Nevin Manimala

Nurse Educ Today. 2022 Feb 3;111:105295. doi: 10.1016/j.nedt.2022.105295. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to synthesise the best available evidence on the effectiveness of education interventions to teach evidence-based practice (EBP) on nurse-related and patient-related outcomes.

DESIGN: This is a systematic review and meta-analytic paper.

DATA SOURCES: Published and unpublished studies in English were searched from 10 databases from 2005 to 2021.

REVIEW METHODS: Randomised controlled trials (RCTs) and clinical controlled trials (CCTs) describing education interventions to improve EBP knowledge, skills, attitude, confidence and behaviours among nurses were eligible. Two reviewers independently screened, appraised and extracted data. Meta-analysis was conducted using a random-effect model to synthesise data using review manager software. Standardised mean difference (SMD) represented an effect measure. Heterogeneity was assessed using Cochran-Q square test and I square statistics. Subgroup and narrative synthesis were also conducted.

RESULTS: Ten studies (6 RCTs and 4 CCTs) were selected for this review. Results from a CCT suggested that education interventions improved EBP knowledge with a large effect size (SMD = 2.01). Education interventions also enhanced EBP skills (n = 1), combined knowledge/skills (SMD = 0.48, N = 5), attitude toward EBP (SMD = 0.39, N = 4), confidence to conduct EBP (SMD = 0.43, n = 1) and EBP behaviour (SMD = 0.26, n = 5). None of the studies used patient-related outcomes.

CONCLUSION: Overall, education interventions improved nurses’ EBP knowledge, skills, attitude, confidence and behaviour. EBP education interventions should be part of nurses’ professional development in clinical settings. The interventions may be delivered through combined lectures, group discussions, hands-on practice via face-to-face and/or online learning. Future research should test education interventions using RCTs, large sample size, and in-depth qualitative data.

PMID:35144204 | DOI:10.1016/j.nedt.2022.105295

Nurse Educ Today. 2022 Feb 2;111:105290. doi: 10.1016/j.nedt.2022.105290. Online ahead of print.

ABSTRACT

BACKGROUND: Recently, moral sensitivity and professional values have become increasingly important in nursing education and have been tried to be improved.

OBJECTIVES: To investigate the effects of an ethics laboratory program integrated with the fundamentals of nursing course on the moral sensitivity and professional values of nursing students.

DESIGN: The present study was designed as a randomized controlled study. The 8-week ethics laboratory program was applied to the students in the intervention group. In the ethics laboratory program, interactive education methods, such as ethical scenarios, case studies, roleplay, group discussions, project papers and watching movies, were applied. Control group received the standard fundamentals of nursing curriculum.

PARTICIPANTS: The sample size was determined using stratified block randomization method, and 100 nursing students were assigned to intervention (n = 50) and control group (n = 50).

RESULTS: There was no baseline difference between the groups. The moral sensitivity average of the students in the intervention (82.66 ± 12.57) was lower than the average of the control group (85.64 ± 16.83) after the ethics laboratory program; however, the difference was not statistically significant (p > .05). Similarly, there were no significant differences between the intervention (132.32 ± 16.83) and the control group (131.81 ± 20.55) regarding the average score of professional values. In the responsibility sub-dimension of professional values, there was a statistically significant increase in the intervention group (p < .05).

CONCLUSION: The findings suggest that the ethics laboratory program for nursing students is effective in promoting responsibility sub-dimension of professional values. However, there was no significant effect on students’ moral sensitivity and other dimensions of professional values. Further refinements of interventional research in ethics education and measurement of learning outcomes should be developed.

PMID:35144203 | DOI:10.1016/j.nedt.2022.105290

Int J Hyg Environ Health. 2022 Feb 7;241:113943. doi: 10.1016/j.ijheh.2022.113943. Online ahead of print.

ABSTRACT

In the first national human biomonitoring study in the Slovenian population of adults (18-49 years), including men (n = 297) and lactating primiparous women (n = 304), exposure to polycyclic aromatic hydrocarbons (PAHs) was evaluated. Nine urinary metabolites of four parent PAHs were determined. These included 1-hydroxypyrene (1-OHPYR), 2-hydroxynaphthalene (2-OHNAP), 2-hydroxyphenanthrene (2-OHPHE), 3-hydroxyphenanthrene (3-OHPHE), 4-hydroxyphenanthrene (4-OHPHE), a combination of 2-hydroxyfluorene and 3-hydroxyfluorene (2/3-OHFLU) and a combination of 1-hydroxyphenanthrene and 9-hydroxyphenanthrene (1/9-OHPHE). For comparison, the analysed phenanthrene metabolites were reported as a sum (ΣOHPHE = 1/9-OHPHE + 2-OHPHE + 3-OHPHE + 4-OHPHE) and all the analysed PAH metabolites were reported as a sum (ΣOHPAH = 1-OHPYR + 2/3-OHFLU + 2-OHNAP + ΣOHPHE). All metabolites or their combinations were determined in more than 91% of the samples, except 4-OHPHE, which was determined in only 5% of the samples. The highest concentration was found for 2-OHNAP. This was followed by 2/3-OHFLU and the phenanthrene metabolites, while the lowest concentration was determined for 1-OHPYR. Among the phenanthrene metabolites, the highest concentration was determined for 2-OHPHE, followed by 1/9-OHPHE and then by 3-OHPHE. Values in units of volume and values adjusted for specific gravity were significantly higher in men than in lactating primiparous women for all metabolites, whereas values in units adjusted for creatinine were generally higher in lactating primiparous women than in men. The difference between the two study groups, men and lactating primiparous women, was no longer significant in statistical models adjusted for specific gravity, suggesting that smoking, wood-burning exposure, and/or education largely explained the difference in PAH exposure in both study groups. For most metabolites, predictors of exposure were less significant in lactating primiparous women than in men. Also, site-specific patterns of exposure were observed, with additional predictors identified in certain areas, namely, proximity to roads and release of particulate matter (PM₁₀) from industry. The time of year in which sampling took place appeared to be an important determinant in urban areas and in the case of participants who used wood for heating. Specific dietary factors could not be identified, as the study questionnaire did not include information on PAH-related diet. Despite the low number of paired partners (women and men living in the same household, n = 84), significant positive correlations for all metabolites were observed. This indicated that 31%-56% of variability in exposure could be explained by shared exposure to sources within the households (such as diet and wood-burning-related determinants).

PMID:35144196 | DOI:10.1016/j.ijheh.2022.113943

Nurse Educ Pract. 2022 Feb 1;60:103305. doi: 10.1016/j.nepr.2022.103305. Online ahead of print.

ABSTRACT

AIM: The study aims to determine nursing and medical students’ preferences for assessment in education and factors affecting their preferences for assessment.

BACKGROUND: It is crucial to design the evaluation and evaluation processes in education to develop desired behaviours in education and to determine whether the intended goals in education have been achieved. In earlier studies on assessment practices affecting student learning and academic achievement, it has been emphasized that students’ preferences for assessment and different practices in assessment have a significant effect on their academic performance.

DESIGN: This research was designed as nonexperimental and quantitative research of correlational design with linear regression statistical analyses approach.

METHODS: The participants consisted of 641 students (including 169 medical students with 472 nursing students), who were volunteered to participate in the study and reached with the method of convenience sampling. The ‘Assessment Preferences Inventory’ adapted to Turkish by Gulbahar and Buyukozturk (2008) was used as a data collection tool. To analyze the data, descriptive statistics, the Mann-Whitney-U test, the Kruskal-Wallis test and logistic regression with Bonferroni correction to control the type I error were applied.

RESULTS: In the study, it was found that male students preferred alternative assessment methods and complex/constructive assessment more than female students and male students expected more questions assessing cognitive processes while female students needed more preparations for assessment. In addition, it was determined that medical students preferred complex/constructive assessment more; on the other hand, nursing students preferred simple-multiple choice assessment more and had the need for pre-assessment preparations more. Besides, it was detected that the variables of the students’ grade level had an impact on their assessment preferences and that there was a minimal relationship between the students’ age and academic achievement with their assessment preferences.

CONCLUSIONS: This study showed that the department, gender and grade level were effective on assessment preferences.

PMID:35144163 | DOI:10.1016/j.nepr.2022.103305

Tissue Cell. 2022 Feb 4;76:101752. doi: 10.1016/j.tice.2022.101752. Online ahead of print.

ABSTRACT

INTRODUCTION: BCC (Basal Cell Carcinoma) and trichoblastoma are skin tumors originating from the hair follicle. BCC is the most common non-melanoma skin cancer. Differential diagnosis of BCC from trichoblastoma, which is a common benign tumor in terms of histology, morphology, and immunohistochemistry, is not possible. The effects of adipokines on tumorigenesis have attracted attention.

MATERIALS AND METHODS: By examining the effects of Asprosin and Meteorine like peptide (METRNL) on these tumors, it is aimed to reach new information in the differential diagnosis of BCC and trichoblastoma. Twenty normal healthy tissue, 17 basal cell carcinoma and 12 trichoblastoma samples were included in the study.

RESULTS: Increased expression of Asprosin and METRNL was observed in tumor and stromal tissues in BCC. Although overexpression of METRNL was observed in the lesion area in trichoblastoma, no increase in Asprosin expression was observed. Asprosin and METRNL immunoreactivity were found to be statistically significantly higher in BCC samples compared to control and trichoblastoma.

CONCLUSION: Asprosin and METRNL can be used in the diagnosis of BCC. METRNL can be used in the diagnosis of trichoblastoma. These biomarkers are helpful for differentiation between BCC and trichoblastoma.

PMID:35144124 | DOI:10.1016/j.tice.2022.101752

Forensic Sci Int Genet. 2022 Feb 4;58:102675. doi: 10.1016/j.fsigen.2022.102675. Online ahead of print.

ABSTRACT

The possibility of providing investigative leads when conventional DNA identification methods fail to solve a case can be of extreme relevance to law enforcement. Therefore, the forensic genetics community has focused research towards the broadened use of DNA, particularly for prediction of appearance traits, bio-geographical ancestry and age. The VISible Attributes through GEnomics (VISAGE) Consortium expanded the use of DNA phenotyping by developing new molecular and statistical tools for appearance, age and ancestry prediction. The VISAGE basic tool for appearance (EVC) and ancestry (BGA) prediction was initially developed using Ampliseq chemistry, but here is being evaluated using ForenSeq chemistry. The VISAGE basic tool offers a total of 41 EVC and 115 BGA SNPs and thus provides more predictions, i.e., skin color, than achieved with the ForenSeq DNA Signature Prep kit that is based on 24 EVC and 56 BGA SNPs. Five VISAGE laboratories participated in collaborative experiments to provide foreground for developmental validation of the assay. Assessment of assay performance and quality metrics, reproducibility, sensitivity, inhibitor tolerance and species specificity are described. Furthermore, the assay was tested using challenging samples such as mock casework samples and artificially degraded DNA. Two different analysis strategies were applied for this study and output on genotype calls and read depth was compared. Overall, inter-laboratory, inter-method and concordance with publicly available data were analysed and compared. Finally, the results showed a reliable and robust tool, which can be easily applied for laboratories already using a MiSeq FGx with ForenSeq reagents.

PMID:35144074 | DOI:10.1016/j.fsigen.2022.102675

Pract Radiat Oncol. 2022 Feb 7:S1879-8500(22)00044-3. doi: 10.1016/j.prro.2022.01.005. Online ahead of print.

ABSTRACT

PURPOSE/OBJECTIVE(S): In patients with borderline resectable or locally advanced pancreatic adenocarcinoma (BRPC/LAPC), local failure rates after resection remain significant, even in the setting of neoadjuvant chemotherapy and radiation. Sub-optimal local control may relate to variable radiation target delineation, as no consensus exists around clinical tumor volume (CTV) design in this context. In the surgical literature, recent attention has been given to the “Triangle” volume (TV) as a source of subclinical, residual disease. In order to understand whether the TV can inform optimal CTV design, we mapped locoregional failures after resection in a large cohort of BRPC/LAPC patients and compared locations of failure to the TV.

MATERIALS/METHODS: Patients with BRPC/LAPC of the head/neck diagnosed between 2016-2019 who developed locoregional failure after surgery following neoadjuvant chemotherapy and radiation were identified. Descriptive statistics were generated to report the frequency of locoregional failures located within the TV and the frequency of new vascular involvement at time of failure, as compared to vascular involvement at diagnosis. Additionally, dosimetric coverage of the TV with the pre-operative radiation plan that had been utilized was assessed.

RESULTS: In 31 patients who experienced locoregional failure, the centroid of failure was located within the TV in 28 cases (90%). Extent of vascular involvement at time of locoregional failure included vasculature that had not been involved at diagnosis in 13 cases (42%). The pre-operative radiation plan that had been utilized provided a median V33 Gy and V25 Gy of the TV of only 53% (IQR: 34-72%) and 70% (IQR: 48-85%), respectively.

CONCLUSION: The TV encompassed the vast majority of locoregional failures, but dosimetric coverage of the TV was poor when only targeting gross disease and the full circumference of involved vasculature. As such, the TV may better serve as a basis for CTV design in BRPC/LAPC patients undergoing neoadjuvant radiation.

PMID:35144016 | DOI:10.1016/j.prro.2022.01.005

J Mother Child. 2022 Feb 8. doi: 10.34763/jmotherandchild.20212503SI.d-21-00013. Online ahead of print.

ABSTRACT

BACKGROUND: The paper focuses on Bulgarian adolescents’ behaviours that put their health at risk and their relationship to family-related characteristics: structure of family and material status, family support, communication with parents, parental monitoring and school-related parental support. It also discusses intervention programs with a focus on parent support gradient.

MATERIAL AND METHODS: The analysis is based on the Bulgarian sample of Health Behaviour in School-Aged Children survey, the 2018 round. Logistic regression models of current cigarette smoking, regular alcohol consumption, sexual debut and current cannabis use are applied. Main national programs on adolescent health and the parental involvement component in them are also discussed.

RESULTS: The statistical analyses reveal significant gender and age differences in Bulgarian adolescents’ health risk behaviours. Girls have significantly higher odds of smoking and are less likely to report an early start of sexual life. Odds of cigarette smoking and regular alcohol consumption increase with age. Children living with one parent have significantly higher odds of smoking, regular alcohol consumption and current cannabis use. Interactions between FAS and family support reveal that students who report low family support, regardless of the material status of the family, have significantly higher odds of health risk behaviours.

CONCLUSION: The main contribution of the analysis reveals the alleviating effect of family support on socio-economic inequalities between families. An evidence-based approach delineating a preventive potential of family support on Bulgarian adolescents’ health risk behaviours despite the level of family affluence provides solid arguments for increasing national family support programs.

PMID:35143718 | DOI:10.34763/jmotherandchild.20212503SI.d-21-00013

CPT Pharmacometrics Syst Pharmacol. 2022 Feb 10. doi: 10.1002/psp4.12765. Online ahead of print.

ABSTRACT

Promising drug development efforts may frequently fail due to unintended adverse reactions. Several methods have been developed to analyze such data, aiming to improve pharmacovigilance and drug safety. In this work, we provide a brief review of key directions to quantitatively analyzing adverse events and explore the potential of augmenting these methods using additional molecular data descriptors. We argue that molecular expansion of adverse event data may provide a path to improving the insights gained through more traditional pharmacovigilance approaches. Examples include the ability to assess statistical relevance with respect to underlying biomolecular mechanisms, the ability to generate plausible causative hypotheses and/or confirmation where possible, the ability to computationally study potential clinical trial designs and/or results, as well as the further provision of advanced features incorporated in innovative methods, such as machine learning. In summary, molecular data expansion provides an elegant way to extend mechanistic modeling, systems pharmacology, and patient centered approaches for the assessment of drug safety. We anticipate that such advances in real world data informatics and outcome analytics will help to better inform public health, via the improved ability to prospectively understand and predict various types of drug-induced molecular perturbations and adverse events.

PMID:35143713 | DOI:10.1002/psp4.12765

Clin Transplant. 2022 Feb 10:e14611. doi: 10.1111/ctr.14611. Online ahead of print.

ABSTRACT

Lay-caregivers in organ transplantation (to candidates, recipients, and donors) are essential to pre- and post-operative care, but report significant caregiving-related stressors. This review aims to summarize studies testing non-pharmacological interventions aimed at improving organ transplant caregiver-reported outcomes.

METHODS: In accordance with PRISMA, we conducted a systematic review (searched PubMed, Embase, Cochrane Central, PsycInfo, and CINAHL, no start-date restriction through 7/1/2021). Quality of comparative studies assessed by ROBS-2 or ROBINS.

RESULTS: Twelve studies met inclusion. Study designs, interventions, and outcomes varied. Sample sizes were small across caregivers to adult (nine studies, five with caregiver samples ns≤50) and pediatric patients (three studies, caregiver samples ns≤16). Study designs included seven single-arm interventions, two pre-post with comparison cohorts, and three randomized-controlled trials. Eight studies included transplant-specific education as the intervention, an interventional component, or as the comparison group. Outcomes included transplant specific knowledge, mental health, and intervention acceptability. Of the nine pre-post caregiver assessments and/or comparison groups, four studies demonstrated no statistically significant intervention effects.

CONCLUSION: Few interventions addressing the needs of organ transplant caregivers have been empirically evaluated. Existing interventions were well-received by caregivers. Given complexities of care in transplantation, research is needed evaluating interventions using rigorous trial methodology with adequate samples. This article is protected by copyright. All rights reserved.

PMID:35143701 | DOI:10.1111/ctr.14611