Category: Nevin Manimala

J Nurs Meas. 2023 Aug 9:JNM-2021-0076.R1. doi: 10.1891/JNM-2021-0076. Online ahead of print.

ABSTRACT

Background and Purpose: Healthcare-seeking behavior is an issue affecting the promotion of sexual health among Filipino men. However, tools to measure healthcare-seeking behaviors among men, in general, are scarce. This study aimed to find evidence of validity and reliability of the Health Care-Seeking Behavior Questionnaire (HCSBQ). Methods: A cross-sectional online survey was conducted among N = 464 Filipino men. Linear Structural Relations (LISREL®) was used for statistical analysis. Results: The HCSBQ demonstrates validity and reliability after data analysis. The overall Cronbach’s α of 0.94 shows excellent internal consistency. The exploratory factor analysis revealed three latent variables, namely, interactional, intellectual, and active and decision-making. Cronbach’s α for each latent variable is 0.91, 0.84, and 0.88, respectively. A confirmatory factor analysis shows an excellent goodness-of-fit indices (Adjusted Goodness-of-fit Index [AGFI] = .95; Goodness-of-fit Index [GFI] = .97; Comparative Fit Index [CFI] = .99; Incremental Fit Index [IFI] = .99; Expected Cross Validation Index [ECVI] = .45; and Root Mean Square Error of Approximation [RMSEA] = .03). Conclusions: The HCSBQ is a valid and reliable tool to measure healthcare-seeking behaviors among Filipino men.

PMID:37558255 | DOI:10.1891/JNM-2021-0076

J Nurs Meas. 2023 Aug 9:JNM-2021-0068.R1. doi: 10.1891/JNM-2021-0068. Online ahead of print.

ABSTRACT

Background and Purpose: The prevention of aggressive behavior in child and adolescent inpatient settings is essential. However, it can be difficult to prompt a quick appropriate intervention without an early warning scale for the prevention and management of behavioral emergencies in a psychiatric inpatient adolescent unit. Behavioral emergencies often result in restraint/seclusion and/or administration of psychotropic medications. The objectives are to develop and evaluate the Pediatric Behavioral Early Warning Scale (Pedi-BEWS) as a screening tool to prompt quick appropriate interventions and to decrease incidents of restraint/seclusion and/or administration of psychotropic medications. Methods: A two-phase methodological design was applied. A total of 447 inpatients and 21 nurses were used to test internal consistency reliability and validity. Results: Receiver operating characteristic curve areas for the developed instrument were calculated to be 0.890 (Cognition), 0.959 (affect), and 0.951 (behavior). The overall Pedi-BEWS indicated high reliability (Cronbach’s alpha = .98). Conclusions: The Pedi-BEWS shows high internal consistency and validity. The use of the newly developed tool may reduce or eliminate episodes of seclusion and restraint for pediatric patients with a behavioral problem. In addition, the tool has the potential to enhance psychiatric nurses’ assessment skills and competencies. The use of the newly-developed Pedi-BEWS can promote an appropriate and timely nursing assessment and intervention before the deterioration in psychiatric nursing practice.

PMID:37558252 | DOI:10.1891/JNM-2021-0068

BMJ. 2023 Aug 9;382:e076222. doi: 10.1136/bmj-2023-076222.

ABSTRACT

OBJECTIVES: To characterize the long term risk of death and hospital readmission after an index admission with covid-19 among Medicare fee-for-service beneficiaries, and to compare these outcomes with historical control patients admitted to hospital with influenza.

DESIGN: Retrospective cohort study.

SETTING: United States.

PARTICIPANTS: 883 394 Medicare fee-for-service beneficiaries age ≥65 years discharged alive after an index hospital admission with covid-19 between 1 March 2020 and 31 August 2022, compared with 56 409 historical controls discharged alive after a hospital admission with influenza between 1 March 2018 and 31 August 2019. Weighting methods were used to account for differences in observed characteristics.

MAIN OUTCOME MEASURES: All cause death within 180 days of discharge. Secondary outcomes included first all cause readmission and a composite of death or readmission within 180 days.

RESULTS: The covid-19 cohort compared with the influenza cohort was younger (77.9 v 78.9 years, standardized mean difference -0.12) and had a lower proportion of women (51.7% v 57.3%, -0.11). Both groups had a similar proportion of black beneficiaries (10.3% v 8.1%, 0.07) and beneficiaries with dual Medicaid-Medicare eligibility status (20.1% v 19.2%; 0.02). The covid-19 cohort had a lower comorbidity burden, including atrial fibrillation (24.3% v 29.5%, -0.12), heart failure (43.4% v 49.9%, -0.13), and chronic obstructive pulmonary disease (39.2% v 52.9%, -0.27). After weighting, the covid-19 cohort had a higher risk (ie, cumulative incidence) of all cause death at 30 days (10.9% v 3.9%; standardized risk difference 7.0%, 95% confidence interval 6.8% to 7.2%), 90 days (15.5% v 7.1%; 8.4%, 8.2% to 8.7%), and 180 days (19.1% v 10.5%; 8.6%, 8.3% to 8.9%) compared with the influenza cohort. The covid-19 cohort also experienced a higher risk of hospital readmission at 30 days (16.0% v 11.2%; 4.9%, 4.6% to 5.1%) and 90 days (24.1% v 21.3%; 2.8%, 2.5% to 3.2%) but a similar risk at 180 days (30.6% v 30.6%;-0.1%, -0.5% to 0.3%). Over the study period, the 30 day risk of death for patients discharged after a covid-19 admission decreased from 17.9% to 7.2%.

CONCLUSIONS: Medicare beneficiaries who were discharged alive after a covid-19 hospital admission had a higher post-discharge risk of death compared with historical influenza controls; this difference, however, was concentrated in the early post-discharge period. The risk of death for patients discharged after a covid-19 related hospital admission substantially declined over the course of the pandemic.

PMID:37558240 | DOI:10.1136/bmj-2023-076222

J Dermatolog Treat. 2023 Dec;34(1):2245084. doi: 10.1080/09546634.2023.2245084.

ABSTRACT

Mesotherapy is a technique by which lower doses of therapeutic agents and bioactive substances are administered by intradermal injections to the skin. Through intradermal injections, mesotherapy can increase the residence time of therapeutic agents in the affected area, thus allowing for the use of lower doses and longer intervals between sessions which may in turn improve the treatment outcome and patient compliance. This systematic review aims to summarize the current literature that evaluates the efficacy of this technique for the treatment of hair loss and provides an overview of the results observed. Of the 416 records identified, 27 articles met the inclusion criteria. To date, mesotherapy using 6 classes of agents and their combinations have been studied; this includes dutasteride, minoxidil, growth factors or autologous suspension, botulinum toxin A, stem cells, and mesh solutions/multivitamins. While several studies report statistically significant improvements in hair growth after treatment, there is currently a lack of standardized regimens. The emergence of adverse effects after mesotherapy has been reported. Further large-scale and controlled clinical trials are warranted to evaluate the utility of mesotherapy for hair loss disorders.

PMID:37558233 | DOI:10.1080/09546634.2023.2245084

Int J Sports Physiol Perform. 2023 Aug 9:1-10. doi: 10.1123/ijspp.2023-0130. Online ahead of print.

ABSTRACT

PURPOSE: To determine the effects and transferability of a resisted-jump training program on strength, speed, power, and agility maintenance during the in-season phase of rugby training.

METHODS: Thirty high-level male rugby players (age: 21.78 [1.86] y; height: 1.83 [0.10] m; mass: 95.17 [10.45] kg) participated in a crossover, within-subject study design. Participants were randomly assigned to treatment groups (resistance band [VertiMax, VM] or control [Con]) and evaluated on jumping, sprinting, agility, and strength over a 4-week period. A 10-week wash-out period was initiated, followed by a crossover that incorporated randomization of the treatment sequence (ie, receiving VM during the first or second phase of the testing period). Within- and between-groups differences for each variable of interest were evaluated using a linear mixed-effects model.

RESULTS: No significant treatment (VM vs Con) or time (pre vs postintervention) effects were evident across all variables (all P > .197), although the order or treatment allocation may play a role for strength (P = .037) and jumping (P = .003). Power, agility, and countermovement-jump height were statistically equivalent for the intervention period. Following the VM treatment, changes in strength seem to transfer favorably to changes in agility (r = -.54, P < .05) but no other variables, and no significant associations were evident for the Con treatment.

CONCLUSION: Regardless of treatment, power, agility, and jump height were conserved throughout the treatment period. Although changes in mean sprint and strength were not significantly different from zero, it was not possible to conclude whether performance decrements could be eliminated.

PMID:37558219 | DOI:10.1123/ijspp.2023-0130

J Dermatolog Treat. 2023 Dec;34(1):2245080. doi: 10.1080/09546634.2023.2245080.

ABSTRACT

Hand eczema is one of the most frequent dermatological diseases, with an incidence increased during the COVID-19 pandemic. The impact on life quality is considerable, giving rise to the need for a psycho-dermatological approach. This is a Randomized Control Trial (RCT) evaluating, either by the dermatological or psychological point of view, the effectiveness of an emollient and rehydrating topical product (Rilastil Difesa Sterile® cream) versus a standard treatment (i.e. moisturizing basic cream) in a group of 51 healthcare workers suffering from hand eczema during the COVID-19 pandemic. The enrolled subjects were randomized into a treatment or a control arm, treated for 8 weeks, and monitored through a clinical score (HECSI) and questionnaires evaluating the impact of the pathology and treatment on quality of life (DLQI and QOLHEQ). A psychometric evaluation was performed using the SCL-90 R, OCI-R, and CPDI scales. Our data, despite not reaching the statistical significance, demonstrated that both the clinical and psychological scores decreased mostly in patients treated with Rilastil Difesa Sterile^® cream when compared to those treated with simple topical emollients. Moreover, we observed a high level of psychic suffering in dermatological patients and a parallel change in dermatological and psychological indicators, thus confirming their connection.

PMID:37558217 | DOI:10.1080/09546634.2023.2245080

Aust J Prim Health. 2023 Aug 10. doi: 10.1071/PY22227. Online ahead of print.

ABSTRACT

BACKGROUND: The 75+ health assessment has been identified as a suitable trigger to introduce advance care planning (ACP) to general practice patients. Australian general practitioners (GPs) were surveyed to explore their perceptions, attitudes and practices in introducing ACP during 75+ health assessments.

METHODS: A cross-sectional postal survey of Australian GPs covering their personal, professional and workplace characteristics, their current practice regarding ACP within a 75+ health assessment, and their attitude towards ACP. Multivariate logistic regression was used to analyse the factors associated with routinely discussing ACP as part of the 75+ health assessment.

RESULTS: A total of 185 (19.2%) out of 964 eligible GPs returned a completed survey. Most GPs reported that patients interested in ACP were supported by the GPs or the practice nurse. Two factors, (1) attitude that ACP is an essential component of the 75+ health assessment, and (2) regional or rural location of the practice, had a statistically and clinically significant association with the GP’s self-reported discussion of ACP during 75+ health assessments.

CONCLUSIONS: GPs showed a high level of support and involvement in discussing ACP during 75+ health assessments. ACP support during 75+ health assessments was often provided directly by the GP or via the practice nurse. Given the international evidence that ACP training programs improve skills and knowledge, and foster positive attitudes towards ACP, there is an important need to continue funding ACP training programs for GPs and practice nurses.

PMID:37558212 | DOI:10.1071/PY22227

Exp Parasitol. 2023 Aug 7:108591. doi: 10.1016/j.exppara.2023.108591. Online ahead of print.

ABSTRACT

Mass rearing of mosquitoes as required to fulfil research studies is a technically challenging endeavor. Blood meal source has been recognized as a key consideration in mass rearing of mosquitoes that affects colony health and fecundity. Four species of laboratory-colonized mosquitoes from the Department of Entomology, US Army Medical Directorate – Armed Forces Research Institute of Medical Sciences (USAMD-AFRIMS); Anopheles cracens, An. dirus, An. minimus and An. sawadwongporni were fed blood meals from human and rhesus macaque sources using an artificial membrane feeder. The effects of different blood meal sources were evaluated concerning blood-feeding, survival and reproduction (fecundity and hatching rates). Adult survival was monitored at days 7, 14 and 21 post blood-feeding. Although the mosquitoes fed on human blood exhibited higher rates of engorgement, there were no significant differences in blood-feeding rates in An. cracens (P = 0.08) and An. dirus (P = 0.91) between rhesus macaque and human blood sources. Twenty-one days post-feeding, no significant differences were observed in the survival rates of mosquitoes fed on human versus rhesus macaque blood. Except for An. dirus, which had better survival rates with human blood (97.5%) than after feeding on rhesus macaque blood (95.4%). All mosquito species fed on human blood produced significantly more eggs when compared to those fed on rhesus macaque blood. However, there was no statistical difference in hatching rates between blood sources, except for An. dirus, which had better hatching rates with human blood. These results indicate that human and rhesus macaque blood may be a viable alternative for maintaining Anopheles mosquitoes in colony.

PMID:37558194 | DOI:10.1016/j.exppara.2023.108591

J Endod. 2023 Aug 7:S0099-2399(23)00471-5. doi: 10.1016/j.joen.2023.07.026. Online ahead of print.

ABSTRACT

INTRODUCTION: A combination labial infiltration (1.8 mL) plus lingual infiltration (1.8 mL) of 4% articaine with 1:100,000 epinephrine in the mandibular lateral incisor was found superior to a labial infiltration of 1.8 mL of the same solution. However, it is not known whether the volume or the location had the greatest effect. Therefore, the purpose of this prospective, randomized crossover study was to determine the anesthetic efficacy of a labial infiltration of a 3.6 mL volume of 4% articaine with 1:100,000 epinephrine compared to labial infiltration (1.8 mL) plus lingual infiltration (1.8 mL) of 4% articaine with 1:100,000 epinephrine in the mandibular lateral incisor.

METHODS: One hundred subjects randomly received two sets of injections, using 4% articaine with 1:100,000 epinephrine, consisting of labial and lingual infiltrations of 1.8 mL (3.6 mL total) and two labial infiltrations of 1.8 mL (3.6 mL total) of the mandibular lateral incisor in two separate appointments. Electric pulp testing was used to determine anesthetic success (highest 80/80 reading). The data were analyzed statistically.

RESULTS: The labial and lingual combination exhibited a significantly higher anesthetic success rate (97%) when compared to the two labial infiltrations (74%) and had significantly higher 80/80s readings from 1 minute to 58 minutes.

CONCLUSIONS: Within the limitations of this clinical study, a combination labial plus lingual infiltration using a 3.6 mL volume of 4% articaine with 1:100,000 epinephrine significantly increased pulpal anesthetic success for the mandibular lateral incisor when compared to a labial infiltration using a 3.6 mL volume of articaine. Therefore, location of the infiltrations was more important than volume.

PMID:37558177 | DOI:10.1016/j.joen.2023.07.026

J Obstet Gynaecol Can. 2023 Aug 7:S1701-2163(23)00498-X. doi: 10.1016/j.jogc.2023.08.001. Online ahead of print.

ABSTRACT

OBJECTIVE: Our objective was to explore the workforce and clinical care of first and second trimester surgical abortion (FTSA, STSA) providers following the publication of updated Society of Obstetricians and Gynaecologists of Canada (SOGC) surgical abortion guidelines.

METHODS: We conducted a national, cross-sectional, online, self-administered survey of physicians who provided abortion care in 2019. This anonymized survey collected participant demographics, types of abortion services, and characteristics of FTSA and STSA clinical care. Through health care organizations using a modified Dillman technique, we recruited from July to December 2020. Descriptive statistics were generated by R Statistical Software.

RESULTS: We present the data of 222 surgical abortion provider respondents, of whom 219 provided FTSA, 109 STSA, and 106 both. Respondents practiced in every Canadian province and territory. Most were obstetrician-gynaecologists (56.8%) and family physicians (36.0%). The majority of FTSA and STSA respondents were located in urban settings, 64.8% and 79.8% respectively, and more than 80% practiced in hospitals. More than 1 in 4 respondents reported <5 years’ experience with surgical abortion care and 93.2% followed SOGC guidelines. Noted guideline deviations included that prophylactic antibiotic use was not universal, and more than half of respondents used sharp curettage in addition to suction. Fewer than 5% of STSA respondents used mifepristone for cervical preparation.

CONCLUSIONS: The surgical abortion workforce is multidisciplinary and rejuvenating. Education, training, and practice supports, including SOGC guideline implementation, are required to optimize care and to ensure equitable FTSA and STSA access in both rural and urban regions.

PMID:37558165 | DOI:10.1016/j.jogc.2023.08.001