Nevin Manimala

JBI Evid Synth. 2021 Aug 12. doi: 10.11124/JBIES-20-00387. Online ahead of print.

ABSTRACT

OBJECTIVE: This review aims to examine the effect of patient activation interventions compared with usual care on health-related behavioral outcomes in adults with chronic kidney disease stages 3-5.

INTRODUCTION: Chronic kidney disease is a global health problem associated with a high mortality, reduction of health-related quality of life, and high health care costs. The chronic nature requires active involvement and self-management of the person with chronic kidney disease. Patient activation is a self-management approach that refers to the knowledge, confidence, and skills of people to enable them to manage their own health needs. However, the effectiveness of patient activation interventions on health-related behavioral outcomes in this population have not yet been systematically evaluated.

INCLUSION CRITERIA: This systematic review will include primary research studies measuring the effect of behavioral change interventions addressing beliefs, knowledge, confidence, and/or skills to optimize self-management in adult patients with chronic kidney disease stages 3-5 who are not receiving dialysis. Studies included in this review will be randomized controlled trials.

METHODS: Published studies will be searched in MEDLINE, Embase, Emcare, and PsycINFO. Unpublished studies and gray literature sources will also be searched. Titles and abstracts of search results published in English from 2005 onward will be screened, and the full text of potentially relevant studies will be assessed in detail. Studies selected for inclusion will undergo critical appraisal. Data extracted will include specific details about population, study methods, interventions, and outcomes. Studies will be pooled in statistical meta-analysis, if possible.

SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42020205084.

PMID:34387282 | DOI:10.11124/JBIES-20-00387

JBI Evid Synth. 2021 Aug 12. doi: 10.11124/JBIES-20-00385. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this systematic review was to determine the safety and effectiveness of parent- or nurse-controlled analgesia on neonatal patient outcomes. More specifically, the objective was to determine the effect of parent- or nurse-controlled analgesia on neonatal pain scores, analgesic use, and incidence of iatrogenic withdrawal syndrome, as well as any opioid-associated adverse events.

INTRODUCTION: Despite recent innovations in neonatology leading to significant improvements in short- and long-term outcomes for newborns requiring intensive care, optimal management of pain and distress remains a challenge for the treating multidisciplinary team. The inability of neonates to communicate pain easily, inconsistent practice among health professionals, insufficient analgesic prescriptions, and delays in medical reviews all impact effective pain management. Exploring the effect of parent- or nurse-controlled analgesia may identify a modality that negates these concerns and improves the pharmacological management of pain in newborns.

INCLUSION CRITERIA: This review considered experimental and observational studies evaluating the safety and effectiveness of parent- or nurse-controlled analgesia that included babies born at 23 weeks’ gestation to four weeks post-term. The interventions considered for inclusion were any type of analgesia delivered by an infusion pump that allowed bolus dosing or a continuous analgesic infusion with bolus dosing as required. Studies using algorithms and protocols to guide timing and dosage were eligible for inclusion. Comparators included the standard management of pain for neonates in the newborn intensive care unit. A modification to the a priori protocol was made to include all neonates nursed outside of a neonatal intensive care unit to ensure all studies that examined the use of parent- or nurse-controlled analgesia in the neonatal population were included in the review.

METHODS: An extensive search of six major databases was conducted (CINAHL, Cochrane Library, Embase, PubMed, PsycINFO, and Web of Science). Studies published from 1997 to 2020 in English were considered for inclusion in this review. Databases searched for unpublished studies included MedNar and ProQuest Dissertations and Theses.

RESULTS: Fourteen studies were included in this review: two randomized controlled trials, six quasi-experimental studies, one case-control study, and five case series. There was considerable heterogeneity in the interventions and study outcome measures within the studies, resulting in an inability to statistically pool results. The small sample sizes and inability to distinguish data specific to neonates in six of the studies resulted in low quality of evidence for the safety and effectiveness of parent- or nurse-controlled analgesia in neonates. However, studies reporting neonatal data demonstrated low pain scores and a trend in reduced opioid consumption when parent- or nurse-controlled analgesia was used.

CONCLUSIONS: The use of parent- or nurse-controlled analgesia in the neonatal population has shown some effect in reducing the amount of opioid analgesia required without compromising pain relief or increasing the risk of adverse events. Due to the paucity of evidence available, certainty of the results is compromised; therefore, larger trials exploring the use of parent- or nurse-controlled analgesia in neonates and the development of nurse-led models for analgesia delivery are needed.

SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42018114382.

PMID:34387281 | DOI:10.11124/JBIES-20-00385

J Craniofac Surg. 2021 Aug 13. doi: 10.1097/SCS.0000000000008073. Online ahead of print.

ABSTRACT

BACKGROUND: Burr-hole craniostomy (BHC) is considered to be the most effective method for the treatment of chronic subdural hematoma (CSDH), and middle meningeal artery embolization is a new therapy used in clinical practice in recent years to treat CSDH. However, the optimal therapeutic effect of these 2 procedures is still controversial. This study prospectively designed a modified burr-hole craniostomy (mBHC) with drainage to treat CSDH.

METHODS: A total of 101 patients diagnosed with CSDH from January 2019 to April 2020 were prospectively included in this study. They were divided into BHC and mBHC groups. Among them, 40 selected CSDH patients received mBHC treatment. For comparison, 61 CSDH patients who received BHC treatment were used as the control group. Primary outcomes were hematoma recurrence and postoperative complications. Secondary outcomes included midline recovery, hematoma clearance, operation time, and hospital stay. The Chi-square test was used to compare the 6-month follow-up results between the 2 groups.

RESULTS: Among patients treated with mBHC, 39 patients had a good prognosis, and one 87-year-old patient with bilateral hematoma died of postoperative heart failure. Of the patients treated with BHC, 52 patients had good prognoses, and one 53-year-old patient with unilateral hematoma died of postoperative acute intracranial bleeding. During the 6-month follow-up period, no relapse occurred in the patients treated with mBHC, whereas 8 (13%) of the patients treated with BHC relapsed. There was a significant difference in the recurrence rate between the 2 groups (P < 0.05). In addition, midline recovery, hematoma clearance rate, operation time, and complications were found to be significantly different statistically (P < 0.05), and other characteristics of operation and outcome were not significantly different (P > 0.05) between the 2 groups.

CONCLUSIONS: Modified burr-hole craniostomy has a positive therapeutic effect on patients with CSDH and is more effective than conventional BHC therapy.

PMID:34387269 | DOI:10.1097/SCS.0000000000008073

J Craniofac Surg. 2021 Aug 13. doi: 10.1097/SCS.0000000000008081. Online ahead of print.

ABSTRACT

BACKGROUND: Maxillary advancement may affect speech in cleft patients.

AIMS: To examine whether the amount of maxillary advancement and preoperativecephalometric skeletal and dentoalveolar relationships are associated with articulation errors of the Finnish alveolar consonants /s/, /l/, and /r/ in cleft patients.

MATERIALS AND METHODS: Fifty-seven nonsyndromic cleft patients who underwent Le Fort I or bimaxillary osteotomies were evaluated retrospectively. Pre- and post-operative lateral cephalometric radiographs and standardized speech video recordings were analyzed. The Aspin-Welch unequal variance t test, Student t test sign test, intraclass correlation and Kappa statistics were used in the statistical analyses.

RESULTS: The mean advancement of the maxilla (point A) was 4.65 mm horizontally (range -2.80 to 11.30) and -3.82 mm vertically (range -14.20 to 3.90). The overall articulation (especially the sounds /s/ and /l/) improved significantly postoperatively, but the amount of maxillary advancement did not affect the articulation. The preoperative mean percentages of /s/, /l/, and /r/ errors were 32%, 33%, 46% and the postoperative percentages 23%, 19%, 40%, respectively. Preoperative articulation errors of /s/ were related to palatal inclination of the upper incisors.

CONCLUSIONS: Orthognathic surgery may improve articulation errors. The amount of maxillary advancement is not related to the improvement.

PMID:34387267 | DOI:10.1097/SCS.0000000000008081

J Glaucoma. 2021 Aug 12. doi: 10.1097/IJG.0000000000001922. Online ahead of print.

ABSTRACT

PRCIS: Tape sealing of the face mask can prevent fogging artifacts of visual field testing. Here we demonstrate that tape sealing can improve visual field scores even when fogging artifacts are not obvious.

PURPOSE: To demonstrate that visual field scores improve when the face masks are taped in order to prevent fogging artifacts.

METHODS: Single-center, randomized 2×2 cross-over study. Twenty-six visual fields of 13 patients of the glaucoma outpatient clinic were included. Patients were randomized in either sequence 1 (Octopus visual field examination without tape sealing, followed by examination with tape sealing) or sequence 2 (examination with, followed by without tape sealing).

RESULTS: The results for mean defect and square root of Loss Variance (sLV) differ significantly in the examination with and without tape sealing (mean difference (without-with) 0.39▒dB; 95% CI: 0.07 to 0.70▒dB; P=0.018 and 0.49▒dB; 95% CI: 0.19 to 0.79▒dB; P=0.003, respectively). There was no sequence effect (P=0.967) for mean defect nor sLV (P=0.779). A significant effect for period (P=0.023) for mean defect was yielded.

CONCLUSION: Tape sealing of face masks during visual field testing prevented fogging artifacts and improved visual field scores even when fogging artifacts were not obvious, and should be considered in clinical practice.

PMID:34387258 | DOI:10.1097/IJG.0000000000001922

J Patient Saf. 2021 Aug 11. doi: 10.1097/PTS.0000000000000886. Online ahead of print.

ABSTRACT

INTRODUCTION: The second victim phenomenon that occurs after critical events poses a serious factor for patient and workplace safety. These experiences can be evaluated using the Second Victim Experience and Support Tool (SVEST), originally in English, or the translated and validated Korean or Chinese versions. In 2020, a revised version was published (SVESTR) with the addition of resilience items. The aim of this study is the validation of the German version, the G-SVESTR, in a multiprofessional setting.

METHODS: The G-SVESTR questionnaire was designed according to World Health Organization recommendations. This entails translation, test for face validity, back translation, pretest, expert panel evaluation, and a test in a large population for validity and reliability. We provided an anonymous online questionnaire to physicians, nurses, paramedics, medical assistants, and physician assistants to test our developed tool. Statistics were accomplished using XL-Stats.

RESULTS: Altogether, 72% (306 of 428) of the participants completed the survey. The mean time for completion was 9.4 minutes. Physician assistants and medical assistants were significantly younger than other respondents. The analysis revealed satisfactory reliability (Cronbach α = 0.844). A principal component analysis showed 11 factors with eigenvalues greater than 1. Factor loading on distinct dimensions was satisfactory with one exception, the absenteeism item (item 31), which showed cross-loadings and poor factor loading on the absenteeism dimension. The results of the G-SVESTR revealed only some differences between the professional subgroups.

CONCLUSION: The G-SVESTR is a valid and reliable testing instrument for the evaluation of second victim experiences in different medical professions.

PMID:34387250 | DOI:10.1097/PTS.0000000000000886

J Dev Behav Pediatr. 2021 Aug 11. doi: 10.1097/DBP.0000000000000986. Online ahead of print.

ABSTRACT

OBJECTIVE: School readiness is strongly associated with a child’s future school success and well-being. The primary objective of this study was to determine whether meeting 24-hour movement guidelines (national physical activity, sedentary behaviors, and sleep recommendations) was associated with school readiness measured with mean scores in each of the 5 developmental domains of the Early Development Instrument (EDI) in Canadian children aged 4 to 6 years. Secondary objectives include examining the following: (1) the association between meeting 24-hour movement guidelines and overall vulnerability in school readiness and (2) the association between meeting individual physical activity, screen use and sleep recommendations, and overall school readiness.

METHODS: A prospective cohort study was performed using data from children (aged 4-6 years) who participated in a large-scale primary care practice-based research network.

RESULTS: Of the 739 participants (aged 5.9 + 0.12 years) in this prospective cohort study, 18.2% met the 24-Hour Movement Guidelines. Linear regression models (adjusted for child/family demographic characteristics, number of siblings, immigration status, and annual household income) revealed no evidence of an association between meeting all 24-hour movement guidelines and any of the 5 domains of the EDI (p > 0.05). Adjusted linear regression models revealed evidence of an association between meeting screen use guidelines and the “language and cognitive development” (β = 0.16, p = 0.004) domain, and for the sleep guideline, there was a statistically significant association with the “physical health and well-being” (β = 0.23, p = 0.001), the “language and cognitive development” (β = 0.10, p = 0.003), and the “communication skills and general knowledge” (β = 0.18, p < 0.001) domain.

CONCLUSION: Early lifestyle interventions targeting screen use and sleep may be beneficial for improving a child’s readiness for school.

PMID:34387247 | DOI:10.1097/DBP.0000000000000986

Cancer Nurs. 2021 Aug 11. doi: 10.1097/NCC.0000000000000970. Online ahead of print.

ABSTRACT

BACKGROUND: The quality of life of patients receiving chemotherapy decreases, and fatigue is one of the most common symptoms. Reiki is used for cancer patients as an energy-based complementary and alternative method.

OBJECTIVE: The aim of this study was to determine the effect of Reiki therapy on the quality of life and fatigue levels in breast cancer patients receiving chemotherapy.

METHODS: This was a pretest-posttest, quasi-experimental study with a control group: 70 patients enrolled with 35 participants in the experimental group and 35 in the control group. The experimental group received 6 sessions of Reiki therapy. The data were collected using a Patient Information Form, the Piper Fatigue Scale, and the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire.

RESULTS: The mean scores on the general well-being subscale in the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire increased in the experimental group and decreased in the control group, whereas the mean scores on the general function and general symptom subscales decreased in the experimental group and increased in the control group. The differences between the groups were statistically significant (P < .001). The mean Piper Fatigue Scale scores of the experimental group decreased, whereas that of the control group increased; the group differences were statistically significant (P < .001).

CONCLUSION: Reiki can reduce fatigue and increase the quality of life of breast cancer patients receiving chemotherapy.

IMPLICATIONS FOR PRACTICE: Reiki therapy can be used as a nursing intervention to increase the quality of life and reduce fatigue in breast cancer patients receiving chemotherapy.

PMID:34387236 | DOI:10.1097/NCC.0000000000000970

Retina. 2021 Aug 6. doi: 10.1097/IAE.0000000000003284. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the screening potential of a deep learning algorithm derived severity score by determining its ability to detect clinically significant severe retinopathy of prematurity (ROP).

METHODS: Fundus photographs were collected, and standard panel diagnosis was generated for each examination by combining 3 independent image-based gradings. All images were analyzed using a deep learning algorithm and a quantitative assessment of retinal vascular abnormality (DeepROP score) were assigned on a 1-100 scale. The area under the receiver operating curve (AUROC) and distribution pattern of all diagnostic parameters and categories of ROP were analyzed. The correlation between the DeepROP score and expert rank ordering according to overall ROP severity of 50 examinations was calculated.

RESULTS: A total of 9882 individual examinations with 54626 images from 2801 infants were analyzed. 56 (0.6%) examinations demonstrated type 1 ROP, 54 (0.5%) examinations demonstrated type 2 ROP. The DeepROP score had an AUROC of 0.981 for detecting type 1 ROP and 0.986 for type 2 ROP. There was a statistically significant correlation between the expert rank ordering of overall disease severity and the DeepROP score (correlation coefficient 0.758, p<0.001). When hypothetical referral cut-off score of 35 was selected, all cases of severe ROP (type 1 and type 2 ROP) was captured, 8562 (87.6%) eyes with no or mild ROP were excluded.

CONCLUSION: The DeepROP score determined by deep learning algorithm was an objective and quantitative indicator for the severity of ROP, and it had potential in automated detecting clinically significant severe ROP.

PMID:34387234 | DOI:10.1097/IAE.0000000000003284

J Pediatr Orthop. 2021 Aug 12. doi: 10.1097/BPO.0000000000001932. Online ahead of print.

ABSTRACT

BACKGROUND: Patients continue to utilize physician review websites (PRWs) to assist in their selection of a health care provider. Studies on PRWs and how they affect patient care have recently become popular in the literature. This study analyzes PRW ratings of a previously unexamined subspecialty, pediatric orthopaedic surgeons.

METHODS: Three hundred ninety-nine randomly selected Pediatric Orthopaedic Society of North America member’s PRW ratings were examined from May 4, 2020 to July 18, 2020. Healthgrades.com, Vitals.com, RateMDs.com, and Google.com were reviewed. Number of ratings and average ratings (0 to 5.0) were recorded. Provider sex, years in practice (0 to 10, 11 to 20, and 21+), practice type (academic, private), geographic location (Northeast, Southeast, Midwest, Southwest, West), degree (Medical Doctor, Doctor of Osteopathic Medicine), and fellowship training (yes, no) were recorded. Kruskal-Wallis testing was performed to determine factors affecting positive surgeon ratings.

RESULTS: 98.5% (393) of Pediatric Orthopaedic Society of North America surgeons were rated on a PRW at least once and were highly rated with an average rating of 4.14 of 5.0. Surgeons in practice 1 to 10 years had higher ratings than those in practice 11 to 20 and 21+ years, on Healthgrades.com (P=0.049) and RateMDs.com (P=0.011). Academic surgeons were found to have higher ratings than those in private practice on Google.com (P=0.007). Sex, region of practice, degree type, and fellowship training status did not have an effect on online ratings across all PRWs.

CONCLUSIONS: Pediatric orthopaedic surgeons are frequently and highly rated, similar to other orthopaedic subspecialties. Surgeons in practice 1 to 10 years were found to have statistically higher ratings on some websites. Academic surgeons were found to have statistically higher ratings on some websites.

PMID:34387231 | DOI:10.1097/BPO.0000000000001932