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BACKGROUND: Providing effective health education is essential for patients with cancer-related pain. One solution is leveraging instant messaging tools for teach-back health education. OBJECTIVES: This study investigated the effects of WeChat-based teach-back health education on patients with advanced cancer who underwent patient-controlled intrathecal analgesia implantation and used hydromorphone. METHODS: This retrospective study evaluated 150 hospitalized patients with advanced cancer pain. Patients were classified into a conventional health education group (N = 50) and a teach-back group (N = 100) based on whether they received WeChatbased teach-back health education. Pain was rated using a numeric rating scale, and sleep quality was measured using the Pittsburgh Sleep Quality Index at one, two, and three months postdischarge. FINDINGS: Patients who received remote teachback health education better managed their pain. Data also demonstrated improvements in patients' sleep quality and caregiver satisfaction, and reductions in the occurrence of adverse reactions. [ABSTRACT FROM AUTHOR]

Variations in different urinary measurements for evaluating iodine status are concerning to clinicians and researchers. The present study aimed to analyze the interindividual and intraindividual variations in the urinary iodine concentration (UIC) and urinary iodine/creatinine (UI/Cr) ratio and evaluate their application in assessing the iodine nutrition of preschool children. Four repeated spot urine samples were collected from 163 children at different times within one day. The urinary iodine concentration (UIC) and urinary creatinine concentration (UCr) were measured, and the UI/Cr ratio was calculated. The UIC (P < 0.001) and urinary iodine/creatinine ratio (P = 0.019) of multiple measurements were significantly different. The UIC of morning urine was highest (99.83 μg/L) and then gradually decreased with collection time (P < 0.001). In contrast, the UI/Cr ratio of morning urine samples increased with collection time. By computing the mean intraindividual and interindividual coefficients of variance (CV), the intraindividual variation of the UI/Cr ratio (68%) was significantly lower than that of the UIC (86%). Nevertheless, the interindividual variation was lowest in the UIC (78.62%) of morning urine. In addition, the UIC and UI/Cr ratio showed moderate correlations (r = 0.52, P < 0.001), with kappa values of 0.42 in assessing iodine nutrition. The UIC of morning urine samples taken at 8:00–10:00 am was perhaps more stable and reliable in evaluating the iodine nutrition of preschool children at the population level. The UI/Cr ratio showed lower intraindividual variation and may be more suitable for assessing individual iodine nutrition. [ABSTRACT FROM AUTHOR]

To investigate Mandarin Tone 2 production of disyllabic words of prelingually deafened children with a cochlear implant (CI) and a contralateral hearing aid (HA) and to evaluate the relationship between their demographic variables and tone-production ability. Thirty prelingually Mandarin-speaking preschoolers with CI+HA and 30 age-matched normal-hearing (NH) children participated in the study. Fourteen disyllabic words were recorded from each child. A total of 840 tokens (14 × 60) were then used in tone-perception tests in which four speech therapists participated. The production of T2-related disyllabic words of the bimodal group was significantly worse than that of the NH group, as reflected in the overall accuracy (88.57% ± 16.31% vs 99.29% ± 21.79%, p < 0.05), the accuracy of T1+T2 (93.33% vs 100%), the accuracy of T2+T1 (66.67 ± 37.91% vs 98.33 ± 9.13%), and the accuracy of T2+T4 (78.33 ± 33.95% vs 100%). In addition, the bimodal group showed significantly inferior production accuracy of T2+T1 than T2+T2 and T3+T2, p < 0.05. Both bimodal age and implantation age were significantly negatively correlated with the overall production accuracy, p < 0.05. For the error patterns, bimodal participants experienced more errors when T2 was in the first position of the tone combination, and T2 was most likely to be mispronounced as T1 and T3. Bimodal patients aged 3–5 have T2-related disyllabic lexical tone production defects, and their performances are related to tone combination, implantation age, and bimodal age. [ABSTRACT FROM AUTHOR]

Context: Stretching intensity is an important variable that can be manipulated with flexibility training. However, there is a lack of evidence regarding this variable and its prescription in stretching programs. Objective: To investigate the effects of 12 weeks of knee flexor static stretching at different intensities on joint and muscle mechanical properties. Design: A randomized clinical trial. Setting: Laboratory. Participants: A total of 14 untrained men were allocated into the low- or high-intensity group. Main Outcome Measures: Assessments were performed before, at 6 week, and after intervention (12 wk) for biceps femoris long head architecture (resting fascicle length and angle), knee maximal range of motion (ROM) at the beginning and maximal discomfort angle, knee maximal tolerated passive torque, joint passive stiffness, viscoelastic stress relaxation, knee passive torque at a given angle, and affective responses to training. Results: No significant differences were observed between groups for any variable. ROM at the beginning and maximal discomfort angle increased at 6 and 12 weeks, respectively. ROM significantly increased with the initial angle of discomfort (P < .001, effect size = 1.38) over the pretest measures by 13.4% and 14.6% at the 6- and 12-week assessments, respectively, and significantly improved with the maximal discomfort angle (P < .001, effect size = 1.25) by 15.6% and 18.8% from the pretest to the 6- and 12-week assessments, respectively. No significant effects were seen for muscle architecture and affective responses. Initial viscoelastic relaxation for the low-intensity group was lower than ending viscoelastic relaxation. Conclusion: These results suggest that stretching with either low or high discomfort intensities are effective in increasing joint maximal ROM, and that does not impact on ROM, stiffness, fascicle angle and length, or affective response differences. [ABSTRACT FROM AUTHOR]

Frailty, featured by the presence of fatigue, weight loss, decrease in grip strength, decline gait speed and reduced activities substantially increase the risk of falls, disability, hospitalizations, and mortality of older people. Nutritional supplementation and resistance exercise may improve muscle function and reverse frailty status. To evaluate whether whey protein supplements can improve muscle function of frail older people in addition to resistance exercise. 115 community-dwelling older adults who met the Fried's criteria for frailty from four hospitals' out-patients clinic in Beijing, China completed the study. It's a case–control study which whey protein was used as daily supplementation for 12 weeks for active group and regular resistance exercise for active group and control group. Handgrip strength, gait speed, chair-stand test, balance score, and SPPB score were compared in both groups during the 12-week follow-up. Overall, 115 subjects were enrolled for study with 66 in active group and 49 in control group. Handgrip strength, gait speed, and chair-stand time were all significantly improved in both groups with significant between-group differences. The active group improved significantly in handgrip strength compared with the control group, which between-group effect (95% confidence interval) for female was 0.107 kg (0.066–0.149), p = 0.008 and for male was 0.89 kg (0.579–1.201), p = 0.007. For chair-stand time, between-group effect (95% confidence interval) was −2.875 s (−3.62 to −2.124), p = 0.004 and for gait speed, between-group effect (95% confidence interval) was 0.109 m/s (0.090 to 0.130), p = 0.003. The 12-week intervention of whey protein oral nutritional supplement revealed significant improvements in muscle function among the frailty elderly besides aiding with resistance exercise. These results warrant further investigations into the role of a multi-modal supplementation approach which could prevent adverse outcomes among frailty elderly at risk for various disabilities. [ABSTRACT FROM AUTHOR]

Abstract Background Peripherally-inserted central catheter-related venous thrombosis has serious complications including the loss of vascular access, recurrent venous thrombosis, and post-thrombotic syndrome. Current guidelines recommend non-pharmacological strategies to prevent peripherally-inserted central catheter-related venous thrombosis. There is little evidence for the effectiveness of handgrip exercise on the prevention of peripherally-inserted central catheter-related venous thrombosis. Objectives To examine the effectiveness of handgrip exercise using an elastic ball to prevent peripherally-inserted central catheter-related venous thrombosis in patients with solid cancers. Design A randomized controlled trial. Settings One teaching hospital in Nanjing, China. Participants In total, 120 subjects with solid cancers were eligible; each had a new peripherally-inserted central catheter. They were recruited and randomly assigned into two exercise groups and one control group. Methods Subjects from exercise groups 1 and 2 performed a 3-week, 25-repetition handgrip exercise, 3 and 6 times daily, respectively. The control group subjects performed a gentle limb exercise with no frequency and intensity requirements. Ultrasound was used to detect venous thrombosis development and examine axillary vein blood flow over the three points. Results There were 32 cases of peripherally-inserted central catheter-related venous thrombosis detected. Two venous thrombosis cases in the control group were symptomatic, but all venous thrombosis cases in the exercise groups were asymptomatic. All venous thromboses were partial. There were significant differences in the incidence of venous thrombosis among the three groups (χ2 = 12.813, p = 0.002; χ2 = 9.340, p = 0.009; χ2 = 11.480, p = 0.003; and χ2 = 10.534, p = 0.005, respectively) at days 2, 3 and 21. The incidence of venous thrombosis in the two exercise groups was lower than that in the control group over the 3 time points (all, p < 0.05). The between-group effects and interaction effect in vein maximum velocity and time-mean flow velocity showed significant differences (F = 4.180, p = 0.025; F = 4.010, p = 0.045; and F = 2.928, p = 0.025) at days 2, 3, and 21, respectively. The axillary vein blood flow parameters in the control group were lower than those in the two exercise groups at day 21 (all, p < 0.05). However, no significant differences occurred in the incidence of venous thrombosis and axillary vein blood flow parameters between the two exercise groups. Conclusion Handgrip exercise using an elastic ball daily for three weeks could decrease the incidence of peripherally-inserted central catheter-related venous thrombosis. The method is simple, with no negative consequence reported. Further studies are required to confirm this conclusion and to explore the optimal frequency of handgrip exercise. [ABSTRACT FROM AUTHOR]

Aims and objectives: To compare and evaluate the reliability, validity, feasibility, clinical utility, and nurses’ preference of the Premature Infant Pain Profile‐Revised, the Neonatal Pain, Agitation, and Sedation Scale, and the Neonatal Infant Acute Pain Assessment Scale used for procedural pain in ventilated neonates. Background: Procedural pain is a common phenomenon but is undermanaged and underassessed in hospitalised neonates. Information for clinician selecting pain measurements to improve neonatal care and outcomes is still limited. Design: A prospective observational study was used. Methods: A total of 1,080 pain assessments were made at 90 neonates by two nurses independently, using three scales viewing three phases of videotaped painful (arterial blood sampling) and nonpainful procedures (diaper change). Internal consistency, inter‐rater reliability, discriminant validity, concurrent validity and convergent validity of scales were analysed. Feasibility, clinical utility and nurses’ preference of scales were also investigated. Results: All three scales showed excellent inter‐rater coefficients (from 0.991–0.992) and good internal consistency (0.733 for the Premature Infant Pain Profile‐Revised, 0.837 for the Neonatal Pain, Agitation, and Sedation Scale and 0.836 for the Neonatal Infant Acute Pain Assessment Scale, respectively). Scores of painful and nonpainful procedures on the three scales changed significantly across the phases. There was a strong correlation between the three scales with adequate limits of agreement. The mean scores of the Neonatal Pain, Agitation, and Sedation Scale for feasibility and utility were significantly higher than those of the Neonatal Infant Acute Pain Assessment Scale, but not significantly higher than those of the Premature Infant Pain Profile‐Revised. The Neonatal Pain, Agitation, and Sedation Scale was mostly preferred by 55.9% of the nurses, followed by the Neonatal Infant Acute Pain Assessment Scale (23.5%) and the Premature Infant Pain Profile‐Revised (20.6%). Conclusions: The three scales are all reliable and valid, but the Neonatal Pain, Agitation, and Sedation Scale and the Neonatal Infant Acute Pain Assessment Scale perform better in reliability. The Neonatal Pain, Agitation, and Sedation Scale appears to be a better choice for frontier nurses to assess procedural pain in ventilated neonates based on its good feasibility, utility and nurses’ preference. Relevance to clinical practice: Choosing a valid, reliable, feasible and practical measurement is the key step for better management of procedural pain for ventilated newborns. Using the right and suitable tool is helpful to accurately identify pain, ultimately improve the neonatal care and outcomes. [ABSTRACT FROM AUTHOR]

Background: Modified ultrafiltration (MUF) can be performed in infants with ventricular septal defects (VSDs) after cardiopulmonary bypass (CPB) to reduce haemodilution and its potential adverse effects. High-flow MUF might reduce ultrafiltration duration and hasten the necessary correction of haemodilution during CPB. However, its influence on brain oxygenation remains controversial. Objective: This non-randomized, prospective, pilot study aimed to investigate the influence of high-flow MUF on brain oxygenation in infants with VSDs. Methods: High-flow MUF (≥20 mL/kg/min) was performed in twenty infants. Brain oxygen saturation (rSO2) and tissue haemoglobin index (tHI) were non-invasively and continuously measured intraoperatively using near-infrared spectroscopy (NIRS). Transcranial Doppler non-invasively detected the mean flow velocity of the middle cerebral artery (Vmean). Results: rSO2 increased significantly during MUF, as did tHI, Vmean, mean arterial pressure and haematocrit (all p<0.05). No correlation was found between changes in rSO2 and changes in other parameters (all p≥0.05). Conclusion: In infants with ventricular septal defects managed with CPB during VSDs repair, high-flow MUF did not reduce brain oxygenation. [ABSTRACT FROM AUTHOR]

This study investigated the effects of fingertip tactile sensitivity on the structural variability of thumb and index finger forces during stable precision grip. Thirty right-handed healthy subjects participated in the experiment. Transient perturbation of tactile afferents was achieved by wrapping up the distal pads of the thumb or index finger with transparent polyethylene films. The time-dependent structure of each digit force and the variability of interdigit force correlation were examined by detrended fluctuation analysis (DFA) and detrended cross-correlation analysis (DCCA), respectively. Results showed that the tactile sensitivity affected αDFA of the vertical shear force Fx (F3,239 = 6.814, p<0.001) and αDCCA of Fx (χ2 = 16.440, p<0.001). No significant difference was observed in αDFA or αDCCA of the normal forces produced by the thumb or index finger. These results suggested that with blurred tactile sensory inputs the central nervous system might decrease the vertical shear force flexibility and increase the interdigit shear force coupling in order to guarantee a stable grip control of an object against gravity. This study shed light on the feedback and feed-forward strategies involved in digit force control and the role of SA-II afferent fibers in regulation of vertical shear force variability for precision grip. [ABSTRACT FROM AUTHOR]

Pain assessment is crucial for in-labour pain management. Even though women's self-rated pain intensity is the standard for pain relief or analgesic administration, multiparas appear to receive worse in-labour pain management than primiparas do. The discrepancy in pain perception between primiparas and multiparas remains unclear. Healthcare providers tend to think that multiparas endure the pain and report less pain because they have experienced childbirth. To retrospectively analyse the intensity of in-labour pain during first and second vaginal childbirth within the same group of women and explore whether parity may be an influential factor in labour pain intensity. Retrospective cohort study. Labour and delivery in a large academic specialized hospital in Guangzhou, China. Women were included if they had two consecutive vaginal childbirths with singleton cephalic presentations and cervical dilation ≤ 3 cm for the first childbirth and ≤ 2 cm for the second childbirth. The final study sample consisted of 417 women. All childbirth case records between January 2015 and August 2018 were scanned using a structured electronic medical system. Maternal and neonatal demographics as well as obstetric and neonatal outcomes were extracted. The in-labour pain for each childbirth was compared between first and second births. Paired t -tests, McNemar's c hi -square tests and mixed-effects modelling were applied to compare the differences in labour pain intensity between the two vaginal childbirths and explore the factors that influenced maximum labour pain scores during the second childbirth. Four hundred seventeen women were included, with an average birth interval of 1.7 years. The average maximum labour pain score during the latent phase was 6 (5,6) for the first childbirth and 5 (4,6) for the second childbirth (paired t =-6.13, P <0.001). Pain scores decreased in 28.1% (117/417) of women and increased in 13.7% (57/417) of women from the first to the second childbirth. More than half of the women in our study experienced the same maximum labour pain score during the first and second labour. Mixed-effects modelling revealed that parity, education and pregnancy complications were independently associated with maximum labour pain scores. From a clinical point of view, in-labour pain is not clinically different for women when comparing their first and second labours. Health care professionals may underestimate in-labour pain in primiparas when comparing them with nulliparas. More studies are warranted to explore options for achieving better pain management for women with more childbirths. [ABSTRACT FROM AUTHOR]