Category: Nevin Manimala

J Infect Dev Ctries. 2021 Apr 30;15(4):573-578. doi: 10.3855/jidc.12646.

ABSTRACT

INTRODUCTION: The increasing resistance to antibiotics is a public health problem and an imminent therapeutic challenge in hospitals. In this report we aimed to analyze the relationship between antimicrobial resistance and antibiotic consumption in a third-level pediatric hospital.

METHODOLOGY: A cross-sectional analysis was conducted using the information from the microbiology and pharmacy databases of the Pediatric Hospital “Doctor Silvestre Frenk Freund”, during the period 2015-2018. Prevalence of antimicrobial resistance by microorganisms and dispensed grams of selected antibiotics were calculated annually. Antibiotic resistance trend over the time was evaluated using the Chi-square trends test and to assess the correlation between the dispensed grams of antibiotics with their antimicrobial resistance prevalence, we calculated the Pearson’s coefficient (r).

RESULTS: A total of 4,327 isolated bacterial samples were analyzed (56.5% Gram-positive and 44.5% Gram-negative). Most frequently isolated microorganisms were coagulase-negative staphylococci (CoNS), E. coli, K. pneumoniae, P. aeruginosa and S. aureus. We found a significant increase in resistance to clindamycin and oxacillin for CoNS and significant decrease in nitrofurantoin and amikacin resistance for E. coli and K. pneumoniae. We observed a strong positive and statistically significant correlation between amikacin resistance prevalence and amikacin dispensed grams for P. aeruginosa (r = 0.95, p = 0.05).

CONCLUSIONS: The antibiotic resistance profile showed by our study highlights the need of an appropriate antibiotic control use in the Hospital setting.

PMID:33956659 | DOI:10.3855/jidc.12646

Med Sci Sports Exerc. 2021 Jan 1;53(1):246. doi: 10.1249/01.mss.0000725668.35113.c4.

NO ABSTRACT

PMID:33956727 | DOI:10.1249/01.mss.0000725668.35113.c4

J Infect Dev Ctries. 2021 Apr 30;15(4):552-558. doi: 10.3855/jidc.11885.

ABSTRACT

INTRODUCTION: The increasing number of persons > 65 years of age form a special population at risk for nosocomial and other health care-associated infections. Nosocomial infections are major problems in terms of morbidity and mortality as well as prolonged hospitalization and increased costs. The aim of the present study was determination of nurses’ awareness of hospital-acquired infection risks of the geriatric patients.

METHODOLOGY: This descriptive and cross-sectional study was conducted at a university hospital in North Cyprus. A total of 164 voluntary nurses composed the sample of the study. A questionnaire that was developed by the researchers based on the literature was used as data collection tool. After the ethical approval, data were collected using a questionnaire in September and October 2017 with self-completion method. The methods used to analyze the data include an analysis of descriptive statistic variables such as frequency and percentages for the categorical variables and the Pearson’s Chi-square test for comparisons.

RESULTS: Results of the study showed inadequate awareness among nurses on hospital-acquired infection risks of the geriatric patients. It was also determined that there were the statistically significant differences in term of education levels and experiences of nurses with different items on hospital-acquired infection risks of the geriatric patients.

CONCLUSIONS: Based on the results of the study, implementations of comprehensive, systematic, and continuous educational programs to enhance awareness of the nurses on health care-associated infections was recommended.

PMID:33956656 | DOI:10.3855/jidc.11885

JMIR Res Protoc. 2021 May 6;10(5):e15716. doi: 10.2196/15716.

ABSTRACT

BACKGROUND: Lupus is a complex autoimmune disease that is difficult to diagnose and treat. It is estimated that at least 5 million Americans have lupus, with more than 16,000 new cases of lupus being reported annually in the United States. Social media provides a platform for patients to find rheumatologists and peers and build awareness of the condition. Researchers have suggested that the social network Twitter may serve as a rich avenue for exploring how patients communicate about their health issues. However, there is a lack of research about the characteristics of lupus patients on Twitter and their attitudes toward using Twitter for engaging them with their health care.

OBJECTIVE: This study has two objectives: (1) to conduct a content analysis of Twitter data published by users (in English) in the United States between September 1, 2017 and October 31, 2018 to identify patients who publicly discuss their lupus condition and to assess their expressed health themes and (2) to conduct a cross-sectional survey among these lupus patients on Twitter to study their attitudes toward using Twitter for engaging them with their health care.

METHODS: This is a mixed methods study that analyzes retrospective Twitter data and conducts a cross-sectional survey among lupus patients on Twitter. We used Symplur Signals, a health care social media analytics platform, to access the Twitter data and analyze user-generated posts that include keywords related to lupus. We will use descriptive statistics to analyze the data and identify the most prevalent topics in the Twitter content among lupus patients. We will further conduct self-report surveys via Twitter by inviting all identified lupus patients who discuss their lupus condition on Twitter. The goal of the survey is to collect data about the characteristics of lupus patients (eg, gender, race/ethnicity, educational level) and their attitudes toward using Twitter for engaging them with their health care.

RESULTS: This study has been funded by the National Center for Advancing Translational Science through a Clinical and Translational Science Award. The institutional review board at the University of Southern California (HS-19-00048) approved the study. Data extraction and cleaning are complete. We obtained 47,715 Twitter posts containing terms related to “lupus” from users in the United States published in English between September 1, 2017 and October 31, 2018. We included 40,885 posts in the analysis. Data analysis was completed in Fall 2020.

CONCLUSIONS: The data obtained in this pilot study will shed light on whether Twitter provides a promising data source for garnering health-related attitudes among lupus patients. The data will also help to determine whether Twitter might serve as a potential outreach platform for raising awareness of lupus among patients and implementing related health education interventions.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/15716.

PMID:33955845 | DOI:10.2196/15716

Blood Coagul Fibrinolysis. 2021 Jun 1;32(4):248-252. doi: 10.1097/MBC.0000000000001025.

ABSTRACT

Early diagnosis of disseminated intravascular coagulation (DIC) before its progression to an overt stage is beneficial for its treatment and prognosis.This retrospective study aimed to evaluate the diagnostic performance of D-dimer and fibrin monomer in the early stage of DIC.A total of 707 patients suspected of having DIC, 302 healthy people were enrolled and divided into four groups: overt DIC, nonovert DIC, non-DIC based on the International Society of Thrombosis and Hemostasis scoring for overt DIC and the modified nonovert DIC criteria, healthy people as control group. Quantitative determination was done by immunoturbidimetry for D-dimer and fibrin monomer.The median of fibrin monomer in overt, nonovert and non-DIC was 41.65, 26.89 and 8.68 μg/ml, respectively. The median of D-dimer in overt, nonovert and non-DIC was 9.69, 3.98 and 3.08 μg/ml, respectively. D-dimer and fibrin monomer values were higher in overt DIC than other groups, but there was no difference between nonovert DIC and non-DIC in D-dimer. Unlike D-dimer, statistically significant differences were found in fibrin monomer between nonovert and non-DIC. At receiver operator characteristic curve-generated cutoff values, fibrin monomer had much excellent predictive performance compared with D-dimer for distinguishing nonovert DIC from non-DIC. D-dimer and fibrin monomer had same diagnostic performance in distinguishing overt DIC from non-DIC.Fibrin monomer is a better indicator compared with D-dimer in distinguishing patients with nonovert DIC from non-DIC. Hence, it might serve as an excellent negative exclusion marker to provide a reference for early clinical diagnosis and intervention through more studies.

PMID:33955858 | DOI:10.1097/MBC.0000000000001025

Subst Abus. 2021 May 6:1-2. doi: 10.1080/08897077.2021.1915919. Online ahead of print.

ABSTRACT

Lebanon, a small middle-income nation in western Asia, has been crippled by decades of political turmoil and armed conflict. A “quadruple crisis” hit the country over the past years, starting with the protracted humanitarian Syrian refugee crisis, followed by a severe socioeconomic collapse, the global COVID-19 pandemic, and lastly the Beirut port catastrophic blast. With the exposure to repetitive traumatic events and associated organic brain injury, the Lebanese population has become at a higher risk of addiction, among other psychiatric comorbidities. With the scarce statistics about the topic and limited addiction services in the country, collaborative local efforts and international help are urgently needed to fight the upcoming substance use epidemic. Raising awareness, providing adequate training, and securing resources for the management of both addiction and trauma are of utmost importance.

PMID:33955819 | DOI:10.1080/08897077.2021.1915919

JMIR Med Inform. 2021 May 6;9(5):e28413. doi: 10.2196/28413.

ABSTRACT

BACKGROUND: Improving the understandability of health information can significantly increase the cost-effectiveness and efficiency of health education programs for vulnerable populations. There is a pressing need to develop clinically informed computerized tools to enable rapid, reliable assessment of the linguistic understandability of specialized health and medical education resources. This paper fills a critical gap in current patient-oriented health resource development, which requires reliable and accurate evaluation instruments to increase the efficiency and cost-effectiveness of health education resource evaluation.

OBJECTIVE: We aimed to translate internationally endorsed clinical guidelines to machine learning algorithms to facilitate the evaluation of the understandability of health resources for international students at Australian universities.

METHODS: Based on international patient health resource assessment guidelines, we developed machine learning algorithms to predict the linguistic understandability of health texts for Australian college students (aged 25-30 years) from non-English speaking backgrounds. We compared extreme gradient boosting, random forest, neural networks, and C5.0 decision tree for automated health information understandability evaluation. The 5 machine learning models achieved statistically better results compared to the baseline logistic regression model. We also evaluated the impact of each linguistic feature on the performance of each of the 5 models.

RESULTS: We found that information evidentness, relevance to educational purposes, and logical sequence were consistently more important than numeracy skills and medical knowledge when assessing the linguistic understandability of health education resources for international tertiary students with adequate English skills (International English Language Testing System mean score 6.5) and high health literacy (mean 16.5 in the Short Assessment of Health Literacy-English test). Our results challenge the traditional views that lack of medical knowledge and numerical skills constituted the barriers to the understanding of health educational materials.

CONCLUSIONS: Machine learning algorithms were developed to predict health information understandability for international college students aged 25-30 years. Thirteen natural language features and 5 evaluation dimensions were identified and compared in terms of their impact on the performance of the models. Health information understandability varies according to the demographic profiles of the target readers, and for international tertiary students, improving health information evidentness, relevance, and logic is critical.

PMID:33955834 | DOI:10.2196/28413

JMIR Mhealth Uhealth. 2021 May 6;9(5):e25895. doi: 10.2196/25895.

ABSTRACT

BACKGROUND: Melanoma is attributable to predisposing phenotypical factors, such as skin that easily sunburns and unprotected exposure to carcinogenic UV radiation. Reducing the proportion of young adults who get sunburned may reduce the incidence of melanoma, a deadly form of skin cancer. Advances in technology have enabled the delivery of real-time UV light exposure and content-relevant health interventions.

OBJECTIVE: This study aims to examine the feasibility of young adults performing the following tasks daily: wearing a UV dosimeter, receiving text messages and real-time UV-B doses on their smartphone, and responding to daily web-based surveys about sunburn and sun protection.

METHODS: Young adults aged 18-39 years (n=42) were recruited in the United States in June 2020 via social media. Participants received the UV Guard sun protection system, which consisted of a UV dosimeter and a smartphone app. During 3 consecutive periods, intervention intensity increased as follows: real-time UV-B dose; UV-B dose and daily behavioral facilitation text messages; and UV-B dose, goal setting, and daily text messages to support self-efficacy and self-regulation. Data were self-reported through daily web-based surveys for 28 days, and UV-B doses were transmitted to cloud-based storage.

RESULTS: Patients’ median age was 22 years (IQR 20, 29), and all patients had sun-sensitive skin. Sunburns were experienced during the study by fewer subjects (n=18) than those in the preceding 28 days (n=30). In July and August, the face was the most commonly sunburned area among 13 body locations; 52% (22/42) of sunburns occurred before the study and 45% (19/42) occurred during the study. The mean daily UV-B dose decreased during the 3 periods; however, this was not statistically significant. Young adults were most often exercising outdoors from 2 to 6 PM, walking from 10 AM to 6 PM, and relaxing from noon to 2 PM. Sunburn was most often experienced during exercise (odds ratio [OR] 5.65, 95% CI 1.60-6.10) and relaxation (OR 3.69, 95% CI 1.03-4.67) relative to those that did not exercise or relax in each category. The self-reported exit survey indicated that participants felt that they spent less time outdoors this summer compared to the last summer because of the COVID-19 pandemic and work. In addition, 38% (16/42) of the participants changed their use of sun protection based on their app-reported UV exposure, and 48% (20/42) shifted the time they went outside to periods with less-intense UV exposure. A total of 79% (33/42) of the participants were willing to continue using the UV Guard system outside of a research setting.

CONCLUSIONS: In this proof-of-concept research, young adults demonstrated that they used the UV Guard system; however, optimization was needed. Although some sun protection behaviors changed, sunburn was not prevented in all participants, especially during outdoor exercise.

TRIAL REGISTRATION: ClinicalTrials.gov NCT03344796; http://clinicaltrials.gov/ct2/show/NCT03344796.

PMID:33955844 | DOI:10.2196/25895

West J Nurs Res. 2021 May 6:1939459211013580. doi: 10.1177/01939459211013580. Online ahead of print.

ABSTRACT

The purpose of this study was to examine individuals’ knowledge of cardiovascular risk-related biometric numbers and to compare self-reported and investigator-measured numbers in a convenience sample of adults in the Midwest region. Sociodemographic data and personal knowledge of cardiovascular risk-related biometric numbers were assessed using self-reported questionnaires. Investigators conducted health assessments to obtain biometric numbers. Among the 224 participants, participants’ reported knowledge about their cardiovascular risk-related biometric numbers was low, especially for high-density lipoprotein and fasting blood glucose levels. Participants’ knowledge was associated with education level and the recency of their last healthcare visit for health assessment. We found statistically significant mean differences between self-reported and investigator-measured blood pressure, and weight. This study found that there were discrepancies between self-reported and investigator-measured cardiovascular risk-related numbers. Future research is needed to develop educational interventions to improve personal knowledge of cardiovascular risks.

PMID:33955791 | DOI:10.1177/01939459211013580

Psychother Res. 2021 May 6:1-15. doi: 10.1080/10503307.2021.1921303. Online ahead of print.

ABSTRACT

Objective: The purpose of this paper is to describe an approach to dynamical systems (DS) using a set of differential equations, and how an application of these equations can be used to address a critical element of the therapeutic relationship. Using APA’s Three Approaches to Psychotherapy with a Female Client: The Next Generation and Three Approaches to Psychotherapy with a Male Client: The Next Generation videos, DS models were created for each of the six sessions with expert clinicians (Judith Beck, Leslie Greenberg, and Nancy McWilliams) from the three theoretical approaches. Method: A second-by-second observational coding system of the emotional exchanges of the therapists and clients was used as the data for the equations. Results: DS modeling allowed for a side-by-side comparison between the three approaches as well as between the two clients. Examining the graphs created by plotting the results of the DS equations (in particular, phase-space portraits) revealed that there were similarities among the three theoretical approaches, and there were notable differences between the two clients. Conclusions: DS modelling can provide researchers and clinicians with a powerful tool to investigate the complex phenomenon that is psychotherapy.

PMID:33955816 | DOI:10.1080/10503307.2021.1921303