Category: Nevin Manimala

Am J Emerg Med. 2021 Dec 18;53:6-11. doi: 10.1016/j.ajem.2021.12.028. Online ahead of print.

ABSTRACT

The classical two-arm randomized clinical trial (RCT) is designed to test the efficacy or effectiveness of an intervention, which may consist of one or more components. However, this approach does not enable the investigator to obtain information that is important in intervention development, such as which individual components of the intervention are efficacious, which are not and possibly should be removed, and whether any components interact. The Multiphase Optimization Strategy (MOST) is a new framework for development, optimization, and evaluation of interventions. MOST includes the RCT for purposes of evaluation, but inserts a phase of research before the RCT aimed at intervention optimization. The optimization phase requires one or more separate trials similar in scope to an RCT, but employing a different experimental design. The design of the optimization trial is selected strategically so as to maximize the amount of scientific information gained using the available resources. One consideration in selecting this experimental design is the type of intervention to be optimized. If a fixed intervention, i.e. one in which the same intervention content and intensity is provided to all participants, is to be optimized, a factorial experiment is often appropriate. If an adaptive intervention, i.e. one in which intervention content or intensity is varied in a principled manner, is to be optimized, a sequential multiple-assignment randomized trial (SMART) is often a good choice. The objective of this article is to describe MOST and the scientific rationale for its use; describe two current applications of MOST in emergency medicine research, one using a factorial experiment and the other using a SMART; and discuss funding strategies and potential future applications in studying the care of individuals with acute illness, injury, or behavioral disorders.

PMID:34968972 | DOI:10.1016/j.ajem.2021.12.028

J Mech Behav Biomed Mater. 2021 Dec 25;126:105064. doi: 10.1016/j.jmbbm.2021.105064. Online ahead of print.

ABSTRACT

The use of Mouthguards (MGs) in contact sports is an interesting biomedical topic. MGs are protective personal equipment made principally from the copolymer ethylene vinyl acetate (EVA). EVA is a thermoplastic whose thickness and rigidity are variables of concern for a good shock energy absorption capability in an MG. A natural fiber polymer composite is an interesting attempt for tackling these variables. Luffa cylindrica (luffa) is a sponge gourd that grows in 3D structure, which is used mainly as an ornament, a filling, or is trimmed for its use as a bathing product. In this work, a new EVA-luffa composite (EVLc) was made from commercial EVA sheets and luffa mat acting as reinforcement. FTIR, DSC, and TGA tests of EVA revealed its nature compared to literature data. A mechanical testing was applied to eight EVLc ASTM D-638 type V dumbbells (D1-D8) that showed low tensile strength values compared to EVA resistance ranges in literature. SEM images of EVLc’s D1-D8 confirmed good adhesion between the reinforcement and matrix without surface treatment, and a descriptive statistical analysis indicated an intrinsic variation.

PMID:34968944 | DOI:10.1016/j.jmbbm.2021.105064

Pregnancy Hypertens. 2021 Dec 24;27:69-73. doi: 10.1016/j.preghy.2021.12.009. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this study was to determine if elevated concentration of soluble receptor tunica interna endothelial cell kinase-2 (Tie-2) in the amniotic fluid represent a risk factor for the subsequent development of preeclampsia (PE).

STUDY DESIGN: Amniotic fluid samples were collected as a part of routine clinical diagnostics from women referred to clinical care due to genetic indications. A total of 12 women with preeclampsia and 26 normotensive pregnant women were included in the study. Mean gestational age at amniocentesis was 17.92 weeks of pregnancy in preeclampsia and 17.88 in control group, respectively. Concentrations of sTie-2 in the amniotic fluid were determined by a standardized enzyme immunoassay.

RESULTS: Median concentration of Tie-2 in the amniotic fluid of PE patients was lower (median 1.109 ng/ml) compared with normotensive pregnant women (median 1.433 ng/Ml) but the difference was not statistically significant (p = 0.2973). Concentration of sTie-2 in the amniotic fluid did not significantly correlate with maternal age, gestational age at amniocentesis or delivery, as well as weight or length at birth. A difference in the gestational age at delivery in PE patients (mean 37.7 weeks) and normotensive pregnant controls (mean 39.8 weeks) was statistically significant (p = 0.0003). Birth weight and length of children delivered by PE women (mean 2863.3 g and 48.3 cm) were significantly lower compared with normal pregnancies (mean 3591.2 g and 51.4 cm, p = 0.0002 and p = 0.006, respectively).

CONCLUSION: Our results suggest that amniotic fluid concentrations of sTie-2 do not predict development of PE and that further studies on biomarkers as predictors of PE should include other angiogenic biological response modifiers.

PMID:34968946 | DOI:10.1016/j.preghy.2021.12.009

Eur J Obstet Gynecol Reprod Biol. 2021 Dec 21;269:35-40. doi: 10.1016/j.ejogrb.2021.12.018. Online ahead of print.

ABSTRACT

CONTEXT: After 41 weeks, the labor induction term varies according to countries and obstetrical teams. The French recommendations are not to exceed 41 weeks 6 days. However, there are no data on the percentage of nulliparous women with an unfavorable cervix at 41 weeks going into spontaneous labor within five or six days.

OBJECTIVE: The objective was to establish the rate of spontaneous labor within five days amongst nulliparous women with an unfavorable cervix at 41 weeks, and to identify the maternal and obstetrical factors associated with this spontaneous labor.

MATERIALS AND METHODS: Retrospective study in a University Hospital Maternity between January 1st and December 31st 2017. All nulliparous women with a cephalic fetal presentation and unfavorable cervix at 41 weeks (Bishop ≤ 3) were included. The maximum term for induced labor was set at 41 weeks 5 days. The population was divided into two groups: spontaneous labor and induced labor (induction between 41 weeks and 41 weeks 4 days for medical indications or maternal wish and induction at 41 weeks 5 days for full term). The maternal and obstetrical characteristics of the two groups at 41 weeks were compared as well as the maternal and neonatal outcomes.

RESULTS: The rate of spontaneous labor among the 269 women included was 38.3% (n = 103/269). At 41 weeks, the presence of painful uterine contractions and a Bishop score of 3 were associated with spontaneous labor within five days (p < 0.01). The Bishop score criteria most associated with spontaneous labor were cervical dilation and fetal station. The cesarean delivery rate was 20.4% in the group of women with spontaneous labor versus 41.0% in the group of induced labor (p < 0.01). There were no differences between the two groups in terms of neonatal outcome.

CONCLUSION: Among nulliparous women with an unfavorable cervix at 41 weeks, almost 40 % will have a spontaneous onset of labor within five days. The only factors found to be associated with this onset of labor are the presence of painful uterine contractions and a higher Bishop score at 41 weeks.

PMID:34968872 | DOI:10.1016/j.ejogrb.2021.12.018

Nurse Educ Today. 2021 Dec 24;109:105256. doi: 10.1016/j.nedt.2021.105256. Online ahead of print.

ABSTRACT

BACKGROUND: Key challenges for clinical education during the COVID-19 pandemic include how to continue teaching and learning, how to teach core clinical skills, and how to demonstrate professional and practical skills in various clinical situations. Therefore, nursing students need to learn how to assist with in-patient intubation, eliminate accumulated sputum overflow, and the basic techniques of sputum suction.

OBJECTIVES: We proposed and investigated an approach to integrating online game-based learning with the watch-summarize-question strategy to improve nursing students’ learning achievement, self-efficacy, learning engagement, and learning satisfaction in sputum suction skill training.

DESIGN: A quasi-experimental study with pretest and posttest design.

SETTINGS AND PARTICIPANTS: We randomly allocated 45 first-year nursing students to an experimental group (n = 21) or a control group (n = 24) at a school of nursing in a university.

METHODS: The experimental group adopted the online game-based learning and watch-summarize-question strategy, while the control group used video-based learning. Participants were assessed on learning achievement of sputum suction skills, self-efficacy, learning engagement, and learning satisfaction before and after the intervention.

RESULTS: The experimental group, which used the proposed approach, achieved statistically significant higher learning achievement, self-efficacy, learning engagement, and learning satisfaction than the control group.

CONCLUSIONS: The integration of online game-based learning with the watch-summarize-question strategy demonstrated a positive impact on nursing students’ sputum suction skill training. Nurse educators and researchers should consider integrating computer technology and teaching strategies to facilitate nursing education.

PMID:34968932 | DOI:10.1016/j.nedt.2021.105256

PLoS One. 2021 Dec 30;16(12):e0261944. doi: 10.1371/journal.pone.0261944. eCollection 2021.

ABSTRACT

Tuberculosis and Human Immunodeficiency Virus are among the top ten causes of death globally. To prevent the spread of these infections, health workers and student nurses should comply to infection prevention and control measures called standard precautions. The aim of this study is to assess compliance of Eswatini university student nurses regarding standard precautions for preventing Tuberculosis and Human Immunodeficiency Virus. A non-experimental quantitative approach was used to conduct a survey on all senior student nurses of Eswatini University using questionnaires. IBM SPSS Statistics version 26 software was used to analyse the data. Results from this study showed that out of the 105 student nurses who were asked only 51.4% (n = 54) said they always used personal protective equipment. However, they did comply well on disposing sharps as 92.4% (n = 97) reported that they always used designated containers. There is a need for close supervision of student nurses in the clinical area. The researcher recommends that clinical facilitator should always accompany student nurses in the clinical area and that preceptors should be exempted from other nursing duties when there are student nurses in the hospitals so that they can mentor the students.

PMID:34968395 | DOI:10.1371/journal.pone.0261944

Med Sci Monit. 2021 Dec 30;27:e935429. doi: 10.12659/MSM.935429.

ABSTRACT

BACKGROUND Women’s health and undertaking health behaviors during the reproductive period by women, especially during pregnancy, are an important indicator that is reflected both in their own health and in health of their children. This study aimed to use a questionnaire to evaluate the health-related behaviors in women of reproductive age in Poland. MATERIAL AND METHODS The studies were conducted among 602 women of reproductive age by diagnostic poll method with the use of questionnaire technique. The applied tool was an original on-line questionnaire. A link to the questionnaire was sent to women aged 18-49 years using the snowball sampling technique and was posted on thematic pro-health website forums. RESULTS The majority of women participating in the study exhibited health behaviors on the average level (65.3%; M=7.6). Pro-health behaviors were exhibited mainly by women with higher education (M=7.7; SD=2.6), married women (M=8.0; SD=2.6), and women who were pregnant at the time (M=8.8; SD=2.6). However, single women participating in the study consumed alcohol more often (80.6%). The observed relationships were statistically significant (P<0.05). CONCLUSIONS This survey showed that younger women with no children were significantly less likely to be aware of positive health-associated behaviors and lifestyle when compared with older women with children. This small study supports the importance of health education in young women before they have children.

PMID:34968369 | DOI:10.12659/MSM.935429

Arch Cardiol Mex. 2021;91(Supl):18-24. doi: 10.24875/ACM.20000518.

ABSTRACT

OBJETIVO: Determinar la percepción de los médicos internos residentes (MIR) de cardiología de España sobre el efecto de la pandemia por COVID-19 en su formación y la adaptación realizada por sus servicios.

MÉTODOS: Estudio de corte transversal a través de una plataforma de encuesta digital con el objetivo de conocer la opinión individual de los MIR de cardiología sobre la influencia de la pandemia en su formación. Se realiza un análisis estadístico para determinar los factores que influyeron en la percepción de la formación afectada.

RESULTADOS: Participó un total de 180 MIR de las 17 comunidades autónomas (CA). Los MIR de tercer año fueron los más afectados, junto con los que rotaban en imagen cardíaca. Los residentes de las CA con una prevalencia >5 casos/1,000 habitantes fueron los que mayor probabilidad tuvieron de ser desplazados de sus servicios.

CONCLUSIONES: Según la opinión de los participantes, el efecto de la pandemia por COVID-19 en su formación fue más negativa en los residentes de tercer año y los que rotaban en imagen cardíaca.

OBJECTIVE: The objectives were to analyze the perception of the Cardiology Fellows in Training (FIT) of Spain about the impact of the COVID-19 pandemic on their academic training and to know the adaptative changes performed by their department.

METHODS: A cross-sectional study performed through a digital survey platform for Cardiology FIT. Chi² analysis and logistic regression were performed to determine the factors that influenced on the perception of an affected training.

RESULTS: A total of 180 FIT from the 17 regions of Spain participated. Third year FIT and those rotating in cardiac imaging were the most affected with statistically significant difference. The residents of the regions with a prevalence of >5 cases/1,000 inhabitants were the most likely to be displaced from their departments.

CONCLUSIONS: According to the opinion of the participants, the impact of the COVID-19 pandemic on their academic training was more negative in third year FITs and those rotating in cardiac imaging.

PMID:34968379 | DOI:10.24875/ACM.20000518

Nurs Rep. 2020 Dec 1;10(2):124-134. doi: 10.3390/nursrep10020016.

ABSTRACT

(1) Purpose: This study aimed to explore the mediating effect of insecure adult attachment on the relationship between smartphone addiction and self-directed learning in university students. (2) Methods: In total, 235 university students participated in this study. Data analysis was carried out through a three-stage verification procedure: Sobel test using technical statistics, Pearson correlation, and multiple regression analysis. (3) Results: Smartphone addiction was positively correlated with insecure adult attachment, attachment anxiety, and self-directed learning, whereas self-directed learning had a significant negative correlation with insecure adult attachment and attachment anxiety. Insecure adult attachment had a mediating effect on the relationship between smartphone addiction and self-directed learning. (4) Conclusion: Higher levels of smartphone addiction indicated higher levels of insecure adult attachment and reduced self-directed learning ability. Therefore, while the prevention of smartphone addiction is critical for improving self-directed learning skills, programs should be developed to foster the formation of secure adult attachment among university students.

PMID:34968357 | DOI:10.3390/nursrep10020016

Nurs Rep. 2020 Nov 23;10(2):95-105. doi: 10.3390/nursrep10020013.

ABSTRACT

Practicing as a nurse may be a factor influencing the overall level of satisfaction with life. The aim of the study was to assess the level of satisfaction with nurses’ lives in relation to the place of employment. The research was conducted among nurses working in hospitals, primary health care, and outpatient specialist care. The study was carried out with the use of the satisfaction with life scale (SWLS) scale. Statistical analysis included a quantitative and qualitative approach to life satisfaction of the nurses surveyed. The impact of independent variables, measured on nominal (qualitative) scales on the results of the SWLS scale in quantitative terms, was assessed using one-way analysis of variance (ANOVA). Pairwise comparisons were assessed with the assumption of equality of variance with the Tukey honestly significant difference test. The level of satisfaction with life of the surveyed nurses was average. The place where nurses worked significantly influenced the level of life satisfaction. Nurses working in a hospital had a high level of satisfaction with life more so than nurses working in primary care or outpatient specialist care. The workplace is a factor that significantly differentiates the level of life satisfaction of the surveyed nurses.

PMID:34968354 | DOI:10.3390/nursrep10020013