Effect of aeromedical training on anxiety levels of ab initio pilots

Purpose Aeromedical training is meant to train aircrew in combating physiological problems that they might face in flight. Given the importance of the training, there are limited studies in the literature investigating the anxiety levels during aeromedical training along with training outcomes. This study aims to assess the untrained participants’ anxiety levels before and after aeromedical training, investigate the differences in anxiety levels across different physiological training devices and determine whether participants’ anxiety levels affect their G tolerances. Design/methodology/approach This study was carried out on 61 healthy male subjects (n = 61) who had applied for initial aeromedical training. Anxiety surveys and visual analog scales were administered before and after the practical aeromedical training. In addition, blood pressure and heart rate measurements were carried out. Findings Participants had significantly higher anxiety levels before human centrifuge training (pre-Glab) than before the altitude chamber training (pre-hypobaric). Participants who experienced G-induced loss of consciousness (G-LOC) had slightly more anxiety reported than the non-G-LOC group. There was a significant decrease between pre-Glab and post-Glab (after the human centrifuge training) and between pre-hypobaric and post-hypobaric (after the altitude chamber training) anxiety levels. The incidence of G-LOC was lower in participants having higher pre-G-Lab blood pressure. However, the difference in anxiety levels between the G-LOC group and the non-G-LOC group was not statistically significant. Research limitations/implications In this study, state anxiety inventory was not performed after human centrifuge training as centrifuge training lasted for around 5 min only, and it is not advisable to repeat state anxiety inventory in such short periods. Blood pressure was not measured after G-Lab training because human centrifuge training is hard training and has an impact on blood pressure. Hence, it would have been difficult to distinguish whether the blood pressure change was due to anxiety or hard physical activity. These limitations, especially for the G-Lab, caused us to evaluate state anxiety only with VAS. It would be worthwhile to repeat similar studies with objective measurements before and after the training. Practical implications This information suggests that instructors who train the applicants on aerospace medicine be ready for the possible consequences of anxiety. Originality/value There are only a few centers in the world that include all the physiological training devices (practical aeromedical training laboratories) together. To the best of authors’ knowledge, there are no studies in the literature investigating the differences in anxiety levels across various physiological training devices. The studies about the effect of anxiety levels on aeromedical training outcomes and anxiety levels before and after the training are scant.

Utility of Visual Analog Scale of Subdomain Scores of the 22-Item Sinonasal Outcome Test in Chronic Rhinosinusitis

The burden of chronic rhinosinusitis (CRS) symptomatology is frequently measured with the 22-item Sinonasal Outcome Test (SNOT-22). In some situations, such as when there is need for frequent sampling, a full SNOT-22 may be impractical, and an abbreviated measure may be useful. Herein, we study 4 questions reflecting the 4 SNOT-22 subdomains as accurate reflections of SNOT-22 content. In total, 250 patients with CRS completed a SNOT-22 and answered 4 questions about their total nasal symptoms, poor sleep quality, ear/facial pain, and mood (reflecting SNOT-22 subdomains) using visual analog scales (VASs). The 4 SNOT-22 subdomain VAS scores each correlated strongly with the corresponding SNOT-22 subdomain scores. The sum of the 4 subdomain question VAS scores was highly correlated with the total SNOT-22 score ( r = 0.77, P < .001). This preliminary study suggests information from the SNOT-22 may be ascertained through 4 questions reflecting the 4 SNOT-22 subdomains, although further validation is needed.

Comparative analysis of visual analog scales for assessing acute pain in women after radical mastectomy

BACKGROUND: Effective quantitative assessment of acute pain as an urgent problem in clinical medicine. One of the solutions to this problem is a color discrete scale (CDS). AIM: To determine the efficacy of the clinical usage of color discrete scale compared with linear visual analog scale to assess acute pain in women after radical mastectomy. MATERIALS AND METHODS: This study includes a prospective, observational, and non-randomized clinical trial. A total of 110 females who underwent radical mastectomy (RM) were interviewed. We used a 100-point linear visual analog scale (lVAS) and CDS with monotonic (mCDS) and random (rCDS) color arrangement. Pain was assessed 2, 6, 12, 24, 48, and 72 h after surgery. RESULTS: Pain scores obtained 2 h after RM were 6 (0; 30), 12 (0; 24), 8 (0; 20) points according to IVAS, mCDS, and rCDS, respectively (p 0.05). Furthermore, the pain scores were gradually reduced on all three scales and had no statistically significant difference (p 0.05). In women who underwent paravertebral blockade (PVB), pain scores were significantly less at 2, 6, 12, and 48 h after surgery (p 0.05). Spearmans correlation coefficient for lVAS and mCDS is 0.90, 0.86 for lVAS and rCDS, and 0.90 for mCDS and rCDS (all p 0.05). CONCLUSIONS: The CDS is an alternative, independent, and sufficient tool for quantifying pain. A strong correlation was found between the pain assessments according to CDS and lVAS. PVB significantly improves the quality of pain relief after RM.

Reliability and validity of a brief version of the Questionnaire of Olfactory Disorders (brief QOD) in patients with olfactory dysfunction

Background: The aim of this study was to determine the reliability and validity of the brief version of Questionnaire of Olfactory Disorders (brief QOD). Methods: A total of 372 patients participated in this study. Olfactory function was examined using the Sniffin’ Sticks test. The brief version of QOD, including 4 items concerning parosmia (QOD-P), 7 items concerning quality of life (QOD-QOL), and 3 visual analog scales to rate disease burden, awareness of the disorder and issues related to professional life (QOD-VAS), was used to assess subjective information on olfactory dysfunction. We evaluated the split-half reliability, internal consistency and validity of the brief QOD. Results: The split-half reliability was 0.60 (QOD-P), 0.87 (QOD-QOL), and 0.66 (QOD-VAS), respectively. The Cronbach’s α coefficient was 0.63 (QOD-P), 0.87 (QOD-QOL), and 0.71 (QOD-VAS), respectively. Olfactory function was found to be associated with QOD-P, QOD-QOL and QOD-VAS. Conclusions: The brief QOD is a suitable scale for the assessment of subjective severity of olfactory dysfunction for purposes such as treatment counseling, disability assessment, treatment control, and research in patients with olfactory disorder.

Footwear comfort: a systematic search and narrative synthesis of the literature

Objective To provide a narrative synthesis of the research literature pertaining to footwear comfort, including definitions, measurement scales, footwear design features, and physiological and psychological factors. Methods A systematic search was conducted which yielded 101 manuscripts. The most relevant manuscripts were selected based on the predetermined subheadings of the review (definitions, measurement scales, footwear design features, and physiological and psychological factors). A narrative synthesis of the findings of the included studies was undertaken. Results The available evidence is highly fragmented and incorporates a wide range of study designs, participants, and assessment approaches, making it challenging to draw strong conclusions or implications for clinical practice. However, it can be broadly concluded that (i) simple visual analog scales may provide a reliable overall assessment of comfort, (ii) well-fitted, lightweight shoes with soft midsoles and curved rocker-soles are generally perceived to be most comfortable, and (iii) the influence of sole flexibility, shoe microclimate and insoles is less clear and likely to be more specific to the population, setting and task being performed. Conclusion Footwear comfort is a complex and multifaceted concept that is influenced not only by structural and functional aspects of shoe design, but also task requirements and anatomical and physiological differences between individuals. Further research is required to delineate the contribution of specific shoe features more clearly, and to better understand the interaction between footwear features and individual physiological attributes.

After the Pandemic: The Future of Italian Medicine. The Psychological Impact of COVID-19 on Medical and Other Healthcare-Related Degrees Students

Objective: The study aimed to explore the psychological symptoms and the readiness to fight the pandemic of the new generation of healthcare professionals: medical and other healthcare degree students.Methods: We enrolled 509 medical and healthcare-related degree students during the second outbreak of COVID-19 in Italy. We have examined their psychological symptoms using the 12-item General Health Questionnaire (GHQ-12) and their readiness to fight the pandemic together with their academic career status, their relationship with the university, and their emotional reactions to the pandemic with Visual Analog Scales.Results: We retrieved a GHQ mean of 21.65 (SD = 40.63) and readiness to fight the pandemic mean of 53.58 (SD = 31.49). Perceived control affects variables: a negative effect on psychological symptoms and a positive effect on the willingness to fight the pandemic. The other variables with an impact were stress, loneliness, and anger that had a significant and positive impact on psychological symptoms. Age and concern for patients had a significant positive impact on readiness to fight for the pandemic, while years of attendance had a significant but negative impact.Conclusion: Universities and Institutions should consider the impact of the pandemic on students, in particular, for its effect on their mental health.

The Effect of Sleep Quality on Pain in Chilean Individuals with Musculoskeletal Disorders

Poor sleep quality (SQ) negatively affects pain associated with musculoskeletal disorders (MSD). As the level of economic development of a country determines its sanitary conditions, these can influence the sleep–pain relationship; therefore, it is relevant to generate evidence in the population with MSD in developing countries. This cross-sectional study sought to determine the effect of poor SQ on pain in Chilean individuals with MSD, controlling for sex and duration of pain (in months). Method: A total of 228 individuals were included. SQ was measured with the Pittsburg Sleep Quality Index (PSQI), pain (intensity, interference and distress relative to pain) was measured with visual analog scales. Structural equation modeling (SEM) was performed to analyze the effect of SQ on pain. Results: A high frequency of poor SQ was present in the studied group, and was more prevalent in women. The SEM model evidenced that poor SQ predicts greater pain. Sex influences sleep quality and pain, but not pain duration. Conclusions: These findings indicate that poor SQ predicts higher pain in MSD and that women exhibit worse SQ and more significant pain than men. Our findings support that SQ should be considered in the comprehensive approach to pain in individuals with MSD.

Appetite and Satiety Effects of the Acute and Regular Consumption of Green Coffee Phenols and Green Coffee Phenol/Oat β-Glucan Nutraceuticals in Subjects with Overweight and Obesity

Green coffee has weight management properties, yet its effects on appetite and satiety remain unclear as few, mainly acute, studies perform objective measurements. Therefore, the influence on appetite/satiety of acute and regular consumption of two nutraceuticals, a decaffeinated green coffee phenolic extract (GC) alone or combined with oat β-glucans (GC/BG), with known satiating properties, has been analysed subjectively using visual analog scales (VAS) and objectively measuring actual food intake and postprandial appetite and satiety hormones. A randomised, cross-over, blind trial was carried out in 29 overweight volunteers who consumed GC or GC/BG twice a day for 8 weeks. After acute (day = 0) and regular consumption (day = 56) of the nutraceuticals, satiety was measured at 30, 60, 90, 150, and 210 min, as well as food intake at breakfast (30 min) and lunch (300 min). Additionally, in a subgroup of participants (n = 9), cholecystokinin, peptide-YY, glucagon-like-peptide-1, ghrelin and leptin concentrations were analysed in blood samples taken at the same time-points. According to VAS results, GC/BG reduced hunger more efficiently than GC. However, there were no statistically significant differences in food intake. Comparing the effects of the acute consumption of GC/BG and GC, leptin concentration at 150 min was higher after GC/BG intake vs. GC. Moreover, when comparing the effects of regularly consuming the two nutraceuticals, maximum ghrelin level decreased with GC/BG vs. GC. In conclusion, acute and regular effects of the nutraceuticals on appetite/satiety differed, and subjective and objective results partially agreed; GC/BG may reduce hunger more efficiently than GC.

Case Report: Corpus Callosotomy in a Cat With Drug-Resistant Epilepsy of Unknown Cause

A 2-month-old, intact male domestic shorthair cat with dullness, bilateral central blindness, and recurrent epileptic seizures was presented to a local clinic. Seizures were the generalized myoclonic and tonic-clonic type. Phenobarbital was initiated and maintained; however, seizures were not controlled. Other anti-seizure drugs, including levetiracetam, zonisamide, and diazepam, also provided insufficient seizure control with seizures occurring hourly to daily. By 8 months of age, the cat displayed non-ambulatory tetraparesis and deep somnolence. Magnetic resonance imaging (MRI), cerebrospinal fluid analysis, and pre- and post-prandial total bile acid analyses were unremarkable. Scalp electroencephalography (EEG) revealed central dominant but generally synchronized spikes and multiple spikes. The cat was diagnosed with drug-resistant epilepsy of unknown cause and was included in a clinical trial of epilepsy surgery. Given the unremarkable MRI and bilateral synchronized EEG abnormalities, a corpus callosotomy was performed at 12 months of age, and partial desynchronization of spikes was confirmed on EEG. Incomplete transection was found in the genu of the corpus callosum on postoperative MRI. After surgery, the mental status and ambulation clearly improved, and seizure frequency and duration were remarkably reduced. Recheck with follow-up EEG and MRI were performed at 3, 6, and 12 months after surgery. Scores of activities of daily living and visual analog scales including cat's and owner's quality of life had also improved considerably. This case report is the first documentation of the one-year clinical outcome of corpus callosotomy in a clinical feline case with drug-resistant epilepsy.

Standing time and daily proportion of sedentary time are associated with pain-related disability in a one month accelerometer measurement in adults with overweight or obesity

Objectives The association between the subjective experience of pain-related disability (PRD) and device-measured physical activity (PA) and sedentary behavior (SB) in overweight and obese adults is not well known. The aim of this study was to investigate the associations of pain markers with accelerometer-measured SB duration and different intensities of PA among physically inactive middle-aged adults with overweight or obesity. Methods This cross-sectional analysis included 72 subjects (27 men) with mean age of 57.9 (SD 6.7) years and mean BMI of 31.6 (SD 4.1) kg/m2. SB and standing time (ST), breaks in sedentary time, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) were measured for four consecutive weeks (mean 25 days, SD 4) with a hip-worn triaxial accelerometer. Headache, musculoskeletal pain, back pain, and PRD were assessed by visual analog scales (VAS) and using the Oswestry disability index (ODI). RAND-36 questionnaire was applied to assess health-related quality of life. The associations were studied by linear models. Results ST was positively and SB proportion was negatively associated with PRD when adjusted for age, sex, BMI, accelerometry duration, MVPA, pain medication use, and general health perceptions assessed by RAND-36. No associations were found between ST and back pain. SB or different PA intensities were not associated with pain experience at specific sites. Conclusions Longer daily ST, but not LPA or MVPA is associated with higher level of PRD. Correspondingly, higher proportion of SB is associated with lower level of PRD. This suggests that individuals with PRD prefer to stand, possibly to cope with pain. These results may highlight the importance of habitual standing behaviors in coping with experienced PRD in adults with overweight or obesity.