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Logistic Regression Analysis of Factors Influencing the Effectiveness of Intensive Sound Masking Therapy in Patients with Tinnitus
Get PDFObjectives: To investigate factors influencing the effectiveness intensive sound masking therapy on tinnitus using Logistic Regression Analysis.
Design: The study used a retrospective cross-section analysis.
Participants: 102 patients with tinnitus were recruited at the Sun Yat-sen Memorial Hospital of Sun Yat-sen University, China.
Intervention: Intensive sound masking therapy was used as an intervention approach for patients with tinnitus.
Primary and secondary outcome measures: participants underwent audiological investigations and tinnitus pitch and loudness matching measurements, followed by intensive sound masking therapy. The Tinnitus Handicap Inventory (THI) was used as the outcome measure pre- and post-treatment. Multivariate logistic regression was performed to investigate the association of demographic and audiological factors with effective therapy.
Results: According to the THI score changes pre-and post-sound masking intervention, fifty-one participants were categorised into an effective group, the remaining 51 participants were placed in a non-effective group. Those in the effective group were significantly younger than those in the non-effective group (p=0.012). Significantly more participants had flat audiogram configurations in the effective group (p=0.04). Multivariable logistic regression analysis showed that age (OR=0.96, 95% CI: 0.93, 0.99, p=0.007), audiometric configuration (p=0.027) and THI score pre-treatment (OR=1.04, 95% CI: 1.02, 1.07, p<0.001) were significantly associated with therapeutic effectiveness. Further analysis showed that patients with flat audiometric configurations were 5.45 times more likely to respond to intervention than those with high-frequency steeply sloping audiograms (OR=5.45, 95% CI: 1.67, 17.86, p=0.005).
Conclusion: Audiometric configuration, age and THI scores appear to be predictive for the effectiveness of sound masking treatment. Gender, tinnitus characteristics and hearing threshold measures seem not to be related to treatment effectiveness. Further randomized control study is needed to provide further evidence of the effectiveness of prognostic factors in tinnitus interventions
The effect of sepsis and septic shock on the viscoelastic properties of clot quality and mass using rotational thromboelastometry: a prospective observational study
Get PDFPurpose: The study purpose was to define changes in coagulation across the sepsis spectrum using rotational thromboelastometry (ROTEM).Methods: Sepsis patients were recruited on admission to the Emergency Department and Intensive Care Units of a large teaching hospital in Wales. ROTEM markers of clot development and fibrinolysis were determined, as well as standard coagulation markers. A healthy control group matched for age and gender was also recruited (n = 44). Results: 100 patients were recruited (50 sepsis, 20 severe sepsis and 30 septic shock). Maximum clot firmness was significantly higher in the sepsis (p < 0.001) and severe sepsis (p = 0.012) groups than the healthy control (71.6 ± 4.5 and 70.4 ± 4.1 vs 64.4 respectively). In septic shock there was prolonged clot development; however, maximum clot firmness remained normal. Fibrinolytic function was significantly impaired in septic shock, which was also significantly associated with 28-day mortality (p < 0.001). Conclusions: ROTEM indicated significantly enhanced clot structural development in sepsis and severe sepsis, which could be indicative of a hypercoagulable phase. In septic shock, despite there being a prolongation of clotting pathways and impaired fibrinolysis, clot mass was comparably normal, suggestive of the development of a clot with healthy characteristics
Low cost carriers versus traditional carriers and its impact on financial performance: a comparative study on the UAE airlines companies
Get PDFThe initial appearance of US low-cost carriers forced incumbents to create new forms of competitive advantage. However, these hindrances proved to be successful for nearly two decades. In any case, a new report by the NBK capital, an investment bank based in Kuwait, recorded that in the Middle East, especially in the Gulf region, the low cost carrier sector has established itself as a thriving industry with lots of potential in hardly four years. This paper endeavours to highlight some of the differences between the two markets and it gives an explanation as to how the advantages of the Middle East low cost airlines would be enough to bypass the financial performance of the traditional carriers
Differential impact of water immersion on arterial blood flow and shear stress in the carotid and brachial arteries of humans
Get PDFArterial shear stress is a potent stimulus to vascular adaptation in humans. Typically, increases in retrograde shear have been found to acutely impair vascular function while increases in antegrade shear enhance function. We hypothesized that blood flow and shear stress through the brachial and carotid arteries would change in a similar manner in response to water immersion, an
intervention which modifies hemodynamics. Nine healthy young male subjects were recruited to undergo controlled water immersion in a standing upright position to the level of the right atrium in 30°C water. Diameters were continuously and simultaneously recorded in the brachial and common carotid arteries along with mean arterial pressure (MAP), cardiac output (CO), and heart rate before, during, and after 10 min of immersion. MAP and CO increased during water immersion (baseline vs. 8–10 min; 80 9 vs. 91 12 mmHg; and 4.8 0.7 vs. 5.1 0.6 L/min, P < 0.01 and P < 0.05, respectively). We observed a differential regulation of flow and shear stress patterns in the brachial and carotid arteries in response to water immersion; brachial conductance decreased markedly in response to immersion (1.25 0.56 vs. 0.57 0.30 mL.min/mmHg, P < 0.05), whereas it was unaltered in the carotid artery (5.82 2.14 vs. 5.60 1.59). Our findings indicate that adaptations to systemic stimuli and arterial adaptation may be vessel bed specific in humans, highlighting the need to assess multiple vascular sites in future studies
Honey is potentially effective in the treatment of atopic dermatitis: Clinical and mechanistic studies
Get PDFIntroduction: As manuka honey (MH) exhibits immunoregulatory and anti-staphylococcal activities, we aimed to investigate if it could be effective in the treatment of atopic dermatitis (AD).
Methods: Adult volunteers with bilateral AD lesions were asked to apply MH on one site overnight for 7 consecutive days and leave the contralateral site untreated as possible. Three Item Severity score was used to evaluate the response. Skin swabs were obtained from both sites before and after treatment to investigate the presence of staphylococci and enterotoxin production. In addition, the ability of MH and its methanolic and hexane extracts to down regulate IL4-induced CCL26 protein release from HaCaT cells was evaluated by enzyme linked immunosorbent assay. Also, the ability of MH to modulate calcium ionophore-induced mast cell degranulation was assessed by enzyme immunoassay.
Results: In 14 patients, AD lesions significantly improved post MH treatment vs. pre-treatment as compared to control lesions. No significant changes in the skin staphylococci were observed after day 7, irrespective of honey treatment. Consistent with the clinical observation, MH significantly down regulated IL4-induced CCL26 release from HaCaT cells in a dose dependent manner. This effect was partially lost, though remained significant, when methanolic and hexane extracts of MH were utilized. In addition, mast cell degranulation was significantly inhibited following treatment with MH.
Conclusions: MH is potentially effective in the treatment of AD lesions based on both clinical and cellular studies through different mechanisms. This needs to be confirmed by randomized and controlled clinical trials.
Perceptions of Psychological Momentum of Elite Soccer Players
Get PDFThe purpose of this research was to investigate elite soccer players’ perceptions and experiences of psychological momentum (PM) using a mixed methodological approach. Specifically, by comparing responses, the study aimed to provide coaches with a more appropriate method for collecting PM data. Interviews and focus groups were conducted with 10 English Academy, elite male soccer players. In addition, 75 professional male soccer players completed a 49-item measure about their experiences of PM. Interviews and focus groups were manually analysed using a combination of inductive and deductive approaches with Chi-square tests used to assess differences between responses to the PM measure. The majority of questionnaire responses were supported by themes highlighted by players interviewed. Scoring and conceding goals were the most frequently reported match variables associated with positive and negative PM, respectively. In addition, ‘feeling confident’, ‘having a positive attitude’ and ‘being cohesive as a team’ were important aspects of positive PM. A ‘perceived lack of ability’ and ‘feeling anxious’ were the most frequently reported experiences of negative PM. The similarity of results from both methods support the measure as a useful tool for coaches to collect data pertaining to players’ experiences and perceptions of PM. Overall, findings suggest that PM is a complex (dynamic) process whereby triggers, characteristics, and consequences can hardly be separated. By understanding players’ experiences and perceptions of PM, coaches may incorporate specific training methods to help players maximise positive PM, reduce negative PM as well as develop strategies to optimise PM
Martial arts pedagogies and practice: A report on the contributions to coaching knowledge
Get PDFThe 4th International Coaching Conference held at Cardiff Metropolitan University, UK, showcased a range of studies concerning pedagogy in martial arts (MA). They varied in regards to their underpinning discipline, theory and method, but were united by a concern for enhancing practice in both pedagogy (the science) and pedagogies (the objects of study). One theoretical talk advocated a study of individual practices (techniques of the body and their corresponding methods) via praxiography in relation for a balanced, critical health pedagogy examining the duality of ‘dark’ and ‘light’ aspects. This in turn was applied by an emerging study looking at rapid weight loss practices in Judo and other combat sports that is beginning to scrutinise policies in order to regular this problem. Meanwhile, an investigation into the mental toughness of Karate practitioners uncovered similarly alarming findings on extreme training methods among veteran Welsh Karateka, while another study of a British context of Savate and Capoeira shared ways of studying MA pedagogies in their total form through traditional approach to ethnography. Together, these papers exemplify the increasing corpus of knowledge on teaching and learning in MA that could support that of coaching alongside sport and body pedagogy
Management and leadership in UK universities: exploring the possibilities of change
Get PDFThis paper considers the case for reform of management struc- tures in UK universities and offers proposals for change. The model of top-down, performance-led management that characterises many institutions is both outmoded and ill-suited to the chal- lenges of an increasingly turbulent higher education sector. Drawing on the experiences of a university that introduced a new scheme of performance management, I explore alternative approaches to leadership and management, collaborative or part- nership working designed to improve employee voice and the need to re-evaluate approaches to Human Resource Management. I conclude with a five-point model for change
Design for dementia: Making spaces for uncertainty
Get PDFThis paper presents research undertaken as part of the LAUGH project to explore design processes and design of hand held playful objects for people living with advanced dementia. A series of six co-design workshops were carried out with experts in relationto dementia and design. This paper reports on a workshop with designers that enabled them to draw on their experience and training in design, provided creative opportunities to reflect on their personal values, and challenged preconceptions about designing for dementia care
The role of violent thinking in violent behaviour; it’s more about thinking than drinking
Get PDFThis article aims to explore and report on violent thinking and alcohol misuse; how these factors may predict self-reported violence. The role of violent thinking in violent behavior is both well established in theoretical models, yet there are few measures that explain this role. One measure that has been identified is the Maudsley Violence Questionnaire (MVQ). This is the first study to explore the use of the MVQ with a general (nonoffender) adult sample, having already been shown to be valid with young people (under 18 years old), adult male offenders, and mentally disordered offenders. This study involved 808 adult participants—569 female and 239 male participants. As figures demonstrate that around half of all violent crime in the United Kingdom is alcohol related, we also explored the role of alcohol misuse. Regression was used to explore how these factors predicted violence. The results demonstrate the important role of violent thinking in violent behavior. The MVQ factor of “Machismo” was the primary factor in regression models for both male and female self-reported violence. The role of alcohol in the regression models differed slightly between the male and female participants, with alcohol misuse involved in male violence. The study supports theoretical models including the role of violent thinking and encourages those hoping to address violence, to consider “Machismo” as a treatment target. The study also provides further validation of the MVQ as a helpful tool for clinicians or researchers who may be interested in “measuring” violent thinking