Category: Nevin Manimala

Nurs Open. 2021 Jul 22. doi: 10.1002/nop2.988. Online ahead of print.

ABSTRACT

OBJECTIVES: Less than 5% of all harmful medicine-related incidents (MIs) or adverse drug reactions received by the Spanish Pharmacovigilance system are notified by Registered Nurses (RNs). The main objective of this study was to determine the impact of a multifaceted institutional intervention (MII) in patient safety on the reporting competence of medication incidents of hospital RNs.

DESIGN: One-group pre-test-posttest design.

SETTING: Tertiary, public, teaching hospital in Spain.

PARTICIPANTS: A total of 139 RNs responded to pre- and postintervention questionnaires constituting the paired sample subjected to analysis.

INTERVENTION: A MII, consisting of educational activities and materials, change in MI reporting form from paper to electronic and appointment of reporting support services, was designed and directed to all hospital RNs and midwifes.

MAIN OUTCOME MEASURES: Overall MIs reporting competence (OC) and its dimensions (attitudes, knowledge and skills) were measured through a synthetic variable (total OC value range: 34-170 points) by means of an electronic questionnaire.

RESULTS: A statistically significant 7.96-point increase in OC from baseline to the final measurement was obtained (CI: 5.05-10.85). There was an increase of 7.38 points in the skills dimension (CI: 5.06-9.68). After the MII, 73.4% nurses improved their OC and 33.8% reported at least one no-harm MI postintervention compared to 4.4% pre-intervention (p < .001). A one-point increase in OC improved the probability of becoming reporter by 2.9% and a one-point increase in skills by 6.4%.

CONCLUSION: MIs reporting competence among RNs increased after a multifaceted institutional intervention, due to an improvement in the skills dimension. The MII was also effective in raising both, the rate of RNs who become reporters and the number of no-harm MIs reported.

PMID:34291607 | DOI:10.1002/nop2.988

J Biomed Opt. 2021 Jul;26(7). doi: 10.1117/1.JBO.26.7.077001.

ABSTRACT

SIGNIFICANCE: Measurements of auditory ossicles displacement are commonly carried out by means of laser-Doppler vibrometry (LDV), which is considered to be a gold standard. The limitation of the LDV method, especially for in vivo measurements, is the necessity to expose an object in a straight line to a laser beam operating from a distance. An alternative to this approach is the use of a handheld laser-fiber vibrometry probe (HLFVP) with a curved tip.

AIM: We evaluate the feasibility of an HLFVP with a curved tip for measuring sound-induced displacement of the auditory ossicles.

APPROACH: A handheld vibrometer probe guiding the laser beam with a fiber-optic cable was used for displacement measurements of the incus body and the posterior crus of the stapes. Tonal stimuli at frequencies of 0.5, 1, 2, and 4 kHz were presented by means of an insert earphone positioned in the outer ear canal. The probe was fixed at the measurement site using a tripod or hand-held by one of the two surgeons.

RESULTS: The measurements were carried out on six fresh temporal bones. Multivariate analysis of variance showed statistically significant differences for stimulus frequency (F3,143 = 29.37, p < 0.001, and η2 = 0.35), bone (F5,143 = 4.61, p = 0.001, and η2 = 0.01), and measurement site (F1,143 = 4.74, p = 0.03, and η2 = 0.02) in the absence of statistically significant differences for the probe fixation method (F2,143 = 0.15, p = 0.862, and η2 = 0.001). Standard deviations of the means were 6.9, 2.6, 1.9, and 0.6 nm / Pa for frequency, bone, site, and fixation, respectively. Ear transfer functions were found to be consistent with literature data.

CONCLUSIONS: The feasibility of applying HLFVP to measure the displacement of auditory ossicles has been confirmed. HLFVP offers the possibility of carrying out measurements at various angles; however, this needs to be standardized taking into account anatomical limitations and surgical convenience.

PMID:34291616 | DOI:10.1117/1.JBO.26.7.077001

Geriatr Gerontol Int. 2021 Jul 21. doi: 10.1111/ggi.14244. Online ahead of print.

ABSTRACT

AIM: To explore the risk factors associated with suicidal behavior (SB) using logistic regression analysis and the propensity score matching (PSM) method among Chinese patients suffering from late-life depression (LLD).

METHOD: Patient information sheets were retrieved with the International Classification of Diseases, Tenth Revision (ICD-10) code from an electronic database that comprised patient medical information. Herein, we set SB as a dependent variable, and gender, marital status, monthly income, quality of interpersonal relationships, hobbies, impulsivity, severity of depression, psychiatric symptoms or not, and having histories of smoking, drinking, major mental trauma as independent variables according to clinical experience and previous findings. For uncertain independent risk factors associated with SB generated by logistic regression analysis, PSM was performed for further verification.

RESULTS: The differences between the SB group and non-SB group for marital status, severity of depression, a history of drinking, and a history of major mental trauma were found to be statistically significant in univariate comparisons (P < 0.05); binary logistic regression analysis and PSM analysis showed that the severity of depression, a history of drinking, and a history of major mental trauma were independent risk factors associated with SB of patients with LLD with an odds ratio greater than one.

CONCLUSION: The severity of depression, a history of drinking, and a history of major mental trauma were independently associated with the occurrence of SB of patients with LLD in China. Further longitudinal and prospective studies are warranted to examine the dynamic changes of confounding risk factors. Geriatr Gerontol Int 2021; ••: ••-••.

PMID:34291556 | DOI:10.1111/ggi.14244

Thorac Cancer. 2021 Jul 21. doi: 10.1111/1759-7714.14075. Online ahead of print.

ABSTRACT

BACKGROUND: Programmed cell death ligand-1 (PD-L1) is a useful biomarker in non-small cell lung cancer (NSCLC) patients who would probably benefit from immunotherapy. In most patients with advanced stage NSCLC, only small biopsy specimens were available for the evaluation of PD-L1 expression. In this study, we evaluated the feasibility and reliability of PD-L1 testing on small biopsy samples.

METHODS: Small specimens of advanced NSCLC patients obtained via endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), endobronchial biopsy (EBB), or computed tomography (CT)-guided core-needle biopsy were collected. Tumor cell count and tissue sufficiency for PD-L1 immunohistochemistry (IHC) were evaluated and compared. The clinical course of patients who received immunotherapy in the study population was also examined.

RESULTS: Tissue acquisitions for PD-L1 testing in three groups were all above 90%, with no statistically significant differences. The PD-L1 expressions levels were concordant in most patients with more than one sample (8/11). In the EBB group, PD-L1-positive patients had higher objective response rate (ORR) (53.2% vs. 26.9%, p = 0.048) and longer progression-free survival (PFS) (312 vs. 179 days, p = 0.035) than PD-L1 negative patients. In the core needle biopsy group, patients with positive PD-L1 expression also trended to have higher ORR and longer PFS. However, in the EBUS-TBNA group, both ORR and PFS were similar between patients with positive or negative PD-L1 expression.

CONCLUSIONS: This study showed that EBUS-TBNA, EBB, and core needle biopsy provides adequate samples for PD-L1 testing. The predictive value of PD-L1 expression on different small samples still warrants further studies.

PMID:34291566 | DOI:10.1111/1759-7714.14075

Brain Behav. 2021 Jul 21. doi: 10.1002/brb3.2252. Online ahead of print.

ABSTRACT

BACKGROUND: Orthostatic hypotension (OH) is a common nonmotor symptom in patients with Parkinson’s disease (PD), with an incidence ranging from 14% to 54%.

AIMS: This study explored changes in cognition and transcranial sonography (TCS) findings in patients with PD and OH.

METHODS: We enrolled PD patients who visited the outpatient or inpatient department from 2017 to 2020. Blood pressure was measured in different positions, and demographic data were collected. Motor and nonmotor symptoms were evaluated using standard scales. A subset of 107 patients underwent TCS.

RESULTS: We enrolled 66 PD-OH patients and 92 PD-no orthostatic hypotension (NOH) patients. There were no significant differences in gender, age, disease duration, or Hoehn and Yahr stage between groups. Binary logistic regression revealed age as an independent risk factor for OH in PD patients. There were statistically significant group differences in visuospatial and executive function and Unified Parkinson’s Disease Rating Scale (UPDRS) I and II scores (p < .05). Among PD-OH patients, there was a statistically significant difference in UPDRS II and III scores between patients with or without clinical symptoms (p < .05). The substantia nigra (SN) area was significantly larger in PD-NOH patients (0.45 ± 0.18 cm² ) than PD-OH patients (0.34 ± 0.16 cm² ) (p < .05).

CONCLUSIONS: PD-OH patients had poorer visuospatial and executive function and lower UPDRS I and II scores compared with PD-NOH patients. Within the PD-OH group, there was no significant difference in cognition between patients with or without clinical symptoms. The difference in the SN area may indicate different subtypes of PD or a tendency to develop parkinsonism syndrome.

PMID:34291604 | DOI:10.1002/brb3.2252

J Anim Physiol Anim Nutr (Berl). 2021 Jul 21. doi: 10.1111/jpn.13609. Online ahead of print.

ABSTRACT

Pre-weaning nutrition has significant influence on post-weaning performance of lambs. Strategic weaning management on milk replacer allowance at this phase can be a promising approach for harvesting desired carcass trait in finisher phase. Therefore, present experiment aimed economizing pre-weaning weight gain in lambs by feeding milk replacer and subsequently minimizing weaning age. A study of 90 days duration was conducted to determine the production performance, nutrient utilization and rumen fermentation of lambs on milk replacer allowance at different weaning age. Sixty-six Malpura lambs (10 days of age) were randomly divided into 3 equal groups. Lambs in control group were allowed conventional free suckling of dam up to 90 day of age, whereas lambs in the two treatment groups, that is W60 and W90 were offered milk replacer and weaned at 60 and 90 days, respectively. Lambs in all groups were offered ad-libitum creep mixture, Ziziphus nummularia leaves, Vigna unguiculata hay and fresh Ailanthus excelsa leaves. Overall weight gain was 12.7 per cent higher (p < 0.05) in W90 than control whereas in W60 group it was statistically comparable with both control and W90 groups. Overall average daily gain was 12.1 per cent higher (p < 0.05) in W90 group as compared to control. In case of nutrient digestibility, there was significant depression of dry matter (DM), organic matter (OM), crude protein (CP) and neutral detergent fibre (NDF) by 16.9, 17.2, 9.3 and 32.0 per cent in W60 than control; however, in W90, CP digestibility was higher (p < 0.05) than control and W60. Considering economic analysis, the net return obtained from W90 (90 days weaning plus milk replacer allowance) was more 20.0 per cent higher than control. Therefore, it can be concluded that lamb rearing on milk replacer and weaning at 90 days have a sustained positive effect on lambs’ production performance and is more profitable than the practice of milk replacer allowance and early weaning in semiarid conditions.

PMID:34291505 | DOI:10.1111/jpn.13609

Health Soc Care Community. 2021 Jul 21. doi: 10.1111/hsc.13521. Online ahead of print.

ABSTRACT

This study identifies the key factors underlying the unmet dental care needs of South Korean homeless adults that obstructed their dental service access. We analysed data from 551 Korea Homeless Survey respondents (17 years and older) who reported having an oral disease in the previous 12 months. We conducted multiple logistic regression analyses to examine the factors associated with homeless individuals’ unmet dental care needs, using weights to make the data nationally representative. Approximately 43% of the homeless people reported having unmet dental care needs. Housing type (living in the street) was significantly associated with an increased odds ratio of unmet dental care needs. However, when social protection programs (housing benefits and Medical Aid [MA]) were included in the model, the statistical significance of the housing type disappeared. Homeless MA recipients were less likely to have unmet needs than those not covered by MA. On the other hand, homeless people who received housing benefits were more likely to receive dental care than people who do not receive these benefits. Consequently, policy makers should develop social protection programs influencing homeless individuals’ access to dental care and ensure the sustainable implementation of integrated community-based dental services for homeless adults.

PMID:34291516 | DOI:10.1111/hsc.13521

SAGE Open Med. 2021 Jul 10;9:20503121211030837. doi: 10.1177/20503121211030837. eCollection 2021.

ABSTRACT

OBJECTIVES: To compare the characteristics and outcomes of patients presenting to hospital with alcohol-induced and gallstone-induced acute pancreatitis.

METHODS: Retrospective study of all patients with alcohol-induced or gallstone-induced pancreatitis during the period 1 June 2012 to 31 May 2016. The primary outcome measure was hospital mortality. Secondary outcome measures included hospital length of stay, requirements for intensive care unit admission, intensive care unit mortality, mechanical ventilation, renal replacement therapy, requirement of inotropes and total parenteral nutrition.

RESULTS: A total of 642 consecutive patients (49% alcohol; 51% gallstone) were included. No statistically significant differences were found between alcohol-induced and gallstone-induced acute pancreatitis with respect to hospital mortality, requirement for intensive care unit admission, intensive care unit mortality and requirement for mechanical ventilation, renal replacement therapy, inotropes or total parenteral nutrition. There was significant difference in hospital length of stay (3.07 versus 4.84; p < 0.0001). On multivariable regression analysis, Bedside Index of Severity in Acute Pancreatitis score (estimate: 0.393; standard error: 0.058; p < 0.0001) and admission haematocrit (estimate: 0.025; standard error: 0.008; p = 0.002) were found to be independently associated with prolonged hospital length of stay.

CONCLUSION: Hospital mortality did not differ between patients with alcohol-induced and gallstone-induced acute pancreatitis. The duration of hospital stay was longer with gallstone-induced pancreatitis. Bedside Index of Severity in Acute Pancreatitis score and admission haematocrit were independently associated with hospital length of stay.

PMID:34290866 | PMC:PMC8274077 | DOI:10.1177/20503121211030837

Pak J Med Sci. 2021 Jul-Aug;37(4):1161-1165. doi: 10.12669/pjms.37.4.4229.

ABSTRACT

BACKGROUND AND OBJECTIVES: It is known that the prevalence of obstructive sleep apnea (OSA) is increased in acromegaly. Craniofacial anomalies, macroglossia, and thickening of the laryngeal wall caused by the increase in soft tissue in these patients lead to OSA. Also, the increase in growth hormone can trigger central apnea by causing a decrease in respiratory drive. Determining the polysomnographic characteristics of acromegaly patients is important to reveal the effect of these mechanisms.

METHODS: The demographic and polysomnographic characteristics of 33 acromegaly patients who underwent polysomnography (PSG) with suspicion of sleep disorders between 2011 and 2018 in the sleep laboratory of our hospital were retrospectively analyzed. One of the patients was excluded from the analysis because PSG was performed in the postoperative period. The remaining 32 patients with active acromegaly were grouped according to their gender and the presence of OSA and compared with statistical methods in terms of polysomnographic and clinical features.

RESULTS: OSA (AHI>5) was detected in 78.1% of 32 active acromegaly patients (18 females, 14 males) who underwent PSG with suspicion of sleep-disordered breathing. Moderate-severe OSA (62.5%) was found in most patients, and there was no difference between the sexes in terms of OSA detection rate and OSA severity. Respiratory events appear to be predominantly obstructive hypopneas. Also, the polysomnographic features of female and male acromegaly patients with OSA were found to be similar. It is seen that the OSA group is similar to the group with simple snoring in terms of body mass index (BMI), but is statistically significantly older (p=0,007). A positive correlation was found between age and AHI in pairwise correlation analysis (r:0,426 p:0,015, respectively).

CONCLUSION: Considering that the prevalence of OSA in the population is approximately 5%, our results show that the risk of OSA in acromegaly increases, and obstructive pathways are effective in this increase. The probability of OSA occurrence and polysomnographic features between the genders are similar. Although the median BMI of the patients with and without OSA was similar, the median age was higher in the group with OSA, middle-aged acromegaly patients should be evaluated in terms of OSA even if there is no obvious obesity.

PMID:34290801 | PMC:PMC8281146 | DOI:10.12669/pjms.37.4.4229

Pak J Med Sci. 2021 Jul-Aug;37(4):1201-1205. doi: 10.12669/pjms.37.4.4124.

ABSTRACT

OBJECTIVE: Problematic cell phone use is common among young age groups which include university students, and may be accompanied by social anxiety and eating disorders. We aimed to examine the relationship between problematic cell phone use, social anxiety and eating disorders among university students.

METHODS: The universe of this cross-sectional study consists of 28,669 students receiving education at a Inonu University between October 2017 – November 2017. With a confidence interval of 95% and power of 80%, the sample size was calculated to be 308. The survey forms used in the study included students’ sociodemographic characteristics, data regarding cell phone usage, Problematic Mobile Phone Use Scale, Liebowitz Social Anxiety Scale and Eating Attitudes Test. The statistical analyses were conducted using Student t, One Way ANOVA, Spearman Correlation Test and Binomial Logistic Regression Analysis.

RESULTS: The students in the study group demonstrated a 46.1% rate of problematic cell phone use. The students’ Problematic Mobile Phone Use Scale total scores showed a significant correlation with smoking, and daily duration and purpose of cell phone use (p<0.05).

CONCLUSION: University students demonstrate high rates of problematic cell phone use; in addition, individuals who use cell phones for increased hours or for certain purposes display higher total scores on the Problematic Mobile Phone Use Scale. Students should be educated on limiting problematic cell phone use.

PMID:34290808 | PMC:PMC8281188 | DOI:10.12669/pjms.37.4.4124