Nevin Manimala

PLoS One. 2022 Mar 2;17(3):e0264163. doi: 10.1371/journal.pone.0264163. eCollection 2022.

ABSTRACT

BACKGROUND: Food service in hospital is one of the essential parts of the treatment process that determines recovery length and a hospital stay of patients. Even though many researches have been conducted on patients’ satisfaction with healthcare services, there is a lack of studies that specifically address the satisfaction with food service at healthcare facilities in Ethiopia. This study aimed to assess patient satisfaction with regular hospital food service and associated factors among adults admitted to in-patient departments of hospitals.

METHODS: A hospital-based cross-sectional study design was conducted to interview 423 patients admitted to three randomly selected hospitals namely Wolaita Sodo University Referral and Teaching Hospital, Dubo St. Catholic Hospital and Sodo Christian Hospital. Participants were recruited based on probability proportional to the number of clients in each hospital. After data entry using EpiInfo v7.2.2.6, the data were exported to SPSS v23 software for further analysis. Bivariate and multivariate logistic regressions were undertaken to see the association between variables. Statistically significant variables were declared using an adjusted odds ratio with a 95% confidence interval.

RESULT: Among the total participants 33.6% (95%CI: [29.1, 38.3]) of patients were satisfied with regular hospital food services. Multivariate analysis revealed that residence (AOR = 2.16; 95%CI: [1.28, 3.63]), monthly income (AOR = 5.64; 95%CI: [2.30, 8.28]), flavour of meal, (AOR = 2.63; 95%CI: [1.34, 5.56]), and provision of easily chewable food (AOR = 7.50; 95%CI: [2.00, 12.82]) were influencing factors for satisfaction on hospital foodservices.

CONCLUSION: This research ascertained a low patient satisfaction with regular hospital meal service. The identified factors need to be addressed giving attention for each foodservice dimension to scale up the patient satisfaction with hospital food services.

PMID:35235592 | DOI:10.1371/journal.pone.0264163

PLoS One. 2022 Mar 2;17(3):e0264076. doi: 10.1371/journal.pone.0264076. eCollection 2022.

ABSTRACT

INTRODUCTION: Urologic malignancies are the major causes of morbidity and mortality in men over 40 years old, accounting for more than 20% of all malignant tumors. Several meta-analyses are shown that statin exposure can reduce the morbidity and mortality of various urologic cancers. The adjuvant roles of statin in tumor prevention and anti-tumor activity are now being gradually recognized and have gained attention. Nevertheless, to date, multiple clinical studies and meta-analyses found inconsistent results of their anti-cancer effects. This study aims to evaluate the credibility of the published systematic reviews and meta-analyses that assessed the effects of statin exposure for the incidence and mortality of urologic cancers through an umbrella review.

METHODS AND ANALYSIS: The guidance of overviews of systematic reviews reported in the Cochrane Handbook for Systematic Reviews of interventions will be followed while performing and reporting this umbrella review. This project was registered in PROSPERO with the registration number of CRD42020208854. PubMed, Embase and Cochrane Library will be searched for systematic reviews to identify and appraise systematic reviews or meta-analyses of interventional and observational studies examining statin use and the risks of urologic cancer incidence and mortality without language restriction. The search will be carried out on 10 February 2022. Systematic reviews based on qualitative, quantitative or mixed-methods studies will be involved and critically evaluated by two authors using the Assessment of Multiple Systematic Reviews 2 (AMSTAR2, an updated version of AMSTAR) tool. We will determine the level of evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) tool. The summary effect estimates will be calculated using random-effects models. Between- study heterogeneity will be assessed using the I2 statistic. Furthermore, we will also assess the evidence of excess significance bias and evidence of small study effects.

ETHICS AND DISSEMINATION: Ethics approval is not required as we will search and gather data based on the published systematic reviews and meta-analyses. We plan to publish the results of this umbrella review in a peer-reviewed journal and will be presented at a urological disease conference. All the relevant additional data will also be uploaded to the online open access databases.

PROSPERO REGISTRATION NUMBER: CRD42020208854.

PMID:35235590 | DOI:10.1371/journal.pone.0264076

PLoS One. 2022 Mar 2;17(3):e0264461. doi: 10.1371/journal.pone.0264461. eCollection 2022.

ABSTRACT

BACKGROUND: Globally, the burden of overweight and obesity is a major cardiovascular disease risk factor and is even higher among patients with psychiatric disorders compared to the general population. This is mainly due to the deleterious lifestyles characterized by physical inactivity, excessive substance use, and unhealthy diets common among patients with psychiatric disorders, as well as the negative metabolic effects of psychotropic medications. Despite these conditions being a high burden among patients with psychiatric illness, little attention is given to them during routine reviews in psychiatric clinics in most African nations, including Ethiopia. Therefore, this study aimed to estimate and compare the prevalence of and associated risk factors for overweight and obesity among patients with psychiatric illnesses.

METHODS: A comparative cross-sectional study was conducted between severely ill psychiatric patients and non-psychiatric patients in Dire Dawa, Eastern Ethiopia. The study included 192 study participants (96 psychiatric patients and 96 non-psychiatric controls). Weight and height were measured for 192 study participants. Baseline demographic and clinical characteristics of psychiatric and non-psychiatric patients were described. The data were cleaned and analyzed using the Statistical Package for Social Sciences, Version 21. The intergroup comparisons were performed using an independent sample t-test and Chi-square tests. Logistic regression analysis was used to identify the association between overweight/obesity and the associated variables.

RESULTS: The magnitude of overweight/obesity was significantly higher in the severely ill psychiatric groups (43.8%) than in the non-exposed controls (20.80%). The prevalence of overweight/obesity was highest in major depressive disorders (40%), followed by schizophrenia (32%), and bipolar disorder (28%).

CONCLUSIONS: There was a high prevalence of obesity/overweight among psychiatric patients. Educational status, unemployment, and late stages of the disease were significant predictors of overweight/ obesity. Clinicians should be aware of the health consequences of overweight/obesity, and considering screening strategies as a part of routine psychiatric care is strongly recommended.

PMID:35235579 | DOI:10.1371/journal.pone.0264461

PLoS One. 2022 Mar 2;17(3):e0263461. doi: 10.1371/journal.pone.0263461. eCollection 2022.

ABSTRACT

Angiotensin-receptor blockers (ARBs) are a class of drugs approved for the treatment of several common conditions, such as hypertension and heart failure. Recently, regulatory agencies have started to identify possibly carcinogenic nitrosamines and azido compounds in a multitude of formulations of several ARBs, resulting in progressive recalls. Furthermore, data from several randomized controlled trials suggested that there is also a clinically increased risk of cancer and specifically lung cancer with ARBs; whereas other trials suggested no increased risk. The purpose of this analysis was to provide additional insight into the ARB-cancer link by examining whether there is a relationship between degree of cumulative exposure to ARBs and risk of cancer in randomized trials. Trial-level data from ARB Trialists Collaboration including 15 randomized controlled trials was extracted and entered into meta-regression analyses. The two co-primary outcomes were the relationship between cumulative exposure to ARBs and risk of all cancers combined and the relationship between cumulative exposure and risk of lung cancer. A total of 74,021 patients were randomized to an ARB resulting in a total cumulative exposure of 172,389 person-years of exposure to daily high dose (or equivalent). 61,197 patients were randomized to control. There was a highly significant correlation between the degree of cumulative exposure to ARBs and risk of all cancers combined (slope = 0.07 [95% CI 0.03 to 0.11], p<0.001), and also lung cancer (slope = 0.16 [95% CI 0.05 to 0.27], p = 0.003). Accordingly, in trials where the cumulative exposure was greater than 3 years of exposure to daily high dose, there was a statistically significant increase in risk of all cancers combined (I2 = 31.4%, RR 1.11 [95% CI 1.03 to 1.19], p = 0.006). There was a statistically significant increase in risk of lung cancers in trials where the cumulative exposure was greater than 2.5 years (I2 = 0%, RR 1.21 [95% CI 1.02 to 1.44], p = 0.03). In trials with lower cumulative exposure to ARBs, there was no increased risk of all cancers combined or lung cancer. Cumulative exposure-risk relationship with ARBs was independent of background angiotensin-converting enzyme inhibitor treatment or the type of control (i.e. placebo or non-placebo control). Since this is a trial-level analysis. the effects of patient characteristics such as age and smoking status could not be examined due to lack of patient-level data. In conclusion, this analysis, for the first time, reveals that risk of cancer with ARBs (and specifically lung cancer) increases with increasing cumulative exposure to these drugs. The excess risk of cancer with long-term ARB use has public health implications.

PMID:35235571 | DOI:10.1371/journal.pone.0263461

PLoS One. 2022 Mar 2;17(3):e0264060. doi: 10.1371/journal.pone.0264060. eCollection 2022.

ABSTRACT

High quality daily testing for the presence of the SARS-CoV-2 in workplace settings has become part of the standard and mandatory protection measures implemented widely in response to the current pandemic. Such tests are often limited to a small fraction of the attending personnel due to cost considerations, limited availability and processing capabilities and the often cumbersome requirements of the test itself. A maximally efficient use of such an important and frequently scarce resource is clearly required. We here present an optimal testing strategy which minimises the presence of pre-symptomatic and asymptomatic infected members of the population in a workplace setting, derived under a series of simplifying statistical assumptions. These assumptions however, retain many of the generalities of the problem and yield robust results, as verified through a number of numerical simulations. We show that reduction in overall infected-person-days, IPD, by significant percentages can be achieved, for fixed numbers of tests per day of 5% and 10% of the population, of 30% and 50% in the IPD numbers, respectively.

PMID:35235566 | DOI:10.1371/journal.pone.0264060

Vestn Oftalmol. 2022;138(1):23-30. doi: 10.17116/oftalma202213801123.

ABSTRACT

Primary open-angle glaucoma (POAG) is the most common form of glaucoma. Insufficient information about the pathogenetic aspects of POAG development necessitates further research of the main clinical, functional, and genetic risk factors for the disease development, as well as their correlations using modern methods of mathematical analysis.

PURPOSE: To assess the significance of risk factors in POAG development based on multivariate analysis of variance.

MATERIAL AND METHODS: The study included 348 patients (348 eyes) with stages I-IV POAG aged 45 to 87 years, who underwent a comprehensive ophthalmological and genetic examination. The control group consisted of 48 individuals (48 eyes) without glaucoma, matched with POAG patients in terms of gender and age. Ophthalmological examination of patients was carried out in 2013-2019 at the «Optimed» Laser Eye Surgery Center in Ufa, molecular genetic research – at the Institute of Biochemistry and Genetics of the Ufa Federal Research Center of the Russian Academy of Sciences. The results were statistically processed using the IBM SPSS Statistics v.21 program. The multivariate analysis employed the principal component method. Correlations between patient parameters and main factors were calculated using the method of rotation – varimax. The significance level was taken equal to 0.05 when testing statistical hypotheses.

RESULTS: Factor analysis was used to rank the factors associated with POAG development, the following variables were attributed to the most significant indicators of high risk (16.75% of the total variance) of developing the disease: age, comorbidity index, cataract, pseudoexfoliative syndrome, pigmentation intensity in the anterior chamber angle.

CONCLUSION: Factor analysis is a multivariate method of mathematical analysis that allows studying the role of the risk factors for POAG development and their association with the disease, which contributes to early diagnosis and identification of clinical and functional features of the disease.

PMID:35234417 | DOI:10.17116/oftalma202213801123

Rehabil Nurs. 2022 Mar-Apr 01;47(2):43-49. doi: 10.1097/RNJ.0000000000000361.

ABSTRACT

PURPOSE: Nursing assistant turnover is a growing healthcare concern that negatively impacts healthcare organization work environments and has significant financial implications. The purpose of this study was to implement a career ladder program for rehabilitation nursing technicians-nursing assistants who specialize in performing care duties aligned with therapeutic goals in inpatient rehabilitation. The study evaluated the effect on organizational quality metrics of employee engagement, job satisfaction, and annual turnover of rehabilitation nursing technicians.

DESIGN: This pilot study was conducted using a quality improvement approach and a between-subjects pretest-posttest design.

METHODS: A three-tier career ladder intervention for rehabilitation nursing technicians in a 76-bed inpatient rehabilitation facility was implemented. Employee engagement and job satisfaction were evaluated in all rehabilitation nursing technicians (n = 44), with a pre-implementation sample size of n = 23 and a post-implementation sample size of n = 21, from January 2020 through December 2020. Twelve rehabilitation nursing technicians participated in the intervention, which consisted of online learning modules, added job responsibilities, and continuing education and were included in the post-implementation sample size. Nondirectional statistical tests were performed with the level of significance set at .05 (two tailed).

FINDINGS: A majority of the pre-post intervention sample (n = 44) were female (91%), African American (91%), and aged 30-59 years. Employee engagement increased from 78% favorable in 2019 to 86% favorable in 2020. Overall job satisfaction improved from 74% favorable in 2019 to 86% favorable in 2020. Annual turnover decreased from 35% in 2019 to 31% in 2020.

CONCLUSION: In this pilot study, a career ladder program for rehabilitation nursing technicians was effective in increasing and improving employee engagement and job satisfaction while reducing turnover.

CLINICAL RELEVANCE: Rehabilitation nursing technicians are crucial members of the interdisciplinary rehabilitation team providing direct bedside care to optimize patient function. Rehabilitation nursing technician career ladders have the capacity to engage an often underrecognized employee population by creating a positive work environment that promotes job growth and retention in the rehabilitation setting.

PMID:35234404 | DOI:10.1097/RNJ.0000000000000361

HIV Med. 2022 Mar 1. doi: 10.1111/hiv.13265. Online ahead of print.

ABSTRACT

OBJECTIVES: To pinpoint factors associated with low-level viraemia (LLV) and virological failure (VF) in people living with HIV in the era of high-efficacy antiretroviral treatment (ART) and widespread use of integrase strand transfer inhibitor (INSTIs)-based ART.

METHODS: We included adults aged > 18 years starting their first ART between 2015 and 2018 in the Spanish HIV/AIDS Research Network National Cohort (CoRIS). Low-level viraemia was defined as plasma viral load (pVL) of 50-199 copies/mL at weeks 48 and 72 and VF was defined as pVL ≥ 50 copies/mL at week 48 and pVL ≥ 200 copies/mL at week 72. Multivariable logistic regression models assessed the impact on LLV and VF of baseline CD4 T-cell count, CD4/CD8 T-cell ratio and pVL, initial ART classes, age at ART initiation, time between HIV diagnosis and ART initiation, gender and transmission route.

RESULTS: Out of 4186 participants, 3120 (76.0%) started INSTIs, 455 (11.1%) started boosted protease inhibitors (bPIs) and 443 (10.8%) started nonnucleoside reverse transcriptase inhibitors (NNRTIs), either of them with two nucleos(t)ide reverse transcriptase inhibitors (NRTIs). Low-level viraemia was met in 2.5% of participants and VF in 4.3%. There were no significant differences throughout the years for both virological outcomes. Baseline HIV-1 RNA > 5 log₁₀ copies/mL was the only consistent predictor of higher risk of LLV [adjusted odds ratio (aOR) = 9.8, 95% confidence interval (CI): 2.0-48.3] and VF (aOR = 5.4, 95% CI: 1.9-15.1), even in participants treated with INSTIs.

CONCLUSIONS: The rates of LLV and VF were low but remained steady throughout the years. Baseline HIV-1 RNA > 5 log₁₀ copies/mL showed a persistent association with LLV and VF even in participants receiving INSTIs.

PMID:35234328 | DOI:10.1111/hiv.13265

Nurs Crit Care. 2022 Mar 2. doi: 10.1111/nicc.12766. Online ahead of print.

ABSTRACT

BACKGROUND: Family-centred care (FCC) is an approach to promote family and health care provider partnership. This has been incorporated into neonatal intensive care units (NICUs) worldwide. However, FCC in low resource health settings, such as Thailand, is challenging and further impacted by coronavirus disease 2019 (COVID-19).

AIMS: To evaluate FCC innovations to improve respect, collaboration and support in a Thai NICU.

STUDY DESIGN: A quasi-experimental study was conducted in an NICU in southern Thailand. Pre-implementation was prior to COVID-19, and parental and staff perceptions of FCC were measured via Perceptions of Family Centred Care-Parent (PFCC-P) and -Staff (PFCC-S) survey. The FCC innovations were developed by stakeholders based on the COVID-19 restrictions, pre-survey results, parents’ and clinicians’ interviews and integrative review, then implemented via a flowchart. Post-implementation evaluation was via repeated surveys. Comparisons were made pre-and post-implementation, with Mann-Whitney U-test statistics for parents and Wilcoxon’s Rank Sum for staff.

RESULTS: A total of 185 (85 pre; 100 post) parents and 20 (pre and post; paired group) health care professionals participated. Because of COVID-19, many planned interventions were unfeasible, however, other innovations achieved (e.g., structured telephone updates, information booklet revision). There was an increase in parents’ perception of respect ([median] 2.50-3.50), collaboration (2.33-3.33) and support (2.60-3.60) domains and overall (2.50-3.43; p < .001; 95% CI: 2.93-3.11). Interdisciplinary professionals’ perception of FCC did not significantly change pre-and post-implementation/COVID-19 pandemic for respect (3.00-2.92), collaboration (3.22-3.33), support (3.20-3.20) and overall (3.15-3.20; 95% CI: 3.10-3.25).

CONCLUSION: Despite the challenges of COVID-19 restricting NICU access, the provision of FCC was maintained and even improved.

RELEVANCE TO CLINICAL PRACTICE: Further research is necessary to develop FCC practice innovations associated with communication, across diverse health care systems and resources.

PMID:35234320 | DOI:10.1111/nicc.12766

Child Care Health Dev. 2022 Mar 1. doi: 10.1111/cch.12994. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to understand the impact of the initial COVID-19 pandemic remote schooling period on self-reported wellness among adolescents in Chicago.

METHODS: Students (n=55) completed a 22-item wellness questionnaire before (February 2020) and shortly after the onset of the COVID-19 outbreak (April 2020). Pre/post comparisons (overall and by survey item) were evaluated using two-sided paired t-tests with an alpha level of 0.05. Descriptive statistics were used to evaluate mean scores overall by demographic variables.

RESULTS: Significant differences were found in the following areas: Balance (Pre: 7.3, During: 6.4, p=0.02), Education (Pre: 8.4, During 7.7, p=0.03) and Friends (Pre:8.0, During: 6.3, p=0.001). Overall wellness scores varied by demographic variables, though not significantly.

CONCLUSIONS: Results suggest the onset of the pandemic impacted students’ ability to effectively learn, as well as to maintain balance in their lives and social relationships. Comprehensive support is needed in these areas to promote adolescent wellness.

PMID:35234301 | DOI:10.1111/cch.12994