Nevin Manimala

Int J Nurs Stud. 2021 Mar 3;118:103921. doi: 10.1016/j.ijnurstu.2021.103921. Online ahead of print.

ABSTRACT

INTRODUCTION: Monitoring vital signs in hospital is an important part of safe patient care. However, there are no robust estimates of the workload it generates for nursing staff. This makes it difficult to plan adequate staffing to ensure current monitoring protocols can be delivered.

OBJECTIVE: To estimate the time taken to measure and record one set of patient’s vital signs; and to identify factors associated with the time required to measure and record one set of patient’s vital signs.

METHODS: We undertook a time-and-motion study of 16 acute medical or surgical wards across four hospitals in England. Two trained observers followed a standard operating procedure to record the time taken to measure and record vital signs. We used mixed-effects models to estimate the mean time using whole vital signs rounds, which included equipment preparation, time spent taking vital signs at the bedside, vital signs documentation, and equipment storing. We tested whether our estimates were influenced by nurse, ward and hospital factors.

RESULTS: After excluding non-vital signs related interruptions, dividing the length of a vital signs round by the number of vital signs assessments in that round yielded an estimated time per vital signs set of 5 min and 1 second (95% Confidence Interval (CI) = 4:39-5:24). If interruptions within the round were included, the estimated time was 6:26 (95% CI = 6:01-6:50). If only time taking each patient’s vital signs at the bedside was considered, after excluding non-vital signs related interruptions, the estimated time was 3:45 (95% CI = 3:32-3:58). We found no substantial differences by hospital, ward or nurse characteristics, despite different systems for recording vital signs being used across the hospitals.

DISCUSSION: The time taken to observe and record a patient’s vital signs is considerable, so changes to recommended assessment frequency could have major workload implications. Variation in estimates derived from previous studies may, in part, arise from a lack of clarity about what was included in the reported times. We found no evidence that nurses save time when using electronic vital signs recording, or that the grade of staff measuring the vital signs influenced the time taken.

CONCLUSIONS: Measuring and recording vital signs is time consuming and the impact of interruptions and preparation away from the bedside is considerable. When considering the nursing workload around vital signs assessment, no assumption of relative efficiency should be made if different technologies or staff groups are deployed.

PMID:33812297 | DOI:10.1016/j.ijnurstu.2021.103921

Vet Microbiol. 2021 Mar 19;256:109040. doi: 10.1016/j.vetmic.2021.109040. Online ahead of print.

ABSTRACT

The objective of this study was to evaluate the efficacy of ultraviolet C light (UVC) for inactivating Senecavirus A (SVA) on three different experimentally contaminated surfaces commonly found in swine farms. An experimental study under controlled conditions assessed the effect of UVC on an SVA isolate on coupons composed of three surface types: cardboard, cloth, and plastic. Each coupon was inoculated with 2 mL of SVA (10^7.5 TCID₅₀/mL) and 1 mL of PBS or 1 g of feces on the top or bottom surface of the coupon and allowed to dry (90 min at 25℃). Coupons were exposed to UVC in a commercially available pass-through chamber (PTC) for 5 min or in a simulated supply entry room (SER) for 120 min. After exposure, virus isolation was attempted from each coupon and virus titers were determined in cell culture. The efficacy of UVC was determined by the reduction in virus titer for the UVC treated groups compared to their respective non-treated positive controls. UVC was effective at inactivating SVA on plastic surface free of organic material. The plastic coupons inoculated with SVA and PBS had a significantly lower virus titer (>7-log reduction) in both the PTC and SER when compared to their relative positive controls. All other groups in the PTC and SER had a 2-log reduction or less. The reduction in virus titer on the top and bottom inoculated surfaces, following exposure to UVC, were not statistically different. The data from this study provide some guidance when applying UVC for disinfection in the field.

PMID:33812295 | DOI:10.1016/j.vetmic.2021.109040

Res Vet Sci. 2021 Mar 26;136:416-421. doi: 10.1016/j.rvsc.2021.03.022. Online ahead of print.

ABSTRACT

Reliability of canine plasma amino acid analysis depends on sample stability which can be influenced by pre-analytical handling techniques, storage temperature, storage time, and deproteinization status. Extrapolating data to dogs from research in other species is limited given discordant methodology and interspecies differences. The present study investigated the effects of deproteinization status (non-deproteinized or deproteinized) and storage temperature (at -20 °C or – 80 °C) on the concentration of 22 canine plasma amino acids during a 300-day storage period. Storage time had a significant effect (p < 0.05) of overall declining concentration of most amino acids. Compared to non-deproteinized samples, deproteinization contributed to overall higher concentrations of cyst(e)ine and glutamic acid, and consistently modified the effect of storage time and temperature on cyst(e)ine, glutamic acid, and glutamine. Compared to -20 °C, storage at -80 °C contributed to a higher concentration of cyst(e)ine and glutamic acid, and modified the effect of storage time on arginine, glutamic acid, glutamine, and tryptophan. Storage time had a consistent, significant effect on amino acid concentrations in canine plasma samples. Although sample deproteinization and low storage temperature modified the effect of storage time, these interactions were variable among analyzed amino acids. Therefore, timely sample analysis is recommended. If delayed sample analysis is inevitable, deproteinization should be performed prior to sample banking to preserve amino acid stability.

PMID:33812284 | DOI:10.1016/j.rvsc.2021.03.022

J Affect Disord. 2021 Mar 27;287:293-300. doi: 10.1016/j.jad.2021.03.067. Online ahead of print.

ABSTRACT

BACKGROUND: College students are at-risk populations of mental health problems and risky sexual behaviors. However, little literature focuses on the association between mental health problems and risky sexual behaviors. Our study examined the association between mental health problems (depressive symptoms, suicide, and mental disorders) and risky sexual behaviors among a large sample of Chinese college students.

METHODS: A total of 49,728 Chinese college students (47.5% male) eventually participated in the analysis. A self-administered questionnaire was used to measure mental health, risky sexual behaviors (casual sex, no condom use at last sexual intercourse, group-sex, and a high number of sexual partners), and other sociodemographic characteristics. Logistic regression analysis was used to explore the relationship between mental health and risky sexual behaviors. To ensure the data is representative of the nation’s statistics, all analyses were weighed.

RESULTS: The prevalence of depressive symptoms, suicide ideation and suicide attempts, and mental disorders was 42.83%, 41.29%, and 7.74%, respectively. 26.13% of participants were sexually active in the previous twelve months. Nearly 35% of sexually active participants were engaged in risky sexual behaviors. Logistic regression results demonstrated that mental health problems were associated with risky sexual behaviors after adjusting confounders.

LIMITATIONS: cross-sectional analysis; The self-reported variables may be subject to recall bias and fraud.

CONCLUSIONS: There is a relatively high prevalence of mental health problems and risky sexual behaviors amongst Chinese college students. A significant association between mental health problems and risky sexual behaviors was suggested by our study. Our findings support the importance of advocating for mental and reproductive healthcare for college students.

PMID:33812242 | DOI:10.1016/j.jad.2021.03.067

J Clin Anesth. 2021 Mar 29;71:110258. doi: 10.1016/j.jclinane.2021.110258. Online ahead of print.

NO ABSTRACT

PMID:33812212 | DOI:10.1016/j.jclinane.2021.110258

Am J Otolaryngol. 2021 Mar 22;42(5):103000. doi: 10.1016/j.amjoto.2021.103000. Online ahead of print.

ABSTRACT

OBJECTIVES: Failures in communication are a leading contributor to medical error. There is increasing attention on cultivating robust communication practices in the Operating Room (OR) to mitigate against patient injury and optimize efficient patient care. Few studies have evaluated how surgical equipment may introduce barriers to team dynamics.

DESIGN: We conducted a pilot observational study to examine the relationship between anesthesia screen drapes (which are used inconsistently) and the frequency of verbal exchanges between surgical and anesthesia members. 25 procedures spanning various procedures in Otolaryngology were covertly observed, 12 of which employed a screen. Verbal exchanges were recorded across three stages of the surgery: pre-procedure (before the draping), procedure (drapes placed throughout) and post-procedure (after the removal of the draping). Speaker and content of the exchange was noted as well as various features about the procedure.

RESULTS: Decreases in rates of exchanges were most pronounced during the procedure stage, although they did not reach significance on T-testing (p = 0.0719). After controlling for attending, table orientation and number of professionals, regression analysis did reveal a statistically significant decrease in rates of verbal exchanges during the procedure in the presence of the anesthesia screen (7.17 (± 6.33) versus 2.23 (± 1.00), p = 0.0318). Differences were also significant among surgeon-initiated and patient-care-related exchanges (p = 0.0168 and p = 0.0432, respectively). Decreases in anesthesiologist-initiated and non-clinical exchanges did not reach significance (p = 0.1530 and p = 0.5120, respectively).

CONCLUSION: This pilot study suggests that anesthesia screens may negatively impact communication practices in the OR.

PMID:33812208 | DOI:10.1016/j.amjoto.2021.103000

Sleep Med. 2021 Mar 13;81:358-364. doi: 10.1016/j.sleep.2021.03.006. Online ahead of print.

ABSTRACT

This study was conducted with 39 inpatients diagnosed with IBD in the gastroenterology department of Samsun Ondokuz Mayis University Health Application and Research Center to evaluate the relationship between chronotype and biochemical findings, nutrition, and gastrointestinal symptoms in patients with inflammatory bowel disease. The data were collected using a general information form, Food Frequency Questionnaire, Gastrointestinal Symptom Rating Scale, and Morning-Evening Questionnaire. The biochemical findings of the patients were obtained from the medical records. Statistical analysis of the patients included in the study was performed with the SPSS package program. For all analyses, p < 0.05 was considered statistically significant. Twenty-eight patients were diagnosed with ulcerative colitis and 11 with Crohn’s disease. There was a significant relationship between chronotype and daily polyunsaturated fatty acid and vitamin B₆ intake in female subjects (p < 0.05). There was also a significant relationship between chronotype and percentage of carbohydrate consumed, polyunsaturated and saturated fatty acid intake in male subjects (p < 0.05). A significant relationship was found between chronotype and serum glucose, hematocrit, magnesium, and iron levels (p < 0.05). It was determined that while E-type had higher glucose and magnesium levels; M-type had higher hematocrit and iron levels. It was observed that there was a relationship between chronotype and biochemical findings and nutrition in patients with IBD. Chronotype is easy to determine and these results show that it should be considered as a factor when evaluating nutrition and clinical status in patients with IBD.

PMID:33812204 | DOI:10.1016/j.sleep.2021.03.006

Clin Biomech (Bristol, Avon). 2021 Mar 23;84:105337. doi: 10.1016/j.clinbiomech.2021.105337. Online ahead of print.

ABSTRACT

BACKGROUND: Leg stiffness is important during running to increase velocity and maximise efficiency by facilitating use of the stretch-shortening cycle. Children with cerebral palsy who have neuromuscular impairments may have altered leg stiffness. The aim of this study was to describe leg stiffness during running in typically developing children and those with cerebral palsy in Gross Motor Function Classification Scale levels I and II at a range of speeds.

METHODS: This cross-sectional study examined kinematic data collected from typically developing children (n = 21) and children with cerebral palsy (Gross Motor Function Classification Scale level I n = 25, Gross Motor Function Classification Scale level II n = 13) during jogging, running and sprinting. Derived variables were resultant ground reaction force, change in leg length and three-dimensional leg stiffness. Linear mixed models were developed for statistical analysis.

FINDINGS: Children with cerebral palsy had reduced stiffness when jogging (Gross Motor Function Classification Scale level I affected t = 3.81 p < 0.01; non-affected t = 2.19 p = 0.03; Gross Motor Function Classification Scale level II affected t = 2.04 p = 0.04) and running (Gross Motor Function Classification Scale level I affected t = 3.23 p < 0.01) compared to typically developing children. Affected legs were less stiff than non-affected legs only in Gross Motor Function Classification Scale level I during running (t = 2.26 p = 0.03) and sprinting (t = 2.95 p < 0.01).

INTERPRETATION: Children with cerebral palsy have atypical leg stiffness profiles which differ according to functional classification.

PMID:33812200 | DOI:10.1016/j.clinbiomech.2021.105337

Food Chem. 2021 Mar 26;356:129603. doi: 10.1016/j.foodchem.2021.129603. Online ahead of print.

ABSTRACT

This work investigated the effect of sprouting and drying post-sprouting on technological functionalities of sorghum flour as probed by Low-resolution Proton Nuclear Magnetic Resonance (¹H NMR) and Dynamic Mechanical Analysis (DMA). Multivariate statistics were used to assess the effect of flour (from sprouted and unsprouted sorghum, and wholewheat) and hydration level on flour-water systems molecular and viscoelastic properties. Overall, sorghum-based systems showed greater molecular mobility explaining poorer viscoelastic properties than those obtained from wheat. Sprouting affected the molecular properties of sorghum flour-water systems, while no differences were observed in the two sprouted samples dried in different conditions. However, sprouting did not affect the viscoelastic properties of sorghum-water systems. These results bolster the use of sprouted sorghum in composite flours for the development of sustainable finished products with high nutritional value and satisfactory technological and organoleptic properties.

PMID:33812195 | DOI:10.1016/j.foodchem.2021.129603

Food Chem. 2021 Mar 23;356:129670. doi: 10.1016/j.foodchem.2021.129670. Online ahead of print.

ABSTRACT

A closed-vessel microwave-assisted extraction (MAE) of simmondsins and polyphenols from defatted Jojoba cake using Box-Benkhen design with four independent variables (solvent/cake ratio, ethanol concentration, extraction time and microwave power) was investigated. ANOVA results showed that the obtained models were significant at 95% confidence level. Optimal extraction conditions were found for highest values of microwave power (500 W) and extraction time (15 min) and for moderate values of solvent to cake ratio (41 – 45 mL/g). Optimum simmondsins yield (23.35%) was obtained with pure water as solvent. However, optimum polyphenols yield (2.33%) and ORAC antioxidant activity (656 µmol TE/g) were obtained with 46.79% and 42.04% ethanol in water, respectively. ORAC antioxidant activity was found to be well correlated to polyphenol and simmondsin contents. These results indicate that MAE is an effective technique for recovery of bioactive compounds for food and pharmaceutical industries from Jojoba by-products.

PMID:33812189 | DOI:10.1016/j.foodchem.2021.129670