Category: Nevin Manimala

J Am Acad Psychiatry Law. 2024 Jun 4;52(2):153-160. doi: 10.29158/JAAPL.240008-24.

ABSTRACT

A systematic review of the literature on restoration of competence to stand trial identified a predominance of retrospective case studies using descriptive and correlational statistics. Guided by National Institutes of Health (NIH) quality metrics and emphasizing study design, sample size, and statistical methods, the authors categorized a large majority of studies as fair in quality, underscoring the need for controlled designs, larger representative samples, and more sophisticated statistical analyses. Implications for the state of forensic research include the need to use large databases within jurisdictions and the importance of reliable methods that can be applied across jurisdictions and aggregated for meta-analysis. More sophisticated research methods can be advanced in forensic fellowship training where coordinated projects and curricula can encourage systematic approaches to forensic research.

PMID:38834368 | DOI:10.29158/JAAPL.240008-24

J Nurs Meas. 2024 Jun 4:JNM-2023-0022.R1. doi: 10.1891/JNM-2023-0022. Online ahead of print.

ABSTRACT

Background and Purpose: This study was conducted to develop a measurement tool to determine the perception of pregnancy. Methods: The scale was developed in four main stages: the design and development of the items, submitting the draft form to expert opinion, administration of the scale, and performing construct validity and reliability analyses. The study data were collected from 327 women with pregnancies between May 1, 2020, and February 1, 2021. The Statistical Package for the Social Sciences 22 and LISREL software packages were used to evaluate the data. Results: The result of the exploratory factor analysis of the scale indicated that there were three factors with an eigenvalue of greater than 1 and that the factors explained 54.152% of the total variance. Cronbach’s alpha values of the factors were .84, .80, and .81, respectively. Conclusions: Considering the factor structure, item-total test correlations, and reliability coefficients, the negative perceptions of the pregnancy scale that was developed in this study can be used to determine the perception of pregnancy.

PMID:38834353 | DOI:10.1891/JNM-2023-0022

J Nurs Meas. 2024 Jun 4:JNM-2023-0110.R1. doi: 10.1891/JNM-2023-0110. Online ahead of print.

ABSTRACT

Background and Purpose: Stability testing, conducted using a test-retest protocol, measures an instrument’s reliability by evaluating the consistency of participant responses to survey questions with repeated testing within a short interval. No studies have measured the stability of the Verran Professional Governance Scale^© (VPGS). The purpose of this study was to evaluate the test-retest reliability of the VPGS. Methods: Volunteers from a parent study using the VPGS were sent a link to a retest version of the survey 14 days after taking the initial survey with a reminder email sent 5 days after the first request. Item-level and subscale comparisons were made between participants’ initial and retest responses using intraclass correlation coefficients (ICCs) applying a two-way random-effects model. Results: VPGS subscales had ICC scores of 0.71 for decision-making, 0.73 for collateral relationships, and 0.86 for professional obligation. Conclusions: Findings suggest that the VPGS demonstrates test-retest reliability. Future research should evaluate the instrument’s responsiveness.

PMID:38834352 | DOI:10.1891/JNM-2023-0110

J Allied Health. 2024 Summer;53(2):e77-e91.

ABSTRACT

BACKGROUND: Data management (DM) systems represent an opportunity for innovation in education and data-driven decision-making (DDDM) in allied health education. Understanding clinical education (CE) DM systems in entry-level physical therapy (PT) education programs could provide valuable insight into structure and operation and may represent opportunities to address CE challenges. The purpose of this study is to describe how PT programs are using CE DM systems to inform recommendations for CE DM and support knowledge sharing and DDDM.

SUBJECTS: CE faculty and administrators were recruited from entry-level PT education programs to participate in a cross-sectional survey.

METHODS: The authors designed a novel survey which included demographics and use of CE DM systems. Descriptive statistics and content analysis of narrative data were used to examine responses.

RESULTS: The survey was distributed to 220 academic PT programs in June 2021 with 111 respondents (50% response rate). Respondents use multiple systems to complete CE tasks (e.g., placement process, on-boarding, agreement tracking, as a CE site database). Forty-three percent (n=47) use one system, 76% (n=35) of those use the same Software as a Service vendor. Eighty-six percent (n=96) are satisfied with their current CE DM system. Respondents enter data related to CE site information, CE environment, length of the CE experience, and accreditation-required clinical instructor information. Ninety-four percent (n=93) and 70% (n=70) extract data to make decisions about the placement process and curriculum, respectively.

CONCLUSION: While variability across CE DM systems presents a challenge, survey respondents indicated common practices related to functionality, data entry, and extraction. Clinical education DM systems house critical data to address challenges in CE. Strategies to improve accessibility and use of this data to support DDDM should be explored.

PMID:38834346

J Allied Health. 2024 Summer;53(2):155-160.

ABSTRACT

PURPOSE: The highest rates mTBI occurrence are seen among geriatric populations (ages ≥65), and these patients often have persistent and untreated symptoms. This study’s purpose was to explore mild traumatic brain injury initial onset (mTBI-IN) and mild traumatic brain injury subsequent (mTBI-S) emergency department (ED) visit population percentages and associations with geriatric (population ages ≥65), sex, and fall mechanism of injury.

METHODS: The design was a population-based cross-sectional study using data from the 2018 Nationwide Emergency Department Sample (NEDS). Study sample size was 261,349. An independent t-test was used to investigate mean age differences between mTBI-IN and mTBI-S. Pearson’s chi-squared correlational analyses were used to investigate associations of age, sex, and fall injury with mTBI-IN and mTBI-S.

RESULTS: The mean age of those in 2018 with ED visits suggested that age was older for those patients with mTBI-S (age mean, 50.4 yrs) than those with mTBI-IN (age mean, 41.4 yrs) (95% CI 9.77, 8.30; p=0.025). The number of visits for those aged ≥65 was significantly associated with mTBI-S (p<0.001). More males than females reported mTBI-S ED visits in all ages (p=0.022). Falls injury alone was not found to be significantly associated with visits (p<0.001).

CONCLUSIONS: Those returning to the ED for continued care after mTBI were associated with those aged ≥65. Monitoring after mTBI ED visits may need to target geriatric populations for medical management.

PMID:38834343

J Allied Health. 2024 Summer;53(2):116-121.

ABSTRACT

OBJECTIVE: Today’s healthcare system requires interprofessional collaborative practice (IPCP) to improve health outcomes. IPCP often begins with interprofessional education (IPE), which should stimulate meaningful idea exchange. This study’s purpose was to assess the impact of a photovoice-based IPE experience on the attitudes and beliefs of students in two health professions programs.

METHODS: Forty-two Doctor of Physical Therapy students and 13 Radiation Therapy students created photovoice slides representing the most significant “thing” in their professional education. Students discussed their slides in small groups followed by a large-group discussion. A pretest-posttest survey containing researcher-generated questions and the Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R2) and a post-activity evaluation were administered.

RESULTS: Forty-two students completed the pretest survey; 35 completed the posttest survey. A statistically significant difference was found between pretest (M=4.07, SD=0.91) and posttest (M=4.45, SD=0.70) SPICE-R2 total scores, t(928)=7.22, p<0.001. Statistically significant differences were found for all SPICE-R2 factor scores. Thematic analysis revealed three themes: 1) students learned about the other profession, 2) the IPE experience was meaningful, and 3) the IPE experience could be improved.

CONCLUSIONS: The photovoice IPE experience stimulated student reflection, interprofessional collaboration, and new perceptions about the other health profession. Future studies should focus on similar activities offered earlier in the education program.

PMID:38834337

J Allied Health. 2024 Summer;53(2):105-115.

ABSTRACT

Health professions educators can benefit from continuing education to more effectively facilitate interprofessional education (IPE) in clinical settings. Online learning formats enable broader participation and overcome barriers to in-person events, though few studies describe the most effective platforms and methods of online continuing education for this purpose. In the context of the COVID-19 pandemic, we developed a 6-week interactive online program implemented via an integrated online educational platform (OEP) to equip participants with knowledge and skills to better facilitate IPE in clinical settings. Program outcomes evaluation involved mixed-methods data analysis from OEP site usage statistics, pre/post-program surveys, pre/post program validated self-assessment surveys, and post-pro¬gram focus group. Twenty-four participants representing 5 professions from inpatient and outpatient clinical settings completed the program. Quantitative findings include statistically significant improvement in all of 11 measures of IPE knowledge and skills developed for this study, 4 of 9 socialization measures, and 7 of 18 facilitation measures. Qualitative findings include participants placing value on multiple modes of instruction, facilitated small group engagement, brief condensed asynchronous content, clear expectations of program time commitment, and detailed understanding of the OEP.

PMID:38834336

BMJ Open Diabetes Res Care. 2024 Jun 4;12(3):e004191. doi: 10.1136/bmjdrc-2024-004191.

ABSTRACT

INTRODUCTION: None of the studies of type 2 diabetes (T2D) subtyping to date have used linked population-level data for incident and prevalent T2D, incorporating a diverse set of variables, explainable methods for cluster characterization, or adhered to an established framework. We aimed to develop and validate machine learning (ML)-informed subtypes for type 2 diabetes mellitus (T2D) using nationally representative data.

RESEARCH DESIGN AND METHODS: In population-based electronic health records (2006-2020; Clinical Practice Research Datalink) in individuals ≥18 years with incident T2D (n=420 448), we included factors (n=3787), including demography, history, examination, biomarkers and medications. Using a published framework, we identified subtypes through nine unsupervised ML methods (K-means, K-means++, K-mode, K-prototype, mini-batch, agglomerative hierarchical clustering, Birch, Gaussian mixture models, and consensus clustering). We characterized clusters using intracluster distributions and explainable artificial intelligence (AI) techniques. We evaluated subtypes for (1) internal validity (within dataset; across methods); (2) prognostic validity (prediction for 5-year all-cause mortality, hospitalization and new chronic diseases); and (3) medication burden.

RESULTS: Development: We identified four T2D subtypes: metabolic, early onset, late onset and cardiometabolic. Internal validity: Subtypes were predicted with high accuracy (F1 score >0.98). Prognostic validity: 5-year all-cause mortality, hospitalization, new chronic disease incidence and medication burden differed across T2D subtypes. Compared with the metabolic subtype, 5-year risks of mortality and hospitalization in incident T2D were highest in late-onset subtype (HR 1.95, 1.85-2.05 and 1.66, 1.58-1.75) and lowest in early-onset subtype (1.18, 1.11-1.27 and 0.85, 0.80-0.90). Incidence of chronic diseases was highest in late-onset subtype and lowest in early-onset subtype. Medications: Compared with the metabolic subtype, after adjusting for age, sex, and pre-T2D medications, late-onset subtype (1.31, 1.28-1.35) and early-onset subtype (0.83, 0.81-0.85) were most and least likely, respectively, to be prescribed medications within 5 years following T2D onset.

CONCLUSIONS: In the largest study using ML to date in incident T2D, we identified four distinct subtypes, with potential future implications for etiology, therapeutics, and risk prediction.

PMID:38834334 | DOI:10.1136/bmjdrc-2024-004191

BMJ Open Respir Res. 2024 Jun 4;11(1):e002148. doi: 10.1136/bmjresp-2023-002148.

ABSTRACT

OBJECTIVE: This study aims to explore the common genetic basis between respiratory diseases and to identify shared molecular and biological mechanisms.

METHODS: This genome-wide pleiotropic association study uses multiple statistical methods to systematically analyse the shared genetic basis between five respiratory diseases (asthma, chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, lung cancer and snoring) using the largest publicly available genome wide association studies summary statistics. The missions of this study are to evaluate global and local genetic correlations, to identify pleiotropic loci, to elucidate biological pathways at the multiomics level and to explore causal relationships between respiratory diseases. Data were collected from 27 November 2022 to 30 March 2023 and analysed from 14 April 2023 to 13 July 2023.

MAIN OUTCOMES AND MEASURES: The primary outcomes are shared genetic loci, pleiotropic genes, biological pathways and estimates of genetic correlations and causal effects.

RESULTS: Significant genetic correlations were found for 10 paired traits in 5 respiratory diseases. Cross-Phenotype Association identified 12 400 significant potential pleiotropic single-nucleotide polymorphism at 156 independent pleiotropic loci. In addition, multitrait colocalisation analysis identified 15 colocalised loci and a subset of colocalised traits. Gene-based analyses identified 432 potential pleiotropic genes and were further validated at the transcriptome and protein levels. Both pathway enrichment and single-cell enrichment analyses supported the role of the immune system in respiratory diseases. Additionally, five pairs of respiratory diseases have a causal relationship.

CONCLUSIONS AND RELEVANCE: This study reveals the common genetic basis and pleiotropic genes among respiratory diseases. It provides strong evidence for further therapeutic strategies and risk prediction for the phenomenon of respiratory disease comorbidity.

PMID:38834332 | DOI:10.1136/bmjresp-2023-002148

BMJ Open. 2024 Jun 4;14(6):e078085. doi: 10.1136/bmjopen-2023-078085.

ABSTRACT

OBJECTIVES: This study aims to investigate the incidence, associated factors and interventions to address teen pregnancy involvement (TPI) among African, Caribbean and Black (ACB) adolescents in North America.

DESIGN: We conducted a scoping review of the literature, guided by the social-ecological model.

DATA SOURCES: Studies were retrieved from databases such as Ovid Medline, Ovid Embase, CINAHL, CAB Direct and Google Scholar and imported into COVIDENCE for screening.

ELIGIBILITY CRITERIA: The Joanna Briggs Institute scoping reviews protocol guided the establishment of eligibility criteria. Included studies focused on rates, associated factors and interventions related to TPI among ACB boys and girls aged 10-19 in North America. The publication time frame was restricted to 2010-2023, encompassing both peer-reviewed and non-peer-reviewed studies with diverse settings.

DATA EXTRACTION AND SYNTHESIS: Data were extracted from 32 articles using a form developed by the principal author, focusing on variables aligned with the research question.

RESULTS: The scoping review revealed a dearth of knowledge in Canadian and other North American literature on TPI in ACB adolescents. Despite an overall decline in teen pregnancy rates, disparities persist, with interventions such as postpartum prescription of long-acting birth control and teen mentorship programmes proving effective.

CONCLUSION: The findings highlight the need for increased awareness, research and recognition of male involvement in adolescent pregnancies. Addressing gaps in housing, employment, healthcare, sexual health education and health systems policies for marginalised populations is crucial to mitigating TPI among ACB adolescents.

IMPACT: The review underscores the urgent need for more knowledge from other North American countries, particularly those with growing ACB migrant populations.

PMID:38834331 | DOI:10.1136/bmjopen-2023-078085