Lower Energy-Dense Ready Meal Consumption Affects Self-Reported Appetite Ratings with No Effect on Subsequent Food Intake in Women

Slimming World (SW), a commercial weight management organisation, has designed a range of low energy-dense ready meals (LEDRMs) in line with their programme. This randomised crossover study compared commercially available equicaloric ready meals differing in energy density on satiety and food intake. It was hypothesised that the LEDRM would reduce energy intake (EI) whilst increasing fullness and reducing hunger compared to higher energy-dense ready meal (HEDRM, control). A total of 26 female participants (aged 18–65 years; body mass index of 28.8 ± 3.0 kg·m−2) attended two test days. The participants ate a standard breakfast, and four hours later, ate either a LEDRM or HEDRM at lunch. EI was measured four hours later at an ad libitum tea. Satiety measurements were recorded throughout the day using visual analogue scales and a weighed food diary was completed for the remainder of the day. The results revealed that the LEDRM reduced hunger and increased fullness (both p < 0.001). There was no difference in EI at the evening meal between the ready meals (p > 0.05), however, during the whole LEDRM testing day, the participants consumed significantly less fat (7.1%) and saturated fat (3.6%) (both p < 0.01), but significantly more carbohydrates, sugars, fibre, protein, and salt (all p < 0.01). The results indicate that the participants felt more satiated after consuming ready meals of the same energy content but larger portion size. Despite no significant difference in short-term EI between the ready meals, the results indicated that the LEDRM produced beneficial subjective satiety responses and, therefore, can help to improve the nutritional content of meals i.e., reduce saturated fat consumption.

Cognitive Behavioral Therapy in Korean Tinnitus Patients

Cognitive behavioral therapy, first introduced by Beck in the 1950s to treat depression by integrating cognitive and behavioral therapies, is now an established psychotherapy technique used to treat insomnia, chronic pain, and anxiety. Currently, cognitive behavioral therapy is widely used to treat tinnitus in European countries, and the efficacy and safety of the treatment have been proven through randomized clinical trials and meta-analyses. Although interest in cognitive behavioral therapy for tinnitus is increasing in Korea, there are limited reports. Because many studies so far have targeted patients in Western countries, it is difficult to apply the same to domestic patients due to cultural and linguistic differences, the absence of standardized guidelines, and limitations in clinic hours. We experienced various cases in which tinnitus was effectively treated simultaneously with pharmacotherapy and cognitive behavioral therapy, so here we report an introduction to the program along with a literature review. Cognitive behavioral therapy was performed as a 4-week program in our hospital, and progress was evaluated through Visual Analogue Scales (VAS) and tinnitus handicap inventory (THI). After each weekly 20-minute individual counseling session, a take-home writing task was given to the patient. The main goal was to guide the patient to discover and correct automatic thoughts related to their tinnitus symptoms. This paper aimed to introduce a specific scheme on how to perform cognitive behavioral therapy for domestic tinnitus patients.

Continuous fentanyl infusion reduces intra-abdominal pressure, postoperative pain and normalizes lungs’ mechanical changes in newborn with viscera-abdominal disproportion in early post-operative period

We aimed to study the influence of prolonged administration of fentanyl on postoperative pain, intra­ab­dominal pressure and mechanical lungs’ changes that may happen in neonates in early post­operative period. 30 newborns (in the period from January 2017 to May 2021) with gastroschisis were divided into two groups ac­cordingly to the method of analgesia (14 – morphine hydrochloride; 16 – prolonged infusion of fentanyl). Lungs’ mechanical characteristics, effectiveness of post­operative analgesia, abdominal wall relaxation was studied by monitoring of dynamic compliance (Cdyn), pressure and flow­volume loops, capnography. Apprising analgesia sta­tus, we measured hemodynamic, SаO2, blood level of cortizol, C­reactive protein (CRP), glucose, analyzed post­operative pain syndrome using visual analogue scales (VAS). Intra­abdominal pressure (IAP) was controlled by Cron. For statistic analysis we used Student’s t­test. In the group with morphine, thete was the increase of IAP by 11–12 cm H2O, being stable during some period of time, and also variable levels of pain according to VAS, the in­creasing of CRP from 0.8 ± 0.25 mg/dl by 5 mg/dl, cortisol by 674.4 nmol/l, and blood glucosae rate – 7.4 mmol/l. Periods with high traumatic effects and poor analgesia (morphine group) reasoned the increasing IAP, step by step dynamic compliance decreasing in 3.4 times, resistance increasing in 2.42 times and PIP rising till 22 cm H2O. Di­rect correlation between IAP increase and lungs’ mechanical changes took place. The study has demonstrated that prolonged administration of fentanyl prevented high increase of IAP, CRP, levels of glucose and cortizol and changes of VAS data, lungs’ mechanical characteristics.

The predictive value of disability at 2 weeks after plating of distal radial fractures: a prospective study of 101 patients

Assuming that some patients may benefit from early supervised rehabilitation after distal radial fractures, we investigated to what extent self-reported measures of disability, pain and performance of daily activities 2 weeks after anterior locking plating of distal radial fractures could predict long-lasting disability. We included 101 patients in a prediction study and recorded the scores of the Disability of the Arm, Shoulder and Hand questionnaire, visual analogue scales for pain and the Canadian Occupational Performance Measure. We found that the Disability of the Arm, Shoulder and Hand scores with a cut-off score of 50 were the best at predicting disability at 6 months in patients who did not receive early supervised therapy. The positive predictive value was 65% and the negative predictive value was 71%. We conclude that these scores could be used as a single measure to predict patient disability, although the predictive value was rather weak. Level of evidence: II

Clinician-Created Educational Video Resources for Shared Decision-making in the Outpatient Management of Chronic Disease: Development and Evaluation Study

Background The provision of reliable patient education is essential for shared decision-making. However, many clinicians are reluctant to use commonly available resources, as they are generic and may contain information of insufficient quality. Clinician-created educational materials, accessed during the waiting time prior to consultation, can potentially benefit clinical practice if developed in a time- and resource-efficient manner. Objective The aim of this study is to evaluate the utility of educational videos in improving patient decision-making, as well as consultation satisfaction and anxiety, within the outpatient management of chronic disease (represented by atrial fibrillation). The approach involves clinicians creating audiovisual patient education in a time- and resource-efficient manner for opportunistic delivery, using mobile smart devices with internet access, during waiting time before consultation. Methods We implemented this educational approach in outpatient clinics and collected patient responses through an electronic survey. The educational module was a web-based combination of 4 short videos viewed sequentially, followed by a patient experience survey using 5-point Likert scales and 0-100 visual analogue scales. The clinician developed the audiovisual module over a 2-day span while performing usual clinical tasks, using existing hardware and software resources (laptop and tablet). Patients presenting for the outpatient management of atrial fibrillation accessed the module during waiting time before their consultation using either a URL or Quick Response (QR) code on a provided tablet or their own mobile smart devices. The primary outcome of the study was the module’s utility in improving patient decision-making ability, as measured on a 0-100 visual analogue scale. Secondary outcomes were the level of patient satisfaction with the videos, measured with 5-point Likert scales, in addition to the patient’s value for clinician narration and the module’s utility in improving anxiety and long-term treatment adherence, as represented on 0-100 visual analogue scales. Results This study enrolled 116 patients presenting for the outpatient management of atrial fibrillation. The proportion of responses that were “very satisfied” with the educational video content across the 4 videos ranged from 93% (86/92) to 96.3% (104/108) and this was between 98% (90/92) and 99.1% (107/108) for “satisfied” or “very satisfied.” There were no reports of dissatisfaction for the first 3 videos, and only 1% (1/92) of responders reported dissatisfaction for the fourth video. The median reported scores (on 0-100 visual analogue scales) were 90 (IQR 82.5-97) for improving patient decision-making, 89 (IQR 81-95) for reducing consultation anxiety, 90 (IQR 81-97) for improving treatment adherence, and 82 (IQR 70-90) for the clinician’s narration adding benefit to the patient experience. Conclusions Clinician-created educational videos for chronic disease management resulted in improvements in patient-reported informed decision-making ability and expected long-term treatment adherence, as well as anxiety reduction. This form of patient education was also time efficient as it used the sunk time cost of waiting time to provide education without requiring additional clinician input.

Interest of virtual reality hypnosis in the EP lab in clinical practice : an observational study (Preprint)

UNSTRUCTURED Aims: Virtual reality Hypnosis (VRH) has been used successfully in different clinical settings to treat anxiety and the sensation of pain. We aimed to investigate the feasibility and safety of VRH in patients undergoing electrophysiology and stimulation procedures under conscious sedation. Methods: During a two-month period, VRH support was proposed to patients undergoing interventions. Data were compared with a control group (n=61) enrolled during the following three-month period. In the intervention group (n=25), the dedicated VR hypnosis programme was projected during the procedure. In both groups, pain and comfort were measured at the end of the procedure and at discharge, using visual analogue scales (VASs; 0-10). Results: Baseline characteristics were comparable in both groups. There was no difference in procedure duration (46 (±29) vs 56 (±32) min, p=0,18) nor in hypnotic / antalgic consumption (1.95 (±1.44) vs 2.00 (±1.22) mg, p=0,83 and 3.78 (±2.87) vs 3.58 (±2.48) μg, p=0,9) for the control and VR groups respectively. In a multivariate analysis, the use of VR was independently associated with lower comfort during the procedure, assessed by post-operative VAS (OR 15.00 (IC95%4.77;47.16), p<0.01). There was no influence of VR use on pain or drug consumption. Conclusions: In our experience, VR hypnosis in the EP lab doesn’t improve comfort during the procedure, compared to conventional human care. It has no influence on pain or drug consumption.

Keep calm and manage impulsivity: Mood as a modulator of impulsive behaviour

This study investigated how different mood states affect distinct subtypes of impulsivity: motor impulsivity [measured with the Stop Signal (SST) and the 5-Choice Serial Reaction Time Task (5-CSRTT)], reflection impulsivity [assessed with the Information Sampling Task (IST)], and temporal impulsivity (the Delay Discounting Questionnaire). Eighty healthy volunteers completed two experimental sessions. During session 1, which served as a baseline measure, participants underwent a neutral mood induction procedure. In Session 2, they were randomly allocated to one of the mood-induction groups (Neutral, Positive, Sad, and Anxiety). Mood state ratings included bipolar visual analogue scales on mood (positive/negative), tension/relaxation and arousal (tired/active). No group effect was found on any of the impulsivity measures.24 Correlational analyses between mood changes (following the mood manipulation procedures) and behaviour in the tasks revealed that increased relaxation was related to increased information sampling in the IST (decreased reflection impulsivity). In addition, the more active subjects reported to be, the more likely they were to choose a delayed reward over the immediate one (decreased temporal impulsivity). These results indicate that subjective changes in mood state are associated with behavioural impulsivity levels. Importantly, distinct facets of impulsivity (reflection, motor and temporal) are differently affected by changes in mood state.

Usability of Visual Analogue Scales in Assessing Human Perception of Sound with University Students Using a Web-Based Tablet Interface

Response scales in auditory perception assessment are critical for capturing the true responses of listeners. Despite its impact on data, response scales have received the least attention in auditory perception assessment. In this study, the usability of visual analogue scales for auditory perception assessment were investigated. Five response scales (a unipolar visual analogue scale–negated to regular, a unipolar visual analogue scale—regular to negated, a bipolar visual analogue scale–positive to negative, a bipolar visual analogue scale—negative to positive, and a unipolar 11-point scale (ISO/TS 15666:2021)) for auditory perception assessment are presented. Music and traffic noise were presented to 60 university students at two different levels, i.e., 45 and 65 dBA, respectively. A web-based experimental design was implemented, and tablet pads were provided to the respondents to record their responses. The unipolar 11-point scale required the longest response time, followed by the two unipolar visual analogue scales and two bipolar visual analogue scales with statistical significance. All response scales used in this study achieved statistical reliability and sensitivity for the auditory perception assessment. Among the five response scales, the bipolar visual analogue scale (negative to positive) ranked first in reliability over repeated measures, exhibited sensitivity in differentiating sound sources, and was preferred by the respondents under the conditions of the present study. None of the respondents preferred the unipolar 11-point scale. The visual analogue scale was favoured over the traditional unipolar 11-point scale by young educated adults in a mobile-based testing environment. Moreover, the bipolar visual analogue scale demonstrated the highest reliability and sensitivity, and it was preferred the most by the respondents. The semantic labelling direction from negated to regular, or from negative to positive, is preferred over its opposite counterpart. Further research is necessary to investigate the use of response scales for the general public including children and the elderly, as well as that of semantic adjectives and their counterparts for auditory perception assessment.