Purpose: This study aimed to evaluate the efficacy of high-frequency chest wall oscillation for sputum expectoration and hospital length of stay in patients with acute exacerbations of chronic ...obstructive pulmonary disease. The improvements in pulmonary function and oxygenation were also investigated. Patients and Methods: This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. Automated literature database searches were conducted from the earliest records to March 31, 2022. The methodological quality of the included studies was assessed using the Cochrane Risk of Bias tool (RoB 2.0), and meta-analysis software (RevMan 5.4) was used to analyze the data. Results: From 5439 identified articles, 13 studies (with 756 patients) were included in this meta-analysis. Compared to other airway clearance techniques, HFCWO significantly increased expectorated sputum volume by 6.18 mL (95% CI: 1.71 to 10.64; I.sup.2 = 87%), shortened hospital stay by 4.37 days (95% CI: -7.70 to -1.05; I.sup.2 = 84%). However, FEV.sub.1 (%), PaO.sub.2, and PaCO.sub.2 did not improve significantly. Conclusion: AECOPD patients may benefit from HFCWO therapy. HFCWO enables AECOPD patients to excrete more sputum and shorten their hospital stays. However, due to heterogeneity among the included research, these results should be interpreted with caution. Keywords: acute exacerbation of chronic obstructive pulmonary disease, AECOPD, high-frequency chest wall oscillation, HFCWO, sputum expectoration, length of hospital stay
Ambient ultrafine particles (UFPs; with an aerodynamic diameter < 0.1 μm) may exert greater toxicity than other pollution components because of their enhanced oxidative capacity and ability to ...translocate systemically. Studies examining associations between prenatal UFP exposure and childhood asthma remain sparse.
We used daily UFP exposure estimates to identify windows of susceptibility of prenatal UFP exposure related to asthma in children, accounting for sex-specific effects.
Analyses included 376 mother-child dyads followed since pregnancy. Daily UFP exposure during pregnancy was estimated by using a spatiotemporally resolved particle number concentration prediction model. Bayesian distributed lag interaction models were used to identify windows of susceptibility for UFP exposure and examine whether effect estimates varied by sex. Incident asthma was determined at the first report of asthma (3.6 ± 3.2 yr). Covariates included maternal age, education, race, and obesity; child sex; nitrogen dioxide (NO
) and temperature averaged over gestation; and postnatal UFP exposure.
Women were 37.8% Black and 43.9% Hispanic, with 52.9% reporting having an education at the high school level or lower; 18.4% of children developed asthma. The cumulative odds ratio (95% confidence interval) for incident asthma per doubling of the UFP exposure concentration across pregnancy was 4.28 (1.41-15.7), impacting males and females similarly. Bayesian distributed lag interaction models indicated sex differences in the windows of susceptibility, with the highest risk of asthma seen in females exposed to higher UFP concentrations during late pregnancy.
Prenatal UFP exposure was associated with asthma development in children, independent of correlated ambient NO
and temperature. Findings will benefit future research and policy-makers who are considering appropriate regulations to reduce the adverse effects of UFPs on child respiratory health.
The purpose of this study was to report the second phase of instrument development, a culturally sensitive questionnaire of childbearing attitudes to assess the psychosocial responses of infertile ...women. Using a nonexperimental quantitative design, we investigated 238 women who are undergoing in vitro fertilization treatment. Data collection and relevant planning occurred in two phases: in-depth interviews of women to generate items for the questionnaire and establishing the questionnaire’s content and construct validity. Through factor analysis, five factors were extracted from the “attitude toward childbearing questionnaire”: gender identification with self and society, insurance of marriage and inheritance, happy family life, spiritual investment, and continuing the family line and procreation. The total variance of these five factors was 64.31%. Cronbach’s α and test–retest reliability were between .72 and .87 and between .60 and .76, respectively, demonstrating acceptable internal consistency and stability. The information obtained through the questionnaire could be used to provide infertile women with personal counseling and appropriate psychological support during and after assisted reproductive technology.
Evolving animal studies and limited epidemiological data show that prenatal air pollution exposure is associated with childhood obesity. Timing of exposure and child sex may play an important role in ...these associations. We applied an innovative method to examine sex-specific sensitive prenatal windows of exposure to PM2.5 on anthropometric measures in preschool-aged children.
Analyses included 239 children born ≥ 37 weeks gestation in an ethnically-mixed lower-income urban birth cohort. Prenatal daily PM2.5 exposure was estimated using a validated satellite-based spatio-temporal model. Body mass index z-score (BMI-z), fat mass, % body fat, subscapular and triceps skinfold thickness, waist and hip circumferences and waist-to-hip ratio (WHR) were assessed at age 4.0 ± 0.7 years. Using Bayesian distributed lag interaction models (BDLIMs), we examined sex differences in sensitive windows of weekly averaged PM2.5 levels on these measures, adjusting for child age, maternal age, education, race/ethnicity, and pre-pregnancy BMI.
Mothers were primarily Hispanic (55%) or Black (26%), had ≤ 12 years of education (66%) and never smoked (80%). Increased PM2.5 exposure 8–17 and 15–22 weeks gestation was significantly associated with increased BMI z-scores and fat mass in boys, but not in girls. Higher PM2.5 exposure 10–29 weeks gestation was significantly associated with increased WHR in girls, but not in boys. Prenatal PM2.5 was not significantly associated with other measures of body composition. Estimated cumulative effects across pregnancy, accounting for sensitive windows and within-window effects, were 0.21 (95%CI = 0.01–0.37) for BMI-z and 0.36 (95%CI = 0.12–0.68) for fat mass (kg) in boys, and 0.02 (95%CI = 0.01–0.03) for WHR in girls, all per µg/m3 increase in PM2.5.
Increased prenatal PM2.5 exposure was more strongly associated with indices of increased whole body size in boys and with an indicator of body shape in girls. Methods to better characterize vulnerable windows may provide insight into underlying mechanisms contributing to sex-specific associations.
•Data-driven method to identify sensitive windows of prenatal PM2.5 on anthropometry.•Findings suggested time-dependent associations and effect modification by sex.•Sex-specific temporal associations may provide insights into underlying mechanisms.
Quality of life (QOL) is a critical issue in mental health care. The associations between quality of life and schizophrenia patients' stigma perception and stigma coping behavior are not well ...understood.
This study investigated quality of life in schizophrenia patients.
We used a cross-sectional, correlational research design; enrolled 119 individuals diagnosed with schizophrenia as participants; and used instruments including a demographics datasheet, perceived stigma scale, stigma coping behavior scale, and the World Health Organization quality of life scale, brief version to collect data. Data were analyzed using SPSS 12.0 for Windows software.
(1) Participants had an average QOL index score of 62.40, indicating moderate quality of life; (2) Long working hours, holding rehabilitation-related employment, and receiving social welfare support correlated with lower QOL; (3) Marital issues had the greatest impact on quality of life, with participants who chose secrecy ÷ concealment reporting generally better QO
A decrease in the use of physical restraints in Intensive Care Units (ICUs) is an important indicator of quality of nursing care. This quasi-experimental study examined the effect on nurses of a ...session of continuing education aimed at reducing the use of restraints. At a medical center in southern Taiwan, 37 novice nurses were surveyed about their knowledge, perception, attitude and clinical practice of restraint use in 11 ICUs. Two instructors then taught a four-hour continuing education class on patient restraint standards, principles for reducing physical restraint use, and alternatives to restraining. Data were analyzed by paired t-test and the results of identical structured questionnaires which participants received before and after the lecture, showed that, afterwards, knowledge (t = -6.04, p ＜ .01), perception (t = 4.76, p ＜ .01), and attitude (t = 3.93, p ＜ .01) toward restraint use had significantly improved . The continuing education improved the nurses’ knowledge and attitude toward restraint use and may therefore enhance the quality of care provided to ICU patients.
With social structures changing and the average life-span of individuals increasing, Taiwan is experiencing a steady rise in its elderly population. Thus, caring for older parentsis an urgent ...problem. Many foreign caregivers have been hired tocare for older parents.However, measuring the quality ofinformal care has not yet been fully explored in Taiwan, particularly among older people who are cared for by foreign caregivers in home settings.
The purposes of this study were to understand the differences in quality of care for older Taiwanese and to explore the predictors of quality of care in two types of caregiving.
A comparative descriptive study design was conducted. The study was held in several community healthcare centers in the middle and southern regions of Taiwan. Study data were collected over an 18-month period between 2012 and 2014. t Tests were used to compare continuous variables according to the types of caregiving. Multiple linear regressions with group analyses were performed to evaluate the underlying statistical assumptions.
One hundred fifty-nine participants were included. The study results showed that age, activities of daily living level, and quality of care were significantly different between the two types of caregiving. Relationships with caregivers, social support, and depressive symptoms contributed to the quality of care in family caregiving, explaining 50.2% of the variance. Social support and depressive symptoms contributed to the quality of care in foreign caregiving, explaining 36.6% of the variance.
The study results support that the types of primary caregiving affect the quality of care that is received by elderly Taiwanese. This study may be used as a reference for families whose family members need long-term care when considering hiring foreign caregivers as an alternative option to Taiwanese caregivers.
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