Category: Nevin Manimala

Adv Exp Med Biol. 2021;1337:17-25. doi: 10.1007/978-3-030-78771-4_3.

ABSTRACT

This study aimed to examine Greek nurses’ perceptions about hospital ethical climate and to investigate the possible difference of those perceptions regarding their demographic and work-related characteristics. The cross-sectional study design was employed in this study in which 286 nurses and nurse assistants participated. Data were collected by a sheet containing demographic and work-related characteristics and the Greek version of the Oslons’ Hospital Ethical Climate Scale. IBM Statistical Package for Social Sciences 25 was used in data analysis. Frequencies, means, percentages, and standard deviations summarized the data. For the statistical differences, parametric tests were performed. Independent Samples t and Pearson correlation analysis were used to determine the relationship between the ethical climate of the hospital and the nurses’ characteristics. The p-values 0.05 were considered statistically significant. The mean age of the nurses was 44 years (SD: 8.5 years; range 24-66 years). The majority of them were women (77.3%). A percent of 57.7% of the sample was married. Most positive perceptions were concerning managers (4.01) following by peers (3.82), patients (3.69), hospitals (3.29) while the least positive perceptions of the ethical climate were concerning the physicians (3.16). The factors associated with hospital ethical perception were: working experience and responsible position. The highest score of ethical climate reported to managers subscale, while the minimum score was related to physicians. In general, Greek nurses reported positive perceptions regarding hospital ethical climate. The positive ethical climate is associated with a better working environment, fewer nurses’ experience of moral distress, fewer chances for nursing turnover, high quality of nursing care, and fewer errors in nursing practice.

PMID:34972887 | DOI:10.1007/978-3-030-78771-4_3

Adv Exp Med Biol. 2021;1337:59-64. doi: 10.1007/978-3-030-78771-4_7.

ABSTRACT

The objective of this study is to evaluate hand grip strength (HGS) in patients on hemodialysis and to investigate associated factors (anthropometric characteristics, body composition, and quality of life). An observational study of 60 patients in one hemodialysis center (Filoxenia Dialysis center, Aigio, Greece) was conducted. Measures of HGS were performed with a hydraulic dynamometer (Saehan Corporation, South Korea) on the non-fistula hand before the hemodialysis session. Demographic and clinical data (dialysis start date, comorbidities, and etiology of chronic kidney disease) were collected from the patients’ medical charts. Body composition was determined by bioelectrical impedance analysis and calf circumference with inelastic tape. Quality of life was assessed via EuroQol (EQ-5D) questionnaire. Descriptive statistics were used for data analyses. The association between variables was calculated using Pearson’s r correlation coefficients. The experimental design of this study was approved by the Ethics Committee of the Technological Educational Institute of Western Greece. A total of 54 patients (71.2 ± 10.9 years old, 24% diabetic, BMI of 26.34 ± 5.2) participated in this study (response rate 90%). The average duration of hemodialysis was 4.29 ± 6.36 years. The maximum HGS in the dominant was 19.19 ± 12.1 kg (female 12.04 ± 7.26 kg, male 21.82 ± 12.52 kg, p < 0.001). HGS was significantly correlated with age (r = 0.5; p < 0.001) and moderately correlated with gender (r = 0.36; p = 0.008), BMI (r = 0.3; p = 0.03), calf circumference (r = 0.4; p = 0.03), and quality of life (r = 0.37; p = 0.006). The use of hand-held dynamometry could be a fundamental element of the physical examination of patients receiving hemodialysis, particularly if they are older adults.

PMID:34972891 | DOI:10.1007/978-3-030-78771-4_7

Phys Ther. 2021 Dec 23:pzab298. doi: 10.1093/ptj/pzab298. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this study was to compare the effects of integrated and consecutive cognitive dual-task balance training in older adults on balance, fear of falling, and gait performance.

METHODS: Fifty-eight subjects (age > 65 years) were randomly assigned to an integrated dual-task training group (IDTT) (n = 29) and consecutive dual-task training group (CDTT) (n = 29). Balance exercises and cognitive tasks were performed simultaneously by the IDTT group and consecutively by the CDTT group for 8 weeks. Balance was assessed using the Berg Balance Scale (BBS) as a primary outcome measure and the Timed “Up & Go” Test (TUG) (standard-cognitive), fear of falling was assessed using the Tinetti Falls Efficacy Scale (FES), and gait speed was assessed using the 10-Meter Walk Test (10MWT) (under single-task and dual-task conditions). All tests were performed before and after the training.

RESULTS: There was no difference in group-time interaction in the BBS, TUG-ST, 10MWT-ST, and 10MWT-DT tests. Group-time interaction was different in the TUG-Cog and FES scores. Also, the effect of time was significantly different in all scales except for the 10MWT-ST in both groups.

CONCLUSION: At the end of the 8 week training period, the impact of integrated and consecutive dual-task balance training on balance and gait performance in older adults was not statistically significantly different. This study suggests that consecutive dual-task balance training can be used as an alternative method to increase balance performance and gait speed in older adults who cannot perform integrated dual-task activities.

IMPACT: There were no significant differences between the effects of the 2 dual-task training methods on balance and gait speed. Suggesting that the consecutive dual-task balance training method can be used to improve the balance and gait of older adults. Consecutive dual-task training can be performed safely and considered as an alternative method for use in many rehabilitation training programs with older adults who cannot perform simultaneous activities.

PMID:34972869 | DOI:10.1093/ptj/pzab298

Am J Crit Care. 2022 Jan 1;31(1):e10-e19. doi: 10.4037/ajcc2022124.

ABSTRACT

BACKGROUND: Individualized family-centered developmental care (IFDC) is considered the standard of care for premature/medically fragile newborns and their families in intensive care units (ICUs). Such care for infants with congenital heart disease (CHD) varies.

OBJECTIVE: The Consortium for Congenital Cardiac Care- Measurement of Nursing Practice (C4-MNP) was surveyed to determine the state of IFDC for infants younger than 6 months with CHD in ICUs.

METHODS: An electronic survey was disseminated to 1 nurse at each participating center. The survey included questions on IFDC-related nursing practice, organized in 4 sections: demographics, nursing practice, interdisciplinary practice, and parent support. Data were summarized by using descriptive statistics. Differences in IFDC practices and IFDC-related education were assessed, and practices were compared across 3 clinical scenarios of varying infant acuity by using the χ2 test.

RESULTS: The response rate was 66% (25 centers). Most respondents (72%) did not have IFDC guidelines; 63% incorporated IFDC interventions and 67% documented IFDC practices. Only 29% reported that their ICU had a neurodevelopmental team. Significant differences were reported across the 3 clinical scenarios for 11 of 14 IFDC practices. Skin-to-skin holding was provided least often across all levels of acuity. Nurse education related to IFDC was associated with more use of IFDC (P < .05).

CONCLUSION: Practices related to IFDC vary among ICUs. Opportunities exist to develop IFDC guidelines for infants with CHD to inform clinical practice and nurse education. Next steps include convening a C4-MNP group to develop guidelines and implement IFDC initiatives for collaborative evaluation.

PMID:34972853 | DOI:10.4037/ajcc2022124

Phys Ther. 2021 Dec 24:pzab295. doi: 10.1093/ptj/pzab295. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this study was to compare the psychometric properties of the Mini-Balance Evaluation Systems Test (Mini-BESTest) and S-BESTest and to evaluate which is more suitable for use in clinical settings for patients with stroke.

METHODS: This multicenter retrospective cross-sectional study investigated 115 patients with stroke (mean age, 70.8 y [SD = 11.2 y]) who were able to stand without physical assistance. All patients were examined with the BESTest and with the Mini-BESTest and S-BESTest scored based on the BESTest results. The data were analyzed using a Rasch analysis (partial credit model).

RESULTS: The Mini-BESTest results revealed a correctly functioning rating scale, good fit of the data to the model (apart from 1 overfit item), good reliability for both persons and items (6 statistically detectable levels of balance ability), local dependence between 1 item pair, and essential unidimensionality. The S-BESTest results demonstrated disordered rating scale thresholds (1 response option required collapsing), good fit of the data to the model (apart from 1 underfit item), good reliability for both persons and items (5 statistically detectable levels of balance ability), local dependence between 2 item pairs, and essential unidimensionality.

CONCLUSION: The analyses confirmed that the reliability of S-BESTest was good and unidimensional and that the test provides several improved points, such as item redundancy and local independence of items. Nevertheless, the Mini-BESTest results supported previous findings as a whole and were better than those from the S-BESTest.

IMPACT: Rasch analysis demonstrated that the Mini-BESTest was a better balance assessment scale than the S-BESTest for patients with stroke based on its psychometric properties. The Mini-BESTest may serve as a useful scale for assessing balance in patients with stroke, and a keyform plot and strata may help clinical decision making in terms of interpreting scores and goal setting.

PMID:34972868 | DOI:10.1093/ptj/pzab295

Nat Microbiol. 2021 Dec 31. doi: 10.1038/s41564-021-01029-0. Online ahead of print.

ABSTRACT

Global and national surveillance of SARS-CoV-2 epidemiology is mostly based on targeted schemes focused on testing individuals with symptoms. These tested groups are often unrepresentative of the wider population and exhibit test positivity rates that are biased upwards compared with the true population prevalence. Such data are routinely used to infer infection prevalence and the effective reproduction number, R_t, which affects public health policy. Here, we describe a causal framework that provides debiased fine-scale spatiotemporal estimates by combining targeted test counts with data from a randomized surveillance study in the United Kingdom called REACT. Our probabilistic model includes a bias parameter that captures the increased probability of an infected individual being tested, relative to a non-infected individual, and transforms observed test counts to debiased estimates of the true underlying local prevalence and R_t. We validated our approach on held-out REACT data over a 7-month period. Furthermore, our local estimates of R_t are indicative of 1-week- and 2-week-ahead changes in SARS-CoV-2-positive case numbers. We also observed increases in estimated local prevalence and R_t that reflect the spread of the Alpha and Delta variants. Our results illustrate how randomized surveys can augment targeted testing to improve statistical accuracy in monitoring the spread of emerging and ongoing infectious disease.

PMID:34972825 | DOI:10.1038/s41564-021-01029-0

Am J Crit Care. 2022 Jan 1;31(1):65-72. doi: 10.4037/ajcc2022732.

ABSTRACT

BACKGROUND: The Barthel Index, originally developed and validated to assess activities of daily living in patients with neuromuscular disorders, is commonly used in research and clinical practice involving critically ill patients.

OBJECTIVES: To evaluate the internal consistency, reliability, measurement error, and construct validity of the Barthel Index used at intensive care unit discharge.

METHODS: In this observational study, 2 physiotherapists measured the physical functioning of 122 patients at intensive care unit discharge, using the Barthel Index and other measurement instruments.

RESULTS: The patients had a median (IQR) age of 56 (47-66) years, and 62 patients (51%) were male. The primary reason for intensive care unit admission was sepsis (28 patients [23%]), and 83 patients (68%) were receiving mechanical ventilation. The Cronbach α value indicating internal consistency was 0.81. For interrater reliability, the intraclass correlation coefficient for the total score was 0.98 (95% CI, 0.97-0.98; P < .001) and the κ statistic for the individual items was 0.54 to 0.94. The standard error of measurement was 7.22, the smallest detectable change was 20.01, and the 95% limits of agreement were -10.3 and 11.8. The Barthel Index showed moderate to high correlations with the other physical functioning measurement instruments (ρ = 0.57 to 0.88; P < .001 for all).

CONCLUSION: The Barthel Index is a reliable and valid instrument for assessing physical functioning at intensive care unit discharge.

PMID:34972844 | DOI:10.4037/ajcc2022732

Addiction. 2021 Dec 31. doi: 10.1111/add.15786. Online ahead of print.

ABSTRACT

AIMS: To compare quantitatively the efficacy and tolerability of pharmacologically active interventions in the treatment and prevention of alcohol-induced hangover.

METHODS: Systematic review of placebo-controlled randomised trials in healthy adults that evaluated any pharmacologically active intervention in the treatment or prevention of hangover. We searched Medline, Embase, PsycINFO and CENTRAL from database inception until 1^st August 2021. The primary efficacy outcome was any continuous measure of overall hangover symptoms and the primary tolerability outcome the number of people dropping out due to adverse events (AEs). Quality was assessed using the Grading of Recommendations Assessment Development and Evaluation (GRADE) framework.

RESULTS: 21 studies were included reporting on 386 participants. No two studies reported on the same intervention; as such, meta-analysis could not be undertaken. Methodological concerns and imprecision resulted in all studied efficacy outcomes being rated as very low quality. When compared with placebo, individual studies reported a statistically significant reduction in the mean percentage overall hangover symptom score for clove extract (42.5% vs. 19.0%, p<0.001), tolfenamic acid (84.0% vs. 50.0%, p<0.001), pyritinol (34.1% vs. 16.2%, p<0.01), Hovenia dulcis fruit extract (p=0.029), L-cysteine (p=0.043), red ginseng (21.1% vs. 14.0%, p<0.05) and Korean pear juice (41.5% vs 33.3%, p<0.05). All studied tolerability outcomes were of low or very low quality with no studies reporting any drop-outs due to AEs.

CONCLUSIONS: Only very low quality evidence of efficacy is available to recommend any pharmacologically active intervention for the treatment or prevention of alcohol-induced hangover. Of the limited interventions studied, all had favourable tolerability profiles and very low quality evidence suggests clove extract, tolfenamic acid, and pyritinol may most warrant further study.

PMID:34972259 | DOI:10.1111/add.15786

FASEB J. 2022 Feb;36(2):e22124. doi: 10.1096/fj.202101332R.

ABSTRACT

Nerve growth factor-induced gene B (Nur77) has been shown to ameliorate several biological processes in chronic diseases, including inflammatory response, cellular proliferation, and metabolism. Chronic kidney disease (CKD) is characterized by tubulointerstitial fibrosis for which no targeted therapies are available as yet. In this study, we performed in vivo and in vitro experiments to demonstrate that Nur77 targets fibrosis signals and attenuates renal tubulointerstitial fibrosis during the aging process. We observed that the TGF-β/Smads signal pathway was significantly suppressed by Nur77, suggesting that Nur77 controlled the activation of key steps in TGF-β/Smads signaling. We further showed that Nur77 interacted with Smad7, the main repressor of nuclear translocation of Smad2/3, and stabilized Smad7 protein homeostasis. Nur77 deficiency resulted in Smad7 degradation, aggravating Smad2/3 phosphorylation, and promoting transcription of its downstream target genes, ACTA2 and collagen I. Our findings demonstrate that Nur77 is a potential therapeutic target for age-related kidney diseases including CKD. Maintenance of Nur77 may be an effective strategy for blocking renal tubulointerstitial fibrosis and improving renal function in the elderly.

PMID:34972249 | DOI:10.1096/fj.202101332R

Chem Senses. 2022 Jan 1;47:bjab052. doi: 10.1093/chemse/bjab052.

ABSTRACT

CD36 and GNAT3 mediate taste responses, with CD36 acting as a lipid detector and GNAT3 acting as the α subunit of gustducin, a G protein governing sweet, savory, and bitter transduction. Strikingly, the genes encoding CD36 and GNAT3 are genomically superimposed, with CD36 completely encompassing GNAT3. To characterize genetic variation across the CD36-GNAT3 region, its implications for phenotypic diversity, and its recent evolution, we analyzed from ~2,500 worldwide subjects sequenced by the 1000 Genomes Project (1000GP). CD36-GNAT3 harbored extensive diversity including 8,688 single-nucleotide polymorphisms (SNPs), 414 indels, and other complex variants. Sliding window analyses revealed that nucleotide diversity and population differentiation across CD36-GNAT3 were consistent with genome-wide trends in the 1000GP (π = 0.10%, P = 0.64; FST = 9.0%, P = 0.57). In addition, functional predictions using SIFT and PolyPhen-2 identified 60 variants likely to alter protein function, and they were in weak linkage disequilibrium (r2 < 0.17), suggesting their effects are largely independent. However, the frequencies of predicted functional variants were low (P¯ = 0.0013), indicating their contributions to phenotypic variance on population scales are limited. Tests using Tajima’s D statistic revealed that pressures from natural selection have been relaxed across most of CD36-GNAT3 during its recent history (0.39 < P < 0.67). However, CD36 exons showed signs of local adaptation consistent with prior reports (P < 0.035). Thus, CD36 and GNAT3 harbor numerous variants predicted to affect taste sensitivity, but most are rare and phenotypic variance on a population level is likely mediated by a small number of sites.

PMID:34972209 | DOI:10.1093/chemse/bjab052