Immediate effects of real-time postural biofeedback on spinal posture,muscle activity,and perceived pain severity in adults with neck pain

BackgroundPrevious studies have investigated various types of postural biofeedback devices on different body regions to improve posture; however, they focused only on healthy adults without a history of chronic musculoskeletal disorders. In addition, those postural biofeedback devices used in previous studies are often designed for experimental research. The designs are usually bulky with many wires, which is not practical for everyday use.Research questionThe aim of this study was to determine the immediate effect of a commercially available real-time postural biofeedback device on spinal posture, muscle activity, and perceived pain severity in adults with neck pain.Methods21 adults who had chronic or recurrent nonspecific neck pain for more than 3 months and whose pain was induced or aggravated by prolonged computer work were enrolled in this study. Spinal posture (head tilt, neck flexion, cervical and thoracic angles), muscle activity (cervical erector spinae, upper trapezius, and thoracic erector spinae), and self-reported neck and shoulder pain were measured during computer typing tasks, with and without biofeedback.ResultsCompared with the non-biofeedback condition, the biofeedback condition significantly decreased neck flexion, upper cervical, and lower thoracic angles and lowered the activity of the cervical erector spinae. Self-reported neck pain was not influenced by the application of biofeedback, but significantly increased over the 1-hour typing task.SignificanceThe application of a commercially available wearable real-time biofeedback device improves sitting posture and reduces muscular activity in adults with nonspecific neck pain during computer work. Future studies should examine the long-term effects of wearable real-time postural biofeedback devices for prevention and management of neck pain.     

Circadian Rhythmicity as a Predictor of Quality of Life in Allogeneic Hematopoietic Cell Transplant Patients

Context

Quality of life (QoL) is increasingly recognized as an important outcome of cancer treatment. Previous studies have examined clinical predictors of QoL, but with the increasing prevalence of wearable sensors that monitor sleep and activity patterns, further investigation into whether these behaviors are predictive of post-treatment QoL is now feasible. Among patients receiving aggressive cancer treatment such as hematopoietic cell transplantation (HCT), analysis of circadian rhythms (24-hour patterns of sleep and activity) via wearable sensors is limited.

Assessment and management of the predicted difficult airway in babies and children

Although it is essential to take a history and examine every child prior to airway management, preoperative anticipation of a difficult airway is not totally reliable and therefore it is wise to be prepared for the unexpected difficult airway. Information about the airway can be gained from previous medical records, current history, physical examination and other tests. A natural consequence of airway assessment is development of an airway plan. Important anatomical and physiological features may be identified in an airway assessment which can then have a direct influence on the subsequent airway plan. Managing the predicted difficult airway is usually elective. This allows proper preparation of equipment, assistants, expertise and the environment required for the airway plan. This article will discuss paediatric airway assessment, outline those features that contribute to airway difficulty, and identify indications and risk factors associated with various airway techniques. Key objectives for an airway management plan are to maintain oxygenation and avoid trauma. This involves adopting techniques that avoid hypoxia and provide a high success rate with minimum attempts.     

Contraception in autoimmune diseases

Autoimmune diseases (AIDs) affect women and men with a 2:1 ratio, which suggests that hormonal contraceptives play a role in their clinical course.Combined oral contraceptives have complex, sometimes contradictory, effects on AIDs; they can worsen the situation in women with systemic lupus erythematosus and with anti-phospholipid syndrome, conditions in which they are contraindicated. Early studies indicated a positive effect on rheumatoid arthritis (RA), whereas more recent trials failed to do so, possibly because of the lowering of oestrogen content. Evidence of effects on multiple sclerosis (MS) is conflicting: risk may vary depending on the progestin used. Minor adverse effects may exist on inflammatory bowel diseases, and no significant effect was found on autoimmune thyroid diseases. Women can become sensitised to sex hormones.Progestin-only contraceptives may be used, although copper-releasing intra-uterine devices represent the best option.Finally, several organisations have issued guidelines for contraceptive use in women with AIDs.     

Prendre en compte le lien entre la vision et la motricité dans la démarche thérapeutique – Collaboration entre professionnels

Vision and motor skills are intimately linked, both in their own development and functionally. The solicitation of one can therefore promote the development of the other. The various professionals of motor skills (physiotherapist, psychomotor therapists, occupational therapists) and the orthoptists are called upon to integrate these aspects in the follow-up of the patients, as well in the guides as in the installations.     

Innovation in Chemistry,Manufacturing, and Controls—A Regulatory Perspective From Industry

This review describes the landscape of novel modalities such as cell and gene therapies, viruses, other novel biologics, oligomers, and emerging technologies, including modern analytics. We summarize the regulatory history and recent landmark developments in some major markets and examine specific chemistry, manufacturing, and controls (CMC) challenges, including suggestions for exploration of potential science-based approaches in support of regulatory strategy development from an industry perspective. In addition, we evaluate the economic factors contributing to patient access to innovation and discuss the impact of regulation. There is a desperate need for a consistent form of regulation where global approaches to regulatory strategies can be harmonized, and specific CMC challenges can be dealt with using the appropriate science and risk-based tools. Although these tools are well described in current guidance documents, the specifics of applicability to complex novel modalities can still result in differing regulatory advice and outcomes. The future goals for efficiently regulating innovative modalities and technologies could be aided by more regulatory harmonization, regulatory education, and industry cooperation through consortia, enabling industry to supply key information to regulators in a transparent yet well-defined manner, and utilizing mutually understood risk-benefit analyses to produce drugs with appropriate safety, efficacy, and quality characteristics.     

A qualitative study on participants’ experiences with a community-based mindful walking intervention and mobile device activity measurement

BackgroundMindful walking (MW) interventions employ mindfulness training combined with physical activity. Wearable mobile devices have been increasingly used to measure outcomes of physical activity interventions. The purpose of this study was to understand MW participants’ attitudes towards MW and the use of mobile devices in health promotion interventions, including barriers and facilitators of intervention engagement and adherence. Few qualitative studies have documented participant experience with these two types of interventions.MethodThe pilot study involved a randomized MW intervention including 38 participants with self-reported inadequate physical activity. Half of them were randomized to receive MW intervention plus a FitBit device and the other received the FitBit device only. We used a qualitative thematic analysis of the narrative data collected through open-ended survey questions at three time points. Participants in the MW intervention were asked to describe their experiences with MW, while all participants were asked to describe their experience with wearing the FitBit to track their step counts. Results: Participants reported a broad range of perceived benefits and challenges related to adopting the MW intervention and using the mobile device. Participants were generally willing to try to adopt the recommended MW practice and to see value of MW in increasing physical activity and improving overall health. Participants reported using a variety of additional device features beyond goal setting and step counts, indicating using the devices may have been effective in providing additional motivation for participants in meeting physical activity goals in both the control and intervention groups. While most of the feedback about MW (in the intervention group) and the device (all participants) was overwhelmingly positive, a minority of participants reported barriers such as lack of patience with meditation and discomfort with wearing the device.ConclusionMost participants in the MW intervention see the health benefits of this program and most participants using the wearable physical activity tracking device reported the motivational benefits of this device. Issues with the MW intervention (e.g., lack of patience) and the wearable device (e.g., discomfort with wearing) need to be addressed in future interventions.     

基于穿戴式智慧衣的心电远程实时监护系统设计

目的:针对目前心电监护系统在穿戴式、实时性和数据分析上存在的不足之处,设计一种基于穿戴式智慧衣的心电远程实时监护系统。方法:该系统包括穿戴式智慧衣、Android智能手机App和私有云服务器3个部分。通过穿戴式智慧衣实时采集老年人心电信号。Android智能手机App通过无线蓝牙技术接收心电数据,实时传输心电数据到私有云服务器。私有云服务器接收智能手机传输的心电数据,采用基于机器学习的心电分类算法对心电数据进行房颤检测。云端服务器的云端心电图实时监护平台实时显示心电图和心电分析结果,辅助社区监护人员监护老年人心电。结果:心电分类算法的房颤检测效果较好,该系统的心电数据采集和数据远程传输可靠,监护功能运行正常。结论:该系统可以在社区中对老年人进行心电远程实时监护和房颤检测。     

Wearable activity trackers and health awareness: Nursing implications

PurposeWearable devices are commonly used to measure physical activity. However, it remains unclear the effect of wearing these devices on health awareness. Our aim was to provide evidence related to wearing physical activity trackers and health awareness.MethodsA quantitative comparison study design was used comparing participants who wore physical activity tracking devices (n = 108) and those who did not (n = 112). A paper-based Physical Health Knowledge survey designed for the purpose of this research was used for data collection in 2018.ResultsA difference between participants who wore physical activity tracking devices and those that did not was identified in relation to activity levels and physical health awareness. Wearable devices are suggested as an opportunity for nurses to engage people in physical activity with the potential to improve their health awareness.ConclusionsNurses are well placed in the healthcare landscape to work with patients who own an activity tracker device concerning increasing activity self-monitoring. This information the patient has from the device can also form the basis of health discussions between nurses and the people in their care.     

Intrauterine Device Initiation After Gonococcal and Chlamydial Infections: A Practice Workflow Initiative

Unplanned pregnancy remains an issue in the United States. The intrauterine device (IUD) is a solution. The IUD is safe for most women and is recommended for adolescents. Misconceptions exist about IUDs and sexually transmitted infections caused by Neisseria gonorrhoeae and Chlamydia trachomatis. Accepted guidelines ensure the management of these sexually transmitted infections and subsequent, safe initiation of the IUD. The use of best practice alerts preserves the health care team’s adherence to clinical guidelines. This IUD provision initiative creates a workflow for the interprofessional team to ensure the safe initiation of an IUD to clients with a gonococcal or chlamydial infection.