Category: Nevin Manimala

BMC Psychiatry. 2022 Jun 1;22(1):372. doi: 10.1186/s12888-022-03979-z.

ABSTRACT

BACKGROUND: Promoting the health and mental health (MH) of the older adults making up a large part of the world’s population in the coming years can provide the necessary conditions for their health and well-being of them. This study aimed to investigate the relationship between the satisfaction of basic psychological needs (BPNs), general health (GH), and some variables in Iranian older adults.

METHODS: The present descriptive-correlational study was conducted on 780 older adults from Sarpol-e Zahab (Kermanshah) in 2019 including the study by multi-stage cluster random sampling. The data collection tool was BPNs satisfaction and GH questionnaire and a researcher-made questionnaire of individual and background information. Was used for data analysis using the SPSS version 16 program and descriptive statistics and tests Pearson correlation coefficient, chi-square test, independent-sample T-test, and multivariate linear regression.

RESULTS: In the present study, participating a total of 780 older adult men aged 73.0 ± 29.32 years. There was a significant relationship between the satisfaction of BPNs and GH (p < 0.001). Also, 41% of the older adults were in poor GH and 30% were high in BPNs. Multiple logistic regression showed that the BPNs, age, income satisfaction, weather, and war zone were strong predictors of GH. the adjusted R2 value of 0.55 shows that the model described 55% of changes in the GH score.

CONCLUSION: According to the findings of the study on the relationship between the satisfaction of BPNs and GH, providing insurance, social and economic support by developing health policies, creating supportive health environments, strengthening community action, and developing individual skills in the older adults can help improve their MH and that of the community.

PMID:35650584 | DOI:10.1186/s12888-022-03979-z

BMC Musculoskelet Disord. 2022 Jun 1;23(1):521. doi: 10.1186/s12891-022-05482-8.

ABSTRACT

OBJECTIVE: The application of double plating in olecranon fractures is becoming increasingly widespread. There is no research comparing this technique with traditional tension band wiring (TBW) and the single plate technique. The purpose of this study was to compare the efficacy of three fixation techniques in olecranon fractures.

MATERIALS AND METHODS: From March 2016 to May 2020, we collected the clinical data of 95 patients with olecranon fractures who underwent surgical treatment. Thirty-five patients received TBW surgery (TBW Group), 32 patients received a 3.5 mm locking compression plate (LCP, 3.5 mm LCP Group), and 28 patients received double mini-locking plate treatment (DP Group). The operation time, fracture union time, time of return to work, range of motion (ROM), soft tissue stimulation to remove internal fixation, and patient-related functional results (the Weseley score, Mayo Elbow Performance Score [MEPS], and Disabilities of Arm, Shoulder and Hand Score [DASH]) were recorded. The clinical results and complications of the three internal fixation techniques were compared.

RESULTS: The average follow-up time was 15.011.82 months (12-18 months). All patients’ fractures healed by first intention. There were no statistically significant differences in the operation time, fracture union time, ROM, Weseley score, MEPS or DASH scores of the three groups of patients. The postoperative return time for patients in the TBW group was 10.002.15 weeks, the 3.5 mm LCP group was 9.561.93 weeks, and the DP group was 8.432.38 weeks (P = 0.014); 12 patients in the TBW group required removal of plant due to soft tissue stimulation, the 3.5 mm LCP group had 8 cases, and the DP group had 2 cases (P = 0.038).

CONCLUSION: The postoperative clinical results and elbow joint function of patients with olecranon fractures fixed by tension band wiring, 3.5 mm LCP and double mini-locking plate are similar, which indicates that double-plate technology can be used as an alternative to the two groups of traditional techniques. In addition, double-plate technology also helps patients return to work earlier and has a lower incidence of soft tissue stimulation.

PMID:35650582 | DOI:10.1186/s12891-022-05482-8

BMC Med Educ. 2022 Jun 1;22(1):417. doi: 10.1186/s12909-022-03495-4.

ABSTRACT

BACKGROUND: Guideline-based therapy of cardiac arrhythmias is important for many physicians from the beginning of their training. Practical training of the required skills to treat cardiac arrhythmias is useful for acquiring these skills but does not seem sufficient for skill retention. The aim of this study was to compare different retention methods for skills required to treat cardiac arrhythmias with respect to the performance of these skills in an assessment.

METHODS: Seventy-one final-year medical students participated in a newly designed workshop to train synchronized cardioversion (SC) and transcutaneous cardiac pacing (TCP) skills in 2020. All participants completed an objective structured clinical examination (OSCE 1) one week after the training. Afterwards, the participants were stratified and randomized into three groups. Nine weeks later, one group received a standard operating procedure (SOP) for the skills, one group participated in a second workshop (SW), and one group received no further intervention (control). Ten weeks after the first training, all groups participated in OSCE 2.

RESULTS: The average score of all students in OSCE 1 was 15.6 ± 0.8 points with no significant differences between the three groups. Students in the control group reached a significantly (p < 0.001) lower score in OSCE 2 (-2.0 points, CI: [-2.9;-1.1]) than in OSCE 1. Students in the SOP-group achieved on average the same result in OSCE 2 as in OSCE 1 (0 points, CI: [-0.63;+0.63]). Students who completed a second skills training (SW-group) scored not significantly higher in OSCE 2 compared to OSCE 1 (+0.4 points, CI: [-0.29;+1.12]). The OSCE 2 scores in groups SOP and SW were neither significantly different nor statistically equivalent.

CONCLUSIONS: Partial loss of SC and TCP skills acquired in a workshop can be prevented after 10 weeks by reading an SOP as well as by a second workshop one week before the second assessment. Refreshing practical skills with an SOP could provide an effective and inexpensive method for skills retention compared to repeating a training. Further studies need to show whether this effect also exists for other skills and how frequently an SOP should be re-read for appropriate long-term retention of complex skills.

PMID:35650577 | DOI:10.1186/s12909-022-03495-4

BMC Pregnancy Childbirth. 2022 Jun 1;22(1):461. doi: 10.1186/s12884-022-04769-x.

ABSTRACT

BACKGROUND: Maternal characteristics like medical history and health-related risk factors can influence the incidence of pregnancy outcomes and pregnancy-related events of interest (EIs). Data on the incidence of these endpoints in low-risk pregnant women are needed for appropriate external safety comparisons in maternal immunization trials. To address this need, this study estimated the incidence proportions of pregnancy outcomes and pregnancy-related EIs in different pregnancy cohorts (including low-risk pregnancies) in England, contained in the Clinical Practice Research Datalink (CPRD) Pregnancy Register linked to Hospital Episode Statistics (HES) between 2005 and 2017.

METHODS: The incidence proportions of 7 pregnancy outcomes and 15 EIs were calculated for: (1) all pregnancies (AP) represented in the CPRD Pregnancy Register linked to HES (AP cohort; N = 298 155), (2) all pregnancies with a gestational age (GA) ≥ 24 weeks (AP24+ cohort; N = 208 328), and (3) low-risk pregnancies (LR cohort; N = 137 932) with a GA ≥ 24 weeks and no diagnosis of predefined high-risk medical conditions until 24 weeks GA.

RESULTS: Miscarriage was the most common adverse pregnancy outcome in the AP cohort (1 379.5 per 10 000 pregnancies) but could not be assessed in the other cohorts because these only included pregnancies with a GA ≥ 24 weeks, and miscarriages with GA ≥ 24 weeks were reclassified as stillbirths. Preterm delivery (< 37 weeks GA) was the most common adverse pregnancy outcome in the AP24+ and LR cohorts (742.9 and 680.0 per 10 000 pregnancies, respectively). Focusing on the cohorts with a GA ≥ 24 weeks, the most common pregnancy-related EIs in the AP24+ and LR cohorts were fetal/perinatal distress or asphyxia (1 824.3 and 1 833.0 per 10 000 pregnancies), vaginal/intrauterine hemorrhage (799.2 and 729.0 per 10 000 pregnancies), and labor protraction/arrest disorders (752.4 and 774.5 per 10 000 pregnancies).

CONCLUSIONS: This study generated incidence proportions of pregnancy outcomes and pregnancy-related EIs from the CPRD for different pregnancy cohorts, including low-risk pregnancies. The reported incidence proportions of pregnancy outcomes and pregnancy-related EIs are largely consistent with external estimates. These results may facilitate the interpretation of safety data from maternal immunization trials and the safety monitoring of maternal vaccines. They may also be of interest for any intervention studied in populations of pregnant women.

PMID:35650569 | DOI:10.1186/s12884-022-04769-x

BMC Palliat Care. 2022 Jun 1;21(1):96. doi: 10.1186/s12904-022-00981-w.

ABSTRACT

BACKGROUND: Psychosocial distress interferes with the ability to cope effectively with cancer, its physical symptoms and treatment. This in turn leads to poor outcomes in patients.

OBJECTIVE: The aim of this study was to assess the level of psychosocial distress, emotional distress and the quality of life of cancer patients in two health facilities in Cameroon.

METHODS: This study used a cross-sectional hospital-based design. The study was carried out over a period of three months from July-September 2020. The sample size was 120 cancer patients. A consecutive sampling technique was used to select participants. Three validated questionnaires were used: DT, HADS and EORTC QLQ-C30 to assess, psychosocial distress, emotional distress and quality of life respectively. Results were presented using descriptive (frequency, percentage, mean) and inferential statistics (Chi square, Pearson’s correlation, ANOVA). Data were analysed with SPSS version 21. All statistics were considered significant at an alpha value set at 0.05 level.

RESULTS: The majority of patients 83 (69.2%) presented with clinically significant distress, with financial difficulties 87 (72.5%), fatigue 83 (69.2%), transportation 73 (60.8%) and difficulties with work/school 69(57.5%) being the most reported problems. Fifty nine (50.0%) and 56(47.5%) had moderate to severe anxiety and depression symptoms respectively. Overall on HADS, 67 patients (56.8%) presented with emotional distress. The quality of life was fair, with a mean of 52.4 ± 21.3.There was a statistically significant negative relationship (P < 0.0001), between psychosocial distress and quality of life of patients.

CONCLUSION: Cancer patients suffer from psychosocial distress, which has a negative relationship on their quality of life. It is important that healthcare professionals working in these settings, assess psychosocial distress early in patients with cancer to improve the quality of care and enhance quality of life.

PMID:35650571 | DOI:10.1186/s12904-022-00981-w

BMC Pediatr. 2022 Jun 1;22(1):321. doi: 10.1186/s12887-022-03348-5.

ABSTRACT

BACKGROUND: Studies on cognition and brain networks after various forms of brain injury mainly involve traumatic brain injury, neurological disease, tumours, and mental disease. There are few related studies on surgical injury and even fewer pediatric studies. This study aimed to preliminarily explore the cognitive and brain network changes in children with focal, unilateral, well-bounded intracranial space-occupying lesions (ISOLs) in the short term period after surgery.

METHODS: We enrolled 15 patients (6-14 years old) with ISOLs admitted to the Department of Pediatric Neurosurgery of the Beijing Tiantan Hospital between July 2020 and August 2021. Cognitive assessment and resting-state functional magnetic resonance imaging (rs-fMRI) were performed. Regional homogeneity (Reho), seed-based analysis (SBA) and graph theory analysis (GTA) were performed. Paired T-test was used for statistical analysis of cognitive assessment and rs-fMRI. Gaussian random-field theory correction (voxel p-value < 0.001, cluster p-value < 0.05) was used for Reho and SBA. False discovery rate correction (corrected p value < 0.05) for GTA.

RESULTS: Our results showed that psychomotor speed decreased within three months after surgery. Further, rs-fMRI data analysis suggested that sensorimotor and occipital network activation decreased with low information transmission efficiency.

CONCLUSION: We prudently concluded that the changes in cognitive function and brain network within three months after surgery may be similar to ageing and that the brain is vulnerable during this period.

PMID:35650566 | DOI:10.1186/s12887-022-03348-5

BMC Pediatr. 2022 Jun 1;22(1):322. doi: 10.1186/s12887-022-03375-2.

ABSTRACT

BACKGROUND: The rise in the indiscriminate use of antibiotics has become a major global public health problem and presents the biggest global health challenge in the twenty-first century. In developing countries, caregivers initiate treatment with antibiotics at home before presentation to a health facility. However, there is a paucity of evolving data towards surveillance of this trend in low-income countries. We investigated antibiotic use among febrile children presenting to a tertiary health facility in northern Uganda.

METHODS: We conducted a cross-sectional study in a tertiary health facility in northern Uganda between March and September 2021. Children aged 6-59 months with fever were selected using systematic random sampling. A pre-tested interviewer-administered questionnaire was used the collect clinical data from the caregivers. Data were analyzed using SPSS version 23. Descriptive statistics and multiple logistic regression models were applied. P-value < 0.05 was considered for statistical significance.

RESULTS: Eighty-three (39.5%) of the 210 children with fever in this study used antibiotics prior to the hospital visit, 55.4% of which were on a self-medication basis, while 44.6% were empiric prescriptions. The most commonly used antibiotics were amoxicillin 33/83 (39.8%), erythromycin 18 (21.7%), metronidazole 14 (16.9%), ciprofloxacin 13 (15.7%) and ampicillin 6 (7.2%). The main sources of the antibiotics included buying from drug shops 30/83 (36.1%), issuance from clinics (33.7%), remnants at home (12.0%), picking from a neighbour (7.2%) and others (10.8%). The factors associated with antibiotic use among the febrile children were residence (p < 0.001); distance from the nearest health facility (p = 0.005); caregivers’ gender (p = 0.043); cough (p = 0.012); diarrhoea (p = 0.007); duration of fever (p = 0.002); perceived convulsion complicating fever (p = 0.026), and caregivers’ perception that fever (p = 0.001), cough (p = 0.003), diarrhoea (p < 0.001) and any infection (p < 0.001) are indications for antibiotics.

CONCLUSIONS: Inappropriate use of antibiotics for childhood febrile illnesses is prevalent in the study setting, facilitated by the ease of access and use of leftover antibiotics. There is a need to address communities’ health-seeking behaviour and the health providers’ practice alike.

PMID:35650548 | DOI:10.1186/s12887-022-03375-2

BMC Med Res Methodol. 2022 Jun 1;22(1):159. doi: 10.1186/s12874-022-01634-5.

ABSTRACT

BACKGROUND: Accurate and reliable estimates of violence against women form the backbone of global and regional monitoring efforts to eliminate this human right violation and public health problem. Estimating the prevalence of intimate partner violence (IPV) is challenging due to variations in case definition and recall period, surveyed populations, partner definition, level of age disaggregation, and survey representativeness, among others. In this paper, we aim to develop a sound and flexible statistical modeling framework for global, regional, and national IPV statistics.

METHODS: We modeled IPV within a Bayesian multilevel modeling framework, accounting for heterogeneity of age groups using age-standardization, and age patterns and time trends using splines functions. Survey comparability is achieved using adjustment factors which are estimated using exact matching and their uncertainty accounted for. Both in-sample and out-of-sample comparisons are used for model validation, including posterior predictive checks. Post-processing of models’ outputs is performed to aggregate estimates at different geographic levels and age groups.

RESULTS: A total of 307 unique studies conducted between 2000-2018, from 154 countries/areas, and totaling nearly 1.8 million unique women responses informed lifetime IPV. Past year IPV had a similar number of studies (n = 332), countries/areas represented (n = 159), and individual responses (n = 1.8 million). Roughly half of IPV observations required some adjustments. Posterior predictive checks suggest good model fit to data and out-of-sample comparisons provided reassuring results with small median prediction errors and appropriate coverage of predictions’ intervals.

CONCLUSIONS: The proposed modeling framework can pool both national and sub-national surveys, account for heterogeneous age groups and age trends, accommodate different surveyed populations, adjust for differences in survey instruments, and efficiently propagate uncertainty to model outputs. Describing this model to reproducible levels of detail enables the accurate interpretation and responsible use of estimates to inform effective violence against women prevention policy and programs, and global monitoring of elimination efforts as part of the Sustainable Development Goals.

PMID:35650530 | DOI:10.1186/s12874-022-01634-5

BMC Bioinformatics. 2022 Jun 1;23(1):208. doi: 10.1186/s12859-022-04740-9.

ABSTRACT

BACKGROUND: Bioinformatics investigators often gain insights by combining information across multiple and disparate data sets. Merging data from multiple sources frequently results in data sets that are incomplete or contain missing values. Although missing data are ubiquitous, existing implementations of Gaussian mixture models (GMMs) either cannot accommodate missing data, or do so by imposing simplifying assumptions that limit the applicability of the model. In the presence of missing data, a standard ad hoc practice is to perform complete case analysis or imputation prior to model fitting. Both approaches have serious drawbacks, potentially resulting in biased and unstable parameter estimates.

RESULTS: Here we present missingness-aware Gaussian mixture models (MGMM), an R package for fitting GMMs in the presence of missing data. Unlike existing GMM implementations that can accommodate missing data, MGMM places no restrictions on the form of the covariance matrix. Using three case studies on real and simulated ‘omics data sets, we demonstrate that, when the underlying data distribution is near-to a GMM, MGMM is more effective at recovering the true cluster assignments than either the existing GMM implementations that accommodate missing data, or fitting a standard GMM after state of the art imputation. Moreover, MGMM provides an accurate assessment of cluster assignment uncertainty, even when the generative distribution is not a GMM.

CONCLUSION: Compared to state-of-the-art competitors, MGMM demonstrates a better ability to recover the true cluster assignments for a wide variety of data sets and a large range of missingness rates. MGMM provides the bioinformatics community with a powerful, easy-to-use, and statistically sound tool for performing clustering and density estimation in the presence of missing data. MGMM is publicly available as an R package on CRAN: https://CRAN.R-project.org/package=MGMM .

PMID:35650523 | DOI:10.1186/s12859-022-04740-9

J Gen Intern Med. 2022 Jun 1. doi: 10.1007/s11606-022-07674-3. Online ahead of print.

ABSTRACT

BACKGROUND: Communication with clinicians is an important component of a hospitalized patient’s experience.

OBJECTIVE: To test the impact of standardized hospitalist information cards on the patient experience.

DESIGN: Quasi-experimental study in a U.S. tertiary-care center.

PARTICIPANTS: All-comer medicine inpatients.

INTERVENTIONS: Standardized hospitalist information cards containing name and information on a hospitalist’s role and availability vs. usual care.

MAIN MEASURES: Patients’ rating of the overall communication as excellent (“top-box” score); qualitative feedback summarized via inductive coding.

KEY RESULTS: Five hundred sixty-six surveys from 418 patients were collected for analysis. In a multivariate regression model, standardized hospitalist information cards significantly improved the odds of a “top-box” score on overall communication (odds ratio: 2.32; 95% confidence intervals: 1.07-5.06). Other statistically significant covariates were patient age (0.98, 0.97-0.99), hospitalist role (physician vs. advanced practice provider, 0.56; 0.38-0.81), and hospitalist-patient gender combination (female-female vs. male-male, 2.14; 1.35-3.40). Eighty-seven percent of patients found the standardized hospitalist information cards useful, the perceived most useful information being how to contact the hospitalist and knowing their schedule.

CONCLUSIONS: Hospitalized patients’ experience of their communication with hospitalists may be improved by using standardized hospitalist information cards. Younger patients cared for by a team with an advanced practice provider, as well as female patients paired with female providers, were more likely to be satisfied with the overall communication. Assessing the impact of information cards should be studied in other settings to confirm generalizability.

PMID:35650470 | DOI:10.1007/s11606-022-07674-3