.

BACKGROUND: The majority of expectant mothers report sleep alterations during pregnancy and almost 40% report poor sleep quality. There is growing evidence that sleep quality (SQ) during pregnancy influences maternal health. This review focuses on how SQ during pregnancy relates to maternal health-related quality of life (HRQoL). The review also aims to identify whether this relation varies between pregnancy trimesters, and for different subdomains of HRQoL. METHODS: A systematic review was performed according to PRISMA guidelines and registered on Prospero in August 2021 with ID no: CRD42021264707. Pubmed, Psychinfo, Embase, Cochrane, and trial registries were searched up to June 2021. Studies with any design that investigated the relation between SQ and quality of life/HRQoL in pregnant women, published in English, and peer-reviewed, were included. Two independent reviewers screened titles, abstracts, and full texts, and extracted data from the included papers. The quality of the studies was evaluated using the Newcastle-Ottawa Scale. RESULTS: Three hundred and thirteen papers were identified in the initial search, of which 10 met the inclusion criteria. Data included 7330 participants from six different countries. The studies had longitudinal (n = 1) or cross-sectional designs (n = 9). In nine studies SQ was reported subjectively by self-report questionnaires. Actigraphic data was available from two studies. HRQoL was assessed by validated questionnaires in all studies. Due to high levels of clinical and methodological heterogeneity in included studies, a narrative synthesis was employed. Nine studies found that poor sleep quality was related to a lower overall HRQoL during pregnancy. Effect sizes were low to medium. This relation was reported most during the third trimester. Especially sleep disturbances and subjective low SQ seemed to be related consistently to lower HRQoL. Furthermore, an indication was found that SQ might have a relation with the mental and physical domain of HRQoL. The social and environmental domain may also be associated with overall SQ. CONCLUSION: Despite the scarcity of studies available, this systematic review found evidence that low SQ is related to low HRQoL during pregnancy. An indication was found that the relationship between SQ and HRQoL during the second trimester might be less prominent.

Post-acute COVID syndrome (long COVID): What should radiographers know and the potential impact for imaging services.

OBJECTIVES: The COVID-19 pandemic caused an unprecedented health crisis resulting in over 6 million deaths worldwide, a figure, which continues to grow. In addition to the excess mortality, there are individuals who recovered from the acute stages, but suffered long-term changes in their health post COVID-19, commonly referred to as long COVID. It is estimated there are currently 1.8 million long COVID sufferers by May 2022 in the UK alone. The aim of this narrative literature review is to explore the signs, symptoms and diagnosis of long COVID and the potential impact on imaging services. KEY FINDINGS: Long COVID is estimated to occur in 9.5% of those with two doses of vaccination and 14.6% if those with a single dose or no vaccination. Long COVID is defined by ongoing symptoms lasting for 12 or more weeks post acute infection. Symptoms are associated with reductions in the quality of daily life and may involve multisystem manifestations or present as a single symptom. CONCLUSION: The full impact of long COVID on imaging services is yet to be realised, but there is likely to be significant increased demand for imaging, particularly in CT for the assessment of lung disease. Educators will need to include aspects related to long COVID pathophysiology and imaging presentations in curricula, underpinned by the rapidly evolving evidence base. IMPLICATIONS FOR PRACTICE: Symptoms relating to long COVID are likely to become a common reason for imaging, with a particular burden on Computed Tomography services. Planning, education and updating protocols in line with a rapidly emerging evidence base is going to be essential.

Computed tomography colonography: Radiographer independent preliminary clinical evaluation for intraluminal pathology.

INTRODUCTION: We evaluated the reporting competency of radiographers providing preliminary clinical evaluations (PCE) for intraluminal pathology of computed tomography colonography (CTC). METHOD: Following validation of a suitable tool, audit was undertaken to compare radiographer PCE against radiology reports. A database was designed to capture radiographer and radiologist report data. The radiographer's PCE of intraluminal pathology was given a score, the "pathology discrepancy and significance" (PDS) score based on the pathology present, any discrepancy between the PCE and the final report, and the significance of that discrepancy on the management of the patient. Agreement was assessed using percentage agreement and Kappa coefficient. Significant discrepancies between findings were compared against endoscopy and pathology reports. RESULTS: There was agreement or insignificant discrepancy between the radiographer PCE and the radiology report for 1736 patients, representing 97.0% of cases. There was a significant discrepancy between findings in 2.8% of cases and a major discrepancy recorded for 0.2% of cases. There was a 98.4% agreement in the 229 cases where significant pathologies were present. CONCLUSION: From a database of 1815 studies acquired over three years and representing work done in a clinical environment, this study indicates a potential for trained radiographers to provide a PCE of intraluminal pathology.

Risk/Benefit Communication about Food-A Systematic Review of the Literature.

A systematic review relevant to the following research questions was conducted (1) the extent to which different theoretical frameworks have been applied to food risk/benefit communication and (2) the impact such food risk/benefit communication interventions have had on related risk/benefit attitudes and behaviors. Fifty four papers were identified. The analysis revealed that (primarily European or US) research interest has been relatively recent. Certain food issues were of greater interest to researchers than others, perhaps reflecting the occurrence of a crisis, or policy concern. Three broad themes relevant to the development of best practice in risk (benefit) communication were identified: the characteristics of the target population; the contents of the information; and the characteristics of the information sources. Within these themes, independent and dependent variables differed considerably. Overall, acute risk (benefit) communication will require advances in communication process whereas chronic communication needs to identify audience requirements. Both citizen's risk/benefit perceptions and (if relevant) related behaviors need to be taken into account, and recommendations for behavioral change need to be concrete and actionable. The application of theoretical frameworks to the study of risk (benefit) communication was infrequent, and developing predictive models of effective risk (benefit) communication may be contingent on improved theoretical perspectives.

Monitoring the dissemination of an educational protocol on pediatric asthma in family practice: a test of associations between dissemination variables.

Many asthma education programs aim at reducing morbidity. Now that effective programs are available, the next step is the nationwide dissemination to achieve morbidity reduction. A dissemination of a tested program has been undertaken in Dutch primary care, guided by the Diffusion of Innovation theory. It was hypothesized that greater awareness and concern and/or receptivity about asthma self-management would make it more likely that family physicians would adopt the program. Family physicians were considered more likely to adopt the program if they saw it as an improvement on their current way of providing education, as easy to use, and as having observable outcomes. It was expected that once the program had been adopted, and as it was being implemented, it would increasingly be perceived by its users as successful. Finally, more perceived success of performance was expected to be related to continued use. Both longitudinal and cross-sectional data largely confirmed the hypotheses.

Goal setting as a strategy for health behavior change.

This article discusses the beneficial effects of setting goals in health behavior change and maintenance interventions. Goal setting theory predicts that, under certain conditions, setting specific difficult goals leads to higher performance when compared with no goals or vague, nonquantitative goals, such as "do your best." In contrast to the graduated, easy goals often set in health behavior change programs, goal setting theory asserts a positive linear relationship between degree of goal difficulty and level of performance. Research on goal setting has typically been conducted in organizational and laboratory settings. Although goal setting procedures are used in many health behavior change programs, they rarely have been the focus of systematic research. Therefore, many research questions still need to be answered regarding goal setting in the context of health behavior change. Finally, initial recommendations for the successful integration of goal setting theory in health behavior change programs are offered.

Determinants of behavioural risk factors for burn injuries.

Systematically developed health education should be based on a thorough knowledge of the determinants of the behavioural risk factors. Compared to other health-related behaviours, safety behaviour has some specific characteristics, which complicate studying its determinants. First, there is a multitude of circumstances leading to injuries, which means that it is not possible to pinpoint one desired behaviour to be linked with the prevention of injuries. Secondly, people are often not familiar with (the advantages and disadvantages of) all the possible preventive measures. Thirdly, the usefulness of preventive measures may depend on housing situations. So far, no elegant way of coping with these problems in examining the determinants of safety behaviour seems to have been suggested in the literature. In this article an approach to the study of determinants of safety behaviour is presented. The general description of this approach is illustrated by a study on the determinants of the behavioural risk factors for burn injuries in young children, which was conducted among Dutch and Turkish parents of children aged 0-4 years. The results indicate, for instance, that parents who implemented the safety behaviour reported that safety behaviour had become habitual to them.

Aetiology of burn injuries among children aged 0-4 years: results of a case-control study.

During the year 1987/1988 a case-control study was conducted, by means of a postal questionnaire, among parents of children aged 0-4 years. Cases (n = 122) were 0-4-year-old Dutch children who visited emergency departments with burn injuries. Controls (n = 213) were a sample of the Dutch population of 0-4-year-old children without burn injuries. Odds ratios based on logistic regression (OR-LR) and 90 per cent confidence intervals (CI (90 per cent) were calculated for a number of putative risk factors. The risk of burns was higher for children with other than Dutch (e.g. Turkish) ethnicity (OR-LR = 5.6; CI (90 per cent) = 2.6-11.9). Children who lived in relatively small houses turned out to have a higher risk of burns (OR-LR = 2.5; CI(90 per cent) = 1.3-4.7). To our surprise, children belonging to lower socioeconomic classes were found to have a decreased risk of burns (OR-LR = 0.3; CI (90 per cent) = 0.1-0.6). Furthermore, among several manipulatable risk factors, the use of an oven window which gets hot while in use appeared to have an increased risk of burns (OR-LR = 2.1; CI(90 per cent) 1.3-3.5). The same holds for the storage of hot drinks in their original pots instead of in vacuum flasks (OR-LR = 2.0; CI (90 per cent) 1.2-3.1). Cooking on a gas stove was found to be another risk factor (OR-LR = 2.5; CI(90 per cent) 1.1-10.0).

The aetiology of burns in developed countries: review of the literature.

This article reviews the literature on the incidence and aetiology of burn injuries. Burn injuries are among the most serious injuries man can incur. Although prevention of burn injuries has been given a good deal of attention in the past, it has never been subjected to a systematic approach which could result in a thorough knowledge of the incidence and the major risk factors and risk groups. The methodological limitations of the studies carried out in this field are striking. For instance, none of the studies of risk factors has used a control population for comparison. No figures are available on the total number of burn injury patients in the Netherlands. Estimates are derived from the situation in other countries, which yields an incidence of four per 1000 per year. Scalds are relatively common in the 0-4-year category. This is usually assumed to be caused by the stage of development of motor and cognitive skills, coupled with incorrect assumptions about these skills by parents. Men are found to be more often the victims of burns than women. Coffee and tea are assumed to be risk factors. The supposed risk factors and risk groups need to be investigated in a controlled epidemiological study, in order to allow establishment of preventive measures.

How to study the aetiology of burn injury: the epidemiological approach.

Effective prevention of burn injury should be based on sound aetiological knowledge. This article deals with epidemiological methods to study the incidence of burn injury as a function of its risk factors. Central methodological issues are comparability of baseline prognosis, comparability of measurements (of effects in cohort studies and of risk factors in case-control studies), and comparability of external circumstances. These principles are clarified with a number of fictitious examples of risk factors for burn injury. It is explained that in preventive trials comparability may be achieved by randomization, blinding and placebo intervention. The main tools in non-experimental studies are deliberate selection and multivariate analysis. Special attention is given to the definition of the source population and to reducing measurement incomparability in case-control studies. Some well-designed case-control studies following these principles might bring effective prevention of burn injury some steps nearer.