Individual Perception of Telehealth: Validation of a German Translation of the Telemedicine Perception Questionnaire and a Derived Short Version

Telehealth is a growing domain with particular relevance for remote patient monitoring. With respect to the biopsychosocial model of health, it is important to evaluate perception and satisfaction with new methods in telehealth as part of an integrative approach. The Telemedicine Perception Questionnaire (TMPQ) is a 17-item questionnaire measuring patients’ perception of and satisfaction with telecare. We translated this survey into German and determined its validity and reliability in 32 adolescents and adults. Furthermore, we derived a short version of the TMPQ, named Patient and Physician Satisfaction with Monitoring (PPSM), which is a 5-item questionnaire that can be administered to both patients and physicians. Validity and reliability were tested in 32 patients and 32 physicians. Crohnbach’s α for the translated TMPQ was 0.76, and the German version yielded high validity (intraclass correlation coefficient (ICC) 0.995). We tested the PPSM in both patients and physicians and found acceptable values for Crohnbach’s α (0.72 and 0.78) with excellent validity (ICC 0.965). We therefore concluded from this small study that both German versions of the TMPQ and PPSM can be used to investigate the acceptance of telehealth applications.

Airway to Lung Volume Ratio on CT is Associated with Pulmonary Function Transition from Obstructive to Restrictive Pattern in Obesity

Background: Obesity is associated with excessive airway collapse and reduced lung volume; it is unknown whether it affects airway-lung interactions. We sought to compare the airway tree to lung volume ratio, assessed by CT, in obese individuals with and without ventilation disorders.Methods: Participants underwent inspiratory chest CT and pulmonary function. The percentage ratio of the whole airway tree to lung volume, automatically segmented via deep learning, was defined as CT airway volume percent (AWV%). Total airway count (TAC), airway wall area percent (WA%), and other CT indexes were also measured. Results: We evaluated 88 participants including adolescents(age: 14-18, n= 12) and adults (age: 19-25, n= 17; age: 26-35, n= 39; age> 35, n= 20). Obese adolescents had higher forced vital capacity (FVC) (P = 0.001) and lower AWV% (P = 0.008) than obese adults (age >35). Among obese adults, participants with restrictive disorders had larger AWV% (P < 0.001) and those with obstructive disorders showed smaller AWV% (P < 0.001) compared to participants with normal ventilation. AWV% was positively correlated with age and forced expiratory volume in 1 second (FEV1)/FVC and adversely related to FVC (P< 0.05 for all), and in multivariate models, AWV% independently predicted FEV1/FVC (R2 = 0.49, P < 0.001) and FVC (R2 = 0.60, P < 0.001).Conclusion: Transitions in lung function patterns between obese adolescents and adults are associated with airway to lung ratios. The obesity-induced disproportion between the airway tree and lung volume may adversely affect and complicate lung ventilation.

A comparative study of adult and adolescent maternal care continuum following community-oriented interventions in Cambodia, Guatemala, Kenya, and Zambia

Background The coverage for reproductive care continuum is a growing concern for communities in low- income economies. Adolescents (15–19 years) are often at higher odds of maternal morbidity and mortality due to other underlying factors including biological immaturity, social, and economic differences. The aim of the study was to examine a) differences in care-seeking and continuum of care (4 antenatal care (ANC4+), skilled birth attendance (SBA) and postnatal care (PNC) within 24h) between adult (20–49 Years) and adolescents and b) the effect of multilevel community-oriented interventions on adolescent and adult reproductive care-seeking in Cambodia, Guatemala, Kenya, and Zambia using a quasi-experimental study design. Methods In each country, communities in two districts/sub-districts received timed community health worker (CHW) household health promotion and social accountability interventions with community scorecards. Two matched districts/sub-districts were selected for comparison and received routine healthcare services. Results Results from the final evaluation showed that there were no significant differences in the care continuum for adolescents and adults except for Kenya (26.1% vs 18.8%, p<0.05). SBA was significantly higher for adolescents compared to adult women for Guatemala (64% vs 55.5%, p<0.05). Adolescents in the intervention sites showed significantly higher ANC utilization for Kenya (95.3% vs 84.8%, p<0.01) and Zambia (87% vs 72.7%, p<0.05), ANC4 for Cambodia (83.7% vs 43.2%, p<0.001) and Kenya (65.9% vs 48.1%, p<0.05), SBA for Cambodia (100% vs 88.9%, p<0.05), early PNC for Cambodia (91.8% vs 72.8%, p<0.01) and Zambia (56.5% vs 16.9%, p<0.001) compared to the comparison sites. However, the findings from Guatemala illustrated significantly lower care continuum for intervention sites (aOR:0.34, 95% CI 0.28–0.42, p<0.001). The study provides some evidence on the potential of multilevel community-oriented interventions to improve adolescent healthcare seeking in rural contexts. The predictors of care continuum varied across countries, indicating the importance of contextual factors in designing interventions.

The Relationship between Body Composition, Dietary Intake, Physical Activity, and Pulmonary Status in Adolescents and Adults with Cystic Fibrosis

Measures of body fat and lean mass may better predict important clinical outcomes in patients with cystic fibrosis (CF) than body mass index (BMI). Little is known about how diet quality and exercise may impact body composition in these patients. Dual X-ray absorptiometry (DXA) body composition, 24-h dietary recall, and physical activity were assessed in a cross-sectional analysis of 38 adolescents and adults with CF and 19 age-, race-, and gender-matched healthy volunteers. Compared with the healthy volunteers, participants with CF had a lower appendicular lean mass index (ALMI), despite no observed difference in BMI, and their diets consisted of higher glycemic index foods with a greater proportion of calories from fat and a lower proportion of calories from protein. In participants with CF, pulmonary function positively correlated with measures of lean mass, particularly ALMI, and negatively correlated with multiple measures of body fat after controlling for age, gender, and BMI. Higher physical activity levels were associated with greater ALMI and lower body fat. In conclusion, body composition measures, particularly ALMI, may better predict key clinical outcomes in individuals with CF than BMI. Future longitudinal studies analyzing the effect of dietary intake and exercise on body composition and CF-specific clinical outcomes are needed.

Colours, capsules and concept flavour names on cigarette packs appeal to youth in Mexico

BackgroundFlavoured cigarettes are popular in Mexico. We examined how cigarette packaging design features used to communicate flavour influence perceptions of appeal, harm, perceived interest and pack preference among Mexico City residents.MethodsWe conducted an experimental survey. Participants aged 13–34 years were randomly assigned to one of three conditions, viewed packs with systematically manipulated design features (colour, capsule image and flavour name) and answered questions on appeal, perceived harm, perceived interest and pack preference. Data were analysed using mixed effects and conditional logistic regression.Results1500 adolescents and 950 adults participated. Regardless of flavour, cigarette packs with a background colour and capsule image were more appealing to adolescents (OR=13.19, 95% CI 11.53 to 15.10; OR=1.68, 95% CI 1.45 to 1.88) and adults (OR=4.18, 95% CI 3.73 to 4.69; OR=1.66, 95% CI 1.49 to 1.85) than packs without. Among adolescents, ‘Tropical Burst’ named packs were more appealing (OR=1.43, 95% CI 1.20 to 1.72) than packs without a flavour name and among adults, ‘Arctic Air’ named packs were more appealing (OR=1.20, 95% CI 1.02 to 1.14). Adolescents and adults reported a preference for trying packs that displayed a flavour name, background colour or capsule image (b=0.104, b=0.702, b=1.316, p<0.001 and b=0.126, b=0.619, b=0.775, p<0.001).ConclusionsColours and flavour capsule images appeal to adolescents and adults in Mexico. Mexico should consider adopting plain packaging to reduce appeal and interest.

Lymphoma for GPs across the cancer continuum

Lymphomas are a diverse and relatively common cancer type in the UK. Early diagnosis of lymphoma is vital for improving patient outcomes. The majority of patients diagnosed with lymphoma have a life expectancy of more than 5 years. Lymphoma treatments can have long-term health consequences, and patients with a history of lymphoma have a higher risk of subsequently developing other cancers. More robust evidence for the early diagnosis of lymphoma in primary care has been published in recent years, and the classification of lymphoma has recently been updated by the World Health Organisation. This article focuses on the diagnosis of lymphoma in adolescents and adults and the on-going care needs of patients who are being treated for lymphoma or have survived a diagnosis of lymphoma. Further information about lymphoma and other cancers in children can be found in the InnovAiT article by Dr Jennifer Kelly published in 2017.

Interventions for Early-Stage Pericoronitis: Systematic Review of Randomized Clinical Trials

Background: To investigate the efficacy and safety of interventions for early stage pericoronitis. Methods: We searched for randomized controlled trials (RCTs) in databases from inception to July 2020, without language restriction. RCTs assessing adolescents and adults were included. Results: Seven RCT with clinical diversity were included, so, it was not possible to conduct meta-analyses. Individual study data showed an improvement in oral health quality of life in favor of topical benzydamine versus diclofenac capsule (Mean difference (MD) −1.10, 95% Confidence interval (CI) −1.85 to −0.35), and no difference between topical benzydamine and flurbiprofen capsule (MD −0.55 95% CI −1.18 to 0.0). There was no difference between diclofenac and flurbiprofen capsules (MD 0.55, 95% CI −0.29 to 1.39). An imprecise estimate of effects was found for all outcomes, considering (i) oral versus topic pharmacological treatment, (ii) different oral pharmacological treatments, (iii) pharmacological treatment associated with laser versus placebo laser, (iv) pharmacological treatment associated with different mouthwashes, and (v) conventional treatment associated to antimicrobial photodynamic therapy versus conventional treatment, with low to very low certainty of evidence. Conclusions: Until future well-designed studies can be conducted, the clinical decision for early stage pericoronitis should be guided by individual characteristics, settings and financial aspects.

Psychosocial Profile of Juvenile and Adult Offenders Who Acknowledge Having Committed Child-to-Parent Violence

The main objective of this study was to establish the psychosocial profile of adolescents and adults who have admitted to committing child-to-parent violence (CPV) and were serving a judicial sanction or prison sentence, respectively. Two groups of participants took part in this study. The first group was made up of 89 male youths who were serving judicial sanctions, and the second group was made up of 70 men serving a prison sentence. A cross-sectional retrospective design with concurrent measurements was used in this study. Group differences in the exposure-to-violence variables were conducted. Automatic regression models were used to estimate a self-reported CPV. In relation to the variables of indirect exposure to violence, statistically significant differences between those who admitted having committed CPV and those who did not, irrespective of being adults or adolescents, were found for seeing violence in class and at home but not for seeing violence on the street or on television. Regarding the variables related to experiencing violence, the results showed statistically significant differences in experiencing violence at home but not in class or on the street. The best predictive model of CPV includes some of the dimensions of self-concept, specifically academic and family self-concept, as well as the avoidant and rational problem-solving styles and the negative orientation toward problems. The results have shown the existence of a CPV offender profile that is common to minors and adults.

An evaluation of the question types used by criminal justice professionals with complainants in child sexual assault trials

The way that complainants of child sexual assault are questioned about their experiences can profoundly influence the accuracy, credibility, and consistency of their evidence. This is the case for all people, but especially children whose language, social, and cognitive capacity is still developing. In this study, we examined the questions used by a representative sample of Australian prosecutors, defense lawyers, and judges/magistrates to determine if this is an area that warrants improvement. Our focus was the type of questions used by the different professionals and how (if at all) these varied across complainant age groups (children, adolescents, and adults, total N = 63). Our findings revealed that each complainant group was questioned in a manner known to heighten misunderstanding and error (e.g., complex and leading questions were used frequently by all professional groups). There was also little indication of question adaption according to age (e.g., prosecutors asked children more complex questions than they asked adults). When the results are considered in the context of the broader literature on the impact of different question styles, they suggest that professional development in questioning would improve the quality of trial advocacy and judicial rulings.