Category: Nevin Manimala

Child Maltreat. 2022 Oct 10:10775595221125454. doi: 10.1177/10775595221125454. Online ahead of print.

ABSTRACT

This study investigated whether statewide delivery of the wraparound service model (WSM) improved child and caregiver outcomes and reduced subsequent child protective service (CPS) contact among families referred to services following a CPS report. Caregivers (n = 247) completed baseline and 6-month interviews to document self-reported engagement in WSM and non-WSM conditions and assess changes in outcomes. Kernel-weighted difference-in-difference (K-DID) models were used to assess program effects, based on reported condition. Child behavior outcomes improved among WSM-engaged families, but differences by condition were non-significant except for internalizing behaviors. Caregiver receipt of WSM was associated with greater retention of behavioral health services, but did not produce statistically significant improvements in their wellbeing. Households in the WSM condition were more likely to be reported to CPS at 6-month follow-up, but this difference was not significant at 12 months and differences in substantiation were not statistically significant. Supplemental analyses compared alternative means of contrasting group effects, highlighting some differences based on method. The WSM produced few significant differential improvements in child or caregiver outcomes and failed to prevent future CPS involvement. Inadequate program fidelity appeared to be a factor in implementation of the WSM, which may have hampered program effectiveness under real-world conditions.

PMID:36214073 | DOI:10.1177/10775595221125454

Mol Nutr Food Res. 2022 Oct 10:e2200145. doi: 10.1002/mnfr.202200145. Online ahead of print.

ABSTRACT

SCOPE: Consumption of meat has been associated with a higher risk of type 2 diabetes (T2D), but if plasma metabolite profiles associated with these foods reflect this relationship is unknown. The objective was to identify a plasma metabolite signature of consumption of total meat (TM), red meat (RM), processed red meat (PRM), and fish, and to examine if they are associated with the risk of T2D.

METHODS AND RESULTS: The discovery population includes 1833 participants from the PREDIMED trial. The internal validation sample included 1522 of these participants with available 1-year follow-up metabolomic data. Cross-sectional associations between metabolites and TM, RM, PRM, and fish were evaluated with continuous elastic net regression. Prospective associations between the identified profiles and incident T2D were estimated using Cox regressions. The metabolite profiles included 72 metabolites for TM, 69 metabolites for RM, 74 metabolites for PRM, and 66 metabolites for fish. After adjusting for T2D risk factors, only the metabolite profiles of TM (HR: 1.25, 95%CI:1.06,1.49), RM (HR: 1.27, 95%CI:1.07,1.52) and PRM (HR: 1.27, 95%CI:1.07,1.51) were associated with T2D.

CONCLUSIONS: The consumption of total meat, its subtypes, and fish was associated with different metabolites, some of which have been previously associated with T2D. Scores based on the identified metabolites for TM, RM, and PRM showed a significant association with the risk of T2D in a Mediterranean population at high cardiovascular risk. This article is protected by copyright. All rights reserved.

PMID:36214069 | DOI:10.1002/mnfr.202200145

J Xray Sci Technol. 2022 Oct 7. doi: 10.3233/XST-221263. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare image quality, radiation dose, and iodine intake of coronary computed tomography angiography (CCTA) acquired by wide-detector using different tube voltages and different concentrations of contrast medium (CM) for overweight patients.

MATERIALS AND METHODS: A total of 150 overweight patients (body mass index≥25 kg/m2) who underwent CCTA are enrolled and divided into three groups according to scan protocols namely, group A (120 kVp, 370 mgI/ml CM); group B (100 kVp, 350 mgI/ml CM); and group C (80 kVp, 320 mgI/ml CM). The CT values, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and figure-of-merit (FOM) of all images are calculated. Images are subjectively assessed using a 5-point scale. In addition, the CT dose index volume (CTDIvol) and dose length product (DLP) of each patient are recorded. The effective radiation dose (ED) is also calculated. Above data are then statistically analyzed.

RESULTS: The mean CT values, SNR, CNR, and subjective image quality of group A are significantly lower than those of groups B and C (P < 0.001), but there is no significant difference between groups B and C (P > 0.05). FOMs show a significantly increase trend from group A to C (P < 0.001). The ED values and total iodine intake in groups B and C are 30.34% and 68.53% and 10.22% and 16.85% lower than those in group A, respectively (P < 0.001).

CONCLUSION: The lower tube voltage and lower concentration of CM based on wide-detector allows for significant reduction in iodine load and radiation dose in CCTA for overweight patients comparing to routine scan protocols. It also enhances signal intensity of CCTA and maintains image quality.

PMID:36214032 | DOI:10.3233/XST-221263

Work. 2022 Oct 7. doi: 10.3233/WOR-220082. Online ahead of print.

ABSTRACT

BACKGROUND: The coronavirus 2019 (COVID-19) pandemic had a major impact on the educational institutes globally and resulted in the transition from traditional educational systems to online electronic learning methods.

OBJECTIVE: This study endeavored to address and compare the dental student’s understanding regarding the Oral Biology course by assessing their knowledge and skills between the students enrolled during 2020 (online teaching) and 2021 (face-to-face teaching). This study also aimed to assess the perception of dental students regarding the virtual mode of teaching.

METHODS: This quasi-experimental study evaluated students from two years, in which a retrospective group of dental students enrolled during the academic year 2020 were compared with a prospective experimental group enrolled during the academic year 2021. Knowledge and skills for both years were compared. This comprised of theoretical and practical component. Students also completed a questionnaire that assessed student’s perception regarding online teaching.

RESULTS: A total of 98 students of Bahria University Dental College participated. A comparison between grade scores of online and traditional learning groups reported statistically significant differences (p = 0.05*) with regards to short answer question types, viva or verbal questions (p = 0.016*). Strong correlations were observed via the multivariable analysis. All correlations were statistically significant at p < 0.01 level. Learning satisfaction was not satisfactorily observed by the online learning group.

CONCLUSION: It can be concluded that despite the disruption that the educational sector had to face due to the COVID-19 pandemic, based on the differences in the subjective domain scores, students appeared to like on-campus teaching more than the online teaching, as most students found online learning to be stressful and were quite unsatisfied. However, the difference in mode of teaching did not affect the knowledge and skills of the dental students.

PMID:36214029 | DOI:10.3233/WOR-220082

Work. 2022 Oct 7. doi: 10.3233/WOR-211221. Online ahead of print.

ABSTRACT

BACKGROUND: Human error types and error factors are two important elements of error analysis. Understanding the relationship between them can contribute to new case analyses, the tendency of error occurrence statistics, error factor identification, and prevention of error recurrence.

OBJECTIVE: To provide evidence and guidance for the prevention and improvement of medication communication errors by quantitatively exploring the relationship between error types and error factors.

METHODS: Data were collected on self-reported errors in the medication administration process by nurses in all departments of three cooperative medical institutions, and an error sheet of specified style was adopted. Error types were determined by the systematic human error reduction and prediction approach method and human cognition processes. Error factors were extracted using the root cause analysis combined with Berlo’s communication model, and the relationship between error types and error factors was quantitatively studied using the partial least-squares regression method.

RESULTS: After a one-by-one analysis of 303 error cases, the communication errors occurring in the nursing medicine process could be explained by six error types and 12 error factors. In addition, 20 correlation patterns between the error types and error factors were quantitatively obtained, and their path coefficient distributions ranged from 0.088 to 0.467.

CONCLUSION: The results of this study may provide reference to understand errors and establish countermeasures from the statistics of error occurrence trend, extract error factors related to error types and determine key error factors.

PMID:36214025 | DOI:10.3233/WOR-211221

Work. 2022 Oct 3. doi: 10.3233/WOR-210927. Online ahead of print.

ABSTRACT

BACKGROUND: The Indigenous workforce in Canada is challenged by a history of Euro-Canadian colonialism that has presented deleterious health outcomes, including those in the workplace.

OBJECTIVE: The aim of this study was to describe the workplace mental health of Indigenous workers.

METHODS: We used the Canadian Community Health Survey (CCHS) between 2015 to 2016. Data were analyzed using the Public Use Microdata Files to profile the workplace mental health characteristics of First Nation Canadians (n = 6,297) and Canadians (n = 84,155). We utilized secondary data analysis design. The analyses included descriptive statistics (e.g., means and standard deviations) of self-reported mood disorders (depression, bipolar, mania, dysthymia), anxiety (phobia, OCD, panic) and occupational factors (e.g., demographic, days off work due to an acute mental health condition, job type, and job stress) in indigenous peoples living off-reserve and other Aboriginal settlements in the provinces.

RESULTS: We examined the indigenous cohort between the ages of 18-64 who were employed. The sample was 53.1% male, married (34.8% ), and obtained a post-secondary diploma or university degree (57.9% ). The study reported statistically significant gender and age differences across mood and anxiety disorders (p < 0.05), job stress (p < 0.05) and workload (p < 0.05).

CONCLUSION: To the best of our knowledge, this is the first study to describe the work profile of indigenous populations in Canada across various occupational mental health (e.g., mood disorders, anxiety) and demographic (e.g., age, education attainment) outcomes.

PMID:36214013 | DOI:10.3233/WOR-210927

BMC Rheumatol. 2022 Oct 10;6(1):58. doi: 10.1186/s41927-022-00289-5.

ABSTRACT

BACKGROUND: This longitudinal study investigated whether changes in autonomous and controlled motivation to reduce sedentary behaviour were associated with variability in sedentary, standing and stepping time and, in turn, disease activity, systemic inflammation, pain and fatigue in rheumatoid arthritis (RA).

METHODS: People with RA undertook assessments at baseline (T1, n = 104) and 6 months follow-up (T2, n = 54) to determine autonomous and controlled motivation to reduce sedentary behaviour (Behavioural Regulation in Exercise Questionnaire-2), free-living sedentary, standing and stepping time (7 days activPAL3^μ wear), Disease Activity Score-28 (DAS-28), systemic inflammation (c-reactive protein [CRP]), pain (McGill Pain Questionnaire) and fatigue (Multidimensional Assessment of Fatigue Scale). N = 52 participants provided complete data at T1 and T2.

STATISTICAL ANALYSES: In a series of models (A and B), path analyses examined sequential associations between autonomous and controlled motivation to reduce sedentary behaviour with activPAL3^μ-assessed behaviours and, in turn, RA outcomes.

RESULTS: Models demonstrated good fit to the data. Model A (sedentary and stepping time): autonomous motivation was significantly negatively associated with sedentary time and significantly positively related to stepping time. In turn, sedentary time was significantly positively associated with CRP and pain. Stepping time was not significantly associated with any health outcomes. Model B (standing time): autonomous motivation was significantly positively associated with standing time. In turn, standing time was significantly negatively related to CRP, pain and fatigue.

CONCLUSIONS: Autonomous motivation to reduce sedentary behaviour is associated with sedentary and standing time in RA which may, in turn, hold implications for health outcomes.

PMID:36210469 | DOI:10.1186/s41927-022-00289-5

Pediatr Cardiol. 2022 Oct 9. doi: 10.1007/s00246-022-03017-5. Online ahead of print.

ABSTRACT

Children with COVID-19 usually show milder symptoms than adults; however, a minority of them may have cardiac involvement. We aimed to identify the role of troponin I levels that may predict early cardiac involvement in children with COVID-19. A single-center retrospective study was conducted to evaluate hospitalized children diagnosed with COVID-19 between March 11, 2020, and December 31, 2021. Patients with available troponin I levels and with no known cardiac disease were included. During the study period, 412 children with COVID-19 who had troponin I levels on admission were identified. Troponin levels were elevated in 7 (1.7%) patients and were normal in 395 (98.3%) patients. The median age of patients with elevated troponin levels was 4 (min. 2-max. 144) months, which was statistically lower than the age of patients with normal troponin levels (P = 0.035). All the patients with elevated troponin levels had tachycardia. Out of 7 patients with high troponin levels, 3 (42.9%) of them were admitted to the pediatric intensive care unit (PICU), 2 (28.6%) required oxygen support, and 1 (14.3%) required a mechanical ventilator. Patients with elevated troponin levels had a statistically longer hospital stay (P < 0.001). Neutropenia, tachycardia, PICU admission, oxygen support, and mechanical ventilation were statistically more common in patients with elevated troponin levels (P values were 0.033, 0.020, < 0.001, 0.050, and < 0.001, respectively). Electrocardiography (ECG) and echocardiography (ECHO) were performed on all patients with elevated troponin levels, and 6 (85.8%) patients were diagnosed with myocarditis. The ECG and ECHO have been performed in 58 (14.3%) out of 405 patients with normal troponin levels. Two (3.5%) patients had negative T waves on ECG, and all ECHOs were normal. Our results suggest that elevated troponin I levels in children with COVID-19 can be used to evaluate cardiac involvement and decide the need for further pediatric cardiologist evaluation.

PMID:36210385 | DOI:10.1007/s00246-022-03017-5

Arch Orthop Trauma Surg. 2022 Oct 9. doi: 10.1007/s00402-022-04644-6. Online ahead of print.

ABSTRACT

INTRODUCTION: In older people, hip fracture can lead to adverse outcomes. Frailty, capturing biological age and vulnerability to stressors, can indicate those at higher risk. We derived a frailty index (FI) in the Irish Hip Fracture Database (IHFD) and explored associations with prolonged length of hospital stay (LOS ≥ 30 days), delirium, inpatient mortality and new nursing home admission. We assessed whether the FI predicted those outcomes independently of age, sex and pre-operative American Society of Anaesthesiology (ASA) score.

MATERIALS AND METHODS: A 21-item FI was constructed with 17 dichotomous co-morbidities, three 4-level ordinal pre-morbid functional variables (difficulty with indoor mobility, outdoor mobility, and shopping) and nursing home provenance (yes/no). The FI was computed as the proportion of items present and divided into tertiles (low, medium, high risk). Independent associations between FI and outcomes were explored with logistic regression, from which we extracted adjusted Odds Ratios (aOR) and Areas Under the Curve (AUC).

RESULTS: From 2017 to 2020, the IHFD included 14,615 hip fracture admissions, mean (SD) age 80.4 (8.8), 68.9% women. Complete FI data were available for 12,502 (85.5%). By FI tertile (low to high risk), prolonged LOS proportions were 5.9%, 16.1% and 23.1%; delirium 5.5%, 13.5% and 17.6%; inpatient mortality 0.6%, 3.3% and 10.1%; and new nursing home admission 2.2%, 5.9% and 11.3%. All associations were statistically significant (p < 0.001) independently of age and sex. AUC analyses showed that the FI score, added to age, sex, and ASA score, significantly improved the prediction of delirium and new nursing home admission (p < 0.05), and especially prolonged LOS and inpatient mortality (p < 0.001).

CONCLUSIONS: A 21-item FI in the IHFD was a significant predictor of outcomes and added value to traditional risk markers. The utility of a routinely derived FI to more effectively direct limited orthogeriatric resources requires prospective investigation.

PMID:36210379 | DOI:10.1007/s00402-022-04644-6

Sci Rep. 2022 Oct 9;12(1):16944. doi: 10.1038/s41598-022-21304-2.

ABSTRACT

The combination of molecular tools, standard surveying techniques, and long-term monitoring programs are relevant to understanding environmental and ecological changes in coral reef communities. Here we studied temporal variability in cryptobenthic coral reef communities across the continental shelf in the central Red Sea spanning 6 years (three sampling periods: 2013-2019) and including the 2015 mass bleaching event. We used a combination of molecular tools (barcoding and metabarcoding) to assess communities on Autonomous Reef Monitoring Structures (ARMS) as a standardized sampling approach. Community composition associated with ARMS for both methodologies (barcoding and metabarcoding) was statistically different across reefs (shelf position) and time periods. The partition of beta diversity showed a higher turnover and lower nestedness between pre-bleaching and post-bleaching samples than between the two post-bleaching periods, revealing a community shift from the bleaching event. However, a slight return to the pre-bleaching community composition was observed in 2019 suggesting a recovery trajectory. Given the predictions of decreasing time between bleaching events, it is concerning that cryptobenthic communities may not fully recover and communities with new characteristics will emerge. We observed a high turnover among reefs for all time periods, implying a homogenization of the cryptobiome did not occur across the cross shelf following the 2015 bleaching event. It is possible that dispersal limitations and the distinct environmental and benthic structures present across the shelf maintained the heterogeneity in communities among reefs. This study has to the best of our knowledge presented for the first time a temporal aspect into the analysis of ARMS cryptobenthic coral reef communities and encompasses a bleaching event. We show that these structures can detect cryptic changes associated with reef degradation and provides support for these being used as long-term monitoring tools.

PMID:36210380 | DOI:10.1038/s41598-022-21304-2