Nevin Manimala

Nurs Open. 2021 Nov 15. doi: 10.1002/nop2.1091. Online ahead of print.

ABSTRACT

AIM: Early warning scores are commonly used in hospital settings, but little is known about their use in care homes. This study aimed to evaluate the impacts of National Early Warning Scores alongside other measures in this setting.

DESIGN: Convergent parallel design.

METHODS: Quantitative data from 276 care home residents from four care homes were used to analyse the relationship between National Early Warning Scores score, resident outcome and functional daily living (Barthel ADL (Barthel Index for Activities of Daily Living)) and Rockwood (frailty). Interviews with care home staff (N = 13) and care practitioners (N = 4) were used to provide qualitative data.

RESULTS: A statistically significant link between National Early Warning Scores (p = .000) and Barthel ADL (p = .013) score and hospital admissions was found, while links with Rockwood were insignificant (p = .551). Care home staff reported many benefits of National Early Warning Scores, including improved communication, improved decision-making and role empowerment. Although useful, due to the complexity of the resident population’s existing health conditions, National Early Warning Scores alone could not act as a diagnostic tool.

PMID:34780677 | DOI:10.1002/nop2.1091

Biometrics. 2021 Nov 15. doi: 10.1111/biom.13588. Online ahead of print.

ABSTRACT

We thank the editors for organizing the discussions and the discussants for insightful comments. Our rejoinder provides results and comments to address the questions raised in the discussions. Specifically, we present results showing DICA largely demonstrates better or comparable stability as compared with standard ICA. We also validate the DICA in real fMRI application by showing DICA generally shows higher reliability in reproducibly recovering major brain functional networks as compared with the standard ICA. We provide details on the computational complexity of the method. The computational cost of DICA is very reasonable with the analysis of the fMRI and DTI data easily implementable on a PC or laptop. Finally, we include discussions on several directions for extending the DICA framework in the future.

PMID:34780668 | DOI:10.1111/biom.13588

Biometrics. 2021 Nov 15. doi: 10.1111/biom.13590. Online ahead of print.

ABSTRACT

We are grateful for the opportunity to provide a discussion on this paper. We will first focus on the general context. Next, we will emphasize the novel key ideas proposed by the authors before formulating some open questions.

PMID:34780667 | DOI:10.1111/biom.13590

Fam Med. 2021 Nov;53(10):886-889. doi: 10.22454/FamMed.2021.332061.

ABSTRACT

BACKGROUND AND OBJECTIVES: Most literature about flexible nasolaryngoscopy comes from specialty clinics, making it unclear if these indications can be effectively managed without referral. This study evaluated effectiveness of diagnosis and management of upper airway complaints, utilizing flexible nasal endoscopic procedures, in a family medicine center.

METHODS: We performed retrospective chart review for all patients who had nasal endoscopy, nasopharyngoscopy, and nasolaryngoscopy performed at the University of Florida Family Medicine Center over 3 years (n=89) with 5 additional years of follow up. We used descriptive statistics to evaluate indications, diagnoses, effectiveness of management by family medicine, and referral rate.

RESULTS: The most common primary indications were hoarseness (n=33, 37%), chronic cough (n=20, 22%), nasal obstruction (n=9, 10%), and unilateral ear dysfunction (n=6, 7%). The most common primary diagnoses found were allergic rhinitis/postnasal drip (n=41, 46%), laryngopharyngeal reflux (LPR)/gastroesophageal reflux disease (GERD; n=24, 27%), masses concerning for malignancy (n=4, 4.5%), true vocal cord (TVC) polyp (n=3, 3%), TVC nodules (n=3, 3%), and epistaxis (n=3, 3%). Of the four concerning masses, two were confirmed cancers (2%). In addition, there was one case (1%) of erythroleukoplakia with dysplasia of the TVC. Most patients had documented improvement with family medicine management (n=57, 64%) and another six (7%) had follow up without documentation of status and no need for referral. Thus, a total of 71% (n=64) did not require referral and 20% (n=18) needed specialist referral.

CONCLUSIONS: Flexible nasal endoscopic procedures are effective in the care of patients in a family medicine residency center and can be safely performed and taught to residents.

PMID:34780657 | DOI:10.22454/FamMed.2021.332061

Am J Occup Ther. 2021 Sep 1;75(5):7505205010. doi: 10.5014/ajot.2021.041749.

ABSTRACT

IMPORTANCE: Motor vehicle accidents are the leading cause of unintentional deaths of children ages 1 and older, particularly children with health care needs.

OBJECTIVE: To explore family caregivers’ experiences and current practices while transporting children diagnosed with autism spectrum disorder (ASD).

DESIGN: A concurrent nested mixed-methods approach was used to gain insight into caregiver experiences.

SETTING: Participants completed an online Qualtrics survey.

PARTICIPANTS: A convenience sample of 54 caregivers of children with ASD from 17 U.S. states.

RESULTS: Themes that emerged include sensory behaviors of children, education related to child passenger safety, and participation in the community. Statistically significant findings suggest a correlation between caregivers (n = 39) being less likely to participate in activities away from home if the child had attempted to elope (p = .013), displayed aggressive behaviors (p = .005), or demonstrated self-injurious behaviors (p = .001).

CONCLUSIONS AND RELEVANCE: The findings suggest a correlation between caregivers limiting the distance traveled during vehicular transportation and behavioral safety concerns. If caregivers must limit travel, they may refrain from accessing the community and engaging in leisure pursuits. What This Article Adds: The findings suggest that therapists who treat children with ASD should be familiar with child passenger safety restraints, particularly for elopement.

PMID:34780642 | DOI:10.5014/ajot.2021.041749

Am J Occup Ther. 2021 Sep 1;75(5):7505205040. doi: 10.5014/ajot.2021.039487.

ABSTRACT

IMPORTANCE: Premature infants are not prepared developmentally, physically, or cognitively with the multiple survival skills of the typical newborn.

OBJECTIVE: To determine whether physical activity generated spontaneously by premature infants stretching against the resistance of “prepod” garments is as effective as exercises provided by therapists in slowing bone density loss.

DESIGN: Preterm very low birth weight infants were placed in two nonrandomized parallel groups according to birth age.

SETTING: Infants routinely started in a traditional intense intervention setting and graduated to a special care section with private rooms that allowed parents to remain with their child.

PARTICIPANTS: Healthy infants without medical complications, born between 28 and 32 wk postmenstrual age.

INTERVENTION: The control group received traditional exercises. The experimental group wore a prepod almost 24 hr a day. Outcomes and Measures: An ultrasound of the tibia was obtained at 31 to 32 wk and 4 wk later. Weight gain, head circumference growth, and length of stay (LOS) were also measured.

RESULTS: Although not statistically significant, the ultrasound results showed that the prepod group had less loss of bone density than the traditional therapy exercise group. The desired outcome was for pods to be as effective at reducing bone loss as traditional exercise, so the results exceeded expectations. The unexpected, and more notable, finding was a striking drop in LOS for the prepod group.

CONCLUSIONS AND RELEVANCE: Spontaneous exercise by premature infants decreases bone loss and LOS. Better bone health and increased developmental maturity increase the chances of a positive developmental outcome and save the hospital significant expense. What This Article Adds: The prepod is a simple, cost-effective, noninvasive treatment tool occupational therapy practitioners can use to support a premature infant’s development. This study has considerable potential to affect how infants are served, both developmentally and financially.

PMID:34780639 | DOI:10.5014/ajot.2021.039487

Am J Occup Ther. 2021 Sep 1;75(5):7505205020. doi: 10.5014/ajot.2021.041087.

ABSTRACT

IMPORTANCE: Occupational therapy use in the neurological critical care unit (NCCU) may relate to patient factors, but data about these relationships remain unpublished.

OBJECTIVE: To examine how patient factors predict NCCU occupational therapy use and intervention types.

DESIGN: Retrospective cohort study of electronic health records data from adults admitted to the NCCU between May 2013 and September 2015.

SETTING: NCCU in a large, urban academic hospital.

PARTICIPANTS: Adults (age ≥18 yr; N = 1,134) admitted to the NCCU.

MEASURES: Using length of stay (LOS), number of comorbidities, Glasgow Coma Scale (GCS) score, gender, age, and racial-ethnic minority status as independent variables, separate regression models identified predictors for each dependent variable: receipt of NCCU occupational therapy, occupational therapy onset (days after admission), and receipt of self-care or home management (ADL-Home); functional activities or cognitive training (Func-Cog); and therapeutic exercise (Ther-Ex).

RESULTS: Four hundred twenty patients (37.0%) received occupational therapy in the NCCU. Receipt of occupational therapy was positively associated with LOS, number of comorbidities, GCS score, and age. Earlier occupational therapy onset was associated with higher GCS score and shorter LOS. Receipt of ADL-Home or Func-Cog interventions was significantly predicted by number of occupational therapy sessions, but patients with longer LOS were less likely to receive ADL-Home interventions. Receipt of Ther-Ex interventions became less likely as GCS score increased.

CONCLUSIONS AND RELEVANCE: Patients are more likely to receive occupational therapy services if they are older and have a longer NCCU LOS, more comorbidities, and a higher level of consciousness. What This Article Adds: A patient’s level of consciousness is clearly associated with occupational therapy utilization and hospital outcomes, but it should not be the only factor considered when prioritizing patients for NCCU occupational therapy services. Compared with patients who were more awake and alert, patients with a lower level of consciousness had a later onset of occupational therapy, which suggests an opportunity for NCCU occupational therapists to collaborate with physicians in the modification of sedation protocols to enable early rehabilitation.

PMID:34780634 | DOI:10.5014/ajot.2021.041087

PLoS One. 2021 Nov 15;16(11):e0260056. doi: 10.1371/journal.pone.0260056. eCollection 2021.

ABSTRACT

An area of ancient and semi-natural woodland (ASNW) has been investigated by applied aerial spectroscopy using an unmanned aerial vehicle (UAV) with multispectral image (MSI) camera. A novel normalised difference spectral index (NDSI) algorithm was developed using principal component analysis (PCA). This novel NDSI was then combined with a simple segmentation method of thresholding and applied for the identification of native tree species as well as the overall health of the woodland. Using this new approach allowed the identification of trees at canopy level, across 7.4 hectares (73,934 m2) of ASNW, as oak (53%), silver birch (37%), empty space (9%) and dead trees (1%). This UAV derived data was corroborated, for its accuracy, by a statistically valid ground-level field study that identified oak (47%), silver birch (46%) and dead trees (7.4%). This simple innovative approach, using a low-cost multirotor UAV with MSI camera, is both rapid to deploy, was flown around 100 m above ground level, provides useable high resolution (5.3 cm / pixel) data within 22 mins that can be interrogated using readily available PC-based software to identify tree species. In addition, it provides an overall oversight of woodland health and has the potential to inform a future woodland regeneration strategy.

PMID:34780569 | DOI:10.1371/journal.pone.0260056

PLoS One. 2021 Nov 15;16(11):e0259892. doi: 10.1371/journal.pone.0259892. eCollection 2021.

ABSTRACT

PURPOSE: The aim of the paper is to identify management practices that are characteristic for SMEs that achieve market success measured by their business performance in last their years of their operation analyze the relationships between management practices applied in small and medium-sized enterprises and their success measured by their business performance drawing on the data from 2710 SMEs operating on the Polish market.

APPROACH/METHODOLOGY/DESIGN: A cluster analysis was used to distinguish homogenous SME groups in view of their management practices. We examined differences between groups in terms of their business performance. The HINoV algorithm allowed six variables to be selected out of 32 management practices chosen initially for testing, with these variables providing the basis for grouping. Modal values and medians were calculated for 17 business performance measures in the three clusters produced. The subsequent analysis of those findings was focused on capturing significant differences.

FINDINGS: In the group of 2710 Polish SMEs, it was possible to verify that there existed an association between management practices in the field of modern HRM, computer systems supporting management and the company’s economic performance, as measured by an increase in net revenue and number of customers over the last three years. In clusters where the above mentioned practices were appreciated, modal and median values of the increase reported in net revenue and number of customers were significantly higher.

PRACTICAL IMPLICATIONS: The research has shown that at a time marked by a shortage of highly skilled personnel one should pay particular attention to building an integrated and committed team of workers and to employee empowerment. The research has also shown that SME managers monitor only a fraction of basic business performance measures, which may prove to be a major risk to SMEs.

ORIGINALITY/VALUE: Previous studies have been largely conducted in a fragmentary manner, i.e. they were concerned with the relationships between the application of some practices (strategic management, BPR, entrepreneurial orientation, monitoring, etc.) and selected business effectiveness measures. In this paper, the research covered SME management practices from a variety of areas which were then compared with the entrepreneurs’ assessment as to whether the company’s economic condition changed over the last three years. It is also the first attempt in post-socialist economies to identify those SME management practices that are related to better economic results.

PMID:34780564 | DOI:10.1371/journal.pone.0259892

PLoS One. 2021 Nov 15;16(11):e0259968. doi: 10.1371/journal.pone.0259968. eCollection 2021.

ABSTRACT

BACKGROUND: Growth monitoring and promotion are the basic malnutrition preventive strategies usually used to assess the growth of children using anthropometric measurements in comparison with world health organization standards. However, the utilization of growth monitoring and promotion services is inadequate in most developing countries. Therefore, this study aimed to assess the utilization of growth monitoring and promotion service and associated factors among children aged 0-23-month in Banja District, Northwest Ethiopia, 2020.

METHODS: A community-based cross-sectional study was conducted from February 2 to April 1, 2020. A total of 572 children were selected using a simple random sampling technique. Data were collected using structured and pre-tested interviewer-administered questionnaires. Data were entered into Epi data version 4.6 and analyzed using the statistical package for social science (SPSS) version 25. Both binary and multivariable logistic regression analyses with a 95% confidence level were used to identify the associated factors. Statistical significance was set at p <0.05.

RESULTS: This finding revealed that the proportion of growth monitoring and promotion services utilization was 38.9% [95%CI: 34.8%, 43.0%]. Child age from 0-11 months [AOR = 4.98 (95% CI: 2.75,8.37)], mothers who can read and write Amharic language [AOR = 2.04 (95%CI: 1.02,4.08)], know the benefits of weighing their child monthly [AOR = 2.9 (95%CI: 1.23, 6.94)], presence of growth monitoring service nearby [AOR = 3.2 (95%CI: 1.59,6.31)] and monthly income ≥2000 Ethiopian birr [AOR = 1.75(95% CI = 1.08, 3.02)] were some of the factors significantly associated with utilization of growth monitoring and promotion services.

CONCLUSION AND RECOMMENDATION: The findings indicate that utilization of growth monitoring and promotion services is mainly affected by child age, mother/caregiver ability to read and write Amharic language, having maternal information on the benefit of the weighing child, presence of service nearby health facility, and mother/caregiver monthly income. Preparation of growth monitoring charts in local language (Awigna) and creating awareness on the proper utilization of growth monitoring and promotion services is strongly recommended.

PMID:34780536 | DOI:10.1371/journal.pone.0259968