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ilot study demonstrates the immediate self-perceived benefit for all participants and increased frequency range for females after performing 5 and 10 minutes of vocal warm-up. No significant differences were found in delayed perceptual analyses completed by the participants or the expert raters after the different warm-up durations. Future investigations should include a larger population and different levels of education and genres of singing.The purpose of this investigation was to observe laryngeal tissue and vocal function changes over the course of 28 days in a single participant diagnosed by a laryngologist with bilateral nodules. Laryngeal imaging, acoustic variables and perceptual assessments of voice quality, and perceived vocal effort were obtained every morning for 28 consecutive days. A daily journal of occupational and recreational voice use as well as menstruation and alcohol consumption was maintained each day. It was hypothesized that the laryngeal pathology would appear more extensive and the vocal function measures obtained would be worse following extensive voice use. Laryngeal imaging, acoustic variables, and perceptual measures quantified provided evidence to support the study hypotheses. The size, extent, and asymmetry of the bilateral vocal pathologies observed were more extensive on days following occupational and recreational vocal loading. Acoustic and perceptual measures obtained correlated with the laryngeal tissue changes observed. Study findings support a more holistic approach to laryngeal pathology diagnosis that is based on a more thorough understanding of vocal loading considerations up to 48 hours prior to laryngeal endoscopy to better understand the pathophysiology of the observed lesion(s) for most accurate clinical diagnosis.

Recurrent respiratory papillomatosis (RRP) is characterized by recurrent laryngeal papillomas and treated with repeated surgical excision. The human papillomavirus (HPV) vaccine prevents infection with strains of HPV unrelated to RRP, and has recently been shown to increase the interval between surgeries when used as an adjuvant. The objective of this study was to report one case from our institution in which HPV vaccination was found to induce spontaneous regression of disease, absent of surgical intervention or use of other adjuvants.

Retrospective case study.

Records of one patient with RRP receiving partial HPV vaccination was reviewed with attention to videolaryngostroboscopic findings, Derkay score, need for surgical intervention, and voice quality.

Spontaneous regression of disease after vaccination was seen in this patient, as evidenced by reduced tumor burden and decreased voice handicap index. The patient was a 30-year old female, who had improved disease burden and voice quality after one dose and total resolution of disease following the second dose. Vaccine administration was the sole therapeutic mechanism.

These findings suggest that HPV vaccination can treat RRP without surgical intervention. Further studies are needed to investigate the underlying mechanism of disease regression and which patients may benefit most. We believe that HPV vaccination for all patients with RRP, even over the age of 45 years, may decrease treatment costs for individuals and the healthcare system overall.

These findings suggest that HPV vaccination can treat RRP without surgical intervention. Further studies are needed to investigate the underlying mechanism of disease regression and which patients may benefit most. We believe that HPV vaccination for all patients with RRP, even over the age of 45 years, may decrease treatment costs for individuals and the healthcare system overall.

The goal of this study was to examine variability across the 92 Indiana counties in missed opportunities for HPV vaccination and to assess county-level correlates of missed opportunities.

The Indiana immunization registry provided county level data on 2017 missed opportunity rates for adolescents ages 11-18. A missed opportunity was an encounter when a patient eligible for HPV vaccination received one or more other recommended vaccines, but not HPV. Potential county-level correlates of missed opportunities included race, income, population density, education, primary care providers per capita, smoking rates, mammography screening, diabetes monitoring, and Pap testing.

The missed opportunity rate ranged from 31% to 85% across Indiana counties. Higher population density, mammography screening, income inequality, and diabetes monitoring were associated with fewer missed opportunities.

We found wide variability in missed opportunities across counties, which were associated with population density and county-level participation in other health-related behaviors.

This study was supported by the National Cancer Institute under Award Number P30 CA082709-18S4.

This study was supported by the National Cancer Institute under Award Number P30 CA082709-18S4.

Influenza vaccine hesitancy among healthcare workers poses challenges to the achievement of herd immunity and causes infection risks to vulnerable patients. see more This study aimed to quantify the extent of influenza vaccine hesitancy among nurses in Hong Kong, to delineate its pattern, and to explore its socio-demographic, professional and personal correlates.

Nurses in Hong Kong were recruited in a cross-sectional study involving the administration of an online questionnaire survey after the 2017/18 winter influenza season. Respondents' influenza vaccination behaviours, attitudes and psychological antecedents were assessed, followed by their delineation into subgroups along the hesitancy continuum through a combination of multiple correspondence analysis and K-means cluster analysis. Socio-demographic, professional and personal correlations of subgrouping were investigated using generalised ordered logistic regression.

The overall vaccination coverage of nurses for the 2017/18 influenza season was 44%. Five erventions customised to the needs of nurses as reflected from the characteristics of clusters along the vaccine hesitancy continuum could form an important strategy for improving vaccination uptake.

With more than half of the nurses in Hong Kong having moderate or higher level of influenza vaccine hesitancy, interventions customised to the needs of nurses as reflected from the characteristics of clusters along the vaccine hesitancy continuum could form an important strategy for improving vaccination uptake.

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