Nevin Manimala

J Adv Nurs. 2023 Apr 17. doi: 10.1111/jan.15677. Online ahead of print.

ABSTRACT

AIMS: To describe nurses’ perceptions of family nursing practice and to explore the influence of their perceptions of the benefits, barriers and activities of family engagement in care on family nursing practice.

DESIGN: A cross-sectional correlational study.

METHODS: In total, 460 nurses from two tertiary hospitals in the central region of Uganda participated. Quantitative and qualitative data were collected between August 2020 and January 2021 using the Family Nursing Practice Scale. Analyses included descriptive statistics, t-test, Pearson correlation, analysis of variance and ordinal logistics regression. Quantitative content analysis was carried out on the textual data.

RESULTS: Nurses who perceived that family engagement in care improves patient and family outcomes were more likely to rate family nursing practice highly. Perceived barriers to family engagement in care particularly time constraints, work overload and family-related conflicts have a negative and significant influence on family nursing practice. Nurse characteristics such as education, usual shift pattern and personal experience of having a family member in hospital are significantly associated with family nursing practice; nurses who work morning shifts were likely to report higher family nursing practice.

CONCLUSION: The study reveals that several parameters (perceived barriers, perceived benefits and nurse characteristics) influence nursing practice with families. Thus, bearing in mind the diversity of healthcare contexts, the findings show that multiple interacting factors are important for advancing family nursing interventions and practice.

IMPACT: Probabilistic factor-specific predictions of nursing practice with families are provided in this study – this addresses a gap in the evidence regarding the elements that should be optimized when designing well-informed policies and interventions to advance family nursing practice. A comparison of results in the literature with the present study’s findings suggests a need to broaden the scope and context perspective in future research and broaden the understanding of how nurses´ perceptions influence family engagement in care.

REPORTING METHOD: The study adheres to the STROBE reporting guidelines.

PATIENT OR PUBLIC CONTRIBUTION: Family members/caregivers were involved in the design of the study particularly in assessment of validation of the tools used in the study.

PMID:37066738 | DOI:10.1111/jan.15677

Ophthalmic Genet. 2023 Apr 17:1-6. doi: 10.1080/13816810.2023.2194494. Online ahead of print.

ABSTRACT

PURPOSE: To comprehend the etiology of diabetic retinopathy (DR), it is crucial to clarify the genetic susceptibility factors for DR. Previous studies have reported that five single nucleotide polymorphisms (SNPs), including rs9362054 (near the CEP162 gene), rs1990145 (MRPL19), rs10519765 (FMN1), rs237025 (SUMO4) and rs767649 (MIR155HG) were associated with DR. This study was conducted to elucidate the association between the five SNPs and DR in a Chinese Han population.

METHODS: A total of 957 individuals with type 2 diabetes mellitus (T2DM) including diabetes mellitus without retinopathy (DNR = 478), nonproliferative DR (NPDR = 384) and proliferative (PDR = 95) were recruited in this study. SNPs were genotyped using the Mass ARRAY MALDI-TOF system. The genotype and allele frequencies were determined using χ² tests. For genotype and allele risk, odds ratios (OR) and 95% confidence intervals (CI) were calculated. Four genetic models (homozygous, heterozygous, dominant, and recessive) were used to further investigate the link between the five SNPs and DR.

RESULTS: There was a statistically significant difference of CEP162 rs9362054 between NPDR and DNR (P = .027, OR = 1.26, 95%CI = 1.03-1.54) and a significant association of SUMO4 rs237025 detected between PDR and DNR (P = .031, OR = 1.45, 95%CI = 1.03-2.02). The association of CEP162 rs9362054 was also observed under the dominant mode (P = .03, OR = 1.35, 95%CI = 1.03-1.77). The association of SUMO4 rs237025 was found under the heterozygous model (P = .03, OR = 1.68, 95%CI = 1.06-2.69) and the dominant model (P = .02, OR = 1.70, 95%CI = 1.08-2.67). No associations of the other three SNPs with NPDR and PDR were detected when compared with DNR under these genetic models.

CONCLUSIONS: This study showed that rs9362054 and rs237025 were associated with NPDR and PDR when compared with DNR, suggesting that SUMO4 may be involved in the development of PDR, while CEP162 may be associated with NPDR.

PMID:37066695 | DOI:10.1080/13816810.2023.2194494

J Intellect Disabil Res. 2023 Apr 17. doi: 10.1111/jir.13033. Online ahead of print.

ABSTRACT

BACKGROUND: Individuals with Down syndrome (DS) exhibit deficits in static and dynamic balance abilities and maladaptive functions. This study aimed to determine the effectiveness of dance movement therapy (DMT) group intervention in individuals with DS.

METHODS: The 31 participating individuals with DS, aged 5-29 years, were randomly divided into intervention (n = 16) and control (n = 15) groups. Posturography was used for static balance measurement, timed up and go test for dynamic balance measurement and the Achenbach System of Empirically Based Assessment (ASEBA) questionnaire for adaptive function and behavioural problem measurement in participants before and after the DMT interventions. The intervention group underwent 60-min DMT intervention once a week for 10 times, while the control group had usual daily activities.

RESULTS: The results revealed a statistically significant difference and large effect sizes in dynamic balance [(f(1, 29) = 4.52, P = 0.04, η_p² = 0.14)] in the intervention group compared with the control group. There were no statistically significant differences in static balance and ASEBA scores between the groups.

CONCLUSIONS: This study found that the DMT interventions helped to improve the dynamic balance in individuals with DS.

PMID:37066677 | DOI:10.1111/jir.13033

J Intellect Disabil Res. 2023 Apr 17. doi: 10.1111/jir.13031. Online ahead of print.

ABSTRACT

BACKGROUND: We aim to investigate the relationship between bone mass in a sample of Brazilian individuals with DS and handgrip strength, body mass index (BMI) and physical exercise.

METHODS: Dual-energy X-ray emission densitometry analysis of bone mass in 26 individuals with DS (8 men and 18 women with a mean age of 30.7 ± 10.3 years) was conducted. Additionally, weight and height were measured to determine BMI, palmar grip strength was measured using a Jammar dynamometer®, and physical activity was classified using the International Physical Activity Questionnaire (IPAQ).

RESULTS: In this sample, 2/15 (13.3%) individuals with age between 18 to 29 years had low BMD in the spine; 2/8 (25%) of those with age between 30 and 39 years also had low BMD in the spine and 2/3 (66.6%) with age ≥40 had low BMD in the femur. There were significant correlations between palmar grip strength and Z femoral neck score in women (P = 0.02) and between BMI and Z femoral neck score in men (P = 0.04). All other correlations lacked statistical significance (P > 0.05).

CONCLUSIONS: Brazilian patients with DS showed a high prevalence of low bone mass. Traditional factors such as muscle strength, BMI and physical activity appear to have little effect on bone mineral density in this population.

PMID:37066674 | DOI:10.1111/jir.13031

J Hand Surg Eur Vol. 2023 Apr 17:17531934231166343. doi: 10.1177/17531934231166343. Online ahead of print.

ABSTRACT

This study primarily aimed to report the outcome of the arthroscopic cancellous bone grafting technique for treating scaphoid nonunion. The secondary aim was to compare the bone union rate and time, and the ability to correct the angulation of the scaphoid, between arthroscopically treated patients (n = 27), and patients treated with open cancellous bone grafting (n = 27). Nine surgeons (two in the arthroscopic and seven in the open group) with Level III experience operated on the patients. The pain score, grip strength and Quick Disability of the Arm, Shoulder and Hand score improved significantly after the arthroscopic treatment (p = 0.0001). Arthroscopic cancellous bone grafting achieved union in 25 out of 27 patients. A retrospective comparison with open cancellous bone grafting showed four nonunions. Arthroscopically treated patients healed 5.4 weeks faster compared with the open group (p = 0.033). Patients treated with open grafting had a higher risk of failure (odds ratio = 2.17), although this was not found significant (p = 0.39). The open method corrected the angulation deformity better (dorsal cortical angle correction of 4°) than the arthroscopic method (dorsal cortical angle correction of 1°), but this was not statistically significant neither within the groups (p = 0.55, p = 0.87) nor postoperatively between the groups (p = 0.98). The height-to-length ratio was not different before and after the surgery for the arthroscopic group (p = 0.44) and the open group (p = 0.27), or postoperatively between the groups (p = 0.44).Level of evidence: III.

PMID:37066665 | DOI:10.1177/17531934231166343

BJPsych Open. 2023 Apr 17;9(3):e71. doi: 10.1192/bjo.2023.47.

ABSTRACT

BACKGROUND: Both stroke and psychosis are independently associated with high levels of disability. However, psychosis in the context of stroke has been under-researched. To date, there are no general population studies on their joint prevalence and association.

AIMS: To estimate the joint prevalence of stroke and psychosis and their statistical association using nationally representative psychiatric epidemiology studies from two high-income countries (the UK and the USA) and two middle-income countries (Chile and Colombia) and, subsequently, in a combined-countries data-set.

METHOD: Prevalences were calculated with 95% confidence intervals. Statistical associations between stroke and psychosis and between stroke and psychotic symptoms were tested using regression models. Overall estimates were calculated using an individual participant level meta-analysis on the combined-countries data-set. The analysis is available online as a computational notebook.

RESULTS: The overall prevalence of probable psychosis in stroke was 3.81% (95% CI 2.34-5.82) and that of stroke in probable psychosis was 3.15% (95% CI 1.94-4.83). The odds ratio of the adjusted association between stroke and probable psychosis was 3.32 (95% CI 2.05-5.38). On the individual symptom level, paranoia, hallucinated voices and thought passivity delusion were associated with stroke in the unadjusted and adjusted analyses.

CONCLUSIONS: Rates of association between psychosis and stroke suggest there is likely to be a high clinical need group who are under-researched and may be poorly served by existing services.

PMID:37066638 | DOI:10.1192/bjo.2023.47

BJPsych Open. 2023 Apr 17;9(3):e69. doi: 10.1192/bjo.2023.46.

ABSTRACT

BACKGROUND: Cognitive stimulation therapy (CST) is the only non-pharmacological, treatment for dementia recommended by the UK National Institute for Health and Care Excellence, following multiple international trials demonstrating beneficial cognitive outcomes in people with mild-to-moderate dementia. However, there is limited understanding of whether treatment prognosis is influenced by sociodemographic and clinical variables (such as dementia subtype and gender), information which could inform clinical decision-making.

AIM: We describe the protocol for a systematic review and individual patient data meta-analysis assessing the prognostic factors related to CST. In publishing this protocol, we hope to increase the transparency of our work, and keep healthcare professionals aware of the latest evidence for effective CST.

METHOD: A systematic review will be conducted with searches of the bibliographic databases Medline, EMBASE and PsycINFO, from inception to 7 February 2023. Studies will be included if they are clinical trials of CST, use the Alzheimer’s Disease Assessment Scale – Cognitive Subscale (gold-standard measure of cognition in dementia in clinical trials) and include participants with mild-to-moderate dementia. Following harmonisation of the data-set, mixed-effect models will be constructed to explore the relationship between the prognostic indicators and change scores post-treatment.

CONCLUSIONS: This is the first individual patient data meta-analyses on CST, and has the potential to significantly optimise patient care. Previous analyses suggest people with advanced dementia could benefit more from CST treatment. Given that CST is currently used post-diagnosis in people with mild-to-moderate dementia, the implications of confirming this finding, among identifying other prognostic indicators, are profound.

PMID:37066632 | DOI:10.1192/bjo.2023.46

J Genet Couns. 2023 Apr 17. doi: 10.1002/jgc4.1714. Online ahead of print.

ABSTRACT

Noninvasive prenatal screening (NIPS), using placental cell-free DNA from a maternal blood sample, is currently the most sensitive and specific screening tool for detecting common fetal aneuploidies. The aim of this study was to compare the rates of “atypical” single nucleotide polymorphism (SNP)-based NIPS results and subsequent pregnancy outcomes between Arab American and non-Arab American patients. We conducted a retrospective cohort study of pregnant Arab and non-Arab American patients who had SNP-based NIPS performed between September 2018 and January 2021 at an urban health system in Michigan. The rate of “atypical” results and other perinatal outcomes were compared between groups using descriptive statistics. “Atypical” results due to multifetal gestations, either undisclosed or unknown at time of ordering, were excluded. Five thousand eight hundred and seventy-three patients underwent SNP-based NIPS: 771 (13.1%) were identified as Arab American, 5102 (86.9%) were non-Arab American, and 49 (0.8%) patients received “atypical” results. Arab patients represented only 13.1% of patients screened (771/5873) but had a significantly higher rate of “atypical” results than non-Arab American patients (17/771 [2.2%] vs. 32/5102 [0.6%]; p < 0.001). Of the 17 Arab patients with “atypical” results, 9 (52.9%) were in known consanguineous relationships. No major congenital anomalies or chromosomal aberrations were identified for any patients who had “atypical” results, and no significant differences in other perinatal outcomes were observed between Arab and non-Arab American patients. A better understanding of the association between consanguinity and “atypical” SNP-based NIPS results would aid in appropriate test selection and interpretation and may help physicians and genetic counselors provide better perinatal counseling and follow-up care for patients in consanguineous relationships.

PMID:37066630 | DOI:10.1002/jgc4.1714

Epidemiol Psychiatr Sci. 2023 Apr 17;32:e19. doi: 10.1017/S2045796023000136.

ABSTRACT

AIMS: Our study aimed to (1) identify trajectories on different mental health components during a two-year follow-up of the COVID-19 pandemic and contextualise them according to pandemic periods; (2) investigate the associations between mental health trajectories and several exposures, and determine whether there were differences among the different mental health outcomes regarding these associations.

METHODS: We included 5535 healthy individuals, aged 40-65 years old, from the Barcelona Brain Health Initiative (BBHI). Growth mixture models (GMM) were fitted to classify individuals into different trajectories for three mental health-related outcomes (psychological distress, personal growth and loneliness). Moreover, we fitted a multinomial regression model for each outcome considering class membership as the independent variable to assess the association with the predictors.

RESULTS: For the outcomes studied we identified three latent trajectories, differentiating two major trends, a large proportion of participants was classified into ‘resilient’ trajectories, and a smaller proportion into ‘chronic-worsening’ trajectories. For the former, we observed a lower susceptibility to the changes, whereas, for the latter, we noticed greater heterogeneity and susceptibility to different periods of the pandemic. From the multinomial regression models, we found global and cognitive health, and coping strategies as common protective factors among the studied mental health components. Nevertheless, some differences were found regarding the risk factors. Living alone was only significant for those classified into ‘chronic’ trajectories of loneliness, but not for the other outcomes. Similarly, secondary or higher education was only a risk factor for the ‘worsening’ trajectory of personal growth. Finally, smoking and sleeping problems were risk factors which were associated with the ‘chronic’ trajectory of psychological distress.

CONCLUSIONS: Our results support heterogeneity in reactions to the pandemic and the need to study different mental health-related components over a longer follow-up period, as each one evolves differently depending on the pandemic period. In addition, the understanding of modifiable protective and risk factors associated with these trajectories would allow the characterisation of these segments of the population to create targeted interventions.

PMID:37066626 | DOI:10.1017/S2045796023000136

Health Informatics J. 2023 Apr-Jun;29(2):14604582231170892. doi: 10.1177/14604582231170892.

ABSTRACT

The Integrated Clinical and Environmental Exposures Service (ICEES) provides open regulatory-compliant access to clinical data, including electronic health record data, that have been integrated with environmental exposures data. While ICEES has been validated in the context of an asthma use case and several other use cases, the regulatory constraints on the ICEES open application programming interface (OpenAPI) result in data loss when using the service for multivariate analysis. In this study, we investigated the robustness of the ICEES OpenAPI through a comparative analysis, in which we applied a generalized linear model (GLM) to the OpenAPI data and the constraint-free source data to examine factors predictive of asthma exacerbations. Consistent with previous studies, we found that the main predictors identified by both analyses were sex, prednisone, race, obesity, and airborne particulate exposure. Comparison of GLM model fit revealed that data loss impacts model quality, but only with select interaction terms. We conclude that the ICEES OpenAPI supports multivariate analysis, albeit with potential data loss that users should be aware of.

PMID:37066514 | DOI:10.1177/14604582231170892