Category: Nevin Manimala

BMJ Open. 2023 May 15;13(5):e068860. doi: 10.1136/bmjopen-2022-068860.

ABSTRACT

BACKGROUND: Cervical cancer ranks as the second most frequent cancer among all women in Ethiopia and the second most frequent cancer among women between 15 and 44 years of age, resulting in over 4884 moralities annually. Although there is a focus on health promotion through teaching and screening in Ethiopia’s intended transition toward universal healthcare, there is little information available on baseline levels of knowledge and screening uptake related to cervical cancer.

OBJECTIVES: This study explored the levels of knowledge and screening rates of cervical cancer along with its associated factors among women of reproductive age in Assosa Zone, Benishangul-Gumuz, Ethiopia in 2022.

METHODOLOGY: A facility-based cross-sectional study was conducted. A systematic sampling technique was used to select 213 reproductive-age women from selected health institutions, from 20 April 2022 to 20 July 2022. A validated and pretested questionnaire was used for data collection. Multi-logistic regression analyses were done to identify factors independently associated with cervical cancer screening. Adjusted OR with 95% CI was estimated to measure the strength of association. The level of statistical significance was declared at a p value of <0.05. The results were presented in tables and figures.

RESULT: Knowledge of cervical cancer screening in this study was 53.5%, and 36% of respondents had practised cervical cancer screening. Family history of cervical cancer (AOR)=2.5, 95% CI (1.04 to 6.44)), place of residence (AOR=3.68, 95% CI (2.23, 6.54)) and availability of health services at nearby (AOR=2.03, 95% CI (1.134, 3.643)) were significantly associated with knowledge of cervical cancer screening, while educational status (AOR=2.811, 95% CI (1.038 to 7.610)), knowing someone diagnosed with cervical cancer (AOR=8.3, 95% CI (2.4, 28.69)), Knowledge of cervical cancer(AOR=2.17, 95%CI(1.077, 4.384) and feeling feeling at risk (AOR=3.26 95% CI (1.52, 5.04)) were associated with the practice of cervical cancer screening.

CONCLUSION AND RECOMMENDATION: Knowledge and practice of cervical cancer screening in this study were low. Therefore, the reproductive women must be encouraged to have early cervical cancer screening at precancerous stage by informing their susceptibility to cervical cancer.

PMID:37188474 | DOI:10.1136/bmjopen-2022-068860

BMJ Open. 2023 May 15;13(5):e063363. doi: 10.1136/bmjopen-2022-063363.

ABSTRACT

OBJECTIVES: We aim to reveal how loneliness relates to suicidal ideation following the onset of the COVID-19 pandemic.

DESIGN: Cross-sectional online survey.

SETTING: Community cohort study in Japan.

PARTICIPANTS: The second wave of a large web-based survey, Japan COVID-19 and Society Internet Survey, was conducted in February 2021, and we analysed the data of 6436 men and 5380 women who were aged 20-59 years.

MAIN OUTCOME MEASURES: The prevalence ratios (PRs) of suicidal ideation due to loneliness, depression, social isolation and decline in income during the pandemic and other sociodemographic and economic information were adjusted in the analysis.

STATISTICAL METHODS: Estimations were conducted by separating a male and female sample. The survey weight (inverse probability weighting) was applied for analyses, and a Poisson regression model was used with all the potential confounders adjected.

RESULTS: Overall, 15.1% of male and 16.3% of female participants were found to have had suicidal ideation during the COVID-19 pandemic. Among them, 23% of male and 20% of female participants experienced suicidal ideation for the first time. The results of the Poisson regression suggested that those who were feeling lonely had higher PRs for suicidal ideation (4.83 for men (95% CI, 3.87 to 6.16) and 6.19 for women (95% CI, 4.77 to 8.45)). The relationship between loneliness and suicidal ideation remained robust even after adjusting for depression, although there were declines in PRs. Additionally, the results showed that those who were lonely, and continued to feel lonely during the pandemic, had the highest PRs of suicidal ideation.

CONCLUSION: Loneliness had both direct and indirect effects on suicidal ideation mediated through depression. Those who felt lonelier during the pandemic had the highest risk of suicidal ideation. It is necessary to adopt national measures focused on providing psychological support to people who feel lonely to prevent them from taking their own lives.

PMID:37188470 | DOI:10.1136/bmjopen-2022-063363

Taiwan J Obstet Gynecol. 2023 May;62(3):402-405. doi: 10.1016/j.tjog.2023.01.006.

ABSTRACT

OBJECTIVE: To explore the effects of labor analgesia for primiparae with different stages of cervical dilation on parturition and neonates.

MATERIALS AND METHODS: In the past three years, 530 cases of primiparae who had delivered in the Second People’s Hospital of Hefei and were eligible for a vaginal trial of parturition were enrolled as the research subjects. Of these, 360 puerperae had labor analgesia, and the remaining 170 were taken as the control group. Those given labor analgesia were divided into three groups based on the different stages of cervical dilation at that time. There were 160 cases in Group I (cervical dilation <3 cm), 100 cases in Group II (cervical dilation of 3-4 cm), and 100 cases in Group III (cervical dilation of 4-6 cm). The labor and neonatal outcomes were compared among the four groups.

RESULTS: The first, second, and total stages of labor in the three groups receiving labor analgesia were all longer than in the control group, and the differences were statistically significant (p < 0.05 in all). Group I had the longest duration of each stage and the total stage of labor. The differences in labor stages and the total stage of labor were not statistically significant between Group II and Group III (P > 0.05). In the three groups with labor analgesia, the usage rate of oxytocin was higher than in the control group, and the differences were statistically significant (P < 0.05). The differences in the incidence of postpartum hemorrhage, the incidence of postpartum urine retention, and the episiotomy rate were not statistically significant among the four groups (P > 0.05). The differences in the neonatal Apgar score were not statistically significant among the four groups (P > 0.05).

CONCLUSION: Labor analgesia might prolong the stages of labor but does not affect the neonatal outcomes. It would be optimal to conduct labor analgesia when cervical dilation reaches 3-4 cm.

PMID:37188443 | DOI:10.1016/j.tjog.2023.01.006

Mutat Res Genet Toxicol Environ Mutagen. 2023 May-Jun;888:503627. doi: 10.1016/j.mrgentox.2023.503627. Epub 2023 Mar 31.

ABSTRACT

Toxicity assays, including genotoxicity assays, are important components of human safety assessments. The interpretation of the results of such assays depends on several factors, including validation of test performance, statistical analysis of the results, and, most importantly, scientific judgment concerning the relevance of the findings to human health risk under anticipated exposure conditions. Ideally, decisions should be made on the basis of studies that allow consideration of the exposure-response relationship of any observed genotoxic outcome and an estimate of the risks associated with expected human exposures. However, in practice, the available data are often limited; it may be necessary to make judgements on the basis of assays that provide only hazard information that is not related to human exposure levels; also, sometimes, decisions are based on studies with non-human (or even non-mammalian) cells that may respond differently than human systems. Too often, in such situations, decisions are based only on whether “statistical significance” has been achieved in a particular assay, rather than on an overall judgement about the weight of scientific evidence with regard to human risk. Among regulators and toxicologists, the concept of “statistical significance” has played an important role in decision-making. Toxicologists often rely on statistical evaluations based on nominal fixed thresholds (P-value = 0.05 or 0.01), but these are arbitrary values. Such “statistical significance” is merely one of many factors that should be taken into account before drawing final conclusions for risk assessment. Other factors are also very important, including adherence to test guidelines and Good Laboratory Practices (GLPs).

PMID:37188432 | DOI:10.1016/j.mrgentox.2023.503627

J Prof Nurs. 2023 May-Jun;46:92-101. doi: 10.1016/j.profnurs.2023.03.005. Epub 2023 Mar 21.

ABSTRACT

BACKGROUND: The rapid transition to online teaching during the COVID-19 pandemic created additional stress and workload issues for nurse faculty. Burnout has been reported in nurse faculty who cite workplace factors that influence satisfaction and work-life balance as major contributing factors.

PURPOSE: The purpose of this study was to examine life balance and professional quality of life among nurse faculty (N = 216) in 2021 during the first year of the COVID-19 pandemic and to describe the challenges of delivering virtual learning experiences.

METHODS: A cross-sectional design was utilized to survey nurse faculty using the Life Balance Inventory and the Professional Quality of Life Scale. Descriptive statistics and correlations were calculated.

RESULTS: Nurse faculty reported an unbalanced life balance (median = 1.76), average compassion satisfaction (median = 40.00), average burnout (median = 24.00), and low secondary traumatic stress (median = 21.00). Narrative themes included (1) COVID-19 pandemic has made balance nearly impossible, (2) Intentional disconnection from work activities, (3) Challenging/changing priorities, (4) Promoting a healthy work environment, and (5) Moral distress and exhaustion.

DISCUSSION: Understanding the factors that influence nurse faculty delivery of virtual learning experiences during the COVID-19 pandemic may provide opportunities to improve nurse faculty work-life balance and professional quality of life.

PMID:37188429 | DOI:10.1016/j.profnurs.2023.03.005

J Prof Nurs. 2023 May-Jun;46:83-91. doi: 10.1016/j.profnurs.2023.02.010. Epub 2023 Mar 17.

ABSTRACT

BACKGROUND: The rapid shift to virtual learning in response to the COVID-19 pandemic contributed to high academic stress among health profession students. High academic stress was associated with impaired psychosocial well-being and decreased academic performance.

OBJECTIVES: The purpose of this study was to assess the relationship between academic stress, anxiety, sleep disturbances, depressive symptoms, academic performance, and the moderating effect of resourcefulness among undergraduate health profession students.

METHODS: This descriptive and cross-sectional study included undergraduate health profession students. The primary investigator distributed the study link to all students through the university’s Central Messaging Centre, Twitter account, and WhatsApp. The study variables were measured using the Student Life Stress Inventory, the Generalized Anxiety Disorder-7 questionnaire, the Centre for Epidemiology Scale of Depression, the Pittsburgh Sleep Quality Index, and the Resourcefulness Skills Scale. Pearson R correlation and linear regression analysis were utilized for statistical analysis.

RESULTS: Our sample included 94 undergraduate health profession students, 60 % of which were females with a mean age of 21, and the majority were nursing and medicine students. High academic stress, anxiety, sleep disturbances, depressive symptoms, and resourcefulness were reported among 50.6 %, 43 %, 79.6 %, 60.2 %, and 60 % of the participants, respectively. However, no effect of resourcefulness was found on any of the study variables. Instead, academic stress and sleep disturbances were the strongest predictors of depressive symptoms regardless of the level of resourcefulness.

CONCLUSION: Adequate academic support during virtual learning and tools to early detect subtle signs of high academic stress, anxiety, depression, and sleep disturbance should be routinely utilized by educational institutions. In addition, incorporating sleep hygiene and resourcefulness training in health professions education is highly indicated.

PMID:37188428 | DOI:10.1016/j.profnurs.2023.02.010

J Prof Nurs. 2023 May-Jun;46:39-44. doi: 10.1016/j.profnurs.2023.02.006. Epub 2023 Mar 1.

ABSTRACT

BACKGROUND: Academic resilience has been identified as a coping method for nursing students’ educational and practice challenges. Despite the importance of academic resilience, knowledge on how to enhance academic resilience is under-researched. To suggest suitable approaches, relationships between academic resilience and other constructs need to be appraised.

OBJECTIVES: This study aims to evaluate predictors of academic resilience, examining its relationships with other essential constructs: self-compassion and moral perfectionism, in undergraduate nursing students in Iran.

DESIGN: This descriptive cross-sectional study was conducted in 2022.

PARTICIPANTS: A convenience sample of 250 undergraduate nursing students at three universities in Iran participated in this study by completing self-report measures.

METHODS: Data collection tools were Nursing Student Academic Resilience Inventory, Moral Perfectionism scale, and Self-Compassion Scale-Short Form. Correlation and regression analyses were conducted.

RESULTS: The mean and standard deviation of academic resilience were 57.57 ± 23.69; moral perfectionism 50.24 ± 9.97, and self-compassion 37.19 ± 5.02. Self-compassion had significantly related to moral perfectionism (r = 0.23, p < 0.001). Academic resilience had no statistically significant relationship with moral perfectionism (r = -0.05, p = 0.41) and self-compassion (r = -0.06, p = 0.35), but significantly affect age (r = 0.14, p = 0.03), Grade point average (r = 0.18, p < 0.001) and university of study (r = 0.56, p < 0.001). The grade point average and the university of the study predicted 33 % of the changes in academic resilience, and the greatest impact was related to the university (r = 0.56, p < 0.001).

CONCLUSION: Adopting appropriate educational strategies and supporting the students will help improve nursing students’ academic resilience and performance. Promoting self-compassion will lead to the development of nursing students’ moral perfectionism.

PMID:37188420 | DOI:10.1016/j.profnurs.2023.02.006

J Prof Nurs. 2023 May-Jun;46:179-186. doi: 10.1016/j.profnurs.2023.03.011. Epub 2023 Mar 30.

ABSTRACT

BACKGROUND: Nursing Doctor of Philosophy (PhD) students can pursue diverse career opportunities within and outside of academia upon graduation. However, mentor-mentee models, competing demands, and limited resources can challenge students as they search for guidance in navigating career decisions. This article describes the development, implementation, and evaluation of a project to support PhD nursing career development.

METHODS: A student-designed project was implemented over 4 weeks which aligned with four career trajectories that students identified. Descriptive statistics were used to analyze quantitative survey questions. Responses to open-ended questions and field notes were also examined.

RESULTS: Post-implementation survey data suggested that all participants found the sessions helpful and recommended providing the workshop annually. Students’ questions focused on three areas: job searches, job selection, and experiences once in a career trajectory. Workshop speakers’ discussions focused on important tasks and strategies and wisdom and personal reflections offered to PhD students.

DISCUSSION: Nursing PhD students are interested in diverse career trajectories beyond academia and valued an opportunity to explore these options outside of the traditional mentor-mentee relationship. Leveraging resources from schools of nursing and the broader collegiate environment is important in helping students to explore potential career trajectories.

PMID:37188408 | DOI:10.1016/j.profnurs.2023.03.011

J Rheumatol. 2023 May 15:jrheum.2022-1109. doi: 10.3899/jrheum.2022-1109. Online ahead of print.

ABSTRACT

Rheumatology research often involves correlated and clustered data. A common error when analyzing these data occurs when instead we treat these data as independent observations. This can lead to incorrect statistical inference. The data used is a subset of the study from Raheel (2017) consisting of 633 RA patients between 1988 and 2007. RA flare and number of swollen joints served as our binary and continuous outcomes, respectively. Generalized linear models (GLM) were fitted for each while adjusting for RF positivity and sex. Additionally, a generalized linear mixed model (GLMM) with random intercept and a generalized estimating equation (GEE) were used to model RA flare and number of swollen joints, respectively, to take additional correlation into account. The GLM’s β coefficients and their 95% confidence intervals are then compared to their mixed-effects equivalents. The β coefficients compared between methodologies are very similar. However, their standard errors increase when correlation is accounted for. As a result, if the additional correlations are not taken into consideration, the standard error can be underestimated. This results in an overestimated effect size, narrower confidence intervals, increased type I error and a smaller p-value, thus potentially producing misleading results. It is important to model the additional correlation that occurs in correlated data.

PMID:37188383 | DOI:10.3899/jrheum.2022-1109

Am J Trop Med Hyg. 2023 May 15:tpmd220363. doi: 10.4269/ajtmh.22-0363. Online ahead of print.

ABSTRACT

Vaccines are the most efficient and cost-effective tool to halt the transmission and prevention of COVID-19. The current study examined the willingness of parents to vaccinate their children against COVID-19. This was a cross-sectional study that used a questionnaire based on the Health Belief Model, previous history of COVID-19, willingness to accept, and willingness to pay for the COVID-19 vaccine. The questionnaire was administered among parents of children aged 5 to 11 years. Descriptive statistics, χ2 tests, and regression analysis were carried out for data analysis. A total of 474 respondents participated in this survey with a response rate of 67.7%. In our study, a majority of the respondents exhibited a willingness to accept the COVID-19 vaccine for their children (Definitely yes/Probably yes = 252, 53.2%); nevertheless, 229 (48.3%) respondents were unwilling to pay for it. More than three-quarters of the respondents were worried about the probability of COVID-19 infection in their children (n = 361, 76.2%) and were afraid of COVID-19-associated complications (n = 391, 82.5%). Likewise, most respondents showed their concerns regarding the effectiveness of the vaccine (n = 351, 74.1%), vaccine safety (n = 351, 74.1%), and the halal nature of the vaccine (n = 309, 65.2%). Respondents who were aged 40 to 50 years (odds ratio [OR]: 0.101, 95% CI: 0.38-0.268; P < 0.001), family income > 50,000 PKR (OR: 0.680, 95% CI: 0.321-1.442; P = 0.012), and location (OR: 0.324, 95% CI: 0.167-0.628; P = 0.001) were the factors that were likely to impact vaccine acceptance among parents. Education-based interventions are urgently required to improve COVID-19 vaccination acceptance among parents for their children.

PMID:37188339 | DOI:10.4269/ajtmh.22-0363