Category: Nevin Manimala

SAGE Open Nurs. 2023 Jul 5;9:23779608231185922. doi: 10.1177/23779608231185922. eCollection 2023 Jan-Dec.

ABSTRACT

INTRODUCTION: A colostomy is a surgical procedure that brings one end of the large intestine out through the abdominal wall. Approximately 100,000 people in incidence in the United States undergo operations that result in a colostomy or ileostomy each year.

OBJECTIVE: To assess knowledge and associated factors toward colostomy care among staff Nurses working at Dessie Town governmental hospitals, Ethiopia 2022.

METHODS: Institutional-based cross-sectional study design was conducted at governmental hospitals in Dessie Town from August 1, 2022 to August 25, 2022. A simple random sampling technique was deployed using a self-administered questionnaire. Descriptive statistics analyses such as frequencies, percentage, and mean were used to summarize the results. Both bivariable and multivariable logistic regressions were employed to identify factors associated with participants’ knowledge of colostomy care. A p-value of <.05 and 95% confidence interval (CI) was used to declare statistical significance.

RESULTS: A total of 265 nurses participated making a response rate of 98.1%. About 57.6% (157) of the participants had good knowledge of providing colostomy care. Having a clinical experience of 4-6 years (adjusted odds ratio [AOR] = 2.4 95% CI: 1.186, 5.513), 6-8 years (AOR = 2.5, 95% CI: 1.981, 6.177), and >8 years (AOR = 3.3, 95% CI: 1.481, 7.394), providing colostomy care for 6-10 patients (AOR = 2.6, 95% CI: 1.186, 5.512) and 10 or more patients (AOR = 3.3, 95% CI: 1.480, 7.394), and routine reading of professional (AOR = 1.83, 95% CI: 1.062, 3.153) were significantly associated with good knowledge of colostomy care.

CONCLUSION AND RECOMMENDATION: Knowledge of colostomy care was not satisfactory among nurse professionals working in governmental hospitals in Dessie town. Participation in the training of colostomy care, having more than eight years of experience, providing colostomy care for more than seven patients, attending scientific colostomy meetings, and reading professional literature were significant factors associated with good knowledge of providing colostomy care. Thus, capacity-building in-service training is required to enhance the knowledge of colostomy care.

PMID:37435579 | PMC:PMC10331234 | DOI:10.1177/23779608231185922

TH Open. 2023 Jul 10;7(3):e195-e205. doi: 10.1055/s-0043-1770782. eCollection 2023 Jul.

ABSTRACT

Background Intracerebral hemorrhage is the most serious complication of anticoagulant therapy but the effects of different types of oral anticoagulants on the expansion of these hemorrhages are still unclear. Clinical studies have revealed controversial results; more robust and long-term clinical evaluations are necessary to define their outcomes. An alternative is to test the effect of these drugs in experimental models of intracerebral bleeding induced in animals. Aims To test new oral anticoagulants (dabigatran etexilate, rivaroxaban, and apixaban) in an experimental model of intracerebral hemorrhage induced by collagenase injection into the brain striatum of rats. Warfarin was used for comparison. Methods Ex vivo anticoagulant assays and an experimental model of venous thrombosis were employed to determine the doses and periods of time required for the anticoagulants to achieve their maximum effects. Subsequently, volumes of brain hematoma were evaluated after administration of the anticoagulants, using these same parameters. Volumes of brain hematoma were evaluated by magnetic resonance imaging, H&E (hematoxylin and eosin) staining, and Evans blue extravasation. Neuromotor function was assessed by the elevated body swing test. Results and Conclusions The new oral anticoagulants did not increase intracranial bleeding compared with control animals, while warfarin markedly favored expansion of the hematomas, as revealed by magnetic resonance imaging and H&E staining. Dabigatran etexilate caused a modest but statistically significant increase in Evans blue extravasation. We did not observe significant differences in elevated body swing tests among the experimental groups. The new oral anticoagulants may provide a better control over a brain hemorrhage than warfarin.

PMID:37435564 | PMC:PMC10332909 | DOI:10.1055/s-0043-1770782

Psychogeriatrics. 2023 Jul 11. doi: 10.1111/psyg.13000. Online ahead of print.

ABSTRACT

BACKGROUND: Because of physiological changes in geriatric patients, their surgical process differs from that of young adults. In this regard, the perioperative period is an extremely risky time for geriatric patients. The present study examined preoperative fear, anxiety, and perceived stress levels as well as the factors affecting them in elderly patients prior to surgical intervention.

METHODS: This study adopted a cross-sectional descriptive design. The study sample consisted of geriatric patients (n = 407) scheduled for elective laparoscopic cholecystectomy in a research and training hospital in northeast Turkey. Data were collected by the researchers using the personal information form, Perceived Stress Scale (PSS-10), Surgical Fear Questionnaire (SFQ) and Anxiety Specific to Surgery Questionnaire (ASSQ). In the data analysis, descriptive statistics, the t-test in independent groups, one-way analysis of variance (ANOVA), correlation analysis and Bonferroni tests for post hoc analyses were used.

RESULTS: On the PSS-10, the mean score was higher for the 75-and-older age group, single patients, patients with a disease requiring medication, and those who had previously undergone surgery (P < 0.05). On the ASSQ, the mean score was lower for patients aged 65-69, university graduates, patients without children, and those without a disease requiring medication (P < 0.05). On the SFQ, the mean score was higher for the 75-and-older age group, primary school graduates, and single patients (P < 0.05).

CONCLUSION: It was determined that being single, having a chronic disability, and advancing age had an effect on the patients’ surgery-specific anxiety, perceived stress, and fear of surgery. Long-standing chronic diseases can negatively affect both stress and anxiety levels of individuals.

PMID:37433670 | DOI:10.1111/psyg.13000

J Clin Pathol. 2023 Jul 11:jclinpath-2021-207975. doi: 10.1136/jcp-2021-207975. Online ahead of print.

ABSTRACT

AIMS: Microbial flora of dental plaque trigger innate and adaptive immune responses. The function of antigen-presenting cells (APCs) is to bridge the innate and adaptive immune systems. The human immune system contains three main types of APCs: dendritic cells (DC) (Langerhans cells (LCs) and interstitial DCs, IDCs), macrophages and B lymphocytes. In this study, the distribution and density of all APCs in healthy and inflamed human gingival tissue were comparatively analysed.

METHODS: Research was conducted on gingival biopsy specimens obtained from 55 patients and classified in three groups: healthy gingiva (control group, n=10), moderate periodontal disease (PD) (n=21) and severe PD (n=24). For APCs’ identification antibodies raised against CD_1a (for LCs), S₁₀₀ protein (for iDCs), CD₆₈ (for macrophages) and CD₂₀ (for B lymphocytes) were used.

RESULTS: Increased density of IDCs, macrophages and B lymphocytes in lamina propria and reduced density of LCs in the gingival epithelium were found in patients with periodontitis. Simultaneously, it was noticed an increased concentration of macrophages and B cells in the gingival epithelium in patients with PD. No statistically significant difference in the distribution and density of APC was found among patients with moderate and advanced periodontitis.

CONCLUSIONS: It was hypothesised that in the periodontitis the role of antigen presentation was largely taken from LCs by the DCs, macrophages and B cells. These APCs are thought to have less protective and tolerogenic potential than LCs and this is a significant reason for alveolar bone destruction in periodontitis.

PMID:37433669 | DOI:10.1136/jcp-2021-207975

Chaos. 2023 Jul 1;33(7):073123. doi: 10.1063/5.0145079.

ABSTRACT

Urban road networks (URNs), as simplified views and important components of cities, have different structures, resulting in varying levels of transport efficiency, accessibility, resilience, and many socio-economic indicators. Thus, topological characteristics of URNs have received great attention in the literature, while existing studies have used various boundaries to extract URNs for analysis. This naturally leads to the question of whether topological patterns concluded using small-size boundaries keep consistent with those uncovered using commonly adopted administrative boundaries or daily travel range-based boundaries. This paper conducts a large-scale empirical analysis to reveal the boundary effects on 22 topological metrics of URNs across 363 cities in mainland China. Statistical results show that boundaries have negligible effects on the average node degree, edge density, orientation entropy of road segments, and the eccentricity for the shortest or fastest routes, while other metrics including the clustering coefficient, proportion of high-level road segments, and average edge length together with route-related metrics such as average angular deviation show significant differences between road networks extracted using different boundaries. In addition, the high-centrality components identified using varied boundaries show significant differences in terms of their locations, with only 21%-28% of high-centrality nodes overlapping between the road networks extracted using administrative and daily travel range-based boundaries. These findings provide useful insights to assist urban planning and better predict the influence of a road network structure on the movement of people and the flow of socio-economic activities, particularly in the context of rapid urbanization and the ever-increasing sprawl of road networks.

PMID:37433653 | DOI:10.1063/5.0145079

Genome Res. 2023 Jul 11. doi: 10.1101/gr.277490.122. Online ahead of print.

ABSTRACT

Approximately 13% of the human genome at certain motifs have the potential to form noncanonical (non-B) DNA structures (e.g., G-quadruplexes, cruciforms, and Z-DNA), which regulate many cellular processes but also affect the activity of polymerases and helicases. Because sequencing technologies use these enzymes, they might possess increased errors at non-B structures. To evaluate this, we analyzed error rates, read depth, and base quality of Illumina, Pacific Biosciences (PacBio) HiFi, and Oxford Nanopore Technologies (ONT) sequencing at non-B motifs. All technologies showed altered sequencing success for most non-B motif types, although this could be owing to several factors, including structure formation, biased GC content, and the presence of homopolymers. Single-nucleotide mismatch errors had low biases in HiFi and ONT for all non-B motif types but were increased for G-quadruplexes and Z-DNA in all three technologies. Deletion errors were increased for all non-B types but Z-DNA in Illumina and HiFi, as well as only for G-quadruplexes in ONT. Insertion errors for non-B motifs were highly, moderately, and slightly elevated in Illumina, HiFi, and ONT, respectively. Additionally, we developed a probabilistic approach to determine the number of false positives at non-B motifs depending on sample size and variant frequency, and applied it to publicly available data sets (1000 Genomes, Simons Genome Diversity Project, and gnomAD). We conclude that elevated sequencing errors at non-B DNA motifs should be considered in low-read-depth studies (single-cell, ancient DNA, and pooled-sample population sequencing) and in scoring rare variants. Combining technologies should maximize sequencing accuracy in future studies of non-B DNA.

PMID:37433640 | DOI:10.1101/gr.277490.122

Neuropsychopharmacol Rep. 2023 Jul 11. doi: 10.1002/npr2.12367. Online ahead of print.

ABSTRACT

AIMS: The means of suicide vary, but in cases of impaired consciousness, it is often difficult to determine the initial treatment because it is not known whether a patient has overdosed or used pesticides or poisons. Therefore, we investigated the clinical characteristics of suicide by medication in patients with suicide attempts who were brought to the emergency department, especially the influence of age.

METHODS: Patients with suicide attempts were transported to the two hospitals. There were 96 males (38.4%) and 154 females (61.6%). The mean age was 43.5 ± 20 years, and both males and females were most often in their 20s. Data on sex, age, motive for suicide, means of suicide attempt, psychiatric diagnosis, length of hospital stay, and place of discharge were retrospectively analyzed.

RESULTS: The average age of the patients by means of suicide attempt was 40.5 years for “prescription drugs,” 30.2 years for “over-the-counter drugs,” and 63.5 years for “pesticide/poison.” For each means of suicide attempt, there was a significant difference in age among patients with suicide attempts using “prescription drugs,” “over-the-counter drugs” and “pesticides/poisons.” There was a statistical bias in the means and reasons for each suicide attempt.

CONCLUSION: The results showed that the age of patients who used over-the-counter medicines and pesticides and poisons varied significantly. It was thought that pesticide use should be considered first, especially when patients aged 50 years and over are brought to the hospital with impaired consciousness due to suicide attempts.

PMID:37433639 | DOI:10.1002/npr2.12367

BMJ. 2023 Jul 11;382:p1434. doi: 10.1136/bmj.p1434.

NO ABSTRACT

PMID:37433610 | DOI:10.1136/bmj.p1434

Nephrol Dial Transplant. 2023 Jul 11:gfad151. doi: 10.1093/ndt/gfad151. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with kidney replacement therapy (KRT) have been identified as a vulnerable group during the COVID-19 pandemic. This study reports the outcomes of COVID-19 in KRT patients in Sweden, a country where patients on KRT were prioritized early in the vaccination campaign.

METHODS: Patients with KRT between January 2019 and December 2021 in the Swedish Renal Registry were included. Data were linked to national healthcare registries. The primary outcome was monthly all-cause mortality over three-years follow-up. The secondary outcomes were monthly COVID-19 related deaths and hospitalizations. The results were compared with the general population using standardized mortality ratios. The difference in risk for COVID-19 related outcomes between dialysis and kidney transplant recipients was assessed in multivariable logistic regression models before and after vaccinations started.

RESULTS: On January 1, 2020, there were 4097 patients on dialysis (median age 70) and 5905 kidney transplant recipients (median age 58). Between March 2020 and February 2021, mean all-cause mortality rates increased by 10% (from 720 to 804 deaths) and 22% (from 158 to 206 deaths) in dialysis and kidney transplant recipients respectively compared with the same period 2019. After vaccinations started, all-cause mortality rates during the third wave (April 2021) returned to pre COVID-19 mortality rates among dialysis patients, while mortality rates remained increased among transplant recipients. Dialysis patients had a higher risk for COVID-19 hospitalizations and death before vaccinations started aOR 2.1 (95% CI 1.7-2.5), but a lower risk after vaccination, aOR 0.5 (95% CI 0.4-0.7) compared to kidney transplant recipients.

CONCLUSIONS: The COVID-19 pandemic in Sweden resulted in increased mortality and hospitalization rates among KRT patients. After vaccinations started, a distinct reduction in hospitalization and mortality rates was observed among dialysis patients, but not in kidney transplant recipients. Early and prioritized vaccinations of KRT patients in Sweden probably saved many lives.

PMID:37433606 | DOI:10.1093/ndt/gfad151

Radiol Technol. 2023 Jul;94(6):409-418.

ABSTRACT

PURPOSE: This study investigated several determinants of radiation safety culture among radiologic technologists to determine whether factors related to work shifts or workday length affect the perception of workplace radiation safety.

METHODS: The secondary analysis used de-identified data from 425 radiologic technologists collected with the Radiation Actions and Dimensions of Radiation Safety (RADS) questionnaire, a 35-item survey with valid and reliable psychometric properties. Respondents included radiologic technologists working in radiography, computed tomography (CT), mammography, and hospital radiology administration. Descriptive statistics were used to report RADS survey item outcomes, and analysis of variance (ANOVA) tests with Games-Howell post hoc tests were conducted to analyze the hypotheses.

RESULTS: Mean differences in perception of teamwork across imaging stakeholders (P < .001) and leadership actions (P = .001) were found across shift-length groups. In addition, mean differences in perception of teamwork across imaging stakeholders (P = .007) were found across work-shift groups.

DISCUSSION: Longer shifts (≥ 12 hours) and night shifts are related to a diminished perception of the importance of radiation safety among radiologic technologists. The study showed a significant effect of these shift factors on the perception of teamwork and leadership actions concerning radiation safety.

CONCLUSION: These results underscore the importance of leadership actions and messaging, teamwork-building, and in-service training on radiation safety for technologists who frequently work long, after-hours shifts.

PMID:37433604