Nevin Manimala

Aust Occup Ther J. 2024 Feb 27. doi: 10.1111/1440-1630.12940. Online ahead of print.

ABSTRACT

INTRODUCTION: Animal-assisted and nature-based interventions in psychosocial treatment for various groups of clients have been studied internationally. However, there is little knowledge about how young adults with autism experience participation in such types of interventions. This clinical study aimed to describe the feasibility of animal-assisted and nature-based activities on a farm as a complementary intervention for young adults with autism and social withdrawal.

METHODS: The participants were aged 18-30 years, diagnosed with autism and social withdrawal, with no organised occupation during the previous year. Eleven of 13 participants completed a 12-week intervention in small groups. They took part in interviews before and after, which focused on their current life situation and expectations about, and experiences of the intervention. The feasibility was described in terms of participants’ characteristics, attendance, and their experiences of participating in the activity. Data were analysed with descriptive statistics and qualitative content analysis.

CONSUMER AND COMMUNITY INVOLVEMENT: The intervention was formed in collaboration with participating supervisors, ordinary clinical staff, and a young woman with a user perspective.

FINDINGS: The level of feasibility was found to be high. The mean participation rate during the activity days was 75% and varied from 50 to 100%. The analysis of the participants’ experiences from the activity generated three categories, “Being in a meaningful context”, “Creating a comfort zone” and “Developing structure in everyday life”, and each of these included sub-categories.

CONCLUSION: The main categories revealed a dynamic process based in meaningfulness, comfort and structure in everyday life. The positive experiences of undemanding activities, emotional relationships and non-verbal communication with the horses were prominent and might facilitate the development of social interaction. However, the intervention’s timeframe of 12 weeks was experienced as too short for long-lasting change.

PMID:38410868 | DOI:10.1111/1440-1630.12940

JBI Evid Synth. 2024 Feb 27. doi: 10.11124/JBIES-23-00462. Online ahead of print.

ABSTRACT

INTRODUCTION: Several methods exist for bias adjustment of meta-analysis results, but there has been no comprehensive comparison with non-adjusted methods. We compare 6 bias-adjustment methods with 2 non-adjusted methods to examine how these different methods perform.

METHODS: We re-analyzed a meta-analysis that included 10 randomized controlled trials. Two data-based methods: i) Welton’s data-based approach (DB) and ii) Doi’s quality effects model (QE) and 4 opinion-informed methods: i) opinion-based approach (OB), ii) opinion-based distributions combined statistically with data-based distributions (O+DB), iii) numerical opinions informed by data-based distributions (OID [num]), and iv) opinions obtained by selecting areas from data-based distributions (OID [select]) were used to incorporate methodological quality information into the meta-analytical estimates. The results of these 6 methods were compared with 2 unadjusted models: i) the DerSimonian-Laird random effects model and ii) Doi’s inverse variance heterogeneity (IVhet) model.

RESULTS: The 4 opinion-based methods returned the random effects model estimates with wider uncertainty. The DB and QE methods returned different results and aligned with the IVhet method with some minor downward bias adjustment.

CONCLUSION: Opinion-based methods seem to just add uncertainty rather than bias adjust.

PMID:38410861 | DOI:10.11124/JBIES-23-00462

Phytother Res. 2024 Feb 27. doi: 10.1002/ptr.8170. Online ahead of print.

ABSTRACT

Considering the main component of cardiovascular disease and due to the high prevalence of hypertension, controlling blood pressure is required in individuals with various health conditions. Randomized clinical trials (RCTs) which studied the effects of pomegranate consumption on blood pressure have shown inconsistent findings. As a result, we intended to assess the effects of pomegranate consumption on systolic (SBP) and diastolic (DBP) blood pressure in adults. Systematic literature searches up to January 2024 were carried out using electronic databases, including PubMed, Web of Science, and Scopus, to identify eligible RCTs assessing the effects of pomegranate on blood pressure as an outcome. All the individuals who took part in our research were adults who consumed pomegranate in different forms as part of the study intervention. Heterogeneity tests of the selected trials were performed using the I² statistic. Random effects models were assessed based on the heterogeneity tests, and pooled data were determined as the weighted mean difference (WMD) with a 95% confidence interval (CI). Of 2315 records, 22 eligible RCTs were included in the current study. Our meta-analysis of the pooled findings showed that pomegranate consumption significantly reduced SBP (WMD: -7.87 mmHg; 95% CI: -10.34 to -5.39; p < 0.001) and DBP (WMD: -3.23 mmHg; 95% CI: -5.37 to -1.09; p = 0.003). Individuals with baseline SBP > 130 mmHg had a significantly greater reduction in SBP compared to individuals with baseline SBP < 130 mmHg. Also, there was a high level of heterogeneity among studies (SBP: I² = 90.0% and DBP: I² = 91.8%). Overall, the results demonstrated that pomegranate consumption lowered SBP and DBP in adults. Although our results suggest that pomegranate juice may be effective in reducing blood pressure in the pooled data, further high-quality studies are needed to demonstrate the clinical efficacy of pomegranate consumption.

PMID:38410857 | DOI:10.1002/ptr.8170

Cephalalgia. 2024 Feb;44(2):3331024241235156. doi: 10.1177/03331024241235156.

ABSTRACT

BACKGROUND: Comparative evaluations of preventive migraine treatments can help inform clinical decision making for managing migraine in clinical practice.

METHODS: An anchored matching-adjusted indirect comparison analysis was conducted using pooled participant-level data from two phase 3 atogepant trials (ADVANCE and PROGRESS) and one phase 2/3 rimegepant trial (BHV3000-305) to evaluate the relative efficacy and safety/tolerability of atogepant and rimegepant as preventive migraine treatments. Participants receiving atogepant 60 mg once daily, rimegepant orally disintegrating tablet 75 mg once every other day, and placebo were included. Only participants meeting the BHV3000-305 inclusion/exclusion criteria were analyzed: ≥6 monthly migraine days and ≤18 monthly headache days at baseline. The primary efficacy assessment of interest was change in monthly migraine days across weeks 1-12.

RESULTS: There were 252 participants in the atogepant group and 348 in the rimegepant group. Across weeks 1-12, atogepant 60 mg demonstrated a significantly greater reduction in mean monthly migraine days compared with rimegepant 75 mg (mean difference [95% CI]: -1.65 [-2.49, -0.81]; p < 0.001). Both atogepant and rimegepant demonstrated similar safety/tolerability profiles.

CONCLUSION: In this matching-adjusted indirect comparison analysis, oral atogepant 60 mg once daily demonstrated a significantly greater reduction in monthly migraine days compared with rimegepant 75 mg orally disintegrating tablet once every other day.

PMID:38410850 | DOI:10.1177/03331024241235156

Int J Adolesc Med Health. 2024 Feb 28. doi: 10.1515/ijamh-2023-0191. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aims to evaluate the effectiveness of a structured educational module on substance abuse prevention program among adolescents in enhancing their knowledge against substance abuse.

METHODS: A quasi-experimental design was employed involving 120 students (mean age: 14.3±1.03 years, 59.2% boys) from two English medium schools. Participants were exposed to a structured module on substance abuse over a month. The study assessed changes in knowledge through pretest and post-test evaluations. Statistical analyses examined improvements in scores and the relationship between class of study and post-test knowledge scores.

RESULTS: The intervention significantly improved students’ knowledge about substance abuse (p<0.001) across all measured domains, genders, and classes, with the exception of the 7th class. A positive correlation was found between the class of study and post-test scores (Rs=0.288, p<0.001), indicating that higher classes were associated with greater improvements in knowledge. These findings suggest that the training effectively increased awareness and understanding of substance abuse among participants.

CONCLUSIONS: The substance abuse prevention program successfully enhanced adolescents’ knowledge and equipped them with resilience and coping strategies, thus reducing their vulnerability to peer pressure and substance abuse. Despite the lack of significant improvement in the 7th class, the overall positive outcomes underscore the importance of implementing such educational interventions to foster healthy development and well-being among students. Further research is encouraged to explore the specific barriers to effectiveness in younger classes and to refine program content accordingly.

PMID:38410844 | DOI:10.1515/ijamh-2023-0191

Vox Sang. 2024 Feb 27. doi: 10.1111/vox.13609. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: The variability in the number of donations together with a growing demand for platelet concentrates and plasma-derived medicines make us seek solutions aimed at optimizing the processing of blood. Some mathematical models to improve efficiencies in blood banking have been published. The goal of this work is to validate and evaluate an algorithm’s impact in the production of blood components in the Blood and Tissues Bank of Aragon (BTBA).

MATERIALS AND METHODS: A mathematical algorithm was designed, implemented and validated through simulations with real data. It was incorporated into the fractionation area, which uses the Reveos® fractionation system (Terumo BCT) to split blood into its components. After 9 months of daily routine validation, retrospective activity data from the Blood Bank and Transfusion Services before and during the use of the algorithm were compared.

RESULTS: Using the algorithm, the outdating rate of platelet concentrates (PC) decreased by 87.8% in the blood bank. The average shelf life remaining of PC supplied to Transfusion Services increased by almost 1 day. As a consequence, the outdating rate in the Aragon Transfusion Network decreased by 33%. In addition, extra 100 litres of plasma were obtained in 9 months.

CONCLUSIONS: The algorithm improves the blood establishment’s workflow and facilitates the decision-making process in whole blood processing. It resulted in a decrease in PC outdating rate, increase in PC shelf life and finally an increase in the volume of recovered plasma, leading to significant cost savings.

PMID:38410835 | DOI:10.1111/vox.13609

Patient Relat Outcome Meas. 2024 Feb 22;15:61-70. doi: 10.2147/PROM.S450502. eCollection 2024.

ABSTRACT

BACKGROUND: The provision of intensive care services is advancing globally. However, in resource-limited settings, it is lagging far behind and intensive care unit mortality is still higher due to various reasons. This study aimed to assess determinants of mortality among medical patients admitted to the intensive care unit.

METHODS: A five-year facility-based retrospective Cohort Study was conducted. A total of 546 medical patients admitted to the intensive care unit from March 2017 to February 2022 were included. Document review using a structured questionnaire was implemented to collect data. Data entered into Epi Data were analyzed by STATA and summarized using frequency tables and graphs. Binary and multivariate logistic regression analyses were performed to identify determinants of mortality.

RESULTS: The overall mortality was 35.9%. Approximately half of the deaths were attributed to septic shock, congestive heart failure, severe community-acquired pneumonia, and stroke. The most common immediate cause of death was cardio-respiratory arrest. Source of admission, GCS level at admission, duration of ICU stay, treatment with inotropes, septic shock, and retroviral infection status were found to have a statistically significant association with ICU mortality.

CONCLUSION AND RECOMMENDATIONS: This study revealed a significantly higher mortality rate among patients admitted to the intensive care unit. Early identification and admission of patients to the intensive care unit are important factors that could decrease mortality. Patient selection is essential since some patients with a high likelihood of mortality might not benefit from intensive care unit admission in an area with high resource limitations.

PMID:38410832 | PMC:PMC10895994 | DOI:10.2147/PROM.S450502

Patient Relat Outcome Meas. 2024 Feb 22;15:71-80. doi: 10.2147/PROM.S431242. eCollection 2024.

ABSTRACT

INTRODUCTION: Epilepsy is a chronic non-communicable disease of the brain that affects millions of people worldwide. A significant number of children are affected globally, and most live in developing countries, often with physical and cognitive disabilities. Regardless of these factors, epilepsy is poorly controlled, particularly in the developing countries. Thus, this study aimed to assess the magnitude of treatment outcomes and its predictors among pediatrics patients with epilepsy who were followed-up at the Dessie Comprehensive Specialized Hospital, Northeast Ethiopia.

METHODS: Hospital-based cross-sectional study was conducted from 1 June 2022 to 30 August 2022. A total of 200 patients with epilepsy were included in this study. Data were collected through face-to-face interviews, and by reviewing medical records. The collected data were entered into Epi-data version 4.6 and exported to SPSS version 25.0. Descriptive statistics such as frequencies, percentages, means and standard deviations were computed. Binary and multivariate logistic regression analyses were performed. Variables with p < 0.25 in bivariate analysis were entered into multivariable logistic regression. In multivariable analysis, adjusted odd ratio with 95% CI and p-value less than 0.05 were considered statistically significant.

RESULTS: Of 200 pediatric patients with epilepsy, 66 (34.5%) had poor treatment outcomes. In the multivariate analysis, 11-15 years of age (AOR = 4.08; 95% CI = 1.202, 13.848), poor treatment adherence (AOR = 3.21; 95% CI = 1.421, 7.249), history of more seizure frequency before starting treatment (AOR = 4.19; 95% CI = 1.984, 8.834) and history of head injury (AOR = 3.03; 95% CI = 1.502, 6.112) were significantly associated with poor treatment outcomes in pediatric patients with epilepsy.

CONCLUSION: Significant proportion of pediatric patients with epilepsy had poor treatment outcomes. Therefore, health-care workers should strictly follow patient treatment especially for pediatric epileptic patients’ who have poor treatment adherence, more seizure frequency history, head injury history and whose age were 11-15 years old.

PMID:38410831 | PMC:PMC10895992 | DOI:10.2147/PROM.S431242

Front Chem. 2024 Feb 12;12:1057928. doi: 10.3389/fchem.2024.1057928. eCollection 2024.

ABSTRACT

Isotopes have been widely applied in a variety of scientific subjects; many aspects of isotopes, however, remain not well understood. In this study, I investigate the relation between the number of neutrons (N) and the number of protons (Z) in stable isotopes of non-radioactive elements and long-lived isotopes of radioactive elements at the double-linear scale (conventional Segrè chart) and the double-logarithmic scale. Statistical analyses show that N is a power-law function of Z for these isotopes: N = 0.73 × Z ^1.16. This power-law relation provides better predictions for the numbers of neutrons in stable isotopes of non-radioactive elements and long-lived isotopes of radioactive elements than the linear relation on the conventional Segrè chart. The power-law pattern reveled here offers empirical guidance for probing long-lived isotopes of unknown radioactive elements.

PMID:38410817 | PMC:PMC10894952 | DOI:10.3389/fchem.2024.1057928

Digit Health. 2024 Feb 25;10:20552076241231560. doi: 10.1177/20552076241231560. eCollection 2024 Jan-Dec.

ABSTRACT

OBJECTIVE: There are currently an increasing number of mobile health (mHealth) programs offered to patients with breast cancer undergoing chemotherapy, but their rate of adherence to app usage has remained low. This study aimed to examine the feasibility of an mHealth app-based program such as the adherence rate of app usage and determine the preliminary effects on self-efficacy, quality of life, symptom burden and healthcare utilization in these patients.

METHODS: We conducted a randomized controlled pilot trial. Ninety-six participants were randomly allocated into either an intervention group or a control group (routine care plus a placebo app). The intervention group engaged in a 6-week self-regulation activity and received nurse-led social support via the app. The intention-to-treat principle was adopted. The generalized estimating equation was utilized to analyze the between-group, within-group and interaction effectiveness of this program.

RESULTS: Totally 96 participants were enrolled from 16 May to 23 August 2022. The average rate of adherence to app usage increased from 4.8% at week 3 to 51.2% at week 6. There was a statistically significant reduction in the physiological efficacy scores of the intervention (p < .001) and control groups (p < .001) at week 6, compared with the baseline. At week 6, the intervention group reported a significantly lower symptom burden (p = .042) and significantly better physical well-being than the control group (p = .024).

CONCLUSIONS: It is feasible to perform an mHealth app-based self-management program for patients with breast cancer receiving chemotherapy. Nurses can utilize this program to facilitate patient self-management of symptoms during chemotherapy.

REGISTRATION: Clinicaltrials.gov, https://clinicaltrials.gov, (NCT05192525).

PMID:38410790 | PMC:PMC10896051 | DOI:10.1177/20552076241231560