Category: Nevin Manimala

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2021 Jun 20;39(6):428-429. doi: 10.3760/cma.j.cn121094-20201110-00623.

ABSTRACT

Objective: To study the effect of preventive intervention on occupational exposure of nurses after tumor particle implantation in thoracic surgery. Methods: In March 2020, 99 nurses who were engaged in postoperative nursing of tumor particle implantation in thoracic surgery department of our hospital from February 2019 to February 2020 were selected as the research objects. According to different preventive interventions, they were divided into observation group (51 cases) and control group (48 cases) . The observation group received preventive intervention, while the control group received routine intervention. The differences of radiation dose, psychological state and abnormal rate of important organ function between the two groups were analyzed. Results: Compared with the control group, the radiation dose of the observation group was significantly less, and the scores of anxiety and depression were lower after the intervention, the difference were statistically significant (P<0.05) . There was no significant difference of the abnormal rate of important organ function between the two groups (P>0.05) . Conclusion: Preventive intervention can reduce the risk of occupational exposure and improve the psychological status of nurses after tumor particle implantation in thoracic surgery.

PMID:34218558 | DOI:10.3760/cma.j.cn121094-20201110-00623

Int J Dent Hyg. 2021 Jul 4. doi: 10.1111/idh.12533. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of biofilm removal of a treatment protocol combining an air-abrasive device using erythritol powder (AIRFLOW®) and an ultrasonic piezon instrumentation (Guided Biofilm Therapy/GBT) compared to the conventional mechanical approach (Scaling and Root Planing/SRP) during supportive periodontal treatment (SPT).

MATERIALS AND METHODS: Fifty patients, scheduled for supportive periodontal treatment at the Department of Preventive Dentistry, Periodontology and Implant Biology of the Aristotle University of Thessaloniki were randomly assigned to either a GBT (group A: 24 participants) or a SRP (Group B: 26 participants) treatment protocol. Therapeutic interventions and clinical measurements were performed at baseline and repeated at 6 weeks. Oral hygiene instructions were reinforced at each visit. A questionnaire was handed to the participants for evaluation of patient perception of both utilized approaches.

RESULTS: At 6 weeks, the two groups showed statistically significant reduction in plaque score and in gingival bleeding index compared to baseline. GBT required approximately 15% less chair-time than SRP with a mean difference of 5.1 minutes, which was statically significant (p=0.049). Patient perception was more favorable for GBT than SRP.

CONCLUSIONS: Biofilm removal using erythritol AIRFLOW® and ultrasonic piezo-electric instruments (GBT) can be considered equally efficient compared to the conventional SRP. Moreover, GBT seemed to require shorter treatment time and to exhibit a more favorable patient perception than the conventional approach.

PMID:34218516 | DOI:10.1111/idh.12533

Anat Sci Educ. 2021 Jul 4. doi: 10.1002/ase.2117. Online ahead of print.

ABSTRACT

Anatomy is a key knowledge area in chiropractic and is formally offered in the undergraduate component of chiropractic education. There is the potential for loss of anatomy knowledge before the opportunity to apply it in a clinical setting. This study aimed to determine whether chiropractic clinicians retain a level of anatomy knowledge comparable to that of chiropractic students and to compare chiropractors’ self-rating of their anatomical knowledge against an objective knowledge assessment tool. A previously validated multiple-choice test was utilized to measure retention of limb musculoskeletal knowledge in Australian chiropractors. One hundred and one registered chiropractors completed the questionnaire and responses were scored, analyzed, and compared to scores attained by undergraduate and postgraduate chiropractic students who had previously completed the same questionnaire. The results indicated that practitioners retained their anatomy knowledge, with a significantly higher total mean score than the undergraduate group [total mean score = 36.5% (±SD 13.6%); P < 0.01] but not significantly different to the postgraduate group [total mean score = 52.2% (±SD 14.1%); P = 0.74]. There was a weak positive correlation between chiropractors’ self-rated knowledge and test performance scores indicating the effectiveness of this Australian chiropractic group in self-assessing their anatomy knowledge. This study found that Australian chiropractors’ knowledge of musculoskeletal anatomy was retained during the transition from university to clinical practice and they accurately evaluated their own test performance.

PMID:34218520 | DOI:10.1002/ase.2117

Dermatol Ther. 2021 Jul 4:e15052. doi: 10.1111/dth.15052. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of this study is analysis of time to relapse after discontinuation of biologic treatment and identification of factors associated with risk of relapse.

METHODS: The analysis used real-world data of 705 patients treated with biologic drugs (adalimumab, ustekinumab, infliximab and etanercept) in Poland in 2013-2019. Time to relapse was analysed by Kaplan-Meier estimator. Data was stratified by the number of prior relapses. Determinants of risk to relapse were analysed with Prentice-Williams-Peterson model.

RESULTS: Kaplan-Meier estimate of time to the first relapse was 276 days, to the second relapse was 246 days, to the third relapse was 218 days and to the fourth relapse was 178 days. In multidimensional analysis statistically significant variables affecting risk of relapse were the following: biologic naivety (hazard ratio (HR) 0.707), adalimumab (HR 0.787), PASI at the last follow-up visit (HR 1.049), abnormal hemoglobin level (HR 0.794) and abnormal lymphocyte counts (HR 1.278).

CONCLUSIONS: The findings of this study suggest that periods to relapse after discontinuation of biologic drugs become shorter with the number of prior relapses experienced by the patient. 95% of observed relapses occurred within 613 days of the end of the first treatment cycle, within 478 of the second cycle and within 351 days of the third cycle. This article is protected by copyright. All rights reserved.

PMID:34218502 | DOI:10.1111/dth.15052

BJU Int. 2021 Jul 4. doi: 10.1111/bju.15539. Online ahead of print.

ABSTRACT

OBJECTIVES: To develop and test the psychometric properties of a concise, patient reported questionnaire, designed to assess key aspects of the radical cystectomy (RC) patient pathway that are important to both patients and clinicians.

SUBJECTS/PATIENTS AND METHODS: Draft items were developed by a consultation with a 13 member expert clinical panel, and the in-depth qualitative analysis of 14 semi-structured interviews with patients who had received RC within the previous eighteen months. A further 9 cognitive interviews with patients refined the items and ensured they were easy to complete. Pilot testing in 122 patients recruited from five hospitals in England tested the properties of validity and reliability of the resulting 17-item questionnaire.

RESULTS: Patients and clinicians identified the following aspects as important for the delivery of quality patient care. These included timely referral and initial test results; an explanation of risk/benefits of treatment; access to a cancer nurse specialist; training and support in stoma management; timely surgery, surgical complications, and timely follow-up. Pilot testing showed missing data was low (≤3% for all items), and between 73% and 89% of the responses to items were the most positive about their care (indicating ceiling effects). 5 items were identified using factor analysis as being statistically related (Cronbach’s alpha 0.76, ICC test-retest reliability of 0.95) and formed the scored part of the tool ‘care and support’, scored 0-16. There was insufficient evidence at this stage to show the tool was capable of measuring differences between cancer centres.

CONCLUSION: We have developed a questionnaire which captures aspects of quality of care within the cystectomy patient pathway. The results support the validity and reliability of the 17-item Cystectomy-Pathway Assessment Tool (C-PAT). We envisage the tool can be the basis for audit of the patient reported assessment of the quality of care for individual cancer centres.

PMID:34218507 | DOI:10.1111/bju.15539

J Neuropsychol. 2021 Jul 4. doi: 10.1111/jnp.12260. Online ahead of print.

ABSTRACT

OBJECTIVES: The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), emphasizes symptoms severity with regard to the diagnosis of attention deficit hyperactivity disorder (ADHD). Many clinicians use neuropsychological test results as objective measures of cognitive functions as part of the diagnostic work-up. The aim of this study was to investigate whether the psychometric test results regarding verbal working memory and processing speed are useful as indicators of the severity of attention deficits and emotional dysregulation in adults with ADHD.

METHODS: This observational cross-sectional clinical study included 418 adults diagnosed with ADHD according to the DSM-5. Attention deficit severity was defined based on the inattentive subscale of the Adult ADHD Self-Report Scale. Emotional dysregulation was assessed with the Deficient Emotional Self-Regulation scale. Verbal working memory was measured with the Working Memory Index (WMI), and processing speed was measured with the Processing Speed Index (PSI) from the Wechsler Adult Intelligence Scale, third edition.

RESULTS: The full-scale intelligence quotients of the participants were in the normal range, with expected reductions in verbal working memory and processing speed. Only processing speed was associated with attention deficits (β = -.056, p = .003). The association between the psychometric test result for verbal working memory and processing speed and that between the severity of attention deficits and emotional dysregulation were weak (R² < .1) and mostly non-significant.

CONCLUSION: The psychometric index scores for verbal working memory (WMI) and processing speed (PSI) seem to have limited utility as indicators of the severity of attention deficits and emotional dysregulation in adult ADHD patients.

PMID:34218514 | DOI:10.1111/jnp.12260

Clin Oral Implants Res. 2021 Jul 4. doi: 10.1111/clr.13806. Online ahead of print.

ABSTRACT

OBJECTIVES: Comparing PES/WES scores, modified success rate, survival, success, buccal bone thickness and patient-reported outcomes of immediate dental implants placed in fresh alveolar sockets using a flap or a minimal split-thickness envelope flap (MSTEF).

MATERIALS AND METHODS: Implants following random assignment into a flap or MSTEF group were placed immediately in anterior and premolar areas. Guided bone regeneration and autogenous connective tissue graft were used in all cases. A temporary prosthesis was provided followed by the final prosthesis at 16-18 weeks. Success and survival rates together with radiographic buccal bone thickness and patient satisfaction were evaluated at 12 months post-loading. The aesthetic outcome was evaluated through the Pink (PES) and White (WES) Aesthetic Score by 8 blind clinicians of different training background and incorporated in modified success criteria.

RESULTS: 28 implants were placed on 28 patients. No statistically significant differences were noted in PES (10.54 control vs. 10.80 test), WES scores (6.97 control vs. 6.95 test) or success criteria including aesthetic parameters (modified success criteria) for the different specialty groups (Range 69%-92%). In addition, no statistically significant differences were noted in survival (100%), success (100%), buccal wall thickness between control (0.72 +/-0.22) and test group (0.92+/-0.31) and patients’ reported outcomes.

CONCLUSIONS: Immediate dental implant treatment with flap/ MSTEF provided similar mean PES/WES scores, modified success rate, survival, mean buccal bone levels and patients’ satisfaction. However, aesthetic failures were common in both groups.

PMID:34218469 | DOI:10.1111/clr.13806

J Genet Couns. 2021 Jul 3. doi: 10.1002/jgc4.1464. Online ahead of print.

ABSTRACT

Rubinstein-Taybi syndrome (RTS) is a rare genetic disorder. Family-centered care (FCC) is a healthcare delivery approach that aims to create an equal partnership between caregivers and providers. FCC has been shown to improve parental wellbeing, their knowledge of the condition and care, and improve their feelings of self-efficacy and personal control. The purpose of this study was to explore the healthcare experiences of family caregivers of children and adults with RTS to understand the issues they encounter when working with medical professionals and to examine their perspectives on how to improve FCC. Primary family caregivers of individuals with RTS took an online mixed-method survey that contained three primary components: a demographic survey, the Measures of Processes of Care-20 (MPOC-20) [a measure of the FCC an individual feels they receive], and a qualitative assessment of negative and positive interactions with medical professionals and priority areas for improvement. Qualitative data were analyzed using thematic analysis. Quantitative data were analyzed with descriptive statistics. An analysis of variance test was used to determine whether values statistically differed between different-age groups of individuals with RTS being cared for. Sixty-three caregivers completed the survey. The average score of the Providing General Information subscale of the MPOC-20 was 3.18, lower than that seen in other studies. The average scores of the other subscales of the MPOC-20 ranged from 4.60 to 5.02, comparable to other studies of caregivers of children with other medical conditions. All aspects of FCC were ranked as important by caregivers. There were no differences in MPOC-20 values between those caring for the individuals with RTS in different-age groups reviewed. In the qualitative responses, parents noted that experiences with medical professionals would be improved if healthcare providers actively provided FCC, collaborated with parents and other providers, respected caregivers’ time and breadth of knowledge and lived experience, gave a more balanced description of the condition, showed greater respect toward their loved ones and included them in the conversation, and made an effort to learn about RTS. The changes that parents would like to see in their child’s care were not specific to one discipline and could be implemented by all healthcare specialists. While caregivers report that they receive moderate levels of FCC, they indicated that areas of FCC could be improved.

PMID:34218493 | DOI:10.1002/jgc4.1464

Health Econ. 2021 Jul 3. doi: 10.1002/hec.4378. Online ahead of print.

ABSTRACT

We analyze the timing, magnitude, and income dependence of pharmaceutical panic buying around the outbreak of the COVID-19 pandemic in Hungary. We use district-level monthly and daily administrative data on detailed categories of pharmaceutical purchases, merge them to income statistics, and estimate multilevel panel models. Our main results are as follows. First, the days of therapy (DOT) of pharmaceutical purchases increased by more than 30% in March 2020, when major lockdown measures were announced. This pattern holds for almost all categories of pharmaceuticals. Second, shortly after the panic reactions, the aggregate amount of pharmaceutical purchases returned to their preshock levels; however, the frequency of pharmacy visits decreased. Third, the panic buying reaction was significantly stronger in richer geographical areas, where-according to the daily data-people also reacted earlier to the pandemic-related news. Overall, the results suggest that panic buying of pharmaceuticals can have detrimental effects on vulnerable populations.

PMID:34218496 | DOI:10.1002/hec.4378

Int J Health Plann Manage. 2021 Jul 3. doi: 10.1002/hpm.3275. Online ahead of print.

ABSTRACT

BACKGROUND: Despite improvements in many health indicators, providing access to affordable healthcare remains a considerable challenge in Bangladesh. Financing incidence analysis will enable an evaluation of how well the healthcare system performs to achieve equity in health financing. The objective of this study is to assess the burden of out-of-pocket (OOP) cost on different socio-economic groups by assessing the health financing incidence because OOP cost dominates household expenditure on health in Bangladesh.

METHODS: The study was conducted using latest Household Income and Expenditure Survey (HIES) 2016. We focused mainly on four specific indicators: level of monthly household OOP cost on in-patient care, urban-rural differences in OOP cost, socio-economic status differences in different payment mechanisms and the Kakwani index. Descriptive statistics were employed to analyse and summarise the selected variables based on the SES and location of residence (e.g., rural and urban).

RESULTS: The study showed the overall OOP healthcare expenditure was 7.7% of the household monthly income while the poorer income group suffered more and spent up to 35% of their household income on healthcare. The Kakwani index indicated that the poorest quintile spends a greater share of their income on healthcare services than the richest quintile.

CONCLUSIONS: This study observed that OOP cost in Bangladesh is regressive, that is, poorer members of society contribute a greater share of their income. Therefore, policymakers should initiate health reforms for developing and implementing risk-pooling financing mechanisms such as social health insurance to achieve the Universal Health Coverage in Bangladesh.

PMID:34218437 | DOI:10.1002/hpm.3275