Nevin Manimala

Med Pr. 2023 Dec 15;74(5):377-387. doi: 10.13075/mp.5893.01426. Epub 2023 Dec 7.

ABSTRACT

BACKGROUND: The lack of nursing staff is a current problem not only in Poland, but also in the world. The decision of nurses to leave the workplace, apart from the financial aspect, often results from unfavourable working conditions related to the work environment.

MATERIAL AND METHODS: The study was multicentre, cross-sectional. The study was conducted among a group of 1509 nurses employed in surgical and internal medicine wards in 21 hospitals in Poland. The key variables of the study were: the intention of the nurses to leave their jobs, the nurses’ working environment, the level of satisfaction, the level of occupational burnout and the number of patients cared for on the last shift, the number of nurses on the last shift. The Practice Environment Scale of the Nursing Work Index (PES-NWI) and the Maslach Burnout Inventory (MBI) questionnaire were used in the research.

RESULTS: Almost half of the surveyed nurses (48.84%) declared their willingness to leave their current workplace. The statistical analysis showed that nurses declaring their willingness to quit their job in the hospital where they were employed were significantly younger (42.88 vs. 45.04, p = 0.000), had shorter total length of service overall (19.96 vs. 23.20), and also in the hospital where they were employed (15.86 vs. 18.50, p = 0.000). The increase in the number of patients by one was significantly associated with a 1% increase in the risk of leaving work (OR = 1.01, 95% CI 1.00-1.02). An increase in emotional exhaustion significantly increased the risk of leaving work by 2% (OR = 1.02, 95% CI 0.99-1.03).

CONCLUSIONS: Younger age of nurses, greater workload resulting from more patients and occupational burnout – emotional exhaustion is correlated with the risk of leaving work in the hospital. A lower risk of leaving the job is associated with a higher level of job satisfaction in the hospital, salary and promotion opportunities. Med Pr Work Health Saf. 2023;74(5):377-87.

PMID:38104338 | DOI:10.13075/mp.5893.01426

P R Health Sci J. 2023 Dec;42(4):318-321.

ABSTRACT

OBJECTIVE: There are an estimated 5,570 yearly cancer deaths in Puerto Rico. Breast and colorectal are the most common malignancies among Puerto Rican women. Therefore, prevention and early detection of these cancer types are critical to reducing morbidity and mortality. This study assessed whether women who received the influenza vaccine had increased adherence to cervical, breast, and colorectal cancer screening.

METHODS: The Puerto Rico Community Engagement Alliance (PR-CEAL) against COVID-19 Disparities team attended community outreach events throughout Puerto Rico and completed a face-to-face survey among women 18 years or older. The survey gathered demographic information and adherence to influenza vaccination and cervical, breast, and colorectal screening in the past year. The initial sample included 400 women, of whom 347 met the age inclusion criteria (21-74 years). Chi-square tests were used to compare cancer screening adherence according to influenza vaccination status. A p-value <0.05 was considered statistically significant.

RESULTS: Of all participants, 47.0% received the influenza vaccine in the past year. Cancer screening rates among vaccinated and non-vaccinated women were as follows: 64.5% vs. and 13.0% vs. 8.0% for colorectal cancer (p-value=0.19).

CONCLUSION: Adherence to cervical, breast, and colorectal cancer screening in the past year did not differ by influenza vaccination status. Influenza vaccination appointments may therefore represent a missed opportunity to promote preventative cancer screening in Puerto Rico.

PMID:38104289

P R Health Sci J. 2023 Dec;42(4):311-317.

ABSTRACT

OBJECTIVE: Compare the efficacy of the micro-osteoperforation (MOP) and corticotomy techniques in terms of maxillary canine retraction.

METHODS: Thirteen patients (5 females, 8 males; mean age, 18.07 ± 6.74 years) with healthy permanent dentition and requiring the extraction of maxillary first premolars were included in a split-mouth randomized clinical trial. Those subjects with previous orthodontic or endodontic treatment of the canines were excluded. At least 3 months post-extraction, MOPs and corticotomies were performed distal to the canines. Mini-screws with closed-coil springs (150 g) were used for the canine retraction. Dental casts were made at baseline (T0) and 3 months post-intervention (T1). Trained and calibrated examiners measured the distances from the canines to the second premolars on both sides. A signed-rank sum test was used to compare the amount of canine retraction achieved in 3 months (T0-T1) on the 2 sides.

RESULTS: Retraction (mm) at the incisal level was similar in the corticotomy (3.34 ± 1.01) and MOP patients (2.74 ± 1.10) (P = 0.11); furthermore, there were no differences in the degree of medial retraction between the corticotomy (2.56 ± 0.67) and MOP (2.27 ± 0.82) (P = 0.31) procedures. No adverse events were observed.

CONCLUSION: There were not any clinically or statistically significant differences in retraction between the interventions. At 3 months, a MOP is as effective as a corticotomy in accelerating the rate of tooth movement.

PMID:38104288

P R Health Sci J. 2023 Dec;42(4):304-310.

ABSTRACT

OBJECTIVE: There is no Spanish-language instrument for assessing the self-management strategies used by older adults with physical function disabilities to manage the difficulties that can occur in daily living activities. This study aimed to design and test the content validity of a Spanish version of the newly developed Self-Management of Function in Daily Living Activities Questionnaire (SF-DLAQ).

METHODS: A methodological study, guided by the Person-Environment-Occupation-Performance (PEOP) model, was conducted to develop the SF-DLAQ. Stage 1 focused on designing the questionnaire, doing so using qualitative data obtained from 24 older adults and obtained from 10 existing scales that measure the self-management of chronic conditions. Stage 2 focused on expert judgement, which consisted of validating the questionnaire with 8 experts in aging using an item-level content validity index (I-CVI), a scale-level CVI (S-CVI), and the kappa statistic.

RESULTS: All the scores that were attained in stage 2 were favorable, with those of the I-CVI for clarity ranging from 0.09 to 1.0 and those of the I-CVI for relevancy, the S-CVI, and the kappa all being 1.0.

CONCLUSION: The scale and item validity for the SF-DLAQ, Spanish version, has been demonstrated but should be confirmed with further testing.

PMID:38104287

P R Health Sci J. 2023 Dec;42(4):298-303.

ABSTRACT

OBJECTIVE: According to the literature, depression and tobacco use are closely linked. This study’s main objectives were to provide the first population-based epidemiological profile of smokers with depression (SWD) who were 18 years and older and living in Puerto Rico (PR) from 2018 to 2020 and identify any statistically significant differences between SWD and smokers without depression (SWOD).

METHODS: A descriptive cross-sectional study was carried out using PR Behavioral Risk Factor Surveillance System (PRBRFSS) data (2018-2020). Univariate analysis was performed to obtain an epidemiological profile of smokers who had depression. Likewise, using bivariate analysis, SWD and SWOD were compared to identify statistically significant differences in terms of chronic conditions, risk factors, and quit attempts.

RESULTS: Depression prevalence among smokers 18 years and over in PR from 2018-2020 was 23.7%. Smokers with depression were more likely to be physically inactive (P < .001), overweight or obese (P < .001), have arthritis (P < .001), chronic obstructive pulmonary disease (P < .001), asthma (P < .001), high cholesterol (P < .001), hypertension (P < .001), coronary heart disease (P < .001), diabetes (P < .001), stroke (P < .001), and heart attack (P < .001) compared with SWOD. Likewise, SWD made more quitting attempts in the past year than did SWOD (P < .001).

CONCLUSION: Our results indicate that SWD should be targeted in any health-based tobacco-control efforts to develop evidence-based strategies to reduce or eliminate tobacco use in this same population.

PMID:38104286

P R Health Sci J. 2023 Dec;42(4):276-282.

ABSTRACT

OBJECTIVE: Breast cancer is a mortal disease that causes many deaths, especially in women. Improved therapies could contribute positively to survival rates. Metabolomics is an important tool for monitoring the alterations of several metabolites in clinical cases. This study aimed to develop a metabolomics model to observe (via mass spectroscopy) metabolic alterations in patients who suffered from breast cancer (BC), both before and after their recovery.

MATERIALS AND METHODS: Grades 1 and 2 invasive ductal carcinoma patients were evaluated based on their positron emission tomography/computed tomography results. Fourteen patients who had fully recovered from BC were subjected to metabolomics analysis. Plasma samples were extracted and analyzed via quadrupole time-of-flight mass tandem spectroscopy. A chemometrics analysis was performed in order to determine the statistically significant metabolites. All the metabolites were annotated via the mummichog algorithm.

RESULTS AND DISCUSSION: According to the data analysis, glucose, ornithine, phenyalanine, some vitamins, and metabolites in the fatty acid metabolism were statistically altered after recovery of each patient.

CONCLUSION: Untargeted metabolomics studies can be used to understand the etiopathogenesis of breast cancer, finding new biomarkers and alterations of metabolic pathways. After the tumor burden was removed, homeostasis was restored and the concentration of several metabolites began to normalize. This study elucidated the effects of breast cancer at the molecular level.

PMID:38104283

Lab Med. 2023 Dec 16:lmad108. doi: 10.1093/labmed/lmad108. Online ahead of print.

ABSTRACT

BACKGROUND: Rejected samples lead to prolonged turnaround time and delayed diagnosis and treatment of patients. This study was conducted to determine minimum acceptable sample volume in Sarstedt brand coagulation tubes to reduce high sample rejection rate.

METHODS: Blood samples were drawn from 20 participants (10 healthy volunteers and 10 patients receiving oral anticoagulant) into coagulation tubes. Six samples were taken from each participant, with tube fill volumes of 100%, 90%, 80%, 70%, 60%, and 50%. Prothrombin time (PT), active partial thromboplastin time (aPTT), and fibrinogen tests were analyzed.

RESULTS: According to quality performance specifications, the tube fill volume must be at least 70% for PT and aPTT and 50% for fibrinogen. There was no statistical difference in samples from healthy volunteers for PT, aPTT, and fibrinogen tests when the minimum tube fill volume was at least 80%, 90%, and 50%, respectively. These percentages were 50%, 70%, and 60%, respectively, in patients receiving oral anticoagulant.

CONCLUSIONS: Sarstedt tubes meet quality standard specifications at a 70% fill rate for PT and aPTT and a 50% fill rate for fibrinogen. Comprehensive studies with larger populations are needed to accept these values as sample acceptance criteria for the laboratory.

PMID:38104249 | DOI:10.1093/labmed/lmad108

Med Sci Monit. 2023 Dec 17;29:e942087. doi: 10.12659/MSM.942087.

ABSTRACT

BACKGROUND Lower extremity deep vein thrombosis (LEDVT), a common postoperative breast cancer complication, depends on multiple factors, such as systemic inflammation and immune status. We assessed the preoperative systemic immune-inflammatory index (SII) as a LEDVT risk predictor and did stratified nursing intervention based on it. MATERIAL AND METHODS A retrospective analysis was conducted on 552 patients who underwent breast cancer surgery from January 2019 to May 2020. Univariate and multivariate methods were used to screen independent risk factors for postoperative LEDVT, and effects of risk stratification and nursing intervention on the validation cohort were observed. RESULTS A total of 46 patients (8.3%) developed postoperative LEDVT. Compared with the control group, the LEDVT group had older age, higher proportion of menopause, higher preoperative Autar score, SII, and plasma D-dimer level, lower albumin level, and later postoperative pathological stage, with statistically significant differences (P<0.05). Multivariate logistic regression showed SII, plasma D-dimer, and menopause were independent predictors of postoperative LEDVT. ROC curve analysis showed SII had the strongest predictive ability, with an AUC of 0.714. Subsequently, 126 patients in the validation set were stratified according to the preoperative SII score, and intensified nursing intervention was implemented for high-risk patients, resulting in a significant reduction in the incidence of LEDVT (3.3% vs 8.3%, P=0.046). CONCLUSIONS Preoperative SII level can be used as an independent risk predictor of postoperative LEDVT in breast cancer patients. Applying it for risk stratification and implementing intensified nursing intervention for high-risk patients can significantly reduce the incidence of postoperative LEDVT.

PMID:38104239 | DOI:10.12659/MSM.942087

Clinics (Sao Paulo). 2023 Dec 15;79:100318. doi: 10.1016/j.clinsp.2023.100318. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to develop and internally validate a prediction model for estimating the risk of spontaneous abortion in early pregnancy.

METHODS: This prospective cohort study included 9,895 pregnant women who received prenatal care at a maternal health facility in China from January 2021 to December 2022. Data on demographics, medical history, lifestyle factors, and mental health were collected. A multivariable logistic regression analysis was performed to develop the prediction model with spontaneous abortion as the outcome. The model was internally validated using bootstrapping techniques, and its discrimination and calibration were assessed.

RESULTS: The spontaneous abortion rate was 5.95% (589/9,895) 1. The final prediction model included nine variables: maternal age, history of embryonic arrest, thyroid dysfunction, polycystic ovary syndrome, assisted reproduction, exposure to pollution, recent home renovation, depression score, and stress score 1. The model showed good discrimination with a C-statistic of 0.88 (95% CI 0.87‒0.90) 1, and its calibration was adequate based on the Hosmer-Lemeshow test (p = 0.27).

CONCLUSIONS: The prediction model demonstrated good performance in estimating spontaneous abortion risk in early pregnancy based on demographic, clinical, and psychosocial factors. Further external validation is recommended before clinical application.

PMID:38103265 | DOI:10.1016/j.clinsp.2023.100318

Sci Rep. 2023 Dec 16;13(1):22400. doi: 10.1038/s41598-023-49798-4.

ABSTRACT

Host (base) fluids are unable to deliver efficient heating and cooling processes in industrial applications due to their limited heat transfer rates. Nanofluids, owing to their distinctive and adaptable thermo-physical characteristics, find a widespread range of practical applications in various disciplines of nanotechnology and heat transfer equipment. The novel effect of this study is to determine the effects of mixed convection, and activation energy on 3D Sutterby nanofluid across a bi-directional extended surface under the impact of thermophoresis diffusion and convective heat dissipation. The flow equations are simplified in terms of partial differential equations (PDEs) and altered to non-dimensional ODEs by implementing classical scaling invariants. Numerical results have been obtained via the bvp4c approach. The physical insights of crucial and relevant parameters on flow and energy profiles are analysed through plotted visuals. Some factors have multiple solutions due to shrinking sheets. So stability analysis has been adapted to analyses stable solutions. Graphical representations demonstrate the reliability and accuracy of the numerical algorithm across a variety of pertinent parameters and conditions. A comparison between existing results and previously published data shows a high degree of compatibility between the two datasets. The present study extensively explored a multitude of practical applications across a diverse spectrum of fields, including but not limited to gas turbine technology, power generation, glass manufacturing, polymer production, wire coating, chemical production, heat exchangers, geothermal engineering, and food processing.

PMID:38104222 | DOI:10.1038/s41598-023-49798-4