Nevin Manimala

J Prof Nurs. 2021 Mar-Apr;37(2):249-254. doi: 10.1016/j.profnurs.2020.12.015. Epub 2020 Dec 29.

ABSTRACT

BACKGROUND: Food insecurity, the limited or uncertain availability of food, is reported in college students, but little is known about its prevalence in nursing students. Nursing students have extensive required clinical hours limiting their ability to work and spend money on academic and living expenses before spending on food.

PURPOSE: To estimate the prevalence of food insecurity and characterize its relationship to social support and first-generation status among nursing students at a public university.

METHODS: A cross-sectional survey study design was used to assess food security and social support in full-time nursing students (n=55).

RESULTS: The prevalence of food insecurity reported by the survey respondents was 60%. Statistically significant correlations between food security and social support scores were found; as food security worsened, so did social support. Food-insecure students had lower grade point averages, and first-generation students (p=.001) reported food insecurity more frequently than did other participants.

CONCLUSIONS: Findings support that food insecurity is negatively associated with academic performance, and level of social support may impact food insecurity in nursing students. Nursing programs should consider early assessments of cohorts to increase the potential for early intervention with food-insecure students. Collaboration with university-based food pantries and student engagement in hunger initiatives through the Student Nurses Association can support early interventions.

PMID:33867076 | DOI:10.1016/j.profnurs.2020.12.015

Curr Pharm Teach Learn. 2021 Jun;13(6):711-716. doi: 10.1016/j.cptl.2021.01.029. Epub 2021 Feb 11.

ABSTRACT

BACKGROUND AND PURPOSE: Mental health stigma among healthcare providers remains a significant barrier to patients receiving optimal care for psychiatric conditions. This study’s purpose is to evaluate the impact of a psychiatry elective on pharmacy students’ attitudes toward patients with mental health disorders.

EDUCATIONAL ACTIVITY AND SETTING: This study cohort included pharmacy students enrolled in a Special Topics in Psychiatry elective. Attitudes toward mental health disorders were measured at baseline (first day of class) and post-exposure (last day of class) using the 21-item Beliefs toward Mental Illness (BMI) Scale. Wilcoxon signed-rank tests were used to compare each component of the BMI scale as well as each subscale (dangerousness, poor social and interpersonal skills, and incurability) at baseline and post-exposure.

FINDINGS: Fifty-eight pharmacy students (68% response rate) participated in this study. Most respondents were in their first year of the pharmacy program (44%), female (72%), and Asian (59%). There was a statistically significant decline in each BMI subscale at the end of the course: dangerousness, poor interpersonal and social skills, and incurability. There was no significant difference in mean change for the BMI sub-scores by gender, race, or personal experience with mental health disorders.

SUMMARY: Incorporating a psychiatry elective into the pharmacy school curriculum can improve attitudes toward patients with mental health disorders. Future areas of research are warranted on the influence of specific components of a psychiatry elective that impact BMI scores and whether this translates to improved quality of care during clinical practice.

PMID:33867069 | DOI:10.1016/j.cptl.2021.01.029

Curr Pharm Teach Learn. 2021 Jun;13(6):705-710. doi: 10.1016/j.cptl.2021.01.030. Epub 2021 Feb 3.

ABSTRACT

INTRODUCTION: The purpose of this analysis was to determine which characteristics increase a candidate’s likelihood of matching with a post-graduate year 1 (PGY1) community-based residency program (CBRP).

METHODS: Current and former CBRP residents’ curriculum vitae (CVs) were collected and reviewed utilizing a survey and standardized rubric. Eligible participants were current PGY1 CBRP residents or had completed a PGY1 program no earlier than 2015. Primary endpoints included number of participants with extensive leadership experience, relevant experiential rotations, presentation history, and involvement in pharmacy organizations. Descriptive statistics were performed to identify the most common characteristics and their relative quantities.

RESULTS: A total of 50 eligible CVs were submitted and reviewed. The majority of participants had extensive (defined as four or more) presentation experiences, at least three mid- to high-level leadership experiences, multiple ambulatory/outpatient pharmacy experiential rotations, and involvement in pharmacy organizations. Few participants (26%) had previous teaching experience.

CONCLUSIONS: Residency candidates who matched with CBRPs tended to have extensive mid- to high-level leadership experiences and presentation experience. Based on these findings, additional studies are warranted to compare existing and/or redesigned postgraduate training preparation curricula and their impact on residency match rates.

PMID:33867068 | DOI:10.1016/j.cptl.2021.01.030

Curr Pharm Teach Learn. 2021 Jun;13(6):699-704. doi: 10.1016/j.cptl.2021.01.038. Epub 2021 Feb 2.

ABSTRACT

INTRODUCTION: Canadian pharmacy students have varied exposure within their academic curricula and limited opportunities for hands-on preventative health experiences prior to practicums. We aimed to explore pharmacy student perceptions of readiness to engage in patient education and assessment activities in health promotion events.

METHODS: Under licensed pharmacist supervision, volunteer pharmacy students delivered health promotion events to University of British Columbia staff and faculty between 2017 and 2020. Students attended a one-hour, group training session with a licensed pharmacist prior to participating in four hours of service delivery. Post-event, anonymous, electronic surveys were emailed to student participants to gauge perceived change(s) in knowledge and skill development as a result of participation. Data analysis was by descriptive statistics.

RESULTS: Surveys were sent to 151 pharmacy student volunteers from 2017 to 2020. A total of 69 responses were received (response rate = 45.7%), 60 of which were complete (completion rate = 39.7%). Overall, students reported a shift from feeling competent to confident in the various domains assessed as a result of participation. The majority of students strongly agreed or agreed that they were well-prepared for the event and felt supported by pharmacist supervisors.

CONCLUSIONS: Pharmacy students felt that participation in a brief preventative health and wellness intervention increased confidence in knowledge and patient care skills, regardless of year of study. Early exposure to health promotion activities may accelerate and enhance clinical abilities of pharmacy students while preparing them for expanding pharmacist roles.

PMID:33867067 | DOI:10.1016/j.cptl.2021.01.038

Curr Pharm Teach Learn. 2021 Jun;13(6):694-698. doi: 10.1016/j.cptl.2021.01.031. Epub 2021 Feb 5.

ABSTRACT

INTRODUCTION: This study sought to assess the impact student pharmacist-led health outreach events had on participants in the Health Belief Model domains of perceived severity of disease, perceived barriers, perceived benefits, and self-efficacy.

METHODS: This study was an observational pre-/post-survey design conducted between January and December 2019 at student pharmacist-led community health outreach events in the Salt Lake City, Utah metropolitan area. The survey was developed partially based on the Health Belief Model and consisted of seven items with a five-point Likert scale (1 = strongly disagree to 5 = strongly agree). The survey was completed by participants before and immediately after engaging in the outreach event.

RESULTS: A total of 31 participants across a variety of demographics and educational backgrounds completed the study. The surveys from the outreach events showed statistically significant increases in the participants’ perceived severity of disease, perceived barriers, and self-efficacy. Perceived benefits was not significantly changed.

CONCLUSIONS: Student pharmacist-led community health outreach events significantly increase participants’ perceived severity of disease, perceived barriers, and self-efficacy, which may indicate increased willingness to adopt the recommended health behavior.

PMID:33867066 | DOI:10.1016/j.cptl.2021.01.031

Singapore Med J. 2021 Apr 16. doi: 10.11622/smedj.2021031. Online ahead of print.

ABSTRACT

INTRODUCTION: Medullary breast carcinomas (MBCs) are distinguished by circumscribed, high-grade morphology with dense chronic inflammation; they are associated with the basal phenotype but have a relatively good prognosis.

METHODS: This study aimed to review the clinicopathological features of MBCs diagnosed at the Department of Pathology, Singapore General Hospital and correlate them with immunohistochemical expression of hormonal markers and c-erbB-2, the basal markers p53, cytokeratin (CK) 14, epidermal growth factor receptor (EGFR) and 34BE12, and the follow-up outcome.

RESULTS: Using Ridolfi’s criteria for histologic reviews, 62 patients previously diagnosed as having ‘typical MBC’ (n = 26), ‘atypical MBC’ (n = 32) and ‘invasive carcinoma with focal medullary-like features’ (n = 4) were re-classified as follows: ‘typical MBC’ (n = 6; 9.7%), ‘atypical MBC’ (n = 46; 74.2%), and ‘non-medullary infiltrating carcinoma’ (n = 10; 16.1%). Clinicopathological parameters, including ethnicity, age, tumour size and concurrent ductal carcinoma in situ (DCIS), showed no statistically significant correlation with review diagnoses and immunohistochemical findings. Presence of lymphovascular invasion and nodal stage were significantly correlated with recurrence and breast cancer-related deaths, respectively. ER negativity was significantly correlated with triple positivity for basal markers CK14, EGFR and 34BE12, which comprised patients who showed a significantly decreased disease-free survival rate within a 10-15-year follow-up period.

CONCLUSION: Lymphovascular invasion and high nodal stage as well as triple negativity among typical and atypical MBCs that have basal-like phenotype represent a portion of invasive carcinomas with medullary features that may have poor outcomes in this otherwise relatively good prognostic group.

PMID:33866710 | DOI:10.11622/smedj.2021031

Int J Adolesc Med Health. 2021 Apr 15. doi: 10.1515/ijamh-2021-0018. Online ahead of print.

ABSTRACT

OBJECTIVES: Emerging evidence reveals disparities in suicidal behaviour and ideation exist between transgender and cisgender youth. It has been hypothesized that certain gender minority specific risk factors, such as experiences of victimization, could partially explain the mental health disparities between transgender and cisgender youth. We set out to explore whether transgender identity is associated with severe suicidal ideation among Finnish adolescents and whether the possible association persist when a range of covariates is controlled for.

METHODS: The study included 1,425 pupils (mean age [SD]=15.59 [0.41]) who participated in the study during a school lesson. Logistic regression was used to study associations between transgender identity and severe suicidal ideation.

RESULTS: Four models, each adding more covariates, were created. The final model revealed a statistically significant association between transgender identity and severe suicidal ideation, even though the association grew weaker as more covariates were added and controlled for.

CONCLUSIONS: The results indicate that transgender identity is associated with severe suicidal ideation even after prominent covariates or risk factors of suicidal behaviour and ideation have been taken into account.

PMID:33866702 | DOI:10.1515/ijamh-2021-0018

J Esthet Restor Dent. 2021 Apr 18. doi: 10.1111/jerd.12733. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze translucency variations among four different contemporary esthetic ceramic systems having different shades and thicknesses.

MATERIAL AND METHODS: Ceramic specimens having different shades and translucencies were tested: leucite reinforced glass-ceramic (ECAD), conventional feldspathic ceramic (Noritake), zirconia reinforced lithium silicate glass-ceramic (Suprinity) and hybrid ceramic (Enamic). Specimens of 0.6, 0.9, 1.2, 1.5 and 2.0-mm thickness (n = 3/group, 615 total) were prepared. Translucency (TP) and Relative Translucency (RTP) Parameters were calculated from spectroradiometric color readings. Effects of shade and thickness for a given system were statistically analyzed using MANOVA and Tukey post-hoc multiple comparisons tests. Translucency variations were assessed comparatively with literature-based perceptibility and acceptability thresholds.

RESULTS: TP/RTP values of all ceramic materials decreased with increasing thickness. The most translucent specimens were 0.6-mm thick ECAD HT-A3.5 (TP = 31.99) and ECAD HT-C2 (RTP = 23.75), while the least translucent was 2-mm thick Enamic T-3 M2 (TP = 7.27; RTP = 4.79). Thickness and material type significantly influenced translucency (p < 0.001). Noritake and ECAD LT showed similar translucency values, as well as Suprinity HT and ECAD LT.

CONCLUSIONS: For ceramic restorations thicker than 0.9-mm, any thickness increase of 0.3-0.5 mm produces a perceptible but clinically acceptable translucency variation. Increases in thickness larger than 0.6-mm will result in an unacceptable translucency shift. Dental practitioners need to recognize key factors that influence translucency of ceramic restorations in order to choose the optimal material, shade, translucency, and thickness suitable for different clinical scenarios. While shade plays a minor role in translucency variation, ceramic type and restoration thickness significantly affect overall translucency.

PMID:33866673 | DOI:10.1111/jerd.12733

Int J Dent Hyg. 2021 Apr 18. doi: 10.1111/idh.12505. Online ahead of print.

ABSTRACT

OBJECTIVES: This clinical investigation examined the effects of brushing with a test toothpaste containing natural ingredients i.e., Clove (Syzgium Aromaticum), Aloe Vera (Aloe Barbadensis), Amla (Emblica Officinalis), Neem (Azadirachta Indica), Tulsi (Ocimum Basillicum) and Honey (from Apis Mellifera) along with zinc salts and fluoride in comparison to a dentifrice formulated with fluoride alone on dental plaque and gingivitis over a 6-month period.

MATERIALS & METHOD: One-hundred-eighty (180) subjects with mean plaque index scores greater than 1.5 (Turskey Modified Quigley Hein Plaque Index) and gingival index scores greater than 1.0 (Loe and Sillness gingival index) in good general health and who met other study criteria were enrolled in the clinical study. Subjects were evaluated for plaque, gingival index scores and were randomly assigned to perform twice daily oral hygiene with either the test or the control toothpaste for the next six months. One-hundred-fifty (150) subjects [test toothpaste (n=72) and control toothpaste (n=78)] completed the 6 month clinical study with evaluable data. Post treatment assessments identical to baseline were conducted after 3 months and 6 months use of assigned product after subjects refrained from oral hygiene for 12 hours prior to each evaluation. Comparisons of the treatment groups with respect to baseline-adjusted gingival, plaque and bleeding index scores at the follow-up examinations were performed using Analyses of Covariance (ANCOVA). All statistical tests of hypotheses were two sided, and employed a level of significance of p<0.05.

RESULTS: No significant intergroup differences were noted between treatment groups for age and gender by two sample t-test and chi-square analyses respectively (p>0.05). Further the treatment groups demonstrated no differences at baseline for plaque, gingival and bleeding index scores by a two sample t test (p>0.05). At 3 month and 6 month examination, the test toothpaste exhibited progressive reductions in plaque, gingival and bleeding scores as compared to control toothpaste as showed by ANCOVA (p<0.001). In comparison to the control, the test demonstrated reductions of 23.5%, 25.6% and 73.3% for dental plaque, gingival index and bleeding index outcomes respectively at the final visit. Reductions in the frequencies of sites with higher clinical scores were noted over the study with more sites registering improvements in the test group than in the control.

CONCLUSIONS: Routine oral hygiene with the test toothpaste formulated with herbal ingredients and zinc demonstrated a clinical adjunctive improvement in oral hygiene and parameters of gingival health as compared to brushing with a fluoride toothpaste.

PMID:33866666 | DOI:10.1111/idh.12505

Int J Clin Pract. 2021 Apr 18:e14232. doi: 10.1111/ijcp.14232. Online ahead of print.

ABSTRACT

BACKGROUND: Acute appendicitis (AA) is the most common cause of surgery performed for acute abdomen. The standard treatment for AA patients has been appendectomy for more than a century. Use of broad-spectrum antibiotics, the medical treatment option has come to the fore in the treatment of uncomplicated AA.

AIM: Evaluate whether White Blood Cell (WBC), platelet count, Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Red Cell Distribution Width (RDW) and C-reactive protein (CRP) values of patients diagnosed with uncomplicated AA clinically, with laboratory tests and radiologically with abdominal computed tomography (CT) could be a marker for choosing medical or surgical treatment.

MATERIALS AND METHODS: 519 patients aged between 20 and 65 years who were diagnosed with uncomplicated AA by abdominal CT in our centre between January 2016 and January 2019 were retrospectively analysed. The presence of at least one of the criteria of 7 mm or more appendix diameter and oedema or fluid accumulation around the appendix was accepted as uncomplicated AA. After the diagnosis of AA, 223 patients were treated medically, while 296 patients underwent laparoscopic appendectomy. The first group included patients who were treated medically and the second group included patients who underwent laparoscopic appendectomy.

RESULTS: Group 2 patients had higher mean platelet count (p <.005) and RDW (p = .003) values compared to Group 1 patients, while mean PDW (p <.001) values were lower compared to those of Group 1 patients. The differences between the mean WBC, CRP and MPV values of the groups were not statistically significant (p>0.05).

CONCLUSIONS: Recently, studies supporting antibiotic therapy have been conducted in patients diagnosed with AA. As a result, we think that PDW, RDW, and platelet values in patients diagnosed with uncomplicated AA may be a guide in choosing patients to be treated with surgery or antibiotics.

PMID:33866650 | DOI:10.1111/ijcp.14232