Nevin Manimala

J Glob Health. 2022 Sep 3;12:04054. doi: 10.7189/jogh.12.04054.

ABSTRACT

BACKGROUND: Psychiatric bed numbers (general, forensic, and residential) and prison populations have been considered indicators of institutionalization. The present study aimed to assess changes of those indicators across sub-Saharan Africa (SSA) from 1990 to 2020.

METHODS: We retrospectively obtained data on psychiatric bed numbers and prison populations from 46 countries in SSA between 1990 and 2020. Mean and median rates, as well as percentage changes between first and last data points were calculated for all of SSA and for groups of countries based on income levels.

RESULTS: Primary data were retrieved from 17 out of 48 countries. Data from secondary sources were used for 29 countries. From two countries, data were unavailable. The median rate of psychiatric beds decreased from 3.0 to 2.2 per 100 000 population (median percentage change = -16.1%) between 1990 and 2020. Beds in forensic and residential facilities were nonexistent in most countries of SSA in 2020, and no trend for building those capacities was detected. The median prison population rate also decreased from 77.8 to 71.0 per 100 000 population (-7.8%). There were lower rates of psychiatric beds and prison populations in low-income and lower-middle income countries compared with upper-middle income countries.

CONCLUSIONS: SSA countries showed, on average, a reduction of psychiatric bed rates from already very low levels, which may correspond to a crisis in acute psychiatric care. Psychiatric bed rates were, on average, about one twenty-fifth of countries in the Organization for Economic Co-operation and Development (OECD), while prison population rates were similar. The heterogeneity of trends among SSA countries over the last three decades indicates that developments in the region may not have been based on coordinated policies and reflects unique circumstances faced by the individual countries.

PMID:36056592 | DOI:10.7189/jogh.12.04054

Urologia. 2022 Sep 2:3915603221122613. doi: 10.1177/03915603221122613. Online ahead of print.

ABSTRACT

OBJECTIVE: To study was to identify the variables that influence the outcomes of pediatric SWL patients in our clinic and to compare our findings to previously published nomograms.

METHODS: All children who underwent SWL at a single center between 2005 and 2020 were included in this retrospective study. Depending upon the age and mental state of the children, SWL procedures were performed with or without anesthesia. Data from the hospital information system were obtained on patient characteristics, metabolic evaluation, imaging, SWL details, and post-procedure results, and their correlation with the Onal and Dogan nomograms was evaluated.

RESULTS: The present study included 112 pediatric patients in total. The average age was 8.22 ± 4.9 (83.3 ± 58.1 months, 4 months-16 years), and the median stone size was 9.5 ± 3.2 mm (4-20 mm). Even though there was quite a significant positive correlation between age and the number of shots and the intensity of shots (intensity and number of shots increased with increasing age), there was no statistical difference in the number of sessions and stone-free rates. The number of shots and sessions was significantly lower in patients with hydronephrosis (N = 70) than in those without (N = 42) (p < 0.001). When the stone-free rates of patients without and with hydronephrosis were compared, it was discovered that they were 69.05% and 92.86%, respectively, which was statistically significant (p < 0.01).

CONCLUSIONS: It is believed that the nomograms developed for SWL in pediatric patients should be reviewed, and larger, prospective studies should be conducted.

PMID:36056585 | DOI:10.1177/03915603221122613

Child Dev. 2022 Sep 2. doi: 10.1111/cdev.13851. Online ahead of print.

ABSTRACT

This prospective, longitudinal study examined associations between whether and when children first acquire a mobile phone and their adjustment measures, among low-income Latinx children. Children (N = 263; 55% female; baseline M_age = 9.5) and their parents were assessed annually for 5 years from 2012. Children first acquired a mobile phone at a mean (SD) age of 11.62 (1.41) years. Pre-registered multilevel models tested associations linking phone ownership, phone acquisition age, and the interaction between ownership and acquisition age to levels and changing trends of depressive symptoms, school grades, and reported and objectively assessed sleep. Results showed no statistically significant associations, controlling the False Discovery Rate. Findings suggest an absence of meaningful links from mobile phone ownership and acquisition age to child adjustment.

PMID:36056573 | DOI:10.1111/cdev.13851

J Nurs Manag. 2022 Sep 2. doi: 10.1111/jonm.13783. Online ahead of print.

ABSTRACT

AIMS: To evaluate the frequency and outcomes of workplace incivility in healthcare for nursing management.

BACKGROUND: Incivility in the workplace is a significant problem that is important to nurse managers, as it goes directly against the fundamental values and ethics of providing high-quality care to patients. The Joint Commission (2021) and the American Nurses Credentialing Center have called on healthcare organizations to identify and intervene in the problem of workplace incivility.

EVALUATION: Studies included in this scoping review were those that measured and analyzed the frequency and outcomes of workplace incivility in healthcare. Four databases were searched, and 28 articles were reviewed. Evaluation was based on general quality, including study characteristics, instruments, and statistical analyses.

KEY ISSUES: Studies used a quasi-experimental design, and most focused on the Registered Nurse population. The Workplace Incivility Scale was the most commonly used instrument to measure workplace incivility frequency. The most frequently studied work-related outcomes were burnout, satisfaction, and turnover.

CONCLUSIONS: Although the frequency of workplace incivility in healthcare is not clear, its consequences are substantial. Multiple studies have revealed significant relationships between workplace incivility and work-related outcomes that are important to nurse managers. Research is needed on non-nursing healthcare professionals, and validation studies are needed on instruments used to measure workplace incivility frequency.

IMPLICATIONS FOR NURSING MANAGEMENT: The findings of this review can help nurse managers better understand the phenomenon, frequency, and impact of workplace incivility in the healthcare setting and move toward addressing the problem of workplace incivility among nurses and other healthcare professionals.

PMID:36056563 | DOI:10.1111/jonm.13783

Cogn Neuropsychol. 2022 Sep 2:1-19. doi: 10.1080/02643294.2022.2114825. Online ahead of print.

ABSTRACT

ABSTRACTA fundamental problem in semantic cognition is the representation of human concepts in the brain. Much of the knowledge acquired in the last decades comes from the study of dissociations found in patients with acquired difficulties in language, perception, and action. In particular, some deficits involve loss of knowledge about tools. The dissociation between two relevant aspects of tools, function and manipulation, has been the focus of several studies. In this paper, a new test designed to study the dissociation between function and manipulation is proposed and normative values for a control population are provided. This novel test was additionally administered to and evaluated in a group of Parkinson’s disease patients. The Graded-Controlled Hub-and-Spoke model of Lambon Ralph, Jefferies, Patterson and Rogers was used as a theoretical guide to interpret the results.

PMID:36056549 | DOI:10.1080/02643294.2022.2114825

J Environ Manage. 2022 Oct 15;320:115811. doi: 10.1016/j.jenvman.2022.115811. Epub 2022 Aug 11.

ABSTRACT

The Himalayan ecosystem is critical for ecological security and environmental sustainability. However, continuous deforestation is posing a serious threat to Himalayan sustainability. Changing land-use systems exert a tenacious impact on soil carbon (C) dynamics and regulate C emissions from Himalayan ecosystem. Therefore, this study was conducted to determine the changes in different C pools and associated soil properties under diverse land-use systems, viz. natural forest, natural grassland, maize field converted from the forest, plantation, and paddy field of temperate Himalaya in the surface (0-20 cm) and subsurface (20-40 cm) soils. The highest total organic carbon (24.24 g kg^-1) and Walkley-black carbon contents (18.23 g kg^-1), total organic carbon (45.88 Mg ha^-1), and Walkley-black carbon stocks (34.50 Mg ha^-1) were recorded in natural forest in surface soil (0-20 cm depth), while soil under paddy field had least total organic carbon (36.45 Mg ha^-1) and Walkley-black carbon stocks (27.40 Mg ha^-1) in surface soil (0-20 cm depth). The conversion of natural forest into paddy land results in 47.36% C losses. Among the cultivated land-use system, minimum C losses (29.0%) from different pools over natural forest system were reported under maize-filed converted from forest system. Land conversion causes more C losses (21.0%) in surface soil (0-20 cm depth) as compared to subsurface soil. Furthermore, conversion of forest land into paddy fields increased soil pH by 5.9% and reduced total nitrogen contents and microbial population by 28.0% and 7.0%, respectively. However, the intensity of total nitrogen and microbial population reduction was the lowest under maize fields converted from the forest system. The study suggested that the conversion of natural forest to agricultural land must be discouraged in the temperate Himalayan region. However, to feed the growing population, converted forest land can be brought under conservation effective maize-based systems to reduce C loss from the intensive land use and contribute to soil quality improvements and climate change mitigation.

PMID:36056479 | DOI:10.1016/j.jenvman.2022.115811

J Bone Miner Res. 2022 Sep 2. doi: 10.1002/jbmr.4694. Online ahead of print.

ABSTRACT

Metabolic bone disease is a devastating condition in critically ill patients admitted to an intensive care unit (ICU). We investigated the effects of early administration of the antiresorptive drug denosumab on bone metabolism in previously healthy patients. Fourteen patients with severe intracerebral or subarachnoid hemorrhage were included in a phase 2 trial. Within 72 hours after ICU admission, they were randomized in a 1:1 ratio to receive denosumab 60 mg or placebo subcutaneously. The primary endpoint was group differences in the percentage change of C-terminal telopeptide of type 1 collagen (CTX-1) levels in serum from denosumab/placebo application to four weeks thereafter. Changes in serum levels of bone formation markers and urinary calcium excretion were secondary outcome parameters. Regarding serum levels of CTX-1, changes over time averaged -0.45 ng/ml (95%CI: -0.72, -0.18) for the denosumab group and +0.29 ng/ml (95%CI: -0.01, +0.58) for the placebo group. The primary endpoint, the group difference in changes between baseline and secondary measurement, adjusted for baseline serum levels and baseline neurological status, averaged -0.74 ng/ml (95%CI: -1.14, -0.34; p=0.002). The group difference in changes between baseline and secondary osteocalcin measurement averaged -5.60 ng/ml (95%CI: -11.2, -0.04; p=0.049). The group difference in averaged change between baseline and secondary measurement of 24-hour urine calcium excretion was significant (-1.77 mmol/l (95%CI: -3.48; -0.06; p=0.044). No adverse events could be attributed to the study medication. The investigation proved that a single application of denosumab early after admission to an ICU prevents acute immobilization-associated increase in bone resorption among previously healthy individuals. This article is protected by copyright. All rights reserved.

PMID:36056473 | DOI:10.1002/jbmr.4694

Trials. 2022 Sep 2;23(1):726. doi: 10.1186/s13063-022-06638-6.

ABSTRACT

BACKGROUND: The standard procedure for the planning of transcatheter aortic valve replacement (TAVR) is the combination of echocardiography, coronary angiography, and cardiovascular computed tomography (TAVR-CT) for the exact determination of the aortic valve dimensions, valve size, and implantation route. However, up to 80% of the patients undergoing TAVR suffer from chronic renal insufficiency. Alternatives to reduce the need for iodinated contrast agents are desirable. Cardiac magnetic resonance (CMR) imaging recently has emerged as such an alternative. Therefore, we aim to investigate, for the first time, the non-inferiority of TAVR-CMR to TAVR-CT regarding efficacy and safety end-points.

METHODS: This is a prospective, randomized, open-label trial. It is planned to include 250 patients with symptomatic severe aortic stenosis scheduled for TAVR based on a local heart-team decision. Patients will be randomized in a 1:1 fashion to receive a predefined TAVR-CMR protocol or to receive a standard TAVR-CT protocol within 2 weeks after inclusion. Follow-up will be performed at hospital discharge after TAVR and after 1 and 2 years. The primary efficacy outcome is device implantation success at discharge. The secondary endpoints are a combined safety endpoint and a combined clinical efficacy endpoint at baseline and at 1 and 2 years, as well as a comparison of imaging procedure related variables. Endpoint definitions are based on the updated 2012 VARC-2 consensus document.

DISCUSSION: TAVR-CMR might be an alternative to TAVR-CT for planning a TAVR procedure. If proven to be effective and safe, a broader application of TAVR-CMR might reduce the incidence of acute kidney injury after TAVR and thus improve outcomes.

TRIAL REGISTRATION: The trial is registered at ClinicalTrials.gov (NCT03831087). The results will be disseminated at scientific meetings and publication in peer-reviewed journals.

PMID:36056444 | DOI:10.1186/s13063-022-06638-6

BMC Pulm Med. 2022 Sep 2;22(1):332. doi: 10.1186/s12890-022-02131-7.

ABSTRACT

BACKGROUND: Due to the low efficiency of a single clinical feature or laboratory variable in the diagnosis of tuberculous pleural effusion (TBPE), the diagnosis of TBPE is still challenging. This study aimed to build a scoring diagnostic model based on laboratory variables and clinical features to differentiate TBPE from non-tuberculous pleural effusion (non-TBPE).

METHODS: A retrospective study of 125 patients (63 with TBPE; 62 with non-TBPE) was undertaken. Univariate analysis was used to select the laboratory and clinical variables relevant to the model composition. The statistically different variables were selected to undergo binary logistic regression. Variables B coefficients were used to define a numerical score to calculate a scoring model. A receiver operating characteristic (ROC) curve was used to calculate the best cut-off value and evaluate the performance of the model. Finally, we add a validation cohort to verify the model.

RESULTS: Six variables were selected in the scoring model: Age ≤ 46 years old (4.96 points), Male (2.44 points), No cancer (3.19 points), Positive T-cell Spot (T-SPOT) results (4.69 points), Adenosine Deaminase (ADA) ≥ 24.5U/L (2.48 point), C-reactive Protein (CRP) ≥ 52.8 mg/L (1.84 points). With a cut-off value of a total score of 11.038 points, the scoring model’s sensitivity, specificity, and accuracy were 93.7%, 96.8%, and 99.2%, respectively. And the validation cohort confirms the model with the sensitivity, specificity, and accuracy of 92.9%, 93.3%, and 93.1%, respectively.

CONCLUSION: The scoring model can be used in differentiating TBPE from non-TBPE.

PMID:36056429 | DOI:10.1186/s12890-022-02131-7

BMC Womens Health. 2022 Sep 2;22(1):363. doi: 10.1186/s12905-022-01948-y.

ABSTRACT

BACKGROUND: Chronic pelvic pain (CPP) and primary dysmenorrhoea are debilitating conditions that can impair the quality of life of affected women. These conditions are frequently neglected, delaying proper diagnosis and healthcare provision. This study aimed to estimate the prevalence of CPP and primary dysmenorrhoea in Ecuador and identify potential variables associated with their occurrence.

METHODS: We conducted a cross-sectional survey in an urban neighbourhood of Quito, the capital of Ecuador. A total of 2397 participants of 14-49 years of age were included. The data were collected through questionnaires administered by trained interviewers.The crude and adjusted prevalence ratios were calculated using a log-binomial regression model. The correlation between pain intensity catastrophising of symptoms were statistically analysed.

RESULTS: The prevalence of CPP and primary dysmenorrhoea was 9.8% and 8.9%, respectively. Irritative urinary symptoms, primary dysmenorrhoea, and underlying mental disorders were associated with CPP, while smoking, irritable bowel syndrome, sleep disturbance, dyspareunia, and mental disorders were associated with primary dysmenorrhoea.

CONCLUSIONS: The prevalence of CPP and primary dysmenorrhoea in Ecuador was similar to that in other Latin American countries. Primary dysmenorrhoea is a risk factor of CPP, and less than a quarter of women are undergoing treatment for the condition. Our findings reinforce the importance of healthcare interventions in anticipating the diagnosis of these conditions in women of reproductive age.

PMID:36056424 | DOI:10.1186/s12905-022-01948-y