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Nevin Manimala Statistics

Occupational Performance Coaching for parents of picky eaters: A mixed methods study

Aust Occup Ther J. 2024 Mar 27. doi: 10.1111/1440-1630.12947. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: Picky eating is a common childhood phenomenon that impacts many families’ occupations surrounding mealtimes. Evidence of the effectiveness of Occupational Performance Coaching (OPC) for caregivers of children suggests it may represent a useful occupation-focused intervention for parents of picky eaters. Using an OPC-targeted intervention, this study aims to report preliminary effectiveness, explore the experience of parents’ participation, and investigate factors that influence the OPC intervention.

METHODS: This study used an explanatory mixed-method design. Parent participants (n = 8) were recruited via purposive sampling and engaged in three sessions of OPC delivered via an online platform between October and December 2022. Standardised assessments were completed before and after OPC and a qualitative semi-structured interview two weeks after the final OPC session. Variables were analysed descriptively, and independent t tests were performed to compare scores on each standardised assessment pre- and post-intervention. Pearson’s correlation analyses were conducted to consider associations between resistance to change and the extent of change in each outcome measure. Reflexive thematic analysis was conducted on postintervention interview transcripts.

CONSUMER AND COMMUNITY INVOLVEMENT: Consumer invovlement was limited to parents feedback on their experiences of the intervention.

RESULTS: Improvements in occupational performance as measured by the COPM change score were statistically significant (p = <0.001). Child eating behaviours, as measured by the CEBQ Food Fussiness subscale change score (p = 0.01) and BPFAS change score (p = 0.02), demonstrated significant improvements. The extent to which parents viewed these behaviours as problematic as measured by the BPFAS problem change score, showed a significant reduction (p = <0.001). Three themes emerged from interviews with parents: small changes beyond nutrition, parents supported as the experts, and what parents value within an intervention.

CONCLUSION: Targeted OPC intervention delivered online by an occupational therapist may be an effective intervention for parents of picky eaters. Future studies using randomised controls are required before OPC can be routinely recommended in a clinical setting for the management of picky eating in children.

PMID:38538542 | DOI:10.1111/1440-1630.12947

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Preliminary Study on Yeasts Associated with the Production of “Tostado”-a Traditional Sweet Wine from Galicia (NW Spain)

Front Biosci (Elite Ed). 2024 Mar 14;16(1):10. doi: 10.31083/j.fbe1601010.

ABSTRACT

BACKGROUND: Tostado is a traditional sweet wine from the Designations of Origins (DOs) of Ribeiro and Valdeorras in Galicia (NW Spain). The harvested grapes are air-dried and pressed to increase the concentrations of sugars, acids, and flavour compounds. Therefore, knowledge of the yeasts involved in fermentation under these conditions is essential to guarantee the quality and uniqueness of the valuable, distinctive, and expensive Tostado wines.

METHODS: Saccharomyces and non-Saccharomyces yeasts were identified using Wallerstein Laboratory (WL) Nutrient Agar and lysine plating, followed by polymerase chain reaction (PCR) amplification, enzymatic digestion, and sequencing. Saccharomyces cerevisiae isolates were further characterised at the strain level using mitochondrial DNA (mtDNA) restriction fragment length polymorphism (RFLP). Statistical analyses were also performed, including different diversity indices, Similarity Percentage (SIMPER) analysis, principal component analysis (PCA), neighbor-joining clustering, parsimony-phylogram, and network plot. In addition, the total acidity, volatile acidity, reducing sugars, and alcoholic strength by volume of the Tostado wines were analysed.

RESULTS: A wide diversity of autochthonous yeasts was found, which were predominantly species of oenological relevance, such as Lachancea thermotolerans, Starmerella bacillaris, Hanseniaspora uvarum, Debaryomyces hansenii, Torulaspora delbrueckii, Pichia spp., and Saccharomyces cerevisiae from the must and paste stages of Tostado wine. In addition, 19 different S. cerevisiae strains were identified. This high yeast diversity, which changed from the early stages of fermentation, could contribute to the distinctive characteristics observed in Tostado wine.

CONCLUSIONS: Characteristic and differentiating chemical and microbiological profiles were found as early as the pre-fermentation stages, which adds value to these special wines that have rarely been studied.

PMID:38538529 | DOI:10.31083/j.fbe1601010

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Cancer Survivors’ and Care Partners’ Audio Diaries on Stress and Social Support Resources During the COVID-19 Pandemic

Semin Oncol Nurs. 2024 Mar 26:151623. doi: 10.1016/j.soncn.2024.151623. Online ahead of print.

ABSTRACT

OBJECTIVES: To describe cancer survivors’ and care partners’ perceived stress and social support during the COVID-19 pandemic and assess the feasibility of audio diaries for assessing role-related needs and resources.

METHODS: Participants (N = 51; n = 28 survivors, n = 23 care partners) recorded three monthly audio diaries reporting stress and support experiences. Diaries were transcribed and content-analyzed using a hybrid approach. Stress-related content was inductively coded, and social support content was deductively coded by type (instrumental, information, emotional, companionship, appraisal; κ = 0.75) then inductively coded. Descriptive statistics summarized sociodemographic data and compared coding frequencies by role. We developed narrative summaries of stress and support categories and selected quotes for contextual detail.

RESULTS: Cancer-related stressors were most prevalent (28.8%), followed by work (26.8%), family (23.1%), social isolation (13.4%), and finances (8.0%). While no significant difference in reporting frequency was observed between roles, cancer-related stress was more prevalent for survivors while work-related stress was mentioned more by care partners. Emotional support was the most prevalent support type (32.1%), followed by companionship (25.3%), appraisal (17.9%), instrumental (16.67%), and informational support (8%). Survivors reported more appraisal support than care partners (χ2 = 6.48, df = 1, P = .011) and more support for self-care, while care partners expressed more other-oriented concerns and focused more on managing responsibilities and interactions outside the household.

CONCLUSIONS: The pandemic complicated and intensified role-based stressors already present in the survivorship context. Our findings highlight the importance of informal social support networks, particularly when access to formal services is limited, and suggest that audio diaries can be an effective tool for assessing support needs and resources.

IMPLICATIONS FOR NURSING PRACTICE: Nurses and healthcare providers should tailor social support assessments to address the distinct support needs and individual resources of cancer survivors and their care partners. This is especially critical in contexts that limit access to care and formal services.

PMID:38538507 | DOI:10.1016/j.soncn.2024.151623

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Effectiveness of Helmet-CPAP in mild to moderate coronavirus type 2 hypoxemia: An observational study

Med Intensiva (Engl Ed). 2024 Mar 26:S2173-5727(24)00060-2. doi: 10.1016/j.medine.2024.03.007. Online ahead of print.

ABSTRACT

OBJECTIVE: To determine the relative effectiveness of Helmet-CPAP (H_CPAP) with respect to high-flow nasal cannula oxygen therapy (HFNO) in avoiding greater need for intubation or mortality in a medium complexity hospital in Chile during the year 2021.

DESIGN: Cohort analytical study, single center.

SETTING: Units other than intensive care units.

PATIENTS: Records of adults with mild to moderate hypoxemia due to coronavirus type 2.

INTERVENTIONS: None.

MAIN VARIABLES OF INTEREST: Need for intubation or mortality.

RESULTS: 159 patients were included in the study, with a ratio by support of 2:10 (H_CPAP:HFNO). The 46.5% were women, with no significant differences by sex according to support (p = 0.99, Fisher test). The APACHE II score, for HFNO, had a median of 10.5, 3.5 units higher than H_CPAP (p < 0.01, Wilcoxon rank sum). The risk of intubation in HFNO was 42.1% and in H_CPAP 3.8%, with a significant risk reduction of 91% (95% CI: 36.9%-98.7%; p < 0.01). APACHE II does not modify or confound the support and intubation relationship (p > 0.2, binomial regression); however, it does confound the support and mortality relationship (p = 0.82, RR homogeneity test). Despite a 79.1% reduction in mortality risk with H_CPAP, this reduction was not statistically significant (p = 0.11, binomial regression).

CONCLUSIONS: The use of Helmet CPAP, when compared to HFNO, was an effective therapeutic ventilatory support strategy to reduce the risk of intubation in patients with mild to moderate hypoxemia caused by coronavirus type 2 in inpatient units other than intensive care. The limitations associated with the difference in size, age and severity between the arms could generate bias.

PMID:38538497 | DOI:10.1016/j.medine.2024.03.007

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Analysis of education and previous nursing experience of certified PNPs in the United States

J Pediatr Nurs. 2024 Mar 26:S0882-5963(24)00102-7. doi: 10.1016/j.pedn.2024.03.024. Online ahead of print.

ABSTRACT

BACKGROUND: Educational programs to prepare nurse practitioners (NPs) were historically built upon foundational nursing experience. Originally prepared as certificate programs in 1965, the educational requirements for nurse practitioners (NPs) rapidly shifted from certificate programs to the Master’s degree (DellaBella, 2015; Fairman, 2008). As Doctor of Nursing Practice (DNP) degree programs increase in number, it is unknown whether this foundational nursing experience has changed, or if it differs by certification type for pediatric nurse practitioners (PNPs). This study aimed to evaluate the educational preparation and prior nursing experience of primary care and acute care certified PNPs.

METHODS: A national survey of members of the Pediatric Nurse Practitioner Certification Board (N = 17,530) was completed (Mudd et al., 2022). A sub-analysis of this data was conducted (n = 1974).

RESULTS: There was no statistical evidence among either primary or acute care PNPs of an association between previous nursing experience and type of degree preparation (Master’s or DNP). There was only a weak association between educational preparation and experience among acute care nurse practitioners. Most respondents were prepared at the Master’s level, and 85% of all respondents had >1 year of nursing experience prior to returning for additional PNP education.

DISCUSSION: This study adds to the literature as it describes the educational preparation and foundational nursing experience of primary and acute care PNPs. It can serve as a benchmark as the move to the DNP continues for Advanced Practice Registered Nurse preparation.

PMID:38538493 | DOI:10.1016/j.pedn.2024.03.024

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Combination of cryobiopsy with EBUS-TBNA-Might rapid on-site evaluation successfully drive patient selection?

Pulmonology. 2024 Mar 26:S2531-0437(24)00023-0. doi: 10.1016/j.pulmoe.2024.02.008. Online ahead of print.

NO ABSTRACT

PMID:38538490 | DOI:10.1016/j.pulmoe.2024.02.008

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Evaluation of vitamin D levels in children and adolescents after the first year of the COVID-19 pandemic: 1-year results of a secondary-level state hospital

Arch Pediatr. 2024 Mar 26:S0929-693X(24)00022-8. doi: 10.1016/j.arcped.2023.11.001. Online ahead of print.

ABSTRACT

BACKGROUND: The COVID-19 pandemic caused a global public health problem with high morbidity and mortality rates. In this study, we aimed to evaluate the 25-hydroxyvitamin D (25(OH)D) status of patients presenting to the Pediatrics Department of Gaziantep Maternity and Children’s Hospital in the 1-year period after the onset of the COVID-19 pandemic according to ethnicity, age, and gender.

METHOD: This cross-sectional study included the data of 7640 patients whose 25(OH)D levels were assessed at our hospital between March 2021 and March 2022. Vitamin D levels, age, gender, and the ethnic origin of the patients were retrospectively scanned and recorded from the laboratory results system. Based on the World Health Organization (WHO) classification of vitamin D levels, patients were divided into three groups: <10 ng/mL = vitamin D deficiency; 10-19 ng/mL = vitamin D insufficiency, and 20 ng/mL and over = normal vitamin D status.

RESULTS: The mean age of the 7640 patients who presented to the pediatrics department was 7.47 (±5.3) years. Of these patients, 48 % (3665) were male and 52 % (3975) were female. The mean vitamin D level of girls was 18.1 (±15.2) ng/mL, and of boys it was 20.2 (±15.4) ng/mL, with a statistically significant difference (p < 0.001). In total, 21.2 % (1650) of patients had deficient, 43.3 % (3310) of patients had insufficient, and 35.5 % (2710) of patients had normal 25(OH)D levels. Overall, 21.8 % of the patients (1667) were immigrants, and in this group the deficiency was found to be statistically significantly higher at 27.4 % (n = 456; p < 0.001). There was a low negative correlation between the age of the patients and their 25(OH)D levels (r=-0.35; p < 0.001).

CONCLUSIONS: Vitamin D deficiency remains a serious public health problem. Since the most important production source is exposure to the sun, it must be kept in mind that vitamin D should be supported during lockdown pandemic processes.

PMID:38538466 | DOI:10.1016/j.arcped.2023.11.001

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An active-learning laboratory focused on critical care topics

Curr Pharm Teach Learn. 2024 Mar 26:S1877-1297(24)00079-0. doi: 10.1016/j.cptl.2024.03.009. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: To describe an active-learning laboratory on critical care topics including advanced cardiac life support (ACLS), rapid sequence intubation (RSI), and toxicology and its effect on students’ knowledge, skills, and confidence.

EDUCATIONAL ACTIVITY AND SETTING: Third year pharmacy students (n = 88) participated in a critical care focused laboratory with four stations focused on ACLS review, ABBOJECT syringe assembly, ACLS simulations, RSI cases, and toxicology. Prior to the critical care focused skills laboratory, students completed an optional assessment composed of six confidence and eight knowledge questions. After the laboratory, students completed the same confidence and knowledge assessment. Descriptive statistics assessed pre/post-assessment responses. Paired pre/post-assessment Likert data were analyzed using the Wilcoxon signed-rank test and paired pre/post-test multiple choice responses were analyzed using the McNemar test.

FINDINGS: Of the 88 students in the cohort, 76 students completed both the pre/post-assessments (response rate: 86.4%). Students demonstrated a significant increase in their overall knowledge and confidence scores on the post-assessment. All students successfully assembled an ABBOJECT syringe. The majority of respondents rated the critical care laboratory as excellent or good with regards to how enjoyable and effective the activity was to help understand critical care topics.

SUMMARY: A hands-on, active-learning laboratory devoted to teaching and reinforcing common critical care concepts allowed students to gain knowledge and confidence regarding ACLS, RSI, and toxicology.

PMID:38538452 | DOI:10.1016/j.cptl.2024.03.009

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Curious minds to aspiring pharmacists: Impact of high school outreach on pharmacy knowledge and interest

Curr Pharm Teach Learn. 2024 Mar 26:S1877-1297(24)00082-0. doi: 10.1016/j.cptl.2024.03.012. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the impact of a pharmacy student delivered presentation on prospective rural high school students’ interest toward the pharmacy profession and knowledge regarding a career in pharmacy.

METHODS: Presentations about applying to pharmacy school, the Doctor of Pharmacy degree, and pharmacist careers were given at ten high schools across North Dakota and Minnesota by third year pharmacy students attending North Dakota State University. Each pharmacy student presenter received training to ensure that all high school students received clear and consistent information. A pre-post survey was used to understand the impact of the presentation on high school student interest and knowledge regarding a career in pharmacy. Data was analyzed using a chi-square test and McNemar’s test.

RESULTS: Five hundred and eight students consented to the study and completed the pre-post surveys. Of these students, the largest group was high school juniors (number (n) = 239, 47%), followed by sophomores (n = 161, 32%), seniors (n = 104, 20%) and freshmen (n = 3, 1%). The majority of students attended school in North Dakota (n = 469, 92%). Similarly, most students planned to attend a four-year college (n = 451, 89%) and were interested in a medical/healthcare related career (n = 310, 61%). All interest and knowledge questions showed a statistically significant increase in score pre-post.

CONCLUSION: Presentations delivered by pharmacy students to prospective rural high school students improved overall interest and knowledge regarding pharmacy school and the profession. Presentations are a useful tool for pharmacy programs to help promote their school and the profession of pharmacy.

PMID:38538450 | DOI:10.1016/j.cptl.2024.03.012

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Assessment of education in a community hospital on healthcare providers’ knowledge of and attitudes toward medical marijuana

Curr Pharm Teach Learn. 2024 Mar 26:S1877-1297(24)00077-7. doi: 10.1016/j.cptl.2024.03.007. Online ahead of print.

ABSTRACT

INTRODUCTION: Although medical marijuana usage continues to become more socially acceptable and is increasingly regarded as a legitimate treatment alternative for certain medical conditions such as cancer and epilepsy, stigma remains.

METHODS: This study examined whether offering an educational session addressing several key aspects of medical marijuana (e.g., pharmacology, legality) to healthcare providers in a community hospital setting improved knowledge about and/or altered attitudes toward marijuana use. This information was collected through administration of pre- and post-education session surveys. Multiple choice questions were utilized to assess knowledge of marijuana pharmacotherapy, pharmacodynamic interactions, and regulations, whereas descriptive analyses via Likert-scale questions determined attitudes toward medical marijuana. A secondary outcome entailed analysis of drug interactions with marijuana users via retrospective chart review.

RESULTS: A total of 43 healthcare providers participated in the study. There were statistically significant increases in healthcare provider knowledge post-education session across multiple occupations (physician, P < .01; nurse, P < .001; pharmacist, P < .01; and nurse technician, P < .05). A total of 72 patients (83%) who self-reported marijuana use for medical or recreational purposes had a potential drug-drug interaction with marijuana.

CONCLUSIONS: As both medical and recreational marijuana continue to become legalized across the United States, formal education surrounding marijuana use and laws becomes increasingly important for healthcare providers and can be highly effective in preventing misinformation.

PMID:38538449 | DOI:10.1016/j.cptl.2024.03.007