Nevin Manimala

J Emerg Nurs. 2023 Dec 23:S0099-1767(23)00316-1. doi: 10.1016/j.jen.2023.11.012. Online ahead of print.

ABSTRACT

INTRODUCTION: Many strategies have been developed to prevent procedural pain in pediatric emergency units, where nurses play a vital role in ensuring patient comfort. Easy-to-use and inexpensive nonpharmacologic analgesic methods are important in emergency units. This study was conducted to determine the effect of cold spray and ice applied during venipuncture on the level of fear and pain in children aged 7 to 15 years.

METHODS: This was a randomized controlled experimental study of 96 children between the ages of 7 and 15 years (cold spray group, ice group, and control group) who were scheduled to have venous access in the pediatric emergency clinic and met the sampling criteria.

RESULTS: Evaluations of the children, parents, and observers in the groups found a statistically significant difference between the pain and fear scores after the intervention compared with the preintervention (P < .001). The pain and fear scores of the children in the control group were higher than the scores of those in the spray and ice groups (P < .001); the pain and fear scores of the children in the spray group were lower than the scores of the children in the ice group and statistically significant (P < .001).

DISCUSSION: In conclusion, cold spray applied during intravenous access in children aged 7 to 15 effectively reduces pain and fear and should be used in the emergency unit.

PMID:38142386 | DOI:10.1016/j.jen.2023.11.012

J Manipulative Physiol Ther. 2023 Dec 22:S0161-4754(23)00089-1. doi: 10.1016/j.jmpt.2023.11.001. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this study was to describe the utilization of health team practitioners among national-level athletes and report their injury profile as well as access to and knowledge of chiropractic care.

METHODS: This study was a retrospective analysis of non-identifiable, cross-sectional survey data that were previously collected from members of the AthletesCAN organization who voluntarily completed a web-based, bilingual survey in July or August 2017. The sport of the athlete, number of years on a national team, number and type of injuries, health care practitioners visited, and specific details on chiropractic care were collected. Descriptive statistics were performed to summarize the responses in terms of frequencies and percentages.

RESULTS: There was an 11% response rate (198/1733), with 67 unique sports identified (21 winter sports [50 athletes] and 46 summer sports [148 athletes]). Athletics and swimming were the sports with the most respondents. Fewer than half (43.9%) of the 198 respondents were members of AthletesCAN for 2 to 5 years. Seventy percent reported 1 to 5 injuries over their career, with ankle, low back, and shoulder the most likely body parts affected. A majority of athletes (93.4%) reported visiting multiple practitioners, including medical physicians, physiotherapists, athletic therapists, massage therapists, and chiropractors. Two-thirds (67%) of athletes sought chiropractic treatment, most typically for neck or back pain (81.3%), despite nearly half (45.7%) being unsure about access to chiropractic care.

CONCLUSION: This sample of Canadian national team athletes who experience an injury may seek care from multiple types of health care providers and include chiropractic as part of their approach to health care.

PMID:38142379 | DOI:10.1016/j.jmpt.2023.11.001

J Manipulative Physiol Ther. 2023 Dec 21:S0161-4754(23)00087-8. doi: 10.1016/j.jmpt.2023.11.003. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this study was to analyze short-term changes in dynamic and static balance after a manual therapy protocol in healthy participants and analyze any repercussions on mood and perception of change after applying articulatory techniques.

METHODS: A single-blind, randomized, multicenter clinical trial was conducted. Participants were allocated to either a manual therapy group (MTG) (n = 101) or a control group (CG) without intervention (n = 99), and measures were taken before treatment, after the intervention, and 1 week after treatment. Assessments included the Star Excursion Balance Test, Unipedal Stance Test (UPST), Profile of Mood States (POMS), and Patient Global Impression of Change (PGIC) scale.

RESULTS: Two hundred healthy participants completed the study (mean age, 22 [SD = 2.67]). There was a statistically significant interaction between groups and time measurements in the right leg for anterior (P = .003), posteromedial (P < .001), and posterolateral (P = .001) directions in favor of the MTG, as well as in the left leg for anterior (P < .001), posteromedial (P < .001), and posterolateral (P = .012) directions. The analysis failed to show statistically significant interactions between any of the factors for the UPST and POMS (P > .05). The MTG showed a significant improvement compared to the CG after treatment (P = .003) and at 1-week follow-up (P < .001) on the PGIC scale.

CONCLUSION: The results suggest the MT intervention was effective on dynamic balance in post-intervention in healthy participants, and some of the directions maintained the results at 1-week follow-up. Perception of change in post-treatment and 1-week follow-up also significantly improved. The protocol did not seem to produce changes in static balance and mood states. Positive changes after manual therapy were maintained in the short term.

PMID:38142378 | DOI:10.1016/j.jmpt.2023.11.003

Inquiry. 2023 Jan-Dec;60:469580231218440. doi: 10.1177/00469580231218440.

ABSTRACT

Although prior research has linked dental conditions and opioid prescribing in the U.S., it is not yet known whether the receipt of opioid prescriptions prior to seeking emergency care for dental conditions differs in geographical areas that are underserved by health care professionals (Dental Professional Shortage Areas, DPSAs) compared to other areas. Using Indiana’s state-wide electronic health records from January 1, 2016 to October 31, 2020, we examine if patients from DPSAs presenting at the emergency department (ED) for dental conditions are more likely to have received opioid prescriptions in the 30 days prior to their visit, compared to patients from other areas. A higher rate of opioid receipt among DPSA individuals may indicate an association between lower availability of dental professionals and the use of opioids as a coping strategy. We note that our study design has several limitations (such as a lack of data on prescription use after the ED visit) and does not prove causation. We find that individuals experiencing dental condition ED visits in DPSAs are 16% more likely (than those in non-DPSAs) to have filled an opioid prescription in the 30 days prior to the ED visit, after controlling for age, gender, and race/ethnicity. This result is statistically significant at the 1% level. The baseline rate of opioid filling in the 30 days prior to the ED visit is 12% in DPSAs. These correlational results suggest that unmet dental needs might be substantially connected to opioid prescriptions, although further research is needed to establish whether this relationship is causal.

PMID:38142365 | DOI:10.1177/00469580231218440

Clin Pediatr (Phila). 2023 Dec 24:99228231218536. doi: 10.1177/00099228231218536. Online ahead of print.

ABSTRACT

Primary care providers (PCPs) can play an important role in the continuity of care for children who experience sexual abuse (SA). We performed a retrospective, chart-based study of children 3 to 17 years old with SA history. Primary care medical records were reviewed for 2 years after a subspecialty SA evaluation. Descriptive statistics and logistic regression were used to assess factors associated with documentation of SA history and mental health management by the PCP. Of 131 included patients, 43% had PCP documentation of their SA history, which was associated with care from resident providers (P < .01). There was greater mental health management and mental health referrals by PCPs for the group with documentation compared with the group without documentation (52% vs 23%, P < .001). Overall, child SA history was poorly documented in primary care settings. Identifying mechanisms to improve communication about a child’s SA history with PCPs is important for the child’s ongoing care.

PMID:38142359 | DOI:10.1177/00099228231218536

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 Nov;31(6):1433-1438. doi: 10.32687/0869-866X-2023-31-6-1433-1438.

ABSTRACT

This article investigates readiness of Kazakhstan’s population for implementation of pharmaceutical insurance system to overcome inequalities in health care accessibility. The primary data was obtained using questionnaire survey of 5 819 respondents in 17 regions of Kazakhstan in August-October 2022. The data was analyzed by software SPSS 25.0 applied for processing statistical and typology analysis, classification and comparative analysis. The results demonstrated that subjective readiness, per capita family income, urban/rural residence, education, field of employment, gender and health status are factors affecting population’s readiness for implementation of new pharmaceutical insurance system. The study identified average degree of readiness of population to new pharmaceutical insurance system. However, 30% of respondents had no clearly formed opinion. The study concluded that implementing pharmaceutical insurance system with 50% of state co-financing in Kazakhstan is feasible to reduce inequalities in accessing essential medications. The Ministry of Health Care of Kazakhstan is advised to organize regular health education activities in population related to compulsory and voluntary health insurance to ensure successful implementation of the new system.

PMID:38142347 | DOI:10.32687/0869-866X-2023-31-6-1433-1438

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 Nov;31(6):1366-1372. doi: 10.32687/0869-866X-2023-31-6-1366-1372.

ABSTRACT

The cross-sectional study of subjective assessment of quality of life of 300 employees of main professions of metalworking industrial production working in harmful labor environment (classes 3.1-3.4) was carried out using validated Russian version of the WHO QOL-BREF questionnaire. The software Statistica 10 was applied for statistical analysis. The statistical processing of study results was performed by calculating arithmetic mean (M), standard deviation (SD) and presented as M±SD. The non-parametric statistical methods were applied to compare two independent samples: the Mann-Whitney U criterion, the Spearman rank correlation coefficient. The data differences and correlations between the data at p<0.05 were considered statistically significant. Based on the results of analysis, satisfaction of employees with quality of life across all domains was established. The quality of life indicators were independent of gender of respondents. With age and experience, decrease of indicators for all domains was established. High indicators for physical health domain and subjective assessment of health status in examined group can be explained from the standpoint of the “healthy worker effect”, but concealment of information about true state of health cannot be ruled out. The metal industry workers working in harmful labor conditions are conditionally healthy and active. There is a need for additional research to obtain objective assessment of their health status.

PMID:38142337 | DOI:10.32687/0869-866X-2023-31-6-1366-1372

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2023 Nov;31(6):1301-1306. doi: 10.32687/0869-866X-2023-31-6-1301-1306.

ABSTRACT

In conditions of persisting high morbidity of COVID-19, issues related to prompt and timely medical care of population remains actual ones. The purpose of the study to analyze activities of the call-center of the Ministry of Health Care of the Udmurt Republic related to organization of medical care of COVID-19 patients in the Udmurt Republic.

MATERIALS AND METHODS: The statistical (descriptive statistics) and descriptive methods were applied. The indicators of functioning of the call-center of the Ministry of Health Care of the Udmurt Republic in 2020-2022 were analyzed. The psychological characteristics of telephone counseling were studied. The satisfaction of medical organizations and citizens with services of call-center operators was assessed.

THE RESULTS: The main principles of telephone counseling are confidentiality, maintenance of framework of working conversation, respect to personality of addressee. In 2020 the call center phone line received 34160 calls, in 2021 – 128339 calls, in 2022 – 65618 calls. In 25 months of operation the call-center operators received 228,117 calls from citizens related to issues of new coronavirus infection. The number of patient calls to the hot-line increases significantly when incidence of new coronavirus infection increases (r=0.885; p<0.05). Most frequently (25.1%) citizens contacted the call-center of the Ministry of Health Care of the Udmurt Republic due to inability to reach the polyclinic and on issues related to primary before-doctor care. The second place in terms of frequency (18.5%) took issues related to PCR-test results. The third place (14.1%) took issues related to duration of quarantine for patients and persons residing with them, possibility for children to attend preschool and educational institutions. The number of outgoing calling in 2020 was 16146, in 2021 – 89269 and in 2022 9936 calls. During 25 months of operation, call-center operators made 204,782 calls to citizens to monitor their health status and invite them to vaccinations and health screenings. More than half of outgoing calls (58.3%) were related to audio-monitoring of patients undergoing outpatient treatment with making-up of electronic protocol.

CONCLUSIONS: During the period of increasing of COVID-19 morbidity, the call-center becomes an independent structural unit of organizing patient care. The medical organizations and citizens are satisfied with functioning of the call-center of the Ministry of Health Care of the Udmurt Republic organized in order of improving the organization of medical care of patients with COVID-19.

PMID:38142327 | DOI:10.32687/0869-866X-2023-31-6-1301-1306

JPEN J Parenter Enteral Nutr. 2023 Dec 23. doi: 10.1002/jpen.2592. Online ahead of print.

ABSTRACT

BACKGROUND: Opioid-induced constipation (OIC) is a well-known phenomenon, although there is limited literature evaluating the incidence of OIC in children admitted to the pediatric intensive care unit (PICU). The primary aim of this study was to determine the incidence of OIC in the PICU and to determine if it is associated with a higher rate of morbidities or prolonged length of stay (LOS).

METHODS: We conducted a single-center retrospective chart review from July 1, 2014, to June 30, 2015, in our PICU. We included all patients 18 years and younger with a PICU stay of at least 96 hours, who received opioids during their admission. Data were collected on frequency of bowel movements and characteristics of opioid administration. Demographic and clinical data were obtained from Virtual PICU System, LLC.

RESULTS: Of the 94 patients who met study criteria, 39.4% developed constipation. These patients tended to be older (p=0.06) and were noted to weigh more (p=0.03). There was no significant difference in the total or median daily doses, duration of opioid treatment, or mode of administration. Constipation rates did not differ by severity of illness. There was a higher incidence of constipation in the patients who were admitted for neurological issues, or after trauma or abdominal surgery (p=0.002). Patients with constipation had longer LOS than patients without constipation, but the difference was not statistically significant.

CONCLUSION: These results indicate that opioid use is not the sole risk factor for constipation in the PICU setting. This article is protected by copyright. All rights reserved.

PMID:38142301 | DOI:10.1002/jpen.2592

Glob Health Promot. 2023 Dec 23:17579759231213852. doi: 10.1177/17579759231213852. Online ahead of print.

ABSTRACT

AIMS: The study aims to identify and compare health indicators collected by national research in Spain and in Brazil that can generate action strategies for health promoting universities.

METHODS: This is an epidemiological, descriptive, cross-sectional study that uses the database of the Secretariat of Health Surveillance of the Brazilian Ministry of Health and the database of the National Statistics Institute of Spain. Based on the National Health Promotion Policy, the analyzer axis prioritizes defined themes; percentage of physical exercise, daily smokers, sedentary lifestyle, obesity and self-perception of health status were evaluated. The data were collected from 2014 to 2020.

RESULTS: In Brazil, physical exercise is the highest percentage indicator, whereas in Spain, sedentary lifestyle is the highest. Regarding the age group, Brazil presented the lowest prevalence of daily smokers in the age group from 18 to 24, with little increase in older age groups; in Spain, older age groups presented the highest rates of sedentary lifestyle and obesity. In 2020, 4.5% of Brazilians reported a negative self-perception of health and in Spain 6.6%.

CONCLUSION: The indicators ‘physical exercise’, ‘daily smokers’ and ‘sedentary lifestyle’ presented better results in Brazil than in Spain. Brazil presents a better perspective on health when compared with Spain, as the results showed that older ages present higher rates of sedentary lifestyle and obesity. Our study results also show that Brazilians report better self-perception in health, which can be interpreted by health promotion strategies.

PMID:38142294 | DOI:10.1177/17579759231213852