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1.
J Acad Nutr Diet ; 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-39002858

RESUMO

BACKGROUND: Dietetics preceptors are at risk for abandoning the role of dietetic preceptor because of potential burnout. Identifying factors associated with greater and lesser burnout can help key stakeholders identify and implement strategies that prevent or mitigate burnout in dietetics preceptors. OBJECTIVE: The purpose of this study was to identify factors associated with the burnout preceptors attribute specifically to the work of precepting. DESIGN: This study used a cross-sectional study design. A survey instrument including burnout measures, precepting measures, and items querying personal and work characteristics was distributed via email to a random sample of 10,000 credentialed dietetics professionals. PARTICIPANTS/SETTING: Respondents who lived in the United States, were currently practicing, and had precepted during the past year were included in the sample (n=310). The survey was conducted in October and November of 2022. MAIN OUTCOME MEASURES: Precepting-related burnout was measured using scores on the Copenhagen Burnout Inventory, in which scores range from 0-100, with higher numbers indicating greater burnout. STATISTICAL ANALYSES PERFORMED: Factors associated with precepting-related burnout were identified using an analysis of covariance. Pairwise comparisons with Tukey adjustments were done to determine differences across categories for the categorical variable in the model (percent of interns requiring additional coaching). A step-wise variable selection process was performed to determine the best analytic models. RESULTS: Factors associated with lower precepting-related burnout in dietetics preceptors include higher Commitment to the Preceptor Role (CPR) scores, lower percentages of interns requiring additional coaching, feeling appreciated by the dietetic intern, and higher Preceptors' Perceptions of Support (PPS) scores. A factor associated with higher precepting-related burnout was precepting a greater number of dietetic interns in the past year. For every one-point change in each variable, the degree of change in precepting-related burnout was -7.9 for CPR, -3.2 for feeling appreciated by interns, -4.5 for PPS, and +1.2 for number of interns per year. The average difference in precepting-related burnout scores between preceptors who reported <10% interns requiring additional coaching and those who reported >50% interns requiring additional coaching was-13.7 (3.7). CONCLUSIONS: The factors found to be associated with precepting-related burnout scores in dietetics preceptors are potentially modifiable, suggesting this burnout might be prevented or mitigated to some degree.

2.
J Cyst Fibros ; 2023 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-37926667

RESUMO

BACKGROUND: For children with cystic fibrosis (CF), achieving and maintaining optimal growth by the age of 2 years is critical for future health outcomes. A standardized nutrition screening is needed to identify growth problems, enable timely interventions, and improve nutritional outcomes for children (0 to 2 years) with CF. The purpose of this study was to develop a nutrition screening tool for children (0 to 2 years) with CF to identify nutrition risk at every clinical encounter. METHODS: A retrospective cross-sectional study was used to develop a nutrition screening tool to determine if nutrition interventions needed to change (at-risk) or continue (not at-risk). Retrospective data for pertinent nutrition factors were collected for 99 children attending an accredited CF clinic. The nutrition factors were compared to a dietitian assessment. A stepwise discriminant analysis determined weight-for-age (WFA) and weight-for-length (WFL) z-scores were significant. Then anthropometric data and corresponding dietitian assessment results were collected for children with CF attending two other accredited CF clinics (n = 29, n = 30). Discriminant analysis was used to determine sensitivity and specificity of the nutrition factors and to create a nutrition screening tool equation. RESULTS: The nutrition screening model that included WFA z-score, LFA z-score, WFL z-score, and weight change velocity adequacy determined nutrition risk the best. The sensitivity was 89.7 %, specificity 83.2 %, NPV 93.3 %, and PPV 75.4 % for this model. CONCLUSION: The nutrition screening tool equation developed in this study standardizes the process to identify children (0 to 2 years) with CF at nutrition risk. Further validation is needed.

3.
PLoS One ; 18(8): e0288941, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37578962

RESUMO

Pectus carinatum is a chest wall deformity that is often treated through the wearing of an external brace. The treatment of the deformity could benefit from a greater understanding of chest wall characteristics under prolonged loading. These characteristics are difficult to model directly but empirical studies can be used to create statistical models. 185 patients from 2018-2020 received bracing treatment. Data on the severity of the deformity, treatment pressures, and time of wear were recorded at the first fitting and all subsequent follow-up visits. This data was analyzed using a statistical mixed effects model to identify significant measures and trends in treatment. These models were designed to help quantify changes in chest wall characteristics through prolonged bracing. Two statistical models were created. The first model predicts the change in the amount of pressure to correct the deformity after bracing for a given time and pressure. The second model predicts the change in pressure response by the body on the brace after bracing for a given time and pressure. These models show a high significance in the amount of pressure and time to the changes in the chest wall response. Initial deformity severity is also significant in changes to the deformity. The statistical models predict general trends in pectus carinatum brace treatment and can assist in creating treatment plans, motivating patient compliance, and can inform the design of future treatment systems.


Assuntos
Pectus Carinatum , Parede Torácica , Humanos , Pectus Carinatum/terapia , Resultado do Tratamento , Cooperação do Paciente , Braquetes
4.
Materials (Basel) ; 16(13)2023 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-37445002

RESUMO

Delayed atomic layer deposition (ALD) of ZnO, i.e., area selective (AS)-ALD, was successfully achieved on silicon wafers (Si\SiO2) terminated with tris(dimethylamino)methylsilane (TDMAMS). This resist molecule was deposited in a home-built, near-atmospheric pressure, flow-through, gas-phase reactor. TDMAMS had previously been shown to react with Si\SiO2 in a single cycle/reaction and to drastically reduce the number of silanols that remain at the surface. ZnO was deposited in a commercial ALD system using dimethylzinc (DMZ) as the zinc precursor and H2O as the coreactant. Deposition of TDMAMS was confirmed by spectroscopic ellipsometry (SE), X-ray photoelectron spectroscopy (XPS), and wetting. ALD of ZnO, including its selectivity on TDMAMS-terminated Si\SiO2 (Si\SiO2\TDMAMS), was confirmed by in situ multi-wavelength ellipsometry, ex situ SE, XPS, and/or high-sensitivity/low-energy ion scattering (HS-LEIS). The thermal stability of the TDMAMS resist layer, which is an important parameter for AS-ALD, was investigated by heating Si\SiO2\TDMAMS in air and nitrogen at 330 °C. ALD of ZnO takes place more readily on Si\SiO2\TDMAMS heated in the air than in N2, suggesting greater damage to the surface heated in the air. To better understand the in situ ALD of ZnO on Si\SiO2\TDMAMS and modified (thermally stressed) forms of it, the ellipsometry results were plotted as the normalized growth per cycle. Even one short pulse of TDMAMS effectively passivates Si\SiO2. TDMAMS can be a useful, small-molecule inhibitor of ALD of ZnO on Si\SiO2 surfaces.

5.
Artigo em Inglês | MEDLINE | ID: mdl-36011999

RESUMO

To evaluate if experiencing a short-term exposure (18-months) to factors such as menstrual irregularities, dieting, changes in exercise or body weight, and medication usage is associated with bone mineral density (BMD) in college-aged females. A retrospective survey assessing health behaviors during a recent 18-month time period and a DXA scan were completed in 641 females. A total of 45.5% of participants reported amenorrhea during the 18-month time period. Those who experienced amenorrhea had lower femoral neck BMD (p = 0.018), trochanter (p = 0.018) and spine BMD (p = 0.022) compared to eumenorrheic women. Lifetime oral contraceptive usage longer than six months was negatively associated with BMD at femoral neck (p = 0.018) and total hip (p = 0.021). Women who lost weight trended towards having the lowest BMD at all sites compared to women who gained weight. Following a very-low calorie diet during the time period was negatively correlated with spine BMD (p = 0.001). Time spent in vigorous and very vigorous activity was weakly correlated with some hip BMD sites but time spent in extremely vigorous activity was not. In conclusion, females who experienced weight loss, amenorrhea, or a very low-calorie diet within an 18-month period of time in young adulthood had lower BMD. Additionally, oral contraceptive usage for longer than six months during their lifetime was associated with lower BMD.


Assuntos
Amenorreia , Densidade Óssea , Absorciometria de Fóton , Adulto , Anticoncepcionais Orais/uso terapêutico , Feminino , Humanos , Menstruação , Estudos Retrospectivos , Adulto Jovem
6.
J Relig Health ; 2022 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-35305224

RESUMO

This study evaluated whether Latter-day Saints have more favorable perceptions and practices of food and water emergency preparedness than other households. Individuals across 46 states in the USA completed an online survey in 2014 (n = 572). Results indicated that Latter-day Saints, compared to Non-Latter-day Saints, were more likely to have a disaster supplies kit, to have long-term food storage, to have preserved food by canning/bottling, and to perceive neighborhood/community connectedness. Latter-day Saints had significantly lower odds of having less than one month of food storage available compared to Non-Latter-day Saints. Our findings suggest Latter-day Saints may be better prepared to handle a disaster than Non-Latter-day Saints.

7.
Artigo em Inglês | MEDLINE | ID: mdl-35162245

RESUMO

This study retrospectively compared the prevalence of factors related to the female athlete triad (low energy availability, secondary amenorrhea (SA), low bone mineral density (BMD)), and post-study BMD of female college students and female international volunteer missionaries (volunteers). Female college students (21-26 years) completed a survey that retrospectively assessed an 18-month study period (volunteer service or first 18 months of college); Diet History Questionnaire III (DHQ III) and Dual-Energy X-ray Absorptiometry (DXA) scan were optional. One-way ANOVAs and chi-squared distributions assessed group differences. Logistic regression assessed covariates of SA and BMD; corresponding odds ratios (OR) and confidence intervals (CI) were calculated. Statistical significance was set at p < 0.001. 3683 participants (58.8% volunteers, 31.5% non-volunteers, 9.8% others) provided complete survey data; 246 completed the DHQ III, and 640 had a post-study DXA scan. Volunteers had higher metabolic equivalent (MET) hours than non-volunteers and others (p < 0.001), and higher prevalence of food insecurity (p < 0.001) and SA (p < 0.001). Volunteers had higher odds of SA (OR = 2.17, CI = 1.75-2.62) than non-volunteers. Weight loss, body satisfaction, "other" weight loss methods, increased MET hours, and vomiting during the study period increased participants' odds of SA. Participants' average BMD Z-scores were within the expected range at all sites, with no significant group differences. Volunteers' higher MET hours and higher prevalence of food insecurity and SA did not result in significantly lower post-study period BMD.


Assuntos
Síndrome da Tríade da Mulher Atleta , Absorciometria de Fóton , Densidade Óssea , Feminino , Síndrome da Tríade da Mulher Atleta/complicações , Humanos , Prevalência , Estudos Retrospectivos , Fatores de Risco , Voluntários
8.
Disaster Med Public Health Prep ; 16(3): 1029-1037, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-33820591

RESUMO

OBJECTIVE: To evaluate food and water storage practices in the United States, including the extent that government emergency preparedness guidelines were followed. METHODS: Qualtrics panelists (n = 572) completed a 142-item online survey in August 2014. Cognitive interviews (n = 5) and pilot data (n = 14) informed survey development. Descriptive statistics were used to analyze quantitative data. Open-ended responses related to water storage preparation were classified into 5 categories. RESULTS: Many respondents reported being somewhat or well prepared to provide food and water for their households during a large-scale disaster or emergency. Only 53% met Federal Emergency Management Agency (FEMA) guidelines to have water last at least 3 days. Based on respondents' self-report, it appeared that those who prepared personally-filled containers for water did not carefully follow FEMA instructions. Most respondents had non-perishable foods available, with 96% meeting the FEMA guidelines of at least 3 days of storage. CONCLUSION: Households were generally prepared to provide food and, to a lesser extent, water in emergency situations, but were not consistently following FEMA guidelines. Additional easy-to-follow, evidence-based information may better help citizens accurately implement food and water storage emergency preparedness guidelines.


Assuntos
Defesa Civil , Planejamento em Desastres , Desastres , Estados Unidos , Humanos , Água , Inquéritos e Questionários
9.
Artigo em Inglês | MEDLINE | ID: mdl-34948550

RESUMO

BACKGROUND: Previous research has suggested many households are meeting the Federal Emergency Management Agency's 3-day emergency food and water storage recommendations. The impact of limited economic household resources on emergency preparedness practices related to food and water is uncertain. The purpose of this study was to compare emergency preparedness practices in households participating in United States' food assistance programs with households not participating in these programs. METHODS: A convenience sample of adults (n = 572) completed an online Qualtrics survey. Descriptive statistics, chi-square statistics, and independent t-tests were used to measure differences between households participating in food assistance programs vs. non-participating households. RESULTS: Most households participating in food assistance programs felt prepared to provide household members with food and water during an emergency, which did not significantly differ from non-participating households. Households using food assistance programs had less accessible cash but had similar foods on-hand for an emergency compared to non-participating households. However, they more frequently reported having baby formula/food and less frequently reported having vitamin/mineral supplements compared to non-participating households. CONCLUSIONS: Food assistance programs may be effective in providing enough food and water to help low-income families be prepared for an emergency.


Assuntos
Defesa Civil , Assistência Alimentar , Adulto , Características da Família , Alimentos , Abastecimento de Alimentos , Humanos , Pobreza , Estados Unidos
10.
Artigo em Inglês | MEDLINE | ID: mdl-34360146

RESUMO

This study utilized resonant frequency vibration to the upper body to determine changes in pain, stiffness and isometric strength of the biceps brachii after eccentric damage. Thirty-one participants without recent resistance training were randomized into three groups: a Control (C) group and two eccentric exercise groups (No vibration (NV) and Vibration (V)). After muscle damage, participants in the V group received upper body vibration (UBV) therapy for 5 min on days 1-4. All participants completed a visual analog scale (VAS), maximum voluntary isometric contraction (MVIC), and shear wave elastography (SWE) of the bicep at baseline (pre-exercise), 24 h, 48 h, and 1-week post exercise. There was a significant difference between V and NV at 24 h for VAS (p = 0.0051), at 24 h and 1-week for MVIC (p = 0.0017 and p = 0.0016, respectively). There was a significant decrease in SWE for the V group from 24-48 h (p = 0.0003), while there was no significant change in the NV group (p = 0.9341). The use of UBV resonant vibration decreased MVIC decrement and reduced VAS pain ratings at 24 h post eccentric damage. SWE was strongly negatively correlated with MVIC and may function as a predictor of intrinsic muscle state in the time course of recovery of the biceps brachii.


Assuntos
Técnicas de Imagem por Elasticidade , Mialgia , Exercício Físico , Humanos , Contração Isométrica , Força Muscular , Músculo Esquelético , Vibração
11.
Patient Educ Couns ; 104(11): 2724-2731, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33926810

RESUMO

OBJECTIVE: To (1) explore RDNs' descriptions of patient-centered care (PCC), (2) measure Registered Dietitian Nutritionists' (RDNs) preferences for PCC and (3) identify factors that affect RDNs' PCC preferences. METHODS: A survey instrument including two open-ended items exploring RDN descriptions of and experiences with PCC, the Patient-Practitioner Orientation Scale (PPOS), and various factors that could influence PCC (e.g., work intensification, work engagement, and work/demographic characteristics) was expert reviewed, pilot tested, and distributed electronically to 4697 RDNs. A regression analysis was conducted, and two open-ended items were qualitatively analyzed. RESULTS: Three themes emerged when RDNs described PCC (n = 375): dietitian/patient relationship (95.7%), organizational influence (64.4%), and interprofessional teams (26.3%). RDNs (n = 318) scored 4.60/6 on the PPOS. Higher levels of work engagement were predictive of higher PPOS scores, and heavier workloads were predictive of lower PPOS scores (p < 0.05). Primary work position also influenced PPOS scores (p<0.05). CONCLUSION: RDNs have varying personal definitions of and experiences with PCC, however there are common themes. RDNs generally prefer PCC and score moderately high on the PPOS. PRACTICE IMPLICATIONS: To strengthen preferences for PCC, managers should create manageable workloads and prioritize work engagement. Continued emphasis on interprofessional collaboration with and organizational promotion of RDNs could improve PCC.


Assuntos
Dietética , Nutricionistas , Humanos , Assistência Centrada no Paciente , Inquéritos e Questionários
12.
Clin Nutr ESPEN ; 42: 206-211, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33745579

RESUMO

BACKGROUND & AIMS: Cystic Fibrosis (CF) may impact nutritional status. Handgrip strength (HGS) may be used for nutrition assessment. The objective of the study was to evaluate changes in HGS over time in children with CF compared to children without CF. A secondary purpose was to analyze the relationship of clinical characteristics of CF with HGS. METHODS: A prospective, longitudinal study was conducted. The non-CF group (n = 76) was recruited from a school and the CF group (n = 75) from an accredited CF center. Height, weight, mid-upper arm circumference, triceps skinfold, and HGS were measured at baseline and approximately three and six months in both groups. Data for pulmonary function, nutrition risk, enteral supplementation, CF transmembrane conductance regulator modulator, steroids, antibiotics, vitamin levels, CF related diabetes (CFRD), and recent hospitalization were collected for the CF group. A mixed model determined the difference in the change in HGS between the CF group and the non-CF group. For all analyses, p=<0.05 was significant. RESULTS: The rate of change in HGS z-score in the CF-group (0.18 ± 0.05) versus the non-CF group (0.06 ± 0.06) was not significant (p = 0.15). Initial mean dominant HGS z-score was significantly lower (p = 0.02) in those with vitamin D deficiency (-1.35 ± 0.09) versus those without (-1.02 ± 0.11). HGS z-score significantly (p = 0.02) decreased over time in children with CFRD (-0.19 ± 0.22) versus children without CFRD (0.32 ± 0.14), p = 0.02. CONCLUSION: Serial measurements of HGS may help detect changes in muscle function related to CFRD and vitamin D deficiency. Further investigation is warranted to elucidate HGS's role in nutrition assessment of children with CF.


Assuntos
Fibrose Cística , Criança , Força da Mão , Humanos , Estudos Longitudinais , Avaliação Nutricional , Estudos Prospectivos
13.
PLoS One ; 16(3): e0248109, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33690670

RESUMO

Healthcare professionals provide paid care at work and potentially have caregiving responsibilities outside of work; work responsibilities in addition to child and/or elder care is considered double- or triple-duty care. Employees may experience conflict and/or enrichment as their work and family responsibilities interface. This study's purpose is to explore the work and family interface of Registered Dietitian Nutritionists (RDNs), determine the prevalence of work-family conflict and enrichment, and identify characteristics associated with higher work-family conflict and enrichment scores. A survey instrument assessing caregiving responsibilities and work-family conflict and enrichment was distributed electronically to 4,900 RDNs throughout the United States. Frequencies, means, correlative relationships, and ANCOVA were calculated using SAS software 9.04. Of 1,233 usable responses, nearly two-thirds of RDNs (65.5%) reported providing either double-duty or triple-duty care. About half of RDNs (47.2%) reported work-family conflict and fewer (14.8%) reported family-work conflict. Additionally, most RDNs (79.4%) reported work-family enrichment and even more (85.2%) reported family-work enrichment. Higher work-family conflict scores had correlative relationships with higher levels of burnout, lower life satisfaction, and higher intent to quit. Higher work-family enrichment scores had correlative relationships with lower burnout, higher job satisfaction, higher career satisfaction, higher life satisfaction, and lower intent to quit. Understanding the unpaid caregiving responsibilities of RDNs and the interface of work/family responsibilities may provide insight into career planning for RDNs and guide managers of RDNs in efforts to amplify the contribution of RDNs.


Assuntos
Esgotamento Profissional/psicologia , Cuidadores/psicologia , Nutricionistas/psicologia , Adulto , Idoso , Atenção à Saúde , Família/psicologia , Conflito Familiar/psicologia , Feminino , Pessoal de Saúde , Humanos , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Estados Unidos
14.
Front Microbiol ; 12: 588035, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33574806

RESUMO

Paenibacillus larvae is the causative agent of American Foulbrood (AFB), the most destructive bacterial infection in honeybees. Even antibiotic-sensitive strains of P. larvae can produce recurrent AFB months to weeks post-antibiotic treatment due to the survival of bacterial spores. Recently, phages that infect P. larvae have been shown to effectively combat AFB in the field. Here, we present evidence that phages not only bind to vegetative P. larvae but also bind to P. larvae spores. Spore binding was observed in the results of three specific experiments: (1) bacteria counted by flow cytometry generated quantitative data of FITC-labeled phages that were bound to vegetative bacteria as well as those bound to spores, (2) electron microscopy captured images of phages bound to the surface of spores in both horizontal and vertical positions, and (3) phages incubated with P. larvae spores bound to the spores and created plaques in vegetative bacteria under conditions not conducive to spore activation, indicating that binding to spores is reversible and that the phages are still active. Identification of phages with reversible spore-binding capability for use in phage therapy may improve treatment of sporulating bacterial infections.

15.
Histol Histopathol ; 36(3): 347-353, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33576000

RESUMO

Osteoarthritis (OA), formerly understood to be a result of passive wear, is now known to be associated with chronic inflammation. Cigarette smoking promotes systemic inflammation and has been implicated in increased joint OA incidence in some studies, though the recent observational data on the association are contradictory. We hypothesize that second-hand smoke (SHS) treatment will increase the incidence of OA in a mouse model that has been subjected to a surgical destabilization of the medial meniscus (DMM). To test this hypothesis, we applied either SHS treatment or room air (RA) to mice for 28 days post-DMM surgery. Histopathology findings indicated that the knees of SHS mice exhibited more severe OA than their control counterparts. Increased expression of matrix metalloprotease-13 (MMP-13), an important extracellular protease known to degrade articular cartilage, and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), an intracellular effector of inflammatory pathways, were observed in the SHS group. These findings provide greater understanding and evidence for a detrimental role of cigarette smoke on OA progression and systemic inflammation.


Assuntos
Cartilagem Articular/patologia , Articulações/patologia , Osteoartrite/etiologia , Poluição por Fumaça de Tabaco/efeitos adversos , Animais , Cartilagem Articular/metabolismo , Progressão da Doença , Feminino , Mediadores da Inflamação/metabolismo , Articulações/metabolismo , Metaloproteinase 13 da Matriz/metabolismo , Meniscos Tibiais/cirurgia , Camundongos Endogâmicos C57BL , NF-kappa B/metabolismo , Osteoartrite/metabolismo , Osteoartrite/patologia , Fator de Crescimento Transformador beta1/metabolismo
16.
Front Physiol ; 11: 80, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32132930

RESUMO

Osteoarthritis (OA) is a degenerative joint disease characterized by inflammatory degradation of articular cartilage and subchondral bone. Wogonin, a compound extracted from the plant Scutellaria baicalensis (colloquially known as skullcap), has previously been shown to have direct anti-inflammatory and antioxidative properties. We examined the pain-reducing, anti-inflammatory, and chondroprotective effects of wogonin when applied as a topical cream. We validated the efficacy of delivering wogonin transdermally in a cream using pig ear skin in a Franz diffusion system. Using a surgical mouse model, we examined the severity and progression of OA with and without the topical application of wogonin. Using a running wheel to track activity, we found that mice with wogonin treatment were statistically more active than mice receiving vehicle treatment. OA progression was analyzed using modified Mankin and OARSI scoring and direct quantification of cyst-like lesions at the chondro-osseus junction; in each instance we observed a statistically significant attenuation of OA severity among mice treated with wogonin compared to the vehicle treatment. Immunohistochemistry revealed a significant decrease in protein expression of transforming growth factor ß1 (TGF-ß1), high temperature receptor A1 (HTRA1), matrix metalloprotease 13 (MMP-13) and NF-κB in wogonin-treated mice, further bolstering the cartilage morphology assessments in the form of a decrease in inflammatory and OA biomarkers.

17.
J Speech Lang Hear Res ; 63(3): 647-660, 2020 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-32097060

RESUMO

Purpose This study examined differences in selected acoustic measures of speech and voice according to age and sex and across families. Method Participants included 169 individuals, 79 men and 90 women, from 18 families, ranging in age from 17 to 87 years. Participants reported no history of articulation disorders, stroke or active neurologic disease, or severe-to-profound hearing loss. They read aloud two passages to facilitate examination of the following speech and voice acoustic parameters: fricative spectral moments (center of gravity, standard deviation, skewness, and kurtosis), the proportion of time spent speaking, mean speaking fundamental frequency, semitone standard deviation (STSD), and cepstral peak prominence smoothed. Results The results indicated a significant age effect for fricative spectral center of gravity, spectral skewness, and speaking STSD. There was a significant sex effect for spectral center of gravity, spectral kurtosis, and mean fundamental frequency. Familial relationship was significant for spectral skewness, STSD, and cepstral peak prominence smoothed. Conclusions These findings revealed that certain speech and voice features change with age and some change differently for men and women. Additionally, speakers from the same family units may demonstrate similar patterns for prosody, voicing, and articulatory behavior. The results also demonstrated normal differences in speech and voice variation across age, sex, and family unit. Understanding patterns and differences across these demographic variables in healthy speakers is important to distinguishing more confidently between normal and disordered speech and voice patterns clinically.


Assuntos
Fala , Voz , Acústica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Acústica da Fala , Medida da Produção da Fala , Adulto Jovem
18.
J Am Assoc Nurse Pract ; 31(10): 562-572, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31425377

RESUMO

BACKGROUND AND PURPOSE: The United States Preventative Services Task Force (USPSTF) recommends breast cancer risk-screening tools to help primary care providers determine which unaffected patients to refer to genetic specialists. The USPSTF does not recommend one tool above others. The purpose of this study was to compare tool performance in identifying women at risk for breast cancer. METHODS: Pedigrees of 85 women aged 40-74 years with first-degree female relative with breast cancer were evaluated using five tools: Family History Screen-7 (FHS-7), Pedigree Assessment Tool, Manchester Scoring System, Referral Screening Tool, and Ontario Family History Assessment Tool (Ontario-FHAT). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to describe each tool's ability to identify women with elevated risk as defined by Claus Model calculations (lifetime risk ≥15%). Receiver operating curves were plotted. Differences between areas under the curve were estimated and compared through logistic regression to assess for differences in tool performance. CONCLUSIONS: Claus calculations identified 14 of 85 women with elevated risk. Two tools, Ontario-FHAT and FHS-7, identified all women with elevated risk (sensitivity 100%). The FHS-7 tool flagged all participants (specificity 0%). The Ontario-FHAT flagged 59 participants as needing referral (specificity 36.2%) and had a NPV of 100%. Area under the curve values were not significantly different between tools (all p values > .05), and thus were not helpful in discriminating between the tools. IMPLICATIONS FOR PRACTICE: The Ontario-FHAT outperformed other tools in sensitivity and NPV; however, low specificity and PPV must be balanced against these findings. Thus, the Ontario-FHAT can help determine which women would benefit from referral to genetics specialists.


Assuntos
Neoplasias da Mama/diagnóstico , Programas de Rastreamento/normas , Encaminhamento e Consulta/normas , Medição de Risco/normas , Adulto , Idoso , Neoplasias da Mama/epidemiologia , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Anamnese , Pessoa de Meia-Idade , Encaminhamento e Consulta/estatística & dados numéricos , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos
19.
J Acoust Soc Am ; 145(2): 775, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30823814

RESUMO

Occupational speech users such as schoolteachers develop voice disorders at higher rates than the general population. Previous research has suggested that room acoustics may influence these trends. The research reported in this paper utilized varying acoustical conditions in a reverberant room to assess the effects on vocal parameters of healthy talkers. Thirty-two participants were recorded while completing a battery of speech tasks under eight room conditions. Vocal parameters were derived from the recordings and the statistically significant effects of room acoustics were verified using mixed-model analysis of variance tests. Changes in reverberation time (T20), early decay time (EDT), clarity index (C50), speech transmission index (STI), and room gain (GRG) all showed highly correlated effects on certain vocal parameters, including speaking level standard deviation, speaking rate, and the acoustic vocal quality index. As T20, EDT, and GRG increased, and as C50 and STI decreased, vocal parameters showed tendencies toward dysphonic phonation. Empirically derived equations are proposed that describe the relationships between select room-acoustic parameters and vocal parameters. This study provides an increased understanding of the impact of room acoustics on voice production, which could assist acousticians in improving room designs to help mitigate unhealthy vocal exertion and, by extension, voice problems.


Assuntos
Acústica , Acústica da Fala , Voz/fisiologia , Absorção de Radiação , Disfonia/fisiopatologia , Feminino , Humanos , Masculino , Saúde Ocupacional , Fonação/fisiologia , Medida da Produção da Fala , Qualidade da Voz/fisiologia
20.
J Sports Med Phys Fitness ; 59(2): 210-216, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29327828

RESUMO

BACKGROUND: While stretching with vibration has been shown to improve static flexibility; the effect of stretching with vibration on dynamic flexibility is not well known. The purpose of this study was to examine the effectiveness of stretching with vibration on acute dynamic flexibility and jump height in novice and advanced competitive female gymnasts during a split jump. METHODS: Female gymnast (N.=27, age: 11.5±1.7 years, Junior Olympic levels 5-10) participated in this cross-over study. Dynamic flexibility during gymnastic split jumps were video recorded and analyzed with Dartfish software. All participants completed both randomized stretching protocols with either the vibration platform turned on (VIB) (frequency of 30 Hz and 2 mm amplitude) or off (NoVIB) separated by 48 h. Participants performed 4 sets of three stretches on the vibration platform. Each stretch was held for 30 seconds with 5 seconds rest for a total of 7 minutes of stretch. RESULTS: Split jump flexibility decreased significantly from pre to post measurement in both VIB (-5.8±5.9°) (P<0.001) and NoVIB (-2.6±6.1°) (P=0.041) conditions (adjusted for gymnast level). This effect was greatest in lower skill level gymnasts (P=0.003), while the highest skill level gymnasts showed no significant decrease in the split jump (P=0.105). Jump height was not significantly different between conditions (P=0.892) or within groups (P=0.880). CONCLUSIONS: An acute session of static stretching with or without vibration immediately before performance does not alter jump height. Stretching with vibration immediately prior to gymnastics competition decreases split jump flexibility in lower level gymnasts more than upper level gymnasts.


Assuntos
Ginástica/psicologia , Exercícios de Alongamento Muscular/métodos , Músculo Esquelético/fisiologia , Vibração , Adolescente , Criança , Estudos Cross-Over , Feminino , Humanos , Amplitude de Movimento Articular/fisiologia
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