Nevin Manimala

J Am Pharm Assoc (2003). 2021 Feb 19:S1544-3191(21)00075-3. doi: 10.1016/j.japh.2021.02.007. Online ahead of print.

ABSTRACT

OBJECTIVES: The purpose of this study is to evaluate the incidence of glycemic relapse in patients who attained their glycosylated hemoglobin (A1C) goal through a health system-wide collaborative primary care-based pharmacist- and Certified Diabetes Care and Education Specialist (CDCES)-led type 2 diabetes (T2D) management program and to identify relapse risk factors.

METHODS: This retrospective cohort study examined patients with T2D in the diabetes management program with a baseline A1C of at least 9% who attained their A1C goal. The primary outcome was incidence of glycemic relapse. Time to relapse was estimated using Kaplan-Meier curve, and a cox proportional hazards model was fitted to identify the risk factors for glycemic relapse.

RESULTS: Three hundred sixty-two patients were followed-up for a median of 10.5 (interquartile range 12.1) months after program completion; 38 patients (10.5%) experienced a glycemic relapse. Kaplan-Meier analysis estimated a 12-month relapse rate of 8.3%. The presence of a medication adherence barrier, presence of a higher number of chronic medications at baseline, presence of a baseline body mass index (BMI) of 30-39.9, and use of insulin at program completion increased risk for glycemic relapse in a univariate model. In multivariate regression, baseline BMI of 30-39.9 remained statistically significant. Older age at baseline was associated with a statistically significantly decreased relapse risk in both models.

CONCLUSION: This study highlights a low incidence of glycemic relapse for patients with T2D who reach their A1C goal through a collaborative primary care-based pharmacist- and CDCES-led T2D management program. The presence of risk factors for glycemic relapse may indicate a need for ongoing intensive care despite achieving A1C goal.

PMID:33715974 | DOI:10.1016/j.japh.2021.02.007

J Craniomaxillofac Surg. 2021 Feb 27:S1010-5182(21)00078-0. doi: 10.1016/j.jcms.2021.02.021. Online ahead of print.

ABSTRACT

The aim of this study was to determine whether patients benefit from a secondary reconstruction since it carries the risks of no improvement or worsening of their current situation. Patients treated with individual computer-aided-design/computer-aided-manufacturing (CAD/CAM) ceramic implants were reviewed. To ascertain changes throughout the secondary reconstruction, the study investigators reviewed ophthalmological examinations, took volumetric measurements of the orbits and asked the patients for evaluation of their situation before and after the reconstruction. Points addressed were double vision, visual acuity, field of vision, limitations in daily life and aesthetic considerations. A total of 14 patients were reviewed and 11 answered the questionnaire. Ophthalmological examinations showed that the physical integrity of the eye was maintained. Volumetric measurements preopeatively (33.94 ± 3.24 cm³) and postoperatively (30.67 ± 2.07 cm³) showed that a statistically significant overcorrection of orbital volume leads to good functional and aesthetic outcomes. Patients’ subjective opinions were that they greatly benefitted, especially concerning limitations in daily life, which improved by 4.4 ± 2.8 points out of 10 possible points, and aesthetics, with an improvement of 5.9 ± 1.78 points. Based on these findings, we conclude that secondary reconstructions contribute to improvement of the patients’ quality of life and therefore should be considered as an option to improve patients’ condition.

PMID:33715966 | DOI:10.1016/j.jcms.2021.02.021

Vet J. 2021 Feb 27:105650. doi: 10.1016/j.tvjl.2021.105650. Online ahead of print.

ABSTRACT

Determining ideal pacing rates to meet physiological needs and optimizing programming to prevent unnecessary right ventricular pacing in dogs requires an understanding of heart rate profiles and applicable pacing technology. The heart rate and rhythm of the dog is complex necessitating investigation of rate requirements of activity and circadian influences. Overlaying this information are a multiplicity of other factors such as age, breed, temperament, cardiovascular disease and underlining rhythm disorders that contribute to the difficulty in making general conclusions. However, all such information permits better implementation of programming options with the goal of better outcomes. In this review (Part 1 of a two-part review) instantaneous heart rate, rolling average heart rate, simple average heart rate, heart rate tachograms, RR interval tachograms (2D, 3D and dynamic), and Poincaré plots (2D, 3D and dynamic) are discussed as they apply to decisions in the determination and examination of pacing rates for dogs programmed in the VVI pacing mode (Ventricular paced, Ventricular sensed, Inhibited pacing). The applicable pacing operations available for three pacemaker companies are reviewed (Abbott, Biotronik/Dextronix, and Medtronic). The programmable options considered include: slowest pacing rate without additional features to extend the pacing interval, sleep/rest rate preferences, hysteresis to lengthen pacing interval following intrinsic beats, and intermittent increases in pacing following abrupt loss of intrinsic rhythm. Recommendations are suggested for follow-up of individual dogs with examination of pacing statistics and Holter monitoring.

PMID:33715961 | DOI:10.1016/j.tvjl.2021.105650

Intensive Crit Care Nurs. 2021 Mar 11:103028. doi: 10.1016/j.iccn.2021.103028. Online ahead of print.

NO ABSTRACT

PMID:33715957 | DOI:10.1016/j.iccn.2021.103028

Int J Ment Health Nurs. 2021 Mar 14. doi: 10.1111/inm.12846. Online ahead of print.

ABSTRACT

Despite the global prevalence of mental disorders being widely acknowledged, mental illness, complex trauma and the significant impact on individuals, families and communities continues to be poorly recognized, under-diagnosed and underreported. Based on the 2017 Australian census, one-in-five (20%) people have experienced some type of mental illness within the last 12 months (Australian Bureau of Statistics [ABS], 2019). The prevalence rate of mental illness in culturally and linguistically diverse (CALD) communities is difficult to estimate due to cultural and linguistic issues and underutilization of mental health services. In particular, little epidemiological data is available about the prevalence of mental illness in the Somali-Australian community. The aim of this study was to identify the perceived barriers to help-seeking for mental health for Somali-Australian women. A qualitative descriptive study incorporating focus group discussions with 31 Somali-Australian women was conducted in Melbourne, Australia. Braun & Clarke’s (2006) thematic analysis was applied to the data. Four themes relating to help-seeking barriers were abstracted. Influence of faith explored how Islam can impact the person views on mental illness. Stigma focused on the relationship between public and self-stigma and help-seeking. Mistrust of Western healthcare system describes the participants concerns about the cultural disconnect between the community and the Western healthcare system. Finally, denial of mental illness reflected the community views on mental health. This study provides an insight into the factors that influence the Somali-Australian community help-seeking with mental health services. The findings have implications for mental health professionals and the Somali-Australian community.

PMID:33715289 | DOI:10.1111/inm.12846

Nurs Open. 2021 Mar 14. doi: 10.1002/nop2.852. Online ahead of print.

ABSTRACT

AIMS: To investigate the attitudes and beliefs towards the implementation of nurse prescribing among general nurses and nurse specialists.

DESIGN: A cross-sectional survey among general nurses and nurse specialists was conducted in seven provinces and one autonomous region in mainland China using convenience sampling method.

METHODS: The attitudes and beliefs towards nurse prescribing were assessed using the Nurse Attitudes and Beliefs towards Nurse prescribing scale, of which Cronbach’s coefficient was 0.902, retest reliability was 0.808. Respondents from eight hospitals across the country were employed to complete an online questionnaire.

RESULTS: Nurse specialists (n = 399) had statistically significantly more favourable intentions towards nurse prescribing than general nurses (n = 415; 105.64 ± 12.83 vs. 96.39 ± 13.16; p < .001). The years of clinical work experience, professional title, education degree were positively correlated with general nurses’ and nurse specialists’ attitudes and beliefs towards nurse prescribing (p < .05). Among nurse specialists, the variety of specialties and whether they work in nurse-led clinics on an outpatient basis have positively influence on their intentions towards nurse prescribing (p < .05).

PMID:33715286 | DOI:10.1002/nop2.852

Pharmacoepidemiol Drug Saf. 2021 Mar 13. doi: 10.1002/pds.5227. Online ahead of print.

ABSTRACT

PURPOSE: Consensus is needed on conceptual foundations, terminology and relationships among the various self-controlled “trigger” study designs that control for time-invariant confounding factors and target the association between transient exposures (potential triggers) and abrupt outcomes. The International Society for Pharmacoepidemiology (ISPE) funded a working group of ISPE members to develop guidance material for the application and reporting of self-controlled study designs, similar to Standards of Reporting Observational Epidemiology (STROBE). This first paper focuses on navigation between the types of self-controlled designs to permit a foundational understanding with guiding principles.

METHODS: We leveraged a systematic review of applications of these designs, that we term Self-controlled Crossover Observational PharmacoEpidemiologic (SCOPE) studies. Starting from first principles and using case examples, we reviewed outcome-anchored (case-crossover [CCO], case-time control [CTC], case-case-time control [CCTC]) and exposure-anchored (self-controlled case-series [SCCS]) study designs.

RESULTS: Key methodological features related to exposure, outcome and time-related concerns were clarified, and a common language and worksheet to facilitate the design of SCOPE studies is introduced.

CONCLUSIONS: Consensus on conceptual foundations, terminology and relationships among SCOPE designs will facilitate understanding and critical appraisal of published studies, as well as help in the design, analysis and review of new SCOPE studies. This article is protected by copyright. All rights reserved.

PMID:33715267 | DOI:10.1002/pds.5227

Clin Oral Implants Res. 2021 Mar 13. doi: 10.1111/clr.13745. Online ahead of print.

ABSTRACT

OBJECTIVES: To analyze the long-term effect of plaque formation on implant abutments with an antibacterial coating and the ensuing host response in peri-implant tissues.

MATERIALS & METHODS: Four implants were installed in each mandibular premolar region following tooth extraction in 6 dogs. Three months later 2 test abutments with a Titanium-Bismuth-Gallium (Ti-Bi-Ga) coating and 2 control titanium abutments were connected to the implants on each side of the mandible. After 2 months ligatures were placed around the implants in one side of the mandible and plaque formation was allowed until the end of the experiment. The ligatures were removed after 4 weeks. Radiographs and microbiological samples were obtained from each implant site during the plaque formation period. Biopsies were obtained 8 months after abutment connection and prepared for histological analysis.

RESULTS: The analysis did not reveal any statistically significant differences in bone loss, bacterial growth and size of inflammatory lesions between implant units with and without the Ti-Bi-Ga coating. Implant sites exposed to the short period of ligature induced breakdown demonstrated more pronounced bone loss and bacterial growth than non-ligature sites.

CONCLUSIONS: It is suggested that a Ti-Bi-Ga coating does not prevent biofilm formation on the implant device and does not influence the ensuing host response in the adjacent peri-implant mucosa.

PMID:33715254 | DOI:10.1111/clr.13745

Health Promot J Austr. 2021 Mar 14. doi: 10.1002/hpja.479. Online ahead of print.

ABSTRACT

BACKGROUND: Childhood obesity is a significant public health issue. Sugar sweetened beverage (SSB) consumption contributes to this and adolescents are high consumers. This paper provides a descriptive overview of a school-based intervention to address this.

METHODS: 61 secondary schools in New South Wales were randomised to receive a behavioural intervention (BI), a chilled water station (CWS), both interventions or neither (control). The BI was delivered through classroom lessons, school-based promotion and vaccination clinic. The CWS intervention included the installation of one CWS per school. Intervention effectiveness over time was assessed via student surveys at baseline, post-intervention and follow-up (individual-level outcomes), feedback from teachers and vaccination nurses, a school information survey, and remotely monitored CWS water usage (school-level outcomes).

RESULTS: Teachers reported the BI was useful in teaching students about drinking water and negative consequences of SSBs. Nurses considered the post-vaccination waiting period a good opportunity to deliver health promotion messages. Students in this group showed statistically significant changes in knowledge about SSBs, dehydration effects and changes in daily SSB consumption (T1 23.18%; T3 18.20%). Positive feedback regarding CWSs was received with an increase in water consumption reported for students in this group (T1 86.15% to T3 89.66%) and a statistically significant increase in students carrying a water bottle to school and filling it observed.

CONCLUSIONS: Both interventions were readily implemented with high levels of acceptability and impact on students’ knowledge and SSB consumption. The study demonstrates how to promote water consumption in schools utilising two different interventions. SO WHAT?: Evidence regarding how to decrease SSB consumption among secondary school students has been strengthened.

PMID:33715238 | DOI:10.1002/hpja.479

Clin Endocrinol (Oxf). 2021 Mar 14. doi: 10.1111/cen.14459. Online ahead of print.

ABSTRACT

OBJECTIVE: Obesity and liver fat are associated with decreased levels of serum sex hormone-binding globulin (SHBG). Laboratory studies suggest that hepatic de novo lipogenesis (DNL) is involved in the downregulation of SHBG synthesis. The aim of the present study was to address the role of DNL on serum SHBG in humans.

DESIGN: A cross-sectional study examining the association between DNL, measured by stable isotopes, and serum SHBG, stratified by sex.

PARTICIPANTS: Healthy men (n=34) and women (n=21) were combined from two cross-sectional studies. Forty-two percent of participants had hepatic steatosis, and the majority were overweight (62%) or obese (27%).

RESULTS: DNL was inversely associated with SHBG in women (β: -0.015, 95%CI: -0.030;0.000), but not in men (β: 0.007, 95%CI: -0.005;0.019) (p for interaction=0.068). Adjustment for study population, age and BMI did not materially change these results, although statistical significance was lost after adjustment for serum insulin.

CONCLUSIONS: An inverse association between DNL and SHBG may explain the decreased SHBG levels that are observed in obesity, at least in women.

PMID:33715205 | DOI:10.1111/cen.14459